Ancylostomotic anemia: a contribution to the study of its physiopathology

Seventeen ancylostomotic patients was studied and several hematological parameters: hemoglobin level, serum iron level and transferrin, erythrocyte count, hematocrit, mean corpuscular volume (VCM) and mean corpuscular hemoglobin (HCM) was established. This study also included the determination of several erythrokinetic data such as plasma iron turnover and red cell iron turnover. Radioisothopic assays also permitted the estimation of blood volume and hemoglobin lost through feces, as well as the amount of iron absorbed from this hemoglobin. The authors also established the intensity of the patient's infection by egg and worm counts. The patients presented no evident nutritional abnormality. Iron deficiency was the common factor found among those who had anemia, and it constitutes the physiopathologic basis of ancylostomotic anemia. The worms fixed on the intestinal epithelium suck the host's blood and this long-term blood spoliation produces anemia. The volume of blood lost is generally proportional to the degree of infection, but the fall in the patient's hemoglobin level was found to be independent of the spoliated blood volume. The great amount of iron which is absorved from the hemoglobin shed into the feces contributes to the later establishment of anemia as compared to that of other hemorrhages, as for instance, vaginal hemorrhages. The anemic patients were submitted to blood transfusions and thereafter presented an immediate although temporary clinical and laboratorial improvement. A steady clinical improvement, however, was established only after adequate worm therapy.Foram estudados 17 casos de ancilostomose e determinados alguns parâmetros hematológicos como: dosagem de hemoglobina, do ferro sérico e da transferrina, contagem de hemácias, hematócrito, volume corpuscular médio (VCM) e hemoglobina corpuscular média (HCM). O estudo incluiu também a obtenção de alguns dados eritrocinéticos, como a determinação da velocidade de decaimento do ferro plasmático (T1V2 do 59Fe) e da incorporação do ferro à hemoglobina. O estudo radioisotópico permitiu ainda determinar o volume de sangue e a quantidade de hemoglobina perdida nas fezes, bem como o teor de ferro reabsorvido dessa hemoglobina. Estabeleceram também o grau de infecção através da contagem de ovos e de vermes nas fezes. Os doentes não apresentaram evidente alteração nutricional. A carência de ferro foi o fator comum a todos os casos que exibiram anemia, constituindo a base fisiopatológica da anemia ancilostomótica. O verme fixado à mucosa duodenal suga o sangue do hospedeiro e esta espoliação de sangue a longo prazo provoca a anemia. O volume de sangue perdido é geralmente proporcional ao grau de infecção, mas a quantidade de hemoglobina perdida mostrou ser independente do volume de sangue espoliado. A reabsorção de grande parte do ferro da hemoglobina perdida na luz intestinal concorre para que a anemia se estabeleça mais tardiamente que em outras hemorragias como a vaginal. Os indivíduos anêmicos foram submetidos a transfusões de sangue e com isso apresentaram melhora clínica e laboratorial, imediata mas temporária. A cura clínica foi estabelecida somente após tratamento adequado com vermífugos

Importância da reabsorção do ferro da hemorragia intestinal provocada pela ação dos vermes na progressão da anemia

Ten patients presenting ancylostomotic anemia and a high rate of parasitosis were submitted to several hematologic determinations: hemoglobin level, erythrocyte count, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, serum iron level, and transferrin. In addition, measurements were made of the blood volume lost by intestinal bleeding, of iron loss through hemorrhage and in feus, and of iron reabsorption from intestinal bleeding. The main reason for the late appearance of iron deficiency anemia in ancylostomiasis is the high degree of dally iron absorption in the digestive tract, originating from hemoglobin breakdown.Foram estudados 10 doentes, portadores de anemia ancilostomótica e de grande parasitose. Foram determinados alguns parâmetros hematológicos como dosagem de hemoglobina, contagem de hemácias, hematócrito, volume corpuscular médio, hemoglobina corpuscular média, ferro sérico e siderofilina. Foram estudados o volume da perda de sangue intestinal, o ferro perdido nesta hemorragia e eliminado nas fezes, e o ferro reaborvido da hemorragia intestinal. Conclui-se que a reabsorção do ferro da hemoglobina por dia no tubo digestivo é de suma importância no retardamento da instalação da anemia ferropriva, causada pela parasitose ancilostomótica

Digital tomosynthesis spot view in architectural distortions: outcomes in management and radiation dose

Purpose To evaluate if digital breast tomosynthesis spot compression view (DBT-SCV) could be an additional projection to confirm or deny architectural distortions (ADs) detected by digital breast tomosynthesis (DBT) while assessing the average glandular radiation dose. Methods This is a retrospective cohort study enrolling 8864 DBT exams, of which only cases detecting primary AD and with BI-RADS 2-5 score were considered. Seventy-one AD cases examined with DBT-SCV, US and MRI were evaluated for correlation in terms of BI-RADS score; variables among exams were assessed for inter-relationships. Results Of all ADs identified at DBT, biopsy yielded malignancy in only 38%. PPV in identifying malignancy of ADs was higher for DBT-SCV than DBT (p < 0.05); the NPV of DBT-SCV was 94%. The difference between DBT and DBT-SCV in the detection of benign ADs was statistically significant (p < 0.05). AD without US or MRI confirmation was less likely to represent malignancy (p < 0.05). In detecting malignant cases of ADs, both DBT and DBT-SCV were strongly correlated with US and RM (Kappa > 0.90). In identifying benign cases of ADs, DBT-SCV was poorly/moderately correlated with US and RM (Kappa 0.25 and 0.66); DBT was negatively correlated with US and MRI. Conclusion DBT-SCV could be useful to better characterize AD firstly identified by DBT, keeping dose levels within the reference limits. If AD is detected by DBT without an US or MRI correlate, that is not confirmed by DBT-SCV, a "wait and see " approach can be applied to reduce unnecessary biopsy

METROLOGICAL CHARACTERIZATION OF OPTICAL 3D COORDINATE MEASUREMENT SYSTEMS – COMPARISON OF ALTERNATIVE HARDWARE DESIGNS AS PER ISO 10360

Abstract. This research focuses on the characterization of the metrology of Optical 3D Coordinate Measurement Systems (O3DCMS). The focus is set on the identification and execution of the procedure indicated by the currently active technical standards related to industrial O3DCMS, for their metrological assessment, objective comparison, and performance tracking. This work leads to the implementation of an ad hoc software for the execution of the standard tests by the ISO 10360-13 standard. The implemented software application is employed in a real-case scenario for evaluating the performances of an industrial 3D scanner based on structured light. The specific hardware components to be assessed are two light sources of the active stereoscopic vision system, named Digital Light Projectors (DLP). The case study applies the procedures and metrics indicated by the active standards to objectively compare two alternative hardware design of the system under test. This results in the identification of the most performing hardware configuration, allowing the selection of the best system design, basing on objective metrological parameters

Efficacy of intranasal virosomal influenza vaccine in the prevention of recurrent acute otitis media in children

To evaluate the efficacy of an intranasal, inactivated, virosomal subunit influenza vaccine for prevention of new episodes of acute otitis media (AOM) in children with recurrent AOM, 133 children aged 1-5 years were randomized to receive the vaccine (n=67) or no vaccination (n=66). During a 6-month period, 24 (35.8%) vaccine recipients had 32 episodes of AOM; 42 (63.6%) control subjects had 64 episodes. The overall efficacy of vaccination in preventing AOM was 43.7% (95% confidence interval, 18.6-61.1; P=.002). Children vaccinated before influenza season had a significantly better outcome than did those vaccinated after the onset of influenza season. The cumulative duration of middle ear effusion was significantly less in vaccinated children than in control subjects. Data suggest that the intranasal virosomal influenza vaccine might be considered among the options for the prevention of AOM in children <5 years old with recurrent AO

Clausola compromissoria: ambito di applicazione oggettivo e domanda di simulazione

Nota a Cassazione civile, Sez. III, 31 maggio 2019, n. 14884 che conferma la regola ermeneutica secondo la quale in tema di interpretazione di una clausola compromissoria e del suo ambito di applicazione oggettivo ogni questione avente titolo nel contratto deve ritenersi rientrante nella competenza arbitrale