SAPHO: has the time come for tailored therapy?

SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a heterogeneous condition combining osteoarticular and cutaneous manifestations. Conventional treatments are mostly ineffective. We hereby report two patients, the first with an aggressive form of disease and the second with an incomplete response to two different anti-TNF-α agents. Both were successfully treated with tocilizumab and ustekinumab, respectively, over a long period of time. A narrative review of a biological therapy in SAPHO syndrome yielded very little information on the specific use of these agents. We highlight the advantages of personalising therapy and describe emerging promising treatments for this disease.info:eu-repo/semantics/publishedVersio

Urotensin II-Induced Increase in Myocardial Distensibility Is Modulated by Angiotensin II and Endothelin-1

Endogenous regulators, such as angiotensin-II (AngII), endothelin-1 (ET-1) and urotensin-II (U-II) are released from various cell types and their plasma levels are elevated in several cardiovascular diseases. The present study evaluated a potential crosstalk between these systems by investigating if the myocardial effects of U-II are modulated by AngII or ET-1. Effects of U-II (10(-8), 10(-7), 10(-6) M) were tested in rabbit papillary muscles in the absence and in the presence of losartan (selective AT, receptor antagonist), PD-145065 (nonselective ET-1 receptors antagonist), losartan plus PD-145065, AngII or ET-1. U-II promoted concentration-dependent negative inotropic and lusitropic effects that were abolished in all experimental conditions. Also, U-II increased resting muscle length up to 1.008 +/- 0.002 L/L(max). Correcting it to its initial value resulted in a 19.5 +/- 3.5 % decrease of resting tension, indicating increased muscle distensibility. This effect on muscle length was completely abolished in the presence of losartan and significantly attenuated by PD-145065 or losartan plus PD-145065. This effect was increased in the presence of AngII, resulting in a 27.5 +/- 3.9 % decrease of resting tension, but was unaffected by the presence of ET-1. This study demonstrated an interaction of the U-II system with the AngII and ET-1 systems in terms of regulation of systolic and diastolic function

Diabetic Mastopathy: a Case Report

Diabetic mastopathy (DMP) is an uncommon collection of clinical, radiological, and histological features, classically described in premenopausal women with long-term insulin-dependent diabetes mellitus. This entity can mimic breast carcinoma, but, in the appropriate clinical and imaging setting, the diagnosis can be made by core biopsy, avoiding unnecessary surgeries. We report the case of a 34-year-old female, with a 12-year history of type 1 diabetes, who presented with bilateral breast lumps. Mammography, ultrasonography, and magnetic resonance imaging could not exclude the suspicion of malignancy, and a core biopsy was performed showing the typical histologic features of DMP. The literature is briefly reviewed

Synthesis and Characterization of Hybrid Materials Consisting of n-octadecyltriethoxysilane by Using n-Hexadecylamine as Surfactant and Q0 and T0 Cross-Linkers

Novel hybrid xerogel materials were synthesized by a sol-gel procedure. n-octadecyltriethoxysilane was co-condensed with and without different cross-linkers using Q0 and T0 mono-functionalized organosilanes in the presence of n-hexadecylamine with different hydroxyl silica functional groups at the surface. These polymer networks have shown new properties, for example, a high degree of cross-linking and hydrolysis. Two different synthesis steps were carried out: simple self-assembly followed by sol-gel transition and precipitation of homogenous sols. Due to the lack of solubility of these materials, the compositions of the new materials were determined by infrared spectroscopy, 13C and 29Si CP/MAS NMR spectroscopy and scanning electron microscopy

Variables involved in the perception of psychological harassment in the nursing work environment

This is a descriptive-exploratory study with a quantitative approach, with the objective of identifying how nurses perceive psychological harassment at work, the behaviors experienced and the variables involved. In collecting data, two questionnaires were used: one socio-professional and another for identifying the behaviors involving psychological harassment experienced by the subjects in the previous twelve months, along with the duration and frequency of the behaviors. At the end of the questionnaire, a dichotomous question was added, which addressed nurses' perceptions in relation to feeling victimized by psychological harassment at work. Both the questionnaires were applied in electronic and print format between May and September 2010. The data was analyzed through descriptive statistics. The results showed that some of the subjects felt that they were victims of psychological harassment. Only the variables related to characterization of the psychological harassment presented significant association. The following were highlighted among the most-referred-to behaviors: "They question your decisions" and "You receive verbal attacks criticizing work you have done". It's important to open spaces for discussing violence at work, so that managers may establish strategic measures for preventing and containing this type of violence, so as to ensure health, dignity and well-being at work. It is also important to discuss this issue in the academic space, so as to give the theme greater visibility, such that future nurses will be able to identify and appropriately confront this type of violence.Estudio descriptivo-exploratorio de abordaje cuantitativo, con el objetivo de identificar la percepción de enfermeros sobre el asedio moral en el trabajo, las conductas vividas y las variables relacionadas. En la recogida de datos se utilizó un cuestionario socio-profesiográfico y otro para identificar las conductas de asedio moral vividas por los sujetos en los últimos doce meses, el periodo y la frecuencia de las conductas. Al final del cuestionario fue adicionada una cuestión dicotómica relacionada a la percepción del enfermero cuanto a sentirse víctima de asedio moral en el trabajo. Los dos cuestionarios fueran aplicados electrónicamente e impresos entre mayo y septiembre de 2010. Los datos fueran tratados por estadística descriptiva. Los resultados mostraron que los sujetos se sintieron víctimas de asedio moral. Solamente las variables relacionadas a la caracterización del asedio moral presentaron asociación significativa. Entre las conductas más referidas, se destacaron: "Cuestionan las decisiones que usted toma" y "Usted recibe ataques verbales criticando trabajos realizados". Es importante la apertura de espacios de discusión sobre la violencia en el trabajo para que gestores puedan establecer medidas estratégicas de prevención y contención de este tipo de violencia a fin de garantizar la salud, la dignidad y el bienestar del profesional en el trabajo. También es importante discutir el tema en el ámbito académico, con el fin de dar mayor visibilidad a la cuestión, para que los futuras enfermeros puedan identificar y abordar adecuadamente este tipo de violencia.Trata-se de estudo descritivo-exploratório, de abordagem quantitativa, com o objetivo de identificar a percepção de enfermeiros sobre o assédio moral no trabalho, condutas vivenciadas e variáveis envolvidas. Na coleta de dados, utilizaram-se dois questionários: um socioprofissiográfico e outro para identificar as condutas de assédio moral, vivenciadas pelos sujeitos nos últimos 12 meses, o período e a frequência das condutas. Ao final do questionário, foi adicionada uma questão dicotômica que abordava a percepção do enfermeiro em relação a se sentir vítima de assédio moral no trabalho. Ambos os questionários foram aplicados no formato eletrônico e impresso, entre maio e setembro de 2010. Os dados foram tratados por estatística descritiva. Os resultados mostraram que parte dos sujeitos sentiu-se vítima de assédio moral. Somente as variáveis relacionadas à caracterização do assédio moral apresentaram associação significativa. Entre as condutas mais referidas, destacaram-se: "questionam as decisões que você toma" e "você recebe ataques verbais criticando trabalhos realizados". É importante a abertura de espaços para discussão sobre a violência no trabalho, para que gestores possam estabelecer medidas estratégicas de prevenção e contenção desse tipo de violência, a fim de garantir a saúde, a dignidade e o bem-estar no trabalho. Torna-se importante, também, discutir o assunto no espaço acadêmico, a fim de dar maior visibilidade ao tema, para que futuros enfermeiros possam identificar e enfrentar adequadamente esse tipo de violência

Incontinentia pigmenti presenting as hypodontia in a 3-year-old girl: a case report

<p>Abstract</p> <p>Introduction</p> <p>Incontinentia pigmenti or Bloch-Sulzberger syndrome is a rare X-linked dominant disease that mainly affects the skin, eyes, hair, central nervous system and teeth. The disease is predominant among women. Although dermatologic manifestations are among the most important aspects for the diagnosis of the syndrome, they are less damaging to the patient and do not require treatment. However, oral involvement characterized by hypodontia of deciduous and permanent teeth is important for the diagnosis and treatment of the patient.</p> <p>Case presentation</p> <p>We report the case of a 3-year-old girl with ophthalmologic and neurologic disturbances, cutaneous manifestations and hypodontia. Since the patient did not present more damaging manifestations such as neurologic and/or ophthalmologic problems, her most severe complications were related to dental anomalies. The importance of integrated dental treatment, which combines pediatric dentistry, orthodontics and conventional prosthesis, is emphasized.</p> <p>Conclusion</p> <p>Hypodontia is a frequent finding in incontinentia pigmenti, and dentists should be aware of this condition in order to help with the diagnosis.</p

Climate-driven deoxygenation elevates fishing vulnerability for the ocean’s widest ranging shark

Climate-driven expansions of ocean hypoxic zones are predicted to concentrate pelagic fish in oxygenated surface layers, but how expanding hypoxia and fisheries will interact to affect threatened pelagic sharks remains unknown. Here, analysis of satellite-tracked blue sharks and environmental modelling in the eastern tropical Atlantic oxygen minimum zone (OMZ) shows shark maximum dive depths decreased due to combined effects of decreasing dissolved oxygen (DO) at depth, high sea surface temperatures, and increased surface-layer net primary production. Multiple factors associated with climate-driven deoxygenation contributed to blue shark vertical habitat compression, potentially increasing their vulnerability to surface fisheries. Greater intensity of longline fishing effort occurred above the OMZ compared to adjacent waters. Higher shark catches were associated with strong DO gradients, suggesting potential aggregation along suitable DO gradients contributed to habitat compression and higher fishing-induced mortality. Fisheries controls to counteract deoxygenation effects on shark catches will be needed as oceans continue warming

An intelligent healthcare system for detection and classification to discriminate vocal fold disorders

The growing population of senior citizens around the world will appear as a big challenge in the future and they will engage a significant portion of the healthcare facilities. Therefore, it is necessary to develop intelligent healthcare systems so that they can be deployed in smart homes and cities for remote diagnosis. To overcome the problem, an intelligent healthcare system is proposed in this study. The proposed intelligent system is based on the human auditory mechanism and capable of detection and classification of various types of the vocal fold disorders. In the proposed system, critical bandwidth phenomena by using the bandpass filters spaced over Bark scale is implemented to simulate the human auditory mechanism. Therefore, the system acts like an expert clinician who can evaluate the voice of a patient by auditory perception. The experimental results show that the proposed system can detect the pathology with an accuracy of 99.72%. Moreover, the classification accuracy for vocal fold polyp, keratosis, vocal fold paralysis, vocal fold nodules, and adductor spasmodic dysphonia is 97.54%, 99.08%, 96.75%, 98.65%, 95.83%, and 95.83%, respectively. In addition, an experiment for paralysis versus all other disorders is also conducted, and an accuracy of 99.13% is achieved. The results show that the proposed system is accurate and reliable in vocal fold disorder assessment and can be deployed successfully for remote diagnosis. Moreover, the performance of the proposed system is better as compared to existing disorder assessment systems