Progressive Macular Hypomelanosis: A Rarely Diagnosed Hypopigmentation in Caucasians

A 35-year-old woman who developed whitish macules on trunk and limbs at 12 years of age and observed a remarkable increase of the hypopigmentated lesions after her pregnancies at ages 29 and 32 years. Because of the highly characteristic clinical aspect and the light- and electron-microscopic histopathologic findings, we diagnosed progressive macular hypomelanosis (PMH). It is a nonscaly disorder with hypopigmented macules mainly on the trunk and is more often seen in young women. In contrast to some authors assuming the presence of Propionibacterium spp. as a matter of principle in PMH, we report a case with no evidence for Propionibacterium spp

Estudo exploratório sobre a implantação de casas de economia solidária no Estado da Paraíba

The solidarity economy are multifunctional spaces for marketing and training of solidarity economic enterprises benefited by public policies in solidarity economy. Thus, this work has come up with the answer of how implementation is occurring in the State of Paraíba. For this, a study of exploratory analysis, with documentary and bibliographic research. What were the actors involved; How is the participation in this process; How is being held ownership of these spaces; your organization; which the municipalities to be deployed; What houses have to offer to the community. Seeking-if performances that are in addition to the marketing of products and services, in overcoming difficulties arising from the exclusion that the capitalist system normally enforces those in social vulnerability, as an alternative to the capitalist model. A brief history of the solidarity economy in Brazil and its offshoots. Discusses how the instruments of public policies converge with the actions of solidarity economy, to foster and promote the development and empowerment of sympathetic economic enterprises in search of generation and/or income improvement. The importance of public policy actions promoted for the development and empowerment of those involved, when the collective participation is present. It is concluded that there are weaknesses in the process of the implementation of the solidarity economy along with their stakeholders, however, recognizes advances in the public policies of solidarity economy.NenhumaAs Casas de Economia Solidária são espaços multifuncionais para comercialização e formações dos empreendimentos econômicos solidários beneficiados pelas políticas públicas em economia solidária. Assim, este trabalho surgiu com a indagação de que forma está ocorrendo sua implantação no estado da Paraíba. Para isso, realizou-se um estudo de análise exploratória, com pesquisa documental e bibliográfica. Verificaram-se quais os atores envolvidos; como se dá a participação destes neste processo de construção; como está sendo realizada a apropriação destes espaços; sua organização; quais os municípios a serem implantadas; o que as Casas têm a oferecer à comunidade. Buscando-se atuações que estejam para além da comercialização dos produtos e serviços, na superação das dificuldades decorrentes da exclusão que o sistema capitalista normalmente impõe aos que estão em vulnerabilidade social, como alternativa ao modelo capitalista vigente. Apresenta-se um breve histórico da Economia Solidária, no Brasil e seus desdobramentos. Aborda-se de que forma os instrumentos de políticas públicas convergem com as ações de economia solidária, que fomentam e promovem o desenvolvimento e empoderamento dos empreendimentos econômicos solidários em busca da geração e/ou melhoria de renda. Ressalta-se a importância das ações de políticas públicas promovidas para o desenvolvimento e o empoderamento dos envolvidos, quando a participação coletiva se faz presente. Conclui-se que existem fragilidades no processo da implantação das Casas de Economia Solidária juntamente com seus atores envolvidos, entretanto, se reconhece avanços nas políticas públicas de economia solidária

Genetic newborn screening and digital technologies: A project protocol based on a dual approach to shorten the rare diseases diagnostic path in Europe.

Since 72% of rare diseases are genetic in origin and mostly paediatrics, genetic newborn screening represents a diagnostic "window of opportunity". Therefore, many gNBS initiatives started in different European countries. Screen4Care is a research project, which resulted of a joint effort between the European Union Commission and the European Federation of Pharmaceutical Industries and Associations. It focuses on genetic newborn screening and artificial intelligence-based tools which will be applied to a large European population of about 25.000 infants. The neonatal screening strategy will be based on targeted sequencing, while whole genome sequencing will be offered to all enrolled infants who may show early symptoms but have resulted negative at the targeted sequencing-based newborn screening. We will leverage artificial intelligence-based algorithms to identify patients using Electronic Health Records (EHR) and to build a repository "symptom checkers" for patients and healthcare providers. S4C will design an equitable, ethical, and sustainable framework for genetic newborn screening and new digital tools, corroborated by a large workout where legal, ethical, and social complexities will be addressed with the intent of making the framework highly and flexibly translatable into the diverse European health systems

Large-scale analysis of structural brain asymmetries in schizophrenia via the ENIGMA consortium

Left-right asymmetry is an important organizing feature of the healthy brain that may be altered in schizophrenia, but most studies have used relatively small samples and heterogeneous approaches, resulting in equivocal findings. We carried out the largest case-control study of structural brain asymmetries in schizophrenia, using MRI data from 5,080 affected individuals and 6,015 controls across 46 datasets in the ENIGMA consortium, using a single image analysis protocol. Asymmetry indexes were calculated for global and regional cortical thickness, surface area, and subcortical volume measures. Differences of asymmetry were calculated between affected individuals and controls per dataset, and effect sizes were meta-analyzed across datasets. Small average case-control differences were observed for thickness asymmetries of the rostral anterior cingulate and the middle temporal gyrus, both driven by thinner left-hemispheric cortices in schizophrenia. Analyses of these asymmetries with respect to the use of antipsychotic medication and other clinical variables did not show any significant associations. Assessment of age- and sex-specific effects revealed a stronger average leftward asymmetry of pallidum volume between older cases and controls. Case-control differences in a multivariate context were assessed in a subset of the data (N = 2,029), which revealed that 7% of the variance across all structural asymmetries was explained by case-control status. Subtle case-control differences of brain macro-structural asymmetry may reflect differences at the molecular, cytoarchitectonic or circuit levels that have functional relevance for the disorder. Reduced left middle temporal cortical thickness is consistent with altered left-hemisphere language network organization in schizophrenia

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Changes of lung parenchyma density following high dose radiation therapy for thoracic carcinomas - an automated analysis of follow up CT scans

BACKGROUND: An objective way to qualify the effect of radiotherapy (RT) on lung tissue is the analysis of CT scans after RT. In this analysis we focused on the changes in Hounsfield units (ΔHU) and the correlation with the corresponding radiation dose after RT. METHODS: Pre- and post-RT CT scans were matched and ΔHU was calculated using customized research software. ΔHU was calculated in 5-Gy-intervals and the correlation between ΔHU and the corresponding dose was calculated as well as the regression coefficients. Additionally the mean ΔHU and ΔHU in 5-Gy-intervals were calculated for each tumor entity. RESULTS: The mean density changes at 12 weeks and 6 months post RT were 28,16 HU and 32,83 HU. The correlation coefficient between radiation dose and ΔHU at 12 weeks and 6 months were 0,166 (p = 0,000) and 0,158 (p = 0,000). The resulting regression coefficient were 1439 HU/Gy (p = 0,000) and 1612 HU/Gy (p = 0,000). The individual regression coefficients for each patient range from - 2,23 HU/Gy to 7,46 HU/Gy at 12 weeks and - 0,45 HU/Gy to 10,51 HU/Gy at 6 months. When looking at the three tumor entities individually the highest ΔHU at 12 weeks was seen in patients with SCLC (38,13 HU) and at 6 month in those with esophageal carcinomas (40,98 HU). CONCLUSION: For most dose intervals there was an increase of ΔHU with an increased radiation dose. This is reflected by a statistically significant, although low correlation coefficient. The regression coefficients of all patients show large interindividual differences

Pregnancy Outcomes of Women With Physical Disabilities: A Matched Cohort Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146996/1/pmr290.pd

Vom Verschwinden und Entstehen politischer Grenzen in Europa: das Beispiel der Antiterrorpolitik

Kirschner A, Kaletta B, Heitmeyer W. Vom Verschwinden und Entstehen politischer Grenzen in Europa: das Beispiel der Antiterrorpolitik. In: Benninghaus C, ed. Unterwegs in Europa: Festschrift für Heinz-Gerhard Haupt. Frankfurt: Campus; 2008: 41-68