Acute liver injury and anorexia nervosa: A case report

Anorexia nervosa is an eating disorder characterized by restriction of energy intake leading to a significant decrease in body weight. While it is primarily a psychiatric disorder, numerous medical complications can occur. In this article we describe a case of a 25-year-old woman with a 12-year history of severe restrictive anorexia nervosa that was referred to the Emergency Service of our Hospital, transferred from a psychiatric institute, for severe weight loss, dehydration, and progressive increase in transaminases. During the hospital stay she developed an acute liver injury with an increase in transaminase level up to 40× the ULN. Infective and immunological causes of acute hepatitis were excluded. In the suspect of severe starvation acute liver injury, we performed a nutritional assessment and started parenteral nutrition. After 15 days of parenteral nutrition, she gained 2.5 kg of body weight and liver tests were drastically reduced and nearly normal

Il paesaggio che cambia

Convegno: Paesaggio Rurale \u2013 Paesaggio Cultural

Increasing spatiotemporal proximity of heat and precipitation extremes in a warming world quantified by a large model ensemble

Increases in climate hazards and their impacts mark one of the major challenges of climate change. Situations in which hazards occur close enough to one another to result in amplified impacts, because systems are insufficiently resilient or because hazards themselves are made more severe, are of special concern. We consider projected changes in such compounding hazards using the MPI Grand Ensemble under the moderate (RCP4.5) emissions scenario, which produces warming of about 2.25°C between pre-industrial (1851-1880) and 2100. We find that extreme heat events occurring on 3 or more consecutive days increase in frequency by 100-300%, and consecutive extreme precipitation events increase in most regions, nearly doubling for some. The chance of concurrent heat and drought leading to simultaneous maize failures in 3 or more breadbasket regions increases by about 50%, while interannual wet-dry oscillations become at least 20% more likely across much of the subtropics. Our results highlight the importance of taking compounding climate extremes into account when looking at possible tipping points of socio-environmental systems

Decompensated cirrhosis as presentation of LKM1/LC1 positive type 2 autoimmune hepatitis in adulthood. A rare clinical entity of difficult management

Background: Autoimmune hepatitis (AIH) is a chronic and aggressive liver disease that rapidly evolves into cirrhosis and end-stage liver disease if not timely diagnosed and treated with immunosuppressive therapy. AIH is classified into type 1 and type 2 according to the autoantibody pattern, with smooth muscle antibodies and/or antinuclear antibodies as serological markers of AIH-1, while antiliver cytosol antibody type 1 and/or antiliver/kidney microsomal antibody type 1 characterize type 2 AIH, which mainly affects children, including infants, and adolescents. Case Summary: We describe a case of type 2 AIH, clinically onset in a 34-year-old woman with decompensated cirrhosis. Only a thorough analysis of the autoantibody profile allowed for a diagnosis of an AIH-2 evolved into cirrhosis. The patient received a moderate corticosteroid therapy without achieving optimal disease control. We discuss the controversial decision of whether or not to treat the patient with immunosuppressive therapy, which should be balanced with the potential risk of infectious and other complications. A review of the literature on the management of patients with autoimmune cirrhosis is also presented. Conclusions: AIH-2 can be clinically onset in adult patients with cirrhosis and its complications, without being preceded by major clinical signs. Due to the difficult management of cirrhosis with immunosuppressive treatments, a patient-tailored strategy with a case-by-case approach is needed to prevent major complications such as infections, potentially precluding liver transplantation the only curative therapy

Meson-baryon components in the states of the baryon decuplet

We apply an extension of the Weinberg compositeness condition on partial waves of L = 1 and resonant states to determine the weight of the meson-baryon component in the Delta(1232) resonance and the other members of the baryon decuplet. We obtain an appreciable weight of pi N in the Delta(1232) wave function, of the order of 60%, which looks more natural when one recalls that experiments on deep inelastic and Drell Yan give a fraction of pi N component of 34% for the nucleon. We also show that, as we go to higher energies in the members of the decuplet, the weights of the meson-baryon component decrease and they already show a dominant part for a genuine, non-meson-baryon, component in the wave function. We write a section to interpret the meaning of the Weinberg sum rule when it is extended to complex energies and another one for the case of an energy-dependent potential

Cosmological zoo -- accelerating models with dark energy

ecent observations of type Ia supernovae indicate that the Universe is in an accelerating phase of expansion. The fundamental quest in theoretical cosmology is to identify the origin of this phenomenon. In principle there are two possibilities: 1) the presence of matter which violates the strong energy condition (a substantial form of dark energy), 2) modified Friedmann equations (Cardassian models -- a non-substantial form of dark matter). We classify all these models in terms of 2-dimensional dynamical systems of the Newtonian type. We search for generic properties of the models. It is achieved with the help of Peixoto's theorem for dynamical system on the Poincar{\'e} sphere. We find that the notion of structural stability can be useful to distinguish the generic cases of evolutional paths with acceleration. We find that, while the $\Lambda$CDM models and phantom models are typical accelerating models, the cosmological models with bouncing phase are non-generic in the space of all planar dynamical systems. We derive the universal shape of potential function which gives rise to presently accelerating models. Our results show explicitly the advantages of using a potential function (instead of the equation of state) to probe the origin of the present acceleration. We argue that simplicity and genericity are the best guide in understanding our Universe and its acceleration.Comment: RevTeX4, 23 pages, 10 figure

Inflammatory cytokines and biofilm production sustain Staphylococcus aureus outgrowth and persistence: A pivotal interplay in the pathogenesis of Atopic Dermatitis

Individuals with Atopic dermatitis (AD) are highly susceptible to Staphylococcus aureus colonization. However, the mechanisms driving this process as well as the impact of S. aureus in AD pathogenesis are still incompletely understood. In this study, we analysed the role of biofilm in sustaining S. aureus chronic persistence and its impact on AD severity. Further we explored whether key inflammatory cytokines overexpressed in AD might provide a selective advantage to S. aureus. Results show that the strength of biofilm production by S. aureus correlated with the severity of the skin lesion, being significantly higher (P < 0.01) in patients with a more severe form of the disease as compared to those individuals with mild AD. Additionally, interleukin (IL)-β and interferon γ (IFN-γ), but not interleukin (IL)-6, induced a concentration-dependent increase of S. aureus growth. This effect was not observed with coagulase-negative staphylococci isolated from the skin of AD patients. These findings indicate that inflammatory cytokines such as IL1-β and IFN-γ, can selectively promote S. aureus outgrowth, thus subverting the composition of the healthy skin microbiome. Moreover, biofilm production by S. aureus plays a relevant role in further supporting chronic colonization and disease severity, while providing an increased tolerance to antimicrobials

The Search for Gravitational Waves

Experiments aimed at searching for gravitational waves from astrophysical sources have been under development for the last 40 years, but only now are sensitivities reaching the level where there is a real possibility of detections being made within the next five years. In this article a history of detector development will be followed by a description of current detectors such as LIGO, VIRGO, GEO 600, TAMA 300, Nautilus and Auriga. Preliminary results from these detectors will be discussed and related to predicted detection rates for some types of sources. Experimental challenges for detector design are introduced and discussed in the context of detector developments for the future.Comment: 21 pages, 7 figures, accepted J. Phys. B: At. Mol. Opt. Phy

A proposal for multi-tens of GW fully coherent femtosecond soft X-ray lasers

X-ray free-electron lasers1,2 delivering up to 131013 coherent photons in femtosecond pulses are bringing about a revolution in X-ray science3?5. However, some plasma-based soft X-ray lasers6 are attractive because they spontaneously emit an even higher number of photons (131015), but these are emitted in incoherent and long (hundreds of picoseconds) pulses7 as a consequence of the amplification of stochastic incoherent self-emission. Previous experimental attempts to seed such amplifiers with coherent femtosecond soft X-rays resulted in as yet unexplained weak amplification of the seed and strong amplification of incoherent spontaneous emission8. Using a time-dependent Maxwell?Bloch model describing the amplification of both coherent and incoherent soft X-rays in plasma, we explain the observed inefficiency and propose a new amplification scheme based on the seeding of stretched high harmonics using a transposition of chirped pulse amplification to soft X-rays. This scheme is able to deliver 531014 fully coherent soft X-ray photons in 200 fs pulses and with a peak power of 20 GW