Comparing paediatric- and adult-onset linear morphoea in a large tertiary-referral scleroderma centre

Background: Linear morphoea is a severe morphoea subtype associated with extracutaneous manifestations, potentially permanent disfigurement and functional impairment. Linear morphoea is more prevalent in paediatric patients, and knowledge of disease in adults is limited. The objective of this study was to compare paediatric- and adult-onset linear morphoea, in an exclusively adult population. / Methodology: This was a retrospective cohort study of adult patients with linear morphoea seen over a 3-year period at a single-site adult tertiary-referral Connective Tissue Disease centre. Clinical markers of disease severity and course, including anatomical distribution, extracutaneous manifestations, cutaneous symptoms, associated autoimmunity, inflammatory blood parameters, Dermatology Life Quality Index scores, treatment requirements and modified Localised Scleroderma Activity Tool were assessed and compared in paediatric- and adult-onset linear morphoea. / Results: Of 298 patients with morphoea seen during the study period, 135 had linear morphoea and 133 were included in the study. Most were female (78.9%), the mean age was 36.5 years and almost half (43.6%) had adult-onset disease. Disease was similarly severe between groups with regard to anatomical distribution, cutaneous symptoms (n = 89, 66.9%), extracutaneous manifestations (n = 76, 57.1%), antinuclear antibody–positivity (n = 40, 40.4%), raised erythrocyte sedimentation rate (n = 27, 25.0%) and associated autoimmune diagnoses (n = 15, 11.3%). Prescribed treatments were similar between groups; 73.7% receiving methotrexate and almost one-third (32.3%) requiring more than one steroid-sparing agent. Those with paediatric-onset had more disease-related damage, with a mean modified Localised Scleroderma Skin Damage Index score of 19.5 (95% confidence interval: 17.0–22.0) versus 8.1 (95% confidence interval: 4.4–11.8; p < 0.001). Significantly more patients with adult-onset linear morphoea had quiescent disease (p = 0.0332), and even after correcting for disease duration, paediatric-onset patients still had 2.6 times greater odds of active disease (odds ratio = 2.59, 95% confidence interval: 0.9–7.6; p = 0.083). / Conclusion: Linear morphoea in adults can be a severe disease with extracutaneous, autoimmune and systemic features. Adults with paediatric-onset disease appear to have more severe cumulative damage, greater functional impairment and ongoing disease activity. This patient subgroup may require particularly close monitoring and more aggressive therapy

Ultra-deep GEMINI near-infrared observations of the bulge globular cluster NGC 6624

We used ultra-deep $J$ and $K_s$ images secured with the near-infrared GSAOI camera assisted by the multi-conjugate adaptive optics system GeMS at the GEMINI South Telescope in Chile, to obtain a ($K_s$, $J-K_s$) color-magnitude diagram (CMD) for the bulge globular cluster NGC 6624. We obtained the deepest and most accurate near-infrared CMD from the ground for this cluster, by reaching $K_s$ $\sim$ 21.5, approximately 8 magnitudes below the horizontal branch level. The entire extension of the Main Sequence (MS) is nicely sampled and at $K_s$ $\sim$ 20 we detected the so-called MS "knee" in a purely near-infrared CMD. By taking advantage of the exquisite quality of the data, we estimated the absolute age of NGC 6624 ($t_{age}$ = 12.0 $\pm$ 0.5 Gyr), which turns out to be in good agreement with previous studies in the literature. We also analyzed the luminosity and mass functions of MS stars down to M $\sim$ 0.45 M$_{\odot}$ finding evidence of a significant increase of low-mass stars at increasing distances from the cluster center. This is a clear signature of mass segregation, confirming that NGC 6624 is in an advanced stage of dynamical evolution.Comment: Accepted for publication by ApJ. 39 pages, 19 figures, 1 tabl

High-resolution Extinction Map in the Direction of the Bulge Globular Cluster NGC 6440

We used optical images acquired with the UVIS channel of the Wide Field Camera 3 on board the Hubble Space Telescope to construct the first high-resolution extinction map in the direction of NGC 6440, a globular cluster located in the bulge of our Galaxy. The map has a spatial resolution of 0.\u20335 over a rectangular region of about 160\u2033 7 240\u2033 around the cluster center, with the long side in the northwest/southeast direction. We found that the absorption clouds show patchy and filamentary substructures with extinction variations as large as \u3b4E(B-V) 3c0.5 mag. We also performed a first-order proper motion analysis to distinguish cluster members from field interlopers. After the field decontamination and the differential reddening correction, the cluster sequences in the color-magnitude diagram appear much better defined, providing the best optical color-magnitude diagram so far available for this cluster

Prevalence of HBV-genotypes in immigrants affected by HBV-related chronic active hepatitis

BACKGROUND: The genetic heterogeneity of the HBV genome has been established and eight genotypes can be classified according to the criterion of >8% differences in the complete nucleotide sequence of the viral genome. AIMS: To evaluate the prevalence of HBV-infection in a population of immigrants and to determine in patients with detectable serum HBV-DNA the HBV-genotypes. METHODS: Between January 2005 and December 2005 a total of 556 immigrants were tested for HBsAg. In HBsAg positive patients the biochemical and virological activity of infection and the possible presence of co-infections (HCV, HDV, HIV) were evaluated. In patients with detectable serum HBV DNA, the HBV-genotype was determined by INNOLiPA. RESULTS: Among the 556 subjects tested, 60 (10.7%) resulted HBsAg positive. All were men, and 42 (70%) come from Africa, 10 (16.6%) from Asia and 9 (14.4%) from East-Europe. 28/60 (46.6%) patients presented normal ALT levels (<40 IU/L) and undetectable serum HBV DNA (<100 copies/mL in real-time PCR), while 32 (53.4%) patients had ALT levels above laboratory normal values and detectable serum HBV DNA. Genotype distribution was as follow: genotype E, 16 (50%), genotype D, 9 (28.1%), genotype A, 7 (21.9%). CONCLUSION: Our study evidences a moderate prevalence of HBV-infection in immigrants, particularly in sub-Saharan African people, and the potentiality of migratory flow in the introduction of genotype non-D hepatitis B virus, potentially characterized by a different natural history and, possibly, a different response to antiviral treatment

Analysis of short-term blood pressure variability in pheochromocytoma/paraganglioma patients

Data on short-term blood pressure variability (BPV), which is a well-established cardiovascular prognostic tool, in pheochromocytoma and paraganglioma (PPGL) patients is still lack and conflicting. We retrospectively evaluated 23 PPGL patients referred to our unit from 2010 to 2019 to analyze 24 h ambulatory blood pressure monitoring (24-h ABPM)-derived markers of short-term BPV, before and after surgical treatment. PPGL diagnosis was assessed according to guidelines and confirmed by histologic examination. The 24-h ABPM-derived markers of short-term BPV included: circadian pressure rhythm; standard deviation (SD) and weighted SD (wSD) of 24-h, daytime, and night-time systolic and diastolic blood pressure (BP); average real variability (ARV) of 24-h, daytime, and night-time systolic and diastolic BP. 7 males and 16 females of 53 ± 18 years old were evaluated. After surgical resection of PPGL we found a significant decrease in 24-h systolic BP ARV (8.8 ± 1.6 vs. 7.6 ± 1.3 mmHg, p &lt; 0.001), in 24-h diastolic BP ARV (7.5 ± 1.6 vs. 6.9 ± 1.4 mmHg, p = 0.031), and in wSD of 24-h diastolic BP (9.7 ± 2.0 vs 8.8 ± 2.1 mmHg, p = 0.050) comparing to baseline measurements. Moreover, baseline 24-h urinary metanephrines significantly correlated with wSD of both 24-h systolic and diastolic BP. Our study highlights as PPGL patients, after proper treatment, show a significant decrease in some short-term BPV markers, which might represent a further cardiovascular risk factor

A panchromatic view of the bulge globular cluster NGC 6569

We used high-resolution optical HST/WFC3 and multi-conjugate adaptive optics assisted GEMINI GeMS/GSAOI observations in the near-infrared to investigate the physical properties of the globular cluster NGC 6569 in the Galactic bulge. We have obtained the deepest purely NIR color-magnitude diagram published so far for this cluster using ground-based observations, reaching $K_{s}$ $\approx$ 21.0 mag (two magnitudes below the main-sequence turn-off point). By combining the two datasets secured at two different epochs, we determined relative proper motions for a large sample of individual stars in the center of NGC 6569, allowing a robust selection of cluster member stars. Our proper motion analysis solidly demonstrates that, despite its relatively high metal content, NGC 6569 hosts some blue horizontal branch stars. A differential reddening map has been derived in the direction of the system, revealing a maximum color excess variation of about $\delta E(B-V)$ $\sim$ 0.12 mag in the available field of view. The absolute age of NGC 6569 has been determined for the first time. In agreement with the other few bulge globular clusters with available age estimates, NGC 6569 turns out to be old, with an age of about 12.8 Gyr, and a typical uncertainty of 0.8-1.0 Gyr.Comment: 25 pages, 16 Figures, 1 Table. Accepted for publication in Ap

Digging for Relics of the Past: The Ancient and Obscured Bulge Globular Cluster NGC 6256

We used a set of moderately deep and high-resolution optical observations obtained with the Hubble Space Telescope to investigate the properties of the stellar population in the heavily obscured bulge globular cluster (GC) NGC 6256. The analysis of the color–magnitude diagram (CMD) revealed a stellar population with an extended blue horizontal branch severely affected by differential reddening, which was corrected, taking into account color excess variations up to δE(B − V) ~ 0.51. We implemented a Monte Carlo Markov Chain technique to perform the isochrone fitting of the observed CMD in order to derive the stellar age, the cluster distance, and the average color excess in the cluster direction. Using three different sets of isochrones we found that NGC 6256 is characterized by a very old stellar age around 13.0 Gyr, with a typical uncertainty of ~0.5 Gyr. We also found an average color excess of E(B − V) = 1.19 and a distance from the Sun of 6.8 kpc. We then derived the cluster gravitational center and measured its absolute proper motion using the Gaia-DR2 catalog. All this was used to back-integrate the cluster orbit in a Galaxy-like potential and measure its integrals of motion. It turned out that NGC 6256 is currently in a low-eccentricity orbit entirely confined within the bulge and its integrals of motion are fully compatible with a cluster purely belonging to the Galaxy native GC population. All these pieces of evidence suggest that NGC 6256 is an extremely old relic of the past history of the Galaxy, formed during the very first stages of its assembly

Effects of Dietary Protein on Body Composition in Exercising Individuals

Protein is an important component of a healthy diet and appears to be integral to enhancing training adaptations in exercising individuals. The purpose of this narrative review is to provide an evidence-based assessment of the current literature examining increases in dietary protein intake above the recommended dietary allowance (RDA: 0.8 g/kg/d) in conjunction with chronic exercise on body composition (i.e., muscle, fat and bone). We also highlight acute and chronic pre-sleep protein studies as well as the influence of exercise timing on body composition. Overall, a high-protein diet appears to increase muscle accretion and fat loss and may have beneficial effects on bone when combined with exercise. Pre-sleep protein is a viable strategy to help achieve total daily protein goals. Importantly, there appears to be no deleterious effects from a high-protein diet on muscle, fat or bone in exercising individuals

Pre-sleep protein supplementation after an acute bout of evening resistance exercise does not improve next day performance or recovery in resistance trained men

BACKGROUND: To evaluate the effect of pre-sleep protein supplementation after an acute bout of evening resistance training on next day performance and recovery the following day in physically active men. METHODS: Eighteen resistance trained men performed a single bout of resistance exercise then received either a pre-sleep protein (PRO) supplement containing 40 g of casein protein (PRO; n = 10; mean ± SD; age = 24 ± 4 yrs; height = 1.81 ± 0.08 m; weight = 84.9 ± 9.5 kg) or a non-caloric, flavor matched placebo (PLA; n = 8; age = 28 ± 10 yrs; height = 1.81 ± 0.07 m; weight = 86.7 ± 11.0 kg) 30 min before sleep (1 h after a standard recovery drink). Blood samples were obtained pre-exercise and the following morning (+12-h) to measure creatine kinase and C-reactive protein. Visual analog scales were utilized to assess perceived pain, hunger, and recovery. One-repetition maximum (1RM) tests for barbell bench press and squat were performed pre-exercise and the following morning (+12-h). Statistical analysis was performed using SPSS (V.23) and p ≤ 0.05 was considered statistically significant. RESULTS: There were no significant differences between the groups in next morning performance or muscle damage biomarkers. However, pre-sleep PRO resulted in a lower perception of hunger that approached significance the following morning when compared to PLA (PRO:43.6 ± 31.2, PLA: 69.4 ± 2.22; 95% C.I. = −53.6, 2.0; p = 0.07; d = 0.95). CONCLUSIONS: Following an evening bout of exercise, pre-sleep PRO did not further improve next morning muscle damage biomarkers or maximal strength performance in resistance trained men compared to a non-caloric PLA. However, there may be implications for lower perceived hunger the next morning with pre-sleep PRO consumption compared to PLA