Spermiogenesis in the vermetid gastropod Dendropoma petraeum (Gastropoda, Prosobranchia)

The structure and maturation of the male gonad of the Mediterranean vermetid gastropod Dendropoma petraeum are described. Histological sections of the gonads were made throughout development and gonad activity was monitored at regular monthly intervals. During tha autumn monts the gonad is very small and is surrounded by a large quantity of connective tissue; it becomes more voluminous from December to August, with the highest growth peak in springtime. The stages of spermatogenesis were also observed and described

STUDIO NUMERICO DELL'EMODINAMICA IN PAZIENTI CON DISSECAZIONE AORTICA DI TIPO B

The development of type B aortic dissection (AoD) is caused by altered haemodynamic forces exerted on false and true lumina of dissected aorta. This work aims to study haemodynamic and morphological proprieties, which influence the progression or stability of type B AoD. Computational fluid-dynamic analyses were performed on three patients with type B AoD, whose two presented an aneurysm evolution and one presented no further complication connected with dissection. Blood flow features showed that the true lumen flow was laminar and uniform while false lumen flow lost the laminar characteristic with consequent vorticity formation. The entry point zone proximal to the aortic arch showed both high blood velocity and pressure connected with peaks of maximum WSS value. A negative pressure gradient between the false lumen entry and re-entry points was observed. This promotes the blood to flow towards the abdominal aorta reducing the risk of retrograde flow during systole. We concluded that fluid dynamics study of patients with type B AoD is a valid tool to identify the risk of aortic dissection progression as well as the formation of aortic dissection connected pathology

Ethical, philosophical, and practical considerations in adherence to therapy in sleep medicine

This is the author accepted manuscript. The final version is available from Lippincott, Williams & Wilkins via the DOI in this recordPurpose of review We consider a series of linked philosophical issues created by non-adherence to therapy in sleep medicine. Recent findings First, the difficulty of measuring rates of adherence creates an epistemic problem regarding the efficacy of prescribed treatments. Secondly, as diseases are often classified as refractory based on apparent failure of standard medicines, the validity of this classification faces a similar epistemic crisis. This in turn produces ethical issues when therapies are restricted to cases deemed refractory. It also calls into question, if the patient does not take the medicines as prescribed, what they do with them; and the prospect of potential drug diversion arises. Education of patients seems to be of limited help in addressing these issues; what may be needed is a revision of the patient–prescriber relationship to move away from blame when nonadherence occurs. We close by revisiting an ancient debate in the philosophy of action, which may shed light on what such a revised relationship would require. Summary More honest and trusting patient–physician relationships, and a much more accurate sense of when nonadherence is occurring and why, may result from a better practical and philosophical understanding of the patient's decision-making

Engagement of the periesophageal ring during Holothuria polii response to erythrocyte injection.

In Holothuria polii, the periesophageal ring is an important organ supplying spherule cells after stimulation with foreign material. In animals injected with formalinized sheep erythrocytes, in fact, a depletion of spherule cells is observed in the periesophageal ring, whereas in the connective tissue, in the external epithelium and around the antigen- injected site, small, transparent cells can be visualized. It is supposed that the latter are stem cells of spherule cells

Emergence of fox rabies in north-eastern Italy.

Italy has been classified as rabies-free since 1997. In October 2008, two foxes have been diagnosed with rabies in the Province of Udine, north-east Italy. One case of human exposure caused by a bite from one of the foxes has occurred and was properly treated

Twelve years of activity of the International Trichinella Reference Centre.

The ITRC is the official reference laboratory of both the International Commission on Trichinellosis (since 1988) and the International Office of Epizootics (since 1992). The ITRC was created as a repository for Trichinella strains and as a source of materials and information for international research in 1988. To date, about 900 isolates of human and animal origin from throughout the world have been examined and identified by new procedures developed at the ITRC or in collaboration with other institutions. Using material from this collection, the ITRC has provided a complete revision of the systematics of the genus Trichinella. The ITRC database can be consulted by accessing the web-site: www.simi.iss.it/trichinella/index.htm

Contextual factors and prejudice at the beginning of the migrant influx: The Moroccan case in Seville, Spain

Studies addressing contextual factors associated with anti‐immigrant prejudice have focused on out‐group size and rapid demographic changes in receiving locations. However, the territorial concentration and distribution of ethnic minorities at a local and intraurban level has received little attention. We analyse the relationship between emerging territorial concentration points—alongside other contextual variables—by Moroccans and receiving society's growing prejudice towards them in a city experiencing the start of a migrant influx. We combine survey and census data from five Seville districts (southern Spain). Our results show how rapid changes in the general population's ethnic composition, coupled with Moroccan and economic migrants' territorial concentration, correlate strongly with negative attitudes towards Moroccans at this early stage. However, a weaker relationship between the immigrant percentage and degree of prejudice by the receiving group is observed. We also discuss guidelines for ensuring good, local diversity management to prevent socioterritorial fragmentation in multicultural cities.Ministerio de Economía, Industria y Competitividad de España CSO2014‐55780‐C3‐1‐PMinisterio de Economía, Industria y Competitividad de España SEJ2006-14470Junta de Andalucí

Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial

Contains fulltext : 88436.pdf (publisher's version ) (Open Access)BACKGROUND: Transplantation is the only treatment offering long-term benefit to patients with chronic kidney failure. Live donor nephrectomy is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves. In order to guarantee the donor's safety, it is important to optimise the surgical approach. Recently we demonstrated the benefit of laparoscopic nephrectomy experienced by the donor. However, this method is characterised by higher in hospital costs, longer operating times and it requires a well-trained surgeon. The hand-assisted retroperitoneoscopic technique may be an alternative to a complete laparoscopic, transperitoneal approach. The peritoneum remains intact and the risk of visceral injuries is reduced. Hand-assistance results in a faster procedure and a significantly reduced operating time. The feasibility of this method has been demonstrated recently, but as to date there are no data available advocating the use of one technique above the other. METHODS/DESIGN: The HARP-trial is a multi-centre randomised controlled, single-blind trial. The study compares the hand-assisted retroperitoneoscopic approach with standard laparoscopic donor nephrectomy. The objective is to determine the best approach for live donor nephrectomy to optimise donor's safety and comfort while reducing donation related costs. DISCUSSION: This study will contribute to the evidence on any benefits of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy. TRIAL REGISTRATION: Dutch Trial Register NTR1433

Increased blood product use among coronary artery bypass patients prescribed preoperative aspirin and clopidogrel

BACKGROUND: The administration of antiplatelet drugs before coronary artery bypass graft surgery (CABG) is associated with an increased risk of major hemorrhage and related surgical reexploration. Little is known about the relative effect of combined clopidogrel and aspirin on blood product use around the time of CABG. We evaluated the associated risk between the combined use of aspirin and clopidogrel and the transfusion of blood products perioperatively. METHODS: We retrospectively studied a cohort of 659 individuals who underwent a first CABG, without concomitant valvular or aortic surgery, at a single large Canadian cardiac surgical centre between January 2000 and April 2002. The four study exposure groups were those prescribed aspirin (n = 105), clopidogrel (n = 11), the combination of both (n = 46), or neither drug (n = 497), within 7 days prior to CABG. The primary study outcome was the excessive transfusion of blood products during CABG and up to the second post-operative day, defined as ≥ 2 units of packed red blood cells (PRBC), ≥ 2 units of fresh frozen plasma, ≥ 5 units of cryoprecipitate or ≥ 5 units of platelets. Secondary outcomes included the mean number of transfused units of each type of blood product. RESULTS: A greater mean number of units of PRBC were transfused among those who received clopidogrel alone (2.9) or in combination with aspirin (2.4), compared to those on aspirin alone (1.9) or neither antiplatelet drug (1.4) (P = 0.001). A similar trend was seen for the respective mean number of transfused units of platelets (3.6, 3.7, 1.3 and 1.0; P < 0.001) and fresh frozen plasma (2.5, 3.1, 2.3, 1.6; P = 0.01). Compared to non-users, the associated risk of excessive blood product transfusion was highest among recipients of aspirin and clopidogrel together (adjusted OR 2.2, 95% CI 1.1–4.3). No significant association was seen among lone users of aspirin (adjusted OR 1.0, 95% CI 0.6–1.6) or clopidogrel (adjusted OR 0.7, 95% CI 0.2–2.5), compared to non-users. CONCLUSIONS: While combined use of aspirin and clopidogrel shortly before CABG surgery may increase the associated risk of excess transfusion of blood products perioperatively, several study limitations prevent any confident conclusions from being drawn. Beyond challenging these findings, future research might focus on the value of both intraoperative monitoring of platelet function, and the effectiveness of antifibrinolytic agents, at reducing the risk of postoperative bleeding

Intestinal ischemia after cardiac surgery: analysis of a large registry.

Intestinal ischemia after cardiac surgery is a rare but severe complication with a high mortality. Early surgery can be lifesaving. The aim was to analyze the incidence, outcome, and risk factors for these patients