The physicianelderly patient relationship: challenges and perspectives

O objetivo deste artigo é expor os desafios e perspectivas da relação médico-paciente idoso. Nas relações interpessoais, inerentes ao exercício profissional da medicina, é a qualidade do encontro que determina sua eficiência. Assim, na formação e na identificação do bom profissional, a relação médico-paciente idoso é fundamental na promoção da qualidade do atendimento. Os mé dicos devem privilegiar sentimentos e valores dos pacientes idosos e de seus familiares, estimu lando a tomada das decisões necessárias em conjunto, ou seja, a democratização da relação médi co-paciente, resgatando sua humanização. Esta proposta aspira ao nascimento de uma nova imagem deste profissional responsável pela efetiva promoção da saúde, ao considerar o paciente idoso em sua integridade física, psíquica e social, e não somente do ponto de vista biológico.The aim of this article was to discuss challenges and perspectives in the physician-elderly patient relationship. In interpersonal relations, inherent to medical practice, it is the quality of the encounter that determines its efficiency. Thus, in training and identifying good medical professionals, the physician-elderly patient relationship is essential for promoting quality of care. Physicians should prioritize the feelings and values of elderly patients and their families, encouraging the necessary joint decision-making, that is, democratization of the physician-patient relations hip, reclaiming its humanization. This proposal aspires to the birth of a new image for these professionals, who are responsible for effective health promotion, by considering elderly patients in their physical, psychological, and social entirety, and not merely from the biological point of view

CARATTERIZZAZIONE MICROSTRUTTURALE DI SERIE MONETALI APPARTENENTI AL TESORETTO DI ALBERONE (SEC. XV-XVI)

Il Tesoretto di Alberone di Ro Ferrarese è costituito da circa un migliaio di monete di diverso metallo, emesse da zecche italiane ed estere, databili tra il XV e il XVI secolo. Complessivamente l’attività di ricerca ha avuto come obiettivo la caratterizzazione microstrutturale di quattrini e trilline appartenenti alle zecche di Milano, Bologna e Ferrara. In particolare, sono state analizzate monete appartenenti, rispettivamente, alle autorità di Filippo Maria Visconti Duca III (1412-1447), Anonime Pontificie (1422-1424), Leonello d’Este (1441-1450) ed Ercole I D’Este (1471-1505). Le analisi sono state condotte dal gruppo di Metallurgia del Dipartimento di Ingegneria, in collaborazione con il gruppo di Petrografia del Dipartimento di Scienze della Terra dell’Università di Ferrar

Stimulation of Purinergic Receptors Modulates Chemokine Expression in Human Keratinocytes

ATP is abundantly released from stressed or damaged cells in response to mechanical stimulation, bacteria, or noxious agents. In this study, we have investigated the possible involvement of P2 receptors (receptor for extracellular nucleotides) in the expression and release of inflammatory mediators by human keratinocytes. Notably, extracellular ATP displayed a complex regulation of IFN-gamma-stimulated chemokine expression, with upregulation of CC chemokine ligand 2 (CCL2), CCL5 and CXC chemokine ligand 8 (CXCL8), and suppression of the receptor CXC chemokine receptor 3 (CXCR3), CXCL9, CXCL10, and CXCL11. The effect of ATP was mimicked by ADP and adenosine-5'-O-3-thiotriphosphate, whereas 2',3'-O-(4-benzoylbenzoyl) ATP (BzATP) downmodulated all chemokines investigated. UTP had no effect on IFN-gamma-stimulated chemokine secretion. The broad-spectrum P2 receptor antagonist suramin and the selective P2Y1 inhibitor adenosine 3'-phosphate 5'-phosphosulfate counteracted the effect of ATP on secretion of all the chemokines examined, whereas pyridoxal phosphate 6-azophenyl 2',4'-disulfonic acid and KN62 (1-[N,O-bis(5-isoquinoline sulfonyl)-N-methyl-L-tyrosyl] 4 phenylpiperazine) partially prevented the inhibitory effect of ATP on CXCL10 secretion, but on the other hand potentiated the ATP-stimulatory effect on CCL5, CCL2, and CXCL8 release. In lesional skin of psoriasis and atopic dermatitis patients, intense P2X7 reactivity was confined to the cell membrane of the basal layer, whereas diffuse P2Y1 immunostaining was found throughout the epidermis. Collectively, our data suggest that the orchestrated activation of distinct P2Y and P2X receptors modulates skin inflammation

A Fe Model for TRM Reinforced Masonry Walls with Interface Effects

We report on experimental and numerical investigations of textile reinforced mortar (TRM) strengthening systems, an innovative solution for reinforcing historical masonry structures. The experimental campaign presented in this paper is original and concerns two commercial TRM applications to single-leaf clay masonry panels. The proposed FE modelling is based on a multiscale approach is applied to simulate the behaviour of TRM reinforced masonry panels under diagonal compression tests with the possibility of simulating bed joints sliding and TRM-reinforcement debonding. This last phenomenon is frequently reported in the experimental literature and it has been observed also in our experimental tests. The numerical model is applied to simulate study the behaviour of TRM reinforced masonry panels under diagonal compression tests

Extracellular ATP acting at the P2X7 receptor inhibits secretion of soluble HLA-G from human monocytes

Bacterial LPS induces the release of ATP from immune cells. Accruing evidence suggests that extracellular ATP participates in the inflammatory response as a proinflammatory mediator by activating the inflammasome complex, inducing secretion of cytokines (IL-1, IL-18) and cell damaging agents such as oxygen radicals, cationic proteins, and metalloproteases. It is not known whether ATP can also act as a proinflammatory mediator by inhibiting production of molecules down-modulating the immune response. Here, we show that extracellular ATP impairs in an IL-10-dependent fashion the expression of the tolerogenic soluble and membrane-bound HLA-G Ag in human monocytes. The effect of ATP was mimicked by BzATP (3'-O-(4-benzoyl)benzoyl-ATP) and greatly reduced by pretreatment with oATP (periodate-oxidized ATP), KN-62 (1-[N,O-bis(5-isoquinoline-sulfonyl)-N-methyl-L-tyrosyl]-4-phenylpiperazine), and an anti-P2X7 mAb, thus pointing to a specific role of the P2X7 receptor. The effect of ATP was time- and dose-dependent and was not due to a decrease in expression of IL-10 receptor. Inhibition by ATP was reverted by supplementation of culture medium with exogenous IL-10. Due to the well-known immunosuppressive activity of IL-10 and soluble HLA-G, this novel effect of ATP might be relevant for the pathophysiology and therapy of inflammatory disorders