Obstacles on the way to the clinical visualisation of beta cells: looking for the Aeneas of molecular imaging to navigate between Scylla and Charybdis

For more than a decade, researchers have been trying to develop non-invasive imaging techniques for the in vivo measurement of viable pancreatic beta cells. However, in spite of intense research efforts, only one tracer for positron emission tomography (PET) imaging is currently under clinical evaluation. To many diabetologists it may remain unclear why the imaging world struggles to develop an effective method for non-invasive beta cell imaging (BCI), which could be useful for both research and clinical purposes. Here, we provide a concise overview of the obstacles and challenges encountered on the way to such BCI, in both native and transplanted islets. We discuss the major difficulties posed by the anatomical and cell biological features of pancreatic islets, as well as the chemical and physical limits of the main imaging modalities, with special focus on PET, SPECT and MRI. We conclude by indicating new avenues for future research in the field, based on several remarkable recent results

Vampires in the village Žrnovo on the island of Korčula: following an archival document from the 18th century

Središnja tema rada usmjerena je na raščlambu spisa pohranjenog u Državnom arhivu u Mlecima (fond: Capi del Consiglio de’ Dieci: Lettere di Rettori e di altre cariche) koji se odnosi na događaj iz 1748. godine u korčulanskom selu Žrnovo, kada su mještani – vjerujući da su se pojavili vampiri – oskvrnuli nekoliko mjesnih grobova. U radu se podrobno iznose osnovni podaci iz spisa te rečeni događaj analizira u širem društvenom kontekstu i prate se lokalna vjerovanja.The main interest of this essay is the analysis of the document from the State Archive in Venice (file: Capi del Consiglio de’ Dieci: Lettere di Rettori e di altre cariche) which is connected with the episode from 1748 when the inhabitants of the village Žrnove on the island of Korčula in Croatia opened tombs on the local cemetery in the fear of the vampires treating. This essay try to show some social circumstances connected with this event as well as a local vernacular tradition concerning superstitions

Controle de danos: uma opção tática no tratamento dos traumatizados com hemorragia grave Damage control: a tactical alternative for the management of exanguinating trauma patients

RACIONAL: O choque hemorrágico persistente cursa com alta mortalidade. Grande importância tem sido dada para o "controle de danos" como opção terapêutica nestes casos. OBJETIVO: Avaliar a definição, indicações, técnicas e resultados do controle de danos no tratamento dos traumatizados com hemorragia grave. MÉTODO: Revisão bibliográfica. RESULTADOS: Como "controle de danos" entende-se a interrupção da operação antes que o choque hemorrágico alcance a sua fase irreversível, mesmo que as lesões encontradas não tenham o tratamento definitivo neste primeiro momento. Esta alternativa envolve três tempos: a operação abreviada, a recuperação na unidade de terapia intensiva e a reoperação programada. Desta forma, frente à acidose metabólica, hipotermia e coagulopatia, a operação é abreviada através do controle temporário da hemorragia e contaminação. São empregadas técnicas como o tamponamento hepático com compressas e ligadura de eventuais cotos intestinais. Na unidade de terapia intensiva são realizados o aquecimento do doente, restauração da volemia e débito cardíaco, e adequada oferta de oxigênio, além da reposição dos fatores de coagulação. Somente após a estabilização, o traumatizado é levado novamente ao centro cirúrgico para o tratamento definitivo das lesões. Trata-se de uma tática com bons resultados, mas que deve ser restrita a centros especializados, com supervisão cirúrgica contínua e recursos disponíveis para o tratamento de doentes graves. CONCLUSÃO: O controle de danos é opção prática nos casos de hemorragia grave, contudo deve ser empregado com julgamento crítico devido a complicações que podem decorrer da sua indicação.<br>BACKGROUND: Despite the advances in the treatment of exanguinating patients, hemorrhage remains as the leading cause of early deaths. A great deal of attention has been given to "damage control" as a therapeutic alternative in this scenario. AIM: To appraise the definition, indications, operative techniques and results of damage control for the treatment of exanguinating trauma patients. METHOD: Bibliographic review. RESULTS: Damage control introduces the concept of breaking the vicious cycle of metabolic acidosis, hypothermia and coagulopathy which results from hemorrhagic shock. Thus, the operation has to be interrupted before this irreversible stage, even if the injured organs were not given the definitive treatment at this moment. So, damage control involves three steps: an abbreviated operation, a recovering period in the intensive care unit, and the reoperation for the definitive treatment. At the abbreviated operation, operative techniques as stapling intestinal injuries or packing liver wounds are applied, allowing rapid control of the bleeding and spillage. In the intensive care unit, the patient is warmed, oxygen delivery and consumption are restored and coagulation factors administered. As soon as the hemodynamic stability, ideal body temperature and coagulation status are reached, the definitive operation is carried out. Damage control is a helpful option if correctly used. However, there are also severe complications that can occur. Therefore, it should be employed only in centers that could provide optimum resources. CONCLUSION: Damage control is an important tactical alternative for the treatment of exanguinating trauma patients