Occurrence of immune thrombocytopenic purpura in a patient with essential thrombocythemia: How the immune system can overcome a neoplastic clone

Our case highlights the possible coexistence of essential thrombocythemia (ET) and idiopathic thrombocytopenic purpura (ITP), two pathological entities with opposite clinical and laboratory manifestations. It also underlines how an autoimmune attack has been temporarily able to overcome a neoplastic clone

Exploring the parent population of beamed NLS1s: from the black hole to the jet

The aim of this work is to understand the nature of the parent population of beamed narrow-line Seyfert 1 galaxies (NLS1s), by studying the physical properties of three parent candidates samples: steep-spectrum radio-loud NLS1s, radio-quiet NLS1s and disk-hosted radio-galaxies. In particular, we focused on the black hole mass and Eddington ratio distribution and on the interactions between the jet and the narrow-line region.Comment: 6 pages, 2 figures, to appear in Proceedings of High Energy Phenomena in Relativistic Outflows (HEPRO) V, Workshop Series of the Argentinian Astronomical Societ

Unveiling the parent population of beamed narrow-line Seyfert 1s

Narrow-line Seyfert 1 galaxies (NLS1s) are active galactic nuclei (AGN) recently identified as a new class of $\gamma$-ray sources. The high energy emission is explained by the presence of a relativistic jet observed at small angles, just like in the case of blazars. When the latter are observed at larger angles they appear as radio-galaxies, but an analogue parent population for beamed NLS1s has not yet been determined. In this work we analyze this problem by studying the physical properties of three different samples of parent sources candidates: steep-spectrum radio-loud NLS1s, radio-quiet NLS1s, and disk-hosted radio-galaxies, along with compact steep-spectrum sources. In our approach, we first derived black hole mass and Eddington ratio from the optical spectra, then we investigated the interaction between the jet and the narrow-line region from the [O III] $\lambda\lambda$4959,5007 lines. Finally, the radio luminosity function allowed us to compare their jet luminosity and hence determine the relations between the samples.Comment: 6 pages, no figures. Proceedings of the 28th Texas Symposium, Geneva, December 13-18, 201

Enhancement of Jc by Hf -Doping in the Superconductor MgB2: A Hyperfine Interaction Study

Measurements of the critical current density (Jc) by magnetization and the upper critical field (Hc2) by magnetoresistance have been performed for hafnium-doped MgB2. There has been a remarkable enhancement of Jc as compared to that by ion irradiation without any appreciable decrease in Tc, which is beneficial from the point of view of applications. The irreversibility line extracted from Jc shows an upward shift. In addition, there has been an increase in the upper critical field which indicates that Hf partially substitutes for Mg. Hyperfine interaction parameters obtained from time differential perturbed angular correlation (TDPAC) measurements revealed the formation of HfB and HfB2 phases along with the substitution of Hf. A possible explanation is given for the role of these species in the enhancement of Jc in MgB2 superconductor

Mitochondrial DNA Regionalism and Historical Demography in the Extant Populations of Chirocephalus kerkyrensis (Branchiopoda: Anostraca)

Background: Mediterranean temporary water bodies are important reservoirs of biodiversity and host a unique assemblage of diapausing aquatic invertebrates. These environments are currently vanishing because of increasing human pressure. Chirocephalus kerkyrensis is a fairy shrimp typical of temporary water bodies in Mediterranean plain forests and has undergone a substantial decline in number of populations in recent years due to habitat loss. We assessed patterns of genetic connectivity and phylogeographic history in the seven extant populations of the species from Albania, Corfu Is. (Greece), Southern and Central Italy. Methodology/Principal Findings: We analyzed sequence variation at two mitochondrial DNA genes (Cytochrome Oxidase I and 16s rRNA) in all the known populations of C. kerkyrensis. We used multiple phylogenetic, phylogeographic and coalescence-based approaches to assess connectivity and historical demography across the whole distribution range of the species. C. kerkyrensis is genetically subdivided into three main mitochondrial lineages; two of them are geographically localized (Corfu Is. and Central Italy) and one encompasses a wide geographic area (Albania and Southern Italy). Most of the detected genetic variation (<81%) is apportioned among the aforementioned lineages. Conclusions/Significance: Multiple analyses of mismatch distributions consistently supported both past demographic and spatial expansions with the former predating the latter; demographic expansions were consistently placed during interglacial warm phases of the Pleistocene while spatial expansions were restricted to cold periods. Coalescence methods revealed a scenario of past isolation with low levels of gene flow in line with what is already known for other co-distributed fairy shrimps and suggest drift as the prevailing force in promoting local divergence. We recommend that these evolutionary trajectories should be taken in proper consideration in any effort aimed at protecting Mediterranean temporary water bodies

Feasibility of laparoscopy for small bowel obstruction

<p>Abstract</p> <p>Background</p> <p>Adherential pathology is the most common cause of small bowel obstruction. Laparoscopy in small bowel obstruction does not have a clear role yet; surely it doesn't always represent only a therapeutic act, but it is always a diagnostic act, which doesn't interfere with abdominal wall integrity.</p> <p>Methods</p> <p>We performed a review without any language restrictions considering international literature indexed from 1980 to 2007 in Medline, Embase and Cochrane Library. We analyzed the reference lists of the key manuscripts. We also added a review based on international non-indexed sources.</p> <p>Results</p> <p>The feasibility of diagnostic laparoscopy is high (60–100%), while that of therapeutic laparoscopy is low (40–88%). The frequency of laparotomic conversions is variable ranging from 0 to 52%, depending on patient selection and surgical skill. The first cause of laparotomic conversion is a difficult exposition and treatment of band adhesions. The incidence of laparotomic conversions is major in patients with anterior peritoneal band adhesions. Other main causes for laparotomic conversion are the presence of bowel necrosis and accidental enterotomies. The predictive factors for successful laparoscopic adhesiolysis are: number of previous laparotomies ≤ 2, non-median previous laparotomy, appendectomy as previous surgical treatment causing adherences, unique band adhesion as phatogenetic mechanism of small bowel obstruction, early laparoscopic management within 24 hours from the onset of symptoms, no signs of peritonitis on physical examination, experience of the surgeon.</p> <p>Conclusion</p> <p>Laparoscopic adhesiolysis in small bowel obstruction is feasible but can be convenient only if performed by skilled surgeons in selected patients. The laparoscopic adhesiolysis for small bowel obstruction is satisfactorily carried out when early indicated in patients with a low number of laparotomies resulting in a short hospital stay and a lower postoperative morbidity. Although a higher small bowel obstruction recurrence remains the major postoperative risk of the laparoscopic management of these patients.</p

The Role of Spleen and Liver Elastography and Color-Doppler Ultrasound in the Assessment of Transjugular Intrahepatic Portosystemic Shunt Function

The reference standard for assessing transjugular intrahepatic portosystemic shunt (TIPS) function is venography with portosystemic pressure gradient (PPG) measurement. This procedure is invasive and expensive; thus, we assessed the feasibility, reproducibility and diagnostic accuracy of color-Doppler ultrasound (CDUS) and spleen and liver stiffness (LS) measurements for identifying TIPS dysfunction. Twenty-four patients (15 undergoing TIPS placement and nine undergoing TIPS revision) consecutively underwent CDUS examination and LS and spleen stiffness (SS) determination by transient elastography (TE) and point shear-wave elastography (pSWE). All parameters were taken before TIPS placement/revision (1\u201315 d before) and 24 h after, just before revision by venography. pSWE inter-observer agreement was assessed by intra-class correlation coefficient (ICC). CDUS and elastographic data were correlated (Pearson coefficient) with pressure gradients (hepatic venous pressure gradient [HVPG], PPG). Main determinants of TIPS dysfunction were investigated by linear regression. Forty-nine paired examinations were performed in total: 49 (100%) SS reliable measurements by pSWE and 38 (88%) by TE. The ICC for pSWE values was 0.90 (95% confidence interval [CI] 0.81\u20120.94). SS values significantly correlated with HVPG and PPG (R = 0.51, p = 0.01). The area under the Receiver-Operating Characteristic (AUROC) curve of SS for diagnosing TIPS dysfunction was 0.86 (95% CI 0.70\u20120.96) using a 25 kPa cutoff. At multivariate analysis, the flow direction of the intrahepatic portal vein branches and SS values were independently associated to TIPS dysfunction. The intrahepatic portal vein branches flow direction and SS value are two simple, highly sensitive parameters accurately excluding TIPS dysfunction. SS measurement by pSWE is feasible, reproducible and both positively and significantly correlates with HVPG and PPG values