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Ensuring high levels of adherence to highly active anti-retroviral therapy (HAART) is a priority in treating people living with AIDS. This study reports the rates of adherence of patients served by DREAM (Drug Resource Enhancement against AIDS and Malnutrition) in the city of Matola, Mozambique. DREAM, an innovative programme tailored for Africa, was implemented by the Community of Sant'Egidio in August 2001. DREAM provides patients with anti-retroviral drugs and laboratory tests at no charge, and is based on a particular strategy of health education and organization of services designed for a population that is predominantly poor and has a low level of formal education. This study analyzes the adherence of 154 patients over a period of 6 months. In evaluating adherence, two indicators were used: (1) the percentage of appointments kept for check-ups, tests and the collection of medicine, and (2) the overall change in the patients' blood chemistry over the 6-month period. Of the 154 patients, 127 (82.5%) kept more than 90% of their appointments. Adherence to the programme was further confirmed by a relevant increase of hemoglobin levels and CD4 counts, and a significant decrease in the viral loads among the 154 patients.

Student self-assessment survey results indicate that a virtual lab experience improved understanding of many key laboratory learning objectives and that the Materials Digital Library (MatDL) has potential value in supporting a virtual lab.

The NSF-funded National Science Digital Library (NSDL) is engaged in an ongoing discourse about digital library evaluation. The Educational Impact and Evaluation Standing Committee (EIESC) has successfully identified desirable features in digital libraries such as usability and usage, but the hardest measure is impact. What is the impact of a DL? Members of the EIESC have engaged in pilots and feasibility studies using bricolage (a blend of qualitative and quantitative approaches to evaluation), and these activities are moving NSDL toward a richer understanding of impact.

The National Science Foundation created the National Science Digital Library (NSDL) in order to establish a technical, communal, and organizational framework for access to high quality resources and tools that support innovations in teaching and learning at all levels of science, technology, engineering, and mathematics education. As part of the NSDL, the Materials Digital Library (MatDL) Pathway focuses specifically on serving the materials science (MS) community with a target audience that includes MS undergraduate and graduate students, educators, and researchers. MatDL is a collaborative effort involving the Materials Science and Engineering Laboratory at the National Institute of Standards and Technology, Kent State University, Massachusetts Institute of Technology, University of Michigan, Iowa State University, and Purdue University. Our network of collaborations also includes a Nanoscience Interdisciplinary Research Team, Materials Research Science and Engineering Center, and International Materials Institute. A primary goal of MatDL is to bring materials science research and education closer together. MatDL provides innovative uses of digital libraries and the web as educational media in the MS community with particular emphasis on providing: 1) tools to describe, manage, exchange, archive, and disseminate scientific data 2) workspace for open access development of modeling and simulation tools 3) services and content for virtual labs in large undergraduate introductory science courses, and 4) workspace for collaborative development of core undergraduate MS teaching resources for emerging areas. This paper will provide an overview of the NSDL MatDL Pathway, details about specific aspects of the project, as well as interactions between research and education.

The NSF-funded National Science Digital Library (NSDL) is working to develop community-based processes for implementing shared evaluation goals and instruments among its distributed library network to examine library usage, collections growth, and library governance processes. The bricoleur modality of evaluation research is one that integrates scientific methods as well as humanistic values. These activities are helping to provide the foundation for the development of a scientific program of digital library evaluation that crosses disciplinary boundaries.

The Materials Digital Library project, as part of the National Science Foundation's National Science Digital Library program, researches efficient creation and dissemination of materials information using a multifaceted approach: collection of materials content, with an emphasis on soft matter; construction of authoring tools for improved delivery, and; use of materials content in a digital library.

This pilot project investigates facilitating the development of the semantic Web for e-learning through a practical example, using materials property data markup language (MatML) to provide materials property data to a Web-based application program. Property data for 100 materials is marked up with MatML and used as an input format for an application program. Students use the program to generate graphs showing selected properties for different materials. Selected graphs are submitted to the materials digital library (MatDL) so that successive classes may be informed by earlier work to encourage new discoveries.

The National Science Foundation's National Science Digital Library (NSDL) Program is a premier collective portal of authoritative scientific resources supporting education and research. With funding from NSF, the Materials Digital Library (MatDL) is a collaborative project being developed by the National Institute of Standards and Technology's Materials Science and Engineering Laboratory (NIST/MSEL), the Department of Materials Science and Engineering at the Massachusetts Institute of Technology (MIT), the Department of Chemical Engineering and the Department of Materials Science and Engineering at the University of Michigan (U-M), with Kent State University and University of Colorado at Boulder providing the materials science informatics and workflow technology backbone. As part of the NSDL program, MatDL aims to supports the interface of materials science information and its cognate disciplines, with an emphasis on soft matter. Initial content of MatDL begins with resources selected from NIST/MSEL. Students and faculty in three types of materials science and engineering (MSE) courses at MIT and U-M are taking part in a pilot to use and contribute to MatDL utilizing domain-specific authoring tools. Given the central and interdisciplinary role of materials science in science and engineering, two goals of MatDL are to: 1.) expand its founding partnership with additional participants from the MSE community; and 2.) facilitate the flow of digital materials related knowledge from laboratories where the most recent research discoveries are taking place to the classrooms where new scientists are being trained.

Using fluorescent microlymphography, we examined the morphology andfunctional characteristics of the microlymph-vascular network in 36 subjects including 9 patients with "compressible" lymphedema (Group I), 14 with minimally compressible lymphedema (Group II), 9 with noncompressible lymphedema (Group III), and 4 healthy individuals. As lymphedema progressedfrom early to advanced stages (Group I-III), an increasingly greater lymphatic capillary density and diameter were depicted and eventually fibrosis/sclerosis with lymphangiectasia, fragmentation and a gradual decrease in the number of microlymphatics. Concomitantly, there was a prolongation in transport and disappearance of fluorescent dye and a progressive increase in endolymphatic and interstitial hydrostatic pressures.

Green's functions are powerful mathematical tools with strong pedagogical value providing not only solutions to difficult problems but also visualization for understanding phenomena. The majority of upper division engineering and materials science students receive very little exposure to Green's functions and the boundary element method. The Green's Functions Research and Education Enhancement Network (GREEN) Digital Library which the authors are developing will, therefore, play an important role in undergraduate and graduate education. The National Science Foundation has launched the National Science, Mathematics, Engineering, and Technology Education Digital Library (NSDL) program to stimulate and sustain continual improvements in the quality of science, mathematics, engineering, and technology education. The NSDL Program is a major digital library initiative and the GREEN Digital Library is a collaboration of the Center for Theoretical and Computational Materials Science of the Materials Science and Engineering Laboratory at the National Institute of Standards and Technology, Kent State University, and the Massachusetts Institute of Technology. This paper describes the primary components of the GREEN Digital Library, an organized collection of educational materials integrating research, education, and application of Green's functions to serve undergraduate and graduate communities:1. Problem Bank: A bank of available “real-world” problems, introduced by industrial participants.2. Code Bank: Working code for solved Green's functions routines.3. Archive: A list of citations to relevant literature, and published / unpublished works subject to copyright restrictions, with links elsewhere for additional information.4. Teaching Bank: A collection of lecture / course notes from existing university courses, as well as providing a forum for discussion of approaches to teaching this material.

In corso di Sindrome di Apert o Acrocefalosindattilia è possibile rilevare anomalie a carico dell'orecchio interno. Quando esse interessano il vestibolo o i canali semicircolari, sono asintomatiche. Gli autori, dopo un breve cenno sulla Acrocefalosindattilia e sulle più frequenti anomalie dell'orecchio interno, riportano un caso di Sindrome di Apert con associata malformazione bilaterale del vestibolo e del canale semicircolare laterale, studiato con TC ad alta risoluzione.

Intermittent claudication is the primary symptom of chronic obstructive arteriopathies of the lower extremities. Increased walking distance is the aim of all physical or pharmacological treatment of such patients. The study reported aims to assess the increase in distal arterial blood flow in arteriopathic patients achieved by physical treatment using a cuff, generally positioned on the upper third of the thigh to produce pulsed compressions. By tightening for a few milliseconds slightly behind the natural cardiac systole, the cuff reinforces the systolic thrust to increase distal perfusion without making any additional demand, on the cardiac pump. The cuff used is produced by Vascupump Copyright vp-El. The trial was conducted on 36 patients with intermittent claudication divided into 3 groups. Group A included 12 patients given Vascupump Copyright treatment only (20 yen 45 minute sessions); Group B included 12 patients given combined treatment with the Vascupump Copyright and endovenous Pentoxillin (3 fl/per diem for 20 days); Group C included 12 patients given Pentoxyfillin alone (3 n per diem for 20 days). Each patient was examined at the start (D0) and end (D20) of treatment as follows: Treadmill tests at 0 and 12% gradients at a speed of 3 km/h. Doppler arterial tensiometry with calculation of the Winsor Index; photoplethysmography. Group A revealed an increase in relative and absolute walking distance of 230% and 224% respectively on the flat and 357% and 343% respectively uphill. Doppler tensiometry revealed a 40.7% improvement in Group A compared to 29% in Group B and 13.6% in Group C. By contrast the improvement in the plethysmographic reading was higher in Group B (+ 119%) than in Group A (+67.3%). These results suggest that the Vascupump Copyright gives better than expected results on Fontaine Stage B arteriopathies.

Materials informatics integrated into undergraduate and graduate materials education is a key component and critical issue to address the nation’s shortage of well-trained, future scientists.

The atherosclerotic disease is a very important problem for the health in the advanced countries. The Rose's questionnaire was utilised for diagnosing the intermittent claudication but the current diagnostic method is the ankle-arm blood pressure ratio (Winsor's index). The incidence of intermittent claudication is 0.4% to 14.4%, utilising the Rose's questionnaire and 4.2% to 35% using the Winsor's index. The main risk factor for the peripheral arteriopathies is the smoke followed by the hypertension and the diabetic disease. The dyslipidemic and coagulative diseases are important risk factors in some populations. The main cause of death is the myocardial infarction. The risk increases when it is present a cerebral or coronary arterial pathologies.

The authors report a clinical and ultrastructural study on a group of patients with angiomegaly, a vascular disorder characterized by elongated and distended blood vessels affecting the arterial (arteriomegaly) and/or venous system (venomegaly). The arterial group, drawn from a large arteriographic series, focuses on a comparison between atherosclerotic arteriopathy and arteriomegaly. The venous group, drawn from a large ultrasound series of vein disorders, is made up of patients with venomegaly. Venomegaly gives rise to few or no symptoms and it appears to be less frequent than arteriomegaly but as the latter proved to be associated in the majority of cases studied. Based on ultrastructural findings, the chief abnormality of angiomegaly seems to lie in a specific alteration of the elastic component of the vessel wall. We found slightly osmiophil amorphous elastic material neighbouring the basement membrane of the myocytes of the vessel walls. In the superficial parts of these myocytes occurred a great number of pinocytotic vesicles indicating for a rich creation of the new elastic material. Middle or highly osmiophil thick elastic fibers with irregular side protrusions were also found among myocytes remembering the moth-eaten picture. Results from a large ultrasonographic study on patients' relatives suggest an inheritability of this vascular disorder.

The Doppler venous pressure measurement has been used by us since 1977 [1] with interesting results and usefulness not only in the diagnosis of venous diseases but also in the management of therapeutical treatment both in acute and chronic venous pathologies. There is difference between the tensive noninvasive Doppler values, repeatedly proposed by us [2,3,4,5,6] and those quoted by literature and obtained by invasive method [7,8].

Satisfactory function of vascular access is essential for adequate haemodialisys in patients with chronic renal failure. We propose a new non-invasive method to assess function of some vascular accesses. Thermal imaging is hightly developed with contemporary infrared imaging systems having thermal and spatial resolution far in excess of the earlier systems of 1960s. Real time imaging together with efficient processing has improved the ease of use and quality of information.

To evaluate whether there exists a simple method to detect patients risking pulmonary oedema at high altitude (due to Acute Mountain Sickness) and better understand its physiopathology.

Clinical evaluation of pulmonary embolism can often be difficult: alongside the classic symptoms, the reability of non-invasive criteria needs to be researched, as they could back up clinical suppositions with quantitative data.

Mondor's disease is a rare pathology which is characterized from a superficial thrombophlebitis more frequently of a vein on the anterolateral thoraco-abdominal wall. The world literature reported about 500 cases which have been compared to 22 cases which represent our personal case-report. The most frequent etiological causes are represented by post-traumatic and infective events. The most important symptom is pain. The prognosis of the singol phlebitis focus is always favourable.

The data's from National Statistic Institute referring to all Italians hospitalized during 1988 are: 37,312 patient due venous diseases, 2.03 p. cent of all hospitalized patients. Varicose veins diseases are more represented in female (10,948 f. and 4,476 m.). A regional study shows an increase in the north of Italy. The medium amount of days in hospital per patient is reduced in the last years at 11 day (from 18 d). The days in hospital in phlebophatic patients were 409,568 (20,522,122 d. for all diseases) during 1988. The expenses for hospital charges due to venous diseases were estimated in 163,827,000,000 of Italian liras, 136,522,500 US. dollar. Other report consider the factory working as the most important in the scale of job inducing phlebophaties. The first seems to be textile industries, at the second place the food factory, the last are builders. In 1974 were lost 2,300,000 working days. We suppose that increasing of private angiological assistance and having a poor public assistance in Italy the patients undergone to hospitals are reducing (81,599 with venous diseases in 1974 and 37,312 in 1988).

The ultrastructure of the v. colica sinistra in a case of generalized vasomegaly in man was examined. Elastic material was found in three forms: as a lightly osmiophil amorphous material bordering on myocytes, as a highly osmiophil elastic membrane, and as highly osmiophil slim elastic fibres of different orientation in the tunica media and adventitia. The slightly osmiophil elastic material is assumed to be newly formed by pinocytotic activity of the myocytes. The highly osmiophil elastic material indicates its impairment. No typical atherosclerotic changes were found in the examined vein. Based on a comparison with previous findings in the case of vasomegaly of the a. mesenterica inferior, the authors conclude that the venomegaly phenomenon is connected with degenerative changes in the elastic material of the vessel wall.

In 1942, Leriche described the first "dolichomégaartères" (or "arteriomegaly" according to the definition subsequently proposed by Anglo-Saxon researchers). We detected 199 cases of arteriomegaly (16.29% of cases examined) during a review of 1,221 translumbar arteriographies of the lower limbs performed from 1980 to 1985 in the vascular radiology department of our hospital. The percentage of associated aneurysms was 33.16%. The possible dysplastic pathogenesis of the affection and the differential diagnosis with atherosclerosis and other vascular affections found in connective tissue diseases is noted. Histopathology showed dystrophic lesions of the media and especially of the elastic fibers as well as occasional associated venous lesions and a familial basis. The peripheral symptomatology was acute, pseudoembolic and severe as revealed by ischemia and cyanosis. There was no collateral circulation. Medical treatment consisted especially in anti-coagulant and hypervolemic hemorrheologic therapy during ischemia. Ultrasonography enabled us to monitor the regular, systematic course of arteriomegaly, to make the diagnosis initially, to measure the exact size of the arteries, to observe the morphology of the wall and, moreover, to determine the presence or not of megaveins capable of reinforcing the dysplastic genesis of arteriomegaly.

Blood and plasma viscosity, erythrocyte filtrability and blood gas analysis were determined in 25 subjects with arteriosclerosis obliterans of the lower limbs before and after a muscle exercise test. Thirty-six shear rates between 0 and 230 s1 were studied to obtain viscosity curves, and regression analysis was performed for each curve. Mean viscosity curves for pathologic and control populations were plotted. The purpose of the study was to determine whether viscosity curves for blood and plasma before and after exercise, based on a high number of measurements, can provide information on rheological changes during intermittent claudication. Practically all viscosity curves in pathologic and control subjects could be described using a hyperbolic equation. Plasma as well as blood viscosity increased in pathologic subjects after exercise. However, erythrocyte filtrability and blood gas analysis in pathologic and control subjects, and blood and plasma viscosity in control subjects, showed no statistically significant changes after exercise. It is suggested that muscle exercise in reduced blood flow conditions can alter the aggregation of macromolecular complexes of plasma proteins, which could have an influence on cell components by modifying blood rheological behavior during claudication.

Osteoma of the external auditory canal is a benign slow-growing mass, usually solitary and obstructing the ear canal. We stress the importance of MR imaging in the diagnosis of these tumours; MR reveals the fibrovascular channels which are the histological hallmark of osteoma.

Microcomputers and database management packages reduce the difficulties of collecting and analyzing ILL requests. This article examines earlier ILL/collection development studies to identify important ILL record elements for collection analysis. Further, this article reports on the results of a telephone survey of available ILL database management packages to determine whether the elements considered important in the earlier manual studies are being included in these new software packages. The article concludes that through the use of ILL database management packages, ILL activity analysis can be easily incorporated into ILL workflow and quickly passed along to subject selectors.

We use from some years the doppler method for noninvasive meas urements of venous pressure and about seven years ago we communicated the early results.1-3 We have confirmed the reliability and sensitivity of the method carrying on our clinical work. Now we report the results of a more extensive observation.

Die vorliegenden Forschungen zeigen, das die Arteriolen von Leber, Pankreas, Magen, Dunndarm und Dickdarm, Nieren und Hirn, ahnlich wie Venen, Endokard des Vorhofs und des rechten Ventrikels sowie Lungenarterien nicht mit sensitiven und KCN-reizbaren Endigungen ausgestattet sind.

Objective:To assess the predictivity of predefined variables with respect to long-term mortality in a cohort of patients with chronic critical leg ischaemia (CLI).Design:Prospective observational study.Methods:Census offices were asked to release information on survival or death status of 574 patients with CLI 2 years after their recruitment in the study.Results:Of 522 patients with available information, 165 (31.6%) died within 2 years of hospital admission, mostly from vascular causes as expected. Among the variables considered, male sex, current smoking, arterial hypertension, diabetes mellitus, hypercholesterolaemia, obesity, history of myocardial infarction and low ankle systolic pressure showed no univariate association with mortality. The multivariate analysis also excluded revascularisation procedures and the Fontaine stage as prognostic factors in terms of mortality. Besides age ≥ 70 years (relative risk, RR 1.94; 95% confidence interval (CI) 1.37–2.70), only a history of stroke (RR 1.82; 95% CI 1.19–2.79) and major amputation (RR 1.90; 95% CI 1.30–2.80) were significantly associated with mortality.Conclusions:CLI is a clinical condition of such severity that most of the recognised cardiovascular risk factors cannot further influence the fate of the patients, one-third of whom die within 2 years.

Objective:To draw a picture of the different practices adopted for the diagnosis, specific treatment and general care of critical leg ischaemia (CLI) in the light of the recommendations of the recent Consensus Document.Design:Prospective observational study.Setting:A representative sample of vascular and general surgery, angiology, general medicine departments of the Italian National Health Service.Subjects:Patients with leg ischaemia considered as chronic and critical according to the definition and diagnostic criteria adopted in each centre.Chief outcome measures:Epidemiological profile of the standard population; prevalence of definition criteria and of diagnostic and therapeutic procedures; short and medium-term clinical outcome as well as of the general vascular morbidity and mortality.Main results:Over a 3 month period, 574 patients were recruited in 69 centres mainly on the basis of clinical findings of CLI (rest pain and/or trophic lesions). They had an adequate diagnostic assessment of their vascular lesions and a high cardiovascular risk in terms of prior morbidity and presence of risk factors. Over half of the patients underwent revascularisation and three quarters were given pharmacological treatments. At the end of the observation period, 50 patients had died (8.7%), three had had a myocardial infarction (0.5%), six a stroke (1.0%), 70 a major amputation (12.2%) and 103 had persistent CLI (17.9%).Conclusions:This survey confirms the dramatic prognosis of patients with CLI and provides an appropriate background and setting to conduct experimental clinical studies in this field.

Blood and plasma viscosity can be influenced by various therapeutic procedures: among these, that of hemodilution stands out. This can be hypovolemic, normovolemic or hypervolemic; it is hypovolemic if blood subtraction is not followed by a liquid reintroduction, it is normovolemic or hypervolemic if there is a liquid reintroduction of the same or higher quantity than the subtracted blood mass. This method has been considered very favorably by surgery in order to save blood for transfusions. Hypervolemic hemodilution can also be carried out without blood subtraction; a report on this method shows good clinical results and positive hematochemical and hemodynamic effects obtained on 93 peripheral vasculopathic patients at stages III and IV of the Fontaine classification. Plasmapheresis, which would be best called plasma-exchange, consists in the removal of that part of the patient's plasma containing abnormal proteins, immune complexes or toxins, and in its substitution by other colloids or crystalloids. Defibrinogenation is not much employed in Italy, as the most effective drugs, such as ancrod and batroxobin are not available in this country. The good results reported were transitory, due to the rapid appearance of antibodies which can inhibit the effects of these drugs. Nevertheless, there also exist minor fibrinogenolytic drugs.

The AA. have carried out a complete review of the world literature on Mondor phlebitis of the last 50 years (214 cases) pointing out the clinic and epidemiologic characteristics and those of a possible aetiogenesis. 11 personal cases, detailed characteristics of which are given, have been presented. The female sex is the most affected (63,3%) and the most frequent aetiopatogenetic factors are: accidental or surgical traumas (35,7%), muscular stresses (6,3%, centres of infection (4,3%, concomitant mammary pathology (2,4%). The most common symptom is pain (51%) with or without tension sensation (28,9%). The histologic aspect relevant to the biopsy, shows the characteristics of thrombophlebitis non specific, almost always without periphlebitis. The cases presented by the AA. are characterized by the high incidence of relapses (45,4% against 5% of the total cases in the world) as well as by the occasional positivity of the specific serum-agglutination for the Rickettsia Q18 (2 cases out of 11) and the reduction of some immunologic tests (1 cases out of 11). This latter data are leading to two aetiopatogenetic hypothesis: the infective and immunitary one.

A serologic study using the direct seroagglutinate method described by Babudieri and Zardi was carried out in 31 patients affected by Buerger's disease, to determine the positive antibody reaction level against rickettsial disease. In 41.9% of the cases there was a positive test for R. burnetii, in 6.4% a positive test for R. mooserii, and in one a positive test for R. conorii. The results lead us to believe that these pathogenic agents are largely responsible for the development of thromboangiitis obliterans.