Hepatocellular Carcinoma and Antiviral Therapies in HCV Chronic Infection

The development of direct-acting antiviral (DAA) therapies in chronic HCV infection has been associated with increased expectations regarding the prognosis of this infection in the medical community, as the possibility of HCV eradication is now in sight. While the cure of the HVC infection has been associated with a dramatic decrease in its systemic complications, the impact on the progression of the liver disease, especially in patients with cirrhosis, is still controversial. Furthermore, the risk of developing hepatocellular carcinoma (HCC) after direct-acting antiviral therapy is debatable, with studies presenting an increased prevalence of HCC early after the introduction of these therapies, as well as newer contradicting studies. This chapter aims to examine the current literature data available regarding the impact of new HCV therapies in the incidence and prognosis of hepatocellular carcinoma

Particularities of Hepatic Sarcoidosis

Liver sarcoidosis is usually an underdiagnosed disease, which can have severe implications in the evolution of a patient. Due to the fact that sarcoidosis is a disease based on immunological disorders, it is only natural that the liver should be one of the first organs to be affected. The imaging of liver sarcoidosis is of marked importance, especially in the differential diagnosis of the disease. While the histology aspect of sarcoidosis is relatively clear and should prompt a positive diagnosis, finding a liver granuloma in ultrasonography raises a multitude of questions and implies extensive testing for diagnosis. Furthermore, treatment of liver sarcoidosis is controversial, taking into account the possibility of developing end-stage liver disease in patients with a long history of sarcoidosis. This chapter aims to review diagnostic and treatment options for liver sarcoidosis and to determine the best management of these patients

Improving Postdischarge Outcomes in Acute Heart Failure

The global burden that acute heart failure (AHF) carries has remained unchanged over the past several decades (1). European registries (2–5) showed that 1-year outcome rates remain unacceptably high (Table 1) and confirm that hospitalization for AHF represents a change in the natural history of the disease process(6). As patients hospitalized for HF have a bad prognosis, it is crucial to utilize hospitalization as an opportunity to: 1) assess the individual components of the cardiac substrate; 2) identify and treat comorbidities; 3) identify early, safe endpoints of therapy to facilitate timely hospital discharge and outpatient follow-up; and 4) implement and begin optimization guideline-directed medical therapies (GDMTs). As outcomes are influenced by many factors, many of which are incompletely understood, a systematic approach is proposed that should start with admission and continues through post-discharge (7)

Modern approaches for antiandrogen-resistant prostate cancer therapy

Prostate cancer represents the leading malignant tumor in men over 50 years of age with 400,000 new cases being diagnosed yearly in Europe. Even if the incidence rate is higher than the mortality rate, still there is an increasing trend when speaking of its mortality. The increasing incidence of the metabolic syndrome, the unhealthy lifestyle, the high lipid and Calcium intake, the high spread of infections with Human Papilloma Virus, Human Herpes Virus, the excess of androgen consumption and the longer life expectancy, are few of the main causes of prostate cancer increasing incidence. The new systemic therapies such as immunotherapy with Checkpoint Inhibitors or Poly, ADP-Ribose Polymerase inhibitors and local experimental procedures addressing tumor destruction, such as High- Intensity Focused Ultrasound, the Cryo and Focal Laser Ablation, provide good outcomes and become new promising tools for prostate cancer therapy. Physicians consider these methods worth using; the efficacy of some specific categories of patients being arguments for their use in the current protocols even though solid data regarding the improvement of global mortality rates are not yet published. The current article focuses on the newest systemic and local experimental treatment tools highlighting their benefits, especially for hormone-resistant prostate cancer

Congenital Abnormalities of the Fetal Heart

Congenital heart defects (CHDs) are the most frequent congenital malformations, the costliest hospital admissions for structural defects and the leading cause of infant general and malformations related mortality. Fetal echocardiography represents a skilled ultrasound examination, because of the complexity, physiological and structural particularities of the fetal heart. The efficiency of the cardiac scan is reported with great variation, depending on the scanning protocol, examiner experience and equipment quality but CHDs remains among the most frequently missed congenital abnormalities

VIP-2 —High-Sensitivity Tests on the Pauli Exclusion Principle for Electrons

The VIP collaboration is performing high sensitivity tests of the Pauli Exclusion Principle for electrons in the extremely low cosmic background environment of the underground Gran Sasso National Laboratory INFN (Italy). In particular, the VIP-2 Open Systems experiment was conceived to put strong constraints on those Pauli Exclusion Principle violation models which respect the so-called Messiah–Greenberg superselection rule. The experimental technique consists of introducing a direct current in a copper conductor, and searching for the X-rays emission coming from a forbidden atomic transition from the L shell to the K shell of copper when the K shell is already occupied by two electrons. The analysis of the first three months of collected data (in 2018) is presented. The obtained result represents the best bound on the Pauli Exclusion Principle violation probability which fulfills the Messiah–Greenberg rule

High Precision Test of the Pauli Exclusion Principle for Electrons

The VIP-2 experiment aims to perform high precision tests of the Pauli Exclusion Principle for electrons. The method consists in circulating a continuous current in a copper strip, searching for the X radiation emission due to a prohibited transition (from the 2p level to the 1s level of copper when this is already occupied by two electrons). VIP already set the best limit on the PEP violation probability for electrons $\frac{1}{2} \beta^2 < 4.7 \times 10^{-29}$, the goal of the upgraded VIP-2 (VIolation of the Pauli Exclusion Principle-2) experiment is to improve this result of two orders of magnitude at least. The experimental apparatus and the results of the analysis of a first set of collected data will be presented

Search for a remnant violation of the Pauli exclusion principle in a Roman lead target

In this paper we report on the results of two analyses of the data taken with a dedicated VIP-Lead experiment at the Gran Sasso National Laboratory of the INFN. We use measurements taken in an environment that is especially well screened from cosmic rays, with a metal target made of “Roman lead” which is characterised by a low level of intrinsic radioactivity. The analyses lead to an improvement, on the upper bounds of the Pauli Exclusion Principle violation for electrons, which is more than one (four) orders of magnitude, when the electron-atom interactions are described in terms of scatterings (or close encounters) respectively

HIGH SENSITIVITY QUANTUM MECHANICS TESTS IN THE COSMIC SILENCE

The VIP experiment aims to perform high-precision tests of the Pauli Exclusion Principle for electrons in the extremely low cosmic background environment of the Underground Gran Sasso Laboratories of INFN (Italy). The experimental technique consists in introducing a DC current in a copper conductor, searching for K α PEP-forbidden atomic transitions when the K shell is already occupied by two electrons. The results of a preliminary data analysis, corresponding to the first run of the VIP-2 data taking (2016–2017), are presented. The experimental setup in the final configuration is described together with preliminary spectra from the 2019 data-taking campaign