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The Acute Porphyric Attack: A Difficult Diagnosis for a Potential Lethal Event in Emergency Medicine
Get PDFThe porphyrias are a heterogeneous group of metabolic
disorders due to an inherited (but in some forms the disturbance may
also be acquired) enzymatic deficiency in the metabolic pathway
of heme biosynthesis. The variable degree of block in the heme
biosynthetic pathway due to the enzyme deficiency results in
accumulation of different metabolic intermediates, whose toxicity is
responsible for the peculiar (cutaneous and/or neurovisceral) clinical
pictures observed in each of these diseases. According to the clinical
features, the porphyrias are classified as “acute” (or neuropsychic)
[characterized by acute neurovisceral crises (the acute porphyric
attack) involving the autonomic and/or central nervous system, but
also the liver and the kidney] and “on acute” (or dermatological)
(mostly presenting with cutaneous lesions, due to photosensitivity).
The acute porphyrias are often misdiagnosed diseases: the acute
porphyric attack may in fact mimic many other more common medical
and neuropsychiatric conditions; its delayed diagnosis and treatment
(or its inappropriate treatment) may result in a fatal outcome. For
these reasons, many different specialists, such as surgeons,
psychiatrists, gastroenterologists, neurologists, emergency
physicians and dermatologists may be variably involved in the
diagnostic process, especially in those cases presenting with
acute and life-threatening clinical features. An early and definitive
diagnosis is mandatory to improve outcomes and to assure that
potentially harmful drugs are avoided. To date, the availability of an
adequate treatment has significantly improved the outcome of the
acute porphyric attacks, so the knowledge about the management of
these events may be relevant for the physicians working in internal
and emergency medicine units
HYPERHOMOCYSTEINEMIA AND MTHFR C677T POLYMORPHISM IN PATIENTS WITH PORTAL VEIN THROMBOSIS COMPLICATING LIVER CIRRHOSIS
No full textBackground: Portal vein thrombosis (PVT) is serious complication of liver cirrhosis (LC), especially in the presence
of hepatocellular carcinoma (HCC). The liver plays a key role in homocysteine (Hcy) metabolism: mild hyperhomocysteinemia
(HHcy) has been described in LC. HHcy is a risk factor for deep vein thrombosis. Methylentetrahydrofolate-
reductase (MTHFR) C677T polymorphism is the commonest determinant of mild HHcy and
has been involved also in cancer development.
Aim: To investigate a possible relation between HHcy, MTHFR status, HCC and PVT in patients affected by LC.
Materials and methods: 100 patients affected by LC, 38 with (PVT group, 24 with HCC) and 62 without PVT (LC
group, 14 with HCC) sex-, age-, liver disease stage and etiology-matched were assessed for thrombophilia,
smoking status, plasma Hcy, MTHFRC677T polymorphism and homocysteine-related vitamin status.
Results: A higher prevalence of HCC, HHcy and MTHFR TT status was observed in PVT group. No significant
difference in vitamin statuswas observed between groups. PatientswithHCC showed significantly higher plasma
Hcy and higher prevalence of HHcy than patients without HCC. They had also higher prevalence of MTHFR TT
status. In patients with TT status (n = 11) and HCC, 10 had HHcy e 9 had PVT.
Conclusions: Mild HHcy is associated to LC may have a role in PVT development and assessment of plasma Hcy
may be suggested in patients with LC (especially if complicated by HCC). Association between HCC and
MTHFR TT status is intriguing, due the postulated role for this polymorphism in cancer: it may represent a
possible link between HCC and PVT
MARKERS OF ENDOTHELIAL DYSFUNCTION AS PREDICTORS OF ASCITIC DECOMPENSATION IN PATIENTS WITH LIVER CIRRHOSIS.
Get PDFOxford Manuale di Medicina Clinica
No full textTraduzione della nona edizione del manuale tascabile di Medicina Clinic
Markers of Endothelial Dysfunction in patients with liver cirrhosis with anh without portal hypertension
No full textStudio sulla determinazione qualitativa e quantitativa dei marcatori di disfunzione endoteliale in pazienti affetti da cirrosi epatica con senza ipertensione portale significativ
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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