196,247 research outputs found
The Crohn's PillCam
No full textL’endoscopia capsulare (CE) è oggi lo strumento
diagnostico non invasivo più sensibile per lo studio
del piccolo intestino. La principale indicazione
all’CE è il sanguinamento digestivo di origine
oscura. Recenti studi clinici hanno dimostrato
che la CE è uno strumento non invasivo, sicuro
ed efficace nella diagnosi e nel management della
malattia di Crohn del piccolo intestino, dopo
aver escluso la presenza di stenosi
Revenge of the NERDs: Cadherin Fragments Differentiate Functional Heartburn from Non-erosive Reflux Disease
No full textDue to the ever-increasing use of proton pump inhibitors
(PPI), the therapeutic front line in gastroesophageal reflux
disease (GERD) has changed. The successful healing of
esophagitis, an elusive therapeutic target a mere 25 years
ago, has been eclipsed by new considerations, with emphasis
now being focused on symptom resolution, in particular,
heartburn. Moreover, patients with heartburn are a heterogeneous
group, including subpopulations with different
mechanisms responsible for their symptoms. Patients with
GERD symptoms such as heartburn either have increased
esophageal acid exposure with (erosive esophagitis; EE) or
without (non-erosive reflux disease; NERD) erosions, or
with normal acid exposure with acid hypersensitivity (functional
heartburn; FH) [1]. Although EE is readily diagnosed,
the distinction between patients diagnosed with NERD and
those with FH can be difficult despite being highly clinically
relevant: the first group mostly benefits from pharmacological
suppression of acid secretion or from surgical anti-reflux
therapy, whereas in the second group, prolonged therapy
with proton pump inhibitors (PPI) and anti-reflux surgery
are unnecessary and possibly harmful and should thus be
assiduously avoided. Until now, the missing piece in this
puzzle has been the existence of a biomarker useful to differentiate
patients with NERD from FH and to predict the
response to PPI therapy
Tecnici d'avanguardia e longue durée nella Sardegna del primo Ottocento
No full textIl volume intende disegnare una storia economica dell’ambiente italiano, a partire dall’età preindustriale, in una prospettiva di dialogo e confronto con la più recente storiografia internazionale. I contributi raccolti sono rappresentativi dei diversi approcci seguiti dagli storici economici che oggi, in Italia, si interessano dell’ambiente
Aplicabilidade de georecursos portugueses na área da hidrologia médica
No full textDoutoramento em GeociênciasIn Portugal, there is an old tradition in using clayey materials for therapeutic
purposes. They are applied in pelotherapy, at several beaches of
the Atlantic coast in the form of clay-sea water mixtures (peloids) to treat
skin and rheumatic diseases. During many generations, peloids have been
applied without scienti c studies that prove their therapeutic validity.
In the last decade, the Portuguese scienti c community has become
increasingly more interested in assessing the properties that make clayey
materials suitable for therapeutic purposes. The abundance of clayey
formations and the established practices of medical hydrology in our
country turned this interest into a new perspective of application.
The studied materials include di erent clays (in age and origin) mainly
collected from well-known Mesozoic-Cenozoic formations, in some cases
outcropping at beaches where empirical applications occur. This thesis
focus in the study of silt-clay fraction (< 63 m).To determine their
suitability for therapy, compositional, physicochemical, technological,
thermal and rheological properties were assessed.
Conventional techniques (XRD, XRF and Sedigraph) were used to
assess compositional features of silt-clay fraction. Electron microscopy
(SEM, VPSEM, HREM) was used to study the micromorphology and
composition of clay fraction (< 2 m). Physicochemical properties
(cation exchange and speci c surface) were assessed using the Ammonium
Acetate and BET methods. Technological properties (plasticity and
abrasivity indices) were assessed using the Atterberg limits and Einlehner
abrasion tests. Thermal properties (speci c heat and cooling kinetics) were
estimated by DSC analysis and cooling tests. Pharmacotechnical tests
(compressibility index, sediment volume and Brook eld viscosity) were
used to assess the powder
owability as well as the physical stability and
viscosity of clay-water dispersions. We selected as suitable Portuguese clays for health applications the samples
A-Pe, A-Be2, A-Sd, J-Fr , M-To, C-Lu1, C-Lu2, Pl-Ba, M-Ga and J-Ab
because they represent safe materials, with an adequate composition, good
technological, physicochemical and thermal properties for application, also
presenting an adequate rheology when dispersed in water. Their most relevant
characteristics are the high clay minerals content, abundant smectite,
illite and kaolinite, and safe hazardous concentrations. They also showed
moderate capacity to exchange Ca 2+, high plasticity, low abrasivity, high
speci c heat and slow cooling kinetics. They evidenced fair powder
owability
and good potential to formulate viscous dispersions when stabilized.
Because the majority of the assessed characteristics are in accordance with
those presented by clays applied in European spas for pelotherapy, we considered
this group of clays also suitable for medical hydrology treatments in
Portuguese spas.Em Portugal, o uso de materiais argilosos para fins terapêuticos é uma
prática que persiste desde a antiguidade. A aplicação (peloterapia) é
realizada em algumas praias do litoral Atlântico sob a forma de pastas
de argila misturada com água do mar (pelóide). Ao longo de várias
gerações os pelóides têm sido utilizados para tratar doenças dermatológicas
e reumáticas sem estudos científicos que comprovem a sua validade
terapêutica.
Na última década, a comunidade científica Portuguesa tem vindo a
interessar-se cada vez mais pela avaliação das propriedades que tornam os
materiais argilosos adequados para peloterapia. A abundância de formações
argilosas e as práticas de hidrologia médica reconhecidas no nosso pais
transformaram este interesse numa nova perspectiva de aplicação.
Para este estudo, foram amostradas diferentes argilas (em idade e
origem) provenientes sobretudo de formações Mesozóicas-Cenozóicas
bem conhecidas. Algumas destas formações a
oram em praias onde a
aplicação tradicional de argila ocorre. Esta tese foca-se no estudo da
fracção silto-argilosa (< 63 m) dos materiais amostrados. A avaliação das
suas propriedades composicionais, físico-químicas, tecnológicas, térmicas e
reológicas permitiu estimar a sua aplicabilidade terapêutica.
Técnicas convencionais (DRX, FRX, Sedigraph) foram utilizadas para
estudar a composição da fracção silto-argilosa. A microscopia electrónica
(SEM, VPSEM e HREM) permitiu estudar a micromorfologia e a composi
ção da fracção argilosa (< 2 m). As propriedades físico-químicas
(troca catiónica, superfície específica) foram determinadas pelos métodos
do Acetato de Amónio e BET. As propriedades tecnológicas (plasticidade
e abrasividade) foram avaliadas utilizando os limites de Atterberg e teste
de abrasão de Einlehner. As propriedades térmicas foram determinadas
recorrendo á análise térmica calorimétrica (DSC) e cinética de arrefecimento.
Ensaios de tecnologia farmacêutica (compressibilidade, volume de
sedimento e viscosidade de Brook eld) foram utilizados para o estudo da
uidez de pós assim como da estabilidade física e viscosidade das dispersões
argila-água. Foram seleccionadas como argilas Portuguesas com aplicabilidade em saúde
as amostras A-Pe, A-Be2, A-Sd, J-Fr , M-To, C-Lu1, C-Lu2, Pl-Ba, M-Ga
and J-Ab por serem materiais seguros e de composição adequada, com propriedades
físico-químicas, tecnológicas e térmicas benéficas para aplicação.
Estas argilas apresentam igualmente uma reologia apropriada quando dispersas
em água. As suas características mais relevantes são o elevado conteúdo
em minerais de argila, abundância de esmectite, ilite e/ou caulinite e a toxicidade
aceitável. Apresentam uma capacidade razoável para trocar catiões,
destacando-se o Ca 2+, assim como elevada plasticidade, baixa abrasividade,
elevado calor específico e cinética de arrefecimento lenta. Por fim, evidenciaram
uma
uidez de pó razoável e capacidade para originar dispersões
viscosas quando estabilizadas. Uma vez que a maioria das características
avaliadas nas argilas Portuguesas estão de acordo com aquelas aplicadas
nos spas Europeus para peloterapia, consideramos este grupo de argilas
aplicável para tratamentos de hidrologia médica nos spas Portugueses
Il Parlamento del viceré Nicola Pignatelli duca di Monteleone (1688-89). Il processo verbale (1). Suppliche degli stamenti
No full textAnalytical Solutions for Ultimate Stabilizing Action of Anchored Piles in Cohesive Soil Layers
No full textThe design of slope-stabilizing piles is still an open issue for civil engineers, owing to the high number of variables to be determined in the design process and to the complexity of soil-structure interaction problems. In this paper, in the simplified case of subhorizontal cohesive soil strata, analytical solutions are proposed for the maximum available stabilizing action for a pile, also considering the possible presence of an anchor at the pile's head, and thus extending some results already available in literature. Within the framework of an ultimate limit state approach, the influence of soil mechanical properties, of pile characteristics, and of the anchor strength are investigated, and some dimensionless abaci are analytically derived. The solutions demonstrate a marked coupling effect between tensile anchor strength and pile-bending resistance, and an explicit optimization strategy for a safe and effective dimensioning is provided. The results can be profitably employed in the most common limit equilibrium methods for slope stability analysis
Validation of a glucose control protocol in septic patients with continuous venous glucose measurement
No full textIntroduction: Blood glucose control in critically-ill patients is still on debate. A protocolized approach and a tight control limiting wasting of patient's blood are useful to correctly manage glycaemia (1).
Objective: Validation of glucose protocol (2) with a continuous blood glucose measurement (OptiScannerTM 5000).
Materials/Methods: OptiScannerTM was used in 6 patients providing glucose measurement every 15 minutes from a CVC dedicated line, net drawing 9.6 ml blood/24h. 330 ml of saline/24h were reinfused.
Target level was 80-160 mg/dL. Insulin infusion and kcal with nutritional support (NS) were recorded. Data are presented as median [interquartile range] (Sigmaplot11).
Results: 6 septic patients, SAPSII 28 [26-34], were studied for 319 hours (1277 measurements); 58 [40-69] hours for each patient (measurements/patient: 231 [172-265]). Blood glucose was at target for 96.6% of study time (120 [113-131] mg/dL). Overall only 3 measurements showed hypoglycemic episodes (78, 78, 69 mg/dL). Blood glucose was >160 mg/dL in 44 measurements (3%:168 [163-173] mg/dL). Insulin infusion rate was 2.2 [1.2-2.9] UI/h; kcal/day uptake was 1436 [649-1761].
Conclusion: The local glucose control protocol mantained euglycaemia in septic patients with high safeness (blood glucose <80 mg/dL, 0.2%).
Key points of the protocol are (2):
1. Lower blood glucose if >160 mg/dl before starting NS.
2. At the start of NS, provide insulin according to predicted stress status.
3. Targeting insulin need according to CHO/UI insulin observed.
OptiScannerTM 5000 seemed useful to validate the protocol.
References:
1) Dellinger RP Intensive Care Med. 2013;39(2):165-228.
2) Iapichino G Minerva Anestesiol. 2010;76(12):982-5
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