Carpal tunnel syndrome in HIV-positive patients coinfected with HCV.

A wide range of rheumatic and peripheral nervous system disorders may develop in patients with HIV infection, leading to pain, sensory symptoms, and muscle weakness. Over the past three decades, the progress in management of HIV disease with anti-retroviral therapy (ART) has resulted in increased life expectancy for people living with HIV disease. With this new chronicity of the disease has a constellation of chronic musculoskeletal, orthopaedic and rheumatic manifestations has emerged, as potential complications of the disease itself and/or the results of ART treatment regimen and/or because of expected age-related symptoms/manifestations. The incidence of CTS in the general population is around 3.8% with clinical examination and, when electroneuromyography is used, it is 2.7%. In the HIV-positive population, the incidence is very close to that of the general population. The aim of this study was to evaluate the incidence of CTS and to identify factors influencing the development of CTS in HIV-infected patients attending our clinic. This syndrome has been associated with advanced HIV disease and the use of ART possibly due to an increased inflammatory state and the presence of concurrent HCV infection.

Omalizumab treatment in patient with severe asthma and Eosinophilic Granulomatosis with Polyangiitis . A case report.

Eosinophilic Granulomatosis with Polyangiitis (EGPA), formerly named Churg Strauss Syndrome, is a multisystem disorder characterized by chronic rhinosinusitis, asthma, and prominent peripheral blood eosinophilia; it is classified as a vasculitis of the small and medium sized arteries, although the vasculitis is often not clinically apparent in the initial phases of the disease. We present the case of a woman with EGPA who was frequently treated with high dose steroid therapy during hospital admission for refractory asthma. After December 2008, the date when we started Omalizumab, we observed a significative reduction of circulating eosinophils and IgE serum level, and the patient was no more hospitalized for respiratory failure or asthma attacks.

Idiopathic nonspecific interstitial pneumonia: an interstitial lung disease associated with autoimmune disorders?

Recent evidence suggests that idiopathic nonspecific interstitial pneumonia (iNSIP) is a distinct clinical entity amongst other idiopathic interstitial pneumonias, and some data seem to suggest a possible pathogenetic role of autoimmunity. The aim of the present study was to assess if iNSIP might represent an early lung manifestation of an autoimmune disease. After initial review of cases found in the medical records database by searching for the term "NSIP" (n = 63), 37 iNSIP cases were identified, and were re-evaluated using a dynamic integrated multidisciplinary approach. 27 cases with iNSIP were selected for the study. Mean ± sd age at first respiratory symptom was 54.2 ± 8 yrs, 70% were females, and 59% were never-smokers. At follow-up (mean ± sd 59.7 ± 29 months, range 12-138 months), autoimmune diseases occurred in 14 (52%) patients, with seven (26%) cases of autoimmune thyroiditis, six (22%) of undifferentiated connective tissue disease and three (11%) of connective tissue disease. Patients developing autoimmune diseases were older and more frequently never-smoking females. In >50% of patients diagnosed with iNSIP, evidence of autoimmune diseases develops within 2 yrs, suggesting a probable link between the clinical entity of iNSIP and autoimmune disorders.

Focal nodular hyperplasia after busulfan treatment.

The case of a 48-year-old woman in whom focal nodular hyperplasia of the liver developed after busulfan therapy was administered for essential thrombocytosis is described. Focal nodular hyperplasia is a reactive disorder related to a circulation disorder. The close temporal relation between the haematological disease, busulfan treatment and the appearance of hyperplastic diseases of the liver in our patient supports the possibility that the association of the events might not be casual.

Holonomic quantum computation in the presence of decoherence.

We present a scheme to study non-Abelian adiabatic holonomies for open Markovian systems. As an application of our framework, we analyze the robustness of holonomic quantum computation against decoherence. We pinpoint the sources of error that must be corrected to achieve a geometric implementation of quantum computation completely resilient to Markovian decoherence.

Is Anti Cyclic citrullinated peptide a useful laboratory test for the diagnosis of rheumatoid arthritis?

AIM OF THE STUDY: To evaluate Anti Cyclic citrullinated peptide (anti-CCP) and Rheumatoid Factor (RF) sensitivity and specificity in patients with Rheumatoid Arthritis (RA). MATERIALS AND METHODS: Anti-CCP and RAtest for the assessment of RF have been tried out in 35 patients with RA and in a group of 42 patients whose hands were affected by arthralgic/arthritis-like symptoms. RESULTS: Sensitivity of anti-CCP was 71,4% with 95,2% of specificity. RAtest sensitivity was 91,4% with specificity of 31%. Anti-CCP and RAtest both positive showed an overall 71.4% sensitivity and 95.2% specificity; sensitivity was 91.4% and specificity was 31.0%, if at least RAtest or anti-CCP resulted positive, The positive predictive value of the two test performed together was 97.0%, higher than that of anti-CCP (71.4%) and RAtest (88.5%9) alone. The negative predictive value of the two test performed together was 30.9% similar to that of the RAtest performed alone (30.9%). All patients affected by HCV related chronic liver disease were negative for anti-CCP test; 12/14 of them had RAtest positive. CONCLUSIONS: Anti-CCP antibody has a diagnostic specificity higher than RF. Anti-CCP and RA tests together prove to have the some specificity as anti-CCP alone and a lower sensitivity. Sensitivity is better when at least either RAtest or anti-CCP results positive. The best positive predictive value is obtained performing both anti-CCP and RAtest. Anti-CCP is a useful laboratory marker to confirm the diagnosis of rheumatoid arthritis; it seems to be very important to differentiate patients with RA from those with HCV related arthritis.

[The child with recurrent infections: a problem of pediatric practice]. / Il bambino con infezioni ricorrenti: un problema di pratica pediatrica.

A wide range of topics can be included under the heading of recurrent infections in children. This discussion focuses on 1) the definition of recurrent infection and physiopathogenetic mechanisms predisposing to; 2) controversies in the management of upper respiratory tract infections; 3) recurrent upper and lower respiratory infections in immunocompromised hosts, emphasizing advances in diagnosis and treatment of "mild" immunodeficiencies such as IgG subclass deficiency or antibody deficiency in normogammaglobulimia, trying to define an operative flow chart.