Articular manifestations in inflammatory bowel disease patients: a prospective study

Background and aims: Rheumatic manifestations are frequent in inflammatory bowel disease (IBD) and are associated with a wide range of clinical patterns. Methods: Articular symptoms and signs were investigated by questionnaire in a cohort of 651 pts, mean age 42 +/- 14 years, followed at two referral hospitals over a 12-month period. Results: 142 ulcerative colitis (UC) and 120 Crohn's disease (CD) patients referred articular pain during their IBD history: in 46% this was associated with active IBD, in 56% symptoms were intermittent and in 19% symptoms preceded IBD diagnosis. 62 pts (28 UC, 34 CID) complaining of articular symptoms at the time of the interview, were investigated by the rheumatologist: arthropathy was axial in 52%, oligoarticular in 16% and polyarticular in 23%. Oligoarthritis commonly involved the lower limbs and was more commonly associated with UC. The mean number of small joints involved was significantly higher in CD than in UC pts (9.9 +/- 8.2 vs. 5.6 +/- 4.3; p < 0.01). Bone scintigraphy was abnormal in 70% of pts. Conclusions: Prevalence of self-reported articular symptoms in IBD patients exceeds 40% with 9.5% incidence during 1-year follow up. Symptoms predict entheropatic involvement of the locomotor system. (c) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved

Clinical practice guidelines for the management of cirrhotic patients with ascites. Committee on Ascites of the Italian Association for the Study of the Liver.

An ad hoc Committee appointed by the Italian Association for the Study of the Liver prepared these Clinical Practice Guidelines for the Management of Cirrhotic Patients with Ascites. The initial evaluation of a patient with ascites should include a history, physical evaluation, paracentesis with ascitic fluid analysis, abdominal ultrasonography and biochemistry to assess the severity of liver disease and renal functionality. To improve the efficiency of the choice between the different opportunities available in the treatment of ascites, patients can be classified into two subgroups: patients with uncomplicated ascites and patients with complicated ascites, including refractory ascites, bacterial peritonitis, hyponatraemia and renal failure. Based upon evidence emerging from controlled clinical trials or case-control studies, satisfactory treatment for uncomplicated ascites is represented by paracentesis, sodium-restricted diet and diuretics, whereas the treatment of patients with complicated ascites requires other specific approaches. As the prognosis for most patients with ascites is poor, the last part of the paper offers simple criteria in the selection of patients candidates for liver transplantation. The aim of these guidelines is to reduce inappropriate practice and to improve efficiency in the management of patients with ascites. The Committee holds that a periodic update will be necessary to conform to future scientific developments

Performance of a solar energy powered falling film evaporator with film promoter

A solar energy powered failing film evaporator with film promoter was developed for concentrating diluted solutions (industrial effluents). The procedure proposed here does not emit CO(2), making it a viable alternative to the method of concentrating solutions that uses vapor as a heat source and releases CO(2) from burning fuel oil in a furnace, in direct opposition to the carbon reduction agreement established by the Kyoto protocol. This novel device consists of the following components: a flat plate solar collector with adjustable inclination, a film promoter (adhering to the collector), a liquid distributor, a concentrate collector. and accessories. The evaporation rate of the device was found to be affected both by the inclination of the collector and by the feed flow. The meteorological variables cannot be controlled, but were monitored constantly to ascertain the behavior of the equipment in response to the variations occurring throughout the day. Higher efficiencies were attained when the inclination of the collector was adjusted monthly, showing up to 36.4% higher values than when the collector remained in a fixed position. (c) 2008 Elsevier Ltd. All rights reserved.CNP