Las enfermedades cardiovasculares, subgrupo de enfermedades crónicas no trasmisibles, constituyen un importante problema de salud pública, no solo por su magnitud, reflejada en el primer lugar que ocupan entre las causas de morbi-mortalidad en el mundo, sino por su elevado poder discapacitante. Según la OMS cada año mueren más personas por esta causa que por otra. Se calcula que en 2005 murieron por esta causa 17,5 millones de personas, lo cual representa un 30% de todas las muertes registradas en el mundo; 7,6 millones de esas muertes se debieron a la cardiopatía coronaria, y 5,7 millones a los AVC. Las causas más importantes de las enfermedades cardiovasculares son los factores de riesgo. El objetivo de este estudio es cuantificar la prevalencia de los factores de riesgo cardiovascular, en el año 2008, en la población urbana del estado Lara, Venezuela. La población objetivo de este estudio esta constituida por residentes del área urbana del estado Lara, Venezuela, con 15 o más años de edad. El muestreo realizado se asocia a un diseño complejo, en cuatro etapas por conglomerados dado que se agrupan unidades urbanas en una mayor, que combina la selección aleatoria simple y sistemática de las unidades sin reemplazo. Resultado: Del total de individuos seleccionados para encuestar fueron 1675, de los cuales se entrevistó a 1294. Las prevalencias estimadas de los diferentes factores de riesgos para las enfermedades cardiovasculares fueron: El sedentarismo resultó ser la más alta prevalencia (47,6%), siendo mayor en las mujeres que en los hombres, seguida de la hipertensión, una de cada tres personas son hipertensas siendo esta mayor en hombres que en las mujeres, así como la diabetes resultó ser la menor prevalencia (5%), una de cada cinco personas presentan el factor de riesgo de tabaquismo y/o obesidad, siendo en ambas mayor en hombres que en las mujeres y una de cada seis personas tienen el colesterol alto, sin diferencia importante por sexo. Conclusiones: La prevalencia de hipertensión arterial, la obesidad y el sedentarismo en la población urbana de 15 o más años de edad se puede considerar alta. Las personas entrevistadas manifestaron conocer bien las consecuencias que genera la presión arterial elevada. Los resultados encontrados en relación a la prevalencia de angina de pecho, sugieren que en el grupo de edad 25 a 44 años existen diferencias entre hombres y mujeres, mientras que en el grupo de 45 a 74 años, no. / Cardiovascular diseases, which form a subgroup of non-transmisible chronic diseases, constitue a key problem of public health, not only in its magnitude, as manifested in the fact that they are the primary cause of morbimortality in the world, but also for its high disability power. According to the WHO, every year more people die of this cause than of any other. It was calculated that in 2005, 17.5 million people died of this cause, which represented 30% of all deaths registered in the world; 7.6 million of these deaths were due to coronary cardiopathies, and 5.7 million were affected by some AVC. The most important causes of cardiovascular diseases are risk factors.The main objective is to quantify the prevalence of cardiovascular risk factors, in 2008, among the urban population at Lara’s state in Venezuela. The purpose of this study is an analysis of a group of people aged above 15 years in the urban area of Lara’s state in Venezuela. The sampling is associated with a complex design of analysis divided into four phases for a conglomerate of population that belong to a bigger unit of population, the one combine the simple aleatory and systemic selection of the units without replacement. Results: The total number of people chosen for the survey was 1675, of which 1294 were interviewed. The results of estimated prevalence of the different risk factors for cardiovascular desease were: firstly, a sedentary lifestyle had the highest prevalence (47.6 %), this percentage was higher among women than men; the second highest prevalence was hypertension, where one above three persons had hypertension, this proportion being higher among women than in men; thirdly, diabetes had the least prevalence (5%); the last group there were smokers and/or obese people, where in both was higher among men than in women. In this last group, one of every six persons showed a higher cholesterol, independently of sex gender. Conclusions:The prevalence of high blood pressure, obesity and a sedentary lifestyle can be considered as higher in the urban population over the age of 15 years. The interviewed individuals showed well enough to know the consequences generated by a high blood pressure. The results found in relation to the prevalence of angina pectoris suggest that in the age group 25 - 44 years old there are differences between men and women, whereas in the group between 45-74 years, there were no gender differences.

Studio osservazionale condotto presso la Dermatologia dell'Università di Bologna atto a valutare l'efficacia di methotrexate e, in particolare, la sua influenza sui titoli degli autoanticorpi patogeni nei pazienti affetti dalla malattia rara Pemfigoide Bolloso / Observational study to evaluate efficacy of methotrexate in bullous pemphigoid and in particular to evaluate the influence of methotrexate on the titres of pathogenic autoantibodies in patients affected by bullous pemphigoid

Le neoplasie cutanee non melanoma (NMSCs) hanno un’aumentata incidenza tra i pazienti trapiantati d’organo. L’obiettivo di questo studio è quello di comparare gli aspetti clinico-patologici dei NMSCs dei pazienti trapiantati con quelli dei soggetti immunocompetenti. A questo scopo abbiamo analizzato i NMSCs insorti tra i pazienti trapiantati dell’ Ambulatorio Pazienti Immunocompromessi della Dermatologia di Bologna (132 SCCs e 119 BCCs), nel periodo Gennaio 2013/Dicembre 2015, confrontandoli con un numero equivalente di NMSC (132 SCCs e 119 BCCs) insorti tra i pazienti immunocompetenti del Centro Tumori Cutanei della Dermatologia di Bologna. I pazienti trapiantati erano in media 12 anni più giovani al momento della diagnosi di NMSCs rispetto ai pazienti immunocompetenti; i tumori nei trapiantati erano più spesso multipli ed extracefalici. Una componente istologica a cellule fusate era più comune tra i CCSs dei pazienti trapiantati, una componente superficiale era invece più frequente tra i BCCs dei pazienti sottoposti a trapianto. Il decorso si è rivelato peggiore per gli SCCs dei pazienti trapiantati ma non per i BCCS. Questi risultati hanno un’implicazione diretta nella pratica clinica quotidiana. L’aumentata incidenza di NCSCs nei pazienti trapiantati e la loro distribuzione in sedi differenti rispetto ai soggetti immunocompetenti sottolineano l’importanza di un’attenta sorveglianza cutanea in questo gruppo di pazienti. Gli SCCs dei trapiantati, in particolare quelli a cellule fusate, dovrebbero richiedere un trattamento più aggressivo, che non è invece necessario per i BCCs. Infine i nostri dati sono a favore di una differente eziopatogenesi dei NMSCs nei trapiantati che potrebbero influenzare le future stategie di prevenzione e terapia. / Non-melanoma skin cancers (NMSCs) are increased in organ transplant recipients The objective of this study is to compare clinicopathologic features of transplant and immunocompetent NMSCs. For this reason we have analyzed consecutive transplant NMSCs (132 SCCs, 119 BCCs) and immunocompetent NMSCs (132 SCCs, 119 BCCs) presenting between January 2013 and December 2015. Transplant patients were 12 years younger at time of NMSC diagnosis compared with immunocompetent individuals, and transplant tumors were often more multiple and extracephalic. Spindle cell morphology was more common in transplant SCCs, a superficial component was more common in transplant BCCs. Outcome was worse for transplant SCCs but not transplant BCCs. These findings have direct implications for clinical care. The increased frequency and distribution of transplant NMSCs underscore the importance of whole-body surveillance. Transplant SCCs, particularly those with diffuse spindle cell change, may require more aggressive management, whereas transplant BCCs do not. Finally, our data support differences in the pathogenesis of transplant NMSC, which may influence future preventive and therapeutic strategies.

Questa tesi si basa su uno studio retrospettivo clinico, dermatoscopico e istopatologico sulle follicoliti superficiali del cuoio capelluto. Le follicoliti superficiali del cuoio capelluto rappresentato un gruppo di patologie di frequente riscontro nella pratica ambulatoriale, ma poco descritte in letteratura. La chiave per comprendere questo vasto argomento della tricologia è capire prima di tutto la sede e le caratteristiche dell’insulto infiammatorio a livello del follicolo pilifero. In base al tipo di processo infiammatorio si può così risalire al fattore scatenante ed impostare la terapia specifica per bloccare l’infiammazione prima di creare un danno permanente ai follicoli con alopecia cicatriziale. Lo scopo di questa tesi è descrivere le patologie che si presentano clinicamente come follicoliti del cuoio capelluto, identificarne le cause e le caratteristiche, per creare una classificazione standardizzata. Per ognuna delle patologie analizzate si è cercato di descrivere le peculiarità cliniche sia da un punto di vista obiettivo che soggettivo, gli strumenti necessari dal punto di vista diagnostico, nonché alcuni accenni di terapia, confrontando le nozioni già note con gli ultimi studi presenti in letteratura. Gli strumenti usati in questo studio sono stati di due tipi: non invasivo ed invasivo. Lo strumento non invasivo utilizzato è stata la dermatoscopia, una tecnica che consente di osservare ad alto ingrandimento il cuoio capelluto ed i capelli valutando le condizioni della cute e dei follicoli piliferi. Lo strumento di tipo invasivo utilizzato è stata la biopsia cutanea in sede di follicolite con relativo esame istologico. E’ anche stato effettuato l’esame colturale nella gran parte dei casi. Attraverso questo studio retrospettivo clinico, dermatoscopico e istopatologico abbiamo voluto raccogliere tutti i pazienti che si sono presentati con un quadro clinico di follicoliti superficiali del cuoio capelluto e cercare una correlazione tra la diagnosi dermatoscopica e la diagnosi istologica. / This study is based on a retrospective clinical, dermoscopic and histopathology study on the superficial folliculitis of the scalp. Superficial folliculitis of the scalp represented a group of diseases frequently visited in clinical practice, but a few case reports are described in the literature. Their classification can be so difficult, especially for dermatologists without trichological experience, and since today there is no standardized classification. The key to understand this diseases is to know, first of all, the inflammatory characteristics of the infiltrate of the hair follicle. On the basis of the type of inflammatory process, it is possible to find the trigger factors and gives the specific therapy to block the inflammation before creating permanent damage to the follicles with scarring alopecia. The purpose of this study is to describe the diseases that clinically occur as scalp folliculitis, identify the causes and characteristics of the disease, and create a standardized classification. For each type of folliculitis, we tried to describe the clinical features both an objective and subjective point of view, the tools for the diagnosis and the therapy, comparing what is know in the literature. The instruments used in this study were of two types: non-invasive and invasive. The non-invasive tool used was the dermoscopy, a technique that permit to observe at high magnification the scalp and hairs, evaluating the conditions of the skin and hair follicles. The invasive instrument used was skin biopsy in the site of folliculitis with histological examination. It was also performed a culture examination in most cases. Through this clinical, dermoscopic and histopathological retrospective study, we collected all the patients who presented with a clinical aspect of superficial folliculitis of the scalp and find a correlation between the dermoscopic and histological diagnosis.

Il carcinoma a cellule basali (BCC) costituisce l'80 peercento dei tumori cutanei non-melanoma, rappresentando dunque il tumore maligno della cute più frequente nella popolazione generale. Tuttavia, non esistono ad oggi studi epidemiologici ampi ed approfonditi condotti su scala nazionale su questo tipo di neoplasia, poichè i tumori cutanei non-melanoma sono esclusi dal registro statistico dei tumori. A tale scopo presso la Dermatologia dell'Università di Bologna sono stati raccolti di tutti i casi di carcinoma basocellulare osservati dal 1 gennaio 1990 sino al 31 dicembre 2014, e sono stati rielaborati statisticamente. Il criterio di inclusione adottato è stato la positività per BCC all’esame istologico, sia in caso di biopsia semplice, sia in caso di asportazione radicale. Il progetto è stato svolto presso l’ambulatorio di chirurgia oncologica della nostra UO, così come il follow-up dei pazienti nei casi di recidività multiple o di comparsa di nuovi tumori cutanei. Ad oggi, tale neoplasia è risultata essere quella di più frequente osservazione nella Unità Operativa di Dermatologia dell’Università di Bologna. Non solo, la nostra casistica rimane quella più numerosa fino ad ora riportata in tutta Italia negli ultimi 24 anni. / Basal cell carcinoma (BCC) accounts for 80 percent of non-melanoma skin cancer, thus representing the most common malignant tumor of the skin. Nonetheless in our country the absolute incidence of BCC is difficult to establish with precision, since non-melanoma skin cancers are excluded from the statistical records of the tumors. The aim of the study we conducted was therefore to analyze retrospectively the cases of BCC of the Dermatology Unit of Bologna, in a period between 1990 and 2014. The inclusion criteria has been the positivity to BCC at histological examination, both in case of a simple biopsy, and in case of radical excision. Patients have been medical and/or surgical treated and followed up, in cases of multiple relapses or occurrance of new skin tumors, at the Oncologic-Dermatological-Surgery Unit of University of Bologna. We concluded that, by far, than any other skin cancers, basal cell carcinoma is the most frequently tumor observed in the Dermatology Unit of the University of Bologna. Not only that, our case study is also the largest so far reported throughout Italy in the last 24 years.

The possible trends for atmospheric carbon monoxide in the next 100 yr have been illustrated using a coupled atmospheric chemistry and climate model driven by emissions predicted by a global economic development model. Various model runs with different assumptions regarding emissions or model parameters have been carried out to investigate the impacts of model and emission uncertainties on the predictions. We have found complicated interactions among emissions, atmospheric chemistry, and climate regarding the distributions and evolution of CO in the atmosphere. Based on the predicted emissions of methane and carbon monoxide, the model predicts an increasing trend of carbon monoxide in the next century with a tropospheric mole fraction of CO in 2100 double its present-day value. Methane emissions are found to have the most important effect on the future atmospheric CO budget. High methane emissions cause significant depletion of tropospheric OH, increase of CO concentrations, and lengthening of lifetimes of many chemical species including CO and CH4. The global average atmospheric lifetime of CO is predicted in our reference model run to be about 0.6 month longer than its present value (~2 months). The predicted emissions of CO increase only slightly over the next century, so the impact of CO emissions on the predicted CO abundance appears to be less important than that of methane. Consequently, maintaining the emissions of CH4 at their current levels can prevent significant future changes in tropospheric chemistry, while similar controlling emissions of CO cannot achieve the same result. This study also indicates that climate variations, especially those causing changes in H2O concentrations, can influence atmospheric trends of carbon monoxide. A two-way interaction between chemistry and climate regarding CO is evident. Specifically, the budget of atmospheric CO affects the destruction of methane and the production of CO2, ozone, and sulfate aerosols and thus affects climate, while the resultant changes in climate modify the budget of CO-CH4 in turn through their effects on H2O and temperature. / Includes bibliographical references (p. 11). / Abstract in HTML and technical report in HTML and PDF available on the Massachusetts Institute of Technology Joint Program on the Science and Policy of Global Change website (http://mit.edu/globalchange/www/)

No description available.

No description available.

No description available.

No description available.