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Clustering in dilute matter with medium effects
Get PDFThe formation and dissolution of light and heavy clusters in warm and dilute strongly interacting matter is studied using a generalized relativistic density functional. This phenomenological theoretical description is an extension of a relativistic mean-field model with density dependent nucleons-meson couplings. It considers nuclei as explicit degrees of freedom in addition to nucleons. Nuclei and nucleons are treated as quasiparticles with medium dependent masses. For clusters, one contribution to the mass shift represents an effective way to take into account the Pauli exclusion principle for nucleons, whether free or bound in nuclei. This mechanism causes the dissolution of clusters at high densities. The consequences are explored for compact star matter as an example for the application of the model in astrophysics. General features and open questions of the approach are discussed
Breast cancer cells treated with proton beam: Immunological features and gene signatures
Get PDFThe breast cancer (BC) disease is characterized by a wide heterogeneity at both clinical and molecular level, showing distinct subtypes with different clinical outcomes. Thus, the choice of the therapeutic plan, such as the type of radiotherapy (RT) need to take into account this complexity. Indeed, the proton therapy (PT) shows a medical benefit compared to conventional X-ray RT, as regards the localized delivery of the radiation dose sparing health tissues, but few data regarding proton-induced molecular changes are currently available. The aim of this study was therefore to investigate the production of immunological molecules and gene expression profiles induced by proton irradiation on BC cell lines. Clonogenic survival assay, luminex assay and cDNA microarray gene expression analyses were performed both in the non-tumorigenic MCF10A cell line and in two tumorigenic MCF7 and MDA-MB-231 cell lines, following irradiation with 0.5, 2 and 9 Gy of clinical proton beams. We found that proton irradiation induced gene expression changes useful to define a cell line and dose-dependent gene signatures. The lack of molecular data in the literature can be filled by data here presented that could represent a useful tool to better understand the molecular mechanisms elicited by protons predicting the treatment outcome
Life-Saving Combined Heart–Kidney Transplantation in a Previous Sequential Heart and Kidney Transplant Recipient
Get PDFPurpose: Solid organ re-transplantation in the context of allograft failure is a challenging clinical and ethical problem. Ideally, solid organ re-transplantation after initial allograft failure should be performed in all recipients, but this is often not clinically or logistically feasible.
Methods: This report details what we believe is the first combined heart–kidney transplant in a recipient of a previous sequential heart and kidney transplant. Results: Eight years after a combined heart and kidney transplant after initially receiving a sequential heart and kidney transplant, a 31-year-old man is doing extremely well, with no rejection episodes or significant complications after transplantation.
Summary: This case confirms that combined heart and kidney transplantation is a viable option for tackling the complex issue of graft failure in recipients of previous cardiac and renal grafts
Atypical Presentation of Glioblastoma Multiforme
Get PDFBackground: Glioblastoma multiforme (GBM) is a highly malignant glial tumour classified by the World Health Organization (WHO) as a stage IV astrocytoma. It varies in shape and size and can be cystic, vascular and necrotic. It often appears as a ring-enhancing lesion on magnetic resonance imaging (MRI). The most common symptoms of GBM, such as headache, vomiting and seizures, are due to increased intracranial pressure. The objective of this case report is to describe an atypical presentation of GBM.
Case Report: A 53-year-old woman of Italian origin presented with a 2-week history of lack of coordination in her hands and some difficulty in speech. Electromyography for assessment of her arms and cranial bulbar function was normal. However, 2 days later, the patient presented to the emergency department with progressive weakness in her left arm and leg as well as difficulty in speech. Mild left facial asymmetry was noted. A brain MRI revealed a right frontal mass. Stereotactic surgical resection was performed 2 days later, and biopsy confirmed the diagnosis of GBM. Although headache and other features of raised intracranial pressure are the most common initial symptoms of GBM, any atypical neurological or psychiatric presentation in an adult patient should raise suspicion for this tumour.
Conclusion: Careful analysis of an adult with atypical signs and symptoms along with thorough review of radiological tests will facilitate early diagnosis of dangerous tumours such as GBM
A Challenging Diagnosis of Leg Ulcer
Get PDFIschaemic ulcers of the lower limb can have several aethiopathological mechanisms. For instance, the uncommon Martorell hypertensive leg ulcer is an infrequent complication of long-term uncontrolled arterial hypertension and is largely ignored and underdiagnosed. The typical ulcer is on the lower leg, is extremely painful and presents in female patients over 60 years of age with cardiovascular risk factors, mainly severe arterial hypertension. The diagnosis is histological, with obliteration of the arterioles by arteriolosclerosis. In these cases, antihypertensive medication is the standard treatment. We describe the case of an African-American female patient with long-term hypertension who presented with a very painful leg ulcer. The diagnosis was complicated by the coexistence of more common causes of ulcer. Despite analgesic medicines, pain relief was only obtained with control of hypertension. A definite diagnosis was made following biopsy.
In describing this diagnosis of an ischaemic leg ulcer, we highlight the need to consider the skin as a target organ of arterial hypertension
Caffeine Toxicity Following Ingestion of an Exercise Supplement by a Patient with Type 1 Diabetes
Get PDFWe report the case of a patient with type 1 diabetes who developed acute severe diabetic ketoacidosis following ingestion of an energy supplement containing caffeine. Some 95% of the US adult population consume caffeine, and the general perception is that there are no negative consequences for health. The upper limit of safe consumption is less than 400 mg per day. However, acute ingestion of high doses of caffeine may cause significant metabolic changes that can be fatal. Here the patient consumed a toxic dose of caffeine causing unpleasant and puzzling symptoms, vomiting and, following omission of his long-acting basal insulin, severe diabetic ketoacidosis. As the sports nutrition market continues to expand, providers and manufacturers have a responsibility to give clear and accurate dosing instructions as well as side effect profiles for their products, particularly for diabetic patients
When a Goitre is a Thyroid Lymphoma
Get PDFPrimary thyroid lymphoma is a rare cause of both thyroid malignancy and extra-nodal lymphoma. It typically presents as a rapidly enlarging goitre with compressive symptoms. Histological analysis of a biopsy specimen is necessary to confirm the diagnosis. Awareness of this disease is important for early diagnosis and appropriate treatment. A 55-year-old man was admitted due to a 3-month history of cervical enlargement, facial and periorbital oedema and dyspnoea, apparently due to a superior vena cava syndrome. However, cervical ultrasound showed asymmetrical thyroid enlargement, lobulated contours and a hypoechogenic texture. A neck CT scan showed calibre reduction of the superior vena cava. The diagnosis of primary thyroid lymphoma was confirmed by open biopsy of the thyroid gland. The patient started treatment with rituximab with clinical improvement
Tourism and digital endowment in Italy: a spatial analysis
Get PDFIn consideration of the recent trend reversal in the number of foreigners’ and residents’ arrivals and
nights spent in the Italian tourism system, this work is proposing to evaluate to what extent the
endowment of infrastructures for telephonic and telematic and the digital endowment among the
enterprises are able to boost the domestic tourism demand in Italy. The results of the proposed spatial
models confirm the general assumption regarding the centrality of the digitalization processes, both from
the public interventions perspective and from the entrepreneurial initiatives perspective. In this way, the
need to harmonize public and private policies becomes pivotal in order to revitalize and stimulate the
internal tourism demand in Italy. The policy implications can be read as an instrument for rebalancing a
troubling trend involving the tourism demand in Italy of the last 30 years
La regione Sardegna e il turismo 4.0 per lo sviluppo e la promozione smart del territorio
Get PDFIn an increasingly digital world, tourism is among those strategic sectors whose performances are
mainly linked to the provision of adequate and modern technological infrastructures, that are important
for the accomodation system, for the training of operators and for the accessibility of destinations. The
aim of this paper is to draw an overview about the relationship between tourism, digitalization processes
and ICT and to deepen the strategic importance of open data for the local tourism development. In
particular it will be examined the main strategy adopted by the Sardinia Region in accordance with its
policies to transform itself into a Smart Tourism Destination
Prison, recidivism, and alternative measures to detention in Italy over the past ten years
Get PDFThis article aims to analyse the reality in the Italian prison system over the last decade, with particular reference to the phenomena of overcrowding, recidivism, and the effectiveness of alternative measures to detention. The analysed statistical data show that implementation of such alternative measures to detention is completely effective in preventing convicted criminals from re-offending during the period of execution and is suitable for ensuring adequate social protection.
Then, this article focused on examining a rehabilitation project aimed at prisoners conducted in non-prison detention centres. It has become apparent that there is a need to further promote the use of alternative measures to detention through the identification of good practices to progressively reduce the risk of these rights becoming "privileges" for a selected population