Managing urinary tract infections

Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-stage renal failure. The relevance and the sequence of the renal imaging following initial UTI, and the role of antimicrobial prophylaxis and surgical intervention are currently undergoing an intense debate. Prompt treatment of UTI and appropriate follow-up of those at increased risk of recurrence and/or renal scarring are important

Phosphodiesterase 4 inhibition in the treatment of psoriasis, psoriatic arthritis and other chronic inflammatory diseases

Agents which increase intracellular cyclic adenosine monophosphate (cAMP) may have an antagonistic effect on pro-inflammatory molecule production so that inhibitors of the cAMP degrading phosphodiesterases have been identified as promising drugs in chronic inflammatory disorders. Although many such inhibitors have been developed, their introduction in the clinic has been hampered by their narrow therapeutic window with side effects such as nausea and emesis occurring at sub-therapeutic levels. The latest generation of inhibitors selective for phosphodiesterase 4 (PDE4), such as apremilast and roflumilast, seems to have an improved therapeutic index. While roflumilast has been approved for the treatment of exacerbated chronic obstructive pulmonary disease (COPD), apremilast shows promising activity in dermatological and rheumatological conditions. Studies in psoriasis and psoriatic arthritis have demonstrated clinical activity of apremilast. Efficacy in psoriasis is probably equivalent to methotrexate but less than that of monoclonal antibody inhibitors of tumour necrosis factor (TNFi). Similarly, in psoriatic arthritis efficacy is less than that of TNF inhibitors. PDE4 inhibitors hold the promise to broaden the portfolio of anti-inflammatory therapeutic approaches in a range of chronic inflammatory diseases which may include granulomatous skin diseases, some subtypes of chronic eczema and probably cutaneous lupus erythematosus. In this review, the authors highlight the mode of action of PDE4 inhibitors on skin and joint inflammatory responses and discuss their future role in clinical practice. Current developments in the field including the development of topical applications and the development of PDE4 inhibitors which specifically target the subform PDE4B will be discussed

Everyday-Life Business Deviance Among Chinese SME Owners

Despite its prevalence in emerging economies, everyday-life business deviance (EBD) and its antecedents have received surprisingly little research attention. Drawing on strain theory and the business-ethics literature, we develop a socio-psychological explanation for this deviance. Our analysis of 741 owners of Chinese small- and medium-sized enterprises (SMEs) suggests that materialism and trust in institutional justice affect EBD both directly and indirectly in a relationship mediated by the ethical standards of SME owners. These findings have important implications for researching deviant business behavior within SMEs

Tissue-enhanced plasma proteomic analysis for disease stratification in amyotrophic lateral sclerosis

Motor Neurone Disease Association (Malaspina/Apr13/817–791). Wellcome Trust support to a parallel study (Pathfinder Award, grant number 103208)

Robbery of Financial InstitutionsTHE ROBBERY OF FINANCIAL INSTITUTIONS- EXECUTIVE SUMMARY* by

of view or opinions expressed in this report are those o

Outcome Evaluation in Adult Diaorrhea, a new validation proposal based on Quality of Life Concepts endpoints

The currently used main endpoint in comparing treatments in acute diarrhoea is the Number of Unformed Stools (NUS) since baseline. This measure has no direct link with Quality of Life. We investigated the perception of the severity of related symptoms. A randomized controlled study (n=359) compared the efficacy of two enkephalinase inhibitors in adult outpatients suffering from acute gastroenteritis. A checklist of 18 symptoms was documented at D0, D3 and D6. Construct validation was carried out by a factor analysis with quartimax rotation to find the best scale. From factor analysis, 8 symptoms and signs were finally considered. The internal consistency of the scale was confirmed by Cronbach Alpha values of 0.78, .83 and .82 at each examination. Finally, as a symptom and signs checklist, AD3S both addresses clinical endpoint as well as Well Being and Health Related Quality of Life concern. AD3S consists at our knowledge the only validated scale in this pathology.Ce travail examine la pertinence d'utilisation alternative en tant que critere de jugement principal d'une liste de symptomes dans la pathologie de la diarrhée aigue de l'adulte. L'outil denommé AD3S combine 8 symptomes, dont l'aspect discriminant/convergent a été confirmé par analyse factorielle confirmatoire. On met aussi en évidence la proche relation d'Ad3S en tant que critère voisin de QUalité de Vie