Nanostructured 3C-SiC on Si by a network of (111) platelets: a fully textured film generated by intrinsic growth anisotropy.

In this paper, we address the unique nature of fully textured, high surface-to-volume 3C-SiC films, as produced by intrinsic growth anisotropy, in turn generated by the high velocity of the stacking fault growth front in two-dimensional (111) platelets. Structural interpretation of high resolution scanning electron microscopy and transmission electron microscopy data is carried out for samples grown in a hot-wall low-pressure chemical vapour deposition reactor with trichlorosilane and ethylene precursors, under suitable deposition conditions. By correlating the morphology and the X-ray diffraction analysis we also point out that twinning along (111) planes is very frequent in such materials, which changes the free-platelet configuration.

Cambios académicos e institucionales en la escuela secundaria bonaerense durante el primer ciclo de reformas / Academic and institutional changes at the Buenos Aires’ secondary school during the first cycle of reforms

En este trabajo se delimita el período histórico comprendido entre los años 1994 y 2003, que constituyen lo que denominamos primer ciclo de reformas de la educación secundaria de la provincia de Buenos Aires. En primer lugar, a partir del análisis jurídico normativo, se evalúa el impacto de la política de transferencias de los servicios nacionales en la jurisdicción y las políticas que ésta instrumentó para iniciar su proceso de reforma, durante la década del noventa. A continuación se analizan las sucesivas transformaciones en las dimensiones de la organización institucional y de la estructura académica del sistema educativo provincial. Se consideran en particular las modificaciones del régimen de evaluación, calificación y promoción de los estudiantes del nivel secundario ya que demuestran los comportamientos reactivos del sistema ante la aplicación de una reforma sin instancias de una planificación integral efectiva...

[Rheumatoid arthritis: frequency of hospitalization and evaluation of economic burden] / Artrite reumatoide: stima della frequenza dei ricoveri e valutazione dei costi della malattia.

About 10% of the Italian general population is affected by rheumatic diseases (RD). Due to their chronic and disabling nature, RD are cause of an annual economic burden evaluated in about 17,000 billions italian lire. In Italy, rheumatoid arthritis (RA) affects nearly 400,000 people. One hundred RA patients answered to a questionnaire concerning hospitalization during the first ten years of disease. Seventy-two patients needed hospitalization with a total of 147 hospital admissions. Eleven patients were admitted thrice to the hospital, 53 patients twice, and 8 patients only once with a mean number of hospital admissions per patients of 1.8. Hospitalization costs were calculated on the basis of the cost of the DRG for RA and inferred for the total population of Italian RA patients. The result was about 350 billions italian lire. Two methods were used in order to evaluate the economic impact of RA including both direct and indirect costs. First, internationally accepted criteria for cost assessment were applied to the Italian system. Second, different evaluations were performed by the authors. With the first method, direct and indirect costs were 3,000 and 3,500 billions Italian lire, respectively. With the second method, based on a more precise assessment of costs including the costs of wager from a reduction or cessation of work, the total costs for RA was between 3,100 and 3,600 billions Italian lire. Since psychological and social problems often influence patients with RA in relation to their families and society, the issue of intangible costs has also been addressed.

Study of peripheral bone mineral density in patients with diffuse idiopathic skeletal hyperostosis.

Diffuse idiopathic skeletal hyperostosis (DISH) is an ossifying systemic enthesopathy which involves not only the spine but which may also appear in other sites. Degenerative, inflammatory and metabolic factors have been reported for a possible pathogenic role in the new bone growth that characterises DISH. In the present study peripheral bone mineral density (BMD) has been measured in patients affected by DISH and the results compared to those of a control group. Forty-two patients (33 females and 9 males) affected by DISH and 84 controls (66 females and 18 males) were examined. All subjects underwent radiological study of the lumbar and dorsal spine and the pelvis. BMD was evaluated using dual-energy X-ray absorptiometry and the examination was performed in the distal radius. In DISH patients the mean value of BMD was significantly higher than in controls (P<0.002), even when it was referred to sex subgroups. Statistical analysis showed significant differences between both the two male groups (P<0.002) and the two female groups (P<0.01). In the two female subgroups (DISH patients and controls) BMD was significantly inversely related to age and to the duration of the postmenopausal period. The present study showed higher BMD in DISH patients than in the control group.

Relationship of rheumatoid factor isotype levels with joint lesions detected by magnetic resonance imaging in early rheumatoid arthritis.

OBJECTIVE: To evaluate the relationship between rheumatoid factor isotypes and articular damage detected by magnetic resonance imaging and plain radiography in early rheumatoid arthritis. METHODS: 20 consecutive patients with early active rheumatoid arthritis underwent determinations of serum IgM, IgA, and IgG rheumatoid factors by enzyme-linked immunosorbent assay (ELISA). Plain radiographs of the hands and wrists were obtained, and the wrist, metacarpophalangeal joints, and proximal interphalangeal (PIP) joints on the more severely affected side were investigated by magnetic resonance imaging before and after gadolinium-DTPA injection. RESULTS: IgM, IgA, and IgG rheumatoid factors were found in 13 (65%), 13 (65%), and 15 (75%) of patients, respectively. Sera from five patients (25%) contained no detectable rheumatoid factor isotypes. Correlations were found among the levels of the three rheumatoid factor isotypes. Levels of IgA, IgG, and IgM rheumatoid factor were significantly higher in patients with than without erosions on magnetic resonance imaging scans. No such difference was found when patients with and without erosions on plain radiographs were compared. Magnetic resonance imaging detected soft tissue lesions more frequently than plain radiography. Magnetic resonance imaging was also more likely than plain radiography to show bone erosions and bone cysts, but this difference was not statistically significant. CONCLUSIONS: Quantitative rheumatoid factor isotype assays and magnetic resonance imaging evaluation of erosions of the hand and wrist may be useful for investigating patients with early rheumatoid arthritis.

Time course of radiologic lesions in spinal hyperostosis: an osteoradiometric study.

The purpose of this study was to evaluate changes over time in the flowing spinal ossification characteristic of spinal hyperostosis. Thirty-two patients were studied. A QR-ORM osteoradiometry apparatus was used to measure variations in the surface area of the ossification on radiographs obtained after three, ten, and 20 years. The size of the ossification increased gradually in every case. Patients with a small ossification on the initial radiograph and younger patients were more likely to have larger ossification size increases over time; male gender and diabetes mellitus had a similar effect, although the differences were not significant, perhaps because of the small number of subjects. The magnitude of the ossification increase was not the same on the anteroposterior and lateral films at the various time points. The rate of ossification increase was slower in patients with long-standing disease or osteoporosis, although differences were not statistically significant. Over time, the density of the ossification increased, particularly near the vertebral bodies, perhaps as a result of transformation of fibrocartilage tissue into compact bone tissue.

Somatostatin 14 and joint inflammation: evidence for intraarticular efficacy of prolonged administration in rheumatoid arthritis.

Previous studies with intraarticular administration of somatostatin (SST14) in rheumatoid arthritis showed an antiinflammatory and analgesic effect. The aim of the present study was to demonstrate the efficacy and tolerability of SST14 in rheumatoid arthritis (RA) patients for a longer period of treatment than previously scheduled. Forty-one patients with RA of the knee were treated with a cycle of intraarticular injection of 750 micrograms of SST14, every 15 days. The efficacy of SST14 was evaluated by determining acute phase parameters (erythrocyte sedimentation rate, C-reactive protein [CRP]) and by clinical assessment (pain at rest and on movement, joint tenderness, morning stiffness, spontaneous pain). Additionally, telethermography was performed to evaluate the intensity of the joint inflammation. The tolerability of the treatment was also assessed both by patients and physicians. SST14 produced a reduction in all parameters; this was already statistically significant after the second injection in terms of pain at rest and on movement, and after the third injection for all other symptoms. The treatment showed an excellent tolerability, both local and systemic. Our results indicate the analgesic property of SST14 and demonstrate its capacity to reduce progressively joint inflammation confirmed by thermography and by reduction of pain, after a month of therapy.

Intra-articular somatostatin 14 reduces synovial thickness in rheumatoid arthritis: an ultrasonographic study.

Sixteen patients with RA (3 males, 13 females), diagnosed according to RA revised criteria, were selected and entered the study. They underwent six intra-articular injections of 750 mcg of SST14 at 15-day intervals. The thickness of the synovial membrane (SM) was measured with a 5-MHz linear sound with longitudinal and transversal scanning carried out on the upper patellar cavity. The contralateral knee was also assessed together with the injected knee in order to ascertain any systemic effect of the drug. A significant reduction of SM thickness was observed already at the first control (T3) in 14 out of 16 patients. At the 5th and 6th injections (T5 and T6) the reduction was still significant but to a lower extent. In 8 out of 16 cases a reduction of SM thickness was observed in the contralateral knee. Analysis of these data clearly shows that the intra-articular injection of SST14 is able to reduce the thickness of SM in patients with RA, and indicates that SST14 may directly reduce synovitis. This particularity has been detected in our work with a non-invasive technique such as the joint ultra-sound (US). In conclusion, our work confirms the efficacy of SST14 in the control of RA synovial hypertrophy and the reliability of US technique in the measurement of SM thickness.

[Intra-articular treatment with somatostatin 14 in rheumatoid arthritis]. / Trattamento endoarticolare con somatostatina 14 nell'artrite reumatoide.

19 patients with RA underwent six intraarticular injections of 750 micrograms of Somatostatin 14 in one knee at 15-day intervals. In all patients some clinical parameters were evaluated: articular function, pain on pressure, spontaneous pain, pain on movement, duration of morning stiffness. Also some laboratory parameters were examined: complete blood cell count, ESR and CRP. An overall and significant improvement of the symptomatology of the treated knee was seen in all patients especially after the 3rd infiltration and still more after the 5th. At follow up 3 months after the end of treatment 12 patients were controlled, 11 of these showed a persistence of the improvement. No side-effects were seen.

[Synchronous tumors of the colon]. / I tumori sincroni del colon.

Although rare, synchronous tumors of the colon represent an important clinical manifestation of cancer of the colon. The paper reports a study carried out in 437 patients with the aim of evaluating the incidence of synchronous tumours and identifying the most useful diagnostic tools for diagnosis. On the basis of the results obtained the authors conclude that the incidence of synchronous tumours of the colon ranges between 1-3% and that in comparison to other methods pancolonoscopy enables a complete diagnosis for a prophylactic approach to multiple tumours.

[Simultaneous bilateral primary lymphomatous tumors of the testis]. / Tumore primitivo sincrono bilaterale linfomatoso del testicolo.

Among the malignant tumours of the gonads, primary lymphoma of the testis represents a rare pathology. It is even more rare to observe this pathology in a bilateral localisation. After a careful evaluation of the cases described in the literature, the authors report a case or primary synchronous and bilateral lymphoma of the testis in a 68-year-old patient; they examine the clinical data and diagnostic methods and analyse the surgical treatment. In conclusion the authors affirm that primary synchronous bilateral lymphoma of the testis represents a rare form of tumour which is burdened by a high mortality rate.

[Current etiopathogenic guides in pulmonary embolism]. / Attuali orientamenti etiopatogenetici dell'embolia polmonare.

Pulmonary embolism is still a dangerous postoperative complication in spite of antithrombotic prophylaxis. The paper examines the etiopathogenetic stages of the disease and stresses the relevance of Wircov's triad today, even in the light of recent acquisitions which highlight the role of endothelium as a modulator of the fibrinolytic process.

[The diabetic foot]. / Il piede diabetico.

The rise in the mean age and the increase in diabetes have frawn the surgeon's attention to gangrene of the lower limb which requires a multidisciplinary approach (doctor, surgeon, prosthesis specialist). Contrary to the concept of high thigh amputation, the possibility of carrying out a lumbar sympathectomy has encouraged the idea of a more distal amputation with conservation of physiological joints and an early recovery of function thus enabling patients who would otherwise have been condemned to permanent invalidity to return to social life.

Barriers to bicycle helmet use among children. Results of focus groups with fourth, fifth, and sixth graders.

As a preliminary step in the development of a school-based educational intervention to promote bicycle helmet use among children, focus group encounters were conducted with fourth, fifth, and sixth graders at three elementary schools in the Boston, Mass, area. Analysis of transcripts of encounter tape recordings indicated that (1) the prevalence of helmet ownership and use was low, (2) children were concerned that helmet use would invite derision from their peers, and (3) children tended to respect other children who wore helmets. We concluded that focus groups can be useful in conceptualizing health education interventions and suggest that school-based peer-led bicycle helmet programs may be effective in developing normative change toward helmet use among elementary schoolchildren.

[Physiokinesitherapeutic management of traumatic lesions of the brachial plexus. Indications and results]. / Il trattamento fisiokinesiterapico delle lesioni traumatiche del plesso brachiale. Indicazioni e risultati.

An account is given of the indications and results of physical and rehabilitative management of brachial plexus lesions when used electively or as a complement to surgery. Material from the Florence Traumatological and Orthopaedics Centre and the V. Putti Mutilated Patients Centre, Bologna (formerly directed by Prof. O. Scaglietti) dating from 1940 to 1980 is used to explain the indications for conservative and surgical management, in the conviction that sound results depend on exact indication. A selected sample of 51 patients treated conservatively and 194 surgically is presented. The results were satisfactory in about 50% of each group, with a slight advantage in favour of physiotherapy, this being obviously employed when lesions were less severe.

Glucose-induced GIP levels in patients with insulinoma.

Gastric inhibitory polypeptide (GIP) levels during an oral glucose tolerance test (OGTT) have been determined in eight patients suffering from a single benign beta-cell adenoma. GIP hypersecretion and an absent correlation between the insulin: glucose ratio and plasma GIP concentration have been observed. Our data show that the insulinotropic effect of GIP is almost abolished in insulinoma patients. This finding may help explain blood glucose levels and the inappropriate plasma insulin response to oral glucose often observed in these patients.

Effect of bombesin on plasma insulin, pancreatic glucagon, and gut glucagon in man.

The effect of bombesin on insulin, pancreatic glucagon, and gut glucagon was investigated in eight healthy volunteers and two pancreatectomized patients. Bombesin, infused iv at the constant rate of 5 ng kg-1 min-1, produced a sharp and statistically significant rise in the plasma insulin concentration. The peak was reached at 5 min (26 +/- 2.17 microU/ml; P less than 0.005 vs. basal values), followed by a prolonged and statistically significant (P less than 0.05) decrease in blood glucose. Pancreatic glucagon rapidly rose to a maximal value of 80.5 +/- 7.6 pmol/liter (P less than 0.005 vs. basal values). In contrast with the prompt increase in insulin and glucagon plasma levels, the peak in gut glucagon concentration (55.8 +/- 4.6 pmol/liter; P less than 0.005 vs. basal values) was reached 30 min after bombesin infusion was discontinued. In the two pancreatectomized patients, bombesin induced an increase in gut glucagon concentrations only. The results presented indicate that bombesin acts directly on the A and B cells of the pancreas, influencing glucose homeostasis; however, more complex mechanisms seem to be involved in gut glucagon secretion.

Diazoxide infusion test in patients with single benign insulinoma.

The diazoxide infusion test (600 mg i.v. over a 1-hour period) was performed in 12 patients bearing single benign islet B-cell adenoma and in 6 normal subjects. Blood glucose, plasma insulin and glucagon concentrations were measured every 15 min during the infusion and thereafter up to 150 min. In insulinoma patients, blood glucose levels failed to increase significantly while in the control group a significant rise starting from 30 min persisted throughout the test (p less than 0.05 or less). Plasma insulin mean levels decreased significantly in normal subjects from 30 to 60 min (p less than 0.05), while they were significantly suppressed in hypoglycemic patients from 15 to 120 min (p less than 0.02). Diazoxide administration induced in the normal group a significant decrease in glucagon levels (p less than 0.02 from 30 to 150 min) whereas no such suppression occurred in patients. In our experience, insulin response to diazoxide infusion in patients with insulinoma may provide additional information for diagnosis.