In systemic sclerosis (SSc), digital ulcers (DU) are painful, difficult to heal and frequently infected, thus greatly affecting quality of life and increasing SSc-related disability. Vitamin E has ...been previously used in cutaneous lesions for its antioxidant and anti-inflammatory effects.
To study the healing effect of D-alpha-tocopheryl acetate (acetic ester of alpha-tocopherol) (VE) gel on DU of SSc patients.
27 SSc patients with a total of 86 DU were enrolled in an open pilot study. The patients were randomly assigned to two groups: 15 patients were treated until DU healing with the local standard ulcer care protocol with the application of vitamin E gel (experimental group), while 12 patients were treated with standard ulcer care protocol only (control group). In both groups, DU were treated twice a week and pain was scored by a NRS (numeric rating scale). In both groups the cost of medications was analysed.
VE induced a faster healing of DU in respect to controls (13.22+/-2.72 weeks, versus 20.94+/-3.65; p<0.0001) with a lower number of medications (26.18+/-5.63 vs. 41.88+/-7.31; p<0.0001). Resolution of pain was faster in experimental (17.82+/-4,59 medications) than in controls (26.26+/-19.16 medications) (p=0.0022). In the experimental group, the cost of medications was significantly lower (6,919.15 euros/patient) than in the control group (11,056.32 euros/patient).
The application of VE reduces time of healing and has a faster resolution of pain, with a significant reduction of costs. Topical VE may improve the management of DU in SSc.
Introduction
This article points out the design, methods, development and deployment of the international registry promoted by the AutoInflammatory Disease Alliance (AIDA) Network with the aim to ...define and assess paediatric and adult patients with immune-mediated scleritis.
Methods
This registry collects both retrospective and prospective real-world data from patients with non-infectious scleritis through the Research Electronic Data Capture (REDCap) tool and aims to promote knowledge and real-life evidence from patients enrolled worldwide; the registry also allows the collection of standardised data, ensuring the highest levels of security and anonymity of patients’ data and flexibility to change according to scientific acquisitions over time. The communication with other similar registries has been also ensured in order to pursue the sustainability of the project with respect to the adaptation of collected data to the most diverse research projects.
Results
Since the launch of the registry, 99 centres have been involved from 20 countries and four continents. Forty-eight of the centres have already obtained a formal approval from their local ethics committees. At present, the platform counts 259 users (95 principal investigators, 160 site investigators, 2 lead investigators, and 2 data managers); the platform collects baseline and follow-up data using 3683 fields organised into 13 instruments, including patient’s demographics, history, symptoms, trigger or risk factors, therapies and healthcare utilization.
Conclusions
The development of the AIDA International Registry for patients with non-infectious scleritis will allow solid research on this rare condition. Real-world evidence resulting from standardised real-life data will lead to the optimisation of routine clinical and therapeutic management, which are currently limited by the rarity of this ocular inflammatory condition.
La statue de Giordano Bruno dressée sur le Campo de Fiori, le procès de Galilée dont la mémoire est toujours présente à travers le théâtre ou les débats de l’Académie pontificale des sciences disent ...assez combien le destin de la Rome des XVIIe et XVIIIe siècles a été négativement associé à celui de la science moderne et de son avènement conflictuel. Les études réunies dans ce volume, résultat d’un programme collectif de recherche sur la genèse de la culture scientifique européenne, entendent apporter une nouvelle contribution non seulement au dossier de la révolution scientifique en milieu catholique, mais plus largement à celui des relations que chaque société entretient avec les acteurs et la production du savoir et de la science. La focale mise sur Rome, comme milieu social spécifique, comme capitale de la catholicité et comme centre d’une monarchie pontificale en profond renouvellement entre XVIe et XVIIIe siècle, permet de discuter les paradigmes classiques d’une historiographie qui a trop hâtivement relégué le milieu romain à la marge de toute forme d’innovation savante. Il s’agit aussi d’ouvrir de nouvelles pistes de réflexions et de nouveaux chantiers sur les diverses configurations socio-intellectuelles au sein desquelles le travail savant a continué à faire de Rome un centre actif de travail et de production de savoirs.
Heart involvement is a frequent cause of morbidity and mortality in autoimmune diseases. All cardiac structures can be involved: pericardium, endocardium, myocardium, coronary circle, and conduction ...system. In the last decade many patients affected by autoimmune diseases have been treated with hematopoietic stem cell transplantation; the vast majority of these transplants have been autologous, and most have been within the context of phase I and II clinical trials; now, phase III trials are ongoing. Patients affected by autoimmune disease often have cardiac involvement which potentially puts them at higher risk from acute cardiotoxicity due to alkylating agents such as cyclophosphamide. The authors propose an algorithm for cardiac assessment before stem cell transplantation in order to identify those patients at highest risk, prior to administering any drug, to avoid further worsening of heart involvement and possible organ failure.A baseline assessment includes physical examinations, ECG to highlight arrhythmias and conduction abnormalities, chest X-ray to evaluate the presence of pericardial effusion and cardiothoracic ratio.A second-step evaluation includes echocardiography (which assesses the following parameters: left ventricular ejection fraction, diastolic function, tricuspid gradient, pulmonary acceleration time, right ventricular diameter and pericardial effusion, wall motion), Holter ECG that may highlight the presence of arrhythmias and biohumoral parameters such as brain natriuretic peptide and troponin I. If these parameters show abnormalities, a further step is required before transplantation. Cardiac catheterization allows to identify ischemic coronary diseases and pulmonary artery hypertension. Intensive monitoring with life card assessment before inclusion might establish ischemic coronary diseases or complex arrhythmias requiring pacing. Magnetic resonance imaging and single-photon emission computed tomography with dipyridamole are useful tools to evaluate the coronary flow. Treatment of ischemic coronary disease (assessment for revascularization), cardiac failure, pulmonary artery hypertension and arrhythmias constitutes the final step. The aim is to optimize cardiac status in order to allow intense immunosuppressive treatments.
La statue de Giordano Bruno dressée sur le Campo de Fiori, le procès de Galilée dont la mémoire est toujours présente à travers le théâtre ou les débats de l’Académie pontificale des sciences disent ...assez combien le destin de la Rome des XVIIe et XVIIIe siècles a été négativement associé à celui de la science moderne et de son avènement conflictuel. Les études réunies dans ce volume, résultat d’un programme collectif de recherche sur la genèse de la culture scientifique européenne, entendent apporter une nouvelle contribution non seulement au dossier de la révolution scientifique en milieu catholique, mais plus largement à celui des relations que chaque société entretient avec les acteurs et la production du savoir et de la science. La focale mise sur Rome, comme milieu social spécifique, comme capitale de la catholicité et comme centre d’une monarchie pontificale en profond renouvellement entre XVIe et XVIIIe siècle, permet de discuter les paradigmes classiques d’une historiographie qui a trop hâtivement relégué le milieu romain à la marge de toute forme d’innovation savante. Il s’agit aussi d’ouvrir de nouvelles pistes de réflexions et de nouveaux chantiers sur les diverses configurations socio-intellectuelles au sein desquelles le travail savant a continué à faire de Rome un centre actif de travail et de production de savoirs.
Objective
Systemic sclerosis (SSc) is characterized by early perivascular inflammation, microvascular endothelial cell (MVEC) activation/damage, and defective angiogenesis. Junctional adhesion ...molecules (JAMs) regulate leukocyte recruitment to sites of inflammation and ischemia‐reperfusion injury, vascular permeability, and angiogenesis. This study was undertaken to investigate the possible role of JAMs in SSc pathogenesis.
Methods
JAM‐A and JAM‐C expression levels in skin biopsy samples from 25 SSc patients and 15 healthy subjects were investigated by immunohistochemistry and Western blotting. Subcellular localization of JAMs in cultured healthy dermal MVECs and SSc MVECs was assessed by confocal microscopy. Serum levels of soluble JAM‐A (sJAM‐A) and sJAM‐C in 64 SSc patients and 32 healthy subjects were examined by enzyme‐linked immunosorbent assay.
Results
In control skin, constitutive JAM‐A expression was observed in MVECs and fibroblasts. In early‐stage SSc skin, JAM‐A expression was strongly increased in MVECs, fibroblasts, and perivascular inflammatory cells. In late‐stage SSc, JAM‐A expression was decreased compared with controls. JAM‐C was weakly expressed in control and late‐stage SSc skin, while it was strongly expressed in MVECs, fibroblasts, and inflammatory cells in early‐stage SSc. Surface expression of JAM‐A was higher in early‐stage SSc MVECs and increased in healthy MVECs stimulated with early‐stage SSc sera. JAM‐C was cytoplasmic in resting healthy MVECs, while it was recruited to the cell surface upon challenge with early‐stage SSc sera. Early‐stage SSc MVECs exhibited constitutive surface JAM‐C expression. In SSc, increased levels of sJAM‐A and sJAM‐C correlated with early disease and measures of vascular damage.
Conclusion
Our findings indicate that JAMs may participate in MVEC activation, inflammatory processes, and impaired angiogenesis in different stages of SSc.
Appendice. Il contratto con Antonio Rossetti Andretta, Elisa; Baldriga, Irene; Beretta, Francesco ...
Rome et la science moderne : entre Renaissance et Lumières,
05/2013
Journal Article
ASR, TNC, Ferragutus Antonius, uff. 8, b. 49, ff. 268r-271v e 300-302, 7 giugno 1614 Cfr. BANL, Archivio, Linceo, ms. IV, ff. 378-385 Die septima mense Iunii 1614 ... 1. Essendo che l’Accademia o ...vero consesso de studiosi filosofi lincei affaticandosi di continuo ne studii delle nobili scienze di filosofia, e mathematica per tanto più facilitare esse scienze e communicare le proprie fatighe a buoni studiosi desidera che gl’elaborati parti de suoi soggetti in esse fedelmente et diligentement...
Appendice Andretta, Elisa; Baldriga, Irene; Beretta, Francesco ...
Rome et la science moderne : entre Renaissance et Lumières,
05/2013
Journal Article
DOCUMENTO 1 Eminentissimo e Reverendissimo Signore Michele Pinelli, oratore umilissimo, riverentemente espone all’E.V. che avendo notato lo zelo e vigilanza con cui nel governo della Sapienza sotto i ...gloriosi auspicij di Nostro Signore si promuovono le scienze, e specialmente la vera cognizione della medicina colla nuova cattedra di filosofia esperimentale dalla quale la retta maniera del medicar può acquistar quei nuovi lumi che per prima qui in Roma mancavano alli studenti, ed avendo consid...
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