354 research outputs found
Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint: A case report
Rationale:Calcific tendinopathy is one of the most frequent causes of nontraumatic shoulder pain. However, intra-articular calcifications appear to be an infrequent condition. We herein report a rare case study of an intra-articular calcification of the acromioclavicular joint.Patient concerns:A 46-year-old man presented with an acute pain in the anterior superior region of the left shoulder which also radiated to the left cervical region. The man during the physical evaluation also presented severe functional limitation of the shoulder movements in all planes of motion.Diagnoses:The diagnosis was carried out through a radiographic and an echotomographic examination, highlighting the intra-articular calcific formation associated to a reactive inflammatory reaction.Interventions:An ultrasound-guided percutaneous treatment following the guidelines for calcific tendinopathy of the shoulder was carried out.Outcomes:The posttreatment was satisfactory with the disappearance of the pain and the recovery of the shoulder movements in all planes of motion.Lessons:We can affirm that the ultrasound-guided percutaneous treatment in patients with calcification of the acromion-clavicular joint represents a valid and nonpainful therapeutic treatment
Anatomy of the AGN in NGC 5548: V. A clear view of the X-ray narrow emission lines
Context. Our consortium performed an extensive multi-wavelength campaign of
the nearby Seyfert 1 galaxy NGC 5548 in 2013-14. The source appeared unusually
heavily absorbed in the soft X-rays, and signatures of outflowing absorption
were also present in the UV. He-like triplets of neon, oxygen and nitrogen, and
radiative recombination continuum (RRC) features were found to dominate the
soft X-ray spectrum due to the low continuum flux.
Aims. Here we focus on characterising these narrow emission features using
data obtained from the XMM-Newton RGS (770 ks stacked spectrum).
Methods. We use SPEX for our initial analysis of these features.
Self-consistent photoionisation models from Cloudy are then compared with the
data to characterise the physical conditions of the emitting region.
Results. Outflow velocity discrepancies within the O VII triplet lines can be
explained if the X-ray narrow-line region (NLR) in NGC 5548 is absorbed by at
least one of the six warm absorber components found by previous analyses. The
RRCs allow us to directly calculate a temperature of the emitting gas of a few
eV ( K), favouring photoionised conditions. We fit the data with a
Cloudy model of log erg cm s, log cm and log v km s for the emitting
gas; this is the first time the X-ray NLR gas in this source has been modelled
so comprehensively. This allows us to estimate the distance from the central
source to the illuminated face of the emitting clouds as pc,
consistent with previous work.Comment: Accepted by A&A, 15 pages, 6 figure
Food intolerance and chronic constipation: manometry and histology study.
BACKGROUND:
Chronic constipation in children can be caused by cows' milk intolerance (CMI), but its pathogenesis is unknown.
AIMS:
To evaluate the histology and manometry pattern in patients with food intolerance-related constipation.
PATIENTS AND METHODS:
Thirty-six consecutive children with chronic constipation were enrolled. All underwent an elimination diet and successive double-blind food challenge. All underwent rectal biopsy and anorectal manometry.
RESULTS:
A total of 14 patients were found to be suffering from CMI and three from multiple food intolerance. They had a normal stool frequency on elimination diet, whereas constipation recurred on food challenge. The patients with food intolerance showed a significantly higher frequency of erosions of the mucosa, and the number of intra-epithelial lymphocytes and eosinophils. The rectal mucous gel layer showed that the food-intolerant patients had a significantly lower thickness of mucus than the other subjects studied. Manometry showed a higher anal sphincter resting pressure and a lower critical volume in food intolerance patients than in the others suffering from constipation unrelated to food intolerance. Both histology and manometry abnormalities disappeared on the elimination diet.
CONCLUSIONS:
Food intolerance-related constipation is characterized by proctitis. Increased anal resting pressure and a reduced mucous gel layer can be considered to be contributory factors in the pathogenesis of constipation
Anatomy of the AGN in NGC 5548: I. A global model for the broadband spectral energy distribution
An extensive multi-satellite campaign on NGC 5548 has revealed this
archetypal Seyfert-1 galaxy to be in an exceptional state of persistent heavy
absorption. Our observations taken in 2013-2014 with XMM-Newton, Swift, NuSTAR,
INTEGRAL, Chandra, HST and two ground-based observatories have together enabled
us to establish that this unexpected phenomenon is caused by an outflowing
stream of weakly ionised gas (called the obscurer), extending from the vicinity
of the accretion disk to the broad-line region. In this work we present the
details of our campaign and the data obtained by all the observatories. We
determine the spectral energy distribution of NGC 5548 from near-infrared to
hard X-rays by establishing the contribution of various emission and absorption
processes taking place along our line of sight towards the central engine. We
thus uncover the intrinsic emission and produce a broadband continuum model for
both obscured (average summer 2013 data) and unobscured ( 2011) epochs of
NGC 5548. Our results suggest that the intrinsic NIR/optical/UV continuum is a
single Comptonised component with its higher energy tail creating the 'soft
X-ray excess'. This component is compatible with emission from a warm,
optically-thick corona as part of the inner accretion disk. We then investigate
the effects of the continuum on the ionisation balance and thermal stability of
photoionised gas for unobscured and obscured epochs.Comment: Accepted for publication in A&A, 19 pages, 13 figure
Epidemiology and outcome of Clostridium difficile infections in patients hospitalized in Internal Medicine: findings from the nationwide FADOI-PRACTICE study.
BACKGROUND: Clostridium difficile (CD) is a leading cause of diarrhoea among hospitalized patients. The objective of this study was to evaluate the rate, the optimal diagnostic work-up, and outcome of CD infections (CDI) in Internal Medicine (IM) wards in Italy. METHODS: PRACTICE is an observational prospective study, involving 40 IM Units and evaluating all consecutive patients hospitalized during a 4-month period. CDI were defined in case of diarrhoea when both enzyme immunoassay for GDH, and test for A/B toxin were positive. Patients with CDI were followed-up for recurrences for 4 weeks after the end of therapy. RESULTS: Among the 10,780 patients observed, 103 (0.96 %) showed CDI, at admission or during hospitalization. A positive history for CD, antibiotics in the previous 4 weeks, recent hospitalization, female gender and age were significantly associated with CDI (multivariable analysis). In-hospital mortality was 16.5 % in CD group vs 6.7 % in No-CD group (p\u2009<\u20090.001), whereas median length of hospital stay was 16 (IQR\u2009=\u200913) vs 8 (IQR\u2009=\u20098) days (p\u2009<\u20090.001) among patients with or without CDI, respectively. Rate of CD recurrences was 14.6 %. As a post-hoc evaluation, 23 out of 34 GDH+/Tox- samples were toxin positive, when analysed by molecular method (a real-time PCR assay). The overall CD incidence rate was 5.3/10,000 patient-days. CONCLUSIONS: Our results confirm the severity of CDI in medical wards, showing high in-hospital mortality, prolonged hospitalization and frequent short-term recurrences. Further, our survey supports a 2-3 step algorithm for CD diagnosis: EIA for detecting GDH, A and B toxin, followed by a molecular method in case of toxin-negative samples
A fast and long-lived outflow from the supermassive black hole in NGC 5548
Supermassive black holes in the nuclei of active galaxies expel large amounts
of matter through powerful winds of ionized gas. The archetypal active galaxy
NGC 5548 has been studied for decades, and high-resolution X-ray and UV
observations have previously shown a persistent ionized outflow. An observing
campaign in 2013 with six space observatories shows the nucleus to be obscured
by a long-lasting, clumpy stream of ionized gas never seen before. It blocks
90% of the soft X-ray emission and causes simultaneous deep, broad UV
absorption troughs. The outflow velocities of this gas are up to five times
faster than those in the persistent outflow, and at a distance of only a few
light days from the nucleus, it may likely originate from the accretion disk.Comment: 25 pages, 8 figures. This is the author's version of the work. It is
posted here by permission of the AAAS for personal use, not for
redistribution. The definitive version was published in Science,
electronically available at Science Express (June 19, 2014). For a brief
video explaining the key results of this paper, please visit
http://www.issibern.ch/teams/ngc5548/?page_id=2
Sloshing cold fronts in galaxy groups and their perturbing disk galaxies: an X-ray, Optical and Radio Case Study
We present a combined X-ray, optical, and radio analysis of the galaxy group
IC 1860 using the currently available Chandra and XMM data, literature
multi-object spectroscopy data and GMRT data. The Chandra and XMM imaging and
spectroscopy reveal two surface brightness discontinuities at 45 and 76 kpc
shown to be consistent with a pair of cold fronts. These features are
interpreted as due to sloshing of the central gas induced by an off-axis minor
merger with a perturber. This scenario is further supported by the presence of
a peculiar velocity of the central galaxy IC 1860 and the identification of a
possible perturber in the optically disturbed spiral galaxy IC 1859. The
identification of the perturber is consistent with the comparison with
numerical simulations of sloshing. The GMRT observation at 325 MHz shows faint,
extended radio emission contained within the inner cold front, as seen in some
galaxy clusters hosting diffuse radio mini-halos. However, unlike mini-halos,
no particle reacceleration is needed to explain the extended radio emission,
which is consistent with aged radio plasma redistributed by the sloshing. There
is strong analogy of the X-ray and optical phenomenology of the IC 1860 group
with two other groups, NGC 5044 and NGC 5846, showing cold fronts. The evidence
presented in this paper is among the strongest supporting the currently favored
model of cold-front formation in relaxed objects and establishes the group
scale as a chief environment to study this phenomenon.Comment: 22 pages, 21 figures, accepted for publication in the Astrophysical
Journa
Anatomy of the AGN in NGC 5548. III. The high-energy view with NuSTAR and INTEGRAL
We describe the analysis of the seven broad-band X-ray continuum observations of the archetypal Seyfert 1 galaxy NGC 5548 that were obtained with XMM-Newton or Chandra, simultaneously with high-energy (>10 keV) observations with NuSTAR and INTEGRAL. These data were obtained as part of a multiwavelength campaign undertaken from the summer of 2013 till early 2014. We find evidence of a high-energy cut-off in at least one observation, which we attribute to thermal Comptonization, and a constant reflected component that is likely due to neutral material at least a few light months away from the continuum source. We confirm the presence of strong, partial covering X-ray absorption as the explanation for the sharp decrease in flux through the soft X-ray band. The obscurers appear to be variable in column density and covering fraction on time scales as short as weeks. A fit of the average spectrum over the range 0.3â400 keV with a realistic Comptonization model indicates the presence of a hot corona with a temperature of 40^(+40)_(-10) keV and an optical depth of 2.7^(+0.7)_(-1.2) if a spherical geometry is assumed
Transient obscuration event captured in NGC 3227. I. Continuum model for the broadband spectral energy distribution
© ESO 2021. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1051/0004-6361/202141324From Swift monitoring of a sample of active galactic nuclei (AGN) we found a transient X-ray obscuration event in Seyfert-1 galaxy NGC 3227, and thus triggered our joint XMM-Newton, NuSTAR, and Hubble Space Telescope (HST) observations to study this event. Here in the first paper of our series we present the broadband continuum modelling of the spectral energy distribution (SED) for NGC 3227, extending from near infrared (NIR) to hard X-rays. We use our new spectra taken with XMM-Newton, NuSTAR, and HST/COS in 2019, together with archival unobscured XMM-Newton, NuSTAR, and HST/STIS data, in order to disentangle various spectral components of NGC 3227 and recover the underlying continuum. We find the observed NIR-optical-UV continuum is explained well by an accretion disk blackbody component (Tmax = 10 eV), which is internally reddened by E(B-V) = 0.45 with a Small Magellanic Cloud (SMC) extinction law. We derive the inner radius (12 Rg) and the accretion rate (0.1 solar mass per year) of the disk by modelling the thermal disk emission. The internal reddening in NGC 3227 is most likely associated with outflows from the dusty AGN torus. In addition, an unreddened continuum component is also evident, which likely arises from scattered radiation, associated with the extended narrow-line region (NLR) of NGC 3227. The extreme ultraviolet (EUV) continuum, and the 'soft X-ray excess', can be explained with a 'warm Comptonisation' component. The hard X-rays are consistent with a power-law and a neutral reflection component. The intrinsic bolometric luminosity of the AGN in NGC 3227 is about 2.2e+43 erg/s in 2019, corresponding to 3% Eddington luminosity. Our continuum modelling of the new triggered data of NGC 3227 requires the presence of a new obscuring gas with column density NH = 5e+22 cm^-2, partially covering the X-ray source (Cf = 0.6).Peer reviewe
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