Treatment of severe psoriasis with infliximab

Psoriasis is a chronic, immune mediated inflammatory disease characterized by increased cell signalling via cytokines and chemokines on a background of up-regulated gene expression. There is substantial evidence that psoriasis should be regarded as more than a cutaneous disease; major psychological morbidity and increased mortality from cardiovascular disease and cancer are increasingly recognized. Improved understanding of the genetic and immunological mechanisms underpinning psoriasis has occurred concurrently with the development of targeted biological therapies including infliximab. These newer therapeutic approaches can be very effective but their long term safety profile is not yet fully determined

Cognitive Components of Regularity Processing in the Auditory Domain

BACKGROUND: Music-syntactic irregularities often co-occur with the processing of physical irregularities. In this study we constructed chord-sequences such that perceived differences in the cognitive processing between regular and irregular chords could not be due to the sensory processing of acoustic factors like pitch repetition or pitch commonality (the major component of 'sensory dissonance'). METHODOLOGY/PRINCIPAL FINDINGS: Two groups of subjects (musicians and nonmusicians) were investigated with electroencephalography (EEG). Irregular chords elicited an early right anterior negativity (ERAN) in the event-related brain potentials (ERPs). The ERAN had a latency of around 180 ms after the onset of the music-syntactically irregular chords, and had maximum amplitude values over right anterior electrode sites. CONCLUSIONS/SIGNIFICANCE: Because irregular chords were hardly detectable based on acoustical factors (such as pitch repetition and sensory dissonance), this ERAN effect reflects for the most part cognitive (not sensory) components of regularity-based, music-syntactic processing. Our study represents a methodological advance compared to previous ERP-studies investigating the neural processing of music-syntactically irregular chords

Boussignac continuous positive airway pressure for the management of acute cardiogenic pulmonary edema: prospective study with a retrospective control group

<p>Abstract</p> <p>Background</p> <p>Continuous positive airway pressure (CPAP) treatment for acute cardiogenic pulmonary edema can have important benefits in acute cardiac care. However, coronary care units are usually not equipped and their personnel not adequately trained for applying CPAP with mechanical ventilators. Therefore we investigated in the coronary care unit setting the feasibility and outcome of the simple Boussignac mask-CPAP (BCPAP) system that does not need a mechanical ventilator.</p> <p>Methods</p> <p>BCPAP was introduced in a coronary care unit where staff had no CPAP experience. All consecutive patients transported to our hospital with acute cardiogenic pulmonary edema, a respiratory rate > 25 breaths/min and a peripheral arterial oxygen saturation of < 95% while receiving oxygen, were included in a prospective BCPAP group that was compared with a historical control group that received conventional treatment with oxygen alone.</p> <p>Results</p> <p>During the 2-year prospective BCPAP study period 108 patients were admitted with acute cardiogenic pulmonary edema. Eighty-four of these patients (78%) were treated at the coronary care unit of which 66 (61%) were treated with BCPAP. During the control period 66 patients were admitted over a 1-year period of whom 31 (47%) needed respiratory support in the intensive care unit. BCPAP treatment was associated with a reduced hospital length of stay and fewer transfers to the intensive care unit for intubation and mechanical ventilation. Overall estimated savings of approximately € 3,800 per patient were achieved with the BCPAP strategy compared to conventional treatment.</p> <p>Conclusion</p> <p>At the coronary care unit, BCPAP was feasible, medically effective, and cost-effective in the treatment of acute cardiogenic pulmonary edema. Endpoints included mortality, coronary care unit and hospital length of stay, need of ventilatory support, and cost (savings).</p