Erythematous Macular Eruption in an Older Woman

A white woman in her 70s with advanced Alzheimer disease was referred to the hematology clinic for evaluation of a high hemoglobin level (169 g/L; normal range, 120-160 g/L) and red blood cell count (5.67 × 1012/L; normal range, 3.8-4.8 × 1012/L) as well as a generalized itch that was worse after a bath. On examination, she had a florid, erythematous macular eruption over the trunk and limbs (Figure, A) but no hepatosplenomegaly or lymphadenopathy. In addition to the high hemoglobin level, mild lymphocytosis (absolute lymphocyte count, 6.2 × 109/L, range 1.5-4.0 × 109/L) was noted with the lymphocyte morphology, suggesting reactive changes. Skin biopsy specimen (Figure, B) showed a normal epidermis with a pericapillary infiltrate of small lymphocytes restricted to the dermis and no leukocytoclastic vasculitis, fungal organisms, or dermal mucin. The absence of cellular atypia and epidermal involvement suggested a diagnosis of lupus, or gyrate or annular erythema, and the need for clinicopathological correlation

''Auctor in fabula'': la rappresentazione dell'autore come personaggio nella narrativa femminile ( Jeanette Winterson, Penelope Fitzgerald e Antonia S. Byatt)

Il presente studio analizza un motivo sempre più ricorrente nella narrativa contemporanea inglese almeno dalla seconda metà del XX secolo: l’autore come personaggio. I primi due capitoli introduttivi illustrano il tema da un punto di vista teorico oltre che specificamente letterario. Il primo capitolo si sofferma sulla lunga riflessione novecentesca scaturita nel 1968, con la proclamazione di Roland Barthes della ‘mort de l’Autheur’, fino a giungere ai tempi più recenti, in cui si riscopre l'importanza di stabilire le intenzioni di significato di chi scrive, soprattutto per motivi riconducibili, sostanzialmente, all'etica della trasmissione letteraria dell'immagine autoriale. Le articolazioni tematiche , gli sviluppi diacronici delle avventure dell’autore-personaggio sono invece al centro del secondo capitolo, dove l'argomento è illustrato attraverso l’analisi di un campione di alcune delle opere letterarie più rappresentative, sia maschili, sia femminili. Nella seconda parte, il campo della ricerca si restringe, focalizzandosi su tre autrici, Jeanette Winterson, Penelope Fitzgerald e Antonia S. Byatt. Il loro rapportarsi sorprendentemente originale al topos dell’autore come personaggio conferma non soltanto, nelle parole di Carla Benedetti, ‘l’ombra lunga dell’autore’ ma parrebbe tracciare un percorso verso una nuova mimesi, desiderosa di congedarsi dalle istanza postmoderne per addentrarsi verso una nuova fase che forse potremmo definire ‘ipermoderna’

An exemplar population-based study to predict up-take of non-intensive therapies in acute myeloid leukaemia

Recent advances in non-intensive therapy (non-IC) have demonstrated the potential for improved outcomes in patients with non-promyelocytic acute myeloid leukaemia (AML) unsuitable for intensive chemotherapy [1]. These data are mainly derived from clinical trial participants and therefore numbers of unselected patients that could benefit from novel agents are unknown. Identifying factors that influence treatment decisions in unselected patients would be useful to predict up-take of non-IC. A previous study on Medicare beneficiaries has identified variables influencing intensive treatment in older AML patients, but not the reasons for favouring SC over non-IC [2]. As the use of non-IC in patients increases [3], predicting the size of the target population for non-IC, identifying barriers to therapy and the determinants of survival in ‘real-world’ patients will help budgetary planning and patient outcomes. In the absence of a national registry of AML patients in the United Kingdom, through this retrospective study, we aimed to identify the proportion of AML patients that receives non-IC in our catchment population of 450,000, and factors affecting treatment and survival

El financiamiento de las PyMEs del sector TICs en Argentina: un análisis preliminar

Este trabajo pretende realizar una descripción del perfil de las empresas del sector TICs, más específicamente, aquellas enmarcadas dentro del concepto de PyMEBTs, y evaluar dichas características en relación a las necesidades y el acceso al financiamiento. Los datos utilizados en este trabajo surgen de un relevamiento que se está llevando a cabo en la actualidad, cuyo objetivo es detectar los problemas de acceso al financiamiento de las PyMEBTs. Hasta la actualidad se ha reunido información de 72 empresas. Los resultados muestran que las variables que están relacionadas con la utilización de recursos ajenos son; el tamaño de la empresa y la forma jurídica. En este análisis preliminar, las características del empresario no se relacionan con la utilización de recursos ajenos

k-core organization of complex networks

We analytically describe the architecture of randomly damaged uncorrelated networks as a set of successively enclosed substructures -- k-cores. The k-core is the largest subgraph where vertices have at least k interconnections. We find the structure of k-cores, their sizes, and their birth points -- the bootstrap percolation thresholds. We show that in networks with a finite mean number z_2 of the second-nearest neighbors, the emergence of a k-core is a hybrid phase transition. In contrast, if z_2 diverges, the networks contain an infinite sequence of k-cores which are ultra-robust against random damage.Comment: 5 pages, 3 figure

Adoptive transfer of cytomegalovirus-specific CTL to stem cell transplant patients after selection by HLA–peptide tetramers

Stem cell transplantation is used widely in the management of a range of diseases of the hemopoietic system. Patients are immunosuppressed profoundly in the early posttransplant period, and reactivation of cytomegalovirus (CMV) remains a significant cause of morbidity and mortality. Adoptive transfer of donor-derived CMV-specific CD8(+) T cell clones has been shown to reduce the rate of viral reactivation; however, the complexity of this approach severely limits its clinical application. We have purified CMV-specific CD8(+) T cells from the blood of stem cell transplant donors using staining with HLA-peptide tetramers followed by selection with magnetic beads. CMV-specific CD8(+) cells were infused directly into nine patients within 4 h of selection. Median cell dosage was 8.6 x 10(3)/kg with a purity of 98% of all T cells. CMV-specific CD8(+) T cells became detectable in all patients within 10 d of infusion, and TCR clonotype analysis showed persistence of infused cells in two patients studied. CMV viremia was reduced in every case and eight patients cleared the infection, including one patient who had a prolonged history of CMV infection that was refractory to antiviral therapy. This novel approach to adoptive transfer has considerable potential for antigen-specific T cell therapy