The intraductal approach to the breast: raison d'être

Opportunities for the detection, prediction, and treatment of breast cancer exist at three biological levels: systemically via the blood, at the whole organ level, and within the individual ductal lobular structures of the breast. This review covers the evaluation of approaches targeted to the ductal lobular units, where breast cancer begins. Studies to date suggest the presence of 5 to 12 independent ductal lobular systems per breast, each harboring complex cellular fluids contributed by local and systemic processes. New techniques for accessing and interrogating these systems offer the potential to gauge the microenvironment of the breast and distill biological risk profiles

Energy performance strategies for the large scale introduction of geothermal energy in residential and industrial buildings: The GEO.POWER project

Use of shallow geothermal energy, in terms of ground coupled heat pumps (GCHP) for heating and cooling purposes, is an environmentally-friendly and cost-effective alternative with potential to replace fossil fuels and help mitigate global warming. Focusing on the recent results of the GEO.POWER project, this paper aims at examining the energy performance strategies and the future regional and national financial instruments for large scale introduction of geothermal energy and GCHP systems in both residential and industrial buildings

Delayed diagnosis of Prader-Willi syndrome in a 24 year-old patient

Background: Prader-Willi syndrome (PWS) is the most common known genetic cause of life-threatening obesity in children. The purpose of the study was to present the case of a delayed diagnosis of PWS in a 24-year-old male and the importance of an early PWS diagnosis as well as behavioral and institutional treatment issues. Case Report: A young man presented with a history of hyperphagia, severe obesity, and mental retardation. From his history, laboratory data, and molecular analysis using a DNA marker it was decided that he was affected by PWS. Conclusions: As healthcare professionals, we emphasize the need for approaching each person who has PWS as an individual and to be sensitive to traits and choose the most appropriate therapeutic approach. © The American Journal of Case Reports, 2010

Short term omega-3 polyunsaturated fatty acid supplementation induces favorable changes in right ventricle function and diastolic filling pressure in patients with chronic heart failure; A randomized clinical trial

Introduction: Omega-3 polyunsaturated fatty acids (omega 3-PUFAs) seem to favorably affect cardiac hemodynamics and may benefit the clinical course of heart failure patients. The role of omega 3-PUFAs supplementation on the left and right ventricular function of patients with chronic compensated systolic heart failure, under optimal treatment, was studied. Methods: 205 consecutive patients with chronic compensated heart failure, due to ischemic (IHF) or dilated cardiomyopathy (DCM)-NYHA classification I-III, under optimal medical treatment, were enrolled. Participants were 1-to-1 randomized on 1000 mg omega 3-PUFA supplementation or no supplementation, in a non-blinded fashion. Echocardiographic assessment was performed at first visit and 6 months after. Plasma BNP and serum creatinine levels were also measured. Results: As compared with the control group, BNP levels in omega 3-PUFA intervention group were 34.6% lower (p = 0.001); end-diastolic and end-systolic left ventricle dimensions were decreased by 2.5% (p = 0.047) and 3.7% (p = 0.01), maximum diameter of left atrium was decreased by 8.4% (p = 0.004), left atrium ejection fraction was ameliorated by 6.03% (p = 0.021) and as regards tissue Doppler parameters, TDI_Etv/Atv was decreased in omega 3-PUFA intervention group by 6.3% (p = 0.038). Moreover, improvement in diastolic indices was more prominent in subjects with DCM as compared to IHF patients. Conclusion: Omega 3-PUFA supplementation was associated with improved left diastolic function and decreased BNP levels in patients with chronic heart failure. These findings suggest a beneficial role of omega 3-PUFAs on the hemodynamic course of patients with systolic heart failure. © 2016 Elsevier Inc

Energetic Analysis of Low Global Warming Potential Refrigerants as Substitutes for R410A and R134a in Ground-Source Heat Pumps

The European building sector is responsible for approximately 40% of total energy consumption and for 36% of greenhouse gas emissions. Identifying technological solutions capable of reducing energy consumption and greenhouse gas emissions is one of the main objectives of the European Commission. Ground source heat pumps (GSHPs) are of particular interest for this purpose, promising a considerable reduction in greenhouse gas emissions of HVAC systems. This paper reports the results of the energetic analysis carried out within the EU research project GEO4CIVHIC about the performance of geothermal heat pumps working with low-GWP refrigerants as alternatives for R134a and R410A. The work has been carried out through computer simulations based on base and regenerative reverse cycles. Several heat sink and heat source temperature conditions have been considered in order to evaluate the GSHPs’ performance in the whole range of real conditions that can be found in Europe. Particular attention has been paid to the evaluation of compression isentropic efficiency and its influence on the overall cycle performance when dealing with steady-state heat pump simulations. To do so, five different scenarios of isentropic efficiency calculation have been studied and discussed

Energetic and exergetic analysis of low global warming potential refrigerants as substitutes for R410A in ground source heat pumps

In the European Union (EU), buildings are responsible for about 40% of the total final energy consumption, and 36% of the European global CO2 emissions. The European Commission released directives to push for the enhancement of the buildings energy performance and identified, beside the retrofit of the current building stock, Heating, Ventilation, and Air Conditioning (HVAC) systems as the other main way to increase renewable energy sharing and overall building energy efficiency. For this purpose, Ground Source Heat Pumps (GSHPs) represent one of the most interesting technologies to provide energy for heating, cooling, and domestic water production in residential applications, ensuring a significant reduction (e.g., up to 44% compared with air-source heat pumps) of energy consumption and the corresponding emissions. At present, GSHPs mainly employ the refrigerant R410A as the working fluid, which has a Global Warming Potential (GWP) of 2087. However, following the EU Regulation No. 517/2014 on fluorinated greenhouse gases, this high GWP refrigerant will have to be substituted for residential applications in the next years. Thus, to increase the sustainability of GSHPs, it is necessary to identify short time alternative fluids with lower GWP, before finding medium-long term solutions characterized by very low GWP. This is one of the tasks of the UE project "Most Easy, Efficient, and Low-Cost Geothermal Systems for Retrofitting Civil and Historical Buildings" (acronym GEO4CIVHIC). Here, a thorough thermodynamic analysis, based on both energy and exergy analysis, will be presented to perform a comparison between different fluids as substitutes for R410A, considered as the benchmark for GSHP applications. These fluids have been selected considering their lower flammability with respect to hydrocarbons (mainly R290), that is one of the main concerns for the companies. A parametric analysis has been performed, for a reversible GSHP cycle, at various heat source and sink conditions, with the aim to identify the fluid giving the best energetic performance and to evaluate the distribution of the irreversibilities along the cycle. Considering all these factors, R454B turned out to be the most suitable fluid to use in a ground source heat pump, working at given conditions. Special attention has been paid to the compression phase and the heat transfer in evaporator and condenser