22 research outputs found
Cutaneous Manifestations of Dermatomyositis : a Comprehensive Review
No full textDermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by the presence of skin lesions and inflammation of skeletal muscles; however, this feature may be absent in amyopathic DM. DM is a rare disease, occurring at any age, and has two peaks of incidence: one in childhood between 5 and 15 years of age and one in adulthood between 40 and 60 years, with a female preponderance. DM has been associated with malignancy; therefore, every newly diagnosed patient should undergo screening investigations, but evidence-based guidelines on their extension are lacking. The etiopathogenesis is still unclear, but a range of factors such as genetic predisposition, environment triggers, and immune- and non-immune-mediated mechanisms play a role in the development of the disorder. Some dermatological findings and new discoveries on immunological mechanisms in DM, including the association of certain autoantibodies with cancer, can be helpful in clinical practice. Therapy should consider both skin and muscle or internal organ involvement. Photoprotection, including the use of antimalarial drugs, plays an important role in the therapeutic approach of skin involvement. Treatment of muscle and internal organ involvement is based on systemic corticosteroids, alone or in association with disease-modifying antirheumatic drugs. Intravenous immunoglobulins have been demonstrated to be effective as second-line therapy. Rituximab is an emerging treatment for difficult-to-treat DM, both in adults and children. In this review article, we discuss DM subforms, focusing on their dermatological manifestations that can be classified as pathognomonic, characteristic, compatible, less common, rare, recently-described, and non-specific skin lesions
A Pattern-Based System to Support Collaborative Production of Learning Objects
No full textThe use of Web 2.0 technologies has established itself even in corporate environments, profoundly changing both the organizational both operational practices. The so-called " knowledge workers", that are workers whose main object of their business is information, were the main protagonists of this change, adopting very frequently Web 2.0 communication tools for their activities. In previous works, we have identified a methodology that aims to identify and model the collaborative business activities by extracting the latter from a catalogue of models of collaborative activities. The application of the methodology and of the models catalogue to the re-engineering process has been successful in various contexts such as public administration, the ICT Company and Banking Company. In this work, we introduce the experience of using methodology and some collaborative pattern to model the Learning Objects production activities. It has the goal of designing an information system that gives support to collaborative activities related to these processes.
The following work is developed as part of a collaborative project between the University of Salento and the CLIO SpA Lecce Company, which has developed a multichannel and interactive system of knowledge transmission called MediaBook. The goal of this work is the review of business processes related to the creation of a MediaBook, in order to improve the support and collaboration between the actors involved making the production phase more efficient. This activity presents different interaction moments between two main actors in the process, which are Author and Publisher. These interactions take place mainly through collaborative tools (chat, mail, etc.) and are not tracked and supported by the production system.
Once having modelled the existing process of MediaBook production, we started a phase of review and optimization of the process, paying particular attention to stress collaborative activities carried out by the actors of the process. Re-engineering process was carried out by following a well-defined and methodological approach. In detail, after modelling the processes in an AS-IS version, we identified the major areas of interest and we applied to the latter some collaborative pattern.
Subsequently we redesigned in the TO-BE version the MediaBook production process using the patterns. The new process highlights several collaborative aspects that were not raised in the AS-IS version of the process. It allows, in this way, to develop a truly collaborative model of activities to support the production of Learning Object. The used patterns allow to manage and coordinate the collaborative activities (eg: Deadline Agreement, Retrieve Contribution and Flexible Providers, Coordinates Contributions and Flexible providers), but also to "catch" the knowledge produced using the means of communication freely chosen by the actors (Aggregate Activity Loop). This result shows once again the efficiency and effectiveness that we can obtain modelling a process using the methodology and collaborative pattern
The Hybridizer: A strategy for the diversification of Midtown Manhattan
No full textArchitecture, Urbanism and Building Science
Contempt and Desire: Women in Italian Futurism
No full textDiskurz o spolu v zgodovinskih avantgardnih gibanjih, še posebej pa v italijanskem futurizmu, je kompleksen in interno kontradiktoren. A številne umetnice, ki so delovale znotraj italijanskega futurističnega gibanja, so v futurističnem uporu proti tradicionalnim konservativnim vrednotam in sentimentalizmu našle mesto za umetniško udejstvovanje. Futuristke in sopotnice futurizma, kot so Sibilla Aleramo, Mina Loy, Valentine de Saint- Point, Enif Robert, Rosa Rosà, Benedetta Cappa Marinetti, Magamal, Maria Ginanni, Maria Goretti, Gianinna Censi, Barbara, Regina, Marisa Mori, Rosetta Amadori Depero ter Luce in Elica Balla, so s svojimi umetniškimi deli ustvarjale radikalno novo pojmovanje spola v eksplicitnem nasprotju s tedaj uveljavljenimi standardi ženskosti. Članek raziskuje, kako so te futuristične in avantgardne umetnice v svojem delu obravnavale spol, kakšno je bilo njihovo mesto v futurizmu in kako so umetnice skozi futuristično estetiko in strategije iskale (ali našle) pot do emancipacije.The discourse on gender in the historical avant-garde movements, especially in Italian Futurism, is complex and internally contradictory. However, many female artists found an avenue for artistic engagement in the Futurist rebellion against traditional conservative values and sentimentalism. Female Futurists or female artists associated with the Futurist movement – such as Sibilla Aleramo, Mina Loy, Valentine de Saint-Point, Enif Robert, Rosa Rosà, Benedetta Cappa Mainetti, Magamal, Maria Ginanni, Maria Goretti, Gianinna Censi, Barbara, Regina, Marisa Mori, Rosetta Amadori Depero, and Luce and Elica Balla – created in their art a radically new conception of gender that explicitly challenged the prevailing standards of femininity. This article explores how the female Futurists addressed gender in their art, their role within the Futurist movement, and how female artists sought (or found) a path to emancipation through Futurist aesthetics and strategies
Elevata incidenza di Diabete tipo 1 tra i bambini di famiglie migranti provenienti dal Nord Africa nella regione Emilia Romagna.
No full textInterposición yeyunal esofagogástrica en la esofagitis péptica grave
No full textThe author reviews the clinico-pathological forms of peptic esophagitis, so as to avoid confusion when adopting a surgical procedureEl autor revisa las formas clínico patológicas de la esofagitis péptica para evitar la confusión en el procedimiento quirúrgico a adoptars
Current Perspectives on Erythema Multiforme
No full textRecognition and timely adequate treatment of erythema multiforme remain a major challenge. In this review, current diagnostic guidelines, potential pitfalls, and modern/novel treatment options are summarized with the aim to help clinicians with diagnostic and therapeutic decision-making. The diagnosis of erythema multiforme, that has an acute, self-limiting course, is based on its typical clinical picture of targetoid erythematous lesions with predominant acral localization as well as histological findings. Clinically, erythema multiforme can be differentiated into isolated cutaneous and combined mucocutaneous forms. Atypical erythema multiforme manifestations include lichenoid or granulomatous lesions as well as lesional infiltrates of T cell lymphoma and histiocytes. Herpes simplex virus infection being the most common cause, other infectious agents like-especially in children-Mycoplasma pneumoniae, hepatitis C virus, Coxsackie virus, and Epstein Barr virus may also trigger erythema multiforme. The second most frequently identified cause of erythema multiforme is drugs. In different studies, e.g., allopurinol, phenobarbital, phenytoin, valproic acid, antibacterial sulfonamides, penicillins, erythromycin, nitrofurantoin, tetracyclines, chlormezanone, acetylsalicylic acid, statins, as well as different TNF-α inhibitors such as adalimumab, infliximab, and etanercept were reported as possible implicated drugs. Recently, cases of erythema multiforme associated with vaccination, immunotherapy for melanoma, and even with topical drugs like imiquimod have been described. In patients with recurrent herpes simplex virus-associated erythema multiforme, the topical prophylactic treatment with acyclovir does not seem to prevent further episodes of erythema multiforme. In case of resistance to one virostatic drug, the switch to an alternative drug, and in patients non-responsive to virostatic agents, the use of dapsone as well as new treatment options, e.g., JAK-inhibitors or apremilast, might be considered
Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
No full textStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered a delayed-type hypersensitivity reaction to drugs. They represent true medical emergencies and an early recognition and appropriate management is decisive for the survival. SJS/TEN manifest with an "influenza-like" prodromal phase (malaise, fever), followed by painful cutaneous and mucous membrane (ocular, oral, and genital) lesions, and other systemic symptoms. The difference between SJS, SJS/TEN overlap, and TEN is defined by the degree of skin detachment: SJS is defined as skin involvement of < 10%, TEN is defined as skin involvement of > 30%, and SJS/TEN overlap as 10-30% skin involvement. The diagnosis of different degrees of epidermal necrolysis is based on the clinical assessment in conjunction with the corresponding histopathology. The mortality rates for SJS and TEN have decreased in the last decades. Today, the severity-of-illness score for toxic epidermal necrolysis (SCORTEN) is available for SJS/TEN severity assessment. Drugs with a high risk of causing SJS/TEN are anti-infective sulfonamides, anti-epileptic drugs, non-steroidal anti-inflammatory drugs of the oxicam type, allopurinol, nevirapine, and chlormezanone. Besides conventional drugs, herbal remedies and new biologicals should be considered as causative agents. The increased risk of hypersensitivity reactions to certain drugs may be linked to specific HLA antigens. Our understanding of the pathogenesis of SJS/TEN has improved: drug-specific T cell-mediated cytotoxicity, genetic linkage with HLA- and non-HLA-genes, TCR restriction, and cytotoxicity mechanisms were clarified. However, many factors contributing to epidermal necrolysis still have to be identified, especially in virus-induced and autoimmune forms of epidermal necrolysis not related to drugs. In SJS/TEN, the most common complications are ocular, cutaneous, or renal. Nasopharyngeal, esophageal, and genital mucosal involvement with blisters, erosions as well as secondary development of strictures also play a role. However, in the acute phase, septicemia is a leading cause of morbidity and fatality. Pulmonary and hepatic involvement is frequent. The acute management of SJS/TEN requires a multidisciplinary approach. Immediate withdrawal of potentially causative drugs is mandatory. Prompt referral to an appropriate medical center for specific supportive treatment is of utmost importance. The most frequently used treatments for SJS/TEN are systemic corticosteroids, immunoglobulins, and cyclosporine A
Primary Biliary Cholangitis Associated with Skin Disorders: A Case Report and Review of the Literature.
No full textPrimary biliary cholangitis (PBC) is a rare autoimmune cholestatic liver disease. It is often associated with extrahepatic autoimmune diseases. Skin disorders are sporadically reported in association with PBC. We report an unusual case of PBC associated with acquired reactive perforating dermatosis (ARPD) and present a review of the literature on skin disorders associated with PBC. Our patient presented to the dermatology department with generalized pruritus associated with nodular perforating skin lesions on the trunk, and cholestatic liver disease of unknown origin. After having established both diagnosis of ARPD and PBC, she was managed in an interdisciplinary manner, and both her skin and liver conditions improved gradually. Only one similar case is reported in the literature, in that case, the liver disease was not treated. By reviewing the literature, we found that lichen planus, vitiligo, and psoriasis are the most frequent skin disorders associated with PBC. However, there is only limited data about specific skin disorders associated with PBC. This case report of a patient with PBC associated with ARPD underlines the importance of interdisciplinary management of patients with rare liver diseases combined with rare skin disorders. The present review of the literature shows that probably, immune-mediated skin conditions are not more frequent in PBC patients than in the general population. However, the available data are scant; there is a need for high-quality data on skin conditions associated with PBC
Bioética anglosajona en su 40 aniversario: el traspaso hacia América Latina y su llegada a Cuba Anglo-Saxon bioethics in its 40th anniversary: the transfer to Latin America and its arrival to Cuba
No full textBioética es un término de origen anglosajón, utilizado por primera vez en 1971 por van Rensselaer Potter; por ello en el 40 aniversario del surgimiento de esta disciplina, se revisó su traspaso de los Estados Unidos de Norteamérica a la América Latina, diferenciando entre moral y ética. Se destaca la labor del profesor José Alberto Mainetti, pionero en esta tarea, así como la importancia de diferentes instituciones, programas y federaciones, entre otras, por su encomiable labor al respecto. Se reseñan las raíces de la bioética en el país y se analizan la formación de sus distintas cátedras, las publicaciones sobre el tema y el apoyo brindado por organizaciones como la Sociedad Cultural "José Martí". El autor, basado en su experiencia, expone cómo ha continuado desarrollándose esta disciplina en Cuba.Bioethics is an Anglo Saxon origin word, used for the first time in 1971 by van Rensselaer Potter; that is why in the 40th anniversary of the emergence of this discipline, its transfer from the United States to Latin America was reviewed, making differences between moral and ethics. Professor José Alberto Mainetti`s work, pioneer in this task is highlighted, as well as the importance of different institutions, programs and federations, among others, for their commendable task on this respect. The roots of bioethics in the country are pointed out, and the formation of their different lectures, the publications on the topic and the support given by organizations such as "José Martí" Cultural Society are analyzed. Based on his experience, the author exposes how this discipline has continued being developed in Cuba
