Calcifilassi peniena: una rara complicanza in corso di emodialisi

La calcifilassi rappresenta una condizione clinica severa ed assai grave che si manifesta prevalentemente - ma non esclusivamente - in pazienti affetti da malattia renale cronica (CKD) sottoposti a terapia sostitutiva. Colpisce circa 1′1– 4% della popolazione dialitica (1, 2) e presenta una mortalità assai elevata (60–80%) (3). È caratterizzata clinicamente dalla presenza di ulcerazioni ischemiche a carico della cute e da necrosi conseguente allo sviluppo di calcificazioni distrofiche delle arteriole sottocutanee. L'interessamento penieno è assai raro ed in letteratura ne sono riportate - fino ad oggi - circa 40 segnalazioni. A tale proposito viene descritto il caso di un paziente di 50 anni, seguito presso la nostra UOC che sviluppò tale grave e, purtroppo fatale, complicanza clinica

Ivabradine, heart failure and chronic kidney disease

The incidence and prevalence of congestive heart failure are actually increasing worldwide, especially inWestern countries. In Europe and the United States, congestive heart failure represents a disabling clinical disease, accountable for increased hospitalization and health care costs. European guidelines have underlined the importance of pharmacological treatment to improve both patients\u2019 outcomes and quality of life. The latest clinical trials to evaluate ivabradine\u2019s efficacy have underlined its usefulness as a stand-alone medication and in combination with conventional congestive heart failure therapy, including in chronic kidney disease patients

Synchronisation of coupled chaotic systems

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN050223 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Solvency II: cambiano le regole di fare assicurazione

Il presente contributo intende offrire una panoramica dei principali cambiamenti nella concreta operatività di una compagnia di assicurazione alla luce della recente introduzione della nuova cornice regolamentare "Solvency II".This chapter aims to provide an overview of the main changes in the management of insurance companies in the light of the recent introduction of the new regulatory framework "Solvency II"

La produzione assicurativa del ramo danni

Nel presente capitolo l’attenzione è rivolta alla produzione assicurativa danni. In particolare, una volta definiti i principi generali dell’assicurazione danni ed evidenziati gli aspetti che accomunano le polizze assicurative in essa ricomprese, si prendono in esame alcune delle forme contrattuali che assumono maggior rilievo nell’ambito delle tre ampie categorie in cui è possibile ricondurre l’intera produzione danni: l’assicurazione di Responsabilità Civile, l’assicurazione della persona e l’assicurazione sulle cose.This chapter analyzes non-life insurance products. In particular, this section defines the general principles of the non-life insurance products and highlights the common aspects of these insurance policies. Then, it analyzes the main non-life insurance products

Effective framework for seismic analysis of cable-stayed-bridges, Part 2: Analysis’ results

Referring to the article named “Effective framework for seismic analysis of cable-stayed bridges, part.1” in which the studied structure and its modeling are discussed, in this second part one present the study of the values of the monitored parameters in a statistic way. This in an important aspect in order to evaluate if the number of the considered seismic events may be enough to obtain reliable results. The spatial variability of the ground motion is modelled taking into account a time delay of the displacements imposed at the interaction points structure-terrain. The displacements have been obtained from the integration of artificial generated accelerograms, spectra-compatible with the ones suggested by the Eurocode 8. The time delay between the arrival of the seismic waves at the interaction points structure-terrain depends on the propagation velocity of the shear waves. It is been considered the structural response, with the imposition of the same seismic event, under 10 different velocities of the shear waves, from 200 m/s to 1000 m/s, with the purpose of studying eventual critical aspects of the structural response. The structural response of the bridge is evaluated studying the time histories of 10 monitored parameters, kinematical and tensional

Le assicurazioni contro i danni

Nel presente capitolo l’attenzione è rivolta alle assicurazioni contro i danni. In particolare, una volta definiti i principi generali dell’assicurazione danni ed evidenziati gli aspetti che accomunano le polizze assicurative in essa ricomprese, si prendono in esame alcune delle forme contrattuali che assumono maggior rilievo nell’ambito delle tre ampie categorie in cui è possibile ricondurre l’intera produzione danni: l’assicurazione di Responsabilità Civile, l’assicurazione della persona e l’assicurazione sulle cose.This chapter is focused on non-life insurance. In particular, this section defines the general principles of the non-life insurance products and highlights the common aspects of these insurance policies. Then, analyzes the main non-life insurance products

An observer for phase synchronization of chaos

In this Letter we design, using only a single scalar output, a possible class of observers to detect whether a dynamical system perturbed by an unknown harmonic disturbance exhibits phase synchronization with the disturbance

Effective framework for seismic analysis of cable-stayed-bridges, Part 2: Analysis’ results

The spatial variability of the earthquake strong ground motion (SVEGM) leads to significant aspects in the structural response of long-plan structures, such as long-span and medium-span bridges. The main purpose of this article is to investigate the effects of the asynchronism of the ground motion on the structural response of a medium-span cable-stayed bridge, and in doing so the SVEGM takes only into account the time delay between the arrival of the shear waves, without taking into account their incoherency. Referring to the article named "Effective framework for seismic analysis of cable-stayed bridges, pt.1: modeling of the structure and of the seismic action" (Bontempi, Sgambi, Santoboni, 2006), in which the studied structure and its modeling are discussed, once having established a list of the monitored parameters of the bridge, it has been done the evaluation of their values in a statistic way, in order to evaluate if the number of the considered seismic events may be enough to obtain reliable results. One has considered the estimation of the average, variance and standard deviation of the results of both the synchronous and asynchronous motion. Histograms have been evaluated, showing, for established intervals, the number of the registered events; the gaussian distribution has been drawn, considering the obtained values as continuous variables. The statistic reliability of the obtained results has been evaluated by the comparison of the shape of the gaussian distribution with the histograms, by the use of the parametrical χ2 Pearson's test, and doing some physical evaluations. An evaluation has been made of the differences in percentage of the averages of the maximum values reached by each monitored parameter, during the time histories, in both the cases of synchronous and asynchronous motion. Figure 1 shows these differences. Since the time delay depends on the shear wave velocity, the response of the structure under different values of the velocity has been studied with the purpose to establish the dependence between the wave velocity and the structural response and to evaluate the possible existence of a critical value, which may show a particular behavior of the structural response. With those purposes, the response of the structure has been evaluated under a range of velocity which goes from 200 m/s to 1000 m/s, even if the lower values are not compatible with a "Eurocode type A" soil, used for the evaluation of the response spectra. The main results of these studies are: 1. Neglecting the effects of asynchronous ground motion can lead to serious mistakes also into the evaluation of the structural response of medium-span bridges. Considerable differences in the observed parameters are registered only in the axial force in the middle of the longitudinal beam, with an underestimation of 60%; 2. Considering the structural response under different values of the shear wave velocity, from 200 m/s up to 1000 m/s, shows that the differences at the lower velocities are really high; the trend of the values reached by the monitored parameters shows a nonlinear behavior of the structural response; 3. The statistical evaluation of the results shows that the reliability of the results can be improved by the use of a higher number of considered events. © 2006 Taylor & Francis Group