Pilot optical alignment

PILOT (Polarized Instrument for Long wavelength Observations of the Tenuous interstellar medium) is a balloonborne astronomy experiment designed to study the polarization of dust emission in the diffuse interstellar medium in our Galaxy. The PILOT instrument allows observations at wavelengths 240 μm and 550 μm with an angular resolution of about two arcminutes. The observations performed during the two first flights performed from Timmins, Ontario Canada, and from Alice-springs, Australia, respectively in September 2015 and in April 2017 have demonstrated the good performances of the instrument. Pilot optics is composed of an off axis Gregorian type telescope combined with a refractive re-imager system. All optical elements, except the primary mirror, which is at ambient temperature, are inside a cryostat and cooled down to 3K. The whole optical system is aligned on ground at room temperature using dedicated means and procedures in order to keep the tight requirements on the focus position and ensure the instrument optical performances during the various phases of a flight. We’ll present the optical performances and the firsts results obtained during the two first flight campaigns. The talk describes the system analysis, the alignment methods, and finally the inflight performances

Pilot optical alignment

PILOT (Polarized Instrument for Long wavelength Observations of the Tenuous interstellar medium) is a balloonborne astronomy experiment designed to study the polarization of dust emission in the diffuse interstellar medium in our Galaxy. The PILOT instrument allows observations at wavelengths 240 μm (1.2THz) with an angular resolution about two arc-minutes. The observations performed during the first flight in September 2015 at Timmins, Ontario Canada, have demonstrated the optical performances of the instrument

Synovial fluid crystal identification by electron microscopy

Introdução: A identificação de cristais no líquido sinovial é feita habitualmente através do exame microscópico com luz ordinária, luz compensada e algumas colorações. No entanto, dadas as suas pequenas dimensões e diminutas concentrações no líquido sinovial, por vezes nem mesmo após centrifugação estes se conseguem identificar utilizando esses métodos. Objectivos: Analisar a detecção de cristais no líquido sinovial de doentes com monoartrite não infecciosa, sem história de traumatismo ou patologia osteoarticular antecedente, em microscopia de luz polarizada e em microscopia electrónica. Material e Métodos: Foram avaliadas amostras de líquido sinovial de doentes com monoartrite não infecciosa, sem história de traumatismo ou patologia osteoarticular prévia. Os líquidos sinoviais obtidos foram observados numa fase inicial no microscópio de luz polarizada e com a coloração com vermelho de alizarina. Posteriormente, analisámos as mesmas amostras por microscopia electrónica de transmissão e espectroscopia de dispersão de energia, tentando identificar cristais e caracterizar a sua composição química. Resultados:Foram observadas 45 preparações de 23 amostras de líquido sinovial. Por microscopia de luz polarizada identificámos cristais em 11 desses líquidos, 3 com pirofosfato de cálcio, 6 com «cristais contendo cálcio» e 2 com monourato de sódio. Nas restantes 12 amostras não identificámos qualquer tipo de cristal e os líquidos apresentavam características mecânicas.As amostras foram posteriormente analisadas por microscopia electrónica de transmissão convencional e espectroscopia de dispersão de energia. Confirmámos a presença dos cristais anteriormente identificados e na totalidade das 12 amostras sem cristais identificados por microscopia de luz polarizada encontrámos cristais contendo cálcio. Discussão: Os microcristais parecem ser um achado universal em líquidos sinoviais de doentes com osteoartrose. A prevenção da sua formação poderá contribuir para travar a destruição articular nesta patologia. BACKGROUND In clinical practice crystal identification in synovial fluid is made by polarized light microscopy and with some specific stainings. Nevertheless, sometimes we are unable to identify crystals by these means, either because they are too small or because they are widespread on the fluid. AIMS To compare the identification of crystals in synovial fluid from patients with non-infectious monoarthritis but no history of local trauma or articular disease, using polarized light and electronic microscopy. METHODS We analized synovial fluid samples from patients with non-infectious monoarthritis and no history of local trauma or articular disease. First we used a polarized light microscope and alizarin red staining. Later we used conventional transmission electron microscopy and energy dispersive spectroscopy, in order to identify and characterize crystals. RESULTS Fourty-five samples from 23 synovial fluids were analyzed. Under polarized light microscopy we identified crystals on 11 samples: 3 with calcium pyrophosphate crystals, 6 with calcium basic phosphate crystals and 2 with sodium monourate crystals. On the remaining 12 samples we were unable to identify crystals. Samples were then analyzed by conventional transmission electron microscopy and energy dispersive spectroscopy confirming the presence of the previously identified crystals. On the remainig 12 samples we were able to identify calcium basic phosphate crystals. DISCUSSION Microcrystals seem to be an universal finding in synovial fluid of patients with osteoarthritis. The prevention of their deposition in joints might contribute to stop joint damage in this disease.publishersversionpublishe

Foreign body reaction to palm leaf

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Fetal safety profile of drugs used in the treatment of inflammatory rheumatic diseases

The high prevalence of inflammatory rheumatic diseases in women of childbearing age increases the risk of exposure to antirheumatic agents during conception, pregnancy and breast feeding. The decision for pharmacological treatment initiation/ maintenance should be the result between the severity of maternal disease and the risk/benefits with treatment. The aim of this paper was to review recent literature about drug fetal safety profile, strength the importance of monitoring the pregnancy in patients with inflammatory rheumatic diseases and stress the need for further research in this area.publishersversionpublishe

EULAR recommendations for calcium pyrophosphate deposition. Part II: management

Item does not contain fulltextOBJECTIVES: To develop evidence-based recommendations for management of calcium pyrophosphate deposition (CPPD). METHODS: A multidisciplinary guideline development group of 15 experts, representing 10 European countries, generated key propositions for management of CPPD using a Delphi consensus approach. For each recommendation research evidence was searched systematically. Whenever possible, the effect size and number needed to treat for efficacy and RR or OR for side effects were calculated for individual treatment modalities. Strength of recommendation was assessed by the European League Against Rheumatism visual analogue scale. RESULTS: Nine key recommendations were generated, including topics for general management, treatment of acute attacks, prophylaxis against recurrent acute attacks and management of chronic symptoms. It was recommended that optimal treatment requires both non-pharmacological and pharmacological treatments. For acute CPP crystal arthritis, cool packs, temporary rest and joint aspiration combined with steroid injection are often sufficient. For prophylaxis or chronic inflammatory arthritis with CPPD, oral non-steroidal anti-inflammatory drugs with gastroprotective treatment and/or low-dose colchicine 0.5-1.0 mg daily may be used. Other recommendations included parenteral or oral corticosteroid for acute CPP arthritis in those unresponsive or unsuited to other measures, and low-dose corticosteroid, methotrexate or hydroxychloroquine for chronic inflammatory arthritis with CPPD. Asymptomatic CPPD requires no treatment. Strength of recommendations varies from 79% to 95%. CONCLUSION: Nine key recommendations for management of CPP crystal associated arthritis were developed using both research evidence and expert consensus. Strength of recommendations was provided to assist the application of these recommendations

European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis

Item does not contain fulltextOBJECTIVES: To agree terminology and to develop recommendations for the diagnosis of calcium pyrophosphate deposition (CPPD). METHODS: The European League Against Rheumatism (EULAR) CPPD Task Force, comprising 15 experts from 10 countries, agreed the terms and recommendations for diagnosis of CPPD using a Delphi consensus approach. Evidence was systematically reviewed and presented in terms of sensitivity, specificity and positive likelihood ratio (LR) to support diagnosis; ORs were used for association. Strength of recommendation (SOR) was assessed by the EULAR visual analogue scale. RESULTS: It was agreed that 'CPPD' should be the umbrella term that includes acute calcium pyrophosphate (CPP) crystal arthritis, osteoarthritis (OA) with CPPD and chronic CPP crystal inflammatory arthritis. Chondrocalcinosis (CC) defines cartilage calcification, most commonly due to CPPD and detected by imaging or histological examination. A total of 11 key recommendations were generated on the topics of clinical features, synovial fluid (SF) examination, imaging, comorbidities and risk factors. Definitive diagnosis of CPPD relies on identification of SF CPP crystals. Rapid onset inflammatory symptoms and signs are suggestive but not definitive for acute CPP crystal arthritis. Radiographic CC is not highly sensitive or specific, whereas ultrasonography appears more useful (LR=24.2, 95% CI 3.51 to 168.01) for peripheral joints. Recognised risk factors for CPPD include ageing, OA and metabolic conditions such as primary hyperparathyroidism, haemochromatosis and hypomagnesaemia; familial forms are rare. SORs varied from 53 to 99 (maximum 100). CONCLUSION: New terms for CPPD were agreed and 11 key recommendations for diagnosis of CPPD were developed using research evidence and expert consensus

2016 updated EULAR evidence-based recommendations for the management of gout.

New drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of the 2006 recommendations. The EULAR task force consisted of 15 rheumatologists, 1 radiologist, 2 general practitioners, 1 research fellow, 2 patients and 3 experts in epidemiology/methodology from 12 European countries. A systematic review of the literature concerning all aspects of gout treatments was performed. Subsequently, recommendations were formulated by use of a Delphi consensus approach. Three overarching principles and 11 key recommendations were generated. For the treatment of flare, colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), oral or intra-articular steroids or a combination are recommended. In patients with frequent flare and contraindications to colchicine, NSAIDs and corticosteroids, an interleukin-1 blocker should be considered. In addition to education and a non-pharmacological management approach, urate-lowering therapy (ULT) should be considered from the first presentation of the disease, and serum uric acid (SUA) levels should be maintained at<6 mg/dL (360 µmol/L) and <5 mg/dL (300 µmol/L) in those with severe gout. Allopurinol is recommended as first-line ULT and its dosage should be adjusted according to renal function. If the SUA target cannot be achieved with allopurinol, then febuxostat, a uricosuric or combining a xanthine oxidase inhibitor with a uricosuric should be considered. For patients with refractory gout, pegloticase is recommended. These recommendations aim to inform physicians and patients about the non-pharmacological and pharmacological treatments for gout and to provide the best strategies to achieve the predefined urate target to cure the disease