Macrophage activation syndrome triggered by coeliac disease: a unique case report

Background: Macrophage activation syndrome is described as a “clinical syndrome of hyperinflammation resulting in an uncontrolled and ineffective immune response” in the context of an autoinflammatory or rheumatic disease. Current associations of macrophage activation syndrome with autoimmune disease most notably include a host of rheumatological conditions and inflammatory bowel disease. Epidemiological studies have shown that macrophage activation syndrome is precipitated by autoimmune disease more commonly than previously thought. Diagnosing the precipitating factor is essential for effective treatment and prognosis. Case presentation: We report a case of a six year old girl with coeliac disease diagnosed after two episodes of secondary haemophagocytic lymphohistiocytosis. Her condition only responded to treatment once the patient was placed on a gluten free diet. Further immunological testing confirmed anti-transglutaminase and anti-endomysial antibodies, however histological biopsy was deemed inappropriate due to the severity of her condition. She has remained stable with no further episodes of macrophage activation syndrome since commencing a gluten free diet. Conclusion: This case report is the first literature that links macrophage activation syndrome to coeliac disease and highlights the challenge of diagnosing coeliac disease with unusual features such as associated prolonged fever. Clinicians should have a low threshold for screening children with other autoimmune diseases for coeliac disease

A new comprehensive monitoring and diagnostic approach for early detection of mechanical degradation in helicopter transmission systems

Helicopters are complex and vulnerable due to single-load-path critical parts that transmit the engine's power to the rotors. A fault in even one single transmission's gear component may compromise the whole helicopter, involving high maintenance costs and safety hazards. In this work, we present an effective diagnosis and monitoring system for the early detection of the mechanical degradation in such components, also capable of providing insights on the damage's causes. The classification task is performed by an ensemble of two learners: a convolutional autoencoder and a distance&density-based unsupervised classifier that use as regressors specific Health Indexes (HIs) and flight parameters. The proposed approach leverages the autoencoder reconstruction error information to infer the most probable cause of each detected fault, and enacts post-processing filtering policies defined to reduce the number of false alarms. Extensive experimental validation witnesses the effectiveness and robustness of the proposed approach

Economic crisis, mortality and health status. A new perspective

Since the seminal paper by Ruhm (2000), a large body of literature agrees on the existence of pro-cyclical fluctuation between economy’s performance and mortality, and this evidence has been confirmed also during the Great Recession (GR). In this study we identify a series of important limitations that may have severely affected previous results. For the first time in this literature we use patient level data collected by GPs in Italy, reporting mortality and objectively measured health information on a large representative population sample. We find a clear positive effect of a rise in unemployment on three important morbidity outcomes. The lag-lead analysis confirms the validity of our results, with changes in prevalences following the same dynamics of the unemployment rise since the starting of the economic slowdown. Our study shows also that the effect of unemployment on the total mortality is no longer significant when controlling for the existence of poor health conditions and suggests that the impact of severe economic downturns on population mortality should be reconsidered

Antimicrobial peptide cocktail activity in minced turkey meat

Meat products contain valuable nutrients that are important for human health and development but are also highly susceptible to colonization by microorganisms. This can lead to spoilage and serious foodborne illnesses. Natural antimicrobial peptides, produced by many organisms as part of their innate immune system to fight microbial infections, have great potential as food preservatives. In this study, we explored the effect of ternary antimicrobial random peptide mixtures (RPMs) on food spoilage bacteria in minced turkey meat. Amendment of RPMs to meat led to significant reductions in bacterial abundance in experimental tests, and RPMs worked synergistically with nitrite to reduce bacterial loads. Using high-throughput 16 S ribosomal RNA gene amplicon sequencing, we characterized the effect of RPMs and nitrite on meat microbial community structure before and during incubation under refrigerated conditions. Our findings reveal strong antimicrobial activity for RPMs against spoilage bacteria in meat, including Listeria monocytogenes and Pseudomonas putida. These results demonstrate the potential of RPMs as a safer preservative for reducing spoilage in meat and other food products

Absence of Expression of c-sis and Transforming Growth Factor-β mRNA in Malignant Fibrous Histiocytoma

Total RNA was extracted from five malignant fibrous histiocytomas and two benign fibrohistiocytic lesions and assayed for mRNA expressions for transforming growth factor beta (TGF-β) and c-sis by Northern blot analysis. Production of both of these has been associated with cells of monocyte-macrophage lineage, and these factors have been shown to be important in physiologic mesenchymal cell proliferation. No mRNA expression of either TGF-β or c-sis was identified in any of the fibrohistiocytic tumor samples. The lack of expression of TGF-β and c-sis may be consistent with a nonhistiocytic origin of malignant fibrous histiocytoma, or may reflect transformation- associated loss of the normal molecular mechanisms of mesenchymal proliferation. The absence of c-sis mRNA expression can be reconciled with the prior immunohisto chemical demonstration of platelet-derived growth factor in tumor cells of malignant fibrous histiocytoma. Int J Surg Pathol(2):117-122, 1993Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67413/2/10.1177_106689699300100205.pd

Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial

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Use of MRP8/14 in clinical practice as a predictor of outcome after methotrexate withdrawal in patients with juvenile idiopathic arthritis

Funder: UK National Institute for Health Research Biomedical Research CentreFunder: Great Ormond Street Hospital Charity; doi: http://dx.doi.org/10.13039/501100001279Abstract The objective of this study was to determine the effectiveness of MRP8/14 as a predictor of disease flare in patients with juvenile idiopathic arthritis (JIA) following the withdrawal of methotrexate (MTX) in a routine clinical setting. All MRP8/14 tests performed at a single centre in a 27-month period were considered for analysis. Patients were assessed against criteria for inactive disease and subsequent disease flare. Decisions on whether or not to stop treatment were recorded. MRP8/14 results were assessed in conjunction with clinical information. Clinicians were also surveyed to investigate if MRP8/14 influenced their decision to discontinue MTX where this was available at that time point. One hundred four cases met the inclusion criteria during the study period. Although there was no significant difference in flares between patients with an elevated or low MRP8/14 value, in those who stopped MTX (n = 22), no patients with a low MRP8/14 (≤ 4000 ng/ml) result flared (follow-up time 12 months). Clinicians reported that for patients with clinically inactive disease and an elevated MRP8/14 result (&gt; 4000 ng/ml), none would advise withdrawal of MTX. Low MRP8/14 was interpreted favourably when considering stopping MTX treatment in patients with JIA. Implementation of MRP8/14 testing has changed clinical practice at this centre. However, the observation that some patients in our cohort who had an elevated MRP8/14 value did not flare after stopping MTX for non-disease-related reasons highlights the need for further biomarkers to predict the risk of flare off medication in JIA and aid clinicians in treatment decisions. Key Points• First study of serum MRP8/14 measurement in clinical practice to inform treatment decisions in patients with JIA.• No patients with a low MRP8/14 test result went on to suffer a disease flare in 12 months of follow follow-up.• Further biomarkers are needed to predict the risk of flare off medication in JIA and treatment decisions. </jats:p