infective endocarditis today

Endocarditis is an infectious disease caused by numerous microorganisms, many of which habitually colonize the oral cavity and skin. Various bacteria and bacterial factors influence the duration of bacteremia and the possible colonization of cardiac valves. If not recognized and treated early, the disease may have serious consequences until death: despite the possibility of setting up targeted antibiotic therapy, it may occur in 30% of cases. This event is related to sepsis that develops in these patients and can result in cellular functional alterations in many districts, resulting in multi-organ failure (MOF) status. This paper is aimed to present an overview of this condition, based on the author's own clinical experience and literature review

Infective Endocarditis: what is changed in Epidemiology and Prophylaxis

This article shows the most recent opinions in the literature, concerning the epidemiology and prophylaxis of infective endocarditis (I.E.). They are also defined the basic principles of the previous guidelines and the reasons for their comprehensive reformulation. The article finally illustrates the new recommendations for prophylaxis of IE

Eco-innovazione dei processi produttivi: analisi e azioni di intervento per l'efficentamento energetico

La crisi congiunturale ha notevolmente appesantito la situazione del Settore della Pesca già strutturalmente difficile. Nel “Rapporto Annuale sulla Pesca e sull’Acquacoltura in Sicilia”, redatto dall’Osservatorio della Pesca, si afferma che “in un contesto prospettico così difficile la quantità di energia specifica, ossia energia consumata per kg di prodotto (kWh/kg di prodotto), necessaria a fornire il prodotto ittico sul mercato deve diventare un indicatore guida per le politiche di ammodernamento ed innovazione. Pertanto è necessaria un’opportuna conoscenza di tutti i consumi energetici necessari per la produzione che, grazie all’utilizzo di pochi e significativi indicatori (quali l’energia per unità di prodotto, la quantità d’acqua per unità di prodotto e le emissioni ed i rilasci inquinanti per unità di prodotto), consenta di descrivere dinamicamente lo stato e la tendenza della filiera ittica”. In tale quadro, è evidente che il fattore energetico rappresenta una componente che ha una rilevante incidenza sulla competitività della Filiera e che, spesso, i vari anelli produttivi “pagano” costi di gestione elevati a causa dell’inefficienza energetica. In un contesto di consumatori sempre più attenti al rispetto ambientale e alla sostenibilità dei prodotti, l’impatto che i sistemi produttivi non efficienti hanno sull’ambiente ha un ritorno negativo anche rispetto all’immagine complessiva della Filiera e dei prodotti: in tal senso, la mancanza di sistemi di gestione ambientale efficaci ed adeguati può risultare, nel lungo periodo, un elemento di penalizzazione sui mercati. Nel progetto “Centro di certificazione e prova del Distretto”, Piani di sviluppo di filiera, linea di intervento: 5.1.1.1 – piano integrato dei servizi comuni, l’attività svolta da questo laboratorio, ECO-INNOVAZIONE DEI PROCESSI PRODUTTIVI, ha lo scopo di calcolare i consumi energetici delle aziende del distretto, prese in esame come campione di studio, e studiare le possibili azioni per ottimizzare, mitigare i consumi e/o l’impatto ambientale come minore emissione di CO2 in atmosfera. Tali attività consentiranno al Distretto, alle sue aziende e tutte le altre aziende del settore di poter conoscere l'energia consumata e quella potenzialmente risparmiata dalle eventuali azioni di efficientamento che saranno proposte da questo gruppo di lavoro

STATE OF ART ON TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI) FOR THE TREATMENT OF AORTIC STENOSIS

Transcatheter Aortic Valve Implantation (TAVI) technique represents a real revolution in the field of interventional cardiology and medicine, in particularly for the treatment of aortic valve stenosis in elderly patients, or in patients when the periprocedural risk for the traditional surgical option is considered too high, as an alternative to the traditional aortic valve replacement. From the year 2002, when Cribier, in France, performed the first transcatheter aortic valve implantation (TAVI), in a period of just over a decade, this technique has become a reality in clinical practice of cardiologists interventionists worldwide. The data of follow-up in the long term are currently available mainly for the valves of the first generation. These data show an excellent, also at long term, hemodynamic performance. Although experience on the valves of the last generation is still limited in time, the data currently available are definitely in the direction of a minimum hospital mortality (1%), as well as to a drastic reduction in the incidence of complications, compared to the devices of the previous generation. Finally, the evolution of specified materials of the newest generation have greatly enhanced safety and efficacy of TAVI procedures in the last year

Philosophy and Hippocratic Ethic in Ancient Greek Society: Evolution of Hospital - Sanctuaries

The aim of this paper is to offer a new perspective of the Hippocratic thought and how it influenced the evolution of the medical art till now, highlighting the ethical aspects and hospital born from ancient temples and sanctuary. Ethics is defined as a set of values, principles, and rules that regulate human behavior and relate to how human actions can significantly affect not only their own lives but also the lives of others. The essence of a culture can be perceived by the philosophy and the means by which is placed against the illness and its treatment. In this sense, the medical anthropology of every age is an indicator of its culture and help us understand its basic dimensions such as life and death

ADMINISTRATION OF FRUCTOSE 1,6-DIPHOSPHATE DURING EARLY REPERFUSION SIGNIFICANTLY IMPROVES RECOVERY OF CONTRACTILE FUNCTION IN THE POSTISCHEMIC HEART

AbstractObjectives: Fructose-1,6-diphosphate is a glycolytic intermediate that has been shown experimentally to cross the cell membrane and lead to increased glycolytic flux. Because glycolysis is an important energy source for myocardium during early reperfusion, we sought to determine the effects of fructose-1,6-diphosphate on recovery of postischemic contractile function. Methods: Langendorff-perfused rabbit hearts were infused with fructose-1,6-diphosphate (5 and 10 mmol/L, n = 5 per group) in a nonischemic model. In a second group of hearts subjected to 35 minutes of ischemia at 37° C followed by reperfusion (n = 6 per group), a 5 mmol/L concentration of fructose-1,6-diphosphate was infused during the first 30 minutes of reperfusion. We measured contractile function, glucose uptake, lactate production, and adenosine triphosphate and phosphocreatine levels by phosphorus 31–nuclear magnetic resonance spectroscopy. Results: In the nonischemic hearts, fructose-1,6-diphosphate resulted in a dose-dependent increase in glucose uptake, adenosine triphosphate, phosphocreatine, and inorganic phosphate levels. During the infusion of fructose-1,6-diphosphate, developed pressure and extracellular calcium levels decreased. Developed pressure was restored to near control values by normalizing extracellular calcium. In the ischemia/reperfusion model, after 60 minutes of reperfusion the hearts that received fructose-1,6-diphosphate during the first 30 minutes of reperfusion had higher developed pressures (83 ± 2 vs 70 ± 4 mm Hg, p < 0.05), lower diastolic pressures (7 ± 1 vs 12 ± 2 mm Hg, p < 0.05), and higher phosphocreatine levels than control untreated hearts. Glucose uptake was also greater after ischemia in the hearts treated with fructose-1,6-diphosphate. Conclusions: We conclude that fructose-1,6-diphosphate, when given during early reperfusion, significantly improves recovery of both diastolic and systolic function in association with increased glucose uptake and higher phosphocreatine levels during reperfusion. (J Thorac Cardiovasc Surg 1998;116:335-43

Automated Analysis of MUTEX Algorithms with FASE

In this paper we study the liveness of several MUTEX solutions by representing them as processes in PAFAS s, a CCS-like process algebra with a specific operator for modelling non-blocking reading behaviours. Verification is carried out using the tool FASE, exploiting a correspondence between violations of the liveness property and a special kind of cycles (called catastrophic cycles) in some transition system. We also compare our approach with others in the literature. The aim of this paper is twofold: on the one hand, we want to demonstrate the applicability of FASE to some concrete, meaningful examples; on the other hand, we want to study the impact of introducing non-blocking behaviours in modelling concurrent systems.Comment: In Proceedings GandALF 2011, arXiv:1106.081

Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete.

Provide the state of the art concerning (1) biology and aetiology, (2) classification, (3) clinical assessment and (4) conservative treatment of lower limb muscle injuries (MI) in athletes. Seventy international experts with different medical backgrounds participated in the consensus conference. They discussed and approved a consensus composed of four sections which are presented in these documents. This paper represents a synthesis of the consensus conference, the following four sections are discussed: (i) The biology and aetiology of MIs. A definition of MI was formulated and some key points concerning physiology and pathogenesis of MIs were discussed. (ii) The MI classification. A classification of MIs was proposed. (iii) The MI clinical assessment, in which were discussed anamnesis, inspection and clinical examination and are provided the relative guidelines. (iv) The MI conservative treatment, in which are provided the guidelines for conservative treatment based on the severity of the lesion. Furthermore, instrumental therapy and pharmacological treatment were discussed. Knowledge of the aetiology and biology of MIs is an essential prerequisite in order to plan and conduct a rehabilitation plan. Another important aspect is the use of a rational MI classification on prognostic values. We propose a classification based on radiological investigations performed by ultrasonography and MRI strongly linked to prognostic factors. Furthermore, the consensus conference results will able to provide fundamental guidelines for diagnostic and rehabilitation practice, also considering instrumental therapy and pharmacological treatment of MI. Expert opinion, level IV

CNS targets of adipokines

This is the author accepted manuscript. The final version is available from American Physiological Society via the DOI in this record.Our understanding of adipose tissue as an endocrine organ has been transformed over the last twenty years. During this time a number of adipocyte-derived factors or adipokines have been identified. This paper will review evidence for how adipokines acting via the central nervous system (CNS) regulate normal physiology and disease pathology. The reported CNS-mediated effects of adipokines are varied and include the regulation of energy homeostasis, autonomic nervous system activity, the reproductive axis, neurodevelopment, cardiovascular function, and cognition. Due to the wealth of information available and the diversity of their known functions, the archetypal adipokines leptin and adiponectin will be the focused on extensively. Other adipokines with established CNS actions will also be discussed. Due to the difficulties associated with studying CNS function on a molecular level in humans, the majority of our knowledge, and as such the studies described in this paper, comes from work in experimental animal models; however, where possible the relevant data from human studies are also highlighted

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p &lt; 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p &lt; 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p &lt; 0.0001) or urgent (20.4% vs. 38.5%; p &lt; 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p &lt; 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice