102,773 research outputs found
Clinical Manifestations of gallstone disease: evidence from the Multicenter Italian study on Cholelithiasis (MICOL)
No full textAbstract: Despite the many efforts to delineate the clinical manifestations of gallbladder disease, the precise symptom complex associated with gallstones is still a matter of debate, and even the existence of gallstone-specific symptoms has been questioned. We carried out a large population-based cross-sectional study (MICOL) to identify symptoms significantly related to gallstones, Fourteen centers throughout Italy enrolled 29,504 subjects aged 30 to 69 years. All subjects were administered an ultrasonographic examination of the upper abdomen and a preceded questionnaire. All subjects were divided into 4 groups: 25,374 (86.0%) gallstone-free subjects (GF), 1,832 (6.2%) patients with gallstones not previously diagnosed (GNPD), 638 (2.2%) patients with gallstones previously diagnosed (GPD), 1,660 (5.6%) patients with a history of cholecystectomy for gallstones (CC). In logistic regression analysis, pain at epigastrium and, even more, pain at right hypocondrium were significantly associated with gallstones, For pain at right hypocondrium, this association progressively increased from GNPD (OR = 1.60, 95% CI = 0.97-2.65) to GPD (OR = 8.77, 95% CI = 5.27-14.61) to CC (OR = 59.40, 95% CI = 43.87-80.42). Absence of heartburn combined with right hypocondrium or epigastrium pain and intolerance to fried or fatty food were also significantly related to gallstones. We also found some pain characteristics significantly associated with gallstones, i.e,, pain radiated to the right shoulder, forcing the patient to rest, occurring soon after meals or unrelated to meals, not relieved by bowel movements, and frequently accompanied by gallstone-related morbidities. We developed a probability tree reporting the cumulative probability of having gallstones for each combination of those symptoms and characteristics of pain significantly associated with gallstones, In conclusion, we have identified symptoms and signs significantly associated with gallstones. We have shown that there is an increase in frequency and severity of these symptoms and signs across the different stages of gallstone disease. We have proposed a complex of symptoms and signs significantly associated with gallstones that might help physicians in clinical decision making
Constitutional Degradation in a Time of Coronavirus: Reflecting on Governmental Accountability in the United Kingdom and Italy
No full textThe pandemic acted as an accelerator of pre-existing trends that see an overall dominance of Governments over legislative bodies, which are increasingly struggling to oversee executive power. This was the case both in the UK and in Italy, where the governments adopted specific institutional arrangements to manage the health crisis which did not necessarily include a prior involvement of the legislative body. An overview of the legal framework and of the instruments that the two legal orders used to face the pandemic highlights a common trend, and that is the preference for executive law-making to manage emergencies. The way statutory instruments and statutory decrees are used respectively in the UK and in Italy are issues that pre-exist the pandemic, but an analysis of their use throughout the emergency particularly sheds light on specific structural weaknesses which are evident in both exceptional and normal times, and that relate to the two Parliaments' difficulties in keeping up with the executives' law-making activity. Considering that Parliament's inability to oversee Government gives rise to a series of problems which relate more generally to the institutional arrangement of a parliamentary democracy, it is necessary to reflect about Parliament's traditional functions and ask whether these are still adequate as the legal and political systems change. The oversight and steering functions still are one of the most fundamental and determining elements of a parliamentary form of government, but as the two experiences have showed, procedures need to be re-adapted as the Government has become the main legislative actor. For these reasons it is worth exploring post-legislative scrutiny as an instrument to hold the executive into account and to counterbalance its increasing monopoly of decision-making
Two-scale convergence and homogenization on BV(Omega)
No full textWe extend the notion of two-scale convergence introduced by G. Nguetseng and G. Allaire to the case of sequences of bounded Radon measures. We prove a compactness result for two-scale convergence. We then apply it to the study of the asymptotic behaviour of sequences of positively 1-homogeneus and periodically oscillating functionals with linear growth, defined on the space BV of the functions with bounded total variation
Boundary layer tails in periodic homogenization
No full textThis paper focus on the properties of boundary layers in periodic homogenization in rectangular domains which are either fixed or have an oscillating boundary. Such boundary layers are highly oscillating near the boundary and decay exponentially fast in the interior to a non-zero limit that we call boundary layer tail. The influence of these boundary layer tails on interior error estimates is emphasized. They mainly have two effects (at first order with respect to the period ε): first, they add a dispersive term to the homogenized equation, and second, they yield an effective Fourier boundary condition
Keratinocytes from human skin respond as typical immune cells after the stimulation with _Trichophyton rubrum_
No full text_Trichophyton rubrum_ is the main agent causing dermatophytosis (1). Keratinocytes are
considered to be the first physical barrier of defense against pathogens (2). But not
only a physical barrier. They recognize antigens through Toll like receptors (TLR) (3).
The activation of this TLR, present on the surface of the keratinocytes, induce the
expression of different pro-inflammatory cytokines, co-stimulatory molecules and
antimicrobial peptides such as [beta]-defensins (4).
The main objective of this work is to determine if lipopolysaccharides of G – bacteria
(LPS), lipotheichoic acid from G+ bacteria (LTA), and conidias, isolated from _T. rubrum_
were able to activate the expression of TLR2 and TLR6 on the cell surface of a primary
culture of human keratinocytes through Flow cytometry. Furthermore we are looking for
the presence of [beta]-defensins 1 and 2, IL-1b and IL-8 in the supernatant, of the above
mentioned culture of cells, by Western blot.
From the flow cytometry data, the preliminary results showed an important dispersion
in terms of proliferation, increase in size and granularity of keratinocytes, from primary
cultures of skin from healthy donors, stimulated 6 hours with conidias of _T. rubrum_, and
LTA, but not when non stimulated, or stimulated with LPS (Fig 1).
When keratinocytes from primary cultures of skin from healthy donors were cultivated
48 hours, it was found dispersion in terms of proliferation, increase in size and
granularity when stimulated with conidias of _T. rubrum_, and LPS but not when non
stimulated, or stimulated with LTA (Fig 2).
The keratinocytes expressed increased levels of TLR2 and TLR6 when were
stimulated with LTA and less to _T. rubrum_, in the 6 hours cultures, but this last cells still
showed increased size (Fig 3).
The Keratinocytes expressed increased levels of TLR2 in the 48 hours cultures when
were stimulated with LPS and _T. rubrum_.(Fig 4)
Besides, [beta]-defensin-2 was detected in the supernatant of cultures of keratinocytes
stimulated with LPS (Fig 5).
It can preliminary be concluded that keratinocytes from primary cultures of human skin from healthy donors, are cells that respond as typical immune cells, after stimulation
with _T. rubrum_, LTA and LPS in different conditions, and that this mechanism may be
very important, for the protection of local environment. 

References
1.- Arenas R., Dermatofitosis en México. Rev Iberoam Micol 2002; 19: 63-67.
2.- Kupper T. and Fuhlbrigge R. Immune surveillance in the skin: mechanims and clinical consecuences.
Nat Rev Immunol 2004; 4: 211-222
3.- Kôllish G., Naderi B., Voelcker V., Wallich R., Behrendt H., Ring J., Bauer S., Jacob T., Mempel M. and
Olelrt M. Various members of the Toll-Like receptor family contribute to the innate immune response of
human epidermal keratinocytes. Immunology 2005; 114: 531-541.
4.- Akira, S. and Takeda K. 2004. Toll-like Receptor Signalling. Nature Reviews Immunology 4:499-511
Jouventin, P., Micol, T., Verheyden, C. & Guédon, G. — Le ragondin : Biologie et méthodes de limitation des effectifs. ACTA publications, 149 rue de Bercy, 75595 Paris cedex 12. 1996
No full textPons Jean-Marc. Jouventin, P., Micol, T., Verheyden, C. & Guédon, G. — Le ragondin : Biologie et méthodes de limitation des effectifs. ACTA publications, 149 rue de Bercy, 75595 Paris cedex 12. 1996. In: Revue d'Écologie (La Terre et La Vie), tome 52, n°1, 1997. pp. 91-92
Clinical manifestations of gallstone disease: evidence from the multicenter Italian study on cholelithiasis (MICOL)
No full textAIM: To evaluate gallstone incidence and risk factors in a large population-based study. METHODS: Gallstone incidence and risk factors, were evaluated by structured questionnaire and physical examination, respectively, in 9611 of 11 109 (86.5%) subjects who were gallstone-free at the cross-sectional study. RESULTS: Six centers throughout Italy enrolled 9611 subjects (5477 males, 4134 females, aged 30-79 years), 9517 of whom were included into analysis: 424 subjects (4.4%) had gallstones and 61 (0.6%) had been cholecystectomized yielding a cumulative incidence of 0.67% per year (0.66% in males, 0.81% in females). Increasing age, a high body mass index (BMI), a history of diabetes, peptic ulcer and angina, and low cholesterol and high triglyceride levels were identified as risk factors in men while, in females, the only risk factors were increasing age and a high BMI. Increasing age and pain in the right hypocondrium in men and increasing age in females were identified as predictors of gallstones. Pain in the epigastrium/right hypocondrium was the only symptom related to gallstones; furthermore, some characteristics of pain (forcing to rest, not relieved by bowel movements) were significantly associated with gallstones. No correlation was found between gallstone characteristics and clinical manifestations, while increasing age in men and increasing age and BMI in females were predictors of pain. CONCLUSION: Increasing age and BMI represent true risk factors for gallstone disease (GD); pain in the right hypocondrium and/or epigastrium is confirmed as the only symptom related to gallstones
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