372 research outputs found

    Interleukin-6 stimulates gene expression of extracellular matrix components in bovine mesangial cells in culture

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    The effect of interleukin-6 (IL-6) on gene expression of extracellular matrix components in bovine mesangial cells in culture has been investigated. IL-6 (100 U/ml) time dependently increased the steady state expression of mRNAs coding for α1 collagen III and fibronectin, both transcripts being 1.5- and 2.5-fold higher than basal level at 24 and 48 h, respectively. In contrast, IL-6 stimulated laminin mRNA expression only after 48 h incubation (2.5-fold upon basal level). These results suggest that IL-6 could favour glomerular matrix accumulation thus contributing to the development of glomerulosclerosis

    Thallium toxicity due to audultered infusion with thallium sulfate in eight members belonging to the same family nucleus: Autopsy findings and ICP-MS analysis (inductively coupled plasma mass spectrometry) in a triple homicide

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    The banning of the heavy metal thallium (Tl) in many Countries, because of its toxicity, led to a remarkable reduction of the number of cases of poisoning both accidental and homicidal forcing us to better study the pharmacokinetics of this poison using new technologies. The Authors, in this work, are reporting the case of a collective thallium toxicosis caused by voluntary adulteration of an infusion with thallium sulfate, occurred in 8 members of the same familial nucleus; the administration of Prussian Blu resulted to be ineffective for 3 of these members that died at a later time. The most peculiar aspects of this rare manner of poisoning are discussed; the analytical procedures used, Inductively Coupled Plasma Mass Spectrometry (ICP-MS) in particular, resulted to be fundamental in the forensic diagnosis process of acute poisoning cause by thallium

    The Italian document: decisions for intensive care when there is an imbalance between care needs and resources during the COVID-19 pandemic

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    Background: In early 2020, the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) published clinical ethics recommendations for the allocation of intensive care during COVID-19 pandemic emergency. Later the Italian National Institute of Health (ISS) invited SIAARTI and the Italian Society of Legal and Insurance Medicine to prepare a draft document for the definition of triage criteria for intensive care during the emergency, to be implemented in case of complete saturation of care resources. Methods: Following formal methods, including two Delphi rounds, a multidisciplinary group with expertise in intensive care, legal medicine and law developed 12 statements addressing: (1) principles and responsibilities; (2) triage; (3) previously expressed wishes; (4) reassessment and shifting to palliative care; (5) collegiality and transparency of decisions. The draft of the statements, with their explanatory comments, underwent a public consultation opened to Italian scientific or technical-professional societies and other stakeholders (i.e., associations of citizens, patients and caregivers; religious communities; industry; public institutions; universities and research institutes). Individual healthcare providers, lay people, or other associations could address their comments by e-mail. Results: Eight stakeholders (including scientific societies, ethics organizations, and a religious community), and 8 individuals (including medical experts, ethicists and an association) participated to the public consultation. The stakeholders’ agreement with statements was on average very high (ranging from 4.1 to 4.9, on a scale from 1—full disagreement to 5—full agreement). The 4 statements concerning triage stated that in case of saturation of care resources, the intensive care triage had to be oriented to ensuring life-sustaining treatments to as many patients as possible who could benefit from them. The decision should follow full assessment of each patient, taking into account comorbidities, previous functional status and frailty, current clinical condition, likely impact of intensive treatment, and the patient's wishes. Age should be considered as part of the global assessment of the patient. Conclusions: Lacking national guidelines, the document is the reference standard for healthcare professionals in case of imbalance between care needs and available resources during a COVID-19 pandemic in Italy, and a point of reference for the medico-legal assessment in cases of dispute

    “Self stabbing sucide”: 116 casi occorsi nella città di Milano dal 1993 al 2016

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    Introduzione Mentre molti omicidi nel Mondo sono compiuti con armi da taglio, i suicidi realizzati con siffatta modalit\ue0 lesiva sono rari accadimenti, comprovati nello 0,5-0,7% di tutti i casi di autosoppressione; in genere, sui corpi si osserva una sola ferita mortale, per quanto possano esserne eccezionalmente osservate anche molte, che sollevano la necessit\ue0 di stabilire se trattasi di modalit\ue0 realmente suicida piuttosto che omicida. In questi casi, ulteriori informazioni per configurare l\u2019esatta natura dell\u2019accadimento, sono desumibili dall\u2019anamnesi della vittima, dai dati circostanziali e di sopralluogo, nonch\ue9 dalle caratteristiche delle lesioni e dalla loro localizzazione. In questo studio, presentiamo l\u2019analisi dei casi di suicidio con armi da taglio, occorsi a Milano in 24 anni. Materiali e metodi Sono stati analizzati retrospettivamente 23417 verbali di autopsia redatti tra il 1993 e il 2016 presso la Sezione di medicina legale dell\u2019Universit\ue0 degli Studi di Milano estrapolando da 4022 suicidi totali, solo quelli realizzati con armi da taglio. Su questi casi, abbiamo approfondito lo studio delle caratteristiche delle vittime, della distribuzione e del numero delle lesioni autoinferte e delle caratteristiche dell\u2019arma feritrice. Risultati Abbiamo desunto 116 casi di suicidio con armi da taglio di cui: 103 realizzati con modalit\ue0 semplice e 13 con modalit\ue0 complessa, che hanno visto maggiormente coinvolti maschi italiani di et\ue0 compresa tra 41-e 50 anni, affetti da patologie psichiatriche, che si sono uccisi nella propria abitazione utilizzando, prevalentemente, coltelli da cucina. Le lesioni sono risultate monodistrettuali e localizzate agli arti superiori o al torace. In tutti i casi osservati, la morte, per la presenza di lesioni \u201cda assaggio\u201d a profondit\ue0 variabile, mancanza di segni di lotta, sangue limitato all\u2019area circostante il corpo e per la direzionalit\ue0 delle lesioni, da destra a sinistra, con il gomito piegato a 90 gradi verso il corpo, \ue8 stata attribuita, anche nel caso dei suicidi complessi, a shock emorragico da azione suicida. Conclusioni Gli inusuali suicidi compiuti con armi da taglio richiedono un approccio forense completo basato su un approfondito esame della scena del crimine durante il sopralluogo giudiziario, un\u2019accurata raccolta dei dati anamnestico-circostanziali e degli esiti autoptici i quali, unitamente alle indagini tossicologiche, possono rappresentare strumenti fondamentali per esprimersi motivatamente su un giudizio di accadimento omicida piuttosto che suicida

    The Rabbit as a New Reservoir Host of Enterohemorrhagic Escherichia coli

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    We investigated the prevalence of enterohemorrhagic Escherichia coli (EHEC) in rabbits acquired from two commercial vendors and a local petting zoo. Fecal samples from 34 Dutch Belted (DB) and 15 New Zealand White (NZW) rabbits were cultured; and isolates were biotyped, serotyped, tested by polymerase chain reaction (PCR), and genotyped by repetitive-element sequence–based PCR (Rep-PCR). Seven (25%) of 28 DB rabbits acquired from one commercial source were positive for EHEC, including O153:H- and O153:H7. One (9%) of 11 NZW rabbits from the same source was positive for eae-, stx1+ O153 strains. In contrast, six DB rabbits from another commercial source and four rabbits from a petting zoo were negative for EHEC. Rep-PCR demonstrated that the O153 EHEC and O145 enteropathogenic E. coli were two distinct clones. Our study indicates that rabbits are a new reservoir host of EHEC that may pose a zoonotic risk for humans

    Adding a statin to a combination of ACE inhibitor and ARB normalizes proteinuria in experimental diabetes, which translates into full renoprotection

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    The capacity of renin-angiotensin system (RAS) inhibitors to delay progression of diabetic nephropathy depends on the time at which therapy is started. A multimodal intervention is required to afford renoprotection in overt diabetic nephropathy. Here we assessed the effects of maximal RAS inhibition by angiotensin-converting enzyme (ACE) inhibitor plus angiotensin II type 1 receptor blocker (ARB) in combination with statin in rats with overt diabetic nephropathy. Uninephrectomized rats made diabetic by streptozotocin were orally treated from 4 (when proteinuria and renal lesions had developed) to 8 mo with vehicle, lisinopril plus candesartan, lisinopril plus candesartan plus rosuvastatin, or rosuvastatin alone. Systolic blood pressure increased in diabetic rats and was significantly lowered by combined therapies. Dual RAS blockade significantly reduced proteinuria compared with vehicle. Addition of statin further lowered proteinuria to control levels. Glomerulosclerosis was ameliorated by RAS inhibitors or statin, and regression was achieved by the addition of statin. Loss of podocytes of diabetic rats was limited by ACE inhibitor plus ARB while normalized by the three drugs. Defective nephrin expression of diabetes was increased by dual RAS blockade or statin and restored by the triple therapy. Tubular damage, interstitial inflammation, and expression of the fibrotic markers transforming growth factor (TGF)-beta 1 and phosphorylated Smad 2/3 in tubuli were significantly reduced by the triple regimen. These data suggest a strategy to target proteinuria to try to achieve regression of renal disease in diabetic patients who do not fully benefit from RAS inhibition alone

    Ground-Based Ultraviolet-Radiation Measurements during Springtime in the Southern Hemisphere

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    We report the first measurements obtained by a network of UV-B detectors established through Argentina and Chile, at locations covering latitudes extending from 53°S to 18° S. Evidence that UVB increases are detected at these latitudes during the Austral spring 1993 is presented
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