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Kristina Trnjar, S. Pintarić, Marko Mornar Jelavić, V. Nesek, J. Ostojić, S. Pleština, A. Šikić, H. Pintarić

The aim of the study was to investigate the unknown effect of air pollutants on the occurrence or deterioration of respiratory diseases in the area with a humid continental climate. This retrospective study included 5868 patients with respiratory symptomatology (upper respiratory tract infection (URTI), pneumonia, acute bronchitis, chronic obstructive pulmonary disease (COPD), and asthma) admitted to emergency department (ED). The number of patients, values of meteorological parameters (mean daily values of air temperature pressure and relative humidity) and concentrations of air pollution particles (≤10 μm (PM10), ozone (O3) and nitrogen dioxide (NO2)) were collected during a two-year ( July 2008 - June 2010) period. There were 1839 (31.3%), 1712 (29.2%), 1313 (22.4%), 614 (10.5%) and 390 (6.6%) patients with pneumonia, COPD, URTI, acute bronchitis and asthma, respectively. The mean daily concentrations of NO2 (25.9 (1.7-89.7) μg/m3), O3 (47.1 (4.7-135.4) μg/m3) and PM10 particles (25.7 (4.6-146.6) μg/m3) were below the legally defined thresholds. Among other results, the occurrence of respiratory diseases showed positive Spearman's correlation with the values of air humidity (days 0-3, r=0.15 to 0.19), PM10(days 0-3, r=0.10 to 0.13) and NO2 concentrations (day 0, r=0.11), and negative correlation with the values of air temperature (days 0-3, r=-0.36 to -0.34), pressure (day 0, r=-0.10) and O3 concentrations (days 0-3, r=-0.21 to -0.22) (p<0.05 all). In conclusion, the occurrence of respiratory diseases showed correlation with weather conditions and air pollutants despite the legally permitted values in the region with a humid continental climate.

J. Ostojić, H. Pintarić

Chronic obstructive pulmonary disease (COPD) and heart failure (HF) both are global epidemics with substantial burden on morbidity and mortality. They present major challenges to healthcare providers and often coexsist. Multiple interactions exist between these conditions. COPD is often responsible for delayed diagnosis of HF and vice versa, since both conditions have similar symptoms such as dyspnea and poor exercise tolerance based on the skeletal myopathic response rather than the primary organ failure. Patients with COPD also have an increased risk of developing HF and higher hospitalization and death rates compared with HF patients without COPD. Echocardiography and pulmonary function tests along with natriuretic peptides should be performed and carefully interpreted. Diagnostic assessment of both conditions present in the same patient is often difficult, but therapeutic approach is also often non-adherent to current guidelines. For example, patients with coexisting COPD and HF receive beta-blockers at disappointingly low rates below 20%. Closer collaboration between cardiologists and pulmonologists is required for better identification and management of concurrent COPD and HF.

Almira Ćosićkić, F. Skokić, Amel Selimović, Maida Mulić, Sanimir Suljendić, N. Dedić, Damir Sabitović, Fejzo Džafić

Children with atopic dermatitis (AD) usually develop symptoms when they reach the age of 6-7 years, but the risk of developing respiratory allergies, asthma and allergic rhinitis (AR) remains high. In most children with AD, the development of asthma and AR is associated with sensitization to food allergens and/or aeroallergens, while only a small percentage missed atopic diathesis. In about 35% of children with AD, food allergy is the provoking cause, and 60% of infants who had AD in the first 3 months of life were sensitized against aeroallergens by the age of 5. The aim of the study was to follow development of asthma and AR and to assess the most significant risk factors for developing respiratory allergy. A total of 114 children with AD were followed up for five years. At annual visits, the severity of disease, total immunoglobulin E (IgE) antibody values, skin prick tests, specific IgE antibodies to food allergens and aeroallergens, and absolute eosinophil count were assessed. Information on the family history of atopy and AD, feeding patterns during infancy, data on sensitivity to food allergens and/or aeroallergens, and on the occurrence of bronchial obstruction and nose symptoms were obtained. Asthma developed in 36 children, median age 7.7 years; 33 children had symptoms of AR, and 13 children with AD had both diseases associated; 38 children had sensitivity to food, of which 24 developed asthma and 13 AR; asthma developed in 18/23 children with sensitivity to aeroallergens, and almost an equal number of children developed AR. The increased absolute eosinophil count and specific IgE to aeroallergens and food allergens were the best asthma predictors, while AR predictors were family history and early onset of AD. In conclusion, children with AD are at a significant risk of developing respiratory allergies, and those with the increased absolute eosinophil count, positive specific IgE to aeroallergens and food allergens, heredity of AD, and early onset of AD are at the highest risk. Identification of risk factors will enable us to improve the treatments of AD in order to reduce the severity of disease and prevent manifestation of respiratory allergy.

Elma Dedović-Atilla

The paper explores the revolutionary spirit of literary works of two Romantic poets: George Gordon Byron and Percy Bysshe Shelley. In the period of conservative early 19th century English society that held high regard for propriety, tradition, decorum, conventions and institutionalized religion, the two poets’ multi-layered rebellious and subversive writing and thinking instigated public uproar and elitist outrage, threatening to undermine traditional concepts and practices. Acting as precursors to new era notions and liberties, their opuses present literary voices of protest against 19th century social, religious, moral and literary conventions. Their revolutionary and non-conformist methods and ideas are discussed and analyzed in this paper through three works of theirs: Byron’s The Vision of Judgement and Childe Harold’s Pilgrimage and Shelley’s Prometheus Unbound.

Khaled Maaiuf Rabie, B. Adebisi, E. G. Yousif, H. Gačanin, A. Tonello

Most, if not all, existing studies on power line communication (PLC) systems as well as industrial PLC standards are based on orthogonal multiple access schemes, such as orthogonal frequency-division multiplexing and code-division multiple access. In this paper, we propose non-orthogonal multiple access (NOMA) for decode-and-forward cooperative relaying PLC systems to achieve higher throughput and improve user fairness. To quantitatively characterize the proposed system performance, we also study conventional cooperative relaying (CCR) PLC systems. We evaluate the performance of the two systems in terms of the average capacity. In this respect, accurate analytical expressions for the average capacity are derived and validated with Monte Carlo simulations. The impact of several system parameters, such as the branching, impulsive noise probability, cable lengths, the power allocation coefficients, and input signal-to-noise ratio, is investigated. The results reveal that the performance of the proposed NOMA-PLC scheme is superior compared with that of the CCR-PLC system. It is also shown that the NOMA-PLC system can be more effective in reducing electromagnetic compatibility associated with PLC and that increasing the network branches can considerably degrade the performance. Moreover, optimizing the power allocation coefficients is found to be of utmost importance to maximize the performance of the proposed system.

R. Papa, A. Consolaro, F. Minoia, R. Caorsi, G. Magnano, M. Gattorno, A. Ravelli, R. Pillon et al.

P381 Transient periosteal hyperostosis with dysproteinemia (Goldbloom syndrome): two cases report Riccardo Papa, Alessandro Consolaro, Francesca Minoia, Roberta Caorsi, Gianmichele Magnano, Marco Gattorno, Angelo Ravelli, Paolo Picco Pediatria II, Reumatologia, Istituto Giannina Gaslini, Genoa, Italy; Radiologia, Istituto Giannina Gaslini, Genoa, Italy Presenting author: Riccardo Papa Pediatric Rheumatology 2017, 15(Suppl 1):P381

R. Papa, A. Consolaro, F. Minoia, R. Caorsi, G. Magnano, M. Gattorno, A. Ravelli, P. Picco et al.

G. Valatin, J. Abildtrup, C. Accastello, A. Al-Tawaha, M. Andreucci, S. Atanasova, M. Avdibegović, Nikolina Bakšić et al.

The EU Water Framework Directive aims to ensure restoration of Europe’s water bodies to “good ecological status” by 2027. Many Member States will struggle to meet this target, with around half of EU river catchments currently reporting below standard water quality. Diffuse pollution from agriculture represents a major pressure, affecting over 90% of river basins. Accumulating evidence shows that recent improvements to agricultural practices are benefiting water quality but in many cases will be insufficient to achieve WFD objectives. There is growing support for land use change to help bridge the gap, with a particular focus on targeted tree planting to intercept and reduce the delivery of diffuse pollutants to water. This form of integrated catchment management offers multiple benefits to society but a significant cost to landowners and managers. New economic instruments, in combination with spatial targeting, need to be developed to ensure cost effective solutions – including tree planting for water benefits - are realised. Payments for Ecosystem Services (PES) are flexible, incentive-based mechanisms that could play an important role in promoting land use change to deliver water quality targets. The PESFOR-W COST Action will consolidate learning from existing woodlands for water PES schemes in Europe and help standardize approaches to evaluating the environmental effectiveness and cost-effectiveness of woodland measures. It will also create a European network through which PES schemes can be facilitated, extended and improved, for example by incorporating other ecosystem services linking with aims of the wider forests-carbon policy nexus.

G. Budd, W. Barlow, H. Moore, T. Hobday, J. Stewart, C. Isaacs, M. Salim, J. Cho et al.

T. Owonikoko, S. Dahlberg, G. Sica, L. Wagner, J. Wade, G. Srkalović, B. Lash, J. Leach et al.

PURPOSE Veliparib, a poly (ADP ribose) polymerase inhibitor, potentiated standard chemotherapy against small-cell lung cancer (SCLC) in preclinical studies. We evaluated the combination of veliparib with cisplatin and etoposide (CE; CE+V) doublet in untreated, extensive-stage SCLC (ES-SCLC). MATERIALS AND METHODS Patients with ES-SCLC, stratified by sex and serum lactate dehydrogenase levels, were randomly assigned to receive four 3-week cycles of CE (75 mg/m2 intravenously on day 1 and 100 mg/m2 on days 1 through 3) along with veliparib (100 mg orally twice per day on days 1 through 7) or placebo (CE+P). The primary end point was progression-free survival (PFS). Using an overall one-sided 0.10-level log-rank test, the study had 88% power to demonstrate a 37.5% reduction in the PFS hazard rate. RESULTS A total of 128 eligible patients received treatment on protocol. The median age was 66 years, 52% of patients were men, and Eastern Cooperative Oncology Group performance status was 0 for 29% of patients and 1 for 71%. The respective median PFS for the CE+V arm versus the CE+P arm was 6.1 versus 5.5 months (unstratified hazard ratio [HR], 0.75 [one-sided P = .06]; stratified HR, 0.63 [one-sided P = .01]), favoring CE+V. The median overall survival was 10.3 versus 8.9 months (stratified HR, 0.83; 80% CI, 0.64 to 1.07; one-sided P = .17) for the CE+V and CE+P arms, respectively. The overall response rate was 71.9% versus 65.6% (two-sided P = .57) for CE+V and CE+P, respectively. There was a significant treatment-by-strata interaction in PFS: Male patients with high lactate dehydrogenase levels derived significant benefit (PFS HR, 0.34; 80% CI, 0.22 to 0.51) but there was no evidence of benefit among patients in other strata (PFS HR, 0.81; 80% CI, 0.60 to 1.09). The following grade ≥ 3 hematology toxicities were more frequent in the CE+V arm than the CE+P arm: CD4 lymphopenia (8% v 0%; P = .06) and neutropenia (49% v 32%; P = .08), but treatment delivery was comparable. CONCLUSION The addition of veliparib to frontline chemotherapy showed signal of efficacy in patients with ES-SCLC and the study met its prespecified end point.

G. Conti, F. Marchetti, A. Salis, F. Caroli, G. Damonte, V. Bondet, Y. Kusche, K. Barczyk-Kahlert et al.

O1 Efficacy and safety of Canakinumab in patients with periodic fever syndromes (colchicine-resistant fmf, hids/mkd and traps): results from a phase 3, pivotal, umbrella trial F. De Benedetti, J. Anton, M. Gattorno, H. Lachmann, I. Kone-Paut, S. Ozen, J. Frenkel, A. Simon, A. Zeft, E. Ben-Chetrit, H.M. Hoffman, Y. Joubert, K. Lheritier, A. Speziale, J. Guido IRCCS Ospedale Pediatrico Bambino Gesú, Rome, Italy; Hospital Sant Joan de Déu, Barcelona, Spain; Pediatric Rheumatology, G. Gaslini Institute, Genoa, Italy; UK National Amyloidosis Centre, University College London Medical School, London, United Kingdom; Hôpital Kremlin Bicetre, University of Paris SUD, Paris, France; 6 Department of Pediatrics, Hacettepe University, Ankara, Turkey; University Medical Center Utrecht, Utrecht, Netherlands; Radboud University Medical Centre, Nijmegen, Netherlands; Pediatrics Rheumatology, Cleveland Clinic, Cleveland, USA; Rheumatology Unit, Hadassah—Hebrew University Medical Center, Jerusalem, Israel; University of California, San Diego, La Jolla, USA; Novartis Pharma AG, Basel, Switzerland Presenting author: F. De Benedetti Pediatric Rheumatology 2017, 15(Suppl 1):O1

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