Pulmonary hypertension in autoimmune rheumatic diseases.

Objective. Pulmonary hypertension is a severe and rapidly progressive disease, particularly frequent in patients with rheumatic diseases. The aims of this study were the following: to determine the prevalence of pulmonary hypertension in Italian patients with autoimmune rheumatic diseases, and to evaluate if the presence of a rheumatic disease in general, or of a specific autoimmune rheumatic disease, is a risk factor for the development of pulmonary hypertension. Patients and Methods. One hundred and thirteen Italian patients with connective tissue diseases (105 females, 8 males), aged 19 to 83 yrs, entered the study. Fifty-one had systemic sclerosis (SSc): 49 were females, 2 males, aged 34 to 83 yrs; 41 had limited cutaneous SSc, 8 diffuse cutaneous SSc, and 2 SSc sine scleroderma. Thirty-three patients had systemic lupus erythematosus (SLE): all but one were females, their age ranged from 19 to 82 yrs. Twenty-five had rheumatoid arthritis (RA): 21 females, 4 males, aged 26 to 45 yrs. Three females and one male, 51-77 yrs, had mixed connective tissue disease (MCTD). Systolic pulmonary arterial pressure (SPAP) was assessed by Doppler echocardiography. Results. Twenty three patients had pulmonary hypertension, which was more frequent in MCTD than in SLE (75% vs 6.1%, p=0.0002) or in AR (20%, p=0.0313). Pulmonary hypertension was more frequent in SSc than in SLE (25.5% vs 6.1%, p=0.0028) and in limited than in diffuse SSc(21.6% vs 3.9%). SPAP was significanly related to age (R=0.35, P=0.0275), with patients with pulmonary hypertension older than patients with normal SPAP (66±13 vs 52±16 yrs, p=0.0003). Conclusions. These data show a significant association between pulmonary hypertension and autoimmune rheumatic diseases. Therefore pulmonary hypertension assessment seems mandatory, at least in MCTD and SSc. However, more studies are needed to clarify the relationship between age and pulmonary hypertension and to verify whether the low prevalence of pulmonary hypertension we found in our SLE patients is related or not to their lower age

Noise reduction in muon tomography for detecting high density objects

The muon tomography technique, based on multiple Coulomb scattering of cosmic ray muons, has been proposed as a tool to detect the presence of high density objects inside closed volumes. In this paper a new and innovative method is presented to handle the density fluctuations (noise) of reconstructed images, a well known problem of this technique. The effectiveness of our method is evaluated using experimental data obtained with a muon tomography prototype located at the Legnaro National Laboratories (LNL) of the Istituto Nazionale di Fisica Nucleare (INFN). The results reported in this paper, obtained with real cosmic ray data, show that with appropriate image filtering and muon momentum classification, the muon tomography technique can detect high density materials, such as lead, albeit surrounded by light or medium density material, in short times. A comparison with algorithms published in literature is also presented

Polymorphism of the Fractalkine Receptor CX3CR1 and Systemic Sclerosis-associated Pulmonary Arterial Hypertension

Fractalkine (FKN) and its receptor CX3CR1 are critical mediators in the vascular and tissue damage of several chronic diseases, including systemic sclerosis (SSc) and pulmonary arterial hypertension (PAH). Interestingly, the V249I and T280M genetic polymorphisms influence CX3CR1 expression and function. We investigated whether these polymorphisms are associated with PAH secondary to SSc. CX3CR1 genotypes were analyzed by PCR and sequencing in 76 patients with limited SSc and 204 healthy controls. PAH was defined by colorDoppler echocardiography. Homozygosity for 249II as well as the combined presence of 249II and 280MM were significantly more frequent in patients with SSc compared to controls (17 vs 6%, p = 0.0034 and 5 vs 1%, p = 0.0027, respectively). The 249I and 280M alleles were associated with PAH (odd ratio [OR] 2.2, 95% confidence interval [CI] 1.01-4.75, p = 0.028 and OR 7.37, 95%CI: 2.45-24.60, p = 0.0001, respectively). In conclusion, the increased frequencies of 249I and 280M CX3CR1 alleles in a subgroup of patients with SSc-associated PAH suggest a role for the fractalkine system in the pathogenesis of this condition. Further, the 249I allele might be associated with susceptibility to SSc

L'ipertensione polmonare nelle malattie reumatiche autoimmuni [Pulmonary hypertension in autoimmune rheumatic diseases]

Objective. Pulmonary hypertension is a severe and rapidly progressive disease, particularly frequent in patients with rheumatic diseases. The aims of this study were the following: to determine the prevalence of pulmonary hypertension in Italian patients with autoimmune rheumatic diseases, and to evaluate if the presence of a rheumatic disease in general, or of a specific autoimmune rheumatic disease, is a risk factor for the development of pulmonary hypertension. Patients and Methods. One hundred and thirteen Italian patients with connective tissue diseases (105 females, 8 males), aged 19 to 83 yrs, entered the study. Fifty-one had systemic sclerosis (SSc): 49 were females, 2 males, aged 34 to 83 yrs; 41 had limited cutaneous SSc, 8 diffuse cutaneous SSc, and 2 SSc sine scleroderma. Thirty-three patients had systemic lupus erythematosus (SLE): all but one were females, their age ranged from 19 to 82 yrs. Twenty-five had rheumatoid arthritis (RA): 21 females, 4 males, aged 26 to 45 yrs. Three females and one male, 51-77 yrs, had mixed con-nective tissue disease (MCTD). Systolic pulmonary arterial pressure (SPAP) was assessed by Doppler echocardiography. Results. Twenty three patients had pulmonary hypertension, which was more frequent in MCTD than in SLE (75% vs 6.1%, p=0.0002) or in AR (20%, p=0.0313). Pulmonary hypertension was more frequent in SSc than in SLE (25.5% vs 6.1%, p=0.0028) and in limited than in diffuse SSc(21.6% vs 3.9%). SPAP was significanly related to age (R=0.35, P=0.0275), with patients with pulmonary hypertension older than patients with normal SPAP (66\ub113 vs 52\ub116 yrs, p=0.0003). Conclusions. These data show a significant association between pulmonary hypertension and autoimmune rheumatic diseases. Therefore pulmonary hypertension assessment seems mandatory, at least in MCTD and SSc. However, more studies are needed to clarify the relationship between age and pulmonary hypertension and to verify whether the low prevalence of pulmonary hypertension we found in our SLE patients is related or not to their lower age

Pulmonary hypertension in autoimmune rheumatic diseases

Objective. Pulmonary hypertension is a severe and rapidly progressive disease, particularly frequent in patients with rheumatic diseases. The aims of this study were the following: to determine the prevalence of pulmonary hypertension in Italian patients with autoimmune rheumatic diseases, and to evaluate if the presence of a rheumatic disease in general, or of a specific autoimmune rheumatic disease, is a risk factor for the development of pulmonary hypertension. Patients and Methods. One hundred and thirteen Italian patients with connective tissue diseases (105 females, 8 males), aged 19 to 83 yrs, entered the study. Fifty-one had systemic sclerosis (SSc): 49 were females, 2 males, aged 34 to 83 yrs; 41 had limited cutaneous SSc, 8 diffuse cutaneous SSc, and 2 SSc sine scleroderma. Thirty-three patients had systemic lupus erythematosus (SLE): all but one were females, their age ranged from 19 to 82 yrs. Twenty-five had rheumatoid arthritis (RA): 21 females, 4 males, aged 26 to 45 yrs. Three females and one male, 51-77 yrs, had mixed con-nective tissue disease (MCTD). Systolic pulmonary arterial pressure (SPAP) was assessed by Doppler echocardiography. Results. Twenty three patients had pulmonary hypertension, which was more frequent in MCTD than in SLE (75% vs 6.1%, p=0.0002) or in AR (20%, p=0.0313). Pulmonary hypertension was more frequent in SSc than in SLE (25.5% vs 6.1%, p=0.0028) and in limited than in diffuse SSc(21.6% vs 3.9%). SPAP was significanly related to age (R=0.35, P=0.0275), with patients with pulmonary hypertension older than patients with normal SPAP (66\ub113 vs 52\ub116 yrs, p=0.0003). Conclusions. These data show a significant association between pulmonary hypertension and autoimmune rheumatic diseases. Therefore pulmonary hypertension assessment seems mandatory, at least in MCTD and SSc. However, more studies are needed to clarify the relationship between age and pulmonary hypertension and to verify whether the low prevalence of pulmonary hypertension we found in our SLE patients is related or not to their lower age

Gender health and policies: a review of the state of the art from exposure to solutions.

Objective. To synthesize the determinants of gender inequalities through a narrative review that: (i) describes gender related variables that can create different levels of health; (H) describes key points that may assist in policy development and its reorientation towards gender differences; (Hi) debates potential approaches in understanding gender issues. Methods. Review of the international literature through online databases (Pubmed), search engines, publications and documents from "grey literature". Inclusion criteria: publications from 1997, English language; keywords used: gender based analysis; gender and public policy; women's health; gender differences; health policy; gender impact assessment. Among the 300 papers retrieved, 55 were selected for relevance. Results. We performed a narrative synthesis of the included literature, regarding: (i) gender differences and their determinants; (H) elements for the changing; (Hi) possible approaches; (iv) gender influences the pursuit of health and health care access through specific variables; (v) health policies can modify these variables only by a minimal percentage. These interventions should guarantee equity and allow efficient resources allocation. The gap between political announcements and real policy implementation remains unchanged, (vi) Standard approaches to the topic are not feasible due to the scarcity of a specific literature and the numerous cultural differences. Conclusions. Gender analysis of policies suggests they can differently affect women in comparison to men. However, reforms, strategies and interventions introduced in the last two decades, have achieved a limited success towards better gender equality in health. The main aim is to attack the structural sources of gender inequity in the society

Il diritto come processo. Princ\uecpi, regole e brocardi per la formazione critica del giurista

Il diritto come processo. All\u2019esposizione di questa prospettiva, teoretica e pratica ad un tempo, \ue8 dedicata la prima parte del presente lavoro collettaneo, nel quale gli Autori tentano il superamento critico di una concezione esclusivamente \uabnormocentrica\ubb del diritto presentando come meglio difendibile nella scienza giuridica e nell\u2019esperienza pratica una visione giudiziale, secondo cui momento specifico ed irrinunciabile dell\u2019esperienza giuridica \ue8 la controversia che si organizza nel processo. I cinque saggi della prima parte presentano non soltanto una concezione critica per il giurista contemporaneo, ma anche intendono rilevare il suo percorso storico, avviato dalla riflessione filosofica dei Greci e proseguito nella metodologia casistica dei Romani fino all\u2019intensa rielaborazione della giurisprudenza medievale, e la sua attualit\ue0 culturale, del tutto evidente nel ripensamento della teoria delle fonti e della positivit\ue0 del diritto nonch\ue9 nel recupero della formazione retorica del professionista forense. Nella seconda parte dell\u2019opera, si presenta una raccolta ragionata di schede dedicate appunto a princ\uecpi, regole o brocardi di natura processuale, tratti dalla sapienza giuridica classica, al fine di offrire spunti di approfondimento e di riflessione della prospettiva teoretica esposta nella prima parte. Per ciascuna scheda, corredata da opportuni riferimenti bibliografici, si propone un\u2019analisi articolata secondo la \u2018nozione\u2019 (una definizione ed una spiegazione del principio sotteso all\u2019enunciazione latina esaminata); le \u2018origini\u2019 (una lettura storica e culturale della singola nozione illustrata); le \u2018fonti\u2019(un\u2019indicazione di alcuni esempi di determinazione del principio, della regola o del brocardo all\u2019interno del diritto positivo vigente)

Material recognition by using a tagged Cf-252 source

Material recognition by measuring simultaneously the transmission of neutron and gamma ray produced by a Cf-252 source has been studied, determining the average atomic number resolving power. In addition, it is demonstrated the possibility to derive direct signatures able to identify light elements (C, N, O) using the measured transmission versus neutron time-of-flight. This allows one to determine the relevant elemental ratios (C/O and QN) normally used to identify threat organic materials such as explosives and drugs