Calcinosis in juvenile dermatomyositis: Updates on pathogenesis and treatment

Calcinosis, or the deposition of insoluble calcium salts in the skin, subcutaneous tissue, fascia, tendons, and muscles, is a feared complication of juvenile dermatomyositis. Calcinosis is estimated to affect up to 40% of patients with juvenile dermatomyositis and contributes to significant disease morbidity. Calcinosis can be challenging to treat, and the most effective treatment remains unknown because of a lack of comparative studies. We aim to review the literature published in the last 5 years to summarize updates on the pathogenesis and treatment of calcinosis in juvenile dermatomyositis and describe future areas for research

Inmovilización fotocatalítca de nanopartículas de TiO2 sobre películas de polietileno de baja densidad y su aplicación como superficies autolimpiantes fotoinducidas

Los procesos fotocatalíticos sobre TiO2 han emergido como una alternativa promisoria para ser aplicados como superficies autolimpiantes y antimicrobianas foto-inducidas

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reproductive Variables And Risk Of Breast Cancer: A Case-control Study Carried Out In Brazil [variáveis Reproductivas E Risco Para Câncer De Mama: Estudo Caso-controle Desenvolvido No Brasil.]

The purposes of the study were to identify reproductive risk factors for breast cancer and to test the hypothesis that reproductive variables operate through a common factor: the number of times that the mammary tissue has been exposed to the endocrine changes of the ovulatory cycle. The study was conducted in Campinas, and was based on interviews with 348 women with breast cancer first diagnosed between October 1979 and August 1984. The control group consisted of 348 women with healthy breasts. The data were obtained in interviews in the home, which were conducted using a structured questionnaire that had been pretested. The data were analyzed by calculation of the odds ratio, Mantel's statistic, to determine the linear trend; by Cornfield's method to calculate the confidence intervals; and by logistic regression adjusted for paired data. It was found that nulliparity, not having breast-fed, and a high number of menstrual cycles were significantly associated with the risk of presenting the disease. In the multivariate analysis, which included all the women, the only variable associated with the risk of mammary cancer was no history of breast-feeding. When the nulliparas were excluded, logistic regression showed that higher age of the woman at her first delivery was significantly associated with breast cancer.11529310

Reproductive Variables And Risk Of Benign Breast Diseases. A Case-control Study [variáveis Reproductivas E Risco Para Doenças Benignas De Mama. Estudo Caso-controle.]

The purpose of the study was the identification of risk factors for benign breast diseases (BBD); 257 women with BBD diagnosed through pathological anatomy or cytology and a matched control for each were studied. Subjects were selected at The State University of Campinas Hospital and at a private clinic. To enter the study cases had to have a first diagnosis of BBD between October 1979 and August 1984. The following BBD were considered: dysplasia, fibroadenoma, cystic disease, papilloma and ductal ectasia. Reproductive variables were studied as risk factors, including menstrual ovulatory cycles. The date on which the BBD was diagnosed was defined as the index date. For controls, data were considered up to when they had reached the same age as the matched case on the occasion of her diagnosis. Nulliparity was a risk factor for BBD. First birth at or above age 30 was a protective factor. Women who had used contraceptive pills for two or more years had a significantly lower risk than those who had never used them. The number of menstrual ovulatory cycles was not found to be associated with the risk of BBD. The results obtained from the study of Brazilian women confirm some of the conclusions found in the literature, mainly those that associate some reproductive variables with the risk of BBD. A few of these variables are also confirmed as risk factors for breast cancer.This study identified risk factors for benign breast diseases (BBD) and 257 women with BBD diagnosed through pathological anatomy or cytology and a matched control for each were studied. Subjects were selected at the State University of Campinas Hospital, Brazil, and at a private clinic. To enter the study, cases were first diagnosed with BBD between October 1979-August 1984. The BBDs which were considered were: dysplasia, fibroadenoma, cystic disease, papilloma, and ductal ectasia. Reproductive variables were studied as risk factors and included menstrual ovulatory cycles. The date on which BBD was diagnosed was defined as the index date. For controls, data were considered up to when they had reached the same age as the matched case on the occasion of diagnosis. Nulliparity was a risk factor for BBD. First birth or age above 30 was a protective factor. Women who had used oral contraceptives for 2 or more years had a significantly lower risk than those who had never used them. The number of menstrual ovulatory cycles was not found to be associated with BBD risk. Results obtained from this study Brazilian women confirm some of the conclusions found in the literature, mainly those that associate some reproductive variables with the risk of BBD. A few of these variables are also confirmed as risk factors for breast cancer. (author's modified)24538739

Adequacy Of Contraceptive Pill Use Among Women In Union [adequação Do Uso De Pílula Anticoncepcional Entre Mulheres Unidas.]

A total of 2,364 women in marital union, 15 to 49 years of age, were interviewed at home. They lived in poor neighbourhoods in the metropolitan area and in the interior of S. Paulo State, Brazil. The prevalence of contraceptive pill use and the association between socio-demographic characteristics of users and the presence or not of risk factors for pill use were studied. One fourth (25.8 percent) of the women interviewed were using contraceptive pills. Prevalence was higher among younger women, those with no more than one live child and those who had completed between three and eight grades of schooling. Over 40 percent of the users referred having risk factors for pill use at the time they initiated the method. No association was found between age and the percentage of women with risk factors. This percentage increased with number of children and decreased with women's schooling. The fact that pills were prescribed or obtained through the health system was not associated with the proportion of users with risk factors. The percentage of users with risk factors was similar when comparing women who did not consult any health service before initiating use with those who had consulted a public service. The prevalence of use observed in this study is similar to that described by other authors. Results show that the health system in the State of S. Paulo played no role in the improvement in the prescription of hormonal contraceptive pills. Central policy seemed not to have filtered down to the peripheral areas of the system.2529610