Correction to: Impact of smoking habit on adult-onset Still’s disease prognosis,findings from a multicentre observational study

Clinical Rheumatology -     

The use of a telematic connection for the follow-up of hypertensive patients improves the cardiovascular prognosis

BACKGROUND: Inadequate blood pressure (BP) control could be due to incorrect management of hypertensives caused by the lack of interaction between general practitioners (GP) and hypertension specialists. OBJECTIVES: To test the effectiveness on BP and total cardiovascular risk (TCVR) control of an internet-based digital network connecting specialists and GPs. METHODS: We created a network among the Hypertension Clinic, Federico II University (Naples, Italy), 23 hospital-based hypertension clinics and 60 GPs from the area (CampaniaSalute Network, CS). Randomized GPs enrolled in CS could update online records of patients (n = 1979). As a control, we included 2045 patients referred to the specialist clinics by GPs from outside the network. All patients completed a 2-year follow-up. RESULTS: CS provided a larger reduction in BP [systolic/diastolic BP (SBP/DBP): 7.3 +/- 0.4/5.4 +/- 0.3 versus 4.1 +/- 0.4/3.1 +/- 0.26 mmHg, CS versus control; P < 0.001 for both] and percentage of patients with BP < 140/90 mmHg (CS versus control: baseline, 33 versus 34%, NS; end of follow-up, 51 versus 47%, chi = 13.371; P < 0.001). A European Society of Hypertension-European Society of Cardiology (ESH/ESC) TCVR score was calculated [from 1 (average) to 5 (very high TCVR)]. The CS group showed a reduction in the mean TCVR score (CS: from 3.5 +/- 0.02 to 3.2 +/- 0, P < 0.01, ANOVA; control group: 3.5 +/- 0.03 to 3.4 +/- 0.03, NS) and, accordingly, fatal and non-fatal major cardiovascular events (MACE) were less frequent (2.9 versus 4.3%; chi = 5.047, P < 0.02). CS predicts fewer MACE in multiple binary regression analysis (beta:-7.27, P < 0.008) reducing the risk for MACE compared to control [odds ratio (OR): 0.838; 95% confidence interval (CI): 0.73-0.96]. CONCLUSION: Our results support the idea that telemedicine can achieve better control of BP and TCVR.     

The evaluation by video capillaroscopy of the efficacy of a Ginkgo biloba extract with L-arginine and magnesium in the treatment of trophic lesions in patients with stage-IV chronic obliterating arteriopathy]

BACKGROUND AND AIMS: This study aimed to evaluate the influence of Ginkgo biloba extract with arginine and magnesium used for the treatment of trophic lesions in the lower limbs caused by both diabetic and non-diabetic microangiopathy. METHODS: A comparative study was carried out in 20 patients who were divided into two groups: 10 were treated with ASA plus Ginkgo biloba extract with arginine and magnesium and 10 with ASA plus conventional hemorheology. The observation time was extended to 6 months, taking into consideration patients with trophic lesions to the lower limbs suffering from diabetic and non-diabetic peripheral arterial occlusive disease. The evaluation was performed by clinical, ultrasonographic and perilesional video capillaroscopy monitoring. Ultrasonographic and video capillaroscopy instrumental methods were used because they provide a full picture of macro and microcirculatory conditions around lesions. RESULTS: The study showed the undoubted efficacy of Ginkgo biloba extract with magnesium and arginine in relation to the following points: reduced healing times for the trophic lesion compared to the control group, improved painful symptoms, increased perilesional neoangiogenesis. No significant differences were observed from a Doppler ultrasonographic point of view or with regard to the claudication free interval. CONCLUSIONS: Ginkgo biloba extract with arginine and magnesium can improve the dynamics of cutaneous trophism in lesions caused by diabetic and non-diabetic microangiopathy.     

Quantified EEG, somatosensory evoked potentials and cerebral blood flow in monitoring experimental brain ischemia

Cerebral ischemic lesions were induced in rabbits through internal carotid artery embolization by means of microspheres. Different models of stroke ranging from single focal cortical lesion to massive bilateral brain edema were reproduced and monitored up to the 24th hour by electroencephalogram (EEG and QEEG), somatosensory evoked potentials (SEPs), cerebral blood flow (CBF), platelet aggregation. The site and extent of the lesions were verified by histological examinations. Results obtained and physiopathological implications are discussed.

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Sommario Lesioni ischemiche cerebrali sono state indotte sperimentalmente nel coniglio mediante embolizzazione con microsfere attraverso l'arteria carotide interna. Modelli diversi, dall'ischemia corticale singola fino all'edema cerebrale bilaterale massivo, sono stati monitorizzati per 24 ore mediante l'elettroencefalogramma (EEG e QEEG), potenziali evocati somatosensoriali (SEPs), flusso ematico cerebrale (CBF), aggregazione piastrinica. Vengono discussi sia i risultati ottenuti sia alcune considerazioni fisiopatologiche.

     

Sources of ionizing radiation in dwellings]

According to recent surveys made by the International Commission on Radiological Protection (ICRP) and the World Health Organization (WHO), it has been estimated that in temperate regions people spend only 20% of their time outdoors and spend the remaining 80% indoors (homes, schools, other buildings). It is therefore important to establish whether radiation sources exist inside buildings in order to assess risk for the population. The 238U and 232Th radioactive chains are of particular importance because of Radon and Radon daughter production and 40K as component of building materials. It has been estimated that about 4.5% of lung cancers observed in the population are associated with exposure to Radon daughters. In order to comply with international regulations it is estimated that 1.5% of the existing dwellings in temperate regions need to be improved.     

Changes of lymphocyte beta-adrenergic receptors and platelet serotonin reuptake sites in aging and dementias

We have studied the kinetic constants of β;-adrenergic receptors in lymphocytes and of serotonin uptake sites in platelets from adult and elderly volunteers and from aged patients with a diagnosis of multi-infarct dementia (MID) or senile dementia of Alzheimer's type (SDAT). The results showed that in the physiological aging process, β;-adrenergic receptor density is reduced and 5HT transport system is enhanced. MID is associated to a loss of β;-adrenoceptor affinity and a slight increase in the capacity of 5HT uptake. The kinetic constants of both β;-adrenergic receptors in lymphocytes and 5HT uptake sites in platelets from SDAT patients were comparable to those observed in the adult population, being thus different from those found in the aged matched volunteers. These changes could be interpreted as resulting from compensatory mechanisms that replaced altered plasma monoamine concentrations. The apparent absence of such changes in SDAT patients could suggest the lack of these compensatory effects.     

K-opioid receptor changes in experimental models of cerebral ischaemia and atherosclerosis in the rabbit.

Thromboembolic phenomena and transient ischaemic attacks (TIA) are considered the basis of ischaemic pathologies. The aim of the present research is to investigate the involvement of k-opioid receptors in cerebral blood flow (CBF) impairment which results in experimental stroke or dietary atherosclerosis in rabbits. CBF measurement showed a significant decrease in rabbits submitted to embolization and/or atherosclerosis. Binding studies showed that massive cerebral ischaemia and atherosclerosis produced a significant increase in the number of k-opioid receptors (Bmax), without changing (KD) affinity values. In conclusion, the results obtained seem to indicate that the increase in k-opioid receptors might play a crucial role in a common cerebral biochemical mechanism both in ischaemic and atherosclerotic pathologies.     

A Novel Iterative Penalty Method to Enforce Boundary Conditions in Finite Volume POD-Galerkin Reduced Order Models for Fluid Dynamics Problems

A Finite-Volume based POD-Galerkin reduced order model is developed for fluid dynamics problems where the (time-dependent) boundary conditions are controlled using two different boundary control strategies: the lifting function method, whose aim is to obtain homogeneous basis functions for the reduced basis space and the penalty method where the boundary conditions are enforced in the reduced order model using a penalty factor. The penalty method is improved by using an iterative solver for the determination of the penalty factor rather than tuning the factor with a sensitivity analysis or numerical experimentation.The boundary control methods are compared and tested for two cases: the classical lid driven cavity benchmark problem and a Y-junction flow case with two inlet channels and one outlet channel. The results show that the boundaries of the reduced order model can be controlled with the boundary control methods and the same order of accuracy is achieved for the velocity and pressure fields. Finally, the reduced order models are 270-308 times faster than the full order models for the lid driven cavity test case and 13-24 times for the Y-junction test case.     

Effect of calcium inhibitors and calcium mobilizers on doxorubicin accumulation in rat myocardial tissue

The effect of four calcium-modulating agents on myocardial doxorubicin (DXR) accumulation was studied: the calcium-inhibitors verapamil (0.1 microM), trifluoperazine (5 microM) and flunarizine (0.05 microM) and the calcium-mobilizer taurine (50 mM). Myocardial cells of isolated Langendorff rat hearts receiving the drugs showed a significantly enhanced 14C-DXR uptake. These observations are in contrast with the hypothesis that DXR accumulation processes may be related to a decrease in calcium influx and suggest that a combined therapy with DXR and calcium-modulating agents might enhance the drug-induced cardiotoxicity.