Role of brain perfusion SPECT with 99mTc HMPAO in the assessment of response to drug therapy in patients with autoimmune vasculitis: a prospective study

Abstract BACKGROUND: The diagnosis of vasculitis in the brain remains a quite difficult achievement. To the best of our knowledge, there is no imaging method reported in literature which is capable of reaching to a diagnosis of vasculitis with very high sensitivity. AIM: The aim of this study was to determine whether perfusion brain single photon emission computed tomography (SPECT) can be usefully employed in monitoring the treatment of vasculitis, allowing treating only potentially responder patients and avoiding the side effects on patients who do not respond. MATERIALS AND METHODS: Twenty patients (two males and 18 females) suffering from systemic lupus erythematosus (SLE; n = 5), Behcet's disease (BD; n = 5), undifferentiated vasculitis (UV; n = 5), and Sjogren's syndrome (SS; n = 5) were included in the study. All patients underwent a wide neurological anamnestic investigation, a complete objective neurological examination and SPECT of the brain with 99mTc-hexamethyl-propylene-aminoxime (HMPAO). The brain SPECT was then repeated after appropriate medical treatment. The neurological and neuropsychiatric follow-up was performed at 6 months after the start of the treatment. RESULTS: Overall, the differences between the scintigraphic results obtained after and before the medical treatment indicated a statistically significant increase of the cerebral perfusion (CP). In 19 out of 200 regions of interest (ROI) studied, the difference between pre- and post treatment percentages had negative sign, indicating a worsening of CP. This latter event has occurred six times (five in the same patients) in the UV, 10 times (eight in the same patients) in the SLE, never in BD, and three times (two in the same patient) in the SS. CONCLUSION: The reported results seem to indicate the possibility of identifying, by the means of a brain SPECT, responder and nonresponder (unchanged or worsened CP) patients, affected by autoimmune vasculitis, to the therapy

Backyard housing in Gauteng: An analysis of spatial dynamics

This article examines the phenomenon of backyard housing in Gauteng, a prominent driver of urban spatial change in South Africa’s housing market. Backyard housing in South Africa increasingly attracts the attention of policymakers because of the large number of households that this sector accommodates. Moreover, the role played by backyard housing in the overall small-scale rental-housing sector is significant, particularly in Gauteng where a large proportion of households rent their primary dwelling. Drawing on quantitative geo-demographic data from GeoTerraImage (GTI) (2010), Knowledge Factory’s Cluster Plus (2010) as well as StatsSA Census 2011, this article documents the spatial footprint of backyard housing in Gauteng and examines the implications of the findings for infrastructure service planning at the municipal scale.&nbsp

Specific issues concerning the management of patients on the waiting list and after liver transplantation

The present document is a second contribution collecting the recommendations of an expert panel of transplant hepatologists appointed by the Italian Association for the Study of the Liver (AISF) concerning the management of certain aspects of liver transplantation, including: the issue of prompt referral; the management of difficult candidates; malnutrition; living related liver transplants; hepatocellular carcinoma; and the role of direct acting antiviral agents before and after transplantation. The statements on each topic were approved by participants at the AISF Transplant Hepatology Expert Meeting organized by the Permanent Liver Transplant Commission in Mondello on 12-13 May 2017. They are graded according to the GRADE grading system

Protective personality traits: High openness and low neuroticism linked to better memory in multiple sclerosis

Memory impairment in multiple sclerosis (MS) is common, although few risk/protective factors are known

A living laboratory approach in the design of the user requirements of a spatial information platform

The purpose of this article is to introduce the development of the Regional Spatial Profiler – a spatial information and modelling platform – for the Department of Science and Technology. Based on the steps set out in action research, this platform is aimed at strengthening spatial planning at a regional scale by providing accessible and comparable spatial information (of current and past trends) to planning practitioners in government. To ensure that the Profiler met the requirements and expectations of users, and would be used by practitioners, its user-interface and future content requirements were developed using four living laboratories (living labs): the Cape Winelands, Ugu and Amatole District Municipalities, and Mangaung Local (now Metro) Municipality. Municipal participants and project team members believed that a living-lab process was the appropriate way to develop the Profiler and experienced the living-lab Profiler as a positive initiative; however, due to time, budget and technical constraints, it was a temporally – specific and fragmented project initiative. What would be required in future project phases would be a longer time frame and continued user involvement in multiple project phases

Sharing Stories as Legacy: What Matters to Older Adults?

Objectives: Legacy allows individuals to make meaning of their lives by passing on their experiences and beliefs to younger people and influencing their perspectives, perceptions, and actions. This mixed-methods study investigated: (1) What is important for older adults to share as legacy with families, friends and others, based on the types and features of their digital stories ? and (2) How do older adults’ digital stories affect story viewers? Methods: One hundred adults aged between 55 and 95 years participated in ten-week Elder’s Digital Storytelling courses and created short digital stories. Using the content analysis approach, the story transcripts were thematically analyzed and iteratively coded by three researchers and the results were quantified. A diverse group of 60 viewers at a public event provided their reactions to the digital stories. Results: The findings revealed that character, place, and family were chosen as the primary types by the older adults for their legacy digital stories. Accomplishment and career/school were the next most prominent story types. Moreover, these digital stories appeared to have a powerful impact on the viewers. Discussion: A digital story is a powerful artifact to communicate an older person’s legacy because it is based on familiar forms of communication, such as speech and photographs. The major legacy themes chosen by the older adults align with the findings of the research literature. The feedback from the viewers of the digital stories reflects these as a source of life wisdom and legacy for younger generations. Funding details: This work was supported by the AGE-WELL National Centre of Excellence (AW CRP 2015-WP4.3)

Urea-induced ROS generation causes insulin resistance in mice with chronic renal failure.

Although supraphysiological concentrations of urea are known to increase oxidative stress in cultured cells, it is generally thought that the elevated levels of urea in chronic renal failure patients have negligible toxicity. We previously demonstrated that ROS increase intracellular protein modification by O-linked β-N-acetylglucosamine (O-GlcNAc), and others showed that increased modification of insulin signaling molecules by O-GlcNAc reduces insulin signal transduction. Because both oxidative stress and insulin resistance have been observed in patients with end-stage renal disease, we sought to determine the role of urea in these phenotypes. Treatment of 3T3-L1 adipocytes with urea at disease-relevant concentrations induced ROS production, caused insulin resistance, increased expression of adipokines retinol binding protein 4 (RBP4) and resistin, and increased O-GlcNAc–modified insulin signaling molecules. Investigation of a mouse model of surgically induced renal failure (uremic mice) revealed increased ROS production, modification of insulin signaling molecules by O-GlcNAc, and increased expression of RBP4 and resistin in visceral adipose tissue. Uremic mice also displayed insulin resistance and glucose intolerance, and treatment with an antioxidant SOD/catalase mimetic normalized these defects. The SOD/catalase mimetic treatment also prevented the development of insulin resistance in normal mice after urea infusion. These data suggest that therapeutic targeting of urea-induced ROS may help reduce the high morbidity and mortality caused by end-stage renal disease

Assessment of spatial data infrastructures

A Spatial Data Infrastructure (SDI) is an evolving concept, essentially consisting of policies, institutional arrangements, Geographical Information Systems (GISs), data bases, networks, Web services and portals to facilitate and coordinate the availability, exchange and sharing of geospatial data and services between stakeholders from different levels. This article aims to provide some information on the role and value of SDIs and their potential relationship with, and contribution to other geospatial and evidence-based tools and technologies within the South African planning context and system. For this, it provides a brief overview and comparison of the key characteristics of the SDIs in South Africa, China, Brazil, Australia and India. The article highlights some of the complexities and use of an SDI and the value of, and need for an SDI to support the spatial and land development planning envisaged in the Spatial Planning and Land Use Management Act (SPLUMA)