170,122 research outputs found
Banking Union in the Eurozone and the European Union. CEPS Commentary, 12 June 2012
No full textIn this new CEPS Commentary, Jacopo Carmassi, Carmine Di Noia and Stefano Micossi present a rationale and detailed outline for the creation of a banking union in Europe. They argue that it is essential to clearly distinguish between what is needed to address a ‘systemic’ confidence crisis hitting the banking system – which is mainly or solely a eurozone problem – and ‘fair weather’ arrangements to prevent individual bank crises and, when they occur, to manage them in an orderly fashion so as to minimise systemic spillovers and the cost to taxpayers, which is of concern for the entire European Union
Is Sexual Dysfunction in Young Adult Survivors to the L‘Aquila Earthquake Related to Post-traumatic Stress Disorder? A Gender Perspective
No full textBackground: Mental disorders are frequently related to sexual dysfunction (SD) but scant data are still available on trauma-related disorders, particularly post-traumatic stress disorder (PTSD). Aim: To evaluate the relationships between SD and PTSD in 2009 L'Aquila (Italy) earthquake young adult survivors, with particular attention to gender differences. Methods: Five hundred twelve high-school senior students were assessed 21 months after exposure by the following: Trauma and Loss Spectrum–Self-Report (TALS-SR), for post-traumatic spectrum symptoms; Mood Spectrum–Self-Report (MOODS-SR) lifetime version, for mood spectrum symptoms (including SD-related symptoms). Descriptive and inferential statistics were adopted. Outcomes: TALS-SR and MOODS-SR scores were analyzed to evaluate PTSD- and SD-related symptoms. Results: Around 6.5% of subjects reported SD-related symptoms with males showing higher rates than females in each symptom, with a statistically significant difference in item n = 154 (...less sexually active). Survivors with symptomatological PTSD reported rates up to 10%, with higher ratio of endorsing at least one SD-related symptom than with NO-PTSD. Significantly higher total MOODS-SR SD-related symptom scores emerged in survivors with symptomatological PTSD than in those with NO-PTSD, and a 2-way ANOVA showed a significant main effect of symptomatological PTSD and gender and gender × PTSD interaction. Clinical Implications: SD-related symptoms are reported among young adult survivors to earthquake exposure and the number of symptoms is related to PTSD, particularly in males, suggesting the need for accurate evaluation. Strengths & Limitations: Strengths are the large sample of young adult survivors to a massive natural disaster; the long-time frame from exposure corroborating the role of PTSD; the assessment of symptoms specifically occurring after exposure. Limitations are as follows: the lack of a specific scale for SD; the self-report instruments other than clinical interviews, that may be less accurate; the lack of information on the presence of somatic illness and other mental disorders; the lack of a control group; the young age of the sample because of the lifetime sexual experiences of the subjects, in addition to the lack of a comparison measure of sexual functioning before the earthquake. Conclusions: Our results highlight relevant rates of SD-related symptoms in young adults exposed to the L'Aquila earthquake, particularly males and subjects with PTSD, suggesting SD may represent a specific male gender–related somatic complaint. Our results highlight the need for accurate investigation of SD in such population to improve clinical management and appropriate treatment. Carmassi C, Dell'Oste V, Pedrinelli V, et al. Is Sexual Dysfunction in Young Adult Survivors to the L'Aquila Earthquake Related to Post-traumatic Stress Disorder? A Gender Perspective. J Sex Med 2020;17:1770–1778
ON THE BRUHAT G-ORDER BETWEEN LOCAL SYSTEMS ON THE B-ORBITS IN A HERMITIAN SYMMETRIC VARIETY
No full textFollowing Lusztig and Vogan, we study the Bruhat G-order on the set (Formula presented.) of rank 1 local systems on B-orbits in an Hermitian symmetric variety G/L. Supposing Φ irreducible, we obtain a complete combinatorial characterization of the order for Φ of type A, B, D, E and a partial characterization for Φ of type C
Defining Effective Strategies to Prevent Post-Traumatic Stress in Healthcare Emergency Workers Facing the COVID-19 Pandemic in Italy
No full textThe COVID-19 pandemic exponentially increased stress on healthcare workers (HCWs), overwhelming their physical and psychological working capacities. The hospital epicenter of the Italian outbreak promptly provided supportive strategies to prevent PTSD: risk factors and feedbacks in the acute phase are debated
Could the addition of hydro-retention polyacrylamide gels into a substrate really increase its available water amount?
No full textThe aim of the paper is to clarify the advantages for the hard ornamental nursery stocks and to environment derived by the addition of two commercial hydrophilic polyacrylamide gels in a peat/pumice (1:1 V/V) substrate. In both cases, the water absorption capacity of the two hydrophilic polyacrylamide gels was proportional reduced with the presence of dissolved salts in the water. It was found that in the tested substrate an addition of 2 g/L of super-water-retention can increase the amount of retained water of about 130 g for each litre of substrate. However, only 40-50% of the greater amount of water retained by super–water retention was available for the crop. Under operating conditions (drip irrigation with relatively saline water) the increase of water available for the crop in the range (0- -10 KPa) is only about 30 g for each gram of polymer added to the substrate. This higher substrate available water could increase the resistance of the plants to the absence of irrigation for 1-2 days. In conclusion, the addition of hydrophilic polyacrylamide gels to the substrate seems to have positive effects on plants, especially after the end of cultivation (selection and preparation of plants, packaging, storage, transport) and, probably, also during the early stages after transplanting in the customer’s garden, where optimal irrigation could be not always guaranteed
Thromboprophylaxis with reviparin in a patient with acquired hemophilia
No full textReviparin sodium is a low–molecular weight heparin with an anti–factor Xa:anti–factor IIa ratio of ≥3.6 and negligible effects on global clotting tests. It has been shown to be as effective as unfractioned heparin in different prophylactic indications, causing fewer injection-site hematomas as well [1]. Here we report the case of a patient with acquired hemophilia successfully treated with standard therapy plus reviparin.
A 65-year-old man with a history of renal adenocarcinoma was hospitalized with extensive subcutaneous hematomas; he was under treatment with antipsychotic drugs. Hemoglobin was 80 g/L, bilirubin 60.2 μmol/L (indirect: 34.7 μmol/L), and lactate dehydrogenase (LDH) 14.7 μkat/L. Activated partial thromboplastin time (aPTT) was 97 seconds, prothrombin time was normal, fibrinogen level was 6.60 g/L and D-dimer 1751 ng/mL. The patient received fresh frozen plasma, packed red blood cells, and methylprednisolone (0.5 mg/kg per day) without any benefit, then he was transferred to our department. Positive direct antiglobulin test results and low haptoglobin indicated the diagnosis of autoimmune hemolytic anemia. The prolonged aPTT of a mixture of a 1:1 volume of patient’s plasma with normal plasma at 37°C for 2 hours suggested the presence of coagulation inhibitors [2]. Specificity for factor VIII was shown by incubating serial dilutions of the patient’s plasma with an equal volume of normal plasma and performing assays of factor VIII, IX, and XI at 0, 60, and 120 minutes on each mixed dilution [3]. Only factor VIII decreased over time, and the inhibitor titer was 2.6 Bethesda units. The discrepancy between severe bleeding and low titer of antibodies was not surprising; in fact, Bethesda assay underestimates the levels of acquired inhibitors, because of the complexity of reaction kinetics and variation in antibody affinities [4]. On day 3, the patient’s hemoglobin level was 47 g/L; computed tomography revealed a hemothorax and a sub capsular hepatic hematoma. The patient received fresh frozen plasma, packed red blood cells, human factor VIII (bolus of 150 IU/kg plus continuous infusion of 10 IU/kg per hour, to a maximum of 9000 IU), prednisone (1 mg/kg per day), and antifibrinolytic treatment with tranexamic acid (500 mg intravenously 3 times a day) [4,5]. Antipsychotic drugs were withdrawn, because acquired inhibitors may be associated with these drugs. Thromboprophylaxis with subcutaneous reviparin (4200 IU/d) was started, because of the evidence of ongoing intravascular fibrin formation (D-dimer elevation), risk factors for thrombosis (eg, immobilization), and the hemostatic imbalance induced by antifibrinolytic treatment. Although thrombotic events are unusual in acquired hemophilia, there has been a case report concerning pulmonary embolism associated with tranexamic acid therapy [6].
On day 9 aPTT was 85 seconds; there were no signs of active bleeding, but persisting hemolysis was demonstrated by laboratory tests. The patient was started on high-dose intravenous immunoglobulin G (400 mg/kg per day x 5 days, followed by periodic maintenance doses), which resulted in a sudden shortening of aPTT and reduction of the inhibitor titer [7]. On day 63, aPTT was 43 seconds, hemoglobin 108 g/ L, and inhibitors were undetectable. Any recurrence of renal malignancy was ruled out. One month after discharge the aPTT was 30 seconds, fibrinogen 4.46 g/L, D-dimer 342 ng/ mL, bilirubin 5.0 μmol/L, LDH 4.3 μkat/L, haptoglobin 1.83 g/L, and hemoglobin 127 g/L, showing a complete recovery.
In conclusion, antifibrinolytic therapy is of proven benefit in the treatment of bleeding episodes in patients with acquired hemophilia [5]. Nevertheless, tranexamic acid contributes to an increased thromboembolic risk in this setting. In our patient, prophylaxis with reviparin was safe and effective in the prevention of thrombotic events, without any evidence of bleeding complications
Decompensated porto-pulmonary hypertension in a cirrhotic patient with thrombosis of portocaval shunt
No full textWe report a case of decompensated porto-pulmonary hypertension closely associated with the development of intra-portocaval shunt thrombosis. A woman with Laennec's cirrhosis was hospitalized because of severe dyspnea and edema. She underwent surgical portocaval anastomosis ten years ago. Imaging studies showed massive intra-shunt thrombosis, portal hypertension, ascites, pleuro-pericardial effusions and enlargement of right cardiac cavities. Cardiac catheterization allowed to rule out coronary and left-sided heart abnormalities and led to the diagnosis of pre-capillary pulmonary hypertension. Antithrombotic treatment with low molecular weight heparin was instituted. The management also included ACE inhibitors, spironolactone, low-salt diet and lactulose. The patient was discharged and three months later we observed the disappearance of edema, ascites and pleuro-pericardial effusions, a marked body weight reduction and improved dyspnea and liver function tests. A possible link between the development of intra-shunt thrombosis and clinical decompensation in our patient was hypothesized. In fact, it has been demonstrated that the increased portal pressure, caused by occlusion of portosystemic shunt, reduces renal plasma flow and increases systemic endothelin-1 concentration. In our patient the disappearance of edematous state and improved dyspnea observed after recanalization of the shunt strongly support this hypothesis
Evaluation of coagulation parameters in rlation to suspicion, diagnosis and follow-up of pulmonary embolism (EP)
No full textEur. Resp. J
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