Early use of TIPS in patients with cirrhosis and variceal bleeding.

Background Patients with cirrhosis in ChildPugh class C or those in class B who have persistent bleeding at endoscopy are at high risk for treatment failure and a poor prognosis, even if they have undergone rescue treatment with a transjugular intrahepatic porto - systemic shunt (TIPS). This study evaluated the earlier use of TIPS in such patients. Methods We randomly assigned, within 24 hours after admission, a total of 63 patients with cirrhosis and acute variceal bleeding who had been treated with vasoactive drugs plus endoscopic therapy to treatment with a polytetrafluoroethylene-covered stent within 72 hours after randomization (early-TIPS group, 32 patients) or continuation of vasoactive-drug therapy, followed after 3 to 5 days by treatment with propranolol or nadolol and long-term endoscopic band ligation (EBL), with insertion of a TIPS if needed as rescue therapy (pharmacotherapyEBL group, 31 patients). Results During a median follow-up of 16 months, rebleeding or failure to control bleeding occurred in 14 patients in the pharmacotherapyEBL group as compared with 1 patient in the early-TIPS group (P=0.001). The 1-year actuarial probability of remaining free of this composite end point was 50% in the pharmacotherapyEBL group versus 97% in the early-TIPS group (P<0.001). Sixteen patients died (12 in the pharmacotherapyEBL group and 4 in the early-TIPS group, P=0.01). The 1-year actuarial survival was 61% in the pharmacotherapyEBL group versus 86% in the early-TIPS group (P<0.001). Seven patients in the pharmacotherapyEBL group received TIPS as rescue therapy, but four died. The number of days in the intensive care unit and the percentage of time in the hospital during follow-up were significantly higher in the pharmacotherapyEBL group than in the early-TIPS group. No significant diferences were observed between the two treatment groups with respect to serious adverse events. Conclusions In these patients with cirrhosis who were hospitalized for acute variceal bleeding and at high risk for treatment failure, the early use of TIPS was associated with signif icant reductions in treatment failure and in mortality. (Current Controlled Trials number, ISRCTN58150114.)

Pretreatment with statins improves early outcome in patients with first-ever ischaemic stroke: a pleiotropic effect of statins or a beneficial effect of hypercholesterolemia?

Background: Data from different studies suggest a favourable association between pretreatment with statins or hypercholesterolemia and outcome after ischaemic stroke. We examined whether there were differences in in-hospital mortality according to the presence or absence of statin therapy in a large population of first-ever ischaemic stroke patients and assessed the influence of statins upon early death and spontaneous neurological recovery. Methods: In 2,082 consecutive patients with first-ever ischaemic stroke collected from a prospective hospital-based stroke registry during a period of 19 years (1986-2004), statin use or hypercholesterolemia before stroke was documented in 381 patients. On the other hand, favourable outcome defined as grades 0-2 in the modified Rankin scale was recorded in 382 patients. Results: Early outcome was better in the presence of statin therapy or hypercholesterolemia (cholesterol levels were not measured) with significant differences between the groups with and without pretreatment with statins in in-hospital mortality (6% vs 13.3%, P = 0.001) and symptom-free (22% vs 17.5%, P = 0.025) and severe functional limitation (6.6% vs 11.5%, P = 0.002) at hospital discharge, as well as lower rates of infectious respiratory complications during hospitalization. In the logistic regression model, statin therapy was the only variable inversely associated with in-hospital death (odds ratio 0.57) and directly associated with favourable outcome (odds ratio 1.32).

Effect of olive oil on early and late events of colon carcinogenesis in rats: modulation of arachidonic acid metabolism and local prostaglandin E2 synthesis.

BACKGROUND Animal model studies have shown that the colon tumour promoting effect of dietary fat depends not only on the amount but on its fatty acid composition. With respect to this, the effect of n9 fatty acids, present in olive oil, on colon carcinogenesis has been scarcely investigated. AIMS To assess the effect of an n9 fat diet on precancer events, carcinoma development, and changes in mucosal fatty acid composition and prostaglandin (PG)E2 formation in male Sprague-Dawley rats with azoxymethane induced colon cancer. METHODS Rats were divided into three groups to receive isocaloric diets (5% of the energy as fat) rich in n9, n3, or n6 fat, and were administered azoxymethane subcutaneously once a week for 11 weeks at a dose rate of 7.4 mg/kg body weight. Vehicle treated groups received an equal volume of normal saline. Groups of animals were colectomised at weeks 12 and 19 after the first dose of azoxymethane or saline. Mucosal fatty acids were assessed at 12 and 19 weeks. Aberrant crypt foci and the in vivo intracolonic release of PGE2 were assessed at week 12, and tumour formation at week 19. RESULTS Rats on the n6 diet were found to have colonic aberrant crypt foci and adenocarcinomas more often than those consuming either the n9 or n3 diet. There were no differences between the rats on the n9 and n3 diets. On the other hand, administration of both n9 and n3 diets was associated with a decrease in mucosal arachidonate concentrations as compared with the n6 diet. Carcinogen treatment induced an appreciable increase in PGE2 formation in rats fed the n6 diet, but not in those fed the n3 and n9 diets. CONCLUSIONS Dietary olive oil prevented the development of aberrant crypt foci and colon carcinomas in rats, suggesting that olive oil may have chemopreventive activity against colon carcinogenesis. These effects may be partly due to modulation of arachidonic acid metabolism and local PGE2synthesis.

Changes of the mucosal N3 and N6 fatty acid status occur early in the colorectal adenoma-carcinoma sequence

Despite data favouring a role of dietary fat in colonic carcinogenesis, no study has focused on tissue n3 and n6 fatty acid (FA) status in human colon adenoma-carcinoma sequence. Thus, FA profile was measured in plasma phospholipids of patients with colorectal cancer (n = 22), sporadic adenoma (n = 27), and normal colon (n = 12) (control group). Additionally, mucosal FAs were assessed in both diseased and normal mucosa of cancer (n = 15) and adenoma (n = 21) patients, and from normal mucosa of controls (n = 8). There were no differences in FA profile of both plasma phospholipids and normal mucosa, between adenoma and control patients. There were considerable differences, however, in FAs between diseased and paired normal mucosa of adenoma patients, with increases of linoleic (p = 0.02), dihomogammalinolenic (p = 0.014), and eicosapentaenoic (p = 0.012) acids, and decreases of alpha linolenic (p = 0.001) and arachidonic (p = 0.02) acids in diseased mucosa. A stepwise reduction of eicosapentaenoic acid concentrations in diseased mucosa from benign adenoma to the most advanced colon cancer was seen (p = 0.009). Cancer patients showed lower alpha linolenate (p = 0.002) and higher dihomogammalinolenate (p = 0.003) in diseased than in paired normal mucosa. In conclusion changes in tissue n3 and n6 FA status might participate in the early phases of the human colorectal carcinogenesis.

Role of technetium-99m diphosphonate and gallium-67 citrate bone scanning in the early diagnosis of infectious spondylodiscitis: a comparative study

A comparative study of the parts played by technetium-99m diphosphonate and gallium-67 citrate bone scanning in the early diagnosis of infectious spondylodiscitis is presented. Nineteen patients were included in the study. All patients (11 men aged 19-70 years and eight women aged 18-72 years) had a history of back pain varying in duration from one to 15 weeks. A 99mTc diphosphonate bone scan was positive in 17 patients. The two patients with negative results had less than two weeks of back pain. The 67Ga citrate bone scan showed uptake in all patients.

Chemical etching without acids: from early etching solutions to today's corrosive salts

Conferència impartida a l'Accademia di Belle Arti di Bologna en motiu de de les jornades "Atossico incisione e la sua introduzione in istruzione superiore", del 25 al 27 de gener del 2011 a Bologna

From local groups to early states: the development of complexity in protohistoric Catalonia

La recerca sobre la protohistoria de Catalunya s'ha fonamentat tradicionalment en la historia cultural, pero el treba11 deIs darrers vint-i-cinc anys ha comenat a donar 11um sobre aspectes crucials com el canvi social i la formació de l'Estat arcaico Aquest article és una visió general sobre aquests temes. S'hi analitza particularment el paper del creixement demogrMic com a element crucial del canvi social, pero també s'hi té en compte el paper que eventualment hi hagin pogut tenir els moviments de població i el comerç colonial.

Immunomodulation by conjugated linoleic acid (CLA) in early life

Conjugated linoleic acid (CLA) has been reported to exert beneficial physiological effects on body composition and the immune system. However, little information is available on the influence of CLA on immune function during early life periods. The present study evaluates the effect of feeding an 80:20 mixture of cis-9,trans-11- and trans-10,cis-12-CLA isomers duringgestation, suckling and early infancy on the systemic and mucosal immune responses of Wistar rats at three different time points: at the end of the suckling period (21-day-old rats), in early infancy (28-day-old rats), and later in life (adulthood). Cis-9,trans-11- and trans-10,cis-12-CLA isomers were detected in the milk of CLA-fed dams and in the plasma of all CLA-supplemented pups, and the highest content was achieved in those rats supplemented over the longest period. Dietary supplementation with that CLA mix enhances the systemic production of the main in vivo and ex vivo immunoglobulin (Ig) isotypes in 21- and 28-day-old rats. Moreover, CLA supplementation during suckling and early infancy also enhances the humoral immune defenses at intestinal level, by means of mucosal IgA increase, whereas down-regulates thesystemic lymphoproliferative response. Finally, we described herein how feeding a diet enriched with the same isomer mix of cis9,trans11- and trans10,cis12-CLA from gestation to adulthood improves the capacity of adult rats to achieve a specific systemic and mucosal immune responses. All these data support the immunomodulatory effects of dietary supplementation of CLA, particularly of the cis9,trans11-CLA isomer, during early stages of life on immune system development, as well as the long-term effects on the specific immune response in adult age.

On the coincidence of the Mas-Colell bargaining set and the core

In this paper we prove that the Mas-Colell bargaining set coincides with the core for three-player balanced and superadditive cooperative games. This is no longer true without the superadditivity condition or for games with more than three-players. Furthermore, under the same assumptions, the coincidence between the Mas-Collel and the individual rational bargaining set (Vohra (1991)) is revealed. Keywords: Cooperative game, Mas-Colell bargaining set, balancedness, individual rational bargaining set. JEL classi fication: C71, D63, D71.

Gifts of Mars: Warfare and Europe's early rise to riches

Today, per capita income differences around the globe are large ? varying by as much as a factor of 35 across countries (Hall and Jones 1999). These differentials mostly reflect the "Great Divergence" (Sam Huntingon) ? the fact that Western Europe and former European colonies grew rapidly after 1800, while other countries grew much later or stagnated. What is less well-known is that a "First Divergence" preceded the Great Divergence: Western Europe surged ahead of the rest of the world long before technological growth became rapid. Europe in 1500 was already twice as rich on a per capita basis as Africa, and one-third richer than most of Asia (Maddison 2007). In this essay, we explain how Europe's tumultuous politics and deadly penchant for warfare translated into a sustained advantage in per capita incomes.

Evaluación de la psicopatología del preescolar mediante el Early Childhood Inventory-4 (ECI-4): concordancia entre padres y maestros.= Assessment of psychopathology in preschool age children through the Early Childhood Inventory-4 (ECI-4): Agreement among parents and teachers

El objetivo principal de este estudio es conocer la concordancia entre informantes, padres y maestros,en cada una de las dimensiones o categorías diagnósticas del Early Childhood Inventory-4 (ECI-4).Además, se pretende analizar la influencia de la presencia de problemas de salud en los padres en ladescripción y valoración de la conducta de una muestra de 204 alumnos de preescolar (3 a 6 años) deperfiles socioeconómicos diferentes. Los resultados indican que los padres tienden a valorar con mayorseveridad los síntomas, observándose una mayor concordancia entre informantes en los relativos alos trastornos del desarrollo

Multimodal Strategies in Development.Predictive Value of early simultaneosgesture-speech comination

The present study investigates the predictive value of the early appearance of simultaneous pointing-speech combinations. An experimental task was used to obtain a communicative productive sample from nineteen children at 1;0 and 1;3. Infant’s communicative productions, in combination with gaze joint engagement patterns, were analyzed in relation to different social conditions. The results show a significant effect of age and social condition on infants’ communicative productions. Gesture-speech combinations seem to work as a strong communicative resource to attract the adult’s attention in social demanding communicative contexts. Gaze joint engagement was used in combination with simultaneous pointing-speech combinations to attract adults’ attention during social demanding conditions. Finally, the use of simultaneous pointing-speech combinations at 1;0 in demanding conditions predicted greater expressive vocabulary acquisition at 1;3 and 1;6. These results indicate that the use of gesture-speech combinations may be considered a significant step towards the early integration of language components.

Wages and prices in early Catalan industrialisation

[eng] Catalonia was the only Mediterranean region among the early followers of the British Industrial Revolution in the second third of the nineteenth century. The roots of this industrialisation process can be traced back to the seventeenth and eighteenth centuries when the Catalan economy became successfully integrated in international trade and the region enjoyed an intensification of its agrarian and proto-industrial activities. These capitalist developments were subsequently reinforced by a successful printed calico manufacturing business concentrated in the city of Barcelona. Although the factory system was largely adopted by the cotton industry in the 1840s, the diffusion of the spinning jenny had occurred earlier in the 1790s. In this paper, in line with Allen (2009a, 2009b), we explore whether relative factor prices played a role in the widespread adoption of the spinning jenny in Catalonia.

Wages and prices in early Catalan industrialisation

[eng] Catalonia was the only Mediterranean region among the early followers of the British Industrial Revolution in the second third of the nineteenth century. The roots of this industrialisation process can be traced back to the seventeenth and eighteenth centuries when the Catalan economy became successfully integrated in international trade and the region enjoyed an intensification of its agrarian and proto-industrial activities. These capitalist developments were subsequently reinforced by a successful printed calico manufacturing business concentrated in the city of Barcelona. Although the factory system was largely adopted by the cotton industry in the 1840s, the diffusion of the spinning jenny had occurred earlier in the 1790s. In this paper, in line with Allen (2009a, 2009b), we explore whether relative factor prices played a role in the widespread adoption of the spinning jenny in Catalonia.

Wages and prices in early Catalan industrialisation

[eng] Catalonia was the only Mediterranean region among the early followers of the British Industrial Revolution in the second third of the nineteenth century. The roots of this industrialisation process can be traced back to the seventeenth and eighteenth centuries when the Catalan economy became successfully integrated in international trade and the region enjoyed an intensification of its agrarian and proto-industrial activities. These capitalist developments were subsequently reinforced by a successful printed calico manufacturing business concentrated in the city of Barcelona. Although the factory system was largely adopted by the cotton industry in the 1840s, the diffusion of the spinning jenny had occurred earlier in the 1790s. In this paper, in line with Allen (2009a, 2009b), we explore whether relative factor prices played a role in the widespread adoption of the spinning jenny in Catalonia.