Thrombus straddling a patent foramen ovale

We present a case of a 67-year-old male with pulmonary embolism. Transesophageal echocardiography (TEE) showed the presence of a mobile thrombus straddling the patent foramen ovale (PFO) and prolapsing into both atria. Treatment with heparin was started. Five days after admission, repeat TEE revealed a reduction in thrombus dimensions, so anticoagulation therapy was continued. Eleven days after admission, TEE showed complete disappearance of the thrombus

Anterior mitral valve aneurysm perforation in a patient with preexisting aortic regurgitation

We report the case of a 71-year-old man hospitalized for acute heart failure. Transthoracic and transesophageal echocardiography showed mitral valve aneurysm (MVA) rupture and severe mitral regurgitation. No vegetations but significant aortic regurgitation were also observed. MVA perforation is a rare life-threatening condition that typically occurs as a complication of endocarditis but may also be associated with other diseases, in particular connective tissue disorders. In the present case, the absence of such etiology suggests a possible role for of aortic regurgitation in MVA rupture secondary to a “jet lesion” mechanism

Importance of Echocardiography and Clinical "Red Flags" in Guiding Genetic Screening for Fabry Disease

Aim of this study was to evaluate, in a metropolitan area not already explored, the prevalence of Anderson-Fabry disease, by genetic screening, in patients with echocardiographic evidence of left ventricular hypertrophy (LVH) of unknown origin and "clinical red flags"

Predictors of sacubitril/valsartan high dose tolerability in a real world population with HFrEF

Abstract Aims The angiotensin receptor‐neprilysin inhibitor (ARNI) sacubitril/valsartan (Sac/Val) demonstrated to be superior to enalapril in reducing hospitalizations, cardiovascular and all‐cause mortality in patients with ambulatory heart failure and reduced ejection fraction (HFrEF), in particular when it is maximally up‐titrated. Unfortunately, the target dose is achieved in less than 50% of HFrEF patients, thus undermining the beneficial effects on the outcomes. In this study, we aimed to evaluate the role of Sac/Val and its titration dose on reverse cardiac remodelling and determine which echocardiographic index best predicts the up‐titration success. Methods and results From January 2020 to June 2021, we retrospectively identified 95 patients (65.6 [59.1–72.8] years; 15.8% females) with chronic HFrEF who were prescribed Sac/Val from the HF Clinics of 5 Italian University Hospitals and evaluated the tolerability of Sac/Val high dose (the ability of the patient to achieve and stably tolerate the maximum dose) as the primary endpoint in the cohort. We used a multivariable logistic regression analysis, with a stepwise backward selection method, to determine the independent predictors of Sac/Val maximum dose tolerability, using, as candidate predictors, only variables with a P‐value < 0.1 in the univariate analyses. Candidate predictors identified for the multivariable backward logistic regression analysis were age, sex, body mass index (BMI), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), dyslipidaemia, atrial fibrillation, systolic blood pressure (SBP), baseline tolerability of ACEi/ARBs maximum dose, left ventricle global longitudinal strain (LVgLS), LV ejection fraction (EF), tricuspid annulus plane systolic excursion (TAPSE), right ventricle (RV) fractional area change (FAC), RV global and free wall longitudinal strain (RVgLS and RV‐FW‐LS). After the multivariable analysis, only one categorical (ACEi/ARBs maximum dose at baseline) and three continuous (younger age, higher SBP, and higher TAPSE), resulted significantly associated with the study outcome variable with a strong discriminatory capacity (area under the curve 0.874, 95% confidence interval (CI) (0.794–0.954) to predict maximum Sac/Val dose tolerability. Conclusions Our study is the first to analyse the potential role of echocardiography and, in particular, of RV dysfunction, measured by TAPSE, in predicting Sac/Val maximum dose tolerability. Therefore, patients with RV dysfunction (baseline TAPSE <16 mm, in our cohort) might benefit from a different strategy to titrate Sac/Val, such as starting from the lowest dose and/or waiting for a more extended period of observation before attempting with the higher doses

Articles. An annotated bibliography 2011

Mª Aguilar, «Banquetes sin filantro­pia: a proposito de De genio Socratis 594A ss.», Ploutarchos n. s. 9 (2011/2012) 3-14.The paper deals to a certain extent with the formal structure of the dialogue and argues that a paradox exists between, on the one hand, the conversation among the conspirators about the nature of the Socratic “daemon”, which by its subject and the characteristics of the speakers could be considered a real “symposion”, and, on the other, the so-called “symposion”, which gathers Archias, Philip and the other Spartans, who are only preocuppied with women and wine..

Articles. An annotated bibliography 2012

S. Amendola, «Un nomos atopos? Gli Efori e i baffi degli Spartani. Nota esegetica a De sera num. vind. 4.550B», in N., K., D., 121-136. Nelle opere superstiti di Plutarco è citato tre volte il singolare divieto, promulgato a Sparta, che proibiva agli Efori spartani, entrando in carica, di lasciarsi crescere i baffi: nella Vita di Cleomene (Cleom. 9.3), nel De sera numinis vindicta (550B), nel fr. 90 Sandbach (= Arist. fr. 539 Rose), appartenente al perduto commentario plutarcheo agli Erga di Esiodo..

Myc Prevents Apoptosis and Enhances Endoreduplication Induced by Paclitaxel

BACKGROUND: The role of the MYC oncogene in the apoptotic pathways is not fully understood. MYC has been reported to protect cells from apoptosis activation but also to sensitize cells to apoptotic stimuli. We have previously demonstrated that the down-regulation of Myc protein activates apoptosis in melanoma cells and increases the susceptibility of cells to various antitumoral treatments. Beyond the well-known role in the G1-->S transition, MYC is also involved in the G2-M cell cycle phases regulation. METHODOLOGY/PRINCIPAL FINDINGS: In this study we have investigated how MYC could influence cell survival signalling during G2 and M phases. We used the microtubules damaging agent paclitaxel (PTX), to arrest the cells in the M phase, in a p53 mutated melanoma cell line with modulated Myc level and activity. An overexpression of Myc protein is able to increase endoreduplication favoring the survival of cells exposed to antimitotic poisoning. The PTX-induced endoreduplication is associated in Myc overexpressing cells with a reduced expression of MAD2, essential component of the molecular core of the spindle assembly checkpoint (SAC), indicating an impairment of this checkpoint. In addition, for the first time we have localized Myc protein at the spindle poles (centrosomes) during pro-metaphase in different cell lines. CONCLUSIONS: The presence of Myc at the poles during the prometaphase could be necessary for the Myc-mediated attenuation of the SAC and the subsequent induction of endoreduplication. In addition, our data strongly suggest that the use of taxane in antitumor therapeutic strategies should be rationally based on the molecular profile of the individual tumor by specifically analyzing Myc expression levels

Nonadiabatic Breaking of Topological Pumping

We study Thouless pumping out of the adiabatic limit. Our findings show that despite its topological nature, this phenomenon is not generically robust to nonadiabatic effects. Indeed, we find that the Floquet diagonal ensemble value of the pumped charge shows a deviation from the topologically quantized limit which is quadratic in the driving frequency for a sudden switch on of the driving. This is reflected also in the charge pumped in a single period, which shows a nonanalytic behavior on top of an overall quadratic decrease. Exponentially small corrections are recovered only with a careful tailoring of the driving protocol. We also discuss thermal effects and the experimental feasibility of observing such a deviation

Impact of Freezing on the Microbiological Quality and Physical Characteristics of Buffalo Mozzarella Cheese

Buffalo Mozzarella cheese from Campania is one of the most worldwide appreciated Italian dairy products. The increased demand for buffalo dairy products and the limited availability of the finest buffalo milk has prompted the diffusion of illicit practices, such as the use of milk, curd, or other products that are frozen or bought at low cost. The aim of this research was to provide preliminary results about the trend of the microbial communities of buffalo milk, curd and Buffalo Mozzarella cheese, during freezing storage of eleven months. At the same time, the alterations of physical properties and the presence of the molecular marker &ldquo;&gamma;4-casein&rdquo;, have been investigated. The results showed that freezing reduced the concentrations of the total bacterial count, Enterobacteriaceae, coliforms, Escherichia coli and yeasts in fresh milk and, the concentrations of the total bacterial count, coliforms, lactic acid bacteria and yeasts in mature curd. In the finished product, no notable decreases were observed, except for lactic acid bacteria. About the &gamma;4-casein, no increase was observed in all matrices. These preliminary results allow us to conclude that the freezing process if properly carried out, does not compromise the microbiological quality and the physical properties of the Buffalo Mozzarella cheese