Diastasis of rectus abdominis muscles : patterns of anatomical variation as demonstrated by ultrasound

Purpose: The aim of our study was to categorise the anatomical variations of rectus abdominis muscle diastasis (diastasis recti) by using ultrasound (US). Material and methods: In a one-year period 92 women were evaluated with US because of suspected diastasis of rectus muscles. Patients were examined in a supine position, with head extended, upper limbs aligned to the trunk, and knees flexed. US was performed with high-frequency, broad-band transducers. Trapezoid field-of-view and extended field-of-view were employed to measure diastasis exceeding 5 cm. Diastasis was defined as a margin-to-margin distance > 20 mm at rest and classified according to the following anatomical patterns: open only above the navel, open only below the navel, open at the navel level, open completely but wider above the navel, and open completely but wider below the navel. Results: Diastasis was found in 82 patients (30-61 years old, mean age 35 years). The width was 21-97 mm, mean 39 mm. The prevalence and severity of the anatomical patterns was as follows: open only above the navel in 48 patients (21-88 mm, mean 40 mm), open only below the navel in one patient (33 mm), open at the navel level in seven patients (23-39 mm, mean 34 mm), open completely but wider above the navel in 24 patients (21-97 mm, mean 41 mm), open completely but wider below the navel in two patients (21-29 mm, mean 25 mm). Conclusions: The above-navel patterns of recti muscle diastasis are the most common. Even when open completely, diastasis is usually wider above the navel. Knowledge of the anatomical type of rectus muscle diastasis could be of value to the patient (exercises to do and to avoid) and to the surgeon (abdominoplasty planning)

THE SDGs IN THE REPORTS OF THE ITALIAN COMPANIES. RESEARCH DOCUMENT N. 16

The document represents the first result of the study conducted by the research group "SDGs and business reporting" and aims to be the starting point of a process for corporate awareness towards sustainable development objectives. The document reveals our country commitment on Agenda 2030; a commitment that involves the entire "Italian system" in pursuit of the 17 sustainable development goals, through the active role of Italian companies as operators. Hence, it not only creates economic value on sustainable development but also it sensitize other companies, end users and the community in general. Although the results depict a sustainable development goals reporting in becoming and not entirely conscious, they provide inputs for entrepreneurs, directors, managers, regulators, consultants, etc. who, for various reasons, are the actors in a process of profound business change that is affecting the corporate reporting and disclosures. The document provides, in this context, useful hints to a better understanding the new corporate reporting direction; indeed, reporting is increasingly affected by an accountability process and responsibility towards both internal and external stakeholders

Risk of Hepatocellular Carcinoma after HCV Clearance by Direct-Acting Antivirals Treatment. Predictive Factors and Role of Epigenetics

Abstract: Direct-acting antivirals (DAAs) induce a rapid virologic response (SVR) in up to 99% of chronic hepatitis C patients. The role of SVR by DAAs on the incidence or recurrence of carcinoma (HCC) is still a matter of debate, although it is known that SVR does not eliminate the risk of HCC. In this review, we made an updated analysis of the literature data on the impact of SVR by DAAs on the risk of HCC as well as an assessment of risk factors and the role of epigenetics. Data showed that SVR has no impact on the occurrence of HCC in the short–medium term but reduces the risk of HCC in the medium–long term. A direct role of DAAs in the development of HCC has not been demonstrated, while the hypothesis of a reduction in immune surveillance in response to the rapid clearance of HCV and changes in the cytokine pattern influencing early carcinogenesis remains to be further elucidated. HCV induces epigenetic alterations such as modifications of the histone tail and DNA methylation, which are risk factors for HCC, and such changes are maintained after HCV clearance. Future epigenetic studies could lead to identify useful biomarkers and therapeutic targets. Cirrhosis has been identified as a risk factor for HCC, particularly if associated with high liver stiffness and α-fetoprotein values, diabetes and the male sex. Currently, considering the high number and health cost to follow subjects’ post-HCV clearance by DAAs, it is mandatory to identify those at high risk of HCC to optimize management

Phenotypic and genetic characterization of a family carrying two Xq21.1-21.3 interstitial deletions associated with syndromic hearing loss

Sensorineural hearing impairment is a common pathological manifestation in patients affected by X-linked intellectual disability. A few cases of interstitial deletions at Xq21 with several different phenotypic characteristics have been described, but to date, a complete molecular characterization of the deletions harboring disease-causing genes is still missing. Thus, the aim of this study is to realize a detailed clinical and molecular analysis of a family affected by syndromic X-linked hearing loss with intellectual disability

GLI SDGs NEI REPORT DELLE IMPRESE ITALIANE. DOCUMENTI DI RICERCA N. 15

Il documento rappresenta il primo risultato dell\u2019attivit\ue0 di studio condotta dal gruppo di ricerca \u201cSDGs e reporting aziendale\u201d e intende costituire il punto di partenza di un percorso di sensibilizzazione aziendale verso gli obiettivi di sviluppo sostenibile. Le ragioni di un tale documento muovono dall\u2019impegno preso dal nostro paese su Agenda 2030, un impegno che coinvolge l\u2019intero \u201cSistema Italia\u201d nel perseguimento dei 17 obiettivi di sviluppo sostenibile, anche attraverso il ruolo attivo delle imprese italiane nella veste di operatori economici che oltre a creare valore sensibilizzano sullo sviluppo sostenibile altre aziende, consumatori finali e collettivit\ue0 in generale. I risultati a cui la ricerca giunge, pur fotografando un livello di rendicontazione in tema di obiettivi di sviluppo sostenibile in profondo divenire e non del tutto consapevole, forniscono elementi di utilit\ue0 per tutti coloro (imprenditori, amministratori, manager, organi di controllo, consulenti) che, a diverso titolo, sono attori di un processo di profondo cambiamento aziendale che sta interessando il corporate reporting e l\u2019informativa di bilancio. Il documento offre, in tale prospettiva, utili spunti per comprendere la giusta direzione verso cui sta andando la rendicontazione aziendale, una rendicontazione sempre pi\uf9 investita da un processo di accountability e, quindi, di responsabilizzazione verso stakeholder interni ed esterni

Guidelines on the diagnosis, treatment and management of visceral and renal arteries aneurysms: a joint assessment by the Italian Societies of Vascular and Endovascular Surgery (SICVE) and Medical and Interventional Radiology (SIRM)

: The objective of these Guidelines is to provide recommendations for the classification, indication, treatment and management of patients suffering from aneurysmal pathology of the visceral and renal arteries. The methodology applied was the GRADE-SIGN version, and followed the instructions of the AGREE quality of reporting checklist. Clinical questions, structured according to the PICO (Population, Intervention, Comparator, Outcome) model, were formulated, and systematic literature reviews were carried out according to them. Selected articles were evaluated through specific methodological checklists. Considered Judgments were compiled for each clinical question in which the characteristics of the body of available evidence were evaluated in order to establish recommendations. Overall, 79 clinical practice recommendations were proposed. Indications for treatment and therapeutic options were discussed for each arterial district, as well as follow-up and medical management, in both candidate patients for conservative therapy and patients who underwent treatment. The recommendations provided by these guidelines simplify and improve decision-making processes and diagnostic-therapeutic pathways of patients with visceral and renal arteries aneurysms. Their widespread use is recommended

Diagnostic imaging of parotid gland oncocytoma: a pictorial review with emphasis on ultrasound assessment

Parotid gland oncocytoma (PGO) is a rare benign epithelial tumor that usually occurs in the elderly population. The most common clinical presentation is a painless, slow-growing, non-tender, lobulated, and mobile mass. Histologically, it is composed of monotonous sheets of epithelial cells (oncocytes) with a central scar. The cross-sectional appearance is not specific, and it overlaps with other parotid lesions. On ultrasound (US), oncocytoma appears as an ovoid, well-defined, homogeneous, and hypoechoic lesion. Cystic and hemorrhagic areas as well as intralesional fat may be observed. Doppler analysis shows intratumoral vessels, sometimes with a spoke-wheel pattern. The peak systolic flow is high (up to 100 cm/sec). Furthermore, oncocytoma is avid of FDG on a PET scan, as well as a malignant tumor. Thus, a combined clinical, imaging, and pathologic assessment is essential to establish the most accurate diagnosis and plan the best treatment. US, combined with Doppler techniques, can play an important role in suggesting the diagnosis and confirming it through percutaneous sampling. The purpose of this review is to show the imaging findings in PGO, with special emphasis on the US appearance

Procedura di rialzo del seno monofasica verso bifasica: risultati ad 1 anno dal carico di uno studio controllato randomizzato multicentrico.

OBIETTIVO: Confrontare l\u2019efficacia della procedura di rialzo del seno mascellare laterale monofasica verso quella bifasica. MATERIALI E METODI: Sono stati inclusi 60 pazienti parzialmente edentuli che necessitavano da 1 a 3 impianti e con un\u2019altezza ossea residua di 1- 3 mm e uno spessore di almeno 5 mm al di sotto del seno mascellare, misurata su tomografie computerizzate. I pazienti sono stati randomizzati secondo un disegno di studio a gruppi paralleli in 2 gruppi per essere sottoposti a procedura di rialzo del seno in un unico intervento (monofasica) mediante apertura di una finestra laterale e contestuale posizionamento degli impianti oppure ad una procedura di rialzo del seno in 2 interventi (bifasica) con posizionamento degli impianti a distanza di 4 mesi dal rialzo di seno con sostituto d\u2019osso. Gli interventi sono stati eseguiti in 3 centri diversi. Gli impianti sono rimasti sommersi per 4 mesi e in seguito caricati con protesi provvisorie rinforzate, che sono state sostituite dopo 4 mesi con protesi definitive. I parametri di successo, valutati da valutatori in cieco sono stati: fallimenti delle procedure di aumento, fallimenti protesici e fallimenti implantari; complicazioni; e variazioni dei livelli ossei marginali peri-implantari. I pazienti sono stati seguiti fino ad 1 anno dal carico. Sono qui riportati solo i dati relativi agli impianti posizionati in un\u2019altezza ossea subantrale fra 1 e 3 mm. RISULTATI: Nel gruppo della procedura monofasica ci sono stati 2 drop-out verso nessuno per il secondo gruppo. Non c\u2019\ue8 stato nessun fallimento delle procedure di rialzo nel gruppo monofasico verso un fallimento nel gruppo bifasico, ma la differenza non \ue8 stata statisticamente significativa (P = 1,00). Ci sono stati 2 fallimenti protesici (o casi in cui non \ue8 stato possibile posizionare le protesi nel tempo previsto) nel gruppo monofasico e uno nel gruppo bifasico, ma la differenza non \ue8 stata statisticamente significativa (P = 0,51). Sono falliti 3 impianti in 3 pazienti nel gruppo monofasico verso 1 nel gruppo a bifasico, ma la differenza non \ue8 stata statisticamente significativa (P = 0,28). Si sono verificate 2 complicazioni nel gruppo monofasico e 1 nel gruppo bifasico, ma la differenza non \ue8 stata statisticamente significativa (P=0,61). Ad 1 anno dal carico, i pazienti trattati con procedura monofasica hanno perso di media -1,01 mm (DS: 0,56) di osso peri-implantare verso -0,93 mm per i siti del gruppo bifasico (DS: 0,40). Non sono state riscontrate differenze statisticamente significative a livello di variazioni dei livelli ossei tra i 2 gruppi a distanza di 1 anno dal carico (-0,08 mm IC 95%: da -0,33 a 0,18, P = 0,56). CONCLUSIONI: Non \ue8 stata osservata nessuna differenza staticamente significativa tra le 2 procedure di rialzo del seno. Tuttavia, il presente studio potrebbe suggerire che in pazienti con un\u2019altezza ossea residua compresa tra 1 e 3 mm al di sotto del seno mascellare, il rischio di fallimento implantare \ue8 leggermente superiore per la procedura monofasica