A search for magnetic fields on central stars in planetary nebulae

One of the possible mechanisms responsible for the panoply of shapes in planetary nebulae is the presence of magnetic fields that drive the ejection of ionized material during the proto-planetary nebula phase. Therefore, detecting magnetic fields in such objects is of key importance for understanding their dynamics. Still, magnetic fields have not been detected using polarimetry in the central stars of planetary nebulae. Circularly polarized light spectra have been obtained with the Focal Reducer and Low Dispersion Spectrograph at the Very Large Telescope of the European Southern Observatory and the Intermediate dispersion Spectrograph and Imaging System at the William Herschel Telescope. Nineteen planetary nebulae spanning very different morphology and evolutionary stages have been selected. Most of central stars have been observed at different rotation phases to point out evidence of magnetic variability. In this paper, we present the result of two observational campaigns aimed to detect and measure the magnetic field in the central stars of planetary nebulae on the basis of low resolution spectropolarimetry. In the limit of the adopted method, we can state that large scale fields of kG order are not hosted on the central star of planetary nebulae.Comment: Paper accepted to be published in Astronomy and Astrophysics on 20/01/201

Atypical renal presentation of antiphospholipid syndrome

Antiphospholipid syndrome (APS) is a systemic autoimmune disease which can occur as a primary disease or in association with other autoimmune diseases, the most frequent being Systemic Lupus Erythematosus (SLE). Although renal manifestations of SLE are well known, antiphospholipid syndrome renal manifestations such as antiphospholipid syndrome nephropathy and glomerulopathies have yet to be better characterized. The authors present the case of a 39 -year -old Caucasian woman with antiphospholipid syndrome diagnosis and a previous history of deep venous thrombosis and intermittent polyarthralgia, who was referred to a nephrology consultation for proteinuria and microscopic haematuria with preserved renal function. The renal biopsy showed a pattern of membranous glomerulopathy and thrombotic microangiopathy in association with antiphospholipid syndrome nephropathy. This case report illustrates a complex clinical and anatomopathological case of a 39 - year -old woman with a previous antiphospholipid syndrome diagnosis who presented with unspecific manifestations such as proteinuria and microscopic haematuria and preserved renal function. The histological findings alert us to the range of possible renal manifestations of APS and the need to better characterize these patients by preforming renal biopsy.info:eu-repo/semantics/publishedVersio

Towards elimination of measles and rubella in Italy. Progress and challenges

Introduction In the WHO European Region, endemic transmission of measles and rubella had been interrupted by 37 and 42 of the 53 member states (MSs), respectively, by 2018. Sixteen MSs are still endemic for measles, 11 for rubella and nine for both diseases, the latter including Italy. Elimination is documented by each country’s National Verification Committee (NVC) through an annual status update (ASU). Objective By analysing data used to produce the ASUs, we aimed to describe the advances made by Italy towards elimination of measles and rubella. Moreover, we propose a set of major interventions that could facilitate the elimination process. Methods A total of 28 indicators were identified within the six core sections of the ASU form and these were evaluated for the period 2013–2018. These indicators relate to the incidence of measles/rubella; epidemiological investigation of cases; investigation of outbreaks; performance of the surveillance system; population immunity levels; and implementation of supplemental immunization activities (SIAs). Results From 2013 to 2018, epidemiological and laboratory analyses of measles cases in Italy improved substantially, allowing timely investigation in 2017 and 2018 of most outbreak and sporadic cases and identification of the majority of genotypic variants. Moreover, since 2017, vaccination coverage has increased significantly. Despite these improvements, several areas of concern emerged, prompting the following recommendations: i) improve outbreak monitoring; ii) strengthen the MoRoNet network; iii) increase the number of SIAs; iv) reinforce vaccination services; v) maintain regional monitoring; vi) design effective communication strategies; vii) foster the role of general practitioners and family paediatricians. Conclusions The review of national ASUs is a crucial step to provide the NVC with useful insights into the elimination process and to guide the development of targeted interventions. Against this background, the seven recommendations proposed by the NVC have been shared with the Italian Ministry of Health and the Technical Advisory Group on measles and rubella elimination and have been incorporated into the new Italian Elimination Plan 2019–2023 as a technical aid to facilitate the achievement of disease elimination goals

Evolution of occupational asthma: Does cessation of exposure really improve prognosis?

SummaryAimTo assess the evolution of occupational asthma (OA) depending on whether the patient avoids or continues with exposure to the offending agent.MethodsStudy in patients diagnosed with OA using a specific inhalation challenge. Patients underwent the following examinations on the same day: clinical interview, physical examination, forced spirometry, methacholine test and determination of total IgE. Clinical improvement, deterioration or no change were defined according to the changes seen on the GINA severity scale at the time of diagnosis.ResultsOf the 73 patients finally included, 55 had totally ended exposure and 18 continued to be exposed at work. Clinical improvement was observed in 47% of those who had terminated exposure and in 22% of those who remained exposed; clinical deterioration was observed in 14% and 17% respectively (p = 0.805). Logistical regression analysis, including the type of agent and the persistence or avoidance of exposure among the variables, did not show any predictive factors of clinical evolution. Similarly, the changes in FEV1 and in bronchial hyperresponsiveness were not associated with the avoidance or continuation of exposure to the causative agent.ConclusionsAvoiding exposure to the causative agent in patients with OA does not seem to improve prognosis in this disease. Despite these findings, there is insufficient evidence to recommend a change in current management guidelines

Severe Systemic Lupus Erythematosus presentation in patient with alternative complement pathway mutations

Systemic lupus erythematosus (SLE) is an autoimmune disease which can involve almost any organ, making its difficult therapeutic approach. Immune complex deposition can often activate complement, accounting for many of SLE clinical manifestations and laboratory findings. We present a case of a patient who presented with acute pancreatitis and acute kidney injury as onset manifestations of SLE, later developing neurological manifestations, who was successfully treated with rituximab, plasma exchange and steroids as induction therapy. Persistently low C3 level led to a genetic analysis of the complement system components. We found three polymorphisms in the alternative pathway of complement regulators (complement factor H c2669 G>T, p.Ser890Ile and c3019 G>T, p.Val1007Leu and complement factor I c.482+6 G>T), two of which have been correlated with atypical haemolytic uraemic syndrome and dense deposit disease and also complement factor H -related protein (CFHR1 and CFHR3) mutations by deletion. This raises the question whether these polymorphisms and mutations played any role in our patient’s clinical course.info:eu-repo/semantics/publishedVersio

Zone design of specific sizes using adaptive additively weighted voronoi diagrams

Territory or zone design processes entail partitioning a geographic space, organized as a set of areal units, into different regions or zones according to a specific set of criteria that are dependent on the application context. In most cases, the aim is to create zones of approximately equal sizes (zones with equal numbers of inhabitants, same average sales, etc.). However, some of the new applications that have emerged, particularly in the context of sustainable development policies, are aimed at defining zones of a predetermined, though not necessarily similar, size. In addition, the zones should be built around a given set of seeds. This type of partitioning has not been sufficiently researched; therefore, there are no known approaches for automated zone delimitation. This study proposes a new method based on a discrete version of the adaptive additively weighted Voronoi diagram that makes it possible to partition a two-dimensional space into zones of specific sizes, taking both the position and the weight of each seed into account. The method consists of repeatedly solving a traditional additively weighted Voronoi diagram, so that each seed?s weight is updated at every iteration. The zones are geographically connected using a metric based on the shortest path. Tests conducted on the extensive farming system of three municipalities in Castile-La Mancha (Spain) have established that the proposed heuristic procedure is valid for solving this type of partitioning problem. Nevertheless, these tests confirmed that the given seed position determines the spatial configuration the method must solve and this may have a great impact on the resulting partition

SEOM clinical guidelines in early stage breast cancer (2018)

Breast cancer is the most common cancer in women in our country and it is usually diagnosed in the early and potentially curable stages. Nevertheless, around 20–30% of patients will relapse despite appropriate locoregional and systemic therapies. A better knowledge of this disease is improving our ability to select the most appropriate therapy for each patient with a recent diagnosis of an early stage breast cancer, minimizing unnecessary toxicities and improving long-term efficacy