Postpartum Ovarian Vein Thrombosis

Postpartum ovarian vein thrombosis carries a significant risk of morbidity and mortality if not recognized early and managed appropriately

factors underlying the development of chronic temporal lobe epilepsy in autoimmune encephalitis

Abstract Purpose Limbic encephalitis (LE) is an autoimmune condition characterized by amnestic syndrome, psychiatric features and seizures. Early diagnosis and prompt treatment are crucial to avoid long-term sequelae, including psycho-cognitive deficits and persisting seizures. The aim of our study was to analyze the characteristics of 33 LE patients in order to identify possible prognostic factors associated with the development of chronic epilepsy. Methods This is a retrospective cohort study including adult patients diagnosed with LE in the period 2010–2017 and followed up for ≥12 months. Demographics, seizure semiology, EEG pattern, MRI features, CSF/serum findings were reviewed. Results All 33 LE patients (19 M/14F, mean age 61.2 years) presented seizures. Thirty subjects had memory deficits; 22 presented behavioural/mood disorders. Serum and/or CSF auto-antibodies were detected in 12 patients. In 31 subjects brain MRI at onset showed typical alterations involving temporal lobes. All patients received immunotherapy. At follow-up, 13/33 had developed chronic epilepsy; predisposing factors included delay in diagnosis (p = .009), low seizure frequency at onset (p = .02), absence of amnestic syndrome (p = .02) and absence/rarity of inter-ictal epileptic discharges on EEG (p = .06). Conclusions LE with paucisymptomatic electro-clinical presentation seemed to be associated to chronic epilepsy more than LE presenting with definite and severe "limbic syndrome"

Acute thrombosis of the superior mesenteric artery in a 39-year-old woman with protein-S deficiency: a case report

<p>Abstract</p> <p>Introduction</p> <p>Acute thromboembolic occlusion of the superior mesenteric artery is a condition with an unfavorable prognosis. Treatment of this condition is focused on early diagnosis, surgical or intravascular restoration of blood flow to the ischemic intestine, surgical resection of the necrotic bowel and supportive intensive care. In this report, we describe a case of a 39-year-old woman who developed a small bowel infarct because of an acute thrombotic occlusion of the superior mesenteric artery, also involving the splenic artery.</p> <p>Case presentation</p> <p>A 39-year-old Caucasian woman presented with acute abdominal pain and signs of intestinal occlusion. The patient was given an abdominal computed tomography scan and ultrasonography in association with Doppler ultrasonography, highlighting a thrombosis of the celiac trunk, of the superior mesenteric artery, and of the splenic artery. She immediately underwent an explorative laparotomy, and revascularization was performed by thromboendarterectomy with a Fogarty catheter. In the following postoperative days, she was given a scheduled second and third look, evidencing necrotic jejunal and ileal handles. During all the surgical procedures, we performed intraoperative Doppler ultrasound of the superior mesenteric artery and celiac trunk to control the arterial flow without evidence of a new thrombosis.</p> <p>Conclusion</p> <p>Acute mesenteric ischemia is a rare abdominal emergency that is characterized by a high mortality rate. Generally, acute mesenteric ischemia is due to an impaired blood supply to the intestine caused by thromboembolic phenomena. These phenomena may be associated with a variety of congenital prothrombotic disorders. A prompt diagnosis is a prerequisite for successful treatment. The treatment of choice remains laparotomy and thromboendarterectomy, although some prefer an endovascular approach. A second-look laparotomy could be required to evaluate viable intestinal handles. Some authors support a laparoscopic second-look. The possibility of evaluating the arteriotomy, during a repeated laparotomy with a Doppler ultrasound, is crucial to show a new thrombosis. Although the prognosis of acute mesenteric ischemia due to an acute arterial mesenteric thrombosis remains poor, a prompt diagnosis, aggressive surgical treatment and supportive intensive care unit could improve the outcome for patients with this condition.</p

Serum Albumin Is Inversely Associated With Portal Vein Thrombosis in Cirrhosis

We analyzed whether serum albumin is independently associated with portal vein thrombosis (PVT) in liver cirrhosis (LC) and if a biologic plausibility exists. This study was divided into three parts. In part 1 (retrospective analysis), 753 consecutive patients with LC with ultrasound-detected PVT were retrospectively analyzed. In part 2, 112 patients with LC and 56 matched controls were entered in the cross-sectional study. In part 3, 5 patients with cirrhosis were entered in the in vivo study and 4 healthy subjects (HSs) were entered in the in vitro study to explore if albumin may affect platelet activation by modulating oxidative stress. In the 753 patients with LC, the prevalence of PVT was 16.7%; logistic analysis showed that only age (odds ratio [OR], 1.024; P = 0.012) and serum albumin (OR, -0.422; P = 0.0001) significantly predicted patients with PVT. Analyzing the 112 patients with LC and controls, soluble clusters of differentiation (CD)40-ligand (P = 0.0238), soluble Nox2-derived peptide (sNox2-dp; P &lt; 0.0001), and urinary excretion of isoprostanes (P = 0.0078) were higher in patients with LC. In LC, albumin was correlated with sCD4OL (Spearman's rank correlation coefficient [r(s)], -0.33; P &lt; 0.001), sNox2-dp (r(s), -0.57; P &lt; 0.0001), and urinary excretion of isoprostanes (r(s), -0.48; P &lt; 0.0001) levels. The in vivo study showed a progressive decrease in platelet aggregation, sNox2-dp, and urinary 8-iso prostaglandin F2 alpha-III formation 2 hours and 3 days after albumin infusion. Finally, platelet aggregation, sNox2-dp, and isoprostane formation significantly decreased in platelets from HSs incubated with scalar concentrations of albumin. Conclusion: Low serum albumin in LC is associated with PVT, suggesting that albumin could be a modulator of the hemostatic system through interference with mechanisms regulating platelet activation

Nonlinear analysis of masonry panels strengthened with textile reinforced mortar

The paper proposes a simplified modeling approach for the analysis of the in-plane shear behavior of tuff stone masonry panels strengthened with a surface bonded composite Basalt Textile Reinforced Mortar (BTRM) system subjected to diagonal compression. The nonlinear behavior of the unreinforced and reinforced panels is reproduced by means of a macroscopic smeared crack approach. The masonry is modeled as an isotropic continuum material characterized by different nonlinear softening laws in tension and compression. The BTRM composite is modeled with two layers representing the basalt textile and the matrix with different constitutive relationships. Sensitivity numerical analyses are developed in order to investigate the influence of each parameter in the global nonlinear response of the panel. Then, representative numerical models for the unreinforced and the reinforced panel are presented. Two BTRM layouts are investigated: single-side and double-side reinforcement. The models aim to capture the main aspects of the observed experimental nonlinear response, such as stiffness, strength-deformation shear capacity and failure mechanism. The numerical results are compared with the experimental outcomes of diagonal compression tests to investigate the feasibility of the models in the description of the in-plane shear behavior of tuff stone panels strengthened with the BTRM system

Experimental investigation of tuff masonry panels reinforced with surface bonded basalt textile-reinforced mortar

Basalt textile-reinforced mortar (BTRM) composites have shown to be a promising technique for the reinforcement of masonry systems, but their use as in-plane shear reinforcement of wall panels is still far from being fully investigated. This paper illustrates the results of experimental tests carried out on masonry panels built using volcanic tuff stones from the Latium Region, Italy, reinforced with externally bonded BTRM composite. The experimental program involved compressive tests on the unreinforced panels and diagonal compression tests on two unreinforced specimens, three single-side reinforced specimens and two double side reinforced specimens. Structural response characteristics including crack pattern, stress-strain behavior, strength, stiffness and deformation capacity were investigated. Furthermore, the results obtained are compared with those published elsewhere regarding tuff masonry panels strengthened with fabric-reinforced matrix systems

Corrigendum to ‘‘Nonlinear analysis of masonry panels strengthened with textile reinforced mortar” [Eng. Struct. 113 (2016) 245–258]

The authors regret “Fig. 9. Maximum (a)–(b) and minimum (c)–(d) principal stress at point P1 and P2 for the unreinforced masonry panel.” Section 4.2 page 251 “The distribution of minimum principal stress σ II at Point P1, Fig. 9c. Only in proximity to the connection with the steel shoes, are local regions where the stress (colored in blue) is higher than the compressive strength. In these parts, local crushing is observed. Also at point P2, Fig. 9d, minimum principal stresses are always lower than the compressive strength taking the entire panel, with the only exception of these zones. By observing the maximum principal stress σ I at point P1, Fig. 9a, it emerges that the cracking in masonry is due to the attainment of the tensile strength and starts from the panel's geometric center. At point P2, Fig. 9b, a large and extended zone along the vertical diagonal is fully cracked due to tensile failure.” The authors would like to apologize for any inconvenience caused

Pulmonary hypertension second to micro-thrombosis in situ in patient with positive IgG anti-cardiolipin antibodies. A case report

We report a clinical case of pulmonary hypertension by micro-thrombosis in situ and presence of IgG anticardiolipin antibodies in a 36-year-old woman without other clinical findings. The case is interesting as further contribution to a better understanding of antiphospholipid syndrome