Optimization of Laboratory Diagnostics of Primary Biliary Cholangitis: When Solid-Phase Assays and Immunofluorescence Combine

The laboratory diagnostics of primary biliary cholangitis (PBC) have substantially improved, thanks to innovative analytical opportunities, such as enzyme-linked immunosorbent assays (ELISA) and multiple immunodot liver profile tests, based on recombinant or purified antigens. This study aimed to identify the best diagnostic test combination to optimize PBC diagnosis. Between January 2014 and March 2017, 164 PBC patients were recruited at the hospitals of Parma, Modena, Reggio-Emilia, and Piacenza. Antinuclear antibodies (ANA) and anti-mitochondrial antibodies (AMA) were assayed by indirect immunofluorescence (IIF), ELISA, and immunodot assays (PBC Screen, MIT3, M2, gp210, and sp100). AMA-IIF resulted in 89.6% positive cases. Using multiple immunodot liver profiles, AMA-M2 sensitivity was 94.5%, while anti-gp210 and anti-sp100 antibodies were positive in 16.5% and 17.7% of patients, respectively. PBC screening yielded positive results in 94.5% of cases; MIT3, sp100, and gp210 were detected by individual ELISA test in 89.0%, 17.1%, and 18.9% of patients, respectively. The association of PBC screening with IIF-AMA improved the diagnostic sensitivity from 89.6% to 98.2% (p < 0.01). When multiple immunodot liver profile testing was integrated with AMA-IIF, the diagnostic sensitivity increased from 89.1% to 98.8% (p < 0.01). The combination of IIF with solid-phase methods significantly improved diagnostic efficacy in PBC patients

Equity Impacts of Price Policies to Promote Healthy Behaviours

Governments can use fiscal policies to regulate the prices and consumption of potentially unhealthy products. However, policies aimed at reducing consumption by increasing prices, for example by taxation, might impose an unfair financial burden on low-income households. We used data from household expenditure surveys to estimate patterns of expenditure on potentially unhealthy products by socioeconomic status, with a primary focus on low-income and middle-income countries. Price policies affect the consumption and expenditure of a larger number of high-income households than low-income households, and any resulting price increases tend to be financed disproportionately by high-income households. As a share of all household consumption, however, price increases are often a larger financial burden for low-income households than for high-income households, most consistently in the case of tobacco, depending on how much consumption decreases in response to increased prices. Large health benefits often accrue to individual low-income consumers because of their strong response to price changes. The potentially larger financial burden on low-income households created by taxation could be mitigated by a pro-poor use of the generated tax revenues

Estimating the costs of air pollution to the National Health Service and social care : An assessment and forecast up to 2035

BACKGROUND: Air pollution damages health by promoting the onset of some non-communicable diseases (NCDs), putting additional strain on the National Health Service (NHS) and social care. This study quantifies the total health and related NHS and social care cost burden due to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) in England. METHOD AND FINDINGS: Air pollutant concentration surfaces from land use regression models and cost data from hospital admissions data and a literature review were fed into a microsimulation model, that was run from 2015 to 2035. Different scenarios were modelled: (1) baseline 'no change' scenario; (2) individuals' pollutant exposure is reduced to natural (non-anthropogenic) levels to compute the disease cases attributable to PM2.5 and NO2; (3) PM2.5 and NO2 concentrations reduced by 1 μg/m3; and (4) NO2 annual European Union limit values reached (40 μg/m3). For the 18 years after baseline, the total cumulative cost to the NHS and social care is estimated at £5.37 billion for PM2.5 and NO2 combined, rising to £18.57 billion when costs for diseases for which there is less robust evidence are included. These costs are due to the cumulative incidence of air-pollution-related NCDs, such as 348,878 coronary heart disease cases estimated to be attributable to PM2.5 and 573,363 diabetes cases estimated to be attributable to NO2 by 2035. Findings from modelling studies are limited by the conceptual model, assumptions, and the availability and quality of input data. CONCLUSIONS: Approximately 2.5 million cases of NCDs attributable to air pollution are predicted by 2035 if PM2.5 and NO2 stay at current levels, making air pollution an important public health priority. In future work, the modelling framework should be updated to include multi-pollutant exposure-response functions, as well as to disaggregate results by socioeconomic status

Italian Guidelines in diagnosis and treatment of alopecia areata

Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The Italian Study Group for Cutaneous Annexial Disease of the Italian Society of dermatology proposes these Italian guidelines for diagnosis and treatment of Alopecia Areata deeming useful for the daily management of the disease. This article summarizes evidence-based treatment associated with expert-based recommendations

Diffusione delle opere di Baldo a Padova a meta Quattrocento

Sulla base dello studio dei manoscritti costruitisi da uno studente tedesco a Padova a met\ue0 del sec. XV, Iohannes Heller, si \ue8 indagato l'utilizzo delle opere di Baldo da parte degli studenti nell'ambito del conseguimento della laurea in giurispudenza. I suoi commentari al Corpus iuris risultano poco utilizzati e ai suoi consilia si preferivano quelli contemporanei. Rilievo acquisirono invece i suoi commenti alla "Pax Constancie" e ai "Libri feudorum" e fu pure utlizzato il suo "Tractatus de mercatoribus". Sono descritti i manoscritti dello Heller nei quali sono contenute le sue opere

Neue Erkenntnisse ueber den Rechtunterricht in Padua im fuenfzehnten Jahrhundert

Sulla base di un trattato relativo alla docenza del diritto a Padova, di documenti, di statuti, di manoscritti (lezioni e consilia con firme autografe dei docenti e indicazione precisa della loro professione), nel corso di una conferenza tenuta a Trier, si \ue8 delineato il sistema di insegnamento del diritto a Padova nel sec. XV

Agostino Sottili

Biografia scientifica di Agostino Sottili, docente di filologia medioevale e umanistic

Un'ipotesi per le Pandette fiorentine

Per ragioni di natura paleografica e filologica, per le Pandette fiorentine si è proposta l'origine nell'Italia meridionale, presumibilmente nel monastero fondato da Cassiodoro a Vivarium. Si è supposto che, lungi da essere un manoscritto vergato nella cancelleria imperiale, sia stato costruito utilizzando esemplari ormai corrotti dall'uso, al fine di conservare un testo tanto importante, che altrimenti, per la situazione del momento, sarebbe stato destinato alla sparizion

Mareille Buescher, Kuenstvertrage in der Florentiner Renaissance

Il libro consiste nell'esame di contratti stipulati per la creazione di opere scultoree e pittoriche, nate nella Firenze rinascimentale, e di documenti relativi alle liti che talora scaturirono fra artisti e committenti. Oltre a illuminare il retroterra di capolavori diventati famosi, essi forniscono elementi rilevanti per chi indaga il diritto processuale di quei tempi