Correlates of spinal deforming index (SDI) in HIV-positive patients naive and on treatment

Methods HIV-infected subjects naive or on stable HAART were included. Vertebral deformities were identified using SDI (according to semiquantitative method by Genant), calculated by summing the deformity grades of all vertebrae (T4 to L4); pathological deformities are defined as follow: grade 1 between 20–25%, grade 2 between 26–40%, and grade 3 > >40%. According to WHO criteria, osteopenia and osteoporosis were diagnosed in patients having spine BMD calculated as -1 << T-score << -2.5 and T-score ≤≤2.5, respectively. The correlation between SDI and spine BMD was evaluated by univariate and multivariate linear regression. [Other variables considered: gender, age, current CD4 count, CD4 nadir, BMI, lipid parameters, alcohol intake, smoking habit, physical activity, family history for bone fracture, months of ARV exposure, and co-infection with hepatitis viruses; only the variables with p <<0.2 in univariate analyses were included in the final model.

Decompensated liver cirrhosis: assessment of complications and mortality in hospitalised patients

Background. Liver cirrhosis is a severe, progressively fatal disease if untreated. Hospitalised patients face high mortality rates, and current methods for assessing prognosis vary widely. The research aims to investigate complications and predictors of mortality in patients admitted for decompensated cirrhosis to a tertiary care centre in Tirana, Albania. Materials and methods. The retrospective study included 212 patients aged (58.67 ± 10.09) years: 174 (82.1 %) men, 38 (17.9 %) women. The Child-Turcotte-Pugh, MELD, MELD-Na, MELD 3.0, iMELD, MESO, and UKELD scales were used to assess the severity of the condition and risk stratification of patients. The number of patients with a fatal outcome was 43 (20.3 %). Results. Among participants with different etiological factors of liver cirrhosis, the mortality rate did not differ significantly (p = 0.873). The presence of hepatic encepha­lopathy (0.43; p = 0.001), acute-on-chronic liver failure (r = 0.47; p = 0.001) and hepatorenal syndrome (r = 0.49; p = 0.001), and, to a lesser extent, ascites (r = 0.18; p = 0.006) and spontaneous bacterial peritonitis (r = 0.23; p = 0.041) was a marker of unfavourable prognosis of hospitalisation. Also, the risk of death increased in the presence of leukaemia (hazard ratio = 4.21 (1.65; 10.74); p = 0.003). Conclusions. The MELD 3.0 and MELD-Na scores, calculated based on laboratory values obtained within 48–72 hours of hospitalisation, were found to be the prognostically significant (p < 0.05

Direct correlation between ischemic burden induced by dipyridamole and stress peak filling rate: a gated perfusion single-photon emission computed tomography study

Aim and patients: The aim of the present study was to assess the effects of dipyridamole on stress and rest peak filling rate in consecutive patients who showed perfusion and, or function abnormalities at Gated-SPECT. Were enrolled 96 patients (73 males (76%); mean age 71.7 \ub1 9.57). Forty patients (41.7%) had an history of myocardial infarction and fifty-seven (59.4%) of previous cardiac revascularization. All patients underwent a 2-day 99mTc-SestaMIBI gated perfusion SPECT protocol. Results: Twenty-nine (30.2%) patients showed fixed perfusion defects, 54 (56.2%) showed partially or completely reversible ones, while 13 (13.5%) showed normal perfusion but reduced LVEF. SSS was significantly higher than SRS (9.55 \ub1 9.29 vs. 7.10 \ub1 8.48; P = 0.0001). Stress peak filling rate was not significantly higher than rest peak filling rate (1.73 EDV/s \ub1 0.69 EDV/s vs. 1.67 EDV/s \ub1 0.56 EDV/s; P = 0.62). At a multivariate regression analysis, only stress peak filling rate, as independent variable, was directly correlated with myocardial ischemia (SDS) (P = 0.018). We divided patients according to SDS in those with mild (SDS &lt; 5) and severe (SDS 65 5) ischemia. Stress peak filling rate was the only parameter significantly different between groups. Conclusion: Stress PFR showed a better correlation with the degree of ischemia compared to the remaining perfusion and functional parameters. The direct correlation between SDS and stress PFR leads us to speculate that dipyridamole could improve diastolic function in ischemic patients

Proliferation and Apoptosis of Cat (Felis catus) Male Germ Cells during Breeding and Non-Breeding Seasons

The domestic cat (Felis catus) is a seasonal-breeding species whose reproductive period starts when the day length increases. Since the existing information on cat spermatogenesis is limited and somewhat contradictory, in the present study, germ cell proliferation and apoptosis in feral adult tomcats orchiectomized during reproductive (reproductive group, RG; February–July) and non-reproductive (non-reproductive group, NRG; November and December) seasons were compared. Cross-sections taken from the middle third of the left testis were chemically fixed and embedded in paraffin wax. Histological sections were processed for the immunohistochemical detection of proliferating germ cells (PCNA) and for the identification of apoptotic cells (TUNEL method). The percentage of PCNA-positive spermatogonia was higher in the RG than in the NRG. On the contrary, germ cell apoptosis was higher in the NRG than in the RG. Our results confirm that cat spermatogenesis is modulated on a seasonal basis and suggests that spermatogenesis control involves changes in germ cell proliferation and apoptosis according to a common paradigm of seasonally breeding species

A multicentre roadmap to restart elective cardiac surgery after COVID-19 peak in an Italian epicenter

Background: During the Italian Phase-2 of the coronavirus pandemic, it was possible to restart elective surgeries. Because hospitals were still burdened with coronavirus disease 2019 (COVID-19) patients, it was focal to design a separate “clean path” for the surgical candidates and determine the possible effects of major surgery on previously infected patients. Methods: From May to July 2020 (postpandemic peak), 259 consecutive patients were scheduled for elective cardiac surgery in three different centers. Our original roadmap with four screening steps included: a short item questionnaire (STEP-1), nasopharyngeal swab (NP) (STEP-2), computed tomography (CT)-scan using COVID-19 reporting and data system (CO-RADS) scoring (STEP-3), and final NP swab before discharge (STEP-4). Results: Two patients (0.8%) resulted positive at STEP-2: one patient was discharged home for quarantine, the other performed a CT-scan (CO-RADS: 75 years: odds ratio [OR]: 2.6; 95% confidence interval [CI]: 1.25–5.57; p = 0.011; CPB >90 min. OR: 4.3; 95% CI: 1.84–10.16; p = 0.001). At 30 days, no periprocedural contagion and rehospitalization for COVID-19 infections were reported. Conclusions: Our structured roadmap supports the safe restarting of an elective cardiac surgery list after a peak of a still ongoing COVID-19 pandemic in an epicenter area. Mild to moderate CT residuals of coronavirus pneumonia do not justify elective cardiac surgery procrastination

Hepatitis B, C and Delta virus infections in Albanian patients with chronic liver disease: evaluation of possible changes during the last 10 years

Objective and methods The prevalence of viral hepatitis markers and of alcohol intake was evaluated in 106 and 99 Albanian patients with the diagnosis of viral and/or alcoholic chronic liver disease who were consecutively admitted to the University Hospital Center of Tirana, during 1995 and 2005, respectively. Results A slight decrease in HBsAg (78 vs. 70%) and HBeAg (18 vs. 12%) prevalences were observed in patients admitted to the hospital during 2005 compared with those admitted during 1995, respectively. In both periods of time, hepatitis B virus (HBV) DNA (genotype D) tested positive in all HBsAg-positive patients and in 36% of HBsAg-negative patients. Anti-hepatitis C virus (HCV) prevalence (mainly observed after 30 years of age) was 14 versus 11 %; anti-hepatitis Delta virus (HDV) prevalence (more frequently present in young age group patients) was 9 versus 7% during 1995 and 2005, respectively. Among patients who reported alcohol intake, alcoholic liver disease (HBsAg and anti-HCV negative) was diagnosed in 35 and in 57% of patients admitted during 1995 and 2005, respectively (P=0.05). Conclusion In Albanian patients with chronic liver disease, we have found that: (i) HBV remained the most important aetiologic factor of chronic liver disease; HDV and HCV prevalences were still low, (ii) in HBsAg-positive patients, HBeAg-negative chronic hepatitis prevailed, (iii) in HBsAg-negative patients, HBV DNA prevalence was high, (iv) during the last decade, an increased prevalence of alcohol intake in the aetiology of chronic liver disease was observed. Eur J Gastroenterol Hepatol 22:167-171 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Male germ cell proliferation and apoptosis in sexually immature meagre Argyrosomus regius (Asso, 1801) treated with recombinant follicle stimulating hormone

The meagre Argyrosomus regius (Asso, 1801) is a marine fish species that has an increasing aquaculture production in Europe. Lowering the age at maturity of hatchery-produced juveniles would support meagre aquaculture by reducing time between generations in selective breeding programs and reducing industrial costs for broodstock maintenance. The aim of this work was to assess the effects of a treatment with recombinant follicle stimulating hormone (rFsh), produced in ovarian cells of Chinese hamsters, on male germ cell proliferation and apoptosis in sexually immature meagre. The rFsh-treated fish had higher gonadosomatic index, larger seminiferous tubules, more abundant luminal spermatozoa, a lower density of anti-PCNA positive single A spermatogonia, a higher density of anti-PCNA positive spermatocysts and a lower incidence of germ cell apoptosis than control groups. The present study demonstrated the effectiveness of the produced rFsh in stimulating testis development and spermatogenesis in pre-pubertal meagre. Moreover, the rFsh treatment proved to be highly efficient in removing the apoptotic block of spermatogenesis observed in juvenile meagre, allowing spermatogonial survival and progress towards meiosis. The administration of rFsh did not stimulate spermatogonial self-renewal, a process whose control still needs to be elucidated