Necrotizing Panniculitis as an Uncommon Manifestation of Acute Pancreatitis

Pancreatic panniculitis is a rare disorder affecting 2–3% of patients with pancreatic disease. The findings are characterized by tender, erythematous, subcutaneous nodules which may undergo spontaneous ulceration with discharge of brownish and viscous material derived from colliquative necrosis of adipocytes. The lesions are usually localized in the lower limbs, although they may also extend to the buttocks and also involve the trunk, upper limbs and scalp. They can precede overt pancreatic disease in 40% of cases. The typical histological features observed in these lesions are characterized by necrotic adipocytes with absent nuclei (better known as ‘ghost cells’) in the context of a predominantly lobular panniculitis. We describe the case of a 78-year-old cirrhotic woman admitted to our department with abdominal pain affecting the upper abdomen and a 3-day fever. On physical examination, multiple tender erythematous nodules, with irregular margins, were present on the pretibial regions of both lower legs, ranging in size from 0.8 to 1.5 cm. Pancreatic amylase and lipase were elevated and abdominal computed tomography revealed acute pancreatitis with oedema, focal gland enlargement of the pancreatic tail and perivisceral inflammation. Histological examination of the lesions was consistent with a diagnosis of necrotizing granulomatous panniculitis

Cycloastragenol as an exogenous enhancer of chondrogenic differentiation of human adipose-derived mesenchymal stem cells. A morphological study

Stem cell therapy and tissue engineering represent a promising approach for cartilage regeneration. However, they present limits in terms of mechanical properties and premature de-differentiation of engineered cartilage. Cycloastragenol (CAG), a triterpenoid saponin compound and a hydrolysis product of the main ingredient in Astragalus membranaceous, has been explored for cartilage regeneration. The aim of this study was to investigate CAG's ability to promote cell proliferation, maintain cells in their stable active phenotype, and support the production of cartilaginous extracellular matrix (ECM) in human adipose-derived mesenchymal stem cells (hAMSCs) in up to 28 days of three-dimensional (3D) chondrogenic culture. The hAMSC pellets were cultured in chondrogenic medium (CM) and in CM supplemented with CAG (CAG-CM) for 7, 14, 21, and 28 days. At each time-point, the pellets were harvested for histological (hematoxylin and eosin (H&E)), histochemical (Alcian-Blue) and immunohistochemical analysis (Type I, II, and X collagen, aggrecan, SOX9, lubricin). After excluding CAG's cytotoxicity (MTT Assay), improved cell condensation, higher glycosaminoglycans (sGAG) content, and increased cell proliferation have been detected in CAG-CM pellets until 28 days of culture. Overall, CAG improved the chondrogenic differentiation of hAMSCs, maintaining stable the active chondrocyte phenotype in up to 28 days of 3D in vitro chondrogenic culture. It is proposed that CAG might have a beneficial impact on cartilage regeneration approaches

One-year follow-up of young people with ME/CFS following infectious mononucleosis by Epstein-Barr virus

BackgroundInfectious mononucleosis after primary infection with Epstein-Barr virus (EBV-IM) has been linked to the development of myalgic encephalomyelitis/chronic fatigue-syndrome (ME/CFS) in children, adolescents, and young adults. Here, we present clinical phenotypes and follow-up data from a first German cohort of young people with ME/CFS following EBV-IM.Methods12 adolescents and 13 young adults were diagnosed with IM-triggered ME/CFS at our specialized tertiary outpatient service by clinical criteria requiring post-exertional malaise (PEM) and a history of confirmed EBV primary infection as triggering event. Demographic information, laboratory findings, frequency and severity of symptoms, physical functioning, and health-related quality of life (HRQoL) were assessed and re-evaluated 6 and 12 months later.ResultsYoung adults displayed more severe symptoms as well as worsening of fatigue, physical and mental functioning, and HRQoL throughout the study, compared to adolescents. After one year, 6/12 (54%) adolescents no longer met the diagnostic criteria for ME/CFS while all young adults continued to fulfill the Canadian consensus criteria. Improvement in adolescents was evident in physical functioning, symptom frequency and severity, and HRQoL, while young adults showed little improvement. EBV serology and EBV DNA load did not correlate with distinct clinical features of ME/CFS, and clinical chemistry showed no evidence of inflammation. Remarkably, the median time from symptom onset to ME/CFS diagnosis was 13.8 (IQR: 9.1–34.9) months.ConclusionsME/CFS following EBV-IM is a severely debilitating disease often diagnosed late and with limited responses to conventional medical care, especially in adults. Although adolescents may have a better prognosis, their condition can fluctuate and significantly impact their HRQoL. Our data emphasize that biomarkers and effective therapeutic options are also urgently needed to improve medical care and pave the way to recovery

Lardet (Pierre), L'Apologie de Jérôme contre Rufin. Un commentaire. (Suppl. to Vigiliae Chris- tianae ; vol XV) 1993

Pricoco Salvatore. Lardet (Pierre), L'Apologie de Jérôme contre Rufin. Un commentaire. (Suppl. to Vigiliae Chris- tianae ; vol XV) 1993. In: Revue des Études Anciennes. Tome 98, 1996, n°3-4. pp. 447-449

I presupposti della dichiarazione di adottabilità: un accertamento complesso sulla responsabilità genitoriale e sulle corresponsabilità del sistema di protezione e tutela

Questo contributo riflette, con una particolare attenzione alla più recente giurisprudenza nazionale della Corte di legittimità correlata ad alcune delle principali pronunce della Corte Edu, sui presupposti che legittimano la dichiarazione di adottabilità, soffermandosi in particolare sugli elementi connotativi della locuzione, formulata come clausola generale nell'ordinamento interno, dello "stato di abbandono". Se questo è il focus della riflessione, un rilievo certamente particolare assume il rapporto tra sistema giudiziario e amministrativo nel comune obiettivo di porre in essere gli interventi necessari al recupero delle capacità genitoriali, fortemente condizionato dalla rigidità dei vincoli posti dalle risorse economiche effettivamente disponibili per le azioni di welfare a sostegno della genitorialità e dell'infanzia. Nella parte conclusiva il contributo amplia l'esame delle questioni sottese alla dichiarazione di adottabilità e vi include, secondo le più recenti indicazioni della giurisprudenza di legittimità e della Corte Edu, anche la valutazione sull'opportunità di mantenere i rapporti, con alcuni componenti della famiglia di origine: di questo ampliamento del perimetro della cognizione del giudice di merito vengono esaminate alcune delle più rilevanti criticità.</jats:p

Lardet (Pierre), L'Apologie de Jérôme contre Rufin. Un commentaire. (Suppl. to Vigiliae Chris- tianae ; vol XV) 1993

Pricoco Salvatore. Lardet (Pierre), L'Apologie de Jérôme contre Rufin. Un commentaire. (Suppl. to Vigiliae Chris- tianae ; vol XV) 1993. In: Revue des Études Anciennes. Tome 98, 1996, n°3-4. pp. 447-449

Il Giudice delle relazioni tra disagio, devianza e nuove fragilità. Le ragioni della specializzazione nei percorsi della giustizia minorile e familiare

L'articolo riprende, con qualche aggiornamento, la relazione introduttiva al XXXVIII Convegno nazionale dell'Aimmf svoltosi a Lecce dal 5 al 7 ottobre 2019, richiamando prima di tutto i motivi ispiratori del Convegno e le ragioni della scelta del tema. Dopo alcuni riferimenti alla cd. "vicenda di Bibbiano", prende in esame le risoluzioni del Csm sul tema della specializzazione minorile e le implicazioni sul modello professionale del giudice, anche con riferimento ai giudici onorari. Riferisce infine su alcuni risultati, ancora parziali, raccolti dalla "Squadra speciale di giustizia" istituita in ambito ministeriale e sulle possibili evoluzioni di questo lavoro.</jats:p