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Urban areas represent a spatially small impact in relation to other land-uses such as livestock and agriculture, but they undergo rapid changes. Such changes involve their size, shape, interconnectivity, and composition of natural patches. Habitat loss generated by urbanization affects the diversity and abundance of bees and other flower visitors in many sites. In general, the presence of urban areas represents a strict boundary to flower visitors and restricts their movement between natural and suburban habitat patches. The aim of this work is to evaluate how the flower visitor assemblage change along an urban-natural gradient in northwest Argentina. We established five areas in the Yungas ecoregion and sampled three sites with different degrees of urbanization (urban, suburban, and natural), at each area, reaching 15 sites. At each site, we sampled flower visitors during 5-min observation periods done over flowering plants. We found 197 morphospecies of flower-visiting insects along the gradient and an invariant richness, abundance, and Shannon diversity. The assemblage presented the same taxonomic group distributions in the three categories established. However, in urban sites, solitary bees and bees with soil borrowing nesting type predominate, while eusocial and cavity nesting bees were the main flower visitors in suburban sites. Our results suggest that the cities of northwestern Argentina are not a strict boundary for flower visitors; however, urbanization seems to be selecting and favoring certain flower-visitor species traits.
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Flores , Insectos/clasificación , Polinización , Urbanización , Animales , Argentina , Abejas/clasificación , Abejas/fisiología , Biodiversidad , Insectos/fisiología , Dinámica Poblacional , Especificidad de la EspecieRESUMEN
The study of the preparation phase of large earthquakes is essential to understand the physical processes involved, and potentially useful also to develop a future reliable short-term warning system. Here we analyse electron density and magnetic field data measured by Swarm three-satellite constellation for 4.7 years, to look for possible in-situ ionospheric precursors of large earthquakes to study the interactions between the lithosphere and the above atmosphere and ionosphere, in what is called the Lithosphere-Atmosphere-Ionosphere Coupling (LAIC). We define these anomalies statistically in the whole space-time interval of interest and use a Worldwide Statistical Correlation (WSC) analysis through a superposed epoch approach to study the possible relation with the earthquakes. We find some clear concentrations of electron density and magnetic anomalies from more than two months to some days before the earthquake occurrences. Such anomaly clustering is, in general, statistically significant with respect to homogeneous random simulations, supporting a LAIC during the preparation phase of earthquakes. By investigating different earthquake magnitude ranges, not only do we confirm the well-known Rikitake empirical law between ionospheric anomaly precursor time and earthquake magnitude, but we also give more reliability to the seismic source origin for many of the identified anomalies.
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The debated question on the possible relation between the Earth's magnetic field and climate has been usually focused on direct correlations between different time series representing both systems. However, the physical mechanism able to potentially explain this connection is still an open issue. Finding hints about how this connection could work would suppose an important advance in the search of an adequate physical mechanism. Here, we propose an innovative information-theoretic tool, i.e. the transfer entropy, as a good candidate for this scope because is able to determine, not simply the possible existence of a connection, but even the direction in which the link is produced. We have applied this new methodology to two real time series, the South Atlantic Anomaly (SAA) area extent at the Earth's surface (representing the geomagnetic field system) and the Global Sea Level (GSL) rise (for the climate system) for the last 300 years, to measure the possible information flow and sense between them. This connection was previously suggested considering only the long-term trend while now we study this possibility also in shorter scales. The new results seem to support this hypothesis, with more information transferred from the SAA to the GSL time series, with about 90% of confidence level. This result provides new clues on the existence of a link between the geomagnetic field and the Earth's climate in the past and on the physical mechanism involved because, thanks to the application of the transfer entropy, we have determined that the sense of the connection seems to go from the system that produces geomagnetic field to the climate system. Of course, the connection does not mean that the geomagnetic field is fully responsible for the climate changes, rather that it is an important driving component to the variations of the climate.
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Cambio Climático , Planeta Tierra , Campos Magnéticos , Modelos Teóricos , Entropía , Océanos y Mares , Análisis Espacio-TemporalRESUMEN
INTRODUCTION: Although the intervention of knee arthroplasty became routine, there is no standard reference on the densitometric characteristics of the patella before and after surgery. Scope of this work is the evaluation of patellar bone density before and after unilateral knee arthroplasty. PATIENTS AND METHODS: BMD was assessed by DEXA examination in 146 individuals, who have been divided into three distinct groups. Group I: 68 subjects with a mean age of 70.6 years, with an unilateral femoral-tibial knee prothesis. Group II: healthy subjects of similar age (average: 64) and without implants. Group III: healthy adults with a mean age of 26.6 years. The follow-up was performed at 6 months to a maximum of 2 years post surgery. RESULTS: The results were obtained from 68 subjects examined with the DEXA software dedicated to the forearm, which turned out to be the most appropriate for our purpose. The follow-up performed every 6 months after surgery showed a reduction of the density values in the operated knee in the 1st control with a return to the pre-surgiucal situation in the control performed after 1 year. In subsequent checks there was a further increase of the patellar density of the operated knee. CONCLUSION: Patellar DEXA examination is recommended as an addition to the clinical and radiological standard examination.
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Artroplastia de Reemplazo de Rodilla , Rótula/química , Absorciometría de Fotón , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Densidad Ósea , Remodelación Ósea/fisiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Movimiento , Osteoporosis/complicaciones , Periodo Posoperatorio , Periodo Preoperatorio , Recuperación de la Función , Adulto JovenRESUMEN
The gut-liver axis model has helped to explain the liver steatosis (NAFLD) and steatohepatitis (NASH) etiopathogenesis. The discovery of a key role for an altered intestinal permeability (IP) in this pathophysioligcal framework has closed the link between gut lumen antigenic/toxic substances and systemic and liver inflammation in NAFLD and obesity, metabolic syndrome. Recent evidence from the literature show how IP can be modulated by several non-pharmacological and pharmacological agents and be the target for future preventive and curative treatment of NAFLD and NASH. In this review we describe the concept of IP, its ultrastructural basis, its role in the NALFD pathophysiology and emerging evidence on non-pharmacological and pharmacological agents able to favourably modulate it.
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Mucosa Intestinal/metabolismo , Hígado/metabolismo , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Humanos , PermeabilidadRESUMEN
Motor imagery (M.I.) is a mental state in which real movements are evoked without overt actions. There is some behavioural evidence that M.I. declines with ageing. The neurofunctional correlates of these changes have been investigated only in two studies, but none of the these studies has measured explicit correlations between behavioural variables and the brain response, nor the correlation of M.I. and motor execution (M.E.) of the same acts in ageing. In this paper, we report a behavioural and functional magnetic resonance imaging (fMRI) experiment that aimed to address this issue. Twenty-four young subjects (27 ± 5.6 years) and twenty-four elderly subjects (60 ± 4.6 years) performed two block-design fMRI tasks requiring actual movement (M.E.) or the mental rehearsal (M.I.) of finger movements. Participants also underwent a behavioural mental chronometry test in which the temporal correlations between M.I. and M.E. were measured. We found significant neurofunctional and behavioural differences between the elderly subjects and the young subjects during the M.E. and the M.I. tasks: for the M.E. task, the elderly subjects showed increased activation in frontal and prefrontal (pre-SMA) cortices as if M.E. had become more cognitively demanding; during the M.I. task, the elderly over-recruited occipito-temporo-parietal areas, suggesting that they may also use a visual imagery strategy. We also found between-group behavioural differences in the mental chronometry task: M.I. and M.E. were highly correlated in the young participants but not in the elderly participants. The temporal discrepancy between M.I. and M.E. in the elderly subjects correlated with the brain regions that showed increased activation in the occipital lobe in the fMRI. The same index was correlated with the premotor regions in the younger subjects. These observations show that healthy elderly individuals have decreased or qualitatively different M.I. compared to younger subjects.
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Envejecimiento/fisiología , Mapeo Encefálico , Encéfalo/irrigación sanguínea , Imaginación/fisiología , Movimiento/fisiología , Desempeño Psicomotor/fisiología , Adulto , Anciano , Señales (Psicología) , Femenino , Lateralidad Funcional/fisiología , Humanos , Procesamiento de Imagen Asistido por Computador , Modelos Lineales , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Adulto JovenRESUMEN
BACKGROUND: Health care and social service workers face a significant risk of job-related violence. AIMS: To develop a method for quantitative evaluation of the risk of violence, as required by Italian and European regulations, against extra-hospital emergency health care workers employed by the Regional Emergency Healthcare Service (ARES 118) in the Lazio Region in Italy. METHODS: Violence to the ARES 118 workers during working hours was examined by analysing injuries reported by them between 2005 and 2007. The assessment method proposed should give a numerical indicator of the risk of violence for each homogeneous group. The quantitative risk was evaluated on the basis of variables such as the days off work for each episode, the total number of aggressive attacks, the type of health intervention involved, etc. RESULTS: The rate of accidents related to aggression during working hours at the ARES unit was 6.3%, which is significantly higher than the figure of 2% reported for the entire health care sector. CONCLUSIONS: The present evaluation is largely based on analysis of the Injury Register. To increase the sensitivity of the method so that it closely reflects active reporting of events, it would be necessary to implement a procedure for reporting events in a 'company register of acts of violence' and to make workers more aware of the need to report all such episodes.
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Accidentes de Trabajo/prevención & control , Agresión , Servicio de Urgencia en Hospital , Medición de Riesgo , Violencia/estadística & datos numéricos , Estudios de Evaluación como Asunto , Humanos , Grupo de Atención al Paciente , Servicio Social , Recursos Humanos , Heridas y Lesiones/epidemiologíaRESUMEN
To assess the prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) colonization in HIV-1-infected men who have sex with men (MSM), a cross-sectional study was conducted on 104 persons attending a large STI/HIV unit in Rome, Italy in the period June 2007-June 2008. Swabs obtained from both anterior nares and S. aureus isolates were characterized by phenotypic and genotypic methods. A total of 24 individuals (23.1%) were colonized with S. aureus but none carried MRSA. No statistically significant association between colonization with S. aureus and behavioural, clinical, virological or immunological characteristics was identified. This study indicates a lack of circulation of CA-MRSA in HIV-1-infected MSM in Italy and underscores large epidemiological differences between the USA and a European country, so that only locally conducted epidemiological studies can provide insight into the local circulation of CA-MRSA in general and selected populations.
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Portador Sano/epidemiología , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones por VIH/complicaciones , Homosexualidad Masculina , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Estafilocócicas/epidemiología , Adulto , Portador Sano/microbiología , Infecciones Comunitarias Adquiridas/microbiología , Estudios Transversales , Infecciones por VIH/virología , VIH-1/aislamiento & purificación , Humanos , Masculino , Staphylococcus aureus Resistente a Meticilina/clasificación , Persona de Mediana Edad , Nariz/microbiología , Ciudad de Roma/epidemiología , Infecciones Estafilocócicas/microbiologíaRESUMEN
AIM: The aim of this paper was to assess the efficacy of a minimally invasive treatment with percutaneous vertebroplasty and kyphoplasty for traumatic fracture of thoracolumbar junction. Treatment of stable traumatic vertebral fractures of the thoracolumbar junction without neurological deficit is still controversy. Conservative treatment, characterized by discomfort and limitation in patient mobility, was progressively replaced by minimally invasive techniques such as percutaneous vertebroplasty and kyphoplasty. METHODS: Between January 2003 and August 2005, 34 patients suffering from 42 thoracolumbar fractures were treated at Neurosurgical Department of Istituto Galeazzi (Milan). The treatment selected (vertebroplasty versus kyphoplasty), depended on age of patients, timing and type of fracture. Results were clinically assessed by Visual Analogue Score (VAS) and Oswestry Disability Index. RESULTS: Mean preoperative VAS was 8.32 (range 5-10). Percutaneous vertebroplasty was performed in 25 cases (73.5%); while 9 patients were treated by kyphoplasty (27.5%); 27 patients showed a single level and 7 multilevel of the fractures. No complications occurred (infection, neurological deficit, embolic events) after treatment. At the early follow-up 91.7% of the patients achieved a good pain control already after 24 hours. Pain relief and disability, analyzed by VAS and Oswestry Disability Index, showed a good results at late follow-up time. CONCLUSIONS: Percutaneous vertebroplasty and kyphoplasty are two safe and effective techniques for treatment of thoracolumbar traumatic fractures and allow a good pain-control and return to normal working activity and social life.
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Fracturas Óseas/cirugía , Vértebras Lumbares/lesiones , Vértebras Lumbares/cirugía , Vértebras Torácicas/lesiones , Vértebras Torácicas/cirugía , Vertebroplastia/métodos , Femenino , Estudios de Seguimiento , Fracturas Óseas/patología , Humanos , Vértebras Lumbares/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Pruebas Neuropsicológicas , Vértebras Torácicas/patología , Resultado del Tratamiento , Vertebroplastia/efectos adversosRESUMEN
The fabrication and characterization of superconducting and ferromagnetic heterostructures is an open field due to the fundamental interest in the physics of the coexistence of these two competing orders and their possible applications in the spintronics industry. In this paper we present structural, electrical and magnetic characterization for the single La(0.7)Ca(0.3)MnO(3) (LCMO) thin layer, La(0.7)Ca(0.3)MnO(3)/YBa(2)Cu(3)O(7-x) (LCMO/YBCO) bilayers and the LCMO/YBCO/LCMO trilayers. In particular, we show a detailed magnetic characterization of the LCMO thin films by means of low temperature magnetic force microscopy. We discuss the different dynamics of the magnetic domains observed, depending on the substrate induced strain and on the film thickness.
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BACKGROUND: Subjects with irritable bowel syndrome may undergo an excess of cholecystectomy. It is not known, however, whether the cholecystectomy rate parallels an increased risk of gallstones. AIM: Aim was to assess the prevalence and the incidence of gallstones and cholecystectomy in subjects with irritable bowel syndrome symptoms. SUBJECTS AND METHODS: In this population-based study, 29,139 subjects (63.2% of 46,139 randomly selected subjects, age 30-69 years) underwent a physical examination, an interview on gastrointestinal symptoms and an upper abdominal ultrasonography. An identical survey was carried out 7.8+/-1.0 (M+/-S.D.) years later on 8460 gallstone-free subjects at the first survey. Prevalence and incidence of gallstones and cholecystectomy were assessed in subjects with (1) irritable bowel syndrome; (2) abdominal pain and normal bowel; (3) altered bowel and no abdominal pain and (4) asymptomatic controls; univariate and multivariate regression logistic models were used for statistical analysis. RESULTS: Prevalence odds of gallstones and cholecystectomy were significantly higher in irritable bowel syndrome and abdominal pain and normal bowel than in controls. Irritable bowel syndrome and abdominal pain and normal bowel subjects were more aware of gallstones than controls (p<0.001), and the prevalence of gallstones in irritable bowel syndrome subjects unaware of their gallbladder status was not significantly different from the controls. The incidence of gallstone disease in irritable bowel syndrome, abdominal pain and normal bowel, and altered bowel and no abdominal pain subjects did not differ from the controls. The incidence of cholecystectomy was higher in irritable bowel syndrome and abdominal pain and normal bowel groups than in controls and altered bowel and no abdominal pain group. CONCLUSIONS: Irritable bowel syndrome subjects have an increased risk of cholecystectomy that is not due to an increased risk of gallstones, but rather to abdominal pain, awareness of having gallstones, and inappropriate surgical indications.
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Colecistectomía/estadística & datos numéricos , Cálculos Biliares/complicaciones , Cálculos Biliares/epidemiología , Síndrome del Colon Irritable/complicaciones , Adulto , Anciano , Estudios Transversales , Femenino , Cálculos Biliares/cirugía , Humanos , Síndrome del Colon Irritable/epidemiología , Italia/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , PrevalenciaRESUMEN
BACKGROUND: Laws D.Lgs. 626/94 and D.I. 388/03 attach particular importance to the organization of first aid in the workplace. Like every other enterprise, also hospitals and health care facilities have the obligation, as foreseen by the relevant legislation, to organize and manage first aid in the workplace. OBJECTIVES: To discuss the topic in the light of the guidelines contained in the literature. METHODS: We used the references contained in the relevant literature and in the regulations concerning organization of first aid in health care facilities. RESULTS: The regulations require the general manager of health care facilities to organize the primary intervention in case of emergencies in all health care facilities (health care or administrative, territorial and hospitals). CONCLUSIONS: In health care facilities the particular occupational risks, the general access of the public and the presence of patients who are already assumed to have altered states of health, should be the reason for particular care in guaranteeing the best possible management of a health emergency in the shortest time possible.
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Primeros Auxilios , Administración de Instituciones de Salud , Salud Laboral , Instituciones de Salud/legislación & jurisprudencia , ItaliaAsunto(s)
Consentimiento Informado/normas , Competencia Mental/normas , Enfermedades del Sistema Nervioso/terapia , Neurocirugia/normas , Actitud Frente a la Muerte , Neoplasias Encefálicas/psicología , Neoplasias Encefálicas/cirugía , Cuidadores/psicología , Humanos , Consentimiento Informado/psicología , Hemorragias Intracraneales/psicología , Hemorragias Intracraneales/cirugía , Competencia Mental/psicología , Enfermedades del Sistema Nervioso/psicología , Neurocirugia/psicología , Educación del Paciente como Asunto/normas , Relaciones Médico-PacienteRESUMEN
Gene expression is to a large extent controlled at the level of mRNA accumulation. Genes whose products function together are likely under a common regulatory system (e.g., signal transduction pathways, sets of regulatory proteins) such that they are expressed in a coordinated manner. This property has been frequently used in the analysis of genome-wide expression data, as the experimental observation that a group of genes is co-expressed frequently implies that the genes share a common regulatory mechanism. The authors have investigated the situation in which dissimilarity in gene-expression time profiles may still result from the presence of the same regulatory signal, as in the case of common transcription factors. To this aim, a dynamic model that takes into account the effect of specific mRNA degradation on the shape of gene-expression time series has been developed, and the concept of 'dynamically co-regulated' genes has accordingly been introduced as the goodness-of-fit to such a model (called dynamic R2). The statistical analysis of dynamic R2 over a number of different experimental data sets and organisms shows that the presence of dynamically co-regulated genes is by far more significant than that expected from the randomised data. Furthermore, as an example of the usefulness of the proposed method, genome-wide yeast measurements such as cell-cycle time series and transcription factors targets data, were used to prove that dynamic co-regulation is statistically related to the presence of common transcription factor(s). This latter property is very useful when trying to infer computational indications of co-regulation for not-yet annotated genes that do not display a co-expression pattern.
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Perfilación de la Expresión Génica/estadística & datos numéricos , Regulación de la Expresión Génica/genética , Biología de Sistemas/métodos , Ciclo Celular/genética , Biología Computacional/métodos , Genoma Fúngico , Modelos Estadísticos , ARN Mensajero/genética , ARN Mensajero/metabolismo , Elementos Reguladores de la Transcripción , Levaduras/genéticaRESUMEN
AIM: The aim of this retrospective study was to demonstrate the difference in patient outcomes after treatment for bleeding endocranial aneurysms when evaluated with methods based on different assessment criteria. METHODS: The outcome of 237 patients, 141 of which were operated on for anterior communicating artery aneurysm and 96 embolized, was assessed by a new method developed by De Santis. The patients operated on were assessed by the Glasgow Outcome Scale (GOS) and Rank Disability Scale (RDS) and the results of the latter were compared with the new method, the De Santis-CESE (Clinical Emotional Social Evaluation) method, which consists of a clinical evaluation and a numeric scoring system based on seven standard points. Comparison between the three methods showed significantly different outcomes. Patients who underwent surgical operation showed changes in character and behaviour, whereas the others showed cognitive, emotional and sexual habit changes. CONCLUSION: Compared with the GOS and RDS instruments, the CESE method showed significant differences in patient outcome assessment, particularly regarding best outcomes. These differences may be due to the greater sensitivity of the CESE method over the other two scales. Furthermore, surgical patients seemed to achieve a better outcome than endovascular patients. The authors intend to conduct a prospective study to test the results obtained in this retrospective study.
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Evaluación de la Discapacidad , Embolización Terapéutica/efectos adversos , Aneurisma Intracraneal/cirugía , Procedimientos Neuroquirúrgicos/efectos adversos , Evaluación de Resultado en la Atención de Salud/métodos , Complicaciones Posoperatorias/epidemiología , Adolescente , Adulto , Síntomas Afectivos/epidemiología , Anciano , Trastornos del Conocimiento/epidemiología , Embolización Terapéutica/estadística & datos numéricos , Femenino , Escala de Consecuencias de Glasgow , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Pruebas Neuropsicológicas , Procedimientos Neuroquirúrgicos/estadística & datos numéricos , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/psicología , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios Retrospectivos , Disfunciones Sexuales Psicológicas/epidemiologíaRESUMEN
The problem of determining the pupil morphological parameters from pupillometric data is considered. These characteristics are of great interest for non-invasive early diagnosis of the central nervous system response to environmental stimuli of different nature, in subjects suffering some typical diseases such as diabetes, Alzheimer disease, schizophrenia, drug and alcohol addiction. Pupil geometrical features such as diameter, area, centroid coordinates, are estimated by a procedure based on an image segmentation algorithm. It exploits the level set formulation of the variational problem related to the segmentation. A discrete set up of this problem that admits a unique optimal solution is proposed: an arbitrary initial curve is evolved towards the optimal segmentation boundary by a difference equation; therefore no numerical approximation schemes are needed, as required in the equivalent continuum formulation usually adopted in the relevant literature.
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Interpretación de Imagen Asistida por Computador , Iris/anatomía & histología , Pupila , Algoritmos , HumanosRESUMEN
BACKGROUND: The inter-ministerial decree (D.I.) 388/03 (the Italian law on first aid in the workplace) attaches particular importance to the organization of first aid and to the content of the teaching and training of designated workers, specifying teaching objectives, programme and duration of courses. However it provides less details on the requirements and qualifications of the teachers and trainers. OBJECTIVES: To discuss this topic in the light of the guidelines contained in the literature and the existing legislation. METHODS: We used the specific references of literature and legislation concerning first aid training of designated workers. RESULTS: The objectives and the content of the training courses call for a high level of professional competence and approach. Therefore, training of designated workers should be planned and carried out in accordance with the training standards used for the teaching and training of the so-called "lay rescuers". CONCLUSIONS: The need to achieve high training standards for workers responsible for first aid at the workplace is to a large extent justified by the difficulty of the role of employees. This need follows the current tendency in regulations to guarantee adequate and up-dated training also for other agents operating within the system of workplace prevention. In this context the occupational physician plays a significant role in the training programmes for designated workers.
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Medicina de Emergencia/educación , Primeros Auxilios , Servicios de Salud del Trabajador/legislación & jurisprudencia , Medicina del Trabajo/legislación & jurisprudencia , Enseñanza/normas , Accidentes de Trabajo , Servicios Médicos de Urgencia/organización & administración , Medicina de Emergencia/legislación & jurisprudencia , Medicina de Emergencia/organización & administración , Guías como Asunto , Humanos , Agencias Internacionales , Italia , Programas Nacionales de Salud/organización & administración , Servicios de Salud del Trabajador/organización & administración , Rol del Médico , Sociedades Médicas , Enseñanza/legislación & jurisprudencia , Lugar de TrabajoRESUMEN
AIM: The evident rise in the number of neurosurgical malpractice and the apparent lack of adequate training in neurosurgery patient management are discussed. However, alongside neurosurgeons, neurosurgical malpractice claims involve also physicians from primary to specialist care, particularly those attending neurosurgical patients in emergency rooms. Some pathologies and disputed treatments are described. METHODS: The case series includes 138 medical malpractice lawsuits examined over a 10-year period (1992-2002). The pathologies for which disputed treatment led to malpractice lawsuit as well as their frequency are presented. RESULTS: Of the total 138 lawsuits examined, 38 did not involve professional health care workers, whereas the remaining 100 cases involved: neurosurgeons (48 cases); other specialist or primary physicians (51 cases); nursing staff (1 case). These malpractice lawsuits and the relevant pathologies are examined in detail. CONCLUSION: On the basis of personal experience, some considerations and recommendations are suggested for the clinical practice.
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Errores Diagnósticos/legislación & jurisprudencia , Enfermedad Iatrogénica/prevención & control , Mala Praxis/legislación & jurisprudencia , Neurocirugia/legislación & jurisprudencia , Procedimientos Neuroquirúrgicos/efectos adversos , Cuidados Posoperatorios/legislación & jurisprudencia , Diagnóstico Diferencial , Errores Diagnósticos/tendencias , Discectomía/efectos adversos , Servicio de Urgencia en Hospital/legislación & jurisprudencia , Servicio de Urgencia en Hospital/tendencias , Tratamiento de Urgencia/efectos adversos , Epilepsia/diagnóstico , Humanos , Consentimiento Informado/normas , Hipertensión Intracraneal/diagnóstico , Italia , Mala Praxis/tendencias , Mortalidad/tendencias , Neurocirugia/tendencias , Atención de Enfermería/normas , Educación del Paciente como Asunto/normas , Médicos de Familia/legislación & jurisprudencia , Médicos de Familia/estadística & datos numéricos , Cuidados Posoperatorios/efectos adversos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/prevención & control , Traumatismos de la Médula Espinal/diagnóstico , Hemorragia Subaracnoidea/diagnóstico , Resultado del TratamientoRESUMEN
Hepcidin is a recently identified hormone peptide involved in regulation of iron homeostasis. HAMP gene mutations have been described to date in five families with iron overload. We have identified the c.208T>C (p.C70R) mutation in the HAMP gene in a patient affected by a severe form of hereditary hemochromatosis. The variant, occurring in a highly conserved amino acid, disrupts one of the 4 intramolecular disulphide bonds present in hepcidin molecules of all vertebrates, and is presumably able to destabilize the peptide structure. The investigated patient was also found to harbor a heterozygous HFE c.845G>A (p.C282Y) mutation that may have contributed in increasing his iron burden.