Cancer-Associated Thrombosis in Cirrhotic Patients with Hepatocellular Carcinoma.

It is common knowledge that cancer patients are more prone to develop venous thromboembolic complications (VTE). It is therefore not surprising that patients with hepatocellular carcinoma (HCC) present with a significant risk of VTE, with the portal vein being the most frequent site (PVT). However, patients with HCC are peculiar as both cancer and liver cirrhosis are conditions that can perturb the hemostatic balance towards a prothrombotic state. Because HCC-related hypercoagulability is not clarified at all, the aim of the present review is to summarize the currently available knowledge on epidemiology and pathogenesis of non-malignant thrombotic complications in patients with liver cirrhosis and HCC. They are at increased risk to develop both PVT and non-splanchnic VTE, indicating that both local and systemic factors can foster the development of site-specific thrombosis. Recent studies have suggested multiple and often interrelated mechanisms through which HCC can tip the hemostatic balance of liver cirrhosis towards hypercoagulability. Described mechanisms include increased fibrinogen concentration/polymerization, thrombocytosis, and release of tissue factor-expressing extracellular vesicles. Currently, there are no specific guidelines on the use of thromboprophylaxis in this unique population. There is the urgent need of prospective studies assessing which patients have the highest prothrombotic profile and would therefore benefit from early thromboprophylaxis

A Flexible Software Framework for Magnetic Measurements at CERN: a Prototype for the new Generation of Rotating Coils

A new software platform named FFMM (Flexible Framework for Magnetic Measurements) is under development at CERN (European Organization for Nuclear Research) in cooperation with the University of Sannio. The FFMM is aimed at facing the new test requirements arising after the production series of the Large Hadron Collider magnets. In particular, the basic concepts of the FFMM, its architecture, and the experimental implementation of a demonstrator are illustrated in order to show how the quality requirements of software flexibility and scalability are met

Performance Analysis of a Fast Digital Integrator for Magnetic Field Measurements at CERN

A Fast Digital Integrator (FDI) has been designed at CERN for increasing performance of state-of-art instruments analyzing superconducting magnets in particle accelerators. In particular, in flux measurement, a bandwidth up to 50-100 kHz and an accuracy of 10 ppm has to be targeted. In this paper, basic concepts and architecture of the developed FDI are highlighted. Numerical metrological analysis of the instrument performance is shown, by focusing both on deterministic errors and on uncertainty in time and amplitude domains

Technology applications in shoulder replacement

The advancement of technologies in orthopaedic surgery should provide the surgeon with precise and trustworthy support for pre-operative planning, intra-operative guidance and post-operative follow-up. The request for greater accuracy, predictable results and fewer complications, is the engine of digital evolution in pre-operative planning and computer-assisted surgery (CAS). It is an evolution rather than a revolution, and in the last few years these developments have begun to involve shoulder replacement surgery, too

Thyroid ultrasonography reporting: consensus of Italian Thyroid Association (AIT), Italian Society of Endocrinology (SIE), Italian Society of Ultrasonography in Medicine and Biology (SIUMB) and Ultrasound Chapter of Italian Society of Medical Radiology (SIRM)

Thyroid ultrasonography (US) is the gold standard for thyroid imaging and its widespread use is due to an optimal spatial resolution for superficial anatomic structures, a low cost and the lack of health risks. Thyroid US is a pivotal tool for the diagnosis and follow-up of autoimmune thyroid diseases, for assessing nodule size and echostructure and defining the risk of malignancy in thyroid nodules. The main limitation of US is the poor reproducibility, due to the variable experience of the operators and the different performance and settings of the equipments. Aim of this consensus statement is to standardize the report of thyroid US through the definition of common minimum requirements and a correct terminology. US patterns of autoimmune thyroid diseases are defined. US signs of malignancy in thyroid nodules are classified and scored in each nodule. We also propose a simplified nodule risk stratification, based on the predictive value of each US sign, classified and scored according to the strength of association with malignancy, but also to the estimated reproducibility among different operators

Fault self-defection of automatic testing systems by means of aspect-oriented programming

An Aspect Oriented approach to implement fault detection in automatic measurement systems is proposed. Faults are handled by means of "aspects", a specific software unit to better modularize issues transversal to many modules ("crosscutting concerns"). In this way, maintainability and reusability of a measurement software are improved: indeed, once a modification of the fault detection policy occurs, only the related aspects have to be modified. As an experimental case study, this technique has been applied to the fault self-detection of a flexible framework for magnetic measurements, developed at the European Organization for Nuclear Research (CERN)

A Fast Digital Integrator for Magnetic Field Measurements at CERN

A self-calibrating digital instrument for flux measurements on magnets for accelerators used in basic research on subnuclear particles is proposed. The instrument acquires voltage arising from rotating coils transducers with a theoretical resolution of 10 ppt and a maximum sampling frequency of 800 kS/s. Then, samples are integrated on-line and suitably processed in order to improve time resolution and flux accuracy. This allows the limits of state-of-the-art digital fluximeters, related mainly to newgeneration rotating coils, with trigger rate of 20 kHz and coils speed of 10 rps, to be overcome. The instrument has been prototyped at Magnetic Measurement and Testing (MTM) Group of European Laboratory for Nuclear Research (CERN), under a framework of cooperation with the University of Sannio. Details on hardware and firmware conception, as well as on experimental results of the instrument principle validation, and of the preliminary metrological characterization of the prototype, are provided

Association between non-O blood group and spontaneous abortion in women with inherited thrombophilia

Abstract Background Spontaneous abortion is reported to be one of the most frequent pregnancy complications reaching a prevalence up to 15%. The association between congenital thrombophilia and pregnancy loss has been debated in several studies with conflicting results. We aimed to retrospectively evaluate the prevalence of inherited thrombophilia (i.e antithrombin, protein S and C deficiencies, factor V Leiden and prothrombin variant) in a group of women with a personal history of miscarriage. The prevalence non-O blood group, considered the most common thrombophilic condition, was concomitantly considered. Materials and methods A group of n. 566 women with a personal history of spontaneous abortion recruited among caregivers of patients admitted to the Medical Department of our University Hospital between December 2011 and December 2019 were enrolled. Women under 18 yrs, those with a personal history of venous and/or arterial thrombosis and with an acquired thrombophilic condition were excluded. An equally number of healthy women without a personal history of pregnancy loss acted as controls. The Odds Ratios (ORs) and 95% confidence intervals (CIs) were calculated as an estimate of pregnancy loss developing. Results Out of n. 566 enrolled women, n. 127 (22.4%) had an inherited thrombophilic condition. The prevalence of congenital thrombophilia was significantly higher in women with miscarriage than controls (OR 2.12; CI 95% 1.51–2.92). Non-O blood type was observed in n. 325 (57.4%) women. The prevalence of non-O blood group was significantly higher in women with pregnancy loss (p 0.01) and the association of thrombophilia and non-O blood type further increased the risk of pregnancy loss (OR 3.28; CI 95% 2.01–5.36). Conclusions Both inherited thrombophilia and non-O blood type should be considered risk factors for pregnancy loss. The knowledge of this information may help the clinician to better manage women with pregnancy loss. Further studies are required to confirm our findings. Funding Acknowledgement Type of funding sources: None

Transplantation and young surgeons in italy

The relation between young surgeons and transplantation has always been a "love and hate" one. Until a few years ago this branch of surgery was seen as pioneering, with extreme and and extensive training, and was reserved to few elected members. Nowadays things are different. In this article we try to understand the true reasons that young Italian surgeons avoid transplantation surgery

Management of surgical diseases of thyroid gland indications of the United Italian Society of Endocrine Surgery (SIUEC)

A task force of the United Italian society of Endocrine Surgery (SIUEC) was commissioned to review the position statement on diagnostic, therapeutic and health‑care management protocol in thyroid surgery published in 2016, at the light of new technologies, recent oncological concepts, and tailored approaches. The objective of this publication was to support surgeons with modern rational protocols of treatment that can be shared by health-care professionals, taking into account important clinical, healthcare and therapeutic aspects, as well as potential sequelae and complications. The task force consists of 13 members of the SIUEC highly trained and experienced in thyroid surgery. The main topics concern clinical evaluation and preoperative workup, patient preparation for surgery, surgical treatment, non-surgical options, postoperative management, prevention and management of major complications, outpatient care and follow-up