Case report: Enlarging symmetrical masses of the palate of idiopathic etiology [version 1; peer review: 1 approved, 1 approved with reservations]

We report the case of a 33 year-old woman who came to our attention with slowly enlarging exophytic masses of the palate, histologically characterized by sub-epithelial fibrous proliferation with packed collagen bundles and increased fibroblasts number. We describe the condition of idiopathic fibrous hyperplasia, its diagnosis and its surgical treatment, which in our case was carried out with the aid of a custom made thermal printed plaque used as a scaffold

The Expander-Implant Breast Reconstruction in the COVID Era: Which is the “Unhappy” Tissue Expander Priority?

Breast surgeons seem to agree on the fact that a same-day surgery (mastectomy and breast reconstruction) protocol provides appropriate cancer treatment during times of unprecedented resource limitations, such as in the COVID era. In this scenario, pre-pectoral implant-based breast reconstruction can be definitively considered a sustainable technique. Nevertheless, the authors focus on the management of patients who had already undergone a same day procedure with two-stage breast reconstruction, implanting a breast tissue expander during the last two-year period and have been progressively delayed according to a surgical care based on priority. We coined the expression “unhappy tissue expander” to define all those symptomatic patients for which surgery should not be delayed even during an epidemic context. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

The impact of ventral oral graft bulbar urethroplasty on sexual life

Objective: To evaluate the pre- and postoperative aspects of sexual life (SL) in patients with bulbar urethral stricture who underwent ventral oral graft urethroplasty. Methods: Between 2009 and 2010, 52 men (mean age 36 years) were enrolled in our prospective study to ascertain sexual disorders before and after surgery. The validated Male Sexual Health Questionnaire-Long Form (MSHQ-LF) was completed pre- and postoperatively; the unvalidated but adapted Post-Urethroplasty Sexual Questionnaire (PUSQ) was completed postoperatively. Data were compared using the non parametric Wilcoxon test. Results: Before urethroplasty, most of the patients reported sexual disorders, in particular reduced ejaculatory stream (85%); many of them (35%) feared the risk of a postoperative worsening in the quality of SL. After urethroplasty, nobody reported a worsened erection, while most of the patients noticed a significant improvement in erection, ejaculation, relationship with their partner, sexual activity, and desire. Modifications in the scrotoperineal sensitivity were reported by 42% and 15% noticed esthetic changes without impact on SL. All patients reported an improvement in quality of life (QOL) and were satisfied with the outcome of urethroplasty. Conclusion: Urethral stricture disease may be responsible for sexual disorders that have a significant impact upon SL. Patients confessed a marked anxiety tackling urethroplasty and declared that one of their deepest fears regarded a potential further deterioration in the quality of SL. At short-term follow-up, the minimally invasive ventral graft urethroplasty does not cause sexual complications, apart from the post-ejaculation dribbling. On the contrary, this technique showed to restore SL in all its aspects

Postoperative care in finger replantation: our case-load and review of the literature

OBJECTIVE: Technical success of a finger replantation depends on several factors such as surgical procedure, type of injury, number of segments amputated, amputation level and individual patient factors. Among early complications that can occur in this type of surgery the onset of venous or arterial thrombosis is the most dreaded. Local irrigating solutions, oral and intravenous anticoagulants, thrombolytic agents, plasma expanders, vasodilating, and antiaggregant drugs are routinely used in patients undergoing microvascular procedures, but currently there is only a non-standardized practice based on anecdotal personal experience. MATERIALS AND METHODS: The aim of our study is to review selected literature relating to perioperative therapy in microsurgical digital replantation. We also report our case-load of 16 patients with finger avulsion describing our particular protocol for postoperative anticoagulation and restoration of fluid and electrolyte balance. RESULTS: Following our daily pharmacological protocol, the postoperative course of the replanted fingers was uneventful. The survival rate for finger replantations performed was 100% (n = 16) with no need for surgical revisions. CONCLUSIONS: The association Dextran-40/Heparin/fluids in the proposed standardized pro-weight pharmacological protocol is an optimal postoperative prophylactic/therapeutic plan to reduce the incidence of endovascular thrombosis after replantation, so ensuring high rate of success in microvascular surgery

Revealing the competitive effect of N2 and H2O towards CO2 adsorption in N-rich ordered mesoporous carbons

The incorporation of heteroatoms improves CO2 adsorption on carbon-based materials, but it can also provide some hydrophilic character to the bare-carbon frameworks, making the hypothesis of competitive CO2/H2O adsorption not negligible. In this respect, the CO2 capture is here evaluated through a deep characterization of the sorption properties of N-rich ordered mesoporous carbons under dry and moisture conditions, and in CO2/N2 gas mixtures. The nanocasting strategy is used to obtain N-rich CMK-3-type carbons in one pot by impregnating D-glucosamine hydrochloride, a carbon/nitrogen source, into an SBA-15 silica template followed by pyrolysis treatment at 600, 750, and 900 °C. The fine-tuning of the pyrolysis treatment aims to find the right proportion of micropores and N content, which are important features for selective CO2 adsorption. The highest surface amount of N (11.3 at.%), in particular of the pyridinic type, enhances the CO2/N2 selectivity (1.03 mmol/g of adsorbed CO2 from a 20% CO2 in N2), but also the undesired increment in the H2O uptake. CO2 uptake under competitive CO2/H2O conditions is better preserved with 8.3 at.% of surface nitrogen (1.55, 1.52, 0.61, and 0.89 mmol/g of CO2 at a relative humidity of 0, 25, 50, and 75%, respectively). Interestingly, the N-CMK-3 materials retain their capture properties over repetitive adsorption-desorption cycles in pure CO2. In this respect, a TGA-FTIR study is performed to monitor the reusability of the sorbents after CO2 capture from moist flue gases to assess the effectiveness of the reactivation procedure towards the removal of the adsorbed species

Characterizing the structure of diffuse emission in Hi-GAL maps

We present a study of the structure of the Galactic interstellar medium through the Delta-variance technique, related to the power spectrum and the fractal properties of infrared/sub-mm maps. Through this method, it is possible to provide quantitative parameters which are useful to characterize different morphological and physical conditions, and to better constrain the theoretical models. In this respect, the Herschel Infrared Galactic Plane Survey carried out at five photometric bands from 70 to 500 \mu m constitutes an unique database for applying statistical tools to a variety of regions across the Milky Way. In this paper, we derive a robust estimate of the power-law portion of the power spectrum of four contiguous 2{\deg}x2{\deg} Hi-GAL tiles located in the third Galactic quadrant (217{\deg} < l < 225{\deg}, -2{\deg} < b < 0{\deg}). The low level of confusion along the line of sight testified by CO observations makes this region an ideal case. We find very different values of the power spectrum slope from tile to tile but also from wavelength to wavelength (2 < \beta < 3), with similarities between fields attributable to components located at the same distance. Thanks to the comparison with models of turbulence, an explanation of the determined slopes in terms of the fractal geometry is also provided, and possible relations with the underlying physics are investigated. In particular, an anti-correlation between ISM fractal dimension and star formation efficiency is found for the two main distance components observed in these fields. A possible link between the fractal properties of the diffuse emission and the resulting clump mass function is discussed.Comment: Accepted by Ap

Sars-cov-2 and skin: The pathologist’s point of view

The SARS-CoV-2 pandemic has dramatically changed our lives and habits. In just a few months, the most advanced and efficient health systems in the world have been overwhelmed by an infectious disease that has caused 3.26 million deaths and more than 156 million cases worldwide. Although the lung is the most frequently affected organ, the skin has also resulted in being a target body district, so much so as to suggest it may be a real “sentinel” of COVID-19 disease. Here we present 17 cases of skin manifestations studied and analyzed in recent months in our Department; immunohistochemical investigations were carried out on samples for the S1 spike-protein of SARS-CoV-2, as well as electron microscopy investigations showing evidence of virions within the constituent cells of the eccrine sweat glands and the endothelium of small blood vessels. Finally, we conduct a brief review of the COVID-related skin manifestations, confirmed by immunohistochemistry and/or electron microscopy, described in the literature

The Impact of Lockdown on Couples' Sex Lives

Background: the aim of this study was to perform an Italian telematics survey analysis on the changes in couples' sex lives during the coronavirus disease 2019 (COVID-19) lockdown. Methods: a multicenter cross sectional study was conducted on people sexually active and in stable relationships for at least 6 months. To evaluate male and female sexual dysfunctions, we used the international index of erectile function (IIEF-15) and the female sexual function index (FSFI), respectively; marital quality and stability were evaluated by the marital adjustment test (items 10-15); to evaluate the severity of anxiety symptoms, we used the Hamilton Anxiety Rating Scale. The effects of the quarantine on couples' relationships was assessed with questions created in-house. Results: we included 2149 participants. The sex lives improved for 49% of participants, particularly those in cohabitation; for 29% it deteriorated, while for 22% of participants it did not change. Women who responded that their sex lives deteriorated had no sexual dysfunction, but they had anxiety, tension, fear, and insomnia. Contrarily, men who reported deteriorating sex lives had erectile dysfunctions and orgasmic disorders. In both genders, being unemployed or smart working, or having sons were risk factors for worsening the couples' sex lives. Conclusion: this study should encourage evaluation of the long-term effects of COVID-19 on the sex lives of couples