BILATERAL RENAL ARTERY STENOSIS IN A HYPERTENSIVE LUPUS PATIENT WITHOUT RENAL DYSFUNCTION: A CASE REPORT

Systemic lupus erythematosus (SLE) is associated with a high prevalence of atherosclero-sis and an enhanced cardiovascular mortality. In adult subjects, several studies have shown the coexistence of SLE and renal artery stenosis, most of them with unilateral in-volvement or with renal dysfunction. We observed a 62-year-old man with SLE and a 10-year history of moderate-to-severe hy-pertension who was admitted to our hospital because of uncontrolled blood pressure val-ues (152/95 mmHg), despite drug therapy. No signs of renal impairment were evident. After an initial physical examination, which presented a periumbilical bruit, a renal ultra-sound was performed with evidence of bilateral renal artery stenosis. An angio-MR study also confirmed the diagnosis and showed a double renal artery on the right side. Many different factors can contribute to the bilateral renal artery stenosis in this patient. Chronic inflammatory state associated to SLE, metabolic alterations with dyslipidemia and steroid therapy may all be involved in the development of the renal atherosclerotic le-sions

Topoclimate effect on treeline elevation depends on the regional framework: A contrast between Southern Alps (New Zealand) and Apennines (Italy) forests

Deciphering the spatial patterns of alpine treelines is critical for understanding the ecosystem processes involved in the persistence of tree species and their altitudinal limit. Treelines are thought to be controlled by temperature, and other environmental variables but they have rarely been investigated in regions with different land-use change legacies. Here, we systematically investigated treeline elevation in the Apennines (Italy) and Southern Alps (New Zealand) with contrasting human history but similar biogeographic trajectories, intending to identify distinct drivers that affect their current elevation and highlight their respective peculiarities. Over 3622 km of Apennines, treeline elevation was assessed in 302 mountain peaks and in 294 peaks along 4504 km of Southern Alps. The major difference between the Southern Alps and Apennines treeline limit is associated with their mountain aspects. In the Southern Alps, the scarcely anthropized Nothofagus treeline elevation was higher on the warmer equator-facing slopes than on the pole-facing ones. Contrary to what would be expected based on temperature limitation, the elevation of Fagus sylvatica treelines in the Apennines was higher on colder, pole-facing slopes than on human-shaped equator-facing, warmer mountainsides. Pervasive positive correlations were found between treeline elevation and temperature in the Southern Alps but not in the Apennines. While the position of the Fagus and Nothofagus treelines converge on similar isotherms of annual average temperature, a striking isothermal difference between the temperatures of the hottest month on which the two taxonomic groups grow exists. We conclude that actual treeline elevation reflects the ecological processes driven by a combination of local-scale topoclimatic conditions, and human disturbance legacy. Predicting dynamic processes affecting current and future alpine treeline position requires further insight into the modulating influences that are currently understood at a regional scale

Topography modulates near-ground microclimate in the Mediterranean Fagus sylvatica treeline

Understanding processes controlling forest dynamics has become particularly important in the context of ongoing climate change, which is altering the ecological fitness and resilience of species worldwide. However, whether forest communities would be threatened by projected macroclimate change or unaffected due to the controlling effect of local site conditions is still a matter for debate. After all, forest canopy buffer climate extremes and promote microclimatic conditions, which matters for functional plant response, and act as refugia for understory species in a changing climate. Yet precisely how microclimatic conditions change in response to climate warming will depend on the extent to which vegetation structure and local topography shape air and soil temperature. In this study, we posited that forest microclimatic buffering is sensitive to local topographic conditions and canopy cover, and using meteorological stations equipped with data-loggers we measured this effect during 1 year across a climate gradient (considering aspect as a surrogate of local topography) in a Mediterranean beech treeline growing in contrasting aspects in southern Italy. During the growing season, the below-canopy near-ground temperatures were, on average, 2.4 and 1.0 °C cooler than open-field temperatures for south and north-west aspects, respectively. Overall, the temperature offset became more negative (that is, lower under-canopy temperatures at the treeline) as the open-field temperature increased, and more positive (that is, higher under-canopy temperatures at the treeline) as the open-field temperature decreased. The buffering effect was particularly evident for the treeline on the south-facing slope, where cooling of near-ground temperature was as high as 8.6 °C for the maximum temperature (in August the offset peaked at 10 °C) and as high as 2.5 °C for the average temperature. In addition, compared to the south-facing slope, the northern site exhibited less decoupling from free-air environment conditions and low variability in microclimate trends that closely track the free-air biophysical environment. Although such a decoupling effect cannot wholly isolate forest climatic conditions from macroclimate regional variability in the south-facing treeline, it has the potential to partly offset the regional macroclimatic warming experienced in the forest understory due to anthropogenic climate change

Absence of an independent association between serum uric acid and left ventricular mass in Caucasian hypertensive women and men

Background and aim: Experimentally uric acid may induce cardiomyocyte growth and interstitial fibrosis of the heart. However, clinical studies exploring the relationship between serum uric acid (SUA) and left ventricular (LV) mass yielded conflicting results. The aim of our study was to evaluate the relationships between SUA and LV mass in a large group of Caucasian essential hypertensive subjects. Methods and results: We enrolled 534 hypertensive patients free of cardiovascular complications and without severe renal insufficiency. In all subjects routine blood chemistry, including SUA determination, echocardiographic examination and 24 h ambulatory blood pressure (BP) monitoring were obtained. In the overall population we observed no significant correlation of SUA with LV mass indexed for height2.7 (LVMH2.7) (r = 0.074). When the same relationship was analysed separately in men and women, we found a statistically significant correlation in female gender (r = 0.27; p < 0.001), but not in males (r = 0.042; p = NS). When we grouped the study population in sex-specific tertiles of SUA, an increase in LVMH2.7 was observed in the highest tertiles in women (44.5 \ub1 15.6 vs 47.5 16 vs 55.9 \ub1 22.2 g/m2.7; p < 0.001), but not in men. The association between SUA and LVMH2.7 in women lost statistical significance in multiple regression analyses, after adjustment for age, 24 h systolic BP, body mass index, serum creatinine and other potential confounders. Conclusions: Our findings do not support an independent association between SUA and LV mass in Caucasian men and women with arterial hypertension

Effects of intravenous furosemide plus small-volume hypertonic saline solutions on markers of heart failure

Aims: We sought to compare the effects of furosemide&nbsp;+&nbsp;hypertonic saline solution (HSS) treatment in patients with acute decompensated heart failure in comparison with furosemide alone and the response in a compensated state after an acute saline load with regard to serum levels of heart failure biomarkers. Methods and results: We enrolled 141 patients with acute decompensated heart failure with reduced ejection fraction admitted to our Internal Medicine ward from March 2017 to November 2019. A total of 73 patients were randomized to treatment with i.v. high-dose furosemide plus HSS, whereas 68 patients were randomized to i.v. high-dose furosemide alone. Patients treated with furosemide plus HSS compared with controls treated with furosemide alone showed a comparable degree of reduction in the serum levels of interleukin (IL)-6, soluble suppression of tumorigenicity 2 (sST2), and N-terminal pro-brain natriuretic peptide (NT-proBNP) in the ‘between-group’ analysis. Nevertheless, patients treated with high-dose furosemide&nbsp;+&nbsp;HSS showed significantly higher absolute delta values of IL-6 (2.3&nbsp;±&nbsp;1.2 vs. 1.7&nbsp;±&nbsp;0.9, P&nbsp;&lt;&nbsp;0.0005, and 2.0&nbsp;±&nbsp;0.8 vs. 1.85&nbsp;±&nbsp;1.1, P&nbsp;=&nbsp;0.034), sST2 (41.2&nbsp;±&nbsp;8.6 vs. 27.9&nbsp;±&nbsp;7.6, P&nbsp;&lt;&nbsp;0.0005, and 37.1&nbsp;±&nbsp;6.6 vs. 28.4&nbsp;±&nbsp;6.7, P&nbsp;&lt;&nbsp;0.0005), high-sensitivity troponin T (0.03&nbsp;±&nbsp;0.02 vs. 0.02&nbsp;±&nbsp;0.01, P&nbsp;=&nbsp;0.001, and 0.03&nbsp;±&nbsp;0.02 vs. 0.02&nbsp;±&nbsp;0.01, P&nbsp;=&nbsp;0.009), NT-proBNP (7237&nbsp;±&nbsp;7931 vs. 3244&nbsp;±&nbsp;4159, P&nbsp;&lt;&nbsp;0.005, and 5381&nbsp;±&nbsp;4829 vs. 4466&nbsp;±&nbsp;4332, P&nbsp;=&nbsp;0.004), and galectin-3 (15.7&nbsp;±&nbsp;3.2&nbsp;ng/mL vs. 11.68&nbsp;±&nbsp;1.9&nbsp;ng/mL, P&nbsp;&lt;&nbsp;0.0005, and 16.7&nbsp;±&nbsp;3.9&nbsp;ng/mL vs. 11.8&nbsp;±&nbsp;2.4&nbsp;ng/mL, P&nbsp;&lt;&nbsp;0.0005) than patients treated with furosemide alone. After acute saline load, patients treated with i.v. furosemide&nbsp;+&nbsp;HSS in comparison with subjects treated with furosemide alone showed a significantly lower increase in the serum concentrations of IL-6 (−0.26&nbsp;±&nbsp;0.42&nbsp;pg/mL vs. −1.43&nbsp;±&nbsp;0.86&nbsp;pg/mL, P&nbsp;&lt;&nbsp;0.0005), high-sensitivity troponin T (0 vs. −0.02&nbsp;±&nbsp;0.02&nbsp;ng/mL, P&nbsp;&lt;&nbsp;0.0005), sST2 (−8.5&nbsp;±&nbsp;5.9 ng/mL vs. −14.6&nbsp;±&nbsp;6.2&nbsp;ng/mL, P&nbsp;&lt;&nbsp;0.0005), galectin-3 (−2.1&nbsp;±&nbsp;1.5&nbsp;ng/mL vs. −7.1&nbsp;±&nbsp;3.6&nbsp;ng/mL, P&nbsp;&lt;&nbsp;0.0005), and NT-proBNP (77&nbsp;±&nbsp;1373 vs. −1706&nbsp;±&nbsp;2259&nbsp;pg/mL, P&nbsp;&lt;&nbsp;0.0005). Conclusions: Our findings concerning a comparable degree of reduction in the serum levels of three cardinal biomarkers indicate that a reduction in serum heart failure markers is not linked to the higher degree of congestion relief with a more rapid achievement of a clinical compensation state. This issue may have possible benefits on clinical practice concerning its therapeutic effects over and beyond the simple amelioration of clinical congestion signs and symptoms. Nevertheless, our findings of higher delta values after treatment with i.v. furosemide plus HSS indicate a possible higher efficacy by means of modulation of the stretching and fibrosis mechanisms

Magnetic Field Amplification in Galaxy Clusters and its Simulation

We review the present theoretical and numerical understanding of magnetic field amplification in cosmic large-scale structure, on length scales of galaxy clusters and beyond. Structure formation drives compression and turbulence, which amplify tiny magnetic seed fields to the microGauss values that are observed in the intracluster medium. This process is intimately connected to the properties of turbulence and the microphysics of the intra-cluster medium. Additional roles are played by merger induced shocks that sweep through the intra-cluster medium and motions induced by sloshing cool cores. The accurate simulation of magnetic field amplification in clusters still poses a serious challenge for simulations of cosmological structure formation. We review the current literature on cosmological simulations that include magnetic fields and outline theoretical as well as numerical challenges.Comment: 60 pages, 19 Figure

A legal analysis of Australian criminal cases involving defendants with autism spectrum disorder charged with online sexual offending

This paper examines how the symptomology of the small number of individuals with autism spectrum disorder (ASD) charged with online sexual offenses in Australia is established during legal arguments and conceived by the judiciary to impact legal liability and offending behavior. This study aims to provide empirical support for the proposition that judicial discourses regarding the connection between ASD and online sexual offending, including conduct related to child exploitation material (CEM), have little bearing on overall questions of criminal liability or the use of alternative penal dispositions. It does so by exploring a sample of nine recent Australian criminal cases, involving ten rulings, that examine how evidence of ASD is raised in legal arguments in ways that suggest a diagnosed condition may have contributed significantly to the alleged wrongdoing. We conclude by suggesting current Australian judicial practice requires more sensitivity to the impact of clinical factors associated with ASD in shaping alternative supervisory and non-custodial dispositions for individuals convicted of online sexual offenses. Previous article in issu

Campaign 9 of the K2 Mission: Observational Parameters, Scientific Drivers, and Community Involvement for a Simultaneous Space- and Ground-based Microlensing Survey

K2's Campaign 9 (K2C9) will conduct a ~3.7 deg2 survey toward the Galactic bulge from 2016 April 22 through July 2 that will leverage the spatial separation between K2 and the Earth to facilitate measurement of the microlens parallax ${\pi }_{{\rm{E}}}$ for $\gtrsim 170$ microlensing events. These will include several that are planetary in nature as well as many short-timescale microlensing events, which are potentially indicative of free-floating planets (FFPs). These satellite parallax measurements will in turn allow for the direct measurement of the masses of and distances to the lensing systems. In this article we provide an overview of the K2C9 space- and ground-based microlensing survey. Specifically, we detail the demographic questions that can be addressed by this program, including the frequency of FFPs and the Galactic distribution of exoplanets, the observational parameters of K2C9, and the array of resources dedicated to concurrent observations. Finally, we outline the avenues through which the larger community can become involved, and generally encourage participation in K2C9, which constitutes an important pathfinding mission and community exercise in anticipation of WFIRST

Sulla via dello Spielberg. Memorie e antimemorie dell'arrivo a Verona dei "processi del Ventuno"

risorgimento, storia Verona, Memori