Valutazione dell'interessamento subclinico e stratificazione del rischio cardiovascolare in pazienti con miopatia infiammatoria idiopatica mediante l'utilizzo di tecniche strumentali innovative non invasive

I pazienti con miopatia infiammatoria idiopatica presentano un rischio maggiore rispetto alla popolazione generale di essere colpiti da eventi cardiovascolari. Il presente lavoro cerca di identificare i fattori di rischio e la presenza di danno cardiovascolare subclinico in un gruppo di pazienti con miopatia infiammatoria idiopatica seguiti presso l'UO Reumatologia dell'Azienda Ospedaliero-Universitaria Pisana

Extended model for the interaction of dielectric thin films with an electrostatic force microscope probe

To improve measurements of the dielectric permittivity of nanometric portions by means of Local Dielectric Spectroscopy (LDS), we introduce an extension to current analytical models for the interpretation of the interaction between the probe tip of an electrostatic force microscope (EFM) and a thin dielectric film covering a conducting substrate. Using the proposed models, we show how more accurate values for the dielectric constant can be obtained from single-frequency measurements at various probe/substrate distances, not limited to a few tip radii

Rendimento a scuola: quanto penalizza essere stranieri? Un’indagine nella provincia di Pisa

I grandi flussi di immigrazione iniziati dopo gli anni ottanta stanno trasformando l’Italia in una società multietnica. Nell’attuale fase storica in cui, a causa della persistente crisi economica e dei conflitti internazionali, l’intolleranza e l’integralismo stanno aumentando è prioritario promuovere un’efficace interazione tra differenti culture, in un quadro di reciproco rispetto. In questa prospettiva, la scuola può giocare un ruolo fondamentale contrastando le discriminazioni contro i nati stranieri, attraverso il contenimento delle disuguaglianze nell’istruzione, come premessa per ridurre le frustrazioni e l’emarginazione ed alimentare un’armonia sociale e culturale

In inflammatory myopathies, dropped head/bent spine syndrome is associated with scleromyositis: an international case–control study

Dermatomyositis; Polymyositis; Systemic sclerosisDermatomiositis; Polimiositis; Esclerosis sistémicaDermatomiositis; Polimiositis; Esclerosi sistèmicaBackground Some myopathies can lead to dropped head or bent spine syndrome (DH/BS). The significance of this symptom has not been studied in inflammatory myopathies (IM). Objectives To assess the significance of DH/BS in patients with IM. Methods Practitioners from five IM networks were invited to report patients with IM suffering from DH/BS (without other known cause than IM). IM patients without DH/BS, randomly selected in each participating centre, were included as controls at a ratio of 2 to 1. Results 49 DH/BS-IM patients (DH: 57.1%, BS: 42.9%) were compared with 98 control-IM patients. DH/BS-IM patients were older (65 years vs 53 years, p<0.0001) and the diagnosis of IM was delayed (6 months vs 3 months, p=0.009). Weakness prevailing in the upper limbs (42.9% vs 15.3%), dysphagia (57.1% vs 25.5%), muscle atrophy (65.3% vs 34.7%), weight loss (61.2% vs 23.5%) and loss of the ability to walk (24.5% vs 5.1%) were hallmarks of DH/BS-IM (p≤0.0005), for which the patients more frequently received intravenous immunoglobulins (65.3% vs 34.7%, p=0.0004). Moreover, DH/BS-IM patients frequently featured signs and/or complications of systemic sclerosis (SSc), fulfilling the American College of Rheumatology/European Alliance of Associations for Rheumatology criteria for this disease in 40.8% of the cases (vs 5.1%, p<0.0001). Distribution of the myopathy, its severity and its association with SSc were independently associated with DH/BS (p<0.05). Mortality was higher in the DH/BS-IM patients and loss of walking ability was independently associated with survival (p<0.05). Conclusion In IM patients, DH/BS is a marker of severity and is associated with SSc (scleromyositis)

CEP em Selfie: abordando sexting com adolescentes como forma de exposição virtual da sexualidade

Este artigo objetiva relatar e refletir sobre intervenções feitas pelo Centro de Estudos Psicológicos (CEP-RUA) da Universidade Federal do Rio Grande (FURG) acerca do compartilhamento de fotos com conteúdo sexual – sexting – entre adolescentes, a fim de colaborar com o desenvolvimento saudável desse público. Foram realizadas três intervenções no município entre os anos de 2014 e 2015, a primeira numa escola privada com cerca de 100 estudantes que estavam entre o 7º ano do Ensino Fundamental e o 3º ano do Ensino Médio, a segunda na zona rural da cidade com 25 participantes sendo eles adolescentes e responsáveis atendidos pela a equipe do Centro de Referência em Assistência Social (CRAS) da área, a terceira foi feita com 120 adolescentes participantes de um projeto social. Para abordar a temática usou-se dinâmicas grupais, contextualizando a necessidade humana de se autorretratar, a exposição da sexualidade durante diferentes contextos históricos e com diferentes ferramentas, da arte à utilização de dispositivos eletrônicos como celulares, câmeras digitais e computadores. Além disso fez-se a apresentação dos dispositivos legais para proteção e acolhimento da vítima em casos de exposição indevida da imagem, principalmente disposições do Estatuto da Criança e do Adolescentes sobre direito a imagem e punição em caso do denunciado ter também até 18 anos incompletos. As intervenções revelaram que a maioria dos adolescentes já tinham conhecimentos prévios sobre o assunto, embora desconhecem-se o termo sexting, também predominou a culpabilização das vítimas quando se tratava de mulheres expostas. Afirmou-se a necessidade de investir na abordagem multidisciplinar da educação para sexualidade com intuito de desmistificar e desconstruir alguns tabus sobre o tema.     

Gradual caldera collapse at Bárdarbunga volcano, Iceland, regulated by lateral magma outflow

Large volcanic eruptions on Earth commonly occur with a collapse of the roof of a crustal magma reservoir, forming a caldera. Only a few such collapses occur per century, and the lack of detailed observations has obscured insight into the mechanical interplay between collapse and eruption.We usemultiparameter geophysical and geochemical data to show that the 110-squarekilometer and 65-meter-deep collapse of Bárdarbunga caldera in 2014-2015 was initiated through withdrawal of magma, and lateral migration through a 48-kilometers-long dike, from a 12-kilometers deep reservoir. Interaction between the pressure exerted by the subsiding reservoir roof and the physical properties of the subsurface flow path explain the gradual, nearexponential decline of both collapse rate and the intensity of the 180-day-long eruption.</p

Geographical heterogeneity of clinical and serological phenotypes of systemic sclerosis observed at tertiary referral centres. The experience of the Italian SIR-SPRING registry and review of the world literature

Introduction: Systemic sclerosis (SSc) is characterized by a complex etiopathogenesis encompassing both host genetic and environmental -infectious/toxic- factors responsible for altered fibrogenesis and diffuse microangiopathy. A wide spectrum of clinical phenotypes may be observed in patients' populations from different geographical areas. We investigated the prevalence of specific clinical and serological phenotypes in patients with definite SSc enrolled at tertiary referral centres in different Italian geographical macro-areas. The observed findings were compared with those reported in the world literature.Materials and methods: The clinical features of 1538 patients (161 M, 10.5%; mean age 59.8 +/- 26.9 yrs.; mean disease duration 8.9 +/- 7.7 yrs) with definite SSc recruited in 38 tertiary referral centres of the SPRING (Systemic sclerosis Progression INvestiGation Group) registry promoted by Italian Society of Rheumatology (SIR) were obtained and clustered according to Italian geographical macroareas.Results: Patients living in Southern Italy were characterized by more severe clinical and/or serological SSc phenotypes compared to those in Northern and Central Italy; namely, they show increased percentages of diffuse cutaneous SSc, digital ulcers, sicca syndrome, muscle involvement, arthritis, cardiopulmonary symptoms, interstitial lung involvement at HRCT, as well increased prevalence of serum anti-Scl70 autoantibodies. In the same SSc population immunusppressive drugs were frequently employed. The review of the literature underlined the geographical heterogeneity of SSc phenotypes, even if the observed findings are scarcely comparable due to the variability of methodological approaches.Conclusion: The phenotypical differences among SSc patients' subgroups from Italian macro-areas might be correlated to genetic/environmental co-factors, and possibly to a not equally distributed national network of information and healthcare facilities

Influence of Antisynthetase Antibodies Specificities on Antisynthetase Syndrome Clinical Spectrum TimeCourse

Introduction: Increased cardiovascular (CV) morbidity and mortality is observed in inflammatory joint diseases (IJDs) such as rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. However, the management of CV disease in these conditions is far from being well established.Areas covered: This review summarizes the main epidemiologic, pathophysiological, and clinical risk factors of CV disease associated with IJDs. Less common aspects on early diagnosis and risk stratification of the CV disease in these conditions are also discussed. In Europe, the most commonly used risk algorithm in patients with IJDs is the modified SCORE index based on the revised recommendations proposed by the EULAR task force in 2017.Expert opinion: Early identification of IJD patients at high risk of CV disease is essential. It should include the use of complementary noninvasive imaging techniques. A multidisciplinary approach aimed to improve heart-healthy habits, including strict control of classic CV risk factors is crucial. Adequate management of the underlying IJD is also of main importance since the reduction of disease activity decreases the risk of CV events. Non-steroidal anti-inflammatory drugs may have a lesser harmful effect in IJD than in the general population, due to their anti-inflammatory effects along with other potential beneficial effects.This research was partially funded by FOREUM—Foundation for Research in Rheumatolog

COVID-19 in rheumatic diseases in Italy: first results from the Italian registry of the Italian Society for Rheumatology (CONTROL-19)

OBJECTIVES: Italy was one of the first countries significantly affected by the coronavirus disease 2019 (COVID-19) epidemic. The Italian Society for Rheumatology promptly launched a retrospective and anonymised data collection to monitor COVID-19 in patients with rheumatic and musculoskeletal diseases (RMDs), the CONTROL-19 surveillance database, which is part of the COVID-19 Global Rheumatology Alliance. METHODS: CONTROL-19 includes patients with RMDs and proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) updated until May 3rd 2020. In this analysis, only molecular diagnoses were included. The data collection covered demographic data, medical history (general and RMD-related), treatments and COVID-19 related features, treatments, and outcome. In this paper, we report the first descriptive data from the CONTROL-19 registry. RESULTS: The population of the first 232 patients (36% males) consisted mainly of elderly patients (mean age 62.2 years), who used corticosteroids (51.7%), and suffered from multi-morbidity (median comorbidities 2). Rheumatoid arthritis was the most frequent disease (34.1%), followed by spondyloarthritis (26.3%), connective tissue disease (21.1%) and vasculitis (11.2%). Most cases had an active disease (69.4%). Clinical presentation of COVID-19 was typical, with systemic symptoms (fever and asthenia) and respiratory symptoms. The overall outcome was severe, with high frequencies of hospitalisation (69.8%), respiratory support oxygen (55.7%), non-invasive ventilation (20.9%) or mechanical ventilation (7.5%), and 19% of deaths. Male patients typically manifested a worse prognosis. Immunomodulatory treatments were not significantly associated with an increased risk of intensive care unit admission/mechanical ventilation/death. CONCLUSIONS: Although the report mainly includes the most severe cases, its temporal and spatial trend supports the validity of the national surveillance system. More complete data are being acquired in order to both test the hypothesis that RMD patients may have a different outcome from that of the general population and determine the safety of immunomodulatory treatments