221 research outputs found

    Unique association of cardiac amyloidosis and right atrial tumor thrombus in a patient with hepatocellular carcinoma

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    Tumor thrombus is a very rare complication observed in patients with hepatocellular carcinoma. We report a unique case of hepatocellular carcinoma with extension of tumor along the inferior vein cava into the right atrium, in a patient with cardiac amyloidosis and without any cardio respiratory distress or typical clinical findings suggestive of cardiovascular involvement from cardiac amyloidosis. Cardiac magnetic resonance imaging is a useful tool to assess intracardiac tumor extension as well as to provide myocardial tissue characterization

    Unified description of fission in fusion and spallation reactions

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    We present a statistical-model description of fission, in the framework of compound-nucleus decay, which is found to simultaneously reproduce data from both heavy-ion-induced fusion reactions and proton-induced spallation reactions at around 1 GeV. For the spallation reactions, the initial compound-nucleus population is predicted by the Li\`{e}ge Intranuclear Cascade Model. We are able to reproduce experimental fission probabilities and fission-fragment mass distributions in both reactions types with the same parameter sets. However, no unique parameter set was obtained for the fission probability. The introduction of fission transients can be offset by an increase of the ratio of level-density parameters for the saddle-point and ground-state configurations. Changes to the finite-range fission barriers could be offset by a scaling of the Bohr-Wheeler decay width as predicted by Kramers. The parameter sets presented allow accurate prediction of fission probabilities for excitation energies up to 300 MeV and spins up to 60 \hbar.Comment: 16 pages, 20 figures. Submitted to Phys. Rev.

    Arterial hypertension in aortic valve stenosis: A critical update

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    Aortic stenosis (AS) is a very common valve disease and is associated with high mortality once it becomes symptomatic. Arterial hypertension (HT) has a high prevalence among patients with AS leading to worse left ventricle remodeling and faster degeneration of the valve. HT also interferes with the assessment of the severity of AS, leading to an underestimation of the real degree of stenosis. Treatment of HT in AS has not historically been pursued due to the fear of excess reduction in afterload without a possibility of increasing stroke volume due to the fixed aortic valve, but most recent evidence shows that several drugs are safe and effective in reducing BP in patients with HT and AS. RAAS inhibitors and beta‐blockers provide benefit in selected populations based on their profile of pharmacokinetics and pharmacodynamics. Different drugs, on the other hand, have proved to be unsafe, such as calcium channel blockers, or simply not easy enough to handle to be recommended in clinical practice, such as PDE5i, MRA or sodium nitroprusside. The present review highlights all available studies on HT and AS to guide antihypertensive treatment

    Depressed Myocardial Energetic Efficiency Increases Risk of Incident Heart Failure: The Strong Heart Study

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    An estimation of myocardial mechano-energetic efficiency (MEE) per unit of left ventricular (LV) mass (MEEi) can significantly predict composite cardiovascular (CV) events in treated hypertensive patients with normal ejection fraction (EF), after adjustment for LV hypertrophy (LVH). We have tested whether MEEi predicts incident heart failure (HF), after adjustment for LVH, in the population-based cohort of a "Strong Heart Study" (SHS) with normal EF. We included 1,912 SHS participants (age 59 ± 8 years; 64% women) with preserved EF (≥50%) and without prevalent CV disease. MEE was estimated as the ratio of stroke work to the "double product" of heart rate times systolic blood pressure. MEEi was calculated as MEE/LV mass, and analyzed in quartiles. During a follow-up study of 9.2 ± 2.3 years, 126 participants developed HF (7%). HF was preceded by acute myocardial infarction (AMI) in 94 participants. A Kaplan-Meier plot, in quartiles of MEEi, demonstrated significant differences, substantially due to the deviation of the lowest quartile (p < 0.0001). Using AMI as a competing risk event, sequential models of Cox regression for incident HF (including significant confounders), demonstrated that low MEEi predicted incident HF not due to AMI (p = 0.026), after adjustment for significant effect of age, LVH, prolonged LV relaxation, diabetes, and smoking habits with negligible effects for sex, hypertension, antihypertensive therapy, obesity, and hyperlipemia. Low LV mechano-energetic efficiency per unit of LVM, is a predictor of incident, non-AMI related, HF in subjects with initially normal EF

    Diet and Plastic Ingestion in the Blackmouth Catshark Galeus melastomus, Rafinesque 1810, in Italian Waters

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    Simple Summary The blackmouth catshark has a habitat range that spans from the Norwegian seas to Senegal and throughout the Mediterranean Sea, and it is one of the most common sharks in Italian waters. The aim of this work is to investigate, through the analyses of the stomach contents of five populations from the Tyrrhenian and Ionian Seas, the diet of blackmouth catsharks. The analyses showed that the most frequent items were Osteichthyes of the family Myctophidae, except for one population, in which the most common items were Cephalopods and Crustacean of the Decapods order. Plastic debris was also found in all populations analysed and classified by colour and shape. This study ought to increase the knowledge of the feeding ecology of the blackmouth catshark, thus improving the meagre literature about Tyrrhenian and Ionian waters. Galeus melastomus is the most common Pentanchidae in the Mediterranean Sea. A scavenger and opportunistic feeder, and despite the wide distribution, little is known about its feeding habits in Italian waters. The main purpose of this study was to investigate the diet of the blackmouth catshark by analysing the stomach contents. The specimens analysed were obtained from five populations of the Tyrrhenian and of the Ionian Seas, collected from a depth between 40 and 700 m. A total of 259 stomachs were analysed. The stomach contents were grouped into macro-categories and identified to the lowest taxonomic level possible. Crustaceans such as Parapenaeus longirostris, the Cephalopods Heteroteuthis dispar and Onychoteuthis banksii, and Osteichthyes, mostly Myctophidae, were identified. Plastic debris was also found among the stomach contents and classified according to its colour and shape. Osteichthyes represent the most abundant item (44%), above all the Myctophidae family, except for the catshark population from Tuscany, in which the most frequent species were Cephalopods, such as Abralia veranyi and Heteroteuthis dispar. Differences in the plastic debris contents were also observed between the Tuscany population and other populations. These could be explained as a probable consequence of the different depths at which the blackmouth catshark populations were sampled
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