Safe and effective: anti-tumour necrosis factor therapy use in pregnant patients with Crohn disease and ulcerative colitis.

Biological therapy, particularly the anti-tumour necrosis factor (TNF) antibodies, infliximab and adalimumab, are used for the maintenance of remission for patients with inflammatory bowel diseases (IBD). We present 21 pregnancies in IBD patients exposed to anti-TNF agents between 2007 and 2014. Our study demonstrates that anti-TNF therapy is safe and effective in pregnancy. Rates of foetal complications are similar to IBD cohorts from the pre anti-TNF era.

The challenges of managing refractory oesphageal lichen planus.

INTRODUCTION: Lichen planus is an inflammatory mucocutaneous disorder, often idiopathic. It is postulated that the characteristic skin lesions arise from a T cell mediated autoimmune response against basal keratinocytes. Oral mucosal involvement can occur in up to 70 % of cases of cutaneous disease however, oesphageal involvement is rare. RESULT: We report the case of a 60 year old female with ulcerative oesphagitis and concomitant cutaneous lesions suggestive of lichen planus. Multiple immunosuppressant therapies were administered but with little success, except for pulses of oral steroids. CONCLUSION: Oesphageal lichen planus is rare, often unrecognised and can be resistant to treatment. However, diagnosis is crucial as malignant transformation of longstanding ulcerative lichen planus may occur.

Two cases of dermatoses koebnerizing within fields of previous radiotherapy.

We describe two patients with newly diagnosed dermatoses localizing to the radiotherapy field following treatment for breast cancer. Patient 1 was a 53-year-old woman who developed bullous morphoea on her left breast two years after radiotherapy. Patient 2 was a 43-year-old woman who developed urticaria pigmentosa on her right breast eight months after radiotherapy and similar lesions gradually developed beyond the radiotherapy field. Both patients experienced a significant delay in diagnosis due to diagnostic confusion and concern over breast cancer recurrence. Irradiated skin demonstrates gradual and sustained alterations in fibrosis due to the production of long-lived cytokines and chemokines. These changes can induce a koebnerizing response in conditions such as morphoea and urticaria pigmentosa. We explore the mechanisms behind radiotherapy-induced skin changes, and highlight the potential for radiotherapy to exacerbate or unmask underlying dermatoses and systemic disease in the months and years following treatment.

Cutaneous reactions to adalimumab administration.

Patients receiving antitumour necrosis factor-alpha treatment may develop cutaneous reactions. This human monoclonal antibody is used in the treatment of chronic inflammatory diseases, including arthritis and inflammatory bowel disease. A variety of side effects have been documented ranging from infection and vasculitis through to systemic lupus erythematosus and psoriasis. We report on two arthritic patients treated with adalimumab (Humira, Abbot Laboratories, IL, USA) who developed new onset rashes that resolved with discontinuation of therapy. The frequency of these cutaneous reactions has not been fully established and may benefit from a centralised registry.

Aberration corrected analytical electron microscopy studies of sol-immobilized Au + Pd, Au{Pd} and Pd{Au} catalysts used for benzyl alcohol oxidation and hydrogen peroxide production.

In this study, a systematic series of AuPd bimetallic particles were prepared by colloidal synthesis methods, in order to gain better control over the particle size distribution and structure. Particles having random alloy structures, as well as 'designer' particles with Pd-shell/Au-core and Au-shell/Pd-core morphologies, have been prepared and immobilized on both activated carbon and TiO2 supports. Aberration corrected analytical electron microscopy (ACEAM) has been extensively used to characterize these sol-immobilized materials. In particular, state-of-the-art z-contrast STEM-HAADF imaging and STEM-XEDS spectrum imaging has been employed. These techniques have provided invaluable new (and often unexpected) information on the atomic structure, elemental distribution within particles, and compositional variations between particles for these controlled catalyst preparations. In addition, we have been able to compare their differing thermal stability, sintering and wetting behaviors on activated carbon and TiO2 supports. These sol immobilized materials have also been compared as catalysts for (i) benzyl alcohol oxidation and (ii) the direct production of H2O2 in an attempt to elucidate the optimum particle morphology/ support combination for each reaction.

Improvements in the X-ray analytical capabilities of a scanning transmission electron microscope by spherical-aberration correction.

A Nion spherical-aberration (Cs) corrector was recently installed on Lehigh University's 300-keV cold field-emission gun (FEG) Vacuum Generators HB 603 dedicated scanning transmission electron microscope (STEM), optimized for X-ray analysis of thin specimens. In this article, the impact of the Cs-corrector on X-ray analysis is theoretically evaluated, in terms of expected improvements in spatial resolution and analytical sensitivity, and the calculations are compared with initial experimental results. Finally, the possibilities of atomic-column X-ray analysis in a Cs-corrected STEM are discussed.

The hydride anion in an extended transition metal oxide array: LaSrCoO3H0.7.

We present the synthesis and structural characterization of a transition metal oxide hydride, LaSrCoO3H0.7, which adopts an unprecedented structure in which oxide chains are bridged by hydride anions to form a two-dimensional extended network. The metal centers are strongly coupled by their bonding with both oxide and hydride ligands to produce magnetic ordering at temperatures up to at least 350 kelvin. The synthetic route is sufficiently general to allow the prediction of a new class of transition metal--containing electronic and magnetic materials.

Calculation of the electronic structure of carbon films using electron energy loss spectroscopy.

The detailed understanding of the electronic properties of carbon-based materials requires the determination of their electronic structure and more precisely the calculation of their joint density of states (JDOS) and dielectric constant. Low electron energy loss spectroscopy (EELS) provides a continuous spectrum which represents all the excitations of the electrons within the material with energies ranging between zero and about 100 eV. Therefore, EELS is potentially more powerful than conventional optical spectroscopy which has an intrinsic upper information limit of about 6 eV due to absorption of light from the optical components of the system or the ambient. However, when analysing EELS data, the extraction of the single scattered data needed for Kramers Kronig calculations is subject to the deconvolution of the zero loss peak from the raw data. This procedure is particularly critical when attempting to study the near-bandgap region of materials with a bandgap below 1.5 eV. In this paper, we have calculated the electronic properties of three widely studied carbon materials; namely amorphous carbon (a-C), tetrahedral amorphous carbon (ta-C) and C60 fullerite crystal. The JDOS curve starts from zero for energy values below the bandgap and then starts to rise with a rate depending on whether the material has a direct or an indirect bandgap. Extrapolating a fit to the data immediately above the bandgap in the stronger energy loss region was used to get an accurate value for the bandgap energy and to determine whether the bandgap is direct or indirect in character. Particular problems relating to the extraction of the single scattered data for these materials are also addressed. The ta-C and C60 fullerite materials are found to be direct bandgap-like semiconductors having a bandgaps of 2.63 and 1.59eV, respectively. On the other hand, the electronic structure of a-C was unobtainable because it had such a small bandgap that most of the information is contained in the first 1.2 eV of the spectrum, which is a region removed during the zero loss deconvolution.