RESUMO
Polarons-fermionic charge carriers bearing a strong companion lattice deformation-exhibit a natural tendency for self-localization due to the recursive interaction between electrons and the lattice. While polarons are ubiquitous in insulators, how they evolve in transitions to metallic and superconducting states in quantum materials remains an open question. Here, we use resonant inelastic x-ray scattering to track the electron-lattice coupling in the colossal magneto-resistive bi-layer manganite La_{1.2}Sr_{1.8}Mn_{2}O_{7} across its metal-to-insulator transition. The response in the insulating high-temperature state features harmonic emissions of a dispersionless oxygen phonon at small energy transfer. Upon cooling into the metallic state, we observe a drastic redistribution of spectral weight from the region of these harmonic emissions to a broad high energy continuum. In concert with theoretical calculations, we show that this evolution implies a shift in electron-lattice coupling from static to dynamic lattice distortions that leads to a distinct polaronic ground state in the low temperature metallic phase-a dynamic polaron liquid.
RESUMO
PURPOSE: Gorham-Stout disease is a very rare disorder characterized by progressive bone erosion and angiomatous proliferation; its etiopathogenesis is still unknown, and diagnosis is still performed by exclusion criteria. The alteration of bone remodeling activity has been reported in patients; in this study, we characterized circulating osteoclast and osteogenic precursors that could be important to better understand the osteolysis observed in patients. METHODS: Flow cytometry analysis of PBMC (Peripheral Blood Mononuclear Cells) was performed to characterize circulating osteoclast and osteogenic precursors in GSD patients (n = 9) compared to healthy donors (n = 55). Moreover, ELISA assays were assessed to evaluate serum levels of bone markers including RANK-L (Receptor activator of NF-κB ligand), OPG (Osteoprotegerin), BALP (Bone Alkaline Phosphatase) and OCN (Osteocalcin). RESULTS: We found an increase of CD16-/CD14+CD11b+ and CD115+/CD14+CD11b+ osteoclast precursors in GSD patients, with high levels of serum RANK-L that could reflect the increase of bone resorption activity observed in patients. Moreover, no significant alterations were found regarding osteogenic precursors and serum levels of BALP and OCN. CONCLUSION: The analysis of circulating bone cell precursors, as well as of RANK-L, could be relevant as an additional diagnostic tool for these patients and could be exploited for therapeutic purposes.
RESUMO
AIMS: Opportunities and needs for starting insulin therapy in Type 2 diabetes (T2D) have changed overtime. We evaluated clinical characteristics of T2D subjects undergoing the first insulin prescription during a 15-year-observation period in the large cohort of the AMD Annals Initiative in Italy. METHODS: Data on clinical and laboratory variables, complications and concomitant therapies and the effects on glucose control after 12 months were evaluated in T2D patients starting basal insulin as add-on to oral/non-insulin injectable agents, and in those starting fast-acting in add-on to basal insulin therapy in three 5-year periods (2005-2019). RESULTS: We evaluated data from 171.688 T2D subjects who intensified therapy with basal insulin and 137.225 T2D patients who started fast-acting insulin. Overall, intensification with insulin occurred progressively earlier over time in subjects with shorter disease duration. Moreover, the percentage of subjects with HbA1c levels > 8% at the time of basal insulin initiation progressively decreased. The same trend was observed for fast-acting formulations. Clinical characteristics of subjects starting insulin did not change in the three study-periods, although all major risk factors improved overtime. After 12 months from the starting of basal or fast-acting insulin therapy, mean HbA1c levels decreased in all the three investigated time-periods, although mean HbA1c levels remained above the recommended target. CONCLUSIONS: In this large cohort of T2D subjects, a progressively earlier start of insulin treatment was observed during a long observation period, suggesting a more proactive prescriptive approach. However, after 12 months from insulin prescription, in many patients, HbA1c levels were still out-of-target.
Assuntos
Glicemia , Diabetes Mellitus Tipo 2 , Hipoglicemiantes , Insulina , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Masculino , Itália/epidemiologia , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Pessoa de Meia-Idade , Insulina/administração & dosagem , Insulina/uso terapêutico , Idoso , Glicemia/análise , Glicemia/metabolismo , Glicemia/efeitos dos fármacos , Hemoglobinas Glicadas/análise , Seguimentos , Fatores de TempoRESUMO
BACKGROUND: Dermatological research has traditionally concentrated on evaluating mental comorbidities, neglecting positive concepts like happiness. Initial studies indicate that psoriasis and atopic dermatitis (AD) impair the happiness of those affected. Considering global happiness variations, this study aimed to explore the disease- and country-specific differences in disease-related quality of life and happiness, and potential influential factors on heuristic happiness among psoriasis and AD patients in Europe. METHODS: A cross-sectional multicentre study was conducted in dermatology departments of university-affiliated hospitals in eight European countries (Austria, Germany, Italy, Malta, Poland, Portugal, Romania and Ukraine) between October 2021 and February 2023. Adult psoriasis and AD patients completed a standardized questionnaire in their native languages, providing data on demographics, disease-related characteristics, disease-related quality of life (Dermatology Life Quality Index, DLQI), heuristic happiness, positive affect (PA), negative affect (NA) and satisfaction with life (SWL). Descriptive analysis and quantile regression were performed. RESULTS: Between psoriasis (n = 723) and AD (n = 316) patients almost no differences were observed in happiness, SWL and NA, except for DLQI and small differences in PA, with AD patients reporting greater impact than psoriasis patients. Country-wise variation emerged in DLQI, heuristic happiness, PA, NA and SWL with Austrian patients displaying the highest levels of happiness, satisfaction and positivity, coupled with higher treatment care and lower disease severity. Quantile regression revealed varying coefficients for predictor variables across quantiles, indicating, for example positive effects on heuristic happiness associated with current or previous receipt of systemic therapies at different quantiles. CONCLUSION: This study shows notable happiness differences across European countries and significant disease-related variations, particularly with AD patients being more impaired than psoriasis patients. The findings highlight the need for equality in treatment access and support the development of targeted positive psychological interventions to enhance happiness considering country-specific distinctions in future research and health policies for psoriasis and AD patients.
RESUMO
BACKGROUND: Ethical climate in the workplace has been highlighted to have an important impact on workers' mental health; the evaluation of workplace ethics and its impact on workers' health should be considered an occupational health issue. AIMS: The present study aims to investigate ethical climate as perceived by workers, and its correlation with mental health outcomes, in particular, symptoms of depression, anxiety and stress. METHODS: A cross-sectional study was performed by administering an online survey, investigating socio-demographic variables, workplace ethics (through the Italian short version of the Corporate Ethical Virtues questionnaire) and mental health outcomes (using the short version of the Depression, Anxiety and Stress Scale). Descriptive analyses, analyses of variance and regression models were performed; P-values were considered significant for values ≤0.05. RESULTS: The sample included 176 workers; the mean age of participants was 46.22 years and 44% were males. The most represented job sector was health care (37%), and 42% of participants had college-level education. Ethical climate was significantly correlated with all mental health outcomes investigated in the study: anxiety (Pâ ≤â 0.001), depression (Pâ ≤â 0.05) and stress (Pâ ≤â 0.05). CONCLUSIONS: Results from this study highlighted a significant correlation between workplace ethical climate and depression, anxiety and stress. This study underlines the importance of evaluating and improving ethical climate to prevent the onset of psychological distress in workers. Furthermore, results from this study should be a starting point for future research investigating the role of ethics and mental health in employees' turnover intention and job satisfaction.
RESUMO
Introduction: The COVID-19 pandemic has determined a radical change in workplace dynamics, with a reported increase in voluntary resignation from employment at a global level, especially among the young-est workers. The aim of this study is to investigate the social, demographic, and cultural characteristics of young people aged between 25 and 45 years who voluntarily resigned from their previous jobs during the COVID-19 pandemic. Methods: This is a cross-sectional observational study; an ad hoc questionnaire was designed and admin-istered via an online link. Descriptive analyses were performed to describe the sample, and the Pearson analysis was performed to investigate statistically significant correlations; p values ≤ 0.05 were considered statistically significant. Results: A total of 72 valid responses were gathered. Mean age was 32.6 years; 43.1% participants were males, 54.2% were married, and 80.6% had no children; most participants (68.1%) had a college level education. The most reported cause of job resignation was work dissatisfaction (38.9%), followed by inadequate remuneration (27.8%). The most reported perspective for people who had resigned or were planning on resigning, was a better salary (27.8%), followed by the pursuit of a higher work-life balance (25.0%). The perception that having resigned was the right choice was significantly correlated with the timeframe of resignation (p<0.01), with having suffered from COVID-19 (p<0.05), and with a close relative having suffered from COVID-19 (p<0.01). Conclusion: This study highlighted that voluntarily resigning was significantly correlated to having suffered from COVID-19, or a close relative having suffered from it; 84.9% of participants who had resigned thought that it had been the right choice. The COVID-19 pandemic could have changed workplace perception, making employees feel more at risk; the indirect impact of the pandemic should be further investigated, and prevention strategies should be implemented to ensure the safety and wellbeing of employees.
Assuntos
COVID-19 , Masculino , Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Feminino , COVID-19/epidemiologia , Pandemias , Estudos Transversais , Emprego , Local de TrabalhoRESUMO
A study was undertaken to determine the effects of a strain of Arthrobacter sp., a Plant Growth-Promoting Bacteria (PGPB), on plant phenology and qualitative composition of Opuntia ficus-indica (L.) Mill. fruits and cladodes. The strain was inoculated in soil, and its effects on cactus pear plants were detected and compared to nontreated plants. Compared to the latter, the treatment with bacteria promoted an earlier plant sprouting (2 months before the control) and fruitification, ameliorating fruit quality (i.e., improved fresh and dry weight: + 24% and + 26%, respectively, increased total solid content by 30% and polyphenols concentrations by 22%). The quality and quantity of monosaccharides of cladodes were also increased by Arthrobacter sp. with a positive effect on their nutraceutical value. In summer, the mean values of xylose, arabinose, and mannose were significantly higher in treated compared to not treated plants (+ 3.54; + 7.04; + 4.76 mg/kg d.w. respectively). A similar trend was observed in autumn, when the cladodes of inoculated plants had higher contents, i.e., 33% xylose, 65% arabinose, and 40% mannose, respect to the controls. In conclusion, Arthrobacter sp. plays a role in the improvement of nutritional and nutraceutical properties of cactus pear plants due to its capabilities to promote plant growth. Therefore, these results open new perspectives in PGPB application in the agro-farming system as alternative strategy to improve cactus pear growth, yield, and cladodes quality, being the latter the main by-product to be utilized for additional industrial uses.
Assuntos
Arthrobacter , Opuntia , Frutas , Manose , Arabinose , Xilose , Suplementos NutricionaisRESUMO
BACKGROUND: The association between asbestos exposure and ovarian cancer has been questioned given the possible misdiagnosis of peritoneal mesothelioma as ovarian cancer. AIMS: To update a systematic review on ovarian cancer risk in women occupationally exposed to asbestos, exploring the association with the time since first exposure and the duration of exposure. METHODS: We searched PubMed from 2008 onwards, screened previous systematic reviews, combined standardized mortality ratios (SMR) using random effect models and quantified heterogeneity using the I2 statistic. To assess tumour misclassification, we compared the distribution of observed excess ovarian cancers (OEOC) to that expected (EEOC) from the distribution of peritoneal cancers in strata of latency and exposure duration. RESULTS: Eighteen publications (20 populations), including a pooled analysis of 21 cohorts, were included. The pooled SMR was 1.79 (95% confidence interval 1.38-2.31), with moderate heterogeneity between studies (I2â =â 42%), based on 144 ovarian cancer deaths/cases. The risk was increased for women with indirect indicators of higher exposure, longer duration and latency, and lower for chrysotile than for crocidolite exposure. The effect of duration and latency could not be completely disentangled, since no multivariate analysis was available for time-related variables. The dissimilarity index between OEOC and EEOC for the time since first exposure was small suggesting a similar pattern of risk. CONCLUSIONS: While some misclassification between ovarian and peritoneal cancers cannot be excluded, the observed excess risk of ovarian cancer should be added to the overall disease burden of asbestos.
Assuntos
Amianto , Neoplasias Pulmonares , Mesotelioma , Doenças Profissionais , Exposição Ocupacional , Neoplasias Ovarianas , Humanos , Feminino , Amianto/efeitos adversos , Neoplasias Ovarianas/etiologia , Risco , Exposição Ocupacional/efeitos adversos , Fatores de Tempo , Mesotelioma/etiologia , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologiaRESUMO
OBJECTIVES: The aim of this umbrella review of systematic reviews and meta-analyses was to address workplace violence (WPV) against healthcare workers (HCWs). Several systematic reviews exist in the literature, but the diversity of settings, population considered, and type of violence investigated make it difficult to gain insight and use the vast amount of available data to implement policies to tackle WPV. With this in mind, we conducted an umbrella review of systematic reviews and meta-analyses on WPV against HCWs to examine the global prevalence of the phenomena and its features. STUDY DESIGN AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and ISI Web of Science were searched for relevant systematic reviews and meta-analyses published in English up to November 2022. Data on authors, year, country, violence type, prevalence (pooled and not), setting, population, and specific considerations were extracted. RESULTS: A total of 32 systematic reviews were included, 19 of which performed a meta-analysis, investigating overall, physical, and non-physical violence. Even considering the variability of the data, the COVID-19 pandemic has exacerbated the scale of the problem. From our review, we found that overall violence prevalence among HCWs was reported to be as high as 78.9%, and nurses working in psychiatric wards were the professionals most impacted. CONCLUSION: In conclusion, this umbrella review revealed a high prevalence of WPV among HCWs, which varies between countries, population subgroups, and detection methods. Strengthening recognition of the problem could lead to appropriate local and international strategies to address it.
Assuntos
COVID-19 , Violência no Trabalho , Humanos , Pessoal de Saúde , Pandemias , Prevalência , Local de Trabalho , Revisões Sistemáticas como Assunto , Metanálise como AssuntoRESUMO
Introduction: Work-related psychosocial risks have been identified as significant occupational health and safety risks; the occupational physicians must assess and monitor the health status of workers in order to verify that work is not a source of harm to exposed operators. The aim of the study was to investigate the outcomes related to anxiety and depression traits in workers exposed to stress-related work. Methods: A questionnaire was administered to a large population of Italian public administration workers; the Centre for Epidemiologic Studies - Depression Scale questionnaire was used to measure depression, the Self rating Anxiety Scale was used to measure anxiety, the UK Management Standards Indicator tool questionnaire was used to assess work adjustment. A descriptive analysis, a multivariate analysis, as well as logistic regression models were used to assess the health outcomes related to stress. Results: A total of 292 workers participated in the study; 100% of participants had a Centre for Epidemiologic Studies - Depression Scale score over the cut-off; 41.78% had a Self rating Anxiety Scale score over the cut-off; the results support a correlation between the Centre for Epidemiologic Studies - Depression Scale results and the UK Management Standards Indicator tool results; and a correlation between Self-rating Anxiety Scale results and the UK Management Standards Indicator tool results. Conclusions: The Demand, Management, Support and Relationship results were associated with mental health outcomes, and it could be a useful tool in occupational medicine, to identify workers at risk for negative mental health outcomes, becoming an essential tool in workers' health assessment and for prevention of mental health disorders.
Assuntos
Transtornos Mentais , Exposição Ocupacional , Estresse Ocupacional , Angústia Psicológica , Humanos , Projetos Piloto , Estresse Ocupacional/diagnóstico , Estresse Ocupacional/epidemiologia , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/etiologia , Inquéritos e Questionários , Exposição Ocupacional/efeitos adversos , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/etiologiaRESUMO
Patients with chronic schizophrenia and psychosis are more prone to develop hyponatremia. Hyponatremia could be due to medications e.g. antidepressants/antipsychotics or secondary to psychogenic polydipsia. They often present with altered consciousness, seizures and falls. Rapid correction of hyponatremia in patients with psychogenic polydipsia has been associated to cause rhabdomyolysis, an under-recognized yet serious condition which if left untreated can result in various complications e.g. acute kidney injury, electrolyte abnormalities. We report a case of young patient who had background illness of schizophrenia and presented to department with severe hyponatremia secondary to psychogenic polydipsia and was eventually diagnosed as case of rhabdomyolysis due to rapid correction of hyponatremia. Objective of case report is to highlight the correct diagnosis of underlying cause of hyponatremia and challenges associated with managing rhabdomyolysis with IV fluids that can result in worsening of hyponatremia, hence emphasizing the importance of close monitoring of sodium levels and measurement of creatine kinase in any patient who presents with severe hyponatremia, particularly in the presence of other risk factors for rhabdomyolysis and consideration of careful fluid administration strategies in relation to the relative onset and risk of over-correcting hyponatremia.
RESUMO
AIMS: This review summarizes the contribution of Italian diabetologists devoted to a better understanding of the complex relationship linking sex/gender and long-term complications of type 1 (T1DM) and type 2 diabetes (T2DM) over the last fifteen years. DATA SYNTHESIS: Microvascular and macrovascular complications of diabetes show sex- and gender-related differences, involving pathophysiological mechanisms, epidemiological features and clinical presentation, due to the interaction between biological and psychosocial factors. These differences greatly impact on the progression of diabetes and its long-term complications, especially in the cardiovascular, renal and liver districts. CONCLUSION: A better knowledge of such sex- and gender-related characteristics is required for a more precise patient phenotypization, and for the choice of a personalized antihyperglycemic treatment. Despite such mounting evidence, current diabetes clinical guidelines do not as yet adequately consider sex/gender differences.
Assuntos
Complicações do Diabetes , Diabetes Mellitus Tipo 2 , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Hipoglicemiantes/efeitos adversos , Itália/epidemiologia , Fatores SexuaisRESUMO
Reactions involving adsorbates on metallic surfaces and impurities in bulk metals are ubiquitous in a wide range of technological applications. The theoretical modeling of such reactions presents a formidable challenge for theory because nuclear quantum effects (NQEs) can play a prominent role and the coupling of the atomic motion with the electrons in the metal gives rise to important non-adiabatic effects (NAEs) that alter atomic dynamics. In this work, we derive a theoretical framework that captures both NQEs and NAEs and, due to its high efficiency, can be applied to first-principles calculations of reaction rates in high-dimensional realistic systems. More specifically, we develop a method that we coin ring polymer instanton with explicit friction (RPI-EF), starting from the ring polymer instanton formalism applied to a system-bath model. We derive general equations that incorporate the spatial and frequency dependence of the friction tensor and then combine this method with the ab initio electronic friction formalism for the calculation of thermal reaction rates. We show that the connection between RPI-EF and the form of the electronic friction tensor presented in this work does not require any further approximations, and it is expected to be valid as long as the approximations of both underlying theories remain valid.
RESUMO
In Paper I [Litman et al., J. Chem. Phys. (in press) (2022)], we presented the ring-polymer instanton with explicit friction (RPI-EF) method and showed how it can be connected to the ab initio electronic friction formalism. This framework allows for the calculation of tunneling reaction rates that incorporate the quantum nature of the nuclei and certain types of non-adiabatic effects (NAEs) present in metals. In this paper, we analyze the performance of RPI-EF on model potentials and apply it to realistic systems. For a 1D double-well model, we benchmark the method against numerically exact results obtained from multi-layer multi-configuration time-dependent Hartree calculations. We demonstrate that RPI-EF is accurate for medium and high friction strengths and less accurate for extremely low friction values. We also show quantitatively how the inclusion of NAEs lowers the crossover temperature into the deep tunneling regime, reduces the tunneling rates, and, in certain regimes, steers the quantum dynamics by modifying the tunneling pathways. As a showcase of the efficiency of this method, we present a study of hydrogen and deuterium hopping between neighboring interstitial sites in selected bulk metals. The results show that multidimensional vibrational coupling and nuclear quantum effects have a larger impact than NAEs on the tunneling rates of diffusion in metals. Together with Paper I [Litman et al., J. Chem. Phys. (in press) (2022)], these results advance the calculations of dissipative tunneling rates from first principles.
RESUMO
PURPOSE: Denosumab is a fully human monoclonal anti-RANK-L antibody that is clinically used to counteract the bone loss induced by exacerbated osteoclast activity. Indeed, its binding to RANK-L prevents the interaction RANK-L/receptor RANK that is essential for osteoclastogenesis and bone resorbing activity. Although there are many medications available to treat bone loss diseases, including bisphosphonates, Denosumab is highly effective since it reduces the bone erosion. The use in pediatric patients is safe. However, some concerns are related to the interruption of the treatment. Indeed, in this study, we reported hypercalcemia in two pediatric patients and alterations of circulating osteoclast precursors. METHODS: Peripheral Blood Mononuclear Cells (PBMC) were isolated from two pediatric patients with hypercalcemia after Denosumab interruption and from 10 controls. Cytofluorimetric analysis and in vitro osteoclastogenesis experiments were performed. RESULTS: Increase of CD16-CD14+CD11b+ cells was revealed in PBMC from patients reflecting the enhanced in vitro osteoclastogenesis. CONCLUSION: Our data suggest that precautions must be taken when Denosumab therapy is interrupted and gradual decrease of dose and/or timing of treatment should be performed. To prevent the onset of hypercalcemia that could be in the discontinuation phase, cytofluorimetric analysis of PBMC should be performed to evaluate osteoclast precursors.
Assuntos
Denosumab/uso terapêutico , Hipercalcemia/etiologia , Suspensão de Tratamento , Doença Aguda , Adolescente , Bélgica , Cistos Ósseos Aneurismáticos/sangue , Cistos Ósseos Aneurismáticos/tratamento farmacológico , Estudos de Casos e Controles , Células Cultivadas , Criança , Granuloma de Células Gigantes/sangue , Granuloma de Células Gigantes/tratamento farmacológico , Humanos , Hipercalcemia/sangue , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Masculino , Doenças Mandibulares/sangue , Doenças Mandibulares/tratamento farmacológico , Osteoclastos/efeitos dos fármacos , Osteoclastos/fisiologia , Cultura Primária de Células , Transdução de Sinais/efeitos dos fármacosRESUMO
BACKGROUND: Moderate-to-severe atopic dermatitis (AD) in the adolescence is a high burden disease, and its treatment can be very challenging due to paucity of approved systemic drugs for this age and their side-effects. Dupilumab was recently approved for treatment of adolescent AD. OBJECTIVES: A multicentre, prospective, real-world study on the effectiveness and safety of dupilumab in adolescents (aged from ≥12 to <18 years) with moderate-to-severe AD was conducted. The main AD clinical phenotypes were also examined. METHODS: Data of adolescents with moderate-to-severe AD treated with dupilumab at label dosage for 16 weeks were collected. Treatment outcome was assessed by EASI, NRS itch, NRS sleep loss and CDLQI scores at baseline and after 16 weeks of treatment. The clinical scores were also evaluated according to clinical phenotypes. RESULTS: One hundred and thirty-nine adolescents were enrolled in the study. Flexural eczema and head and neck eczema were the most frequent clinical phenotypes, followed by hand eczema and portrait-like dermatitis. Coexistence of more than 1 phenotype was documented in 126/139 (88.5%) adolescents. Three patients (2.1%) contracted asymptomatic SARS-CoV-2 infection and 1 of the discontinued dupilumab treatment before the target treatment period. A significant improvement in EASI, NRS itch, NRS sleep loss and CDLQI was observed after 16 weeks of treatment with dupilumab. This outcome was better than that observed in clinical trials. Dupilumab resulted effective in all AD phenotypes, especially in diffuse eczema. Twenty-eight (20.1%) patients reported adverse events, conjunctivitis and flushing being the most frequent. None of patients discontinued dupilumab due to adverse event. CONCLUSIONS: Dupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores. Moreover, dupilumab showed a good safety profile also in this COVID-19 pandemic era.
Assuntos
Tratamento Farmacológico da COVID-19 , Dermatite Atópica , Eczema , Anticorpos Monoclonais Humanizados , Dermatite Atópica/tratamento farmacológico , Método Duplo-Cego , Humanos , Pandemias , Estudos Prospectivos , Prurido , SARS-CoV-2 , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This first part of the guideline includes general information on its scope and purpose, the health questions covered, target users and a methods section. It also provides guidance on which patients should be treated with systemic therapies, as well as recommendations and detailed information on each systemic drug. The systemic treatment options discussed in the guideline comprise conventional immunosuppressive drugs (azathioprine, ciclosporin, glucocorticosteroids, methotrexate and mycophenolate mofetil), biologics (dupilumab, lebrikizumab, nemolizumab, omalizumab and tralokinumab) and janus kinase inhibitors (abrocitinib, baricitinib and upadacitinib). Part two of the guideline will address avoidance of provocation factors, dietary interventions, immunotherapy, complementary medicine, educational interventions, occupational and psychodermatological aspects, patient perspective and considerations for paediatric, adolescent, pregnant and breastfeeding patients.
Assuntos
Dermatite Atópica , Eczema , Adolescente , Azatioprina/uso terapêutico , Criança , Ciclosporina/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Eczema/tratamento farmacológico , Humanos , Imunossupressores/uso terapêutico , Ácido Micofenólico/uso terapêuticoRESUMO
The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This second part of the guideline includes recommendations and detailed information on basic therapy with emollients and moisturizers, topical anti-inflammatory treatment, antimicrobial and antipruritic treatment and UV phototherapy. Furthermore, this part of the guideline covers techniques for avoiding provocation factors, as well as dietary interventions, immunotherapy, complementary medicine and educational interventions for patients with atopic eczema and deals with occupational and psychodermatological aspects of the disease. It also contains guidance on treatment for paediatric and adolescent patients and pregnant or breastfeeding women, as well as considerations for patients who want to have a child. A chapter on the patient perspective is also provided. The first part of the guideline, published separately, contains recommendations and guidance on systemic treatment with conventional immunosuppressive drugs, biologics and janus kinase (JAK) inhibitors, as well as information on the scope and purpose of the guideline, and a section on guideline methodology.
Assuntos
Anti-Infecciosos , Produtos Biológicos , Dermatite Atópica , Fármacos Dermatológicos , Eczema , Adolescente , Anti-Infecciosos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antipruriginosos/uso terapêutico , Produtos Biológicos/uso terapêutico , Criança , Dermatite Atópica/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Eczema/tratamento farmacológico , Emolientes/uso terapêutico , Feminino , Humanos , Janus QuinasesRESUMO
The search continues for nickel oxide-based materials with electronic properties similar to cuprate high-temperature superconductors1-10. The recent discovery of superconductivity in the doped infinite-layer nickelate NdNiO2 (refs. 11,12) has strengthened these efforts. Here, we use X-ray spectroscopy and density functional theory to show that the electronic structure of LaNiO2 and NdNiO2, while similar to the cuprates, includes significant distinctions. Unlike cuprates, the rare-earth spacer layer in the infinite-layer nickelate supports a weakly interacting three-dimensional 5d metallic state, which hybridizes with a quasi-two-dimensional, strongly correlated state with [Formula: see text] symmetry in the NiO2 layers. Thus, the infinite-layer nickelate can be regarded as a sibling of the rare-earth intermetallics13-15, which are well known for heavy fermion behaviour, where the NiO2 correlated layers play an analogous role to the 4f states in rare-earth heavy fermion compounds. This Kondo- or Anderson-lattice-like 'oxide-intermetallic' replaces the Mott insulator as the reference state from which superconductivity emerges upon doping.
RESUMO
An amendment to this paper has been published and can be accessed via a link at the top of the paper.