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Isolated Congenital Asplenia in an Asymptomatic Patient: A Very Rare Diagnosis
Get PDFIsolated congenital asplenia is a rare condition that mostly manifests in the early years, usually due to fatal systemic infections. In this paper, however, we present a case of a 36-year-old asymptomatic patient who was referred for suspected hyposplenism, with no history of splenectomy. There were no significant changes on physical examination. Blood analysis revealed leukocytosis and thrombocytosis as well as moderate anisopoikilocytosis and red blood cells with Howell–Jolly bodies. No spleen or other malformations were identified on imaging. Individuals with isolated congenital asplenia have an increased susceptibility to invasive infections and sepsis, with rapid clinical decline and a high mortality rate despite treatment
Acute Pyelonephritis Associated with Ruptured Abdominal Aortic Aneurysm: An Unusual Presentation
Get PDFWe describe a rare presentation of acute pyelonephritis associated with a ruptured abdominal aortic aneurysm. A 68-year-old female presented to the emergency department with a 3 day history of cystitis. General examination revealed the acute onset of pain in the left flank accompanied by fever and chills. Blood tests revealed leucocytosis 25,400x109L and C-reactive protein 495 mg/L (<6.1), while urinary sediment analysis revealed many leucocytes and gram-negative bacteria. The patient was admitted with acute pyelonephritis. On the third day of admission, the urine culture isolated Escherichia coli sensitive to the antibiotic prescribed; however, the patient clinically deteriorated. A computed tomography scan revealed a ruptured abdominal aortic aneurysm involving the left renal artery. The patient underwent an exploratory laparotomy but uncontrollable haemorrhage led to a fatal outcome.
This case highlights a rare case of acute pyelonephritis associated with a ruptured abdominal aortic aneurysm. A computed tomography scan or abdominal ultrasound should be considered whenever a patient has acute pyelonephritis with a C-reactive protein >400 mg/L in order to exclude complications and other potentially fatal pathologies
Cardiac Tamponade after Thrombolysis for Acute Ischemic Stroke - A Case with an Excellent Outcome Ana Vera-Cruz
Get PDFIntravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) is the established treatment for acute ischemic stroke and has been highly effective in reducing the neurological deficit. Serious adverse events are not uncommon, with hemorrhage being the major complication. We describe the case of a patient with acute ischemic stroke that also presented with vague cardiac symptoms and was treated with rtPA, which was complicated by a hemopericardium causing cardiac tamponade. Pericardiocentesis was promptly performed, which resulted in rapid resolution of the cardiogenic shock. The patient recovered consciousness within a few minutes. A search of the MEDLINE database shows that this is the first report of cardiac tamponade after rtPA thrombolysis occurring in a patient with no history of recent myocardial infarction or aortic dissection
Fulminant Emphysematous Hepatitis – A Rare Cause of Septic Shock
Get PDFEmphysematous hepatitis is a rare entity characterized by the replacement of hepatic parenchyma by gas, leading to acute liver failure. Often it occurs in patients with diabetes mellitus, liver disease or a recent history of abdominal surgery. We present a case of emphysematous hepatitis in a 74-year-old man with no recognizable risk factors. Despite the early broad-spectrum antimicrobial therapy and supportive care, the condition progressed to a fatal outcome, as seen in other case reports. Early recognition of this condition and rapid and aggressive management may improve patient outcomes
Idiopathic CD4+ T-cell Lymphocytopenia: Report of a Case 11 Years after Diagnosis
Get PDFWe report the case of a 23-year-old woman evaluated for asthenia and lymphocytopenia. Clinical examination was unremarkable but laboratory tests showed the presence of CD4 lymphocytopenia. Secondary causes of CD4 lymphocytopenia were ruled out and a previous diagnosis of idiopathic CD4+ T-cell lymphocytopenia was retained. CD4 lymphocytopenia has persisted for 11 years now but the patient has been clinically asymptomatic
La ricomparsa di un reato desueto fra politiche sociali e congetture giudiziali sulle recidive
Get PDFIl saggio muove dall’analisi dei profili storico-sociali dello shoplifting, caratterizzati dall’affermazione del consumismo e di nuove modalità distributive, i department stores. A tali profili, e al processo di medicalizzazione del comportamento che al fine di deresponsabilizzare le autrici di reato appartenenti alla middle class nell’Inghilterra vittoriana codifica la cleptomania, è riconducibile l’origine dello stereotipo del gap di genere (discusso attraverso la rassegna della letteratura).
Su questo sfondo si procede ad esaminare l’incidenza del mutamento sociale sulla costruzione del deviante nell’età contemporanea: attraverso l’analisi di alcuni recenti casi giurisprudenziali delle corti di merito si opera dapprima una ricognizione dell’attuale consistenza del reato nel settore dei prodotti per l’igiene della persona e della casa, e successivamente si indaga l’atteggiamento dei giudici penali nella determinazione della sanzione con specifico riguardo alla “biografia penale” dell’autore di reato e alla prognosi di recidiva.
Infine, a partire dall’ipotesi di un nesso tra numero di shoplifting e andamento dei tassi di povertà, vagliato in letteratura in rari contributi, che sembra individuare nel reato uno strumento per l’approvvigionamento di beni diretti al soddisfacimento di bisogni primari quali l’igiene e la cura di sé a fronte delle lacune delle politiche sociali contemporanee, l’autrice discute gli elementi di un modello multivariato, potenzialmente esplicativo della motivazione al comportamento deviante e del divario tra reati commessi e reati effettivamente scoperti ed inclusivo di variabili quali la politica aziendale (che a sua volta si ipotizza associata alla quota di mercato toiletry detenuta) e le rapide trasformazioni del mercato dei prodotti per l’igiene della persona e della casa.
Cette étude commence par analyser le vol à l’étalage depuis une perspective historique et sociale, en gardant à l’esprit qu’il est caractérisé par la croissance du consumérisme, de nouveaux canaux de vente et des centres commerciaux.
Dans ce contexte, l’origine du stéréotype de la disparité entre les sexes (cet aspect sera discuté par le biais de l’analyse de la littérature) peut être retracée dans cette perspective et dans le processus de justification médicale du comportement qui, afin de déresponsabiliser les femmes criminelles appartenant à la classe moyenne dans l’Angleterre victorienne, conduisit à la définition de la kleptomanie.
Dans ce cadre, l’auteur continue en analysant l’impact du changement social sur la construction de ce comportement criminel à l’époque contemporaine. Notamment, grâce à l’analyse de certains cas de jurisprudence récents, l’auteur présentera d’abord un aperçu du taux réel de ce délit dans le secteur des produits ménagers et des soins personnels. Ensuite, elle examinera les démarches des juges des Tribunaux Criminels dans la détermination de leur sentence, eu égard à la « biographie criminelle » et au pronostic de la récidive.
Enfin, un lien entre le nombre de cas de vol à l’étalage et l’évolution de la pauvreté, rarement analysé dans la littérature, sera proposé. Cette hypothèse semble identifier le crime comme un moyen d’acquisition de biens qui peuvent satisfaire directement certains besoins élémentaires, notamment l’hygiène et les soins personnels, à défaut de politiques sociales contemporaines. À partir de cette hypothèse, l’auteur discute des éléments clés d’un modèle multivarié qui explique éventuellement la motivation du comportement déviant et de l’écart entre les délits commis et les délits élucidés. Ce modèle comprend aussi des variables, par exemple la politique commerciale, qui pourrait à son tour avoir un lien avec la part de marché détenue par les produits ménagers et de soins personnels.
Pour conclure, l’auteur examine les changements rapides du marché des produits ménagers et de soins personnels.
This study will start by analysing shoplifting from a historical and social perspective, bearing in mind that it is characterised by the growth of consumerism, new sales channels and shopping malls.
In this context, the origin of gender gap stereotype (this aspect will be discussed through literature review) can be traced back both to this perspective and to the process of medical justification of the behaviour that, with the aim of taking responsibility away from female criminals belonging to the middle class of Victorian England, which results in the definition of kleptomania.
In this framework the author continues by examining the impact of social change on the construction of this deviant behaviour in contemporary times. In particular, through the analysis of some recent case-laws, the author will first carry out an overview of the true rate of this crime in the household and personal care products sector. Then, she will investigate the approaches of penal judges in the determination of their judgement, with specific regard to the “criminal biography” and the prognosis of recidivism.
Finally, a link between the number of cases of shoplifting and the trend of poverty rates, a connection rarely analysed in the literature, will be proposed. This hypothesis seems to identify the crime as an instrument for the procurement of goods for the purpose of directly satisfying basic needs, namely hygiene and personal care, because of a lack of contemporary social policies. Starting from this hypothesis, the author discusses the key elements of a multivariate model, which potentially explains the motivation for the deviant behaviour and of the gap between crimes committed and crimes eventually reported. This model also includes some variables, namely business policy, which in turn may be associated with the market share held of toiletry products. Lastly, the author examines the rapid changes in the market of household and personal care products
Adulis (Eritrea). Criticità e peculiarità di un sito complesso nel Corno d’Africa
Get PDFSince 2011 an Eritrean-Italian archaeological mission has initiated research and excavation activities in the area of ancient Adulis, an emporium town located along the coast of the Horn of Africa on the Red Sea, in current Eritrea, documented by the sources as early as the 1st century AD and disappeared between the 7th and 8th centuries. The site, due to the historical and geographical context that determined its ancient splendour, invites us to broaden the research field, extending it from the excavation area to the commercial networks that, in ancient times, set in communication the African, Asian and Mediterranean cultures, without neglecting the intermediate scale, necessary to understand the ways in which the settlement was related to the territorial context and its resources. Among the natural resources water, in particular thanks to the presence of the Haddas, a seasonal watercourse that reaches significant flows, was certainly crucial to the development of the town and to the probable agrarian exploitation of its surroundings. Haddas itself was probably the cause of Adulis’ sudden destruction between the 7th and 8th centuries. Today, this watercourse is at same time one of the main resources and one of the major vulnerability factors of this portion of the coast, where the villages of Zula, Afta and Foro live a fragile equilibrium, seasonally endangered by its floods. The same protection of the important cultural heritage constituted by the site of Adulis today, in a way not entirely dissimilar from what happened in ancient times, depends on this balance
AHP-based methodology integrating modern information technologies for historical masonry churches diagnosis
Get PDFSurveys conducted in the aftermath of recent earthquakes have shown that the structural and anti-seismic performances of historical masonry churches are related not only to structural damages and masonry quality but also to other key features such as effectiveness of connections, damages of wooden elements or criticalities related to humidity. Technical and scientific communities are interested in developing or improving existing procedures for the fast-visual survey and diagnostics in order to measure and analyze all the parameters affecting the building performance. In this paper a new procedure, that can be implemented in a Decision Support System (DSS) based on the Analytic Hierarchy Processes (AHP), is developed to perform a rapid visual survey and diagnostics of masonry building through a set of condition ratings. The originality of the presented work is fourfold: 1) the AHP allows to include in the analysis qualitative and quantitative data such as the quality of masonry and connections effectiveness; 2) the proposed survey and diagnostics performed by suitable condition ratings allow an extensive application in order to identify the most damaged buildings that require more detailed structural investigations; 3) the proposed AHP-based approach is integrated in a DSS to provide a powerful computerized tool, useful to large scale data acquisition; 4) the comparison with a standard diagnostics is performed to validate the procedure and emphasize the advantages of the novel diagnostics
Degradation of Aflatoxin B1 by a Sustainable Enzymatic Extract from Spent Mushroom Substrate of Pleurotus eryngii
Get PDFLigninolytic enzymes from white-rot fungi, such as laccase (Lac) and Mn-peroxidase (MnP), are able to degrade aflatoxin B1 (AFB1), the most harmful among the known mycotoxins. The high cost of purification of these enzymes has limited their implementation into practical technologies. Every year, tons of spent mushroom substrate (SMS) are produced as a by-product of edible mushroom cultivation, such as Pleurotus spp., and disposed at a cost for farmers. SMS may still bea source of ligninolytic enzymes useful for AFB1 degradation. The in vitro AFB1-degradative activity of an SMS crude extract (SMSE) was investigated. Results show that: (1) in SMSE, high Lac activity (4 U g−1 dry matter) and low MnP activity (0.4 U g−1 dry matter) were present; (2) after 1 d of incubation at 25 °C, the SMSE was able to degrade more than 50% of AFB1, whereas after 3 and 7 d of incubation, the percentage of degradation reached the values of 75% and 90%, respectively; (3) with increasing pH values, the degradation percentage increased, reaching 90% after 3 d at pH 8. Based on these results, SMS proved to be a suitable source of AFB1 degrading enzymes and the use of SMSE to detoxify AFB1 contaminated commodities appears conceivable
Gli organismi geneticamente modificati e il loro inquadramento normativo
Get PDFIl volume nasce nell’ambito di un accordo di collaborazione stipulato tra il Ministero dell’Ambiente e della Tutela del Territorio e del Mare (MATTM) e il Consiglio Nazionale delle Ricerche, Dipartimento di Scienze Bio-Agroalimentari (CNR-DiSBA) e fornisce una panoramica sulla normativa internazionale in materia di Organismi Geneticamente Modificati (OGM) e dimostrare come il quadro normativo venga costantemente adeguato al continuo sviluppo scientifico nel campo delle biotecnologie