Stability of L∞L^\infty solutions for hyperbolic systems with coinciding shocks and rarefactions

We consider a hyperbolic system of conservation laws u_t + f(u)_x = 0 and u(0,\cdot) = u_0, where each characteristic field is either linearly degenerate or genuinely nonlinear. Under the assumption of coinciding shock and rarefaction curves and the existence of a set of Riemann coordinates $w$, we prove that there exists a semigroup of solutions $u(t) = \mathcal{S}_t u_0$, defined on initial data $u_0 \in L^\infty$. The semigroup $\mathcal{S}$ is continuous w.r.t. time and the initial data $u_0$ in the $L^1_{\text{loc}}$ topology. Moreover $\mathcal{S}$ is unique and its trajectories are obtained as limits of wave front tracking approximations.Comment: 19 pages, 13 figure

Grey-scale analysis improves the ultrasonographic evaluation of thyroid nodules

Ultrasonography is the main imaging method for the workup of thyroid nodules. However, interobserver agreement reported for echogenicity and echotexture is quite low. The aim of this study was to perform quantitative measurements of the degree of echogenicity and heterogeneity of thyroid nodules, to develop an objective and reproducible method to stratify these features to predict malignancy.A retrospective study of patients undergoing ultrasonography-guided fine-needle aspiration was performed in an University hospital thyroid center. From January 2010 to October 2012, 839 consecutive patients (908 nodules) underwent US-guided fine-needle aspiration. In a single ultrasound image, 3 regions of interest (ROIs) were drawn: the first including the nodule; the second including a portion of the adjacent thyroid parenchyma; the third, the strap muscle. Histogram analysis was performed, expressing the median, mean, and SD of the gray levels of the pixels comprising each region. Echogenicity was expressed as a ratio: the nodule/parenchyma, the nodule/muscle, and parenchyma/muscle median gray ratios were calculated. The heterogeneity index (HI) was calculated as the coefficient of variation of gray histogram for each of the 3 ROIs. Cytology and histology reports were recorded.Nodule/parenchyma median gray ratio was significantly lower (more hypoechoic) in nodules found to be malignant (0.45 vs 0.61; P = 0.002) and can be used as a continuous measure of hypoechogenicity (odds ratio [OR] 0.12; 95% confidence interval [CI] 0.03-0.49). Using a cutoff derived from ROC curve analysis (<0.46), it showed a substantial inter-rater agreement (k = 0.74), sensitivity of 56.7% (95% CI 37.4-74.5%), specificity of 72.0% (67.8-75.9%), positive likelihood ratio (LR) of 2.023 (1.434-2.852), and negative LR of 0.602 (0.398-0.910) in predicting malignancy (diagnostic odds ratio 3.36; 1.59-7.10). Parenchymal HI was associated with anti-thyroperoxidase positivity (OR 19.69; 3.69-105.23). The nodule HI was significantly higher in malignant nodules (0.73 vs 0.63; P = 0.03) and, if above the 0.60 cutoff, showed sensitivity of 76.7% (57.7-90.1%), specificity of 46.8% (42.3-51.4%), positive LR of 1.442 (1.164-1.786), and negative LR of 0.498 (0.259-0.960).Evaluation of nodule echogenicity and echotexture according to a numerical estimate (nodule/parenchyma median gray ratio and nodule HI) allows for an objective stratification of nodule echogenicity and internal structure

Serum albumins are efficient delivery systems for the photosensitizer hypericin in photosensitization-based treatments against Staphylococcus aureus

The naturally occurring photosensitizer hypericin can be effectively delivered to bacterial cells using serum albumins as biocompatible carriers. Using a combination of spectroscopic methods we demonstrate that the photophysics of hypericin is fully preserved when bound to these proteins. Thanks to the excellent transport capabilities of serum albumins, that deliver hypericin to Gram-positive S. aureus, an efficient antibacterial action was observed, with a reduction of up to 8 log in the number of colony-forming units. The photoactive material is fully compatible with the use in food processing environments, and may be exploited as a viable method for decontamination from S. aureus and other Gram-positive bacteria

New molecular approaches in the diagnosis and prognosis of thyroid cancer patients

Thyroid nodules are very common in the adult population, but only a minority of them harbor a malignant lesion. Therefore, the first aim in their clinical evaluation is to exclude malignancy. To date, the fine-needle aspiration cytology (FNAC) represents the main diagnostic tool for the evaluation of thyroid nodules and cervical lymph nodes (CLN) suspected of metastatic disease. It has to be mentioned, however, that FNAC on thyroid nodules suffers from a major diagnostic limit represented by cellular atypias of indeterminate significance, which require the histological diagnosis. Also the FNAC performed on CLN may be a challenging diagnostic category as CLN could harbor metastases from a multiplicity of extrathyroidal malignancies or be affected by several non-tumoral diseases. In addition, inadequate cellularity obtained from both thyroid nodules or CLN prevents diagnosis in about 20% of specimens. Total thyroidectomy followed by adjuvant therapy with 131I is the treatment of choice for most patients affected by DTC. Although the prognosis of DTC patients is favorable, about 20% of them face the morbidity of disease recurrence and tumor-related deaths. Thus far, the prognosis of these patients still relies on clinic-pathological variables such as patient’s age, tumor size, histology, lymph node or distant metastasis, which are not accurate in predicting the long-term outcome. As a consequence, the identification of new molecular biomarkers strictly related to the risk of DTC relapse is highly needed. In the present review we’ll attempt to summarize the recent characterization of new molecular markers able to ameliorate the diagnosis and prognosis of thyroid cancer patients

Benefício da terapia de ondas de choque no tratamento de úlceras cutâneas: uma revisão da literatura

Extracorporeal shockwave therapy (ESWT) has analgesic and anti-inflammatory effects. With the evolution and comprehension of its biological and physical mechanisms, the application of ESWT on other pathologies has also been studied, especially in musculoskeletal diseases. Recently, studies on animal models have shown its angiogenic capacity and a higher rate of local re-epithelization. These small studies led to few trials using low-energy, radial ESWT to treat problematic chronic skin ulcers. Skin ulcers have diverse etiologies, ranging from pressure ulcers, burns, venous or arterial ulcers, and even diabetic ulcers. Their treatment is usually a challenge, due to the long-term treatment and high costs. Objective: To review the literature and evaluate the efficacy of ESWT in caring for skin ulcers of various etiologies: diabetic ulcers, pressure ulcers, burns, post-traumatic ulcers, venous and arterial ulcers. Method: A literature review was made, with only human trials included. Results: 9 articles were selected that fulfilled the eligibility criteria. The studies included evaluations of 788 patients. The manuscripts demonstrated a large variability regarding the interventions made. There was heterogeneity regarding intervention time, number of pulses, frequency of sessions, and also the number of sessions, energy density used, and the type of shock wave used in therapies. Some of the included trials found a higher rate of complete wound healing and faster epithelization in patients with chronic lesions, unresponsive to the traditional measures. However, there were few studies in the literature with proper methodological quality. Conclusion: ESWT is a promising alternative for the treatment of patients unresponsive to conventional measures. The results are promising, although the evidence regarding wound healing and acceleration of wound healing is still limited. The studies selected did not report any significant side effectsA terapia de ondas de choque (TOC) extracorpórea possui ação analgésica e anti-inflamatória. Com a evolução e compreensão de seus mecanismos físicos e biológicos, foi se estudando a sua aplicação em outras patologias, principalmente em afecções ósseas e musculo-tendíneas. Recentemente, estudos em modelos animais demonstraram a sua capacidade angiogênica e maior taxa de re-epitelização local. Estas pesquisas levaram ao início do uso de TOC radial de baixa energia no tratamento e manejo de diversas lesões de pele de difícil tratamento. As úlceras cutâneas possuem diversas etiologias, variando desde úlceras de pressão, queimaduras, úlceras venosas ou arteriais e também úlceras diabéticas. Seu tratamento é um desafio, devido ao seu tempo prolongado de tratamento (resultando em dificuldades quanto ao seguimento clínico) e também elevados custos. Objetivo: Avaliar a eficácia da TOC na cicatrização de úlceras de diversas etiologias: diabéticas, por pressão, queimaduras, pós-traumáticas, vasculares venosas e arteriais, por meio de uma revisão da literatura. Métodos: Foi realizada uma revisão da literatura, sendo incluídos estudos clínicos em humanos Resultados: 9 artigos preencheram os critérios de inclusão. Os estudos inclusos compreenderam 788 pacientes. Os manuscritos trouxeram uma variedade de padrão de intervenções diferentes. Houve heterogeneidade no tempo de intervenção, número de pulsos e na frequência de sessões, bem como na quantidade de sessões, densidade de energia aplicada, e também no tipo de ondas de choque utilizados nas terapias. Alguns dos trabalhos descritos encontraram uma maior taxa na cicatrização e fechamento completo de lesões em pacientes com lesões crônicas, que não responderam ao tratamento conservador. Porém, há poucos estudos na literatura com qualidade metodológica adequada. Conclusão: A TOC surge como uma alternativa promissora para pacientes que não respondem bem à terapia conservadora. Os resultados são promissores porém com evidências limitadas quanto a diminuição do tempo de cicatrização e na aceleração do fechamento de lesões. Os estudos selecionados não relataram efeitos colaterais significativos, sendo uma terapia segur

Establishment and replacement of failures in Prosopis alba plantations in Santiago del Estero, Argentina

El costo de implantación de una especie forestal no solo contempla la actividad de plantación en sí, sino, además, el de su posterior reposición de fallas. El objetivo del presente estudio fue describir y determinar el rendimiento de las tareas de control de prendimiento y reposición de fallas en plantaciones de Prosopis alba Griseb. (algarrobo blanco) bajo la influencia de factores edáficos como pH y conductividad eléctrica. La investigación se centró en el marco del Programa Forestal Santiagueño (PFS), Argentina, ejecutado durante la campaña de forestación 2017–2018. La muestra estuvo conformada por 3 productores con parcelas ubicadas en el departamento Robles de la provincia de Santiago del Estero. El trabajo de campo permitió registrar las tareas de control de prendimiento y reposición de fallas y a su vez, evaluar el establecimiento de las plantas bajo diferentes factores edáficos.The cost of implantation of a forest species not only contemplates the plantation activity itself, but also that of its subsequent replacement of failures. The objective of this study was to describe and determine the performance of the control tasks of picking and replacement of failures in plantations of Prosopis alba (white carob tree) under the influence of edaphic factors such as pH and electrical conductivity. The research focused on the framework of the Santiagueño Forest Program (PFS), Argentina, executed during the 2017–2018 afforestation campaign. The sample consisted of 3 producers with plots located in the Robles department of the Santiago del Estero province. The field work allowed to record the tasks of control of uprooting and replacement of failures and in turn, to evaluate the establishment of the plants under different edaphic factors. The study reflects an average plant loss percentage of 17% and shows that the replacement of 75 carob plants requires 0.12 wages (0.96 h). There is a strong correlation between the variables CE (ds / m) and plant mortality, in this sense a statistical model was obtained capable of estimating plant mortality based on the EC of the soil.Fil: García, Jorge Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Forestales; ArgentinaFil: Álvarez, Pablo. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Forestales; ArgentinaFil: Izzo, Marta Evelia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Forestales; ArgentinaFil: Zurita Bianchini, Cecilia Alejandra. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Forestales; ArgentinaFil: Sarmiento, Miguel Angel. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Forestales; Argentin

Thyroid autoantibodies and breast cancer

Dear Editor We read with interest the recent article by Shi and colleagues (2014) reporting a meta-analysis on the relationship between thyroid hormones, thyroid autoantibodies and breast cancer (BC). In the paper, the authors analyzed eight different studies, including 4,189 participants, and concluded that serum levels of free-triiodothyronine, thyroperoxidase and thyroglobulin autoantibodies are higher in patients affected by BC, compared with the control group. These findings are in agreement with the meta-analysis reported by Hardefeldt and colleagues, showing an increased risk of BC in patients with autoimmune thyroid disease, and with a recent article by our group in which the prevalence of BC in 3,921 female patients affected by both benign and malignant thyroid diseases was evaluated (Hardefeldt et al., 2012; Prinzi et al., 2014). In the latter, we showed that the prevalence of BC in patients affected by thyroid disease, as a whole, was significantly higher, compared to the general population (OR 3.3). Moreover, the age-matched analysis showed that the risk of BC was higher in younger patients (0–44 yr, OR 15.2), to decline with the increasing age. In the same study, when patients were dichotomized based on the presence or the absence of thyroglobulin and/or thyroperoxidase autoantibodies, both groups showed a higher risk of BC, compared to the general female population. When the two groups were compared to each other, however, the risk of BC was significantly lower in autoantibody positive patients. Thus, as clearly stated in our article, among patients affected by thyroid diseases, the presence of thyroid autoantibodies may have a protective role against BC (Prinzi et al., 2014). As a consequence, the sentence reported by Shi and colleagues in the Discussion section of their article stating that their findings are in disagreement with our data is not correct and should be, if at all possible, amended

Síndrome do manguito rotador: reabilitação

Iniciamos a elaboraçao desta diretriz com a capacitaçao dos autores por meio da metodologia empregada pelo&nbsp;Oxford Centre for Evidence Based Medicine, para elaboraçao de diretrizes clínicas pelo Programa Diretrizes da Associaçao Médica Brasileira (AMB). Foram revisados artigos nas bases de dados do MedLine (PubMed) e outras fontes de pesquisa, sem limite de tempo. A estratégia de busca utilizada baseou-se em perguntas estruturadas na forma P.I.C.O. (das iniciais "Paciente", "Intervençao", "Controle", "Outcome").We began the preparation of this guideline with the training of the authors using the methodology employed by the Oxford Centre for Evidence-Based Medicine, for the development of clinical guidelines for the&nbsp;Programa Diretrizes da Associaçao Médica Brasileira-AMB&nbsp;(Brazilian Medical Association's Guideline Program-BMA). Articles were reviewed from the MEDLINE (PubMed) database and other research sources, on an open-ended basis. The search strategy used was based on structured questions in the P.I.C.O. form (from the initials of "Patient", "Intervention", "Control", and "Outcome")

Neck pain: rehabilitation

Iniciamos a elaboraçao desta diretriz com a capacitaçao dos autores por meio da metodologia empregada pelo&nbsp;Oxford Centre for Evidence Based Medicine, para elaboraçao de diretrizes clínicas pelo Programa Diretrizes da Associaçao Médica Brasileira (AMB). Em seguida, realizamos cinco reunioes de elaboraçao de diretrizes juntamente com os coordenadores do Programa da AMB. Foram revisados artigos nas bases de dados do MEDLINE, por meio do PubMed, a base de dados Cochrane de Revisoes Sistemáticas e o Registro de Ensaios Controlados da Colaboraçao Cochrane, por meio da Biblioteca Virtual de Saúde, sem limite de tempo. A estratégia de busca utilizada baseou-se em perguntas estruturadas na forma (P.I.C.O.) das iniciais: "Patient"; "Intervention"; "Control" e "Outcome".&nbsp;We started the preparation of this directive with the capacitation of the authors by means of the metodology employed by the&nbsp;Oxford Centre for Evidence Based Medicine, for the preparation of clinical directives by the Directives Program of the Brazilian Medical Association (Associaçao Médica Brasileira - AMB). Next, we had five directive preparation meetings with the AMB Program's coordinators. Articles from the MEDLINE (PubMed) databases, the Cochrane Database of Systematic Reviews, by means of the Health Virtual Library, with no time limitation. The search strategy adopted was based on (P.I.C.O.) structured questions (from the initials "Patient"; "Intervention"; "Control" and "Outcome".&nbsp