Resistant arterial hypertension in a patient with adrenal incidentaloma multiple steno-obstructive vascular lesions and antiphospholipid syndrome

Resistant hypertension is defined as above of blood pressure (≤ 140/90 mmHg) despite therapy with three or more antihypertensive drugs of different classes at maximum tolerable doses with one bling a diuretic. An important consideration in defining a patient with resistant hypertension is the mislabeling of secondary hypertension as resistant hypertension. Here, we report a patients with resistant hypertension caused by multiple stenoocclusive arteries due to antiphospholipid syndrome and coexisting with subclinical Cushing’s syndrome

Observing the Unobservable? Modeling Coronal Cavity Densities

Prominence cavities in coronal helmet streamers are readily detectable in white-light coronagraph images, yet their interpretation may be complicated by projection effects. In order to determine a cavity's density structure, it is essential to quantify the contribution of noncavity features along the line of sight. We model the coronal cavity as an axisymmetric torus that encircles the Sun at constant latitude and fit it to observations of a white-light cavity observed by the Mauna Loa Solar Observatory (MLSO) MK4 coronagraph from 2006 January 25 to 30. We demonstrate that spurious noncavity contributions (including departures from axisymmetry) are minimal enough to be incorporated in a density analysis as conservatively estimated uncertainties in the data. We calculate a radial density profile for cavity material and for the surrounding helmet streamer (which we refer to as the "cavity rim") and find that the cavity density is depleted by a maximum of 40% compared to the surrounding helmet streamer at low altitudes (1.18 R☉) but is consistently higher (double or more) than in coronal holes. We also find that the relative density depletion between cavity and surrounding helmet decreases as a function of height. We show that both increased temperature in the cavity relative to the surrounding helmet streamer and a magnetic flux rope configuration might lead to such a flattened density profile. Finally, our model provides general observational guidelines that can be used to determine when a cavity is sufficiently unobstructed to be a good candidate for plasma diagnostics

Analysis of short-term blood pressure variability in pheochromocytoma/paraganglioma patients

Data on short-term blood pressure variability (BPV), which is a well-established cardiovascular prognostic tool, in pheochromocytoma and paraganglioma (PPGL) patients is still lack and conflicting. We retrospectively evaluated 23 PPGL patients referred to our unit from 2010 to 2019 to analyze 24 h ambulatory blood pressure monitoring (24-h ABPM)-derived markers of short-term BPV, before and after surgical treatment. PPGL diagnosis was assessed according to guidelines and confirmed by histologic examination. The 24-h ABPM-derived markers of short-term BPV included: circadian pressure rhythm; standard deviation (SD) and weighted SD (wSD) of 24-h, daytime, and night-time systolic and diastolic blood pressure (BP); average real variability (ARV) of 24-h, daytime, and night-time systolic and diastolic BP. 7 males and 16 females of 53 ± 18 years old were evaluated. After surgical resection of PPGL we found a significant decrease in 24-h systolic BP ARV (8.8 ± 1.6 vs. 7.6 ± 1.3 mmHg, p < 0.001), in 24-h diastolic BP ARV (7.5 ± 1.6 vs. 6.9 ± 1.4 mmHg, p = 0.031), and in wSD of 24-h diastolic BP (9.7 ± 2.0 vs 8.8 ± 2.1 mmHg, p = 0.050) comparing to baseline measurements. Moreover, baseline 24-h urinary metanephrines significantly correlated with wSD of both 24-h systolic and diastolic BP. Our study highlights as PPGL patients, after proper treatment, show a significant decrease in some short-term BPV markers, which might represent a further cardiovascular risk factor

A novel metric for coronal MHD models

[1] In the interest of quantitatively assessing the capabilities of coronal MHD models, we have developed a metric that compares the structures of the white light corona observed with SOHO LASCO C2 to model predictions. The MAS model is compared to C2 observations from two Carrington rotations during solar cycle 23, CR1913 and CR1984, which were near the minimum and maximum of solar activity, respectively, for three radial heights, 2.5 R⊙, 3.0 R⊙, and 4.5 R⊙. In addition to simulated polarization brightness images, we create a synthetic image based on the field topology along the line of sight in the model. This open-closed brightness is also compared to LASCO C2 after renormalization. In general, the model\u27s magnetic structure is a closer match to observed coronal structures than the model\u27s density structure. This is expected from the simplified energy equations used in current global corona MHD models

Open and / or laparoscopic surgical treatment of liver hydatic cysts

Hydatid disease is a severe parasitic disease with a widely ranging distribution. In the human being the liver is the most frequent organ affected. 1 The treatment should be individualized to the morphology, size, number and location of the cysts, that is why a variety of surgical operations have been advocated from complete resection like total pericystectomy or partial hepatectomy to laparoscopy to a minimally invasive procedures like percutaneous aspiration of cysts to conservative drug therapy. 3-4 This study compares laparoscopic versus open management of the hydatid cyst of liver the surgical approach to liver echinococcosis is still a controversial issue and shows our results of surgical treatment of liver hydatid cysts during a 3-years period

Legality rating and corporate efficiency: evidence from a conditional nonparametric frontier analysis

Promoting legality and productivity is a central issue in modern economies. In this paper, we investigate the implications of a public policy that aims at achieving these goals through the adoption of the so-called legality rating (LR). The latter reduces corporate risk uncertainty by abating asymmetric information between companies that use good legal, fiscal and ethical practices and the credit system. We match companies whose legal and ethical practices have been certified by the Italian government-through the assignment of the LR-with a sample of unrated firms, and apply recent advances in nonparametric frontier analysis to assess the economic performance. We highlight a positive relationship between legality rating and firms' production efficiency. Our findings also show that legality rating policy is an effective tool to enhance inter-regional technological catching-up of businesses

Isolement de moraxella chez l’animal

Cinquante-six souches de moraxelles ont été isolées chez diverses espèces animales : bovins, ovins, caprins, porc, chien et ragondin, soit 27 Moraxella duplex, 26 Moraxella Iwoffi et 3 Moraxella gluci dolytica. A partir de cas de kérato-conjonctivite contagieuse des bovins nous n’avons pas rencontré M. bovis mais d’autres Moraxelles et Neisseria ovis. Ces résultats fragmentaires ne concernent que deux laboratoires. Ils posent, nous semble-t-il, le problème du rôle de Moraxella en pathologie animale. Il serait souhaitable que d’autres laboratoires fassent part de leur expérience en ce domaine

The Whole Heliosphere Interval in the Context of a Long and Structured Solar Minimum: An Overview from Sun to Earth

Throughout months of extremely low solar activity during the recent extended solar-cycle minimum, structural evolution continued to be observed from the Sun through the solar wind and to the Earth. In 2008, the presence of long-lived and large low-latitude coronal holes meant that geospace was periodically impacted by high-speed streams, even though solar irradiance, activity, and interplanetary magnetic fields had reached levels as low as, or lower than, observed in past minima. This time period, which includes the first Whole Heliosphere Interval (WHI 1: Carrington Rotation (CR) 2068), illustrates the effects of fast solar-wind streams on the Earth in an otherwise quiet heliosphere. By the end of 2008, sunspots and solar irradiance had reached their lowest levels for this minimum (e.g., WHI 2: CR 2078), and continued solar magnetic-flux evolution had led to a flattening of the heliospheric current sheet and the decay of the low-latitude coronal holes and associated Earth-intersecting high-speed solar-wind streams. As the new solar cycle slowly began, solar-wind and geospace observables stayed low or continued to decline, reaching very low levels by June – July 2009. At this point (e.g., WHI 3: CR 2085) the Sun–Earth system, taken as a whole, was at its quietest. In this article we present an overview of observations that span the period 2008 – 2009, with highlighted discussion of CRs 2068, 2078, and 2085. We show side-by-side observables from the Sun’s interior through its surface and atmosphere, through the solar wind and heliosphere and to the Earth’s space environment and upper atmosphere, and reference detailed studies of these various regimes within this topical issue and elsewhere