Struttura e localizzazione dei gruppi di imprese in Emilia Romagna

This paper aims at investigating the presence and the main features of business groups in Emilia Romagna. The research is based on a sample comprising about 48 thousand firms and about 540 thousand employees from Emilia Romagna, the latter representing more than 42 per cent of the total regional employment. First, we find that the presence of corporate grouping in Emilia Romagna is comparable to that documented at national level. Moreover, and surprisingly enough, we show that the extension of the group organizational form is significant also in industrial districts, suggesting that ownership linkages among firms do play a role and should not be neglected in the analysis of these production systems. Although the analysis requires some further investigation, these results support the view that also in Emilia-Romagna the actual size of firms is larger and the number of owners is lower than official statistics reveal. This result has important economic policy implications, as the industrial policy of Emilia-Romagna has traditionally been oriented to supporting small and very small firms

Struttura e localizzazione dei gruppi di imprese in Emilia Romagna

This paper aims at investigating the presence and the main features of business groups in Emilia Romagna. The research is based on a sample comprising about 48 thousand firms and about 540 thousand employees from Emilia Romagna, the latter representing more than 42 per cent of the total regional employment. First, we find that the presence of corporate grouping in Emilia Romagna is comparable to that documented at national level. Moreover, and surprisingly enough, we show that the extension of the group organizational form is significant also in industrial districts, suggesting that ownership linkages among firms do play a role and should not be neglected in the analysis of these production systems. Although the analysis requires some further investigation, these results support the view that also in Emilia Romagna the actual size of firms is larger and the number of owners is lower than official statistics reveal. This result has important economic policy implications, as the industrial policy of Emilia Romagna has traditionally been oriented to supporting small and very small firms

Aorto-iliac aneurysm associated with congenital pelvic kidney: A short series of successful open repairs under hypothermic selective renal perfusion

The occurrence of congenital pelvic kidney (cPK) during aorto-iliac aneurysm repair is an extremely unusual finding. We report a series of four patients with aorto-iliac aneurysm and associated cPK who underwent aorto-iliac repair at our institution over the last 10 years. Aorto-iliac aneurysm repair under cPK selective hypothermic perfusion was successfully accomplished in all cases. All the cPK arteries were spared and were selectively reimplanted when required. No major complications or death were reported at long-term follow-up. Open surgical repair of aorto-iliac aneurysm in patients with cPK is safe and effective and, in our short series, we observed no worsening of the renal function; besides, we reported a persistent improvement of the renal function in two out of the four cases

The use of infrared thermography in evaluating returns to work in an extended rehabilitation program (PRA)

Even with proper treatment of patients with repetitive strain injuries/ work-related musculoskeletal disorders (RSI/WRULD), on certain occasions returning to work can be a difficult judgment call. There are frequent complaints of symptoms not improving or combined with co-morbid associations such as fibromyalgia syndrome. The purpose of this study was to compare the thermal patterns found by a clinical return-to-work evaluation of patients with RSI/WRULD in a double-blind clinical thermographic study. 128 patients were studied suffering from RSI/WRULD from a meat-packing plant from which 62 patients were selected for evaluation to return to work. Of these, 3.2% were cleared for immediate return to work, 77.4% were kept out for 60 days, 6.4% were kept out for 6 months, and 12.9% were retired on disability. Thermal alterations had a direct correlation with the experts' work classifications according to the number of injuries, etiology, thermal differential, and thermographic index for fibromyalgia syndrome. Cutaneous thermometry by infrared thermography has proven itself a useful and objective supplementary method to support clinical evaluations in defining one's capacity to work.Em certas ocasiões, mesmo com tratamento corretamente instituído em pacientes com lesões por esforços repetitivos/distúrbios osteomusculares relacionados ao trabalho (LER/DORT), depara-se com situações de difícil julgamento quanto ao retorno ao trabalho. Muitas vezes por uma queixa persistente de não melhora dos sintomas ou quando associado a outras comorbidades, como síndrome fibromiálgica. O objetivo deste estudo foi comparar os padrões térmicos encontrados com a avaliação pericial de retorno ao trabalho de pacientes acometidos por LER/DORT, por meio de avaliação clínica e termográfica duplo-cega. Foram avaliados 128 pacientes, acometidos por LER/DORT de uma empresa do setor da agroindústria- frigorífico, onde um grupo de 62 pacientes foi selecionado para perícia quanto ao retorno ao trabalho. Destes, 3,2% tiveram retorno imediato ao trabalho, 77,4% afastamento por 60 dias, 6,4%, afastamento por 6 meses e 12,9% aposentadoria por invalidez. As alterações térmicas tiveram direta correlação com a classificação de retorno às atividades realizadas pelos peritos, segundo critérios de número de lesões, natureza etiológica, diferencial térmico e índice termográfico para síndrome fibromiálgica. A termometria cutânea por termografia infravermelha demonstrou-se como método complementar útil e objetivo no apoio a avaliação pericial para definição de capacidade ou incapacidade para o trabalho

Documentation of myofascial pain syndrome with infrared imaging Marcos

Os pontos-gatilho (PG) miofasciais são encontrados em muitas lesões cervicais com hiperextensão/hiperflexão, discopatias e lesões/ desordens por esforço repetitivo. Desde o extremo da simulação, ao frustrante dilema na investigação objetiva da dor crônica, uma das indicações básicas e melhores da comprovação por imagem infravermelha (IR) é a de documentar afecções de tecidos moles, particularmente nos casos em que não são demonstradas por exames radiológicos, eletroneuromiográficos ou laboratoriais. Os autores revisaram a literatura sobre imagem IR na documentação da síndrome dolorosa miofascial. O exame por IR é complemento essencial do diagnóstico clínico mostrando objetivamente PG na forma de pontos aquecidos hiperradiantes. Estas áreas hiperradiantes, correspondem a PG dolorosos anotados no exame clínico. Estes são corroborados pela sensibilidade local e confirmação da dor pelos pacientes. As áreas dolorosas referidas se apresentam termicamente assimétricas com o lado oposto. Os PG latentes, não objetivamente queixados pelos pacientes durante o exame IR, também são descritos sob a forma de pontos hiperradiantes. A presença destes PG latentes pode ser confirmada pela algometria de pressão nestas áreas. Após infiltração/agulhamento há alteração do perfil térmico cutâneo demonstrando resposta neurovegetativa simpática imediata. As alterações de imagem IR se constituem, assim, em importante recurso objetivo na demonstração de PG miofasciais, correlatos com as queixas objetivas do paciente. A documentação dos PG por imagem IR é útil no direcionamento para causa da dor, orientação do tratamento adequado, assim como avaliação de sua resposta.The myofascial trigger points (TP) are involved as much pathologies of hyperextension/hyperflexion cervical injuries, disc injuries, and overuse injuries. One of the basic indications and clinical uses of infrared (IR) imaging is documentation of soft tissue pathology, particularly in conditions which cannot be demonstrated on radiologic tests, electroneuromyography or laboratory workup. The authors review the literature regarding IR imaging in the documentation of myofascial pain syndrome. The IR imaging is a diagnostic test which objectively documents TP in the form of hyperradiant hot spots. These hyperradiant spots corresponding to areas of pain usually represent active TP in clinical examination. They can be corroborated by local tenderness in the region, thus confirming the patient’s complaint. The areas of pain are presented as thermal asymmetry between corresponding areas of opposite sides of the body. Latent TP, not subject to patient complaints at the time of IR imaging examination, are detected in the form of hyperradiant spots. The presence of these latent TP can be documented by abnormal pressure threshold measurement in these areas. There was an alteration of the skin thermal profile after TP local anesthesia/dry needling demonstrating an immediate neurovegetative sympathetic response. The IR imaging findings represent an objective mean to document TP, thus corroborating with the subjective patient’s complaints. The documentation of TP by IR imaging is important to introduce the most adequate treatment directed the pain cause as well as to evaluate its response

Quality Of Sweat Test (st) Based On The Proportion Of Sweat Sodium (na) And Sweat Chloride (cl) As Diagnostic Parameter Of Cystic Fibrosis: Are We On The Right Way?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)To assess the quality of sweat test (ST) based on the proportion of sweat sodium and sweat chloride as diagnostic parameter of cystic fibrosis (CF). Methods: A retrospective study of 5,721 sweat samples and subsequent descriptive analysis were carried out. The test was considered "of good quality" (correct) when: (i) sweat chloride was lower than 60 mEq/L, and sweat sodium was higher than sweat chloride; (ii) sweat chloride was higher than 60 mEq/L, and sweat sodium was lower than sweat chloride. Results: The study included 5,692/5,721 sweat samples of ST which had been requested due to clinical presentations compatible with CF and/or neonatal screenings with altered immunoreactive trypsinogen values. Considering the proportion of sweat sodium and sweat chloride as ST quality parameter, the test was performed correctly in 5,023/5,692 (88.2 %) sweat samples. The sweat chloride test results were grouped into four reference ranges for chloride (i) chloride >= 30 mEq/L: 3,651/5,692 (64.1 %); (ii) chloride = 40 mEq/L to = 60 mEq/L: 716/5,692 (12.6 %). In the comparative analysis, there was no association between ST quality and: (i) symptoms to indicate a ST [respiratory (p = 0.084), digestive (p = 0.753), nutritional (p = 0.824), and others (p = 0.136)], (ii) sweat weight (p = 0.416). However, there was a positive association with: (i) gender, (ii) results of ST (p < 0.001), (iii) chloride/sodium ratio (p < 0.001), (iv) subject's age at the time of ST [grouped according to category (p < 0.001) and numerical order (p < 0.001)]. For the subset of 169 patients with CF and two CFTR mutations Class I, II and/or III, in comparative analysis, there was a positive association with: (i) sweat chloride/sodium ratio (p < 0.001), (ii) sweat chloride values (p = 0.047), (iii) subject's age at the time of the ST grouped by numerical order (p = 0.001). Conclusions: Considering that the quality of ST can be assessed by levels of sweat sodium and sweat chloride, an increasing number of low-quality tests could be observed in our sweat samples. The quality of the test was associated with important factors, such as gender, CF diagnosis, and subjects' age.11103FALM: Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2011/12939-4, 2015/12858-5]Fundo de Apoio a Pesquisa ao Ensino e a Extensao da Universidade Estadual de Campinas [0648/2015]JDR: FAPESP [2011/18845-1]Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Quality Of Sweat Test (st) Based On The Proportion Of Sweat Sodium (na) And Sweat Chloride (cl) As Diagnostic Parameter Of Cystic Fibrosis: Are We On The Right Way?

1

A novel custom high density-comparative genomic hybridization array detects common rearrangements as well as deep intronic mutations in dystrophinopathies

<p>Abstract</p> <p>Background</p> <p>The commonest pathogenic <it>DMD </it>changes are intragenic deletions/duplications which make up to 78% of all cases and point mutations (roughly 20%) detectable through direct sequencing. The remaining mutations (about 2%) are thought to be pure intronic rearrangements/mutations or 5'-3' UTR changes. In order to screen the huge <it>DMD </it>gene for all types of copy number variation mutations we designed a novel custom high density comparative genomic hybridisation array which contains the full genomic region of the <it>DMD </it>gene and spans from 100 kb upstream to 100 kb downstream of the 2.2 Mb <it>DMD </it>gene.</p> <p>Results</p> <p>We studied 12 DMD/BMD patients who either had no detectable mutations or carried previously identified quantitative pathogenic changes in the <it>DMD </it>gene. We validated the array on patients with previously known mutations as well as unaffected controls, we identified three novel pure intronic rearrangements and we defined all the mutation breakpoints both in the introns and in the 3' UTR region. We also detected a novel polymorphic intron 2 deletion/duplication variation. Despite the high resolution of this approach, RNA studies were required to confirm the functional significance of the intronic mutations identified by CGH. In addition, RNA analysis identified three intronic pathogenic variations affecting splicing which had not been detected by the CGH analysis.</p> <p>Conclusion</p> <p>This novel technology represents an effective high throughput tool to identify both common and rarer DMD rearrangements. RNA studies are required in order to validate the significance of the CGH array findings. The combination of these tools will fully cover the identification of causative DMD rearrangements in both coding and non-coding regions, particularly in patients in whom standard although extensive techniques are unable to detect a mutation.</p