HaNDL syndrome: a reversible cerebral vasoconstriction triggered by an infection? A case report and a case-based review

The syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid (CSF) Lymphocytosis (HaNDL) is classified among secondary headaches attributed to "non-infectious, inflammatory intracranial disease". Despite its classification among secondary headaches, the current definition of HaNDL does not contemplate a causal agent. Thus, the aetiology, as well as the pathogenesis of both the headache and the transient focal deficits, remains unknown

Colchicine treatment in amyotrophic lateral sclerosis: safety, biological and clinical effects in a randomized clinical trial

: In preclinical studies, the anti-inflammatory drug colchicine, which has never been tested in amyotrophic lateral sclerosis, enhanced the expression of autophagy factors and inhibited accumulation of transactive response DNA-binding protein 43 kDa, a known histopathological marker of amyotrophic lateral sclerosis. This multicentre, randomized, double-blind trial enrolled patients with probable or definite amyotrophic lateral sclerosis who experienced symptom onset within the past 18 months. Patients were randomly assigned in a 1:1:1 ratio to receive colchicine at a dose of 0.005 mg/kg/day, 0.01 mg/kg/day or placebo for a treatment period of 30 weeks. The number of positive responders, defined as patients with a decrease lesser than 4 points in the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised total score during the 30-week treatment period, was the primary outcome. Disease progression, survival, safety and quality of life at the end of treatment were the secondary clinical outcomes. Secondary biological outcomes included changes from baseline to treatment end of stress granule and autophagy responses, transactive response DNA-binding protein 43 kDa, neurofilament accumulation and extracellular vesicle secretion, between the colchicine and placebo groups. Fifty-four patients were randomized to receive colchicine (n = 18 for each colchicine arm) or placebo (n = 18). The number of positive responders did not differ between the placebo and colchicine groups: 2 out of 18 patients (11.1%) in the placebo group, 5 out of 18 patients (27.8%) in the colchicine 0.005 mg/kg/day group (odds ratio = 3.1, 97.5% confidence interval 0.4-37.2, P = 0.22) and 1 out of 18 patients (5.6%) in the colchicine 0.01 mg/kg/day group (odds ratio = 0.5, 97.5% confidence interval 0.01-10.2, P = 0.55). During treatment, a slower Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised decline was detected in patients receiving colchicine 0.005 mg/kg/day (mean difference = 0.53, 97.5% confidence interval 0.07-0.99, P = 0.011). Eight patients experienced adverse events in placebo arm (44.4%), three in colchicine 0.005 mg/kg/day (16.7%) and seven in colchicine 0.01 mg/kg/day arm (35.9%). The differences in adverse events were not statistically significant. In conclusion, colchicine treatment was safe for amyotrophic lateral sclerosis patients. Further studies are required to better understand mechanisms of action and clinical effects of colchicine in this condition

Real Time Pricing and Home Automation

Proceedings con Refere

Electronic Meters and Automatic Meter Reading Systems

Conference Proceeding con Refere

Safety system with harmless first fault: complete & medical IT-system

In electrical power systems, such as data centers and hospitals, where service continuity is essential, the electrical operation management must be organized and it is necessary to have an emergency response team available at all times (24/7). In hospitals, for instance, doctors, surgeons, administrators, medical devices are rightly at the forefront, but electrical and technological systems and team of technicians are wrongly considered as ancillaries. The paper emphasizes the importance of the Business Continuity Management (BCM) and highlights how IT-M systems have not to carry out power outage for fault both due to overcurrent and also due to overvoltage. When a fault occurs during a surgical operation, the protection system shall include a count-down time so that emergency response team must solve the problem before the system collapses.In electrical power systems, such as data centers and hospitals, where service continuity is essential, the electrical operation management must be organized and it is necessary to have an emergency response team available at all times (24/7). In hospitals, for instance, doctors, surgeons, administrators, medical devices are rightly at the forefront, but electrical and technological systems and team of technicians are wrongly considered as ancillaries. The paper emphasizes the importance of the Business Continuity Management (BCM) and highlights how IT-M systems have not to carry out power outage for fault both due to overcurrent and also due to overvoltage. When a fault occurs during a surgical operation, the protection system shall include a count-down time so that emergency response team must solve the problem before the system collapses

Safety System With Harmless First Fault: Complete and IT-M System

In electrical power systems, such as data centers and hospitals, where service continuity is essential, the electrical operation needs a skilled organization and a team available at all times (24/7) to have a fast emergency response. The hospital management considers doctors, surgeons, administrators, medical devices rightly at the forefront, but electrical and technological systems and the team of technicians wrongly as ancillaries. This paper emphasizes the importance of the business continuity management for service continuity and highlights how medical IT-systems have not to carry out power outage for fault due to overcurrents and overvoltages. When a fault occurs, the protection system could include a countdown time so that emergency response team must solve the problem before the system collapses