bluuebunny/crossref_metadata_2025 huggingface dataset:
Eosinophilic gastroenteritis: a case report and a review of eosinophilic gastrointestinal disorders
Authors: Benatti Chiara , Sacchetti Carla , Pedrazzi Antonio , Gollini Claudio , Vecchi Federica , Pederzoli Stefano , Grandi Marco
Published: April 2013

Background: Despite its uncommon occurrence, eosinophilic gastroenteritis is one of the most important primary eosinophilic gastrointestinal disorders. These are defined as disorders that selectively affect the gastrointestinal tract with eosinophil-rich inflammation in the absence of known causes for eosinophilia. The disorders include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis and eosinophilic colitis. Aim of the study: This review focuses on the epidemiology, pathophysiology, clinical features and treatment of primary eosinophilic gastrointestinal disorders with particular attention to primary eosinophilic gastroenteritis. Clinical case: We report a case of a 32-years-old woman that was admitted to our Hospital complaining of abdominal pain, ascites and diarrhea. Laboratory investigations showed a white cell count of 15.1 thousands/mm3 with eosinophilia; other laboratory studies were within the normal limits. Abdominal ultrasonography demonstrated peritoneal effusion and cytological analysis revealed a prevalence of eosinophils in the ascites. The multiple endoscopic biopsies were normal. However, the clinical history, and the laboratory, radiological and endoscopic findings gave a firm diagnosis of the serosal form of primary eosinophilic gastroenteritis. Discussion: This is a rare, benign condition, pathologically characterized by an important eosinophilic infiltration of the wall of the digestive tract and presents a constellation of symptoms that are related to the degree and area of the gastrointestinal tract affected. Primary eosinophilic gastroenteritis encompasses multiple disease entities subcategorized into three types on the basis of the level of histologic involvement: mucosal, muscolaris and serosal forms. Every layer of the gastrointestinal tract can be involved, so that endoscopic biopsy can be normal in patients with the muscolaris subtype, serosal subtype, or both.
Treatment of recalcitrant cough with baclofen
Authors: Agostinis Paolo , Bardus Paola , Di Piazza Vito , Dassi Ferdinando , Durigon Nadia , Englaro Alfio , Grillo Patrizia , Marchetti Euro , Petris Tiziano , Sabatini Enzo
Published: April 2013

Background: Chronic dry cough is a debilitating symptom often refractory to standard antitussive therapy. It may result from increased sensitivity of the cough reflex. Baclofen, an agonist of gamma-aminobutyric acid (GABA), has been shown, in animals, to have antitussive activity via a central mechanism. In normal subjects baclofen has been revealed ability to inhibit capsaicininduced cough and cough due to angiotensin-converting enzyme (ACE) inhibitors. In addition, chronic therapy with baclofen has been shown to reduce cough reflex sensitivity in subjects with cervical spinal cord injury. Clinical cases: We describe two patients with chronic refractory cough who obtained symptomatic improvement after oral baclofen administration. The antitussive effect of baclofen, usually used for treatment of spasticity associated with multiple sclerosis and spinal cord lesions, can be explained by central inhibition, but may also involve peripheral inhibitory mechanisms.
Evidence-Based Medicine risks
Authors: Cagli Vito
Published: April 2013

Not available
Noninvasive ventilation for acute respiratory failure: state of the art (I part)
Authors: Lari Federico , Giostra Fabrizio , Bragagni Gianpaolo , Di Battista Nicola
Published: April 2013

Background: In the last years Non-Invasive Ventilation (NIV) has been playing an important role in the treatment of Acute Respiratory Failure (ARF). A lot of trials have shown improvements in clinical features (respiratory rate, neurological score), pH and arterial blood gases. Methods: In particular clinical conditions, such as Acute Cardiogenic Pulmonary Edema (ACPE) and acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD), systematic reviews and meta-analysis show a reduction in the need for intubation and in-hospital mortality compared to standard medical treatment. In other clinical conditions, such as acute asthma, Acute Lung Injury (ALI)/Acute Respiratory Distress Syndrome (ARDS) and severe pneumonia, NIV does not show significant improvements in term of avoided intubations or mortality rate. Although the first important data on NIV comes from studies performed in Intensive Care Units (ICUs), subsequently these methodologies of ventilation have been used with increasing frequency in Emergency Departments (ED) and medical wards. Results: Studies developed in ICU sometimes report slightly worse outcomes compared to studies performed in general wards due to the need to treat more severe patients in ICU. Aetiology remains one of the most important factor determining prognosis: different pathological mechanisms substain different clinical conditions and not in all cases the application of positive pressures to the airways is useful. NIV for ARF due to COPD and ACPE is feasible, safe and effective also in a general medical ward if selection of patients, staff training and monitoring are appropriate: its early application improves clinical parameters, arterial blood gases, prevents endotracheal intubation, decreases mortality and hospitalisation. This should encourage the diffusion of NIV in this specific setting.
Pneumonia in nursing home patients: is it time for a specific therapeutic strategy?
Authors: Gussoni Gualberto , Iori Ido , Blasi Francesco , Bulfoni Alessandro , Costantino Sebastiano , Giusti Massimo , Valerio Antonella , Legnani Delfino , FASTCAP Study Group On behalf of the
Published: April 2013

Background: Nursing home-acquired pneumonia (NHAP) was described in 1978, but only in 2005 it has been proposed as part of a new category (health care-associated pneumonia) distinct from community- or hospital-acquired infections. However, limited clinical data exist to validate this proposal. Aim of the study: To compare characteristics and outcome of patients hospitalised for pneumonia and coming from private residence or nursing home. Methods: Post-hoc analysis of the prospective phase of the FASTCAP study, performed to evaluate the impact of the Recommendations issued by the Italian Federation of Internal Medicine (FADOI) in 2002 on the management of hospitalised community-acquired pneumonia (CAP). Results: The study examined 1,219 patients coming from private residence, and 179 with NHAP. Failures of therapy were significantly more frequent in patients with NHAP (35.8% vs 24.9%; Odds Ratio 1.48; 95% confidence interval 1.05-2.09). Mortality was higher in patients coming from nursing home (24.0% vs 9.8%; OR 2.59; 95% CI 1.72-3.90). Antibiotic treatment was more frequently performed as monotherapy in case of NHAP. Conclusions: At the time of FASTCAP, NHAP was included in the category of CAP, and coherently, treatment of NHAP was not more aggressive if compared to community-acquired infections. However, our results confirm that NHAP is at increased risk for worst outcome, and probably worth considering for specific therapeutic strategies. Future studies are needed to better assess the microbiology of NHAP, and to evaluate if specific treatments, as those recommended by recent guidelines, may improve the outcome for these high-risk patients.
Obesity, metabolic syndrome, male hypogonadism and cardiovascular risk
Authors: Corona Giovanni , Lotti Francesco , Sforza Alessandra , Maggi Mario , Chiarini Valerio
Published: April 2013

Background: A large body of evidences indicates that sexual dysfunction, and in particular erectile dysfunction (ED), may represent an early surrogate marker of different disease states such as diabetes mellitus, hypertension, metabolic syndrome (MetS) and depression. Furthermore, it has been suggested that ED could also be considered the first sign of a forthcoming coronary heart disease (CHD) and an efficient predictor of silent CHD in a diabetic population, independently of glycometabolic control and ED severity. Hypogonadism is frequently associated with MetS both in subjects with or without ED, insulin resistance being the putative pathogenetic link. In subjects with ED hypogonadism can exacerbate sexual dysfunction because of its typical symptoms, such as decreased sexual desire and mood disturbances. However, hypogonadism per se has been associated with an increased risk of cardiovascular and overall mortality. Aim of the study: In this review, a comprehensive literature search was carried out, in order to discuss the relationship between insulin resistance, ED, MetS and hypogonadism, focusing on their possible involvement in the development of cardiovascular diseases.
Stroke treatment in Stroke Unit: from scientific evidences to clinical practice
Authors: Stornello Michele , Pietrantonio Filomena
Published: April 2013

Background: In themanagement of stroke disease, evidences fromthe literature demonstrate that the introduction of stroke units, hospital wards with dedicated beds providing intensive care within 48 hours of symptoms’ onset, produced a real improvement in the outcome, reducing in-hospital fatality cases and increasing the proportion of patients independently living in long term follow-up. Discussion: The article focuses on stroke disease-management, suggesting a stroke integrated approach for the admission of patients on dedicated beds, in order to extend the ‘‘stroke care’’ approach outcomes to as many hospitals as possible in Italy. This approach implies the set up of a stroke network for an effective patients’ stratification according to the severity of the illness at debut; the set up of an integrated team of specialists in hospital management of the acute phase (first 48 hours) and a timely rehabilitation treatment. Ultimately the hospital should be organized according to department’s semi-intensive areas in order to assure to the patients, in the early stage of the disease, a timely high intensity care aimed to improve the long term outcome.
Hypertension and diabetic retinopathy: a simple association?
Authors: Dalla Vestra Michele , Simioni Natalino , Patrassi Giovanni Maurizio , Fioretto Paola
Published: April 2013

BACKGROUND Diabetes is known to be a major contributor to blindness in industrialized countries in adults. In addition to glycemic control, arterial hypertension is emerging as important factor in the development and progression of diabetic retinopathy. AIM OF THE STUDY This review describes the epidemiologic studies that explored the relationships between hypertension and diabetic retinopathy and the potential pathogenetic mechanisms underlying this association. Finally the effects of antihypertensive treatment in primary and secondary prevention of diabetic retinopathy are discussed. CONCLUSIONS The understanding of the pathogenetic mechanisms and risk factors is crucial to establish effective preventive and treatment strategies.
Primary antiphospholipid syndrome progressing to systemic lupus erythematosus: a case report
Authors: Manganelli Rocco , Iannaccone Salvatore , De Simone Walter
Published: April 2013

Introduction: Primary antiphospholipid syndrome (APS) is a thrombophilic disease that should be suspected in the presence of thrombotic events associated with hematologic abnormalities such as thrombocytopenia and prolongation of the activated partial thromboplastin time. The diagnosis must be confirmed by the demonstration of autoantibodies directed against anionic phospholipids and/or phospholipid-binding proteins. The disease can cause arterial thrombosis in any vascular district, including those of the kidney and central nervous system. Case report: In 2006 a 29-year-old male presented with kidney and brain involvement that was attributed to primary APS. The clinical diagnosis was confirmed by the results of a renal biopsy, which excluded the presence of systemic lupus erythematosus (SLE). The patient remained stable through 32 months of follow-up and then developed a malar rash with deteriorating renal function, decreasing platelet count, and reduced complement levels. Serological studies revealed positivity for ANA (homogeneous pattern), dsDNA, ACA, and beta-2-glycoprotein-1 antibodies. The diagnosis was revised to APS secondary to SLE. Conclusions: A diagnosis of primary APS should not be considered permanent: progression to SLE can occur, in some cases years after the original diagnosis. This case highlights the importance of ongoing follow-up of patients diagnosed with primary APS to detect changes that herald the emergence of SLE.
Equilibrium disorders in elderly: diagnostic classification and differential diagnosis
Authors: Castiglione Alessandro , Aimoni Claudia , Scanelli Giovanni
Published: April 2013

Background: Balance is primarily related to the proper functioning of three sensory input: vestibular, visual and proprioceptive. The integration of these different afferences contributes to the proper attitude of the body in static and dynamic conditions. Equilibrium disorders are common among elderly patients and are responsible for falls and fractures, leading sometimes to catastrophic outcomes, representing a serious health and social problem. Approximately one third of elderly patients at home and about 50% of institutionalized, over 75 year-old, suffer from this particular condition, with at least one fall a year and almost 50% of these with recurrent episodes. Females are more affected than males. Attempts to ascertain the underlying cause of unbalance should be done, leading then to specific treatment. Nevertheless, many elderly patients do not have a single disease but rather a multitude of medical conditions which may cause dizziness, imbalance and vertigo: effects of ageing, drugs, cardiovascular and neurological disorders, ocular and orthopaedic diseases. Aim of the study: A literature review was carried out with the intention to offer practical and useful notions for the management and treatment of equilibrium disorders. Discussion: In clinical practice, the main challenge is to distinguish between peripheral and central imbalance disorders. The data collected from history and clinical exams should be integrated with the intent to include the patient in one of the following clinical conditions: vertiginous syndrome, pre-syncope and/or syncope, neurological diseases, other conditions.Conclusions: Following the differential diagnosis, treatment mainly consists in drug administration (antiemetic and vestibular suppressor drugs) and vestibular rehabilitation (physiotherapy and vestibular exercises).
Algorithm for the Diagnosis of Scleroderma. Early Systemic Sclerosis: Definitions and diagnostic criteria
Authors: Galasso Domenico , Mazzuca Salvatore , Marigliano Norma
Published: April 2013

Introduction: The term scleroderma derives from the Greek words skleros, which means hard, and derma, which means skin. It refers to an acquired systemic inflammatory disease of the connective tissue –also known as systemic sclerosis (SSc)– characterized by excessive collagen deposition in the skin and the internal organs that results in fibrosis. The typical vascular lesion in SSc leads to narrowing of the vessel lumen, intimal thickening, medial hypotrophy, and adventitial fibrosis of small muscular vessels, collagen deposition in the other matrix components of interstice, and the Raynaud phenomenon secondary to these widespread microvascular abnormalities. All these characteristics lead to a connective tissue re-modeling. Discussion: Several clinical studies utilize the American Rheumatology Association’s 1980 classification. However, these diagnostic criteria are unsatisfactory because they fail to take into consideration part of the disease spectrum. Early-phase SSc is characterized by the Raynaud phenomenon (in 90% of all patients), sclerodactyly, and positivity for SSc-specific autoantibodies (antinuclear antibodies, anti-topoisomerase I antibodies, anti-RNA polymerase I and III antibodies, anti-centromere antibodies, anti-fibrillarin antibodies, anti-PM-SCL antibodies).. It is necessary to reduce delays in the diagnosis of SSc. Conclusions: Patients with red-flag positivity (Raynaud phenomenon and digital edema) require Phase I SSc screening, which consists in capillaroscopic assessment of possible microvascular abnormalities. The work-up will then focus on inflammatory indices, renal function tests, and internal organ involvement (echocardiography, high-resolution computed tomography of the chest, diffusing capacity of the lungs for carbon monoxide).
Infusion of iloprost without a peristaltic pump: Safety and tolerability
Authors: Faggioli Paola , Giani Leopoldo , Mazzone Antonino
Published: April 2013

Introduction: Iloprost is a potent prostacyclin (PGI2) analogue that is effective in the treatment of peripheral arterial disease, vasculitis, pulmonary hypertension, and secondary Raynaud’s phenomenon. Intravenous infusions are generally administered with the aid of a peristaltic pump to reduce the risk of adverse reactions caused by unintentional increases in the infusion rate. This increases the cost of care in terms of equipment and personnel and may limit the use of this drug. Materials and methods: We retrospectively analyzed 18,432 iloprost infusions administered between 1999 and 2009 to 272 patients with systemic sclerosis (n = 253) and 19 with peripheral arterial disease (n = 19). All infusions were administered in the day hospital over 6 h with a normal IV set-up with a roller flow regulator. Flow rates were set to deliver iloprost at 1-2 ng/kg/min. Rates were verified by direct drop counts during the first 15-20 minutes of the infusion and at each subsequent check. Results: There were no adverse events that were fatal, life-threatening, or associated with prolongation of hospitalization and very few events requiring intensive care or continuous monitoring. The latter included 4 cases of tachycardia/arrhythmia (extrasystoles in most cases), 3 cases of hypotension (systolic pressure < 80 mmHg), and 2 cases of hypertension (BP > 170/100 mmHg). All other adverse reactions were mild, reversible, and similar to those seen with iloprost infusion with peristaltic pump. Only one patient had to be switched to another prostanoid (due to intolerance). Discussion: Iloprost infusion administered with a normal IV flow regulator appears to be as safe, well tolerated, and effective as traditional infusion with a peristaltic pump.
Undifferentiated seronegative spondyloarthritis with inflammatory bowel disease and a family history of psoriasis. Sicca syndrome
Authors: Marigliano Norma , Galasso Domenico
Published: April 2013

Background: Seronegative spondyloarthritis is characterized by the presence of subcutaneous nodules, asymmetrical peripheral arthritis, sacroileitis with or without spondylitis, and rheumatoid-factor negativity. Other common clinical manifestations include oral ulcers, conjunctivitis, and cutaneous lesions such as psoriasis. Familial aggregation has also been described. According to the 1986 classification, corresponding clinical entities include ankylosing spondylitis, psoriatic arthritis, Reiter’s syndrome, arthritis associated with inflammatory bowel disease (IBD), and undifferentiated spondyloarthritis. The disease is also frequently associated with the HLA B27 antigen. From the clinical point of view, there are often incomplete forms of spondyloarthritis, such as reactive arthritis triggered by asymptomatic infections, psoriatic arthritis without psoriasis itself, initial phases of specific forms of spondyloarthritis or the phase of ankylosing spondylitis characterized by sacroiliac lesions, and all forms that remain undifferentiated for long periods of time. Moreover, there are close relations between arthropathy and IBDs, such as Crohn’s disease, ulcerative colitis, and Whipple’s syndrome. Recently, microscopic inflammatory bowel lesions and psoriatic arthritis have been described. Case report: A 30-year-old man (HLA B27-negative) who had been vaccinated against TBC and HBV presented with a 6-year history of recurrent episodes of predominantly left-sided sciatica. The pain was worse at night and during rest. He was suffering from bilateral sacroileitis without spondylitis. Three to five times a day, usually after eating, he passed watery feces containing mucous and small amounts of bright red blood. Colonoscopy revealed pancolitis with histological evidence of chronic inflammation interspersed with areas of acute inflammation, edema, hyperemia, and glandular distortion. One year later, the clinical manifestations and histological findings were essentially unchanged: glandular distortions, chronic and acute inflammation of the lamina propria and crypt microabscesses. There were no granulomas and no evidence of uveitis. The inflammatory index was positive; FR, ENA, ANA titers were negative. He began therapy with adalimumab (loading dose 80 mg followed by 40 mg every 15 days) and mesalazine (2.4 g per os), and the clinical manifestations of the disease improved significantly.
B-type natriuretic peptide and COPD in the Emergency Department
Authors: Minora Tiziano , Marino Pietro
Published: April 2013

Introduction: The aim of this study was to evaluate, in patients with chronic obstructive pulmonary disease (COPD) and arrived to the emergency department (ED) with dyspnea / hypoxia, the existence of possible correlations between blood levels of B-type natriuretic peptide (NT-proBNP) and presence of heart failure [HF]), mortality, outcome of the ED visit (discharge, ospitalization,death), and length of post-ED hospital stays. Materials and methods: Clinical history, medical examination and blood levels of NT-proBNP were perfomed in all patients selected to our emergency department with the above symptoms between December 2006 and December 2008. Emergency department and hospital charts for these patients were later retrospectively reviewed to identify patients diagnosed with COPD. Results: A total of 546 patients (mean age 77 years, 52% women) had final diagnoses of COPD (with or without HF). Eight died in the ED, 104 were discharged after the ED visit, and 424 were hospitalized. Hospitalizations were longer for patients with COPD alone (21 days vs. 13 days for COPD + HF). Mortality among hospitalized patients was 9.7%. Seventy-six percent of the patients had elevated blood levels of NT-proBNP (>450ng/L) in the ED. Most of these patients (54%) had COPD and HF; the others (22%) had COPD alone (p < 0.01). Low levels of NT-proBNP (<450ng/L) were more frequent in patients with simple COPD who were discharged after the ED visit (89/ 546). In this group, 25/89 returned to the ED after more than 60 days; 17% had simple COPD, and 10/25 were hospitalized. Elevated blood NT-proBNP levels were significantly associated with mortality (p < 0.001). Discussion: The findings of the present study indicate that HF is the main cause of dyspnea and hypoxia among patients with COPD who present to the ED with these symptoms. High blood levels of NT-proBNP on ED admission can alert ED physicians to the presence of HF, allowing them to prescribe appropriate treatment and make more informed decisions regarding the need for hospitalization. Low levels of NT-proBNP appear to be associated with simple COPD and low-risk that may be manageable on an outpatient basis. Measurement of NT-proBNP levels in dyspneic patients presenting to the ER is helpful for making a correct diagnosis and identifying appropriate management strategies.
Haemorrhage and intestinal lymphoma
Authors: Pizzini Attilia M. , Pilia Annalisa , Silingardi Mauro , Iori Ido , Gelli Maria C.
Published: April 2013

Background: The prevalence of coeliac disease is around 1% in general population but this is often unrecognised. The classical presentation of adult coeliac disease is characterized by diarrhoea and malabsorption syndrome, but atypical presentations are probably more common and are characterized by iron deficiency anaemia, weight loss, fatigue, infertility, arthralgia, peripheral neuropathy and osteoporosis. Unusual are the coagulation disorders (prevalence 20%) and these are due to vitamin K malabsorption (prolonged prothrombin time). Clinical case: A 64-year-old man was admitted to our Department for an extensive spontaneous haematoma of the right leg. He had a history of a small bowel resection for T-cell lymphoma, with a negative follow-up and he didn’t report any personal or familiar history of bleeding. Laboratory tests showed markedly prolonged prothrombin (PT) and partial-thromboplastin time (PTT), corrected by mixing studies, and whereas platelet count and liver tests was normal. A single dose (10 mg) of intravenous vitamin K normalized the PT. Several days before the patient had been exposed to a superwarfarin pesticide, but diagnostic tests for brodifacoum, bromadiolone or difenacoum were negative. Diagnosis of multiple vitamin K-dependent coagulationfactor deficiencies (II, VII, IX, X) due to intestinal malabsorption was made and coeliac disease was detected. Therefore the previous lymphoma diagnosis might be closely related to coeliac disease. Conclusions: A gluten free diet improves quality of life and restores normal nutritional and biochemical status and protects against these complications.
Intermediate care
Authors: Salsi Afro , Calogero Pietro
Published: April 2013

Background: In most cases intermediate care is represented by a residential care service that faces needs of people, mainly older people, between discharge from the hospital and the return to home. Discussion: Some authors have a negative opinion of this system due to the risk of omission of care and malpractice for the elderly as a consequence of early discharge from the hospital. There are different models of implementation based on the resources locally available and on the particular facilities network. Conclusion: The multidimensional assessment of clinical, functional and social problems is the key for a favourable outcome of intermediate care. If appropriately built as organisational care, intermediate care can become a positive chance for patients’ health. The key for success is to operate in a patient-centered mode, by accurately defining the individual plan of care.
Il futuro della ricerca biomedica in Italia
Authors: Gussoni Gualberto
Published: April 2013

Book review of:Il futuro della ricerca biomedica in Italia. Roma: S3.Studium — Collana Officina di NEXT - Ricerche, 2009 106 pagg.
Occurrence of Polymelia in a Female Child
Authors: Verma Satyajeet , Khanna Manish , Tripathi V. N. , Yadav N. C.
Published: April 2013

We report a rare case of polymelia in a 6-month-old female child who presented with developed lower limbs and an additional underdeveloped left lower limb.
Phosphorus enrichment and carbon depletion contribute to high Microcystis biomass and microcystin concentrations in Ugandan lakes
Authors: Poste A. E. , Hecky R. E. , Guildford S. J.
Published: April 2013

We investigated the factors influencing cyanobacterial biomass and microcystin (MC) concentrations in several Ugandan lakes from September 2008 to February 2009. We characterized thermal structure, light availability, nutrient concentrations, chlorophyll a, phytoplankton δ13C (as an indicator of CO2 limitation), and phytoplankton community composition and abundance as well as MC concentrations. We used these data to test several hypotheses based on previous research in temperate lakes regarding the factors that encourage high cyanobacterial biomass and MC concentrations. Site characteristics that appeared to favor high cyanobacterial biomass (especially Microcystis) included: high total phosphorus concentrations, low total nitrogen to total phosphorus (TN : TP) ratios, and possibly low CO2 availability. Light availability, total nitrogen concentrations, and thermal structure of the water column were not related to cyanobacterial biomass. MC concentrations were strongly related to Microcystis biomass (and were not related to the biomass of any other cyanobacterial taxa), which was positively correlated with total phosphorus and chlorophyll a concentrations. MC cell content may be moderated by CO2 availability, with MC cell quotas tending to be lower where the potential for C‐limitation of photosynthesis was higher. In these phosphorus‐rich tropical lakes, the shallowest study sites were most conducive to the development of large standing crops of Microcystis and high MC concentrations. The environmental conditions that appear to favor high cyanobacterial biomass and MC concentrations in our Ugandan study lakes are similar to what has been observed for temperate lakes.
Using the radium quartet (228Ra, 226Ra, 224Ra, and 223Ra) to estimate water mixing and radium inputs in Loch Etive, Scotland
Authors: Hsieh Yu-Te , Geibert Walter , van-Beek Pieter , Stahl Henrik , Aleynik Dmitry , Henderson Gideon M.
Published: April 2013

The radium (Ra) quartet (228Ra, 226Ra, 224Ra, and 223Ra) has been investigated in Loch Etive, a Scottish fjord, to provide new constraints on water mixing rates and on the inputs of Ra from sediments. Maximum water transport rates for the inflowing estuarine layer at 5 m depth, determined from the excess 223Ra (223Raex), indicate that this water travels at no more than 2.4 ± 0.2 cm s−1 net and that it takes 17 ± 2 d for waters to travel from the mouth to the head of the loch if no horizontal mixing is taken into account. Alternatively, neglecting advection, the short‐lived Ra distribution could be explained by horizontal mixing rates of 6.1 × 106 cm2 s−1 (223Raex) or 9.1 × 106 cm2 s−1 (224Raex). Periodic overturning circulation plays an important role in resetting chemical cycles in the isolated deep basin of the inner loch. Sediment in this deep basin provides the major input of 228Ra to the isolated deep water, and the accumulation of 228Ra in deep waters allows an assessment of sedimentary fluxes of 228Ra, a poorly constrained aspect of the 228Ra input to the global ocean. The calculated sedimentary 228Ra flux of 2.1 ± 0.2 (× 109) atoms m−2 yr−1 in the inner deep basin is comparable with previous measurements of sedimentary 228Ra inputs from shelf sediments, supporting existing global 228Ra budgets, which are used to assess global rates of groundwater discharge to the ocean.
Phytoplankton species‐specific release of dissolved free amino acids and their selective consumption by bacteria
Authors: Sarmento Hugo , Romera-Castillo Cristina , Lindh Markus , Pinhassi Jarone , Sala M. Montserrat , Gasol Josep M. , Marrase Cèlia , Taylor Gordon T.
Published: April 2013

Despite representing only a small fraction of the ocean's dissolved organic matter pool, dissolved free amino acids (DFAA) have high turnover rates and are major nitrogen and carbon sources for bacterioplankton. Both phytoplankton and bacterioplankton assimilate and release DFAA, but their consumption and production are difficult to quantify in nature due to their short residence times (min) as dissolved monomers. We segregated DFAA production by phytoplankton and bacterial consumption by measuring individual DFAA concentrations in four axenic phytoplankton cultures during the exponential growth phase, and also after 4 d incubations in the presence of a natural bacterioplankton community. The amounts and composition of the DFAA pool varied widely among phytoplankton species. The proportion of dissolved organic carbon attributed to DFAA varied among cultures. The picoeukaryotic prasinophyte, Micromonas pusilla, released higher amounts of DFAA than the other species tested (diatoms and dinoflagellate), especially alanine, which has been reported as the dominant individual DFAA in some oligotrophic environments. Community structure of heterotrophic prokaryotes responded to differences in the quality of organic matter released among microalgal species, with Roseobacter‐related bacteria responding strongly to exudate composition. Our results demonstrate the specificity of DFAA extracellular release among several algal species and their preferential uptake by members of bacterial communities.
Mineral dust indirect effects and cloud radiative feedbacks of a simulated idealized nocturnal squall line
Authors: Seigel R. B. , van den Heever S. C. , Saleeby S. M.
Published: April 2013

Abstract. Mineral dust is arguably the most abundant aerosol species in the world and as such potentially plays a large role in aerosol indirect effects (AIEs). This study assesses and isolates the individual responses in a squall line that arise (1) from radiation, (2) from dust altering the microphysics, as well as (3) from the synergistic effects between (1) and (2). To accomplish these tasks, we use the Regional Atmospheric Modeling System (RAMS) set up as a cloud-resolving model (CRM). The CRM contains aerosol and microphysical schemes that allow mineral dust particles to nucleate as cloud drops and ice crystals, replenish upon evaporation and sublimation, be tracked throughout hydrometeor transition, and be scavenged by precipitation and dry sedimentation. Factor separation is used on four simulations of the squall line in order to isolate the individual roles of radiation (RADIATION), microphysically active dust (DUST MICRO), and the nonlinear interactions of those factors (SYNERGY). Results indicate that RADIATION acts to increase precipitation, intensify the cold pool, and enhance the mesoscale organization of the squall line due to changes in microphysics originating from cloud top cooling. Conversely, DUST MICRO decreases precipitation, weakens the cold pool, and weakens the mesoscale organization of the squall line due to an enhancement of the warm rain process. SYNERGY shows little impact on the squall line, except near the freezing level, where an increase in mesoscale organization takes place. The combined effect of the mineral dust AIE due to both DUST MICRO and SYNERGY is to weaken the squall line.
OBJECT-BASED FOREST CHANGE DETECTION USING HIGH RESOLUTION SATELLITE IMAGES
Authors: Chehata N. , Orny C. , Boukir S. , Guyon D.
Published: April 2013

Abstract. An object-based approach for forest disaster change detection using High Resolution (HR) satellite images is proposed. An automatic feature selection process is used to optimize image segmentation via an original calibration-like procedure. A multitemporal classification then enables the separation of wind-fall from intact areas based on a new descriptor that depends on the level of fragmentation of the detected regions. The mean shift algorithm was used in both the segmentation and the classification processes. The method was tested on a high resolution Formosat-2 multispectral satellite image pair acquired before and after the Klaus storm. The obtained results are encouraging and the contribution of high resolution images for forest disaster mapping is discussed.
High resolution climate projection of storm surge at the Venetian coast
Authors: Mel R. , Sterl A. , Lionello P.
Published: April 2013

Abstract. Climate change impact on storm surge regime is of great importance for the safety and maintenance of Venice. In this study a future storm surge scenario is evaluated using new high resolution sea level pressure and wind data recently produced by EC-Earth, an Earth System Model based on the operational seasonal forecast system of the European Centre for Medium-Range Weather Forecasts (ECMWF). The study considers an ensemble of six 5 yr long simulations of the rcp45 scenario at 0.25° resolution and compares the 2094–2098 to the 2004–2008 period. EC-Earth sea level pressure and surface wind fields are used as input for a shallow water hydrodynamic model (HYPSE) which computes sea level and barotropic currents in the Adriatic Sea. Results show that a high resolution climate model is needed for producing realistic values of storm surge statistics and confirm previous studies in that they show little sensitivity of storm surge levels to climate change. However, some climate change signals are detected, such as increased persistence of high pressure conditions, an increased frequency of windless hour, and a decreased number of moderate windstorms.
La reforma tributaria 2009 en Nicaragua: una visión jurídica
Authors: Saballos Reynaldo Balladares
Published: April 2013

La reforma tributaria del año 2009 obedece a criterios fundamentalmente recaudatorios, más que de justicia. Significa un quebrantamiento de la lógica inherente a la tributación que encuentra en los principios de justicia tributaria el límite de legitimidad constitucional al ejercicio del poder tributario por parte del Estado para la creación de tributos o su reforma. En relación con el impuesto sobre la renta referido a las personas físicas o al pago mínimo defi nitivo, la regulación legal del mismo operada por la reforma en cuestión es incongruente con las exigencias de los principios de igualdad y capacidad contributiva establecidos en los artículos 114 y 115 de la Constitución nicaragüense. Riassunto: La riforma tributaria dell´anno 2009 obedisce, fondamentalmente, a criteri di riscossione, invece di giustizia costituzionale. Significa una spazzatura della logica propria della imposizione che trova nei principi della giustizia tributaria i limiti della legittimità costituzionale all`utilizzo del potere tributario dallo Stato con riguardo alla creazione dei tributi, sebbene, alla loro riforma. In rapporto con l´imposta sul redito delle persone fi siche o al pagamento minimo defi nitivo, la regolazione legale dei medesimi operata dal legislatore nella suddetta riforma non è congrua nei confronti delle esigenze divenuti dai principi di eguaglianza e capacità contributiva defi niti dal dettato costituzionali negli articoli 114 e 115 della Costituzione nicaraguese. DOI: http://dx.doi.org/10.5377/derecho.v0i15.1030 Revista de Derecho No.15 2011 pp.95-124
Early upper digestive tract side effects of zidovudine with tenofovir plus emtricitabine in West African adults with high CD4 counts
Authors: Ouattara Eric , Danel Christine , Moh Raoul , Gabillard Delphine , Peytavin Gilles , Konan Romuald , Carrou Jérome Le , Bohoussou Franck , Eholie Serge P , Anglaret Xavier
Published: April 2013

Introduction

Tenofovir (TDF) with emtricitabine (FTC) and zidovudine (ZDV) is a recognized alternate first‐line antiretroviral (ART) regimen for patients who cannot start treatment with non‐nucleoside reverse transcriptase inhibitors (NNRTIs). Clinical studies comparing TDF+FTC+ZDV to other regimens are lacking.

Methods

Participants in a trial of early ART in Côte d'Ivoire (Temprano ANRS 12136) started treatment with TDF/FTC plus either efavirenz (EFV) or ZDV (HIV‐1+2 dually infected patients and women refusing contraception or previously treated with nevirapine). We compared rates of upper digestive serious adverse events (sAEs) between TDF/FTC+EFV and TDF/FTC+ZDV patients during the first six months of treatment. sAEs were defined as either grade 3–4 AEs or persistent grade 1–2 AEs leading to drug discontinuation.

Results

A total of 197 patients (76% women, median CD4 count 395/mm3) started therapy with TDF/FTC, 126 with EFV and 71 with ZDV. During the first six months of ART, 94 patients had digestive AEs (nausea/vomiting) of any grade (EFV 36/126, 29%; ZDV 58/71, 82%, p<0.0001), including 20 sAEs (EFV 3/126, 5%; ZDV 17/71, 24%, p<0.0001). In‐patients on TDF/FTC+ZDV with digestive AEs, the median time to the first symptom was two days (IQR: 1–4). Plasma ZDV (Cmax) distributions and pill ZDV dosages were normal. Patients with digestive AEs had higher haemoglobin levels and tended to have higher body mass indices and more frequent past histories of cotrimoxazole (CTX) prophylaxis.

Conclusions

We observed an unexpectedly high rate of digestive sAEs in West African adults, mostly women, who started a 3‐nuc ART with TDF/FTC+ZDV in Côte d'Ivoire. These adults were participating in a trial of early ART and had much higher CD4 counts than those who currently routinely start ART in sub‐Saharan Africa. They all received CTX concomitantly with ZDV. We suggest that further early prescriptions of TDF+XTC+ZDV should be carefully monitored and that whenever possible, the rate of early upper digestive adverse events should be compared to that occurring in‐patients taking other drug regimens.

Clinical Trial Number: NCT00495651.
Intended and Unintended Reverberation of Traditional and Pro‐age Commercials as a Function of Viewer Age
Authors: Bluemke Matthias , Degner Juliane , Lotz Julia , Ritzenhöfer Lisa , Shelliem Lisa
Published: April 2013

Pro‐age advertising campaigns feature mature models, at least in part to reduce the depiction of unrealistic body ideals associated with the use of young models. The introduction of mature models into advertising campaigns may have hitherto unexamined effects on viewers' self‐esteem. We therefore compared the impact of mature and young models on women's levels of self‐esteem. Young adult and middle‐aged women were subtly exposed to young or pro‐age female models before completing an affective priming task designed to measure self‐esteem. As predicted, exposure influenced only appearance‐based self‐esteem, but not global self‐esteem. Furthermore, age congruency led to decreased self‐esteem, whereas age incongruency led to increased self‐esteem. Specifically, exposure to young models decreased young women's self‐esteem, just as exposure to mature models decreased middle‐aged women's self‐esteem. By contrast, exposure to mature models increased young women's self‐esteem, and exposure to young models increased middle‐aged women's self‐esteem. The implications for marketing campaigns are discussed. Copyright © 2013 John Wiley & Sons, Ltd.
Acute seizures predict epilepsy after childhood stroke
Authors: Fox Christine K. , Glass Hannah C. , Sidney Stephen , Lowenstein Daniel H. , Fullerton Heather J.
Published: April 2013

Objective

To determine incidence rates and predictors of epilepsy after childhood stroke and compare these to published estimates of 3 to 5% cumulative epilepsy incidence by 5 years poststroke in adults.

Methods

In a retrospective population‐based study of children with stroke (29 days–19 years) in an integrated health care system (1993–2007), poststroke seizures were identified through electronic searches and confirmed by chart review. Stroke and seizure characteristics were abstracted from medical records. Survival analysis was used to determine rates and predictors of remote seizures and active epilepsy (anticonvulsant treatment for remote seizure within prior 6 months) at last follow‐up.

Results

From a population of 2.5 million children, we identified 305 stroke cases. Over a median follow‐up of 4.1 years (interquartile range = 1.8–6.8), 49 children had a first unprovoked remote seizure. The average annual incidence rate of first remote seizure was 4.4% (95% confidence interval [CI] = 3.3–5.8) with a cumulative risk of 16% (95% CI = 12–21) at 5 years and 33% (95% CI = 23–46) at 10 years poststroke. The cumulative risk of active epilepsy was 13% (95% CI = 9–18) at 5 years and 30% (95% CI = 20–44) at 10 years. Acute seizures at the time of stroke predicted development of active epilepsy (hazard ratio = 4.2, 95% CI = 2.2–8.1). At last follow‐up, ⅓ of the children with active epilepsy had a recent breakthrough seizure despite anticonvulsant usage.

Interpretation

Unlike adults, children are uniquely vulnerable to epilepsy after stroke. Children with acute seizures at the time of stroke are at particularly high risk. Ann Neurol 2013;74:249–256
Copper(II) complexes of acylhydrazones: synthesis, characterization and DNA interaction
Authors: Gökçe Cansu , Gup Ramazan
Published: April 2013

Two new acylhydrazone copper(II) complexes of 4‐hydroxy‐N′‐[(1E)‐1‐(4‐methylphenyl)ethylidene]benzohydrazide (HL1) and 4 ethyl [4‐({(2E)‐2‐[1‐(4‐methylphenyl)ethylidene]hydrazinyl}carbonyl)phenoxy]acetate (HL2) have been synthesized and characterized. The structures of both acylhydrazone and copper(II) complexes were identified by elemental analysis, infrared spectra, UV–visible electronic absorption spectra, magnetic susceptibility measurements, TGA and powder X‐ray diffraction. DNA binding and DNA cleavage activities of the synthesized copper complexes were examined by using UV‐visible titration and agarose gel electrophoresis, respectively. The effect of complex concentration on the DNA cleavage reactions in the absence and presence of H2O2 was also investigated. The results indicate that all the complexes bind slightly to calf thymus DNA and cleavage pBR322 DNA. The mechanistic studies demonstrate that a hydrogen peroxide‐derived species and singlet oxygen (1O2) are the active oxidative species for DNA cleavage. Copyright © 2013 John Wiley & Sons, Ltd.
Structure and property of tetrafluoroethylene‐propylene elastomer‐OVPOSS composites
Authors: Chuanbo Cong , cancan Cui , Xiaoyu Meng , Qiong Zhou
Published: April 2013

Tetrafluoroethylene‐propylene elastomer‐octavinyl‐polyhedral oligomeric silsesquioxane (TFE/P‐OVPOSS) composites containing various percentages of OVPOSS are prepared via room temperature milling and heat vulcanization at 170°C. The composites are characterized by FTIR, 13C‐NMR, 29Si‐NMR, XRD, DSC, SEM, tensile test, DMA, and TGA. The crosslink bond formation between TFE/P and OVPOSS conforms to the structural characterization of the composites. The OVPOSS cages aggregate when the OVPOSS dosage is more than 6 as observed from the XRD curves and SEM images. The swelling test shows that the experimental crosslink density is lower than the calculated crosslink density, indicating that not all reacted vinyl groups are converted into crosslink bonds. Meanwhile, the incorporation of OVPOSS significantly enhances the mechanical property and elevates the glass temperature of the composites. However, the thermal property is only improved slightly. © 2013 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 130: 1281‐1288, 2013
Solid‐State Form Screen of Cardiosulfa and Its Analogues
Authors: Kumar S. Sudalai , Rana Soumendra , Nangia Ashwini
Published: April 2013

Cardiosulfa is a biologically active sulfonamide molecule that was recently shown to induce abnormal heart development in zebrafish embryos through activation of the aryl hydrocarbon receptor (AhR). The present report is a systematic study of solid‐state forms of cardiosulfa and its biologically active analogues that belong to the N‐(9‐ethyl‐9H‐carbazol‐3‐yl)benzene sulfonamide skeleton. Cardiosulfa (molecule 1; R1=NO2, R2=H, R3=CF3), molecule 2 (H, H, CF3), molecule 3 (CF3, H, H), molecule 4 (NO2, H, H), molecule 5 (H, CF3, H), and molecule 6 (H, H, H) were synthesized and subjected to a polymorph search and solid‐state form characterization by X‐ray diffraction, differential scanning calorimetry (DSC), variable‐temperature powder X‐ray diffraction (VT‐PXRD), FTIR, and solid‐state (ss) NMR spectroscopy. Molecule 1 was obtained in a single‐crystalline modification that is sustained by NH⋅⋅⋅π and CH⋅⋅⋅O interactions but devoid of strong intermolecular NH⋅⋅⋅O hydrogen bonds. Molecule 2 displayed a NH⋅⋅⋅O catemer C(4) chain in form I, whereas a second polymorph was characterized by PXRD. The dimorphs of molecule 3 contain NH⋅⋅⋅π and CH⋅⋅⋅O interactions but no NH⋅⋅⋅O bonds. Molecule 4 is trimorphic with NH⋅⋅⋅O catemer in form I, and NH⋅⋅⋅π and CH⋅⋅⋅O interactions in form II, and a third polymorph was characterized by PXRD. Both polymorphs of molecule 5 contain the NH⋅⋅⋅O catemer C(4) chain, whereas the sulfonamide NH⋅⋅⋅O dimer synthon R22(8) was observed in polymorphs of 6. Differences in the strong and weak hydrogen‐bond motifs were correlated with the substituent groups, and the solubility and dissolution rates were correlated with the conformation in the crystal structure of 1, 2, 3, 4, 5, 6. Higher solubility compounds, such as 2 (10.5 mg mL−1) and 5 (4.4 mg mL−1), adopt a twisted confirmation, whereas less‐soluble 1 (0.9 mg mL−1) is nearly planar. This study provides practical guides for functional‐group modification of drug lead compounds for solubility optimization.