A Retrospective Observational Single-Centre Study on the Burden of Immune Thrombocytopenia (ITP)

Background: German data on economic consequences of immune thrombocytopenia (ITP) are limited. Patients and Methods: A retrospective, observational study based on chart review of adult patients with a confirmed diagnosis of ITP was conducted at a German university hospital. Costs are presented from the hospital perspective. Results: Of 50 eligible patients, 45 could be classified by disease duration: 19 patients = 3 to = 12 months (38%, chronic ITP). Complications included 85 bleeding events in 43 patients, including 3 intracranial haemorrhages. Documented were 955 outpatient visits in 43 patients (86%) and 92 inpatient hospital admissions in 45 patients (90%). Of the 46 patients (92%) treated, all received corticosteroids, 25 (50%) intravenous immunoglobulin, and 7 (14%) further therapies. 12 patients (24%) underwent splenectomy. Average total direct medical costs (mean (standard deviation)) were (sic) 17,091 ((sic) 18,859) per patient, (sic) 12,749 ((sic) 11,663) in 17 newly diagnosed ITP patients with a 0.88-month (0.65 months) average disease duration, and (sic) 29,868 ((sic) 29,397) in 13 chronic ITP patients with a 33.5-month (16.8 months) average disease duration. Inpatient stays were the main cost drivers. Conclusion: These data concerning current healthcare provision for ITP patients in Germany indicate considerable resource consumption and the need for more effective treatment options in individual patients

Citoquinas pro inflamatorias y otros marcadores sericos en el síndrome metabólico de pacientes con lupus eritematoso sistémico.

El Lupus Eritematoso Sistémico (LES) es una Enfermedad Autoinmune que cursa con periodos de exacerbación y remisión condicionando un estado proinflamatorio crónico. La prevalencia del Síndrome Metabólico es variable según las diferentes áreas geográficas y por lo general alta en estos pacientes. El Objetivo del estudio fue identificar la frecuencia del Síndrome Metabólico y su correlación con las concentraciones séricas de citosinas proinflamatorias y otros marcadores séricos, así como con las alteraciones ecocardiográficas y en las ecografías carotideas de pacientes con LES que acuden al Departamento de Reumatología del Hospital de Clínicas de la Universidad Nacional de Asunción. El estudio fue prospectivo, observacional de corte transverso y analítico, el muestreo no probabilístico de casos consecutivos. Se incluyeron 50 pacientes de ambos sexos, mayores de 18 años con diagnóstico de LES. Se aplicó una encuesta con variables clínicas, sociodemográficas y de tratamiento, se realizaron analítica laboratorial, se evaluaron citocinas proinflamatorias, reactantes de fase aguda y marcadores del metabolismo. La evaluación cardiovascular incluyó una ecocardiografía y una ecografía carotidea en la que se midió el Grosor Intima Media Carotídea(GIM) y se evaluó la presencia de alteraciones Ecocardiográficas.CONACYT - Consejo Nacional de Ciencia y TecnologíaPROCIENCI

OPTIMIZING THE THERMO-OXIDATION STABILITY OF GAS TURBINE OILS

Pouzdan i neometan rad plinskih turbina bitno ovisi o sustavu podmazivanja i kvaliteti mazivih ulja. U zadnje vrijeme raste tipična radna temperatura turbinskih ulja, budući da plinske turbine u proizvodnji struje postaju sve djelotvornije. Istovremeno se povećavaju zahtjevi za što dugotrajnijim uljima za plinske turbine. Kako bi se zadovoljili svi ti zahtjevi, sadašnja turbinska ulja trebaju imati odgovarajuću termooksidacijsku stabilnost. Međutim, nakon što su u sustav turbina uvedene nove kvalitete ulja za plinske turbine, pojavili su se novi izazovi s obzirom na stvaranje mulja, lakova i taloga. Ova onečišćenja i problemi vezani uz maziva ulja dovode do zastoja, gubitaka i dodatnih troškova održavanja. Kako bi se pojasnili razlozi i pozadina ove složene pojave, potrebno je provesti opsežna ispitivanja i studije o problemima vezanim za termooksidacijsku stabilnost.The reliable and trouble-free operation of the gas turbines is highly dependent upon the lubricating system and the lubricating oil performance. Recently the typical operating temperatures of turbine oils have been rising as modern gas turbines in power generation become more efficient. At the same time gas turbine oils are increasingly required to have longer service life. In order to fulfil all these requirements the current turbine oils need to possess adequate thermo-oxidation stability. However, as new quality of gas turbine oils have been introduced in turbine systems, new challenges appeared in regard of sludge, varnish and deposit formation. These contaminants and lubricating oil related problems led to downtimes, outages and extra maintenance costs. Due to clarify the reasons and backgrounds, extensive investigations and studies of the given thermo-oxidation stability problems are required for a better understanding of the complex phenomena

SPIRITUAL NEEDS OF PTSD PATIENTS IN CROATIA AND BOSNIA-HERZEGOVINA: A QUANTITATIVE PILOT STUDY

Background: As a result of the wars in Croatia and Bosnia-Herzegovina, many people have been affected by post-traumatic stress disorder (PTSD). Considering that religion plays an important role in both of these countries and that religiosity/spirituality can be a positive coping resource, we were interested in investigating the spiritual needs of PTSD patients in these countries. Also, we aimed to compare the spiritual needs of war veterans and civilians with PTSD. Methods: In this cross-sectional study, 120 questionnaires were distributed to civilians and veterans with PTSD at one university hospital in Croatia and in Bosnia-Herzegovina, respectively (response rate: 52.2%). The sample ranged in age from 35-61 years (average age: 49±1 years) and was mostly male (77.8%). The Spiritual Needs Questionnaire (SpNQ 2.1) was used. Data analysis was conducted using SPSS. Results: Two-thirds of participants identified themselves as religious and exhibited a variety of spiritual needs. The intensity of spiritual needs (i.e., Religious Needs, Existential Needs, Inner Peace Needs, Giving / Generativity Needs; but also Social Support needs) did not significantly differ between veterans and civilians. PTSD patients who identified themselves as non-religious had significantly lower Religious Needs and Existential Needs; there was also a trend to lower Inner Peace Needs. Conclusion: Regardless of religious identity, PTSD patients in our study expressed several psychosocial, existential and spiritual needs. A holistic approach to treatment of these patients, which includes psychosocial and spiritual aspects, appears meaningful

Escleredema de Buschke: reporte de un caso

Buschke‘s Scleredema is a rare connective tissue disorder of unknown etiology that is characterized by excess acid mucopolysaccharide deposition in the dermis. Based on etiology, three types are described. Clinically, symmetrical cutaneous induration that progressively affects the neck area, face, thorax, back and limbs, sparing hands and feet, characterize it. Diagnosis is based on clinical presentation and the characteristic histopathological findings. No specific or effective treatment has been established, although the use of immunosuppressants, systemic and local steroids, as well as systemic treatment with psoralens and ultraviolet radiation has been described. In this article we present the case of a patient with Buschke‘s Type 2 Scleredema.El Escleredema de Buschke es una enfermedad poco común del tejido conectivo, de etiología desconocida que se caracteriza por el exceso de mucopolisacáridos ácidos en la dermis. Se describen tres tipos de acuerdo a su etiología. Clínicamente se caracteriza por induración cutánea simétrica que afecta en forma progresiva la región cervical, rostro, tórax, dorso y miembros, respetando manos y pies. El diagnóstico se basa en el cuadro clínico y los hallazgos histopatológicos característicos. No se ha establecido un tratamiento específico y efectivo, aunque se cita el uso de inmunosupresores, esteroides sistémicos y locales, así como fotoquimioterapia sistémica con psoralenos y radiación ultravioleta. En este artículo presentamos el caso de una mujer adulta con Escleredema de Buschke

The MIIM LCA PH.D. club: Presentation and introduction

During 1998, the number of completed Ph.D.s on Life Cycle Assessment (LCA) seemed to be larger than any previous year. In order to mark this achievement, a special series is being published in the International Journal of LCA. In this introductory paper, the Class of MUM outline the results of their research work over the last few years. A number of common points and tendencies have emerged through this work. First of all, the scope-dependency of LCA models: some of us have discerned in particular the need to distinguish between descriptive and change-oriented LCAs. Secondly, a number of the theses focus on the interaction between LCA and decision-making. Thirdly, the benefits of pluralism in impact assessment and allocation have been advocated in some of the theses. Finally, it may be noted that in these theses structuring the management of controversial issues seems to be preferred to eliminating such issues by a process of harmonisation. Future papers will map out the intellectual journeys undertaken in the development of these theses and discuss key findings in more detai

Personal Prayer in Patients Dealing with Chronic Illness: A Review of the Research Literature

Background. Prayer is commonly used among patients for health purposes. Therefore, this review focused on three main questions: (1) why do people turn to prayer in times of illness?, (2) what are the main topics of their prayers?, and (3) how do they pray? Method. We undertook a systematic review of the literature by searching the databases PubMed, Medline, and PsycINFO. The following inclusion criteria were used: (1) participants in the study were patients dealing with an illness, (2) the study examined the use of private rather than intercessory prayer, and (3) the content and purpose of prayer rather than its effects were investigated. Results. 16 articles were included in the final review. Participants suffered from a variety of chronic diseases, mostly cancer. Five main categories for the reasons and topics of prayer were found: (1) disease-centered prayer, (2) assurance-centered prayer, (3) God-centered prayer, (4) others-centered prayer, and (5) lamentations. Among these, disease-centered prayer was most common. Conclusions. Although most patients with chronic diseases do pray for relief from their physical and mental suffering, the intention of their prayers is not only for healing. Rather, prayer can be a resource that allows patients to positively transform the experience of their illness

Arteritis de células gigantes

The Giant Cell Arteritis is considered one of the most prevalent autoimmune vasculitis syndromes, which affects arteries of medium and large caliber, being the most feared complication, anterior ischemic optic neuropathy that can evolve to an irreversible loss of vision. The symptoms are caused by local ischemia due to endovascular damage accompanied by systemic damage mediated by cytokines. In recent years, doppler ultrasound, Magnetic Resonance Imaging (MRI) and PET scans have become important in the search for tools that can confirm or exclude the diagnosis of GCA. However, the Temporal Artery Biopsy (BAT) continues to be the gold standard test for the diagnosis of this disease.La Arteritis de Células Gigantes (ACG) es considerada uno de los síndromes vasculíticos más prevalentes. Afecta predominantemente a las arterias de mediano y gran calibre siendo la complicación más temida, una neuropatía óptica isquémica anterior que puede evolucionar a una pérdida irreversible de la visión. Los síntomas son causados por isquemia local debido al daño endovascular acompañado además de daño sistémico mediado por citoquinas. En los últimos años la ecografía doppler, la resonancia magnética y el PET scan fueron tomando importancia en la búsqueda de herramientas que puedan confirmar o excluir el diagnóstico de ACG sin embargo la biopsia de la arteria temporal (BAT) continúa siendo la prueba estándar para el diagnóstico de esta enfermedad

Seal Bomb Noise as a Potential Threat to Monterey Bay Harbor Porpoise

Anthropogenic noise is a known threat to marine mammals. Decades of research have shown that harbor porpoises are particularly sensitive to anthropogenic noise, and geographic displacement is a common impact from noise exposure. Small, localized populations may be particularly vulnerable to impacts associated with displacement, as animals that are excluded from their primary habitat may have reduced foraging success and survival, or be exposed to increased threats of predation or bycatch. Seal bombs are underwater explosives used in purse seine fisheries to deter marine mammals during fishery operations. Pinnipeds are believed to be the primary target for seal bomb use, however there may be indirect impacts on harbor porpoises. Active purse seine fishing using seal bombs in the greater Monterey Bay area may, at times, span the entire range of the Monterey Bay harbor porpoise stock, which may lead to negative impacts for this population. In this contribution, we review anthropogenic noise as a threat to harbor porpoises, with a focus on the potential for impacts from seal bomb noise exposure in the Monterey Bay region

Untersuchung der Thymian-Kollektion aus der Bundeszentralen Ex situ- Genbank Gatersleben – Vergleich morphologischer, phytochemischer und molekularer Merkmale

18 Akzessionen der Gaterslebener Thymian-Kollektion aus sieben verschiedenen Arten wurden mit einem standardisierten Boniturschema morphologisch beschrieben. Besonderes Augenmerk lag dabei auf der Anzahl der Drüsenhaare. Außerdem wurden durch Durchflusszytometrie die Genomgröße bestimmt und der Ploidiegrad ermittelt. Die Verwandtschaftsverhältnisse wurden durch ITS-Marker analysiert. Des Weiteren wurde die Zusammensetzung des ätherischen Öls mittels Gaschromatographie gekoppelt an Massenspektrometrie untersucht. Verschiedene Chemotypen konnten dabei gefunden werden. Alle erhobenen Daten werden verglichen und miteinander in Beziehung gesetzt. Stichwörter: Ätherisches Öl, Chemotypen, Drüsenhaare, ITS-Analyse, Thymus spp.Screening of the thyme collection of the federal ex situ genebank in Gatersleben – comparison of morphological, phytochemical and molecular data18 accessions of the Gatersleben thyme collection from seven different species were characterized morphologically with a standardized descriptor. A special focus was on the number of secretory cells. Besides, the genome size was detected with flow cytometry in order to determine the number of chromosomes and the ploidy level. ITS markers were used to analyze the phylogenetic relationship. In addition, the essential oil compounds were studied with gas chromatography coupled with mass spectrometry. Within the 18 accessions different chemotypes could be found. All data will be compared and evaluated. Keywords: Chemotypes, essential oil, ITS analysis, secretory cells, Thymus spp