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The bioconversion mediated by the larvae of Hermetia illucens (BSFL) is a relative new tool for the recovering of organic matrices, as agro-industrial by-products. The work describes first a regional project (HERMES) aimed at developing a biorefinery model based on the on the activity of larvae of H. illucens. The project intends to exploit: i) the residue of the rearing as well as of the bioconversion process to produce substrate for soil conditioning; ii) the exuvias, dead adults and mature larvae as source of chitin, fatty acids, and proteins. The second part of the work reports the results of a preliminary study on the use of tomato pomace as substrate for bioconversion. Tomato pomace (TP) collected from fruits of four tomato genotypes with modification of peel colour has been analysed in two substrate/diet ratio (SDR): 90:10 and 50:50. Preliminary results indicated that the metabolic activity of the larvae was influenced by the SDR and by the specific composition of the peels (e.g., the presence of different pigment). Germination test with aqueous extracts of the SDRs from the four genotypes did not affect the germination percentage. Notwithstanding the unbalanced composition against carbohydrates, TP may be considered an interesting substrate for composite diets for larvae of H. illucens, Proceedings of the 30th European Biomass Conference and Exhibition, 9-12 May 2022, Online, pp. 238-243

Ailanthus altissima, tree of heaven is an introduced tree species in Europe, Africa, South America and North America. Seeds were introduced from China to France in the middle of 1700s and in North America as an ornamental shade tree during the late 18th century from Europe. It is a serious threat to ecosystems in introduced areas, as the plant is very competitive through allelopathic chemicals that may inhibit growth of surrounding native plants. It has a complex of secondary chemicals that make it unpalatable to most of the phytophagous generalist arthropods. Management of this species has been very difficult because of its fast growth and production of root-suckers. Europe uses the classic approach using mechanical and chemical treatments which provide only short-term control, however, this usually exacerbates the problem. One potential agent for Ailanthus, the eriophyid mite Aculops mosoniensis (Acari: Eriophyoidea), has been already recorded in six European States: Hungary, Italy, Serbia, Austria, Croatia, Macedonia and Greece. Beside to the classic symptoms associated with the mite infestation (leaf rolling), an important impact has been recorded on the growth and the survival rate of young plants. In this work we are providing some life history data and we are describing the results of some impact bioassays carried out in field and laboratory conditions, comparing the effects of classic biological control alone and in combination with other management approaches.

The provision n° A6505/29-11-2010 of the Lazio Region Agricultural Department states that the plant material resulting from the felling of palms infested by RPW (Rhynchophorus ferrugineus Olivier) must be disinfested by heat treatment or fine mechanical chipping, ensuring that the resulting materials obtained are of a size smaller than 2 cm. This paper describes changes made on one machine chipper FARMI mod. FOREST CH260 for use in the cutting of trees and palm leaves in accordance with the above mentioned provision. The analyzes carried out on the plant material shredded, according to methodology UNI CEN/TS 15149-1 - 2006, show that 94,78% of the fragments is smaller than 16 mm and a water content of 52.5%. In all fragments of the material shredded at least one of the three dimensions was less than 2 cm. A mix of chipped stipes and leaves of palm tree was tested at ENEA facilities to evaluate the ability of RPW larvae to feed and survive on this substrate. Ten plastic containers (130 liters) were filled up with 26 kg each of chipped matter and infested with larvae grouped by weight into 3 classes ranged from < 0.15 g, 0.15 -;- 0.35 g and > 0.35 g till 2 cm (3 containers for each class and 1 as control; 30 larvae for each container). Containers, covered with a metallic net, were kept in an isolated chamber, controlling temperature in order to maintain the substrate around 30°C. The substrate was inspected at 45 dd after infestation. No survival was recorded on the larvae, indicating that chipping technique could be a suitable method to destroy infested palm avoiding potential risks of re-infestation from the disposal sites. © 2013, Copyright G. Sperandio et al.

The aim of this paper was to describe exhaustively, but concisely, the matter of the health technology assessment. It is a method of evaluating health technologies based on principles and tools of Evidence Based Medicine. We started from etymology to speak about its definition and implementation methodology. Moreover we guide the reader throughout the constellation of international societies of health technology assessment and the meaning of their international cooperation. Finally, we deal with the health technology assessment as a tool being an integral part of the clinical governance process.

Medical ethics is the science of survival. It studies the working out of judgments on right or wrong referred to the human being as a biological entity interacting with the whole ecosystem. Medical ethics in clinical research raises numerous moral and technical issues. Methodological aspects are essential for carrying out the aim of clinical research. Medical ethics documents are inspired by the Nuremberg Code and culminate in the recently updated Helsinki Declaration of 1964. In Italy 2 ministerial decrees in 1997 and 1998 laid the basis for the work of a medical ethics committee. They acknowledge the European Good Clinical Practice Guidelines and set professional needs within ethical committees. In clinical research the use of ionising radiation merits special consideration. In the recent past, serious human rights abuses in radiation experiments of the 1950s and 1960s have been found. As regards research in this field we can refer to the publication of the International Commission on Radiological Protection (ICRP) and to the report of the World Health Organi-sation (WHO). Legislative decree no. 187 of May 26, 2000, which transposed the 97/43/ EURATOM Directive represents the most comprehensive and recent normative reference to clinical research using ionising radiation. However, law no. 39 of March 1, 2002 is important for the partial modifications of previous decrees (art. 108 of L.D. no. 230 of March 17, 1995 and, art. 4 and attachment III of L.D. no. 187 of May 26). In this paper medical ethics, research, methodological issues and aspects of ionizing radiation are discussed.

The internet is a communication medium and content distributor that provide information in the general sense but it could be of great utility regarding as the search and retrieval of biomedical information. Search engines represent a great deal to rapidly find information on the net. However, we do not know whether general search engines and meta-search ones are reliable in order to find useful and validated biomedical information. The aim of our study was to verify the reproducibility of a search by key-words (pediatric or evidence) using 9 international search engines and 1 meta-search engine at the baseline and after a one year period. We analysed the first 20 citations as output of each searching. We evaluated the formal quality of Web-sites and their domain extensions. Moreover, we compared the output of each search at the start of this study and after a one year period and we considered as a criterion of reliability the number of Web-sites cited again. We found some interesting results that are reported throughout the text. Our findings point out an extreme dynamicity of the information on the Web and, for this reason, we advice a great caution when someone want to use search and meta-search engines as a tool for searching and retrieve reliable biomedical information. On the other hand, some search and meta-search engines could be very useful as a first step searching for defining better a search and, moreover, for finding institutional Web-sites too. This paper allows to know a more conscious approach to the internet biomedical information universe.

Exact renormalization group techniques are applied to the mass deformed N = 4 supersymmetric Yang{Mills theory, viewed as a regularized N = 2 model. The solution of the flow equation, in case of dominance of the potential term, reproduces the one-loop (perturbatively exact) expression for the eective action of N = 2 supersymmetric Yang-Mills theory, when the regularizing mass, M, reaches the value of the dynamical cutoff. One speculates about the way in which further nonperturbative contributions (instanton eects) may be accounted for.

In 285 patients with prevesical ureteral stone and 247 with upper ureteral stone, extracorporeal shock wave lithotripsy (ESWL) was performed with the Dornier MPL 9000 ultrasonographic targeting device. All these stones were treated "in situ" and without regional or general anaesthesia. At 3-month follow-up 96.8% of the patients treated for prevesical stone and 95.5% of those with upper ureteral stone were stone-free. ESWL was repeated once or twice in 99 cases; the average number of sessions was 1.2 for all patients (similar for prevesical and upper ureteral stones). Sparse use of ureteral stenting (6.2% of cases) did not seem to reduce the efficacy of ESWL or increase complications or need for retreatment. Intravenous fentanyl analgesia was given to 40.9% of the patients and intravenous infusion of a furosemide solution was employed in many cases to give adequate dilation of the urinary tract. In situ echo-guided ureteral ESWL is simple, safe and efficacious and can be the technique of choice for sonographically detectable ureteral stone.

The one-loop contribution to the superpotential, in particular the Veneziano-Yankielowicz potential in N=1 supersymmetric Yang-Mills model is discussed from an elementary field theory method and the matrix model point of view. Both approaches are based on the Renormalization Group variation of the superconformal N=4 supersymmetric Yang-Mills model., 31 pages

OBJECTIVES: To investigate the influence of heredity on obesity-associated hypertension, we evaluated casual and 24-h blood pressure, left ventricular mass and some metabolic and hormonal measurements in normotensive obese subjects. DESIGN: Healthy, normotensive obese subjects (n = 81) with positive or negative family history of hypertension were studied. Both groups were also subdivided according to a positive or a negative family history of obesity. Accordingly, 45 obese subjects had a positive family history of hypertension, 25 of these having a positive (subgroup A) and 20 having a negative family history of obesity (subgroup B). The other 36 obese subjects had a negative family history of hypertension, 19 of these having a positive (subgroup C) and 17 having a negative family history of obesity (subgroup D). METHODS: Casual and 24-h systolic (SBP), diastolic (DBP) and mean blood pressure (MBP) were evaluated. Serum fasting blood sugar, total cholesterol and triglycerides levels, urinary excretion of sodium, immunoreactive fasting insulin, plasma ANF levels, plasma renin activity (PRA), plasma aldosterone level, plasma adrenaline and noradrenaline levels and echocardiographic total left ventricular mass (LVM) and LVM:height ratio were also calculated. RESULTS: Twenty-four-hour DBP, 24-h MBP, LVM, LVM:height ratio, total cholesterol and PRA values were significantly higher in normotensive obese offspring of hypertensive parents than in obese offspring of normotensive parents. Twenty-four-hour DBP and MBP, LVM, LVM:height ratio, insulin level, insulin:glucose ratio and PRA were significantly higher in subgroup A than in subgroup B. Fasting blood sugar level, 24-h DBP and MBP, insulin level, insulin:glucose ratio, PRA, noradrenaline, adrenaline and plasma aldosterone levels were significantly higher in subgroup C than in subgroup D. Multivariate analysis also indicated that 24-h MBP and PRA levels were significantly influenced by the association between a positive family history of hypertension and obesity. CONCLUSIONS: The present results suggest that a family history of obesity might increase the risk of developing hypertension in obese subjects. An elevated PRA may precede the development of hypertension in obese subjects who are at risk for developing hypertension.

We used echocardiography to determine the prevalence of pericardial effusion in rheumatoid arthritis (RA) patients without cardiac systems and compared our results to those obtained in a control group of age-matched subjects. Thirty-six patients with RA (6 men, 30 women; mean age 51 +/- 11 years) were selected from a patient population in treatment at our outpatient Rheumatology Clinic. None of the patients had any symptoms of cardiac disease, and all patients with signs and/or systems of extracardiac disease were excluded from the study. The control group consisted of 60 volunteers (mean age 51 +/- 12 years) randomly selected from a larger group of subjects with neither symptoms, signs and/or clinical findings of extracardiac disease nor symptoms of cardiac disease. Standard two-dimensional and M-mode echocardiography was carried out on all subjects. In the RA patients, we found a high prevalence of pericardial involvement, especially minimal pericardial effusion. There was no statistically significant difference among subgroups of RA patients based on stage and duration of disease respectively. There was no correlation between pericardial involvement and inflammatory indexes or drug therapy. The minimal pericardial effusion found in our patients could be caused by the extra-articular inflammatory process and might be one aspect of a more complex picture characterized by silent cardiac involvement. The potential for symptomless pericardial alterations documented in our patients indicates that careful cardiac evaluation should be given high priority in the assessment and management of subjects with RA.

A gauge invariant regularisation which can be used for non-perturbative treatment of Yang-Mills theories within the exact renormalization group approach is constructed. It consists of a spontaneously broken SU(N|N) super-gauge extension of the initial Yang-Mills action supplied with covariant higher derivatives. We demonstrate that the extended theory in four dimensions is ultra-violet finite perturbatively and argue that it has a sensible limit when the regularisation cutoff is removed., Talk given at 15th International Workshop on High-Energy Physics and Quantum Field Theory (QFTHEP 2000), Tver, Russia, 14-20 Sep 2000

Exact renormalization group techniques are applied to mass deformed N=4 supersymmetric Yang-Mills theory, viewed as a regularised N=2 model. The solution of the flow equation, in the local potential approximation, reproduces the one-loop (perturbatively exact) expression for the effective action of N=2 supersymmetric Yang-Mills theory, when the regularising mass, M, reaches the value of the dynamical cutoff. One speculates about the way in which further non-perturbative contributions (instanton effects) may be accounted for., Comment: 13 pages, no figures, uses JHEP3.cls

The aim of our study was to seek out a possible different reactiveness to cardiovascular stimulation tests among normotensives with and without positive family history of essential hypertension. We have studied about 200 inhabitants of Ustica and 49 medicine students, all normotensives according to the World Health Organization and the Joint National Committee criteria. In an isolated room and in a supine position, blood pressure (BP) and heart rate were measured every 30 s for 15 min with an automatic sphygmomanometer. Averages of last 4 measurements were considered baseline values. Then we have carried out mental stress (MS), handgrip and active orthostatism test (AO) in the inhabitants of Ustica; cold pressor test and AO in students. Patients were divided in 2 groups, genetics and controls, on the basis of a positive family history of essential hypertension. The 2 groups, in every sample, were similar for sex, age, body mass index and alimentary and life habits. RESULTS: a preliminary estimation of Ustica sample showed a different prevalence of positive history between hypertensives and normotensives (63.9% vs 46.61%; p less than 0.05) and no difference between hypertensive and borderline patients (63.9% vs 64.2%); BP and heart rate were slightly higher in controls; there was no statistical difference between genetics and controls. CONCLUSIONS: our results can be explained in various ways: pressor dysregulation in candidates for hypertension may be masked in a large group of normotensives; exaggerated pressor response do not exist in genetics or this pressor dysregulation is impossible to find out with the cardiovascular stimulation tests we have used; other mechanisms are responsible for genetic hypertension.

We aimed to study centrally obese subjects without other diseases, to establish whether a short-term hypoenergetic balanced regimen is able to positively modify left ventricular (LV) patterns.We studied 32 obese subjects (out of 52 recruited for this study) with central fat distribution and without associated diseases. Each subject had undergone a moderately hypoenergetic diet for a four-month follow-up period and had a regular loss in weight. Some relevant clinical and echocardiographic parameters were evaluated. Baseline data and those evaluated at the end of the follow-up period were used for outcome analysis.We found a considerable reduction in LV mass and other LV structural parameters including relative wall thickness (RWT). Moreover, we found an improvement of both LV ejection fraction and filling parameters. As regards the relation ship between parameter changes, LV mass was correlated to LV internal diameter and mainly to LV wall thickness. LV mass change was also correlated to a reduction of diastolic BP and RWT. Only improvements in LV filling were correlated to WHR reduction. None of the changes in cardiac variables resulted significantly correlated to BMI change. Other interesting correlations are reported in the text.Our study points out that improvements in LV structure and function are rapidly possible with a moderately hypoenergetic regimen in obese otherwise healthy subjects. The main changes were those in LV wall thickness even if a more complex cardiovascular adjustment was recognised. All this could be very important to possibly prevent future cardiovascular events (including heart failure), so largely linked to obesity of central type.

We show an application of the Wilson Renormalization Group (RG) method to a SU(2 ) gauge field theory in interaction with a massive fermionic doublet. By choosing suitable boundary conditions to the RG equation, i.e. by requiring the relevant monomials not present in the classical action to satisfy the Slavnov-Taylor identities once the cutoffs are removed, we succeed in implementing the local gauge symmetry. In this way the so called fine-tuning problem, due to the assignation of boundary conditions in terms of the bare parameters, is avoided. In this framework, loop expansion is equivalent to the iterative solution of the RG equation; we perform one loop calculations in order to determine how much the fermionic matter modifies the asymptotic form of the couplings. Then we compute the beta-function and we check gluon transversality. Finally, a proof of perturbative renormalizability is shown., Comment: 12 pages, no figures

OBJECTIVE: To evaluate the relationships among micro-albuminuria, blood pressure and measurements of left ventricular structure and function in centrally and peripherally obese subjects compared with members of a lean control group. METHODS: Centrally obese subjects were subdivided according to whether they had levels of micro-albuminuria higher than 30 mg/24 h (micro-albuminuric group) or lower than or equal to 30 mg/24 h (normo-albuminuric group). For all the subjects we measured heart rate, casual mean blood pressure (MBP), 24 h MBP, total cholesterol level, high-density lipoprotein cholesterol, lipoprotein (a) level, fasting immunoreactive insulin level, plasma renin activity, plasma aldosterone level and micro-albminuria (UAE) by current methods. Left ventricular mass indexed for body height, left ventricular diastolic and systolic diameters, interventricular septal thickness and left ventricular ejection fraction were measured by echocardiography. Peak filling rate was also calculated by radionuclide study. Family history of cardiovascular disease was evaluated for all the obese subjects.RESULTS: Lipoprotein (a) level, total cholesterol level, 24 h MBP and interventricular septal thickness were significantly (P < 0.05) greater for micro-albuminuric than they were for normo-albuminuric centrally obese subjects, whereas high-density lipoprotein cholesterol level and left ventricular ejection fraction were significantly (P < 0.05 lower. In addition, UAE levels of centrally obese subjects were significantly (P < 0.05) higher than those of peripherally obese subjects. UAE of all the centrally obese subjects was correlated directly to lipoprotein (a) level (r = 0.33, P < 0.009), 24 h MBP (r = 0.41, P < 0.002), interventricular septal thickness (= 0.36, P < 0.005) and family history of cardiovascular disease (r = 0.33, P < 0.007). Multiple regression analysis indicated that UAE was independently related to 24 h MBP and family history of cardiovascular disease. CONCLUSION: Our data indicated that measurement of micro-albuminuria is useful for evaluating cardiovascular risk profiles of obese subjects with a central fat distribution

In the present study the prevalence of obesity and its association with ischemic heart disease, recognized according to clinical criteria (chest pain or previous infarction) and/or instrumental data, were described in 8,847 normotensive subjects and in 867 hypertensive subjects, hospitalized during a ten years period (1983-1992), through a cross-sectional study. In view of this all the subjects were considered as lean or obese according to their body mass index (BMI) and to sex specific cut-off values reported in the Italian Consensus Conference on Obesity. In particular, according to BMI values, the subjects were grouped as lean, overweight, moderate and severe obese subjects. Our results indicated that 3,982 normotensive subjects (45%) could be considered lean, whereas 2,654 of them (30%) were overweight, 1,769 of them (20%) were moderate obese and 442 of them (5%) were severe obese. On the contrary only 206 hypertensives (23.7%) might be considered lean, whereas 313 (36.1%) were overweight, 302 (34.8%) were moderate obese and 46 (5.3%) were severe obese. According to age subgrouping (lower than or equal to 65 years or higher than 65 years) the distribution of hypertensives within the lean, overweight, moderate and severe obese groups did not change significantly, but, according to sex subgrouping, the distribution of hypertensives within the BMI groups was significantly different (chi 2, p < 0.001). When we considered the degree of hypertension, distribution of hypertensives was significantly different according to c2 test (p < 0.004), suggesting that the percentage of the subjects with severe hypertension increased only in subjects with severe obesity. Concomitant ischaemic heart disease (IHD) was also documented in 350 normotensives (4%) and in 119 hypertensives (13.8%). The prevalence of IHD was not significantly different in lean, overweight, moderate and severe obese hypertensives, also when sex and smoking habits were considered. Our data indicated a strong association between obesity and hypertension. In addition they may be consistent with the suggestion that obese hypertensives were not characterized by a lower risk of ischaemic heart disease (IHD), than lean hypertensives.

Extensive experience of the circadian variation of blood pressure (BP) has been reported. But some problems exist concerning the correct and satisfactory evaluation of 24-h BP profiles. A well-known approach is the Halberg's 'cosinor' method. But it could be considered inadequate for blood pressure recordings because it is based on a rigid model that does not practically fit empirical data. We suggest an approach based on a cubic function as a suitable method for such an analysis. Our investigation studied the behavior of 24-h blood pressure by a model where the function f(t) is a third-degree polynomial. We recruited 52 untreated patients affected by essential hypertension. Ambulatory BP recordings were made using a portable noninvasive system. Data were analyzed by a computerized procedure for both estimating parameters of the cubic-polynomial model and obtaining conventional and function-derived parameters. Eleven of 52 hypertensives showed no common rhythm: 8 patients had no statistically significant rhythm and 3 had a reversed rhythm. The 8 of 11 hypertensives who had no statistically significant rhythms were also 'nondippers' according to the criteria of Verdecchia et al.. The remaining 41 patients were matched and compared to 41 normotensive subjects. In general, function-derived parameters stressed differences between the two groups more than the conventional ones. We suggested an analysis of 24-h BP data based on a cubic function model. We verified that such a methodology is feasible. At the moment, it seems a useful approach for clinical investigation.

BACKGROUND: We aimed to study centrally obese subjects without other diseases, to establish whether a short-term hypoenergetic balanced regimen is able to positively modify left ventricular (LV) patterns. METHODS: We studied 32 obese subjects (out of 52 recruited for this study) with central fat distribution and without associated diseases. Each subject had undergone a moderately hypoenergetic diet for a four-month follow-up period and had a regular loss in weight. Some relevant clinical and echocardiographic parameters were evaluated. Baseline data and those evaluated at the end of the follow-up period were used for outcome analysis. RESULTS: We found a considerable reduction in LV mass and other LV structural parameters including relative wall thickness (RWT). Moreover, we found an improvement of both LV ejection fraction and filling parameters. As regards the relation ship between parameter changes, LV mass was correlated to LV internal diameter and mainly to LV wall thickness. LV mass change was also correlated to a reduction of diastolic BP and RWT. Only improvements in LV filling were correlated to WHR reduction. None of the changes in cardiac variables resulted significantly correlated to BMI change. Other interesting correlations are reported in the text. CONCLUSIONS: Our study points out that improvements in LV structure and function are rapidly possible with a moderately hypoenergetic regimen in obese otherwise healthy subjects. The main changes were those in LV wall thickness even if a more complex cardiovascular adjustment was recognised. All this could be very important to possibly prevent future cardiovascular events (including heart failure), so largely linked to obesity of central type

OBJECTIVE: To investigate the role of alterations in renal haemodynamics and function and in plasma renin activity on obesity-induced hypertension. DESIGN: Renal haemodynamics and function, salt-regulating hormones and structural cardiac parameters were evaluated in 20 lean normotensives and in 64 obese subjects with central or peripheral fat distribution, 43 of them were normotensives and 21 of them were hypertensives. Obesity and central fat distribution were defined according to sex-specific 85th percentile respectively of Body Mass Index (BMI) and Waist to Hip Ratio (WHR). MEASUREMENTS: Serum immunoreactive insulin (IRI), plasma renin activity (PRA), plasma aldosterone (PA), microalbuminuria (UAE) and 24h urinary excretion of sodium (NaU) were evaluated by current methods. Renal haemodynamics was evaluated by radionuclide study according to Schlegel's and Gate's methods. By radionuclide study, effective renal plasma flow (ERPF), effective renal blood flow (ERBF), glomerular filtration rate (GFR), filtration fraction (FF) and renal vascular resistances (RVR) were measured. Left ventricular mass (LVM) and indexed for body height (LVM/H), cardiac output (CO) and total peripheral resistances (TPR) by ecocardiography were also calculated. RESULTS: CO, LVM and LVM/H were significantly (P < 0.05) higher in all the obese groups than lean controls. In addition, LVM and LVM/H were significantly (P < 0.05) higher in obese hypertensives than obese normotensives either with central fat distribution. TPR values were significantly (P < 0.05) higher in central obese hypertensives than peripheral obese hypertensives and than central obese normotensives. Moreover, IRI levels were significantly (P < 0.05) higher in central normotensive and hypertensive obese subjects than lean subjects. ERBF and ERPF were significantly (P < 0.05) lower and PRA levels were significantly higher only in central obese than lean subjects. On the contrary RVR were significantly (P < 0.05) higher in both obese hypertensive groups and in central obese normotensives than lean subjects. Comparisons between peripheral and central obese groups indicated that PRA, RVR and UAE were significantly (P < 0.05) higher and ERBF and ERPF values were significantly (P < 0.05) lower in both central obese groups than comparable subjects with peripheral obesity. Multiple regression analysis indicated that RVR increased significantly (P < 0.05) with WHR and PRA but not with CO and IRI. CONCLUSIONS: Our results indicate that obesity with body fat distribution of central type, more than obesity of peripheral type, is associated to abnormalities in renal haemodynamics and function. These data are consistent with the indication that change in renal haemodynamics take place at an early stage in the obesity-induced hypertension.

Relevance of latent infection in the epidemiology of tuberculosis (TB) is expected to increase in many developed countries. Indeed, many demographic, social and public health changes could contribute to the expansion of groups or communities at significantly higher risk than the general population for infection to Mycobacterium tuberculosis or progression from latent to active disease. Tuberculin skin testing (TB), the gold standard for diagnosis of M. tuberculosis infection, is imperfect and prone to false positive and negative results, unless strictly targeted and carefully standardized for reliable performance and interpretation. This paper proposes a pre-test risk assessment questionnaire and standardized criteria for evaluation of TB test according to international guidelines.

Studies performed to date on the prevalence of biliary lithiasis (BL) in chronic renal failure patients on hemodialysis (HD) have given contradictory results. The aims of the present study were to evaluate the prevalence of BL and its main associated risk factors in a population of hemodialysis patients, and to compare the results with those we had obtained previously in an overt population of the same zone. The study included 171 patients (83 M, 88 F), mean age 62.5 years and mean duration of dialysis 66.7 months. The screening protocol also included body mass index (BMI), a number of biochemical parameters and an ultrasound scan of the gallbladder and biliary tract. The general prevalence of BL was 33.3% (30.1% in men and 36.4% in women), and this figure was significantly higher than that found in our previous study. Prevalence increased with age in both sexes (Mantel-Haenszel Chisquared = 5.4, p < 0.03), but not with duration of dialysis. The main risk factors, evaluated with multiple logisstic regression, were the presence of diabetes mellitus and high serum phosphorus levels. Specific symptoms were also significantly associated in BL patients. No association was found with parity, BMI or serum lipid alterations. In conclusion, the prevalence of BL in a Sicilian population of HD patients was higher than that found in an overt population of the same area and the associated main risk factors were not coincident. Further studies are needed to establish the role played by the phase of end-stage renal disease before HD and to correct the metabolic disturbances to limit a high percentage of morbidity in a disease already in itself sufficiently disabling.

BACKGROUND: We aimed to analyze the importance of echocardiography in our Internal Medicine Institute. We think that this technique could have a large impact in the evaluation of the internistic inpatient who is usually affected by multiple pathological problems. METHODS: Analysis was performed according to the ACC/AHA guidelines for the application of echocardiography. The data of 1211 consecutive inpatients were analyzed. RESULTS: Sixty-three per cent of all the patients had two or more associated diseases. Moreover, patients in whom echocardiography could be considered appropriate or useful were 67%. Our results point out that echocardiographic examination is generally a technique of great importance for the evaluation of internistic inpatients. CONCLUSIONS: This study could represent a useful background for a cost/benefit analysis that should evaluate the utility of a specifically-dedicated echocardiographic laboratory for optimal, autonomous management of internal medicine inpatients.