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Malaria is a global health problem that causes 1.5–2.7 million deaths worldwide each year. Resistance to antimalarial drugs in malaria parasites and to insecticides in vectors is one of the most serious issues in the fight against this disease. Moreover, the lack of an effective vaccine against malaria is still a major problem. Recent developments in nanotechnology have resulted in new prospects for the fight against malaria, especially by obtaining metal nanoparticles (NPs) that are less toxic, highly biocompatible, environmentally friendly, and less expensive. Numerous studies have been conducted on the synthesis of green NPs using plants and microorganisms (bacteria, fungi, algae, actinomycetes, and viruses). To our knowledge, there is no literature review that compares toxicities and antimalarial effects of some of the existing metallic nanoparticles, revealing their advantages and disadvantages. Hence, the purpose of this work is to assess metal NPs obtained through various green synthesis processes, to display the worth of future malaria research and determine future strategies. Results revealed that there are very few studies on green NPs covering all stages of malaria parasites. Additionally, green metal nanoparticles have yet to be studied for their possible toxic effects on infected as well as healthy erythrocytes. Morever, the toxicities of green metal NPs obtained from various sources differed according to concentration, size, shape, synthesis method, and surface charge, indicating the necessity of optimizing the methods to be used in future studies. It was concluded that studies on the toxic properties of green nanoparticles would be very important for the future.

Relevance. The need to dentify the characteristics of the distribution of radioactive elements in the groundwater of Northern Kazakhstan. Aim. Generalization of available data on the geochemistry of groundwater and uranium and radon distribution in them using the example of the northern regions of the Republic of Kazakhstan. Methods. Generalization of long-term hydrogeochemical research and compilation of an electronic data bank on the territory of Northern Kazakhstan. A laboratory study of the chemical composition of groundwater was carried out at the Research Laboratory of Hydrogeochemistry of the School of Natural Resources Engineering of Tomsk Polytechnic University. Measurements of 222Rn contents in waters were carried out using the Alfarad Plus complex in the Laboratory of Hydrogeology of Sedimentary Basins of Siberia, Institute of Geology and Geography, Siberian Branch, Russian Academy of Sciences. Results. The groundwater of aquifers of different ages, distributed in the territory of Northern Kazakhstan (North Kazakhstan uranium province), was studied. Two geochemical sets of groundwater were identified. The first is characterized by the dominance of HCO3– and Mg2+ in the water composition, and the second by Cl– and Na+. A change in composition and an increase in the value of total mineralization from 0,1 to 49 g/dm3, in the direction from north to south, indicate the development of continental salinization. In natural waters of the first group, uranium content varies from 0.065 to 16000 μg/dm3 and radon activity from 4 to 3885 Bq/dm3. For sodium chloride waters of the second set, concentrations can reach 32500 μg/dm3, and radon activity is 6–59 Bq/dm3, since the emanating reservoir (granitoids) is located to the north – at a distance of 80–100 km. Naturally, granitoid massifs of the studied region are sources of uranium. Their drainage by the river network leads to its removal and concentration on geochemical barriers in the groundwater of the Neogene-Quaternary aquifer. This distribution of radioactive elements is associated with the high migration ability of uranium in solution in the form of uranyl ion in oxidizing geochemical conditions.

The aim of this article is to analyze the delay influence on the attraction for a scalar tick population dynamics equation accompanying two disparate delays. Taking advantage of the fluctuation lemma and some dynamic inequalities, we derive a criterion to assure the persistence and positiveness on the considered model. Furthermore, a time-lag-dependent condition is proposed to insure the global attractivity for the addressed model. Besides, we give some simulation diagrams to substantiate the validity of the theoretical outcomes.

In this paper, a new nonsmooth optimization-based algorithm for solving large-scale regression problems is introduced. The regression problem is modeled as fully-connected feedforward neural networks with one hidden layer, piecewise linear activation, and the L1-loss functions. A modified version of the limited memory bundle method is applied to minimize this nonsmooth objective. In addition, a novel constructive approach for automated determination of the proper number of hidden nodes is developed. Finally, large real-world data sets are used to evaluate the proposed algorithm and to compare it with some state-of-the-art neural network algorithms for regression. The results demonstrate the superiority of the proposed algorithm as a predictive tool in most data sets used in numerical experiments.

The Bundle Enrichment Method (BEM-DC) is introduced for solving nonsmooth difference of convex (DC) programming problems. The novelty of the method consists of the dynamic management of the bundle. More specifically, a DC model, being the difference of two convex piecewise affine functions, is formulated. The (global) minimization of the model is tackled by solving a set of convex problems whose cardinality depends on the number of linearizations adopted to approximate the second DC component function. The new bundle management policy distributes the information coming from previous iterations to separately model the DC components of the objective function. Such a distribution is driven by the sign of linearization errors. If the displacement suggested by the model minimization provides no sufficient decrease of the objective function, then the temporary enrichment of the cutting plane approximation of just the first DC component function takes place until either the termination of the algorithm is certified or a sufficient decrease is achieved. The convergence of the BEM-DC method is studied, and computational results on a set of academic test problems with nonsmooth DC objective functions are provided.

Soil and Water Assessment Tool (SWAT) and Artificial Neural Network (ANN) models have been successfully used in streamflow forecasting problems. In this research SWAT model and developed model called (hybrid SWAT-ANN) were applied for forecast daily streamflow for Khazir River at Asmawa and Khanis gauge stations which lies in Kurdistan region in Iraq. In order to calibration and validation of the models, the recorded daily flow which available for twelve years (2004–2015) was divided into two sets. The output of the SWAT model was compared with the recorded data of the streamflow, the residual time series values, which resulted from the comparison, was solved by using the ANN approach. Finally, hydrological model using combined SWAT and ANN tools were obtained, which called hybrid SWAT-ANN model. The root means square error (RMSE) and coefficient of determination (R2) for Asmawa and Khanis stations using hybrid SWAT-ANN model were found to be more efficient than SWAT model in forecasting the daily streamflow of the basin.

The effect of using basalt fibers in the matrix of ultra-high performance concrete (UHPC) T-beam on the diagonal crack-load and ultimate shear capacity was investigated experimentally. The results compared to similar T-beam containing steel fibers in equal percent. The beam was reinforced with longitudinal bars but did not have transverse shear reinforcements. Two parameters were adopted in this study. These were the volume fraction of fibers and the shear span to effective depth ratio. The results showed that using steel fibers in the matrix led to a ductile behavior upon failure more than adding basalt fibers. Adding basalt fibers to UHPC enhances compressive strength more than the addition of steel fibers at equal percent. The enhancement was reflected in the shear capacity of the compression zone of the T-beam. Also, the compression zone in the T-beam was enlarged due to the presence of the flange. Therefore, the flange contributed to raising the compression shear capacity. Incorporating basalt fibers in the matrix of UHPC delayed the initiation of diagonal cracking more than steel fibers did. Adding basalt fibers at 0.5%, 1.0%, and 1.5% raised the cracking shear load by 160% over the non-fibrous one. However, the 0.5% and 1.0% basalt fibers upheaved the ultimate shear capacity more than the 1.5% content. The 1.5% steel fiber content promoted the shear capacity by 133% over the non-fibrous one. Also, the shear span to effective depth (a/d) ratio had a significant effect on the shear capacity of the beam. Increasing the a/d ratio led to decreasing the shear capacity and raising the mid-span deflection of the T-beam. However, the recorded deflection of the UHPC T-beam was low compared to the conventional concrete one.

Here we dissect the phenomena of oxidative and reductive green-to-red photoconversion of the Green Fluorescent Protein. We characterize distinct orange- and red-emitting forms (λabs/λem = 490/565 nm; λabs/λem = 535/600 nm) arising during the Enhanced Green Fluorescent Protein (EGFP) photoconversion under low-oxygen conditions in the presence of reductants. These forms spectroscopically differ from that observed previously in oxidative redding (λabs/λem = 575/607 nm). We also report on a new green-emitting state (λabs/λem = 405/525 nm), which is formed upon photoconversion under the low-oxygen conditions. Based on the spectral properties of these forms, their light-independent time evolution, and the high-level computational studies, we provide a structural basis for various photoproducts. Under the low-oxygen conditions, the neutral quinoid-like structure formed via a two-electron oxidation process is found to be a key intermediate and a most likely candidate for the novel green-emitting state of the chromophore. The observed large Stokes shift is traced to the formation of the zwitterionic form of the chromophore in the excited state. Subsequently, this form undergoes two types of cyclization reactions, resulting in the formation of either the orange-emitting state (λabs/λem = 490/565 nm) or the red-emitting form (λabs/λem = 535/600 nm). The T65G mutant lacks one of the proposed cyclization pathways and, indeed, the photoconverted T65G EGFP exhibits a single orange-emitting state. In oxidative redding, the red-emitting state resembles the structure of the chromophore from asFP595 (λabs/λem = 572/595 nm), which is directly formed upon two-electron oxidation and deprotonation bypassing the formation of the quinoid-like structure. Our results disclose a general “oxidative” mechanism of various green-to-red photoconversions of EGFP, providing a link between oxidative redding and the photoconversion under low-oxygen conditions.

The present study used both Autoregressive Integrated Moving Average (ARIMA) and Artificial Neural Network (ANN) models for Khazir river basin to simulate the daily flow at Asmawa and Khanis gauge stations. Asmawa station lies on Khazir River while Khanis lies on Gomel River as a tributary of Khazir River. In the stochastic ARIMA model, the Autocorrelation function (ACF) and partial autocorrelation function (PACF) were used to determine how robust the ARIMA model is in predicting the streamflow. In this study, the Akaike Information Criterion (AIC) formula and Bayesian information criterion (BIC) were used to evaluate which model is more accurate. The results of this study showed that models of order ARIMA are (2,0,0)(2,1,0) and (2,0,1)(2,1,0) were found much better than the other models for generating and forecasting daily flow time series for aforementioned stations. Coefficients of determination (R2) were found 0.77 and 0.85 for both Asmawa and Khanis stations, respectively. However, two types of ANN models were used for analyzing the daily flow records of the same two aforementioned stations, Multilayer Perceptron (MLP) and Radial Basis Function (RBF). ANN-MLP model was found to be more accurate than the ANN-RBF for generating and forecasting the daily flow time series as the coefficient of determination provided by ANN-MLP for both stations were 0.83 and 0.85, respectively. In addition, the coefficients of determination produced by the ANN-RBF for both stations were 0.66 and 0.55, respectively. Based on the values of (R2) and (RMSE) obtained in the current work, one can conclude that the ANN-MLP model is the most accurate model among the others in terms of predicting the streamflow for Asmawa station, whereas the performance of both ARIMA and ANN-MLP models for the Khanis station is the same.

Stochastic robustness of discrete noises has already been proposed and studied in the previous work. Nevertheless, the significant phenomenon of delays is left in the basket both in the deterministic and the stochastic parts of the considered equation by the existing work. Stimulated by the above, this paper is devoted to studying the stochastic robustness issue of delayed discrete noises for delay differential equations, including the issues of robust stability and robust boundedness.

The samples, sand and pebble (Sediment River), were collected from their selling places in Sulaymaniyah city, Iraq. Sand and pebble emanate each of 238U, 232Th, 40K, and radon naturally. The radon concentration in the air (Co) and gamma-specific activity (As) of the samples were measured using passive detectors (CR-39) and gamma spectrum analyzer (3 × 3 NaI (Tl) connected to digital spectrum analyzer), respectively. The mean value of the Co ± deviation of the investigated samples was 176.5 ± 6.9 Bq/mᵌ, which is lower than the worldwide value of 300 Bq m− ᵌ reported by the IAEA. However, an anomaly in Co value was found in Tanjaro (Sand) sample. The mean value radon mass exhalation rate (EM) was 10.9 ± 0.5 μBq/kg/h. The second part of the measuring is the gamma-specific activities (As) of each 226Ra, 232Th, and 40K. The As values were ranged (4.3 ± 0.2–22.6 ± 0.2), (1.9 ± 0.1–4.2 ± 0.1), and (39.8 ± 0.2–86.0 ± 0.4) Bq/kg , respectively. The mean calculated value of radium equivalent (Raeq) was 20.2±0.2 Bq/kg. The annual effective dose rate of gamma (Hann) was 0.13 mSv/y. Fortunately, the Hann value of the samples is lower than the world average value of 0.48 mSv/y.

Because of their high mechanical strength, excellent corrosion resistance and good weldability, duplex stainless steels are mostly used in industries such as oil, chemistry, petrochemistry, food and occasionally used in medical industry. These properties have enabled us to use duplex stainless steels in biomedical applications recently. Accordingly, duplex stainless steel material can be highly important to examine the toxic effect on the cells. In this study, the effect of the AISI 2205 duplex stainless steels which are joined by CO2 laser beam welding on viability of L929 fibroblast cells has been studied in vitro for the first time. For this aim, the cells were kept in DMEM/F-12 (Thermofisher Scientific 31331-028) medium for 7 days. The viability study was experimentally studied using the MTT (Thiazolyl Blue Tetrazolium Bromide) method for 7 days. The cell viability of the laser beam welded sample has been detected to be higher than that of the base metal and the control based on 7th day data. According to the obtained results, it was revealed that laser beam welded and base metal AISI 2205 duplex stainless steel has been found suitable to study for biomedical applications. DOI: http://dx.doi.org/10.5755/j01.ms.24.2.18006

This work reports the radon concentration level in the work environment of cement plants (CPs) located in the Sulaymaniyah city-North of Iraq. This survey for the radon concentration is performed in 24 sectors of three different CPs including Tasluja, Mass, and Bazian. The measurements were recorded using solid state nuclear track detector (CR-39 NTDs). The radon effective dose μSv/hr correlated weakly with the gamma effective dose μSv/hr to enhance the radon concentration measuring. The detector was fixed in different places of the plants such Crusher, Correction stores, Raw Mill (Grinding Mill), Preheater (Tower), Clinker, and Cement Storage. The arithmetic mean (AM) value of radon concentration (Ca) was found to be 98 ± 9, 101 ± 10, and 125 ± 10 Bq m−3 and the arithmetic mean value of annual effective dose (E) of radon was 0.767, 0.753, and 0.962 mSv y−1 for Tasluja, Mass, and Bazian CPs, respectively. The maximum values of about 222 ± 20 Bq m−3 and 1.402 mSv y−1, respectively, in sector III (Grinding) at Bazian CP. The achieved results reveal that the maximum value of radon concentration in all sectors of the CPs is below the international standard value (300 Bq m−3) of both the World Health Organization and International Commission on Radiological Protection.

Over the last years, distributed consensus tracking control has received a lot of attention due to its benefits, such as low operational costs, high resilience, flexible scalability, and so on. However, control methods that do not consider faults in actuators and control agents are impractical in most systems. There is no research in the literature investigating the consensus tracking of supply chain networks subject to disturbances and faults in control input. Motivated by this, the current research studies the fault-tolerant, finite-time, and smooth consensus tracking problems for chaotic multi-agent supply chain networks subject to disturbances, uncertainties, and faults in actuators. The chaotic attractors of a supply chain network are shown, and its corresponding multi-agent system is presented. A new control technique is then proposed, which is suitable for distributed consensus tracking of nonlinear uncertain systems. In the proposed scheme, the effects of faults in control actuators and robustness against unknown time-varying disturbances are taken into account. The proposed technique also uses a finite-time super-twisting algorithm that avoids chattering in the system’s response and control input. Lastly, the multi-agent system is considered in the presence of disturbances and actuator faults, and the proposed scheme’s excellent performance is displayed through numerical simulations.

BACKGROUND:Prior acute coronary syndrome (ACS) registries in Saudi Arabia might not have accurately described the true demographics and cardiac care of patients with ACS. We aimed to evaluate the clinical characteristics, management, and outcomes of a representative sample of patients with acute myocardial infarction (AMI) in Saudi Arabia. METHODS:We conducted a 1-month snap-shot, prospective, multi-center registry study in 50 hospitals from various health care sectors in Saudi Arabia. We followed patients for 1 month and 1 year after hospital discharge. Patients with AMI included those with or without ST-segment elevation (STEMI or NSTEMI, respectively). This program survey will be repeated every 5 years. RESULTS:Between May 2015 and January 2017, we enrolled 2233 patients with ACS (mean age was 56 [standard deviation = 13] years; 55.6% were Saudi citizens, 85.7% were men, and 65.9% had STEMI). Coronary artery disease risk factors were high; 52.7% had diabetes mellitus and 51.2% had hypertension. Emergency Medical Services (EMS) was utilized in only 5.2% of cases. Revascularization for patients with STEMI included thrombolytic therapy (29%), primary percutaneous coronary intervention (PCI); (42.5%), neither (29%), or a pharmaco-invasive approach (3%). Non-Saudis with STEMI were less likely to undergo primary PCI compared to Saudis (35.8% vs. 48.7%; respectively, p

The purpose of this work is to study the classification and construction of (k,3)-arcs in the projective plane PG(2,7). We found that there are two (5,3)-arcs, four (6,3)-arcs, six (7,3)arcs, six (8,3)-arcs, seven (9,3)-arcs, six (10,3)-arcs and six (11,3)-arcs. All of these arcs are incomplete. The number of distinct (12,3)-arcs are six, two of them are complete. There are four distinct (13,3)-arcs, two of them are complete and one (14,3)-arc which is incomplete. There exists one complete (15,3)-arc.

High performance concrete, HPC, requires a low water-to-cementitious materials mass ratio w/cm and supplemental cementitious materials with silica fumes in the mixture, and use of a superplasticizer. Because of the low w/cm and rapid reaction at early ages, it becomes more difficult to provide curing water from the top surface and this water will be inadequate to satisfy the conventional curing. Therefore, there is a need to use internal curing that is supplied via internal materials, such as absorbent lightweight aggregate, which will be pre-saturated. The use of internal curing was investigated in this study by two ways. The first way was through the use of partial replacement of original coarse aggregate (gravel), meanwhile, the second was by replacing partiallythe original fine aggregate (sand)by crushed Porcelinite.The results showed that the fine Porcelinite replacement as internal curing material caused better enhancement instrengthof HPC than coarse Porcelinite. The replacement of original fine crushed Porcelinite caused an increase in compressive strength from 3.36 to 5.25percent, for splitting tensile strength from 5.48 to6.85 percent and for flexural strength from 11.76 to 12.74percent.

In this study light elements 30Si , 33S for 30Si(α,n)33S reaction as well as α-particle energy from (5.001) MeV to (6.284) MeV are used according to the available data of reaction cross sections with threshold energy (3.959MeV). The more recent cross sections data of 30Si(α,n)33S reaction is reproduced in fine steps in the specified energy range , as well as cross section (α,n) values were derived from the published data of (n,α) as a function of energy in the same fine energy steps by using the principle of inverse reaction . This calculations involves the first exited state of 30Si , 33S in the reactions 30Si(α,n)33S and 33S(n,α)30Si . These data are listing , plotted and dissection .

In this study intermediate elements 64Ni , 64Cu for 64Ni (p,n)64Cu reaction with proton energy from (1.0) MeV to (132) MeV with threshold energy (2.496) MeV are used according to the available data of reaction cross sections. We calculated the cross sections for 64Cu(n,p)64Ni reaction by application in nuclear technology (reciprocity theory). In reciprocity theory we derive the mathematical formula for 64Cu(n,p)64Ni and we deduced high probability to produced 64Ni because it is very important such as it used in technology field .The evaluated cross sections as a functions of neutron energy between (En =0.504MeV) to (En=129.506MeV) of (0.0106barn) (0.254barn) respectively and statistical factor (gp,n=1 and gn,p=1/3) .

INTRODUCTION:MicroRNAs (miRNAs) are small non-coding RNA that plays a vital role in cancer progression. Neo-adjuvant chemotherapy (NAC) has become the standard of care for locally advanced breast cancer. The aim of this study was to evaluate miRNA alterations during NAC using multiple samples of tissue and serum to correlate miRNA expression with clinico-pathological features and patient outcomes. METHODS:Tissue and serum samples were collected from patients with locally advanced breast cancer undergoing NAC at four time points: time of diagnosis, after the first and fourth cycle of doxorubicin/cyclophosphamide treatment, and after the fourth cycle of docetaxel administration. First, we evaluated the miRNA expression profiles in tissue and correlated expression with clinico-pathological features. Then, a panel of four miRNAs (miR-451, miR-3200, miR-21, and miR-205) in serum samples was further validated using quantitative reverse-transcription polymerase chain reaction (RT-qPCR). The alterations in serum levels of miRNA, associations with clinical and pathological responses, correlation with clinico-pathological features, and survival outcomes were studied using Friedman, Mann-Whitney U, and Spearman, Wilcoxon signed-ranks tests. P≤0.05 was considered statistically significant. RESULTS:We analyzed 72 tissue samples and 108 serum samples from 9 patients and 27 patients, respectively. MicroRNA expression profiling of tumor versus normal tissue revealed more than 100 differentially expressed miRNAs. Serum miR-451 levels were significantly decreased during treatment, and higher serum levels were associated with improved clinical and pathological responses and disease-free survival. This is one of the early reports on miR-3200 in response to treatment in breast cancer, as serum levels of miR-3200 found to decline during NAC, and higher serum levels were associated with lower residual breast cancer burden and relapse rates at time of diagnosis. CONCLUSION:Variations in serum miRNA levels during NAC treatment may be therapeutically significant for predicting response and survival outcomes.

The main objective of this study is to provide a database for renal transplantation in Sudan and to determine the HLA antigens and haplotype frequencies (HFs) in the study subjects. HLA typing was performed using the complement-dependant lymphocytotoxicity test in 250 unrelated healthy individuals selected as donors in the Sudanese Renal Transplantation Program. Considerable polymorphism was observed at each locus; A2 (0.28), A30 (0.12), A3 (0.09), A24 (0.09), A1 (0.09), and A68 (0.06) were the most frequent antigens in the A locus, while B51 (0.092), B41 (0.081), B39 (0.078), B57 (0.060), B35 (0.068), B 50 (0.053) and B 52 (0.051) were the most common B locus antigens. DR13 (0.444) and DR15 (0.160) showed the highest antigen frequencies (AFs) in the DR locus. In the DQ locus, DQ1 showed the highest gene frequency (0.498), while DQ2 and DQ3 AFs were (0.185) and (0.238), respectively. The most common HLA-A and -B haplotypes in positive linkage disequilibrium were A24, B38; A1, B7; and A3, B52. The common HLA-A and -B HFs in positive linkage disequilibrium in the main three tribe-stocks of the study subjects (Gaalia, Nile Nubian and Johyna) were A24, B38 for Gaalia; A24, B38 and A2, B7 for Johyna; and A2, B64 and A3, B53 for Nile Nubian. These results suggest that both class I and class II polymorphisms of the study subjects depict considerable heterogeneity, which reflects recent admixture of this group with neighboring Arabs and African populations.

Os autores relatam o caso de um jovem de 18 anos de idade com fraqueza muscular generalizada, cãibras e crises convulsivas, tratado com corticosteróides por oito anos em decorrência de um diagnóstico de polimiosite, sem melhora clínica. Ao exame físico apresentava força muscular normal, ausência de atrofias musculares, diminuição de reflexos tendíneos profundos e presença do sinal de Chvostek e Trousseau. A hipótese diagnóstica inicial foi de miopatia metabólica e a investigação laboratorial revelou cálcio sérico e urinário diminuídos e dosagem de paratormônio (PTH) indetectável. O diagnóstico final foi de hipoparatireoidismo, tendo sido o paciente tratado com cálcio endovenoso. A tomografia de crânio demonstrou calcificações difusas, características da síndrome de Fahr. O paciente recebeu alta assintomático com carbonato de cálcio e colecalciferol.The authors report a case of an 18-year-old boy using prednisone for eight years for a misdiagnosis of polymyositis. His complains were diffuse weakness, cramps and seizures, with progressive worsening and with no improvement despite treatment with corticosteroid. On admission, the physical examination didn't show muscular weakness or atrophy. Deep tendom reflexes were absent and Chvostek and Trousseau signs were found. The diagnosis of a metabolic myopathy was considered and further laboratory findings revealed a low serum and urinary calcium, undetectable PTH. The diagnosis of hypoparathyreoidism was made and the patient was treated with endovenous calcium. Cranial tomography revealed diffuse calcifications, suggestive of Fahr's syndrome. The patient recovered completely and was discharged with oral calcium carbonate and colecalciferol.

Os autores descrevem o caso de uma garota negra, com diagnóstico de síndrome de superposição dermatomiosite e esclerose sistêmica, que desenvolveu calcinose difusa, complicada por infecções secundárias e significativa limitação funcional de membros. Tratamento com colchicina, diltiazem e alendronato sódico não se mostrou eficaz no controle da calcinose, requerendo uso endovenoso bimestral de clodronato, que contribuiu para significativa melhora na cicatrização das úlceras cutâneas e na qualidade de vida.The authors report an Afro-Brazilian girl with systemic sclerosis and dermatomyositis overlap who evolved with extensive calcinosis, complicated by secondary infections and important disability. Treatment with colchicine, diltiazem and sodium alendronate was not effective in the control of calcinosis, requiring the use of bimonthly intravenous doses of clodronate that resulted in significant improvement in the healing of cutaneous ulcers and in the quality of life of the patient.

O objetivo deste trabalho é analisar a prevalência da disfunção erétil (DE) e a utilidade do Índice Internacional de Função Erétil (IIFE) na investigação da DE em pacientes com esclerose sistêmica (ES). Quinze homens com ES foram questionados acerca dos sintomas da DE e submetidos ao questionário de IIFE. Seus prontuários foram revisados para identificar outras possíveis causas da DE. Os pacientes estudados eram predominantemente caucasóides e tinham ES difusa. DE foi referida por 67% dos pacientes, iniciando-se, em média, 29 meses após o início da ES; quatro pacientes relataram início concomitante da DE e da ES. O diagnóstico da DE pelo IIFE e por interrogação direta foi concordante em todos os pacientes. Não foi encontrada associação nítida entre DE e extensão do envolvimento cutâneo, envolvimento visceral, drogas, escore cutâneo total e duração da doença. Cinco pacientes com DE também tinham outras causas de impotência. A DE afeta um grande porcentual de homens acometidos por esclerose sistêmica e o IIFE pode ser um instrumento válido em sua avaliação. A alta incidência da DE em jovens com ES e a eventual concomitância do início da ES e da DE enfatizam a necessidade de estudos posteriores sobre uma provável relação causal.The aim of this report is to analyze the incidence of erectile dysfunction (ED) and the usefulness of the International Index of Erectile Function (IIEF) on the investigation of ED in men with systemic sclerosis (SSc). Fifteen male SSc patients were asked about the presence of ED symptoms and were submitted to the IIEF questionnaire, after obtaining informed consent. Their medical data were reviewed in the search of other possible causes of ED. The studied patients were predominantly Caucasian and had diffuse SSc. ED was referred by 67% of them, and it was first noted after an average of 29 months of SSc onset; four patients referred concomitant onset of ED and SSc. All men with ED detected by IIEF questionnaire also reported ED when directly asked, and all men who affirmed having ED were also identified by IIEF. There were no clear association between ED and extent of cutaneous involvement, visceral involvement, drugs, total skin score and disease duration. Five patients with ED also had other causes of impotence. ED affects a high percentage of male SSc patients, and the IIEF may be a valid instrument in its evaluation. The high incidence of ED in young SSc patients and the occasional concomitance of the onset of SSc and ED warrants further evaluation of a causal association.

OBJETIVO: determinar as manifestações clínicas ao diagnóstico e durante a evolução de pacientes com doença de Still do adulto em um hospital universitário terciário. MÉTODOS: foram identificados 13 pacientes com a doença no Ambulatório de Artrites do HC-UNICAMP, estudados retrospectivamente, com atenção aos sintomas no momento do diagnóstico, à evolução do quadro articular e à medicação utilizada. RESULTADOS: a prevalência da doença foi de 4,3%. A média de idade foi de 30,8 anos com predomínio masculino (54,2%). Todos apresentaram sintomas constitucionais, febre e exantema cutâneo ao diagnóstico. Comprometimento hepático em 100%, com hepatomegalia em 11 (84,65%), esplenomegalia em 4 (30,7%), aumento de enzimas hepáticas em 6 (46,1%) e hipergamaglobulinemia em 10 (76,9%) dos pacientes. Envolvimento cardíaco em 2 (15,4%) e pleurite em 1 (7,7%) paciente. Hematúria foi constatada em 4 (30,7%) casos. A manifestação articular inicial foi predominantemente poliarticular em 8 (66,5%). Todos os pacientes apresentaram leucocitose ao diagnóstico, com predomínio de neutrófilos, ocorrendo linfocitose em 7 (53,8%). Ferritina elevada em 9 (69,2%) pacientes e, após a resolução do quadro, ocorreu normalização em todos. Quanto ao tratamento, todos utilizaram antiinflamatórios não-hormonais e doses baixas de corticosteróides; 7 (69,2%) precisaram usar metotrexato. Doença monocíclica em somente 4 (30,7%) pacientes, predominando doença recorrente. Bloqueio articular em 53,8% dos pacientes, predominantemente em punhos. CONCLUSÕES: embora rara, a doença de Still do adulto deve ser sempre considerada em pacientes com envolvimento sistêmico e poliartrite, após exclusão de outras doenças, principalmente doenças infecciosas e neoplásicas. O curso da doença de Still do adulto é geralmente crônico e a principal seqüela observada neste estudo foi o bloqueio de punhos, em razão de anquilose óssea.OBJECTIVE: To determine the clinical manifestations at disease onset and during follow-up of patients with Adult-Onset Still Disease (AOSD) in a tertiary university hospital in Brazil. METHODS: Thirteen cases of AOSD were identified in the Arthritis Outpatients Unit - Unicamp. Their clinical records were reviewed retrospectively in order to determine clinical manifestations regarding disease onset, follow-up and prescription. RESULTS: The prevalence of AOSD was 4.3%. The mean age of disease onset was 30.8 years old with a slight prevalence of men (54.2%). Constitutional symptoms, fever and cutaneous rash were observed in all cases. Hepatic involvement was observed in 11 patients, splenomegaly in 4, hematuria in 4, cardiac involvement in 2 and pleuritis in 2. Poliarticular involvement was observed more frequently, and 50% of them presented carpal ankylosis after 3 years of follow-up. Ferritine was elevated in 9 of 13 patients during active disease. All patients used oral non-steroidal anti-inflammatory drugs, steroids and 7 patients needed methotrexate. CONCLUSIONS: Although AOSD is a rare multisystemic rheumatic disorder, it should always be considered in febrile cases with poliarthritis. Neoplasia and infection should always be excluded. Normally it is characterized by a chronic course and carpal ankylosis as the main disabling feature.

Endothelial dysfunction is a key initiating event in vascular disease in chronic kidney disease (CKD) patients and haemodialysis (HD) patients exhibit significant vascular abnormalities. To understand this further, we examined how ex vivo intrinsic function in isolated arteries correlates with in vivo assessments of cardiovascular status in HD patients. Abdominal fat biopsies were obtained from 11 HD patients and 26 non-uremic controls. Subcutaneous arteries were dissected and mounted on a wire myograph, and cumulative concentration-response curves to noradrenalin, endothelin-1, a thromboxane A2 agonist (U46619), angiotensin II, vasopressin, bradykinin (BK), acetylcholine (ACh) and sodium nitroprusside (SNP) were constructed. Pulse wave velocity and blood pressure were measured in HD patients. Enhanced (P600 µm. The potency (pEC50) of U46619 (P600 µm of HD patients. The maximal relaxant response to the endothelium-dependent dilators ACh and BK were lower in HD patients (P

OBJETIVO: Estabelecer a utilidade da medida indireta da pressão venosa periférica (PVP) na avaliação de pacientes com esclerose sistêmica (ES), comparando com uma população controle normal. MÉTODOS: Estudo prospectivo avaliando 18 pacientes esclerodérmicas do sexo feminino (sendo oito delas com úlcera cutânea isquêmica) submetidas à medida indireta da PVP (por pletismografia). Os dados foram comparados a um grupo controle normal de 18 mulheres hígidas, pareadas para idade. RESULTADOS: Os níveis de pressão arterial foram semelhantes nos dois grupos. Os valores de PVP estavam significativamente diminuídos nos pacientes com ES (58.9 ± 11.6 mmHg no grupo ES e 96.9 ± 7.1 mmHg no grupo controle; p < 0.0001); no grupo com ES, os pacientes com úlceras cutâneas isquêmicas apresentaram níveis de PVP significativamente diminuídos comparando-se com os pacientes com ES sem úlceras (50.6 ± 10.8 mmHg no grupo com úlceras e 65.5 ± 7.2 mmHg no grupo sem úlceras; p = 0.006). CONCLUSÕES: Pode-se inferir que a diminuição nos níveis de PVP na ES parece estar associada a uma diminuição do fluxo sangüíneo, predispondo ao aparecimento de úlceras isquêmicas nestes pacientes.OBJECTIVE: The aim of this prospective study was to establish the usefulness of indirect measurement of peripheral venous pressure (PVP) in the evaluation of patients with systemic sclerosis (SSc), comparing them with a normal control population. METHODS: Eighteen female SSc patients (eight patients presenting cutaneous ischemic ulcers) were submitted to indirect measurement of the PVP (by plethysmography), and data were compared with a control group of 18 healthy women, paired by age. RESULTS: Arterial pressure levels were similar in both groups. PVP levels were significantly decreased in the SSc patients (58.9 ± 11.6 mmHg in the SSc group and 96.9 ± 7.1 mmHg in the control group; p < 0.0001); in the SSc group, patients with ischemic ulcers presented PVP levels significantly decreased compared with those patients without ulcers (50.6 ± 10.8 mmHg in the ulcer group and 65.5 ± 7.2 mmHg in the group without ulcers; p = 0.006). CONCLUSIONS: It can be concluded that decreased PVP in SSc is associated with a decrease in the blood flow of these patients, predisposing them to cutaneous ischemic ulcers.

A esclerose sistêmica (ES) sine scleroderma é uma doença rara, caracterizada pelo acometimento visceral (geralmente gastrintestinal, pulmonar ou vascular periférico) da ES, na ausência da característica fibrose cutânea. Os autores descrevem um caso da rara ocorrência da crise renal esclerodérmica como manifestação inicial em uma paciente com ES sine scleroderma.Systemic sclerosis sine scleroderma (ssSSc) is a rare disorder, characterised by visceral involvement (usually peripheral vascular, gastrointestinal and pulmonary) in the absence of the characteristic skin fibrosis. The authors describe in this case report the rare occurrence of sclerodermic renal crisis (SRC) as the initial clinical manifestation in a patient with ssSSc.

The investigation on Heat-Intolerance Syndrome following foot and mouth disease (FMD) infection in cattle in ThiQar–Iraq, used 3ABC FMD ELISA kit, and Radio- immunoassay (RIA) to detect the cortisol level. From 105 there were 65(62%) infected cattle with FMD, which was high at 5- less 8 years old, while the cortrisol level showed three levels; normal (13-21 nmol⁄L), high and low levels were; 6(5.6%), 44(42%) and 55(52%) subsequently. More over the combined result of ELISA and RIA had divided cattle into six groups. First group of 40(38%) cattle infected with FMD and had low level of cortisol, this group containing 21(20%) with clinical signs of heat intolerance. Second group contain 22(21%) FMD infected cattle with high level of cortisol. Third group of 3(2.8%) FMD Infected cattle but normal cortisol level. Fourth group included 3(2.8%) not infected by FMD with normal cortisol level. Fifth group contain 22(21%) not infected with FMD but had high level of cortisol may related to stress. Sixth group consisted 15 (14%) cattle not infected with FMD and had low level of cortisol due to un known cause. Clinical signs of heat intolerance that showed in 21 head of cattle in the first group were: panting, overgrowth of hair coat, emaciation and seeking for shad. The diseased cow known locally as ”Mahrorah” meaning heat-intolerance.