Livedo racemosa in neurological diseases: an update on the differential diagnoses

Livedo is a net‐like violaceous skin pattern. It can be classified as physiological or pathological. The physiological livedo reticularis usually appears in cold conditions, whereas the pathological and irregular livedo, which persists in warm temperatures, is often labeled as 'livedo racemosa'. Some neurological pathologies are associated with livedo, most commonly those with an inflammatory component or those derived from systemic disorders. The present review summarizes the most important central and peripheral neurological diseases in pediatric and adult age groups associated with livedo, providing physicians with an overview of the clinical presentation, etiology, diagnosis and management of these conditions

Cutaneous manifestations in Moyamoya angiopathy: A review.

AbstractBackground and purpose: Moyamoya angiopathy (MA) is a progressive cerebrovascular disease with a poorly understood pathophysiology. It is mainly characterized by progressive bilateral stenosis of the terminal intracranial part of the supraclinoid internal carotid arteries and the proximal parts of the middle and anterior cerebral arteries. This results in early‐onset ischemic or hemorrhagic strokes. The disease may be idiopathic (known as Moyamoya disease) or associated with other heritable or acquired conditions, including type 1 neurofibromatosis or other RASopathies, sickle cell disease, Down syndrome, or autoimmune disorders (known as Moyamoya syndrome). Apart from the brain, other organ manifestations including cutaneous ones have also been described in MA patients.Materials and methods: A literature research on PubMed was performed for articles mentioning the cutaneous association in MA and published between 1994 and October 2020.Conclusion: The present review summarizes the cutaneous associations as well as the coincidental dermatological findings seen in MA patients. Those include changes in the epidermis, dermis, or skin appendages for example café‐au‐lait spots, hypomelanosis of Ito, livedo racemosa, hemangiomas, premature graying of hair, chilblains etc

Untersuchungen zu den Auswirkungen einer Feuerverzinkung auf die Ermüdungsfestigkeit von Bauteilen aus Stahl

Die Feuerverzinkung ist ein langlebiger Korrosionsschutz für Bauteile aus Stahl und damit ein wichtiger Bestandteil, um die Sicherheit einer Konstruktion über die Lebensdauer zu gewährleisten. Ziel ist es, dieses Potential auch im Stahlund Verbundbrückenbau zu etablieren. Mit der bisherigen Forschung ist ein großer Schritt in diese Richtung bereits getan. Aus den rein phänomenologischen Betrachtungen konnte bisher eine Abminderung der Ermüdungsfestigkeit und eine Verschiebung zu niedrigeren Schwingspielzahlen abgeleitet werden. Es bleibt jedoch die Fragestellung nach den Ursachen für die Auswirkung der Feuerverzinkung auf die Ermüdungsfestigkeit von Bauteilen aus Stahl offen. Ziel dieser Arbeit ist, die Grundlage für ein mechanismenbasiertes Verständnis der schädigenden Wirkung der Feuerverzinkung unter ermüdender Beanspruchung zu schaffen. Der Fokus ist dazu auf die Bewertung der kritischen Rissbildung im Zinküberzug und im Stahlsubstrat gerichtet. Anhand von drei Schwerpunkten Kerbwirkung, Mikrostruktur und Bruchmechanik erfolgt eine systematische Identifikation und Bewertung zu den Schädigungsursachen. Neben experimentellen Ermüdungsversuchen dienen werkstoffanalytische Methoden und bruchmechanische Ansätze dazu, die mikrostrukturellen Einflüsse auf das Mikrorisswachstum zu erfassen. Als Ergebnis kann herausgestellt werden, dass die Feuerverzinkung als Korrosionsschutz geeignet ist, um im Brückenbau für sämtliche Kerbfälle eingesetzt zu werden. Die im Normentwurf vorgeschlagene Änderung der Steigung der Zeitfestigkeitsgeraden auf m = 5 erscheint zweckmäßig, sodass alle hier untersuchten Kerbfälle mit feuerverzinkten Bauteilen erfüllt werden können. Der Einfluss der Feuerverzinkung auf die Ermüdungsfestigkeit kann mit den durchgeführten Untersuchungen dennoch bestätigt und darüber hinaus differenzierter bewertet werden. Auf Basis der durchgeführten experimentellen Untersuchungen kann jetzt die Auswirkung der geometrischen Kerbe in Zusammenhang mit der Feuerverzinkung auf die Ermüdungsfestigkeit beurteilt werden. Bei niedrigen Überzugsdicken (< 100 μm) zeigt sich eine Kerbfallabhängigkeit. Die angewandten Methoden bestätigen, dass prozessbedingte thermische Schwindungsrisse im Zinküberzug nicht ursächlich sind für die schädigende Wirkung. Aufgrund der spröden Eigenschaften des Überzugs mit geringer Kohäsionsbruchfestigkeit kommt es zum frühen Risswachstum im Überzug. Eine Differenzierung der Rissbildung und des Risswachstums im Zinküberzug zwischen Normal- und Hochtemperaturverzinkung ist möglich. Aufgrund des verschiedenen Phasenaufbaus resultiert eine unterschiedliche Ausprägung und Verschiebung der Ermüdungsphasen, so dass bei Applikation des dünneren HTV-Überzugs die Rissbildung im Stahl später erfolgt als für Bauteile mit NTV-Überzug. Daraus resultiert eine tendenziell höhere Lebensdauer von HTVBauteilen. Die Ermüdungslebensdauerreduzierende Wirkung des Überzugs bleibt. Gegenüber einem unverzinkten Stahl sind die Phasen der Ermüdung bei feuerverzinkten Bauteilen aus Stahl zu früheren Lebensdauerzeitpunkten verschoben. Die Bewertung der Mikrostruktur des Zinküberzugs ermöglicht die Beschreibung schädigungsbildender Mechanismen. Daraus eröffnet sich die Möglichkeit, den Feuerverzinkungsüberzug zielgerichtet und beanspruchungsgerecht für Stahlbauteile als langlebigen und nachhaltigen Korrosionsschutz einzusetzen

Ageing, physical function, and the diurnal rhythms of cortisol and dehydroepiandrosterone

The present study examined the relationship between ageing, physical function and the diurnal rhythms of cortisol and dehydroepiandrosterone (DHEA). Participants were 36 community dwelling older adults aged between 65-86 years old. Salivary cortisol and DHEA were measured over the course of one day: immediately upon awakening, 30 min later, and then 3 h, 6 h, 9 h and 12 h post-awakening. Participants completed the Nottingham extended activities of daily living index, the Berg Balance Scale and their handgrip strength was assessed. Older participants had a significantly higher cortisol area under the curve (AUC), lower overall DHEA levels, lower DHEA AUC, a decreased diurnal slope of decline and increased cortisol:DHEA ratio. Lower diurnal cortisol levels were associated with poorer performance on the Berg Balance Scale and lower handgrip strength, and those with a flattened DHEA diurnal profile reported less independence in carrying out daily tasks. These associations withstood adjustment for age. In conclusion, this study suggests an association between cortisol, DHEA, ageing and physical function

Hubble Space Telescope observations of [O III] emission in nearby QSO2s : physical properties of the ionized outflows

We use Hubble Space Telescope/Space Telescope Imaging Spectrograph long-slit G430M and G750M spectra to analyse the extended [O iii] λ5007 emission in a sample of 12 nearby (z 1.6 × 1045 erg s−1) QSO2s. The purpose of the study is to determine the properties of the mass outflows of ionized gas and their role in active galactic nucleus feedback. We measure fluxes and velocities as functions of radial distances. Using cloudy models and ionizing luminosities derived from [O iii] λ5007, we are able to estimate the densities for the emission-line gas. From these results, we derive masses of [O iii]-emitting gas, mass outflow rates, kinetic energies, kinetic luminosities, momenta, and momentum flow rates as a function of radial distance for each of the targets. For the sample, masses are several times 103–107M⊙ and peak outflow rates are from 9.3 × 10−3 to 10.3M⊙yr−1. The peak kinetic luminosities are (3.4 × 10−8)–(4.9 × 10−4) of the bolometric luminosity, which does not approach the (5.0 × 10−3)–(5.0 × 10−2) range required by some models for efficient feedback. For Mrk 34, which has the largest kinetic luminosity of our sample, in order to produce efficient feedback there would have to be 10 times more [O iii]-emitting gas than that we detected at its position of maximum kinetic luminosity. Three targets show extended [O iii] emission, but compact outflow regions. This may be due to different mass profiles or different evolutionary histories

Hubble Space Telescope Observations of [O~III] Emission in Nearby QSO2s: Physical Properties of the Ionised Outflows

We use Hubble Space Telescope (HST)/ Space Telescope Imaging Spectrograph (STIS) long-slit G430M and G750M spectra to analyse the extended [O~III] 5007A emission in a sample of twelve nearby (z 1.6 x 10^45 erg s^-1) QSO2s. The purpose of the study is to determine the properties of the mass outflows of ionised gas and their role in AGN feedback. We measure fluxes and velocities as functions of radial distances. Using Cloudy models and ionising luminosities derived from [O~III] 5007A, we are able to estimate the densities for the emission-line gas. From these results, we derive masses of [O~III]-emitting gas, mass outflow rates, kinetic energies, kinetic luminosities, momenta and momentum flow rates as a function of radial distance for each of the targets. For the sample, masses are several times 10^3 - 10^7 solar masses and peak outflow rates are 9.3 x 10^-3 Msun/yr to 10.3 Msun/yr. The peak kinetic luminosities are 3.4 x 10^-8 to 4.9 x 10^-4 of the bolometric luminosity, which does not approach the 5.0 x 10^-3 - 5.0 x 10^-2 range required by some models for efficient feedback. For Mrk 34, which has the largest kinetic luminosity of our sample, in order to produce efficient feedback there would have to be 10 times more [O~III]-emitting gas than we detected at its position of maximum kinetic luminosity. Three targets show extended [O~III] emission, but compact outflow regions. This may be due to different mass profiles or different evolutionary histories.Comment: 14 pages, 11 Figures, accepted for publication in the MNRA

Emotional reasoning and anxiety sensitivity: associations with social anxiety disorder in childhood

Background Two specific cognitive constructs that have been implicated in the development and maintenance of anxiety symptoms are anxiety sensitivity and emotional reasoning, both of which relate to the experience and meaning of physical symptoms of arousal or anxiety. The interpretation of physical symptoms has been particularly implicated in theories of social anxiety disorder, where internal physical symptoms are hypothesized to influence the individual's appraisals of the self as a social object. Method The current study compared 75 children on measures of anxiety sensitivity and emotional reasoning: 25 with social anxiety disorder, 25 with other anxiety disorders, and 25 nonanxious children (aged 7–12 years). Results Children with social anxiety disorder reported higher levels of anxiety sensitivity and were more likely than both other groups to view ambiguous situations as anxiety provoking, whether physical information was present or not. There were no group differences in the extent to which physical information altered children's interpretation of hypothetical scenarios. Limitations This study is the first to investigate emotional reasoning in clinically anxious children and therefore replication is needed. In addition, those in both anxious groups commonly had comorbid conditions and, consequently, specific conclusions about social anxiety disorder need to be treated with caution. Conclusion The findings highlight cognitive characteristics that may be particularly pertinent in the context of social anxiety disorder in childhood and which may be potential targets for treatment. Furthermore, the findings suggest that strategies to modify these particular cognitive constructs may not be necessary in treatments of some other childhood anxiety disorders

Insulin-resistance HCV infection-related affects vascular stiffness in normotensives

Background and Aims. Arterial stiffness evaluated as pulse wave velocity, is an early marker of vascular damage and an independent predictor for cardiovascular events. We investigated if the insulin resistance/hyperinsulinemia chronic hepatitis C virus infection-related could influence arterial stiffness. Methods. We enrolled 260 outpatients matched for age, body mass index, gender, ethnicity: 52 with never-treated uncomplicated chronic hepatitis C virus infection (HCV+), 104 never-treated hypertensives (HT) and 104 healthy subjects (NT). Pulse wave velocity was evaluated by a validated system employing high-fidelity applanation tonometry. We also measured: fasting plasma glucose and insulin, total, LDL- and HDL-cholesterol, triglyceride, creatinine, e-GFR-EPI, HOMA, quantitative HCV-RNA. Results. HCV+ patients with respect to NT had an increased pulse wave velocity (7.9 ± 2.1 vs 6.4 ± 2.1 m/s; P &lt; 0.0001), similar to that observed in HT group (8.8 ± 3.2 m/s). HCV+ patients, in comparison with NT, had higher triglyceride, creatinine, fasting insulin and HOMA (3.2 ± 1.3 vs 2.5 ± 1.0; P &lt; 0.0001). At linear regression analysis, the correlation between pulse wave velocity and HOMA was similar in HT (r = 0.380, P &lt; 0.0001) and HCV+ (r = 0.369, P = 0.004) groups. At multiple regression analysis, HOMA resulted the major determinant of pulse wave velocity in all groups, explaining respectively 11.8%, 14.4% and 13.6% of its variation in NT, HT and HCV+. At correlational analysis hepatitis C virus-RNA and HOMA demonstrated a strong and linear relationship between them, explaining the 72.4% of their variation (P = 0.022). Conclusions. We demonstrated a significant and direct correlation between HOMA and pulse wave velocity in HCV+ patients, similar to that observed in hypertensive