Liszaj śluzowaty z towarzyszącym zespołem Sjögrena

Lichen myxedematosus belongs to the group of disorders with the deposition of mucins in the skin. The disease may coexist with monoclonal gammapathy, e.g. myeloma multiplex or Waldenström macroglobulinemia. A case of a 77-year-old man with lichen myxedematosus and monoclonal gammapathy is presented. Treatment with cyclophosphamide followed by intravenous immunoglobulins was initiated, however, no significant improvement of the skin condition was observed. Currently, the patient is receiving talidomide. This case report indicates, that lichen myxedematosus still remains a challenge for physicians and causes both diagnostics and therapeutic dilemma.Liszaj śluzowaty należy do grupy schorzeń związanych z odkładaniem się złogów mucyn w skórze. Choroba ta może dodatkowo współistnieć z gammapatią monoklonalną, na przykład szpiczakiem mnogim lub makroglobulinemią Waldenströma. W artykule został omówiony przypadek 77-letniego mężczyzny z liszajem śluzowatym i monoklonalną gammapatią. W leczeniu zmian skórnych zastosowano u niego w pierwszej kolejności cyklofosfamid, a następnie ludzkie immunoglobuliny G. Próby te nie przyniosły jednak zadowalającej poprawy, stąd pacjent został obecnie poddany terapii talidomidem. Opisywany przypadek wskazuje, że liszaj śluzowaty wciąż pozostaje wyzwaniem dla lekarzy i stwarza problemy zarówno diagnostyczne (brak jasnych kryteriów klasyfikacyjnych), jak i terapeutyczne

Acute fatty liver of pregnancy – case report

Abstract Severe liver function disorders in late pregnancy are relatively rare but extremely dangerous, as they may quickly develop into a fulminant disease and become a life-threatening disorder for the mother and the fetus. In the following study we have reported a case of a previously healthy woman with severe liver disorder in the third trimester of pregnancy. On the basis of anamnesis, differential diagnosis, typical course and complications of the disease, and proper response to intensive supportive medical therapy, we diagnosed an acute fatty liver of pregnancy. The diagnosis was based on clinical presentation and laboratory abnormalities. Owing to timely intervention and adequate supportive care management, this severe complication of a pregnancy has had a successful outcome for both the mother and the child

Impact of 123 I-MIBG scintigraphy on clinical decision making in pheochromocytoma and paraganglioma

CONTEXT Cross sectional imaging with computed tomography (CT) or magnetic resonance imaging (MRI) is regarded as a first-choice modality for tumor localization in patients with pheochromocytoma and paraganglioma (PPGL). 123I-labeled metaiodobenzylguanidine (123I-MIBG) is widely used for functional imaging but the added diagnostic value is controversial. OBJECTIVE To establish the virtual impact of adding 123I-MIBG scintigraphy to CT or MRI on diagnosis and treatment of PPGL. DESIGN International multicenter retrospective study. INTERVENTION None. PATIENTS 236 unilateral adrenal, 18 bilateral adrenal, 48 unifocal extra-adrenal, 12 multifocal and 26 metastatic PPGL. MAIN OUTCOME MEASURES Patients underwent both anatomical imaging (CT and/or MRI) and 123I-MIBG scintigraphy. Local imaging reports were analyzed centrally by two independent observers who were blinded to the diagnosis. Imaging-based diagnoses determined by CT/MRI only, 123I-MIBG only, and CT/MRI combined with 123I-MIBG scintigraphy were compared with the correct diagnoses. RESULTS The rates of correct imaging-based diagnoses determined by CT/MRI only versus CT/MRI plus 123I-MIBG scintigraphy were similar: 89.4 versus 88.8%, respectively, (P=0.50). Adding 123I-MIBG scintigraphy to CT/MRI resulted in a correct change in the imaging-based diagnosis and ensuing virtual treatment in four cases (1.2%: two metastatic instead of non-metastatic, one multifocal instead of single, one unilateral instead of bilateral adrenal) at the cost of an incorrect change in seven cases (2.1%: four metastatic instead of non-metastatic, two multifocal instead of unifocal and one bilateral instead of unilateral adrenal). CONCLUSIONS For the initial localization of PPGL, the addition of 123I-MIBG scintigraphy to CT/MRI rarely improves the diagnostic accuracy at the cost of incorrect interpretation in others, even when 123I-MIBG scintigraphy is restricted to patients who are at risk for metastatic disease. In this setting, the impact of 123I-MIBG scintigraphy on clinical decision-making appears very limited

Distinct DNA Methylation Patterns of Subependymal Giant Cell Astrocytomas in Tuberous Sclerosis Complex

Tuberous sclerosis complex (TSC) is a monogenic disorder caused by mutations in either the TSC1 or TSC2 gene, two key regulators of the mechanistic target of the rapamycin complex pathway. Phenotypically, this leads to growth and formation of hamartomas in several organs, including the brain. Subependymal giant cell astrocytomas (SEGAs) are low-grade brain tumors commonly associated with TSC. Recently, gene expression studies provided evidence that the immune system, the MAPK pathway and extracellular matrix organization play an important role in SEGA development. However, the precise mechanisms behind the gene expression changes in SEGA are still largely unknown, providing a potential role for DNA methylation. We investigated the methylation profile of SEGAs using the Illumina Infinium HumanMethylation450 BeadChip (SEGAs n = 42, periventricular control n = 8). The SEGA methylation profile was enriched for the adaptive immune system, T cell activation, leukocyte mediated immunity, extracellular structure organization and the ERK1 & ERK2 cascade. More interestingly, we identified two subgroups in the SEGA methylation data and show that the differentially expressed genes between the two subgroups are related to the MAPK cascade and adaptive immune response. Overall, this study shows that the immune system, the MAPK pathway and extracellular matrix organization are also affected on DNA methylation level, suggesting that therapeutic intervention on DNA level could be useful for these specific pathways in SEGA. Moreover, we identified two subgroups in SEGA that seem to be driven by changes in the adaptive immune response and MAPK pathway and could potentially hold predictive information on target treatment response

The coding and non-coding transcriptional landscape of subependymal giant cell astrocytomas

Tuberous sclerosis complex (TSC) is an autosomal dominantly inherited neurocutaneous disorder caused by inactivating mutations in TSC1 or TSC2, key regulators of the mechanistic target of rapamycin complex 1 (mTORC1) pathway. In the CNS, TSC is characterized by cortical tubers, subependymal nodules and subependymal giant cell astrocytomas (SEGAs). SEGAs may lead to impaired circulation of CSF resulting in hydrocephalus and raised intracranial pressure in patients with TSC. Currently, surgical resection and mTORC1 inhibitors are the recommended treatment options for patients with SEGA. In the present study, high-throughput RNA-sequencing (SEGAs n = 19, periventricular control n = 8) was used in combination with computational approaches to unravel the complexity of SEGA development. We identified 9400 mRNAs and 94 microRNAs differentially expressed in SEGAs compared to control tissue. The SEGA transcriptome profile was enriched for the mitogen-activated protein kinase (MAPK) pathway, a major regulator of cell proliferation and survival. Analysis at the protein level confirmed that extracellular signal-regulated kinase (ERK) is activated in SEGAs. Subsequently, the inhibition of ERK independently of mTORC1 blockade decreased efficiently the proliferation of primary patient-derived SEGA cultures. Furthermore, we found that LAMTOR1, LAMTOR2, LAMTOR3, LAMTOR4 and LAMTOR5 were overexpressed at both gene and protein levels in SEGA compared to control tissue. Taken together LAMTOR1-5 can form a complex, known as the 'Ragulator' complex, which is known to activate both mTORC1 and MAPK/ERK pathways. Overall, this study shows that the MAPK/ERK pathway could be used as a target for treatment independent of, or in combination with mTORC1 inhibitors for TSC patients. Moreover, our study provides initial evidence of a possible link between the constitutive activated mTORC1 pathway and a secondary driver pathway of tumour growth

National identity predicts public health support during a global pandemic

Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated self-reported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = -0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics

Psicología social y moral de COVID-19 en 69 países

La pandemia de COVID-19 ha afectado a todos los ámbitos de la vida humana, incluido el tejido económico y social de las sociedades. Una de las estrategias centrales para gestionar la salud pública a lo largo de la pandemia ha sido el envío de mensajes persuasivos y el cambio de comportamiento colectivo. Para ayudar a los estudiosos a comprender mejor la psicología social y moral que subyace al comportamiento en materia de salud pública, presentamos un conjunto de datos compuesto por 51.404 individuos de 69 países. Este conjunto de datos se recopiló para el proyecto de la Colaboración Internacional en Psicología Social y Moral de COVID-19 (ICSMP COVID-19). Esta encuesta de ciencias sociales invitó a participantes de todo el mundo a completar una serie de medidas morales y psicológicas y actitudes de salud pública sobre COVID-19 durante una fase temprana de la pandemia de COVID-19 (entre abril y junio de 2020). La encuesta incluía siete grandes categorías de preguntas: Creencias sobre COVID-19 y conductas de cumplimiento; identidad y actitudes sociales; ideología; salud y bienestar; creencias morales y motivación; rasgos de personalidad; y variables demográficas. Presentamos los datos brutos y depurados, junto con todos los materiales de la encuesta, las visualizaciones de los datos y las evaluaciones psicométricas de las variables clave.The COVID-19 pandemic has affected all domains of human life, including the economic and social fabric of societies. One of the central strategies for managing public health throughout the pandemic has been through persuasive messaging and collective behaviour change. To help scholars better understand the social and moral psychology behind public health behaviour, we present a dataset comprising of 51,404 individuals from 69 countries. This dataset was collected for the International Collaboration on Social & Moral Psychology of COVID-19 project (ICSMP COVID-19). This social science survey invited participants around the world to complete a series of moral and psychological measures and public health attitudes about COVID-19 during an early phase of the COVID-19 pandemic (between April and June 2020). The survey included seven broad categories of questions: COVID-19 beliefs and compliance behaviours; identity and social attitudes; ideology; health and well-being; moral beliefs and motivation; personality traits; and demographic variables. We report both raw and cleaned data, along with all survey materials, data visualisations, and psychometric evaluations of key variables

A roadmap for high-resolution satellite soil moisture applications – confronting product characteristics with user requirements

Soil moisture observations are of broad scientific interest and practical value for a wide range of applications. The scientific community has made significant progress in estimating soil moisture from satellite-based Earth observation data, particularly in operationalizing coarse-resolution (25-50 km) soil moisture products. This review summarizes existing applications of satellite-derived soil moisture products and identifies gaps between the characteristics of currently available soil moisture products and the application requirements from various disciplines. We discuss the efforts devoted to the generation of high-resolution soil moisture products from satellite Synthetic Aperture Radar (SAR) data such as Sentinel-1 C-band backscatter observations and/or through downscaling of existing coarse-resolution microwave soil moisture products. Open issues and future opportunities of satellite-derived soil moisture are discussed, providing guidance for further development of operational soil moisture products and bridging the gap between the soil moisture user and supplier communities

National identity predicts public health support during a global pandemic (vol 13, 517, 2022) : National identity predicts public health support during a global pandemic (Nature Communications, (2022), 13, 1, (517), 10.1038/s41467-021-27668-9)

Publisher Copyright: © The Author(s) 2022.In this article the author name ‘Agustin Ibanez’ was incorrectly written as ‘Augustin Ibanez’. The original article has been corrected.Peer reviewe

National identity predicts public health support during a global pandemic.

Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated self-reported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = -0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics