Bile leak after elective laparoscopic cholecystectomy: Role of MR imaging

Increasing hepatobiliary laparoscopic surgeries have lead to a rise in injury to the biliary tree and other complications like bile leak. Ultrasonography (US) and computed tomography (CT) cannot reliably distinguish bile from other postoperative fluid collections. Magnetic resonance (MR) imaging with hepatobiliary agents and MR cholangiopancreatography provide anatomic and functional information that allows for prompt diagnosis and excludes any other concomitant complications. We report a case of post-cholecystectomy bile leak in a 42-year-old female who presented with persistent dull abdominal pain after the intervention; we emphasize the role of MR imaging in achieving the correct diagnosis

Endoscopia dinamica delle prime vie aeree su treadmill: stato dell'arte e casistica clinica

L’endoscopia dinamica su treadmill ad alta velocità è considerata a oggi il metodo di indagine più accurato per le patologie da instabilità del faringe-laringe. Nonostante non riproduca le reali condizioni di corsa e siano state sviluppate nuove tecnologie per l’esecuzione di endoscopie dinamiche in campo, l’endoscopia su treadmill è indispensabile per la valutazione del tratto respiratorio superiore. Scopo del presente lavoro è stato quello di studiare in maniera retrospettiva la nostra casistica e confrontarla con la letteratur

Mild exposure of RIN-5F β-cells to human islet amyloid polypeptide aggregates upregulates antioxidant enzymes via NADPH oxidase-RAGE: An hormetic stimulus

AbstractThe presence of amyloid aggregates of human islet amyloid polypeptide (hIAPP), a hallmark of type 2 diabetes, contributes to pancreatic β-cell impairment, where oxidative stress plays a key role. A contribution of NADPH oxidase to reactive oxygen species (ROS) generation after cell exposure to micromolar concentrations of hIAPP aggregates has been suggested. However, little is known about β-cells exposure to lower amounts of hIAPP aggregates, similar to those found in human pancreas. Thus, we aimed to investigate the events resulting from RIN-5F cells exposure to nanomolar concentrations of toxic hIAPP aggregates. We found an early and transient rise of NADPH oxidase activity resulting from increased Nox1 expression following the engagement of receptor for advanced glycation end-products (RAGE) by hIAPP aggregates. Unexpectedly, NADPH oxidase activation was not accompanied by a significant ROS increase and the lipoperoxidation level was significantly reduced. Indeed, cell exposure to hIAPP aggregates affected the antioxidant defences, inducing a significant increase of the expression and activity of catalase and glutathione peroxidase. We conclude that exposure of pancreatic β-cells to nanomolar concentrations of hIAPP aggregates for a short time induces an hormetic response via the RAGE-Nox1 axis; the latter stimulates the enzymatic antioxidant defences that preserve the cells against oxidative stress damage

Patient-specific cardiovascular superelastic NiTi stents produced by laser powder bed fusion

To date, there is a general lack of customizability within the selection of endovascular devices for catheter-based vascular interventions. Laser powder bed fusion (LPBF) has been flexibly exploited to produce customized implants using conventional biomedical alloys for orthopedic and dental applications. Applying LPBF for cardiovascular applications, patient-specific stents can be produced with small struts (approximately 100-300 µm), variable geometries, and clinically used metals capable of superelastic behaviour at body temperature (eg. equiatomic nickel-titanium alloys, NiTi). Additionally, the growing availability and use of patient-specific 3D models provides a unique opportunity to outline the necessary manufacturing process that would be required for customizable NiTi devices based on patient geometry. In order to fulfil the potential of the patient-specific superelastic stents, process and design know-how should be expanded to the novel material and fine details at the limits of conventional LPBF machines. In this work, a framework for developing a patient-specific superelastic NiTi stent produced by LPBF is demonstrated. At a proof-of-concept stage, the design procedures are shown in a geometry similar to the artery. The stents with 100 µm nominal strut diameter are later produced with a Ni50.8Ti49.2 powder and heat treated. The results confirm the possibility of producing stents with a design suitable for highly complex patient-specific anatomies and having superelastic behavior at body temperature

Use of different subjective health indicators to assess health inequalities in an urban immigrant population in north-western Italy: a cross-sectional study

BACKGROUND: Despite the steady growth of the immigrant population in Italy, data on the health status of immigrants are scarce. Our main goals were to measure Health-Related Quality of Life (HRQoL), Self-Rated Health (SRH) and morbidity among immigrants in Genoa. We aimed to assess the relative contribution of some social, structural and behavioral determinants to “within-group” health disparities. METHODS: We enrolled 502 subjects by means of snowball sampling. The SF-12 questionnaire, integrated with socio-demographic and health-related items, was used. Multivariate logistic and Poisson regression models were applied in order to identify characteristics associated with poor SRH, lower SF-12 scores and prevalence of self-reported morbidities. RESULTS: Subjects showed relatively moderate levels of HRQoL (median physical and mental scores of 51.6 and 47.3, respectively) and about 15% of them rated their health as fair or poor. Lower scores in the physical dimension of HRQoL were associated with the presence of morbidities and immigration for work and religious reasons, while those who had migrated for religious and family reasons displayed a lower probability of lower scores in the mental dimension of HRQoL. Poor SRH was associated with female gender, overweight/obesity and presence of morbidities. Moreover, compared with immigrants from countries with a low human development index, immigrants from highly developed societies showed significantly lower odds of reporting poor SRH. About one-third of respondents reported at least one medical condition, while the prevalence of multi-morbidity was 10%. Females, over 45-year-olds, overweight and long-term immigrants had a higher prevalence of medical conditions. CONCLUSIONS: Our study confirms the presence of health inequalities within a heterogeneous immigrant population. HRQoL, SRH and morbidity are valid, relatively rapid and cheap tools for measuring health inequalities, though they do so in different ways. These indicators should be used with caution and, if possible, simultaneously, as they could help to identify and to monitor more vulnerable subjects among immigrants

Isolated Forehead Swelling

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