Urinary Citrate, Bone Resorption and Intestinal Alkali Absorption in Stone Formers with Fasting Hypercalciuria

Reduced citrate in urine and increased fasting excretion of calcium are abnormalities frequently reported in stone forming (SF) patients. Increased dietary acid (or reduced alkali) introduction or absorption may be a potential cause of both these pathological findings. To test this hypothesis, we studied 64 SF patients {32 with fasting hypercalciuria (FH) and 32 without FH (NFH)}. After a basal evaluation for nephrolithiasis, while on a 500 mg calcium diet, they were evaluated for: (1) daily intestinal alkali absorption (IAA), by urinary electrolyte excretion; (2) basal concentrations of PTH, calcitonin (CT) and 1,25(OH)2-VitD; (3) oral calcium load for evaluation of changes in calcium and hydroxyproline urinary excretions; (4) intestinal calcium absorption (18 patients), with double curve analysis (stable Sr as tracer); and (S) changes in citrate excretion after an alkali load (50 mEq of a mixture of calcium gluconate, lactate and carbonate) in 10 patients. The results demonstrated: (1) FH stone formers had reduced citrate excretion and lower mean IAA levels than NFH stone formers; (2) FH stone formers also had higher bone resorption levels with lower PTH and higher CT levels; (3) IAA levels were related to both citrate excretion and bone turnover indices; and (4) the increases in citrate excretion after oral alkali load were strictly related to basal IAA values (index of alkali absorption and/or generation after oral load), demonstrating that a different absorptive capacity of alkali rather than a different dietary content may underlie these metabolic abnormalities

Multilateral methodology in physical education improves coping skills, resilience and physical fitness in drug addicts

Drug addiction may cause health problems and social exclusion. Therefore, we investigated the effects of 8-week multilateral physical education intervention (i.e., aerobic-anaerobic exercise at moderate-intensity plus behavioural training), as an adjunct to treatment for drug dependent patients, on psychological and physical fitness variables. 34 male participants (19-71 years) were assigned to an experimental group (n = 17) that performed multilateral intervention, or a control group (n = 17) that did not. At baseline and after 8-week, COPE-NVI, CD-RISC and physical fitness tests assessed coping skills, resilience and fitness levels. Adherence to exercise was 100% and, after intervention, significant improvements (p < 0.05) in the skills and strategies adopted to cope with stressful events and ability to deal with negative experiences were found. In addition, the physical fitness components as static and dynamic balance, anaerobic power and coordination, and endurance of the upper body musculature significantly improved (p < 0.05) in experimental group. Findings highlighted the positive relationship between increased physical fitness and improved functional and adaptive modalities used to cope with stressful events and negative experiences. Therefore, multilateral intervention could improve mental and physical wellbeing in drug addicts by proving to be a key tool in promoting social inclusion

Daylight Saving Time and Spontaneous Deliveries: A Case–Control Study in Italy

(1) Background: Although the current literature shows that daylight saving time (DST) may play a role in human health and behavior, this topic has been poorly investigated with reference to Obstetrics. The aim of this case–control study was to evaluate whether DST may influence the number of spontaneous deliveries. (2) Methods: A low-risk pregnancy cohort with spontaneous onset of labor (n = 7415) was analyzed from a single Italian region for the period 2016–2018. Primary outcome was the number of spontaneous deliveries. Secondary outcomes were: gestational age at delivery, type and time of delivery, use of analgesia, birth weight, and 5-min Apgar at delivery. We compared the outcomes in the two weeks after DST (cases) to the two weeks before DST (controls). (3) Results: Data showed no significant difference between the number of deliveries occurring before and after DST (Chi-square = 0.546, p = 0.46). Vaginal deliveries at any gestational age showed no statistical difference between the two groups (Chi-square = 0.120, p = 0.73). There were no significant differences in the secondary outcomes, as well. (4) Conclusions: DST has neither a significant impact on the number of deliveries nor on the obstetric variables investigated by this study

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P &lt; .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Ecografia ad altissima risoluzione: applicazioni cliniche

Le metodiche di imaging comunemente disponibili, come la tomografia computerizzata, la risonanza magnetica e l’ecografia con sonde convenzionali hanno il limite di fornire immagini con risoluzione nell’ordine dei millimetri; per questo motivo la ricerca si è orientata verso lo sviluppo di strumenti ecografici con risoluzioni microscopiche. Si parla di “ultrasound biomicroscopy” (UBM), di “high frequency ultrasound” (HFUS) e di “ultra high frequency ultrasound” (UHFUS), quando le frequenze impiegate vanno dai 30 ai 100 MHz. Con queste tecnologie è possibile correlare le informazioni derivanti dall’immagine ultrasonografica con quelle provenienti dall’ istologia. Nel 2016 VisualSonics (Toronto, Canada) del gruppo FUJIFILM ha reso disponibile Vevo® MD, il primo sistema di imaging a ultrasuoni ad altissima frequenza (fino a 70 MHz) per uso clinico. Il sistema è stato acquisito dal Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, grazie al “Bando Grandi Attrezzature 2016” ed è in grado di visualizzare ad alta risoluzione quelle strutture anatomiche di piccole dimensioni che con le frequenze convenzionali (fino a 15 MHz) non è possibile apprezzare. Questa tesi affronta le prime applicazioni cliniche degli UHFUS, confrontando le relative acquisizioni con quelle dell’ecografia convenzionale. In particolare, Vevo MD è stato utilizzato nello studio delle patologie vascolari (caratterizzazione di pazienti affetti da vasculiti sistemiche e da displasia fibromuscolare) e dermatologiche (neoplasie melanocitarie, neoplasie epiteliali, neoplasie annessiali e neoplasie vascolari, malattie infiammatorie croniche, malattie autoimmuni, onicopatie). Un’ulteriore applicazione è stata quella di caratterizzare ex vivo alcuni organi parenchimatosi, per un possibile impiego intraoperatorio dello strumento

Comment on "Longitudinal transvaginal ultrasound evaluation of cesarean scar niche incidence and depth in the first two years after single- or double-layer uterotomy closure: A randomized controlled trial"

Certainly, CS is one of the most common surgical operations performed worldwide and its rate has dramatically increased in most developed countries, thus becoming a big concern (5). Yet, the question of which closure technique best avoids symp- tomatic uterine niche remains unanswered, but it seems even more important to find a non-invasive technique to assess the uterine wall defect. The two papers used different sonographic approaches, but we are still wondering if they represent accu- rately the uterine wall defect. Marco Scioscia1, Piergiorgio Iannone2,* , Danila Morano2, Giovanni Pontrelli1 and Pantaleo Greco2 1Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy, and 2Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Cona, Ferrara, Ital

Umbilical Cord Hematoma: A Case Report and Review of the Literature

Objectives. To deepen the knowledge in obstetrics on a very rare pregnancy complication: umbilical cord hematoma. Methods. A review of the case reports described in the last ten years in the literature was conducted in order to evaluate epidemiology, predisposing factors, potential outcomes, prenatal diagnosis, and clinical management. Results. Spontaneous umbilical cord hematoma is a rare complication of pregnancy which represents a serious cause of fetal morbidity and mortality. There are many risk factors such as morphologic anomalies, infections, vessel wall abnormalities, iatrogenic causes, and traction or torsion of the cord, but the exact etiology is still unknown. Conclusions. Due to the rarity of this condition, every new case of umbilical cord hematoma should be reported in order to improve the knowledge of predisposing factors, prenatal diagnosis, and clinical management

Fetal Noncompaction Cardiomyopathy and Histologic Diagnosis of Spongy Myocardium: Case Report and Review of the Literature

Noncompaction cardiomyopathy (NCCM) and left ventricular noncompaction (LVNC), in their isolated form, are rare cardiomyopathies. They are characterized by a thickened myocardium due to the presence of deep trabeculae recesses, and to thick trabeculae. This condition is associated with a variable clinical phenotype including heart failure, thromboembolism, and sudden death. We report a case of LVNC at 26 weeks and 4 days of gestation revised on the basis of what is currently reported in the literature. A review of the literature was performed to better describe this rare condition. Left ventricular noncompaction is a rare fetal condition and it should be suspected in case of cardiomyopathy

Management of Transverse Vaginal Septum by Vaginoscopic Resection: Hymen Conservative Technique

Transverse vaginal septum is a rare female genital tract anomaly, and little is described about its surgical treatment. We report the case of a patient who wished to preserve hymenal integrity due to social and cultural beliefs. We performed a vaginoscopic resection of the septum under laparoscopic view, followed by the introduction of a Foley catheter in the vagina, thus preserving the hymen. After 12 months of follow-up, no septal closure was present, and the menstrual flow was effective. Vaginoscopic hysteroscopy is an effective method of vaginal septum resection, even in cases in which hymenal integrity must be preserved due to social and cultural beliefs

Effect of Ion Milling on the Topography Multilayer Hetrostructure Cross Sections

N/