The first case of systemic lupus erythematosus (SLE) triggered by COVID-19 infection.

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, SARS-CoV-2. The acute phase may be followed by a second phase actually not yet completely understood but probably associated to an autoimmune activation. At the moment is not possible to clearly define an association between immunological findings and pathological symptoms, however, this case report describes the case of a patient who following COVID-19 infection development autoimmune antibodies who persist in time longer than viral phase. Those antibodies can be responsible for the multi pathological clinical picture showed from our patient that, according to EULAR 2019 criteria, could be classified as systemic lupus erythematosus (SLE). SLE is probably one of the possible chronic rheumatologic diseases triggers by COVID-19 and this is the first case of SLE with vasculitis actually described in literature.

Evaluation of microbial contamination of air in two haematology departments equipped with ventilation systems with different filtration devices.

BACKGROUND: Nosocomial infections (NI) are above all due to health-care workers practices, but also the contamination of the environment could lead to their rise in health-care facilities. Introduction. In the last years, the incidence of NI has increased due to a substantial rise in the number of immuno-compromised patients. These patients are often gathered in hospital areas declared at "high risk" of infection such as Hematology and Bone Marrow Transplant ward. In this study, we evaluated microbial contamination of the air in two divisions with high risk patients, focusing on the validity of the air system with correlation to the presence or not of the HEPA absolute filters. METHODS: An environmental surveillance study has been carried out in two Divisions of Haematology, in two different Hospitals. Investigations have been performed by sampling air and by analyzing bacterial and fungal growth on microbiology plates after an incubation period. RESULTS: Unit A, without HEPA filters in the ventilation systems, showed a gradual increase in the bacterial load 20 and 60 days after cleaning of the ventilation system. Mycetes and Aspergilli were not present in basal conditions, at 20 or 60 days after decontamination. Unit B, equipped with HEPA filters placed at the inlet vents, showed extremely low values of the bacterial load either in basal conditions or upon inspection 60 days after cleaning. No mycetes were present. DISCUSSION: From the results obtained, it was evident that following the cleaning operation, the quality of the air is excellent in both types of equipment, since no mycetes were present and the bacterial load was < 20 CFU/mc in all the sites tested. However, although in subsequent controls mycetes were absent in both types of equipment, a great difference in the suspended bacterial load was found: Unit B was close to sterility whereas in Unit A a progressive increase was observed.

Immunogenicity and tolerability of a trivalent virosomal influenza vaccine in a cohort of HIV-infected children.

Twenty-three children infected with the human immunodeficiency virus (HIV) were vaccinated with a trivalent inactivated virosomal influenza vaccine. Serum haemagglutinin inhibition antibody titres were determined for the three viral strains at the time of vaccination and 1 month later. CD4 cell counts and HIV viral loads were measured to evaluate the effect of vaccination on HIV status. Adverse reactions were monitored during the first hour following vaccination by an investigator and then on a continuous basis by the parents. Seroconversion rates against the three viral strains A/H3N2, A/H1N1 and B were 73.9%, 56.5% and 52.2%, respectively. Geometric mean antibody titres increased after 1 month compared with baseline values (A/H3N2: 70.9 versus 13.5; A/H1N1: 24.7 versus 5.8; B: 34.4 versus 9.1). No significant changes were observed in either HIV viral load or CD4 cell count following vaccination. Vaccination was well tolerated with only a few mild, transient symptoms.

A new assay for hepatitis C virus (HCV) core antigen detection: an alternative to nucleic acid technologies in positive or indeterminate anti-HCV subjects?

Markers of viral replication are fundamental tools for understanding the mode of transmission, diagnosis and management of hepatitis C virus (HCV) infection. A new enzyme-linked immunosorbent assay for quantitative detection of free and complexed HCV core antigen (HCV Ag) has been developed. The aim of this study is to evaluate the clinical performance of the new test and compare it with the most widely used commercially available RT-PCR-based assay. To determine the cut-off value we tested 60 samples from anti-HCV negative samples and selected a qualitative cut-off value of 3 pg/ml. To evaluate the usefulness of the new assay in confirming serologically indeterminate results we collected 62 sera. To evaluate the HCV Ag and HCV-RNA relationship we tested 245 samples from patients with different clinical conditions. The results of 61 out of 62 (98.4%) anti-HCV indeterminate samples were found to agree, whereas only one serum was found to be RT-PCR positive and HCV Ag negative. We also found the results to agree in 77.6% (190/245) of the samples from infected patients, while we observed higher agreement in untreated patients, both with and without evidence of liver damage. The correlation coefficient (r) observed between HCV Ag and HCV-RNA was 0.88. The regression line meets the cut-off value at an HCV-RNA concentration of approximately 40,000 IU/ml. In conclusion, we found that the results from the total HCV Ag test agree with the RT-PCR results and therefore we believe that this test could become a useful tool for the diagnosis and management of HCV infection.

Langerhans cell histiocytosis in the elderly: a report of three cases.

Langerhans cell histiocytosis is most common in children and is unusual in the elderly. We describe 3 cases of langerhans cell histiocytosis limited to the skin in elderly patients. Biopsy specimens showed a dermal infiltrate abutting the epidermis composed of atypical langerhans cells with abundant eosinophilic cytoplasm and a "kidney-shaped" nucleus. Immunoperoxidase stain CD1a was positive in all 3 cases and S-100 stain was positive in 2. Electron microscopy revealed Birbeck granules in the cytoplasm of the atypical langerhans cells in 2 cases. Langerhans cell histiocytosis with skin involvement has a chronic course with an overall good prognosis. However, cutaneous manifestations may precede systemic involvement by many years.

The role of the plant properties in point-to-point arm movements: a robustness study.

In recent papers we demonstrated by means of a modeling study that the smoothness of hand paths and the bell-shaped character of hand velocity profiles which have been experimentally observed in point-to-point arm movements can be largely attributed to the biomechanical properties of the arm rather than to specific planning by the central nervous system. In this paper we present a study of the robustness of our earlier results comprising two goals: (i) the determination of the range of model parameters for which such observations remain valid, (ii) the identification of possible relationships between model parameters and kinematic variables. The results of this study imply three conclusions: (i) the valid range of the tested model parameters (namely the main muscle parameters) is large, (ii) the modeled phenomena are well behaved in that parametric changes do not give rise to bifurcations or other behavioral discontinuities in the analyzed ranges, (iii) there exist precise relationships between certain muscle parameters and the time course of the hand velocity. These results point out that the phenomena observed in our previous work are indeed robust and can lead to useful insights into the mechanisms comprising the regulatory action of the central nervous system as well as into the design principles for biologically inspired artificial arms.

Sensitization to para-tertiary-butylphenolformaldehyde resin.

BACKGROUND: Phenolformaldehyde resins, especially the para-tertiary-butylphenolformaldehyde resin (PTBP-FR), are widely used in industry and in numerous materials of everyday use, such as glues, adhesives, or inks. They can cause many occupational and nonoccupational cases of dermatitis. PATIENTS AND METHODS: Forty-one patients with positive patch test results to PTBP-FR were selected for this study. They were patch-tested with a series of chemically related compounds and cross-reactions were noted. RESULTS: Phenolformaldehyde resin (PF-R) was frequently positive (65.8%), whereas other compounds gave a much smaller number of positive results. Cases of occupational exposure (24.4%), location of the dermatitis (hands were involved in 46.3% of cases), and possible sources of exposure (shoes were the responsible agent in 12.2% of cases) were evaluated. CONCLUSIONS: Phenolformaldehyde resins are an important cause of contact dermatitis and must be studied chemically and clinically to improve the prognosis of sensitized patients.

The role of plant properties in arm trajectory formation: a neural network study.

In this paper, we first introduce a neural network model of a planar, six-muscle, redundant arm whose structure and operation principles were inspired by those of the human arm. We developed the model with a motor-learning framework in mind, i.e., with the long-term goal of incorporating it in a parallel distributed learning scheme for the arm controller. We then demonstrate the response of the model to various patterns of activation of the arm muscles in order to study the relative role of control strategies and plant properties in trajectory formation. The results of our simulations emphasize the role of the intrinsic properties of the plant in generating movements with anthropomorphic qualities such as smoothness and unimodal velocity profiles, and demonstrate that the task of an eventual controller for the arm could be simply that of programming the amplitudes and durations of steps of neural input without considering additional motor details. Our findings are relevant to the design of artificial arms and, with some caveats, to the study of the brain strategies in the arm motor system.

A neural-network system for control of eye movements: basic mechanisms.

This paper presents a neural-network-based system that can generate and control movements of the eyes. It was inspired by a number of experimental observations on the saccadic and gaze systems of monkeys and cats. Because of the generality of the approach undertaken, the system can be regarded as a demonstration of how parallel distributed processing principles, namely learning and attractor dynamics, can be integrated with experimental findings, as well as a biologically inspired controller for a dexterous robotic orientation device. The system is composed of three parts: a dynamic motor map, a push-pull circuitry, and a plant. The dynamics of the motor map is generated by a multi-layer network that was trained to compute a bidimensional temporal-spatial transformation. Simulation results indicate (1) that the system is able to reproduce some of the properties observed in the biological system at the neural and movement levels and (2) that the dynamics of the motor map remains stereotyped even when the motor map is subject to abnormal stimulation patterns. The latter result emphasizes the role of the topographic projection that connects the motor map to the push-pull circuitry in determining the features of the resulting movements.

Model of topographic map development guided by a transiently expressed repulsion molecule.

The projection from the retina develops into a precise map of the visual world on the surface of the tectum. The search for molecular position cues that mediate map formation has recently yielded a tectal molecule that exerts a repulsion to fibers from the entire temporal half retina. This molecule appears not to function in the generally accepted gradient manner but instead provides only binary position information, and it is only expressed transiently during early development. Here we describe modeling results that compare the efficacy of binary versus graded position cues in topographic map formation; the model also includes an activity dependent process. We find that binary repulsion is more efficient than graded chemoaffinity in the rapid establishment of map polarity, and transient expression of either cue provides sufficient guidance for precise map formation.

Positive patch test reactions to nickel, cobalt, and potassium dichromate in a series of 576 patients.

In 1988, 633 patients attending our Allergology Center underwent patch testing with the standard series recommended by the Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali. Of these, 576 patients completed the test correctly and their results were evaluated statistically. Nickel, cobalt, and potassium dichromate were the three most common sensitizers; concomitant positive reactions were present at significant levels. The authors discuss environmental and occupational exposure to contact allergens and correlate the major sites of dermatitis with the sensitivity to each metal in patients of both sexes.