This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
The Coherent Neutrino-Nucleus Interaction Experiment (CONNIE) aims to detect the coherent scattering (CE nu NS) of reactor antineutrinos off silicon nuclei using thick fully depleted high-resistivity silicon CCDs. Two Skipper-CCD sensors with subelectron readout noise capability were installed at the experiment next to the Angra-2 reactor in 2021, making CONNIE the first experiment to employ Skipper-CCDs for reactor neutrino detection. We report on the performance of the Skipper-CCDs, the new data processing, data quality, and event selection for CE nu NS interactions, which enable CONNIE to reach a record low detection threshold of 15 eV. The data were collected over 300 days in 2021-2022 and correspond to exposures of 14.9 g-days with the reactor-on and 3.5 g-days with the reactor-off. The difference between the reactor-on and off event rates shows no excess and yields upper limits for the neutrino interaction rates, comparable with previous CONNIE limits from standard CCDs and higher exposures. Searches for new neutrino interactions beyond the Standard Model improve the previous CONNIE limit on a simplified model with light vector mediators. A first dark matter (DM) search by diurnal modulation by CONNIE obtains the best limits on the DM-electron scattering cross section by a surface-level experiment. These promising results, obtained using a very small-mass sensor, illustrate the potential of Skipper-CCDs to probe rare neutrino interactions and motivate the plans to increase the detector mass in the near future.
Armed conflicts can engender substantial detrimental effects for mental health, both within immediate settings and for faraway populations. Guided by frameworks from geopsychiatry, this narrative review underlines the local- and macro-level psychiatric consequences of conflicts, informed by illustrative findings from academic sources and gray literature focusing on contemporary global disputes. Specifically, the review demonstrates that exposure to conflict is consistently associated with elevated rates of mental illnesses, which are worsened by devastated healthcare systems and related phenomena. Subsequently, it highlights how vulnerable populations often experience disproportionate mental health burdens in conflict, before exploring how secondary, distal psychiatric effects can arise from vicarious media exposure, forced displacement, and associated environmental degradation. With the most armed hostilities occurring since the end of World War Two, the paper concludes by considering how the psychiatric discipline can adapt to confront the modern challenges of diversifying patient populations in an increasingly turbulent geopolitical landscape.
Introduction/Objectives: Disseminated histoplasmosis is an opportunistic infection associated with high morbidity and mortality in patients coinfected with HIV. Although new diagnostic methods exist, they are not yet incorporated into the public health system, limiting options to time-consuming methods that require highly trained professionals (cultures and direct visualization in clinical specimens). In addition to seeking more effective means of diagnosis, it is also of interest to determine the risk of unfavorable outcomes at the first evaluation, especially in resource-limited settings. Results: A retrospective analysis of 92 cases of disseminated histoplasmosis was performed, with 62 patients discharged and 30 deaths during treatment of the fungal infection. Signs and symptoms presented at the initial evaluation of the hospitalization in which the diagnosis occurred were analyzed. Both populations had similar epidemiological characteristics to reduce bias: predominance of male sex (83.9% in the “Discharge” group and 83.3% in the “Death” group); mean age 38.2 years in the first group (median 38) and 39.7 years (median 37.5) among those with unfavorable outcomes. Regarding HIV, patients already had a diagnosis of retroviral infection in 67.7% and 66.7% of cases, respectively. There was no statistical difference regarding fever or weight loss, nor in time from admission to diagnostic determination. Both groups underwent invasive evaluation (myelogram and/or biopsy). However, the prevalence of dysphagia and mucosal lesions showed statistically significant differences: the “Discharge” group had 37.1% and 43.5% for dysphagia and mucosal lesions, whereas the “Death” group had 6.7% and 16.7%, respectively. Chi-square analysis showed p-values of 0.005 and 0.021, with odds ratios of 0.12 and 0.26. Conclusion: The presence of dysphagia or mucosal lesions in the context of histoplasmosis seems to be related to better outcomes (hospital discharge). This finding is of interest given the possibility of using lower doses of amphotericin and/or timely transition to oral medications.
Pepper (Capsicumspp.), a horticultural crop of wide distribution and easy handling that represents a key source of income for small and medium producers, sees its production threatened by phytopathogens such as Rhizoctonia solaniand Sclerotinia sclerotiorum, responsiblefor root rot and white mold, respectively. Trichodermaspp., fungi widely recognized for their antagonistic capacity, are effectively used as biological control agents due to mechanisms such as competition, antibiosis, and mycoparasitism. The objective ofthe study was to evaluate the production of metabolites by native isolates of Trichodermaspp. and determine their antifungal activity against R. solaniand S. sclerotiorum. All the organic extracts evaluated showed some degree of antifungal activity. In particular, the organic extract of the isolate Trichodermasp. FCQ14 completely inhibited the growth of both pathogens, while the extract of T. asperellumFCQ42 achieved 100% inhibition against S. sclerotiorum. In the extract of Trichodermasp. FCQ14, a major compound was identified whose spectroscopic properties match those of trichodermin, a trichothecene known to inhibit protein synthesis in eukaryotes. This metabolite is suggested to be responsible for the observed antifungal activity.
