Stability of Oscillating Gaseous Masses in Massive Brans-Dicke Gravity

This paper explores the instability of gaseous masses for the radial oscillations in post-Newtonian correction of massive Brans-Dicke gravity. For this purpose, we derive linearized perturbed equation of motion through Lagrangian radial perturbation which leads to the condition of marginal stability. We discuss radius of instability of different polytropic structures in terms of the Schwarzschild radius. It is concluded that our results provide a wide range of difference with those in general relativity and Brans-Dicke gravity.Comment: 31 pages, 11 figures, to appear in IJMP

Thoracic wall reconstruction with Collamend® in trauma: report of a case and review of the literature

Introduction: Despite progress in reconstructive techniques, rebuilding portions of the thorax remains challenging, in particular when large resections, contamination or infection are involved. No other cases of thoracic reconstruction in trauma patients with biological prosthesis have been described since now.Methods: We report a case of thoracic reconstruction in highly infected field in a trauma patient. We also performed a literature review about the topic.Conclusion: Collamend® demonstrated its usefulness in thoracic wall reconstruction even in trauma patients and infected fields. © 2012 Coccolini et al.; licensee BioMed Central Ltd

Patient satisfaction with calcipotriol/betamethasone dipropionate cutaneous foam for the treatment of plaque psoriasis: The LION real-life multicenter prospective observational cohort study

Topical treatment is the mainstay for mild or moderate psoriasis, but patients are generally little satisfied. Calcipotriol/betamethasone dipropionate (Cal/BD) cutaneous foam has shown to improve signs and symptoms in plaque psoriasis patients. This study assessed patient's satisfaction with Cal/BD foam in a real-life Italian dermatological clinical practice. A multicenter, 4-week observational prospective cohort study enrolled, in 17 Italian dermatology clinics, adult patients with plaque psoriasis on the body and/or scalp. Treatment satisfaction was assessed by 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9), preference over previous treatments by Patient Preference Questionnaire (PPQ), and change in disease state by Psoriasis Area Severity Index (PASI). Overall 256 patients were eligible, with a mean (SD) age of 55.6 (15.4) years, 59.4% were males. Psoriasis severity was mild in 52.0% of patients, moderate in 43.3%, and severe in 4.7%. Scalp involvement was present in 36.7% of patients. Previous antipsoriatic treatments had been received by 80.5% of patients. TSQM-9 median (25th-75th percentile) scores were 83.3 (66.7-88.9) for effectiveness, 77.8 (66.7-88.9) for convenience, and 78.6 (64.3-92.9) for global satisfaction. Mean (SD) PASI value decreased from 7.3 (4.8) to 2.1 (2.7) after 4 weeks. More than 90% of patients previously treated for psoriasis evaluated the Cal/BD foam more effective, easier to use and better tolerated compared to previous topical treatments at PPQ. This observational study provides real-life evidence of a high level of satisfaction with effectiveness and convenience of the Cal/BD foam in a cohort of plaque psoriasis patients, with an objective improvement in PASI

A metodologia enxuta e sua aplicação na gestão de inventário: estudo de caso na cadeia de suprimentos de uma fábrica de lubrificantes

O trabalho tem por objetivo apresentar e analisar os resultados de um programa de manufatura enxuta nas operações de uma fábrica de lubrificantes, abordando principalmente o segmento final de sua cadeia de suprimentos relacionado à gestão de inventário e distribuição de produtos acabados. Dois projetos fundamentados em conceitos Lean serão apresentados como parte do programa enxuto da fábrica, o qual terá seu impacto analisado a partir dos principais indicadores de uma cadeia de suprimentos antes e durante sua aplicação: Acuracidade da previsão de demanda, disponibilidade de produto acabado, nível de serviço oferecido e capital de giro envolvido. Por fim, serão levantadas possibilidades de aproveitamento dos resultados observados e futuras oportunidades de estudo sobre o tema.The goal of this study is to expose and analyze the results of a Lean Manufacturing program in the operations of a Brazilian lubricants plant, focusing mainly on the final segment of its supply chain, related to inventory management and finished products distribution. Two projects developed under lean principles will be presented as part of the main Lean Program, which will have its impact studied from the main key performance indicators of a Supply Chain before and after its application: Demand forecast accuracy, finished products availability, service level and working capital. Finally, opportunities of future studies and possibilities to take advantage from the observed results will be discussed

Laparoscopic right colectomy: Miles away or just around the corner?

Background: Despite the drive toward centralization of surgery in high-volume centers, the majority of colectomies are still performed by low- or medium-volume surgeons. Materials and Methods: A modification of the technique of laparoscopic right colectomy (LRC) originally described by Young-Fadok and Nelson was developed. The key points of that technique were maintained, but a different port-site layout and a counterclockwise approach were adopted, to warrant better trocar triangulation, to reduce the need of right colon manipulation and to avoid dissection along false planes. This modified technique was applied in 82 patients by 16 surgeons with no previous experience in LRC. Results: Average operative time was 125 ± 35 min. Conversion occurred in 10 cases (12.2%). Grade III postoperative complications occurred in 3 patients (3.6%). No postoperative mortality was observed. Average number of lymph nodes retrieved was 19 ± 6. Average length of stay was 7 ± 4 days. Conclusion: Providing low-volume surgeons with simplified and easy-to-learn surgical techniques could improve outcomes and lead to an increased use of laparoscopy

Dimethyl Fumarate's Effectiveness and Safety in Psoriasis: A Real-Life Experience During the COVID-19 Pandemic

Introduction Dimethyl fumarate (DMF) is approved as oral systemic treatment for moderate-to-severe psoriasis. Scarce evidence is available for DMF treatment in psoriatic patients at the time of COVID-19 pandemic. The objective of this study was to assess the long-term effectiveness and safety of DMF monotherapy in moderate-to-severe psoriasis during the COVID-19 pandemic period. Methods This multicenter, retrospective study included patients with moderate-to-severe psoriasis who had received a 48-week DMF treatment during the COVID-19 pandemic. Selected outcomes were: variation of mean PASI, proportion of patients achieving PASI50 and PASI75, variation of mean PGA and face PGA, genital PGA, scalp PGA, mean itch VAS and mean DLQI. Results Forty-four patients were enrolled, and four patients became COVID-19 positive during the observation period but did not discontinue DMF therapy. DMF produced a significant improvement of signs and symptoms of psoriasis as expressed by mean PASI variation from 13.07 at baseline to 6.11 at week 48 (p < 0.0001), itch VAS from 3.22 at baseline to 1.18 at week 48 (p < 0.001), PGA from 2.84 at baseline to 1.30 at week 48 (p < 0.0001) and DLQI from 13.09 at baseline to 6.07 at week 48 (p < 0.0001). The percentage of patients who achieved PASI50 and PASI75 was 4.55% at week 4 and 59.09% at week 48 and 0% at week 4 and 22.73% at week 48, respectively. A clinical important decrease of mean PGA score was observed in all subgroups, face psoriasis, genital psoriasis and scalp psoriasis. Adverse events were predictable and manageable. Conclusions DMF monotherapy is an effective and safe treatment option in moderate-to-severe psoriasis also in patients who develop SARS-CoV-2 infection

Prevalence of HPV genital infection in patients with moderate-to-severe psoriasis undergoing systemic treatment with immunosuppressive agents or biologics

Background Psoriasis is an immune-mediated inflammatory disease and its relationship with infection has been extensively investigated. Concern for the increased prevalence of human papilloma virus (HPV) infection in patients undergoing systemic immunomodulatory or immunosuppressive therapies for psoriasis has been gradually growing among clinicians. Objectives To evaluate the prevalence of HPV in a cohort of patients with psoriasis treated with currently available systemic, conventional and biotechnological drugs. Materials & Methods A multi-centric prospective study was conducted in the main dermatological clinical centres of central and southern Italy. Data from 588 patients (366 males and 222 females) with moderate-to-severe psoriasis, aged >= 18 years and treated with conventional and biological drugs, were collected based on a documented history of HPV infection, a positive Papanicolaou test (Pap-test) when available, and clinical evidence of genital warts reported during consultation. Results Overall, 18 of 588 patients (3.6% [95% CI: 1.8-4.5]) were positive for HPV or had a history of cervical cancer. Considering anamnestic and demographic data, such as gender, age, smoking, weight and body mass index, no statistically significant differences between HPV+ and HPV- patients were found. Moreover, the eradication of HPV infection was successfully achieved using conventional treatments. Conclusion The prevalence of HPV infection in patients with moderate-to-severe psoriasis, undergoing systemic treatment with immunosuppressive agents or biologics, appears to be the same as that in the general Italian population, indicating that the level of infection among such patients is acceptable