clinical outcome of patients over 90 years of age treated for chronic subdural hematoma

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A case of very delayed surgical site infection after instrumented spine surgery

This is a case of a 69-year-old obese woman treated with posterior spinal stabilization for lumbar degenerative stenosis who developed delayed and persistent surgical site infection sustained by Bacteriodes fragilis. This microorganism is characterized by slow growth and resistance to antimicrobial agents. The patient underwent a surgical treatment with debridement of the surgical wound without hardware removal. After fourteen months the patient had a recurrence of low back pain, low-grade fever and dehiscence of surgical wound with the need of hardware removal. The intra-operative culture was positive for the same microrganism, than she healed with target antibiotic therapy

Effects of Energy Drink Acute Assumption in Gastrointestinal Tract of Rats

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Cardiovascular prevention in women: an update by the Italian Society of Cardiology working group on 'Prevention, hypertension and peripheral disease'

: The recent pandemic has substantially changed the approach to the prevention of cardiovascular diseases in women. Women have been significantly impacted by the changes that occurred during the pandemic and the quarantine adopted to prevent the spread of the disease. Changes involved prevention both through the reduction of visits and preventive screening and through social and economic changes. It is necessary to adopt new cardiovascular prevention approaches focused on returning to healthy lifestyles, reducing stress and depression also using modern tools such as telemedicine, mobile phone applications and the web. These tools convey messages in a persuasive way especially in young and adult women. There is less impact of these new tools on older women towards whom it is important to adopt a more traditional approach. This review focuses on the new approach to cardiovascular prevention in women in light of the lifestyle changes recorded during the pandemic and which led to an increase in obesity examines the effects on the cardiovascular system induced by stress and depression and analyses the new high blood pressure guidelines and indications that are specific to women

The role of physical activity in individuals with cardiovascular risk factors: an opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport

: Regular physical activity is a cornerstone in the prevention and treatment of atherosclerotic cardiovascular disease (CVD) due to its positive effects in reducing several cardiovascular risk factors. Current guidelines on CVD suggest for healthy adults to perform at least 150\u200amin/week of moderate intensity or 75\u200amin/week of vigorous intensity aerobic physical activity. The current review explores the effects of physical activity on some risk factors, specifically: diabetes, dyslipidemia, hypertension and hyperuricemia. Physical activity induces an improvement in insulin sensitivity and in glucose control independently of weight loss, which may further contribute to ameliorate both diabetes-associated defects. The benefits of adherence to physical activity have recently proven to extend beyond surrogate markers of metabolic syndrome and diabetes by reducing hard endpoints such as mortality. In recent years, obesity has greatly increased in all countries. Weight losses in these patients have been associated with improvements in many cardiometabolic risk factors. Strategies against obesity included caloric restriction, however greater results have been obtained with association of diet and physical activity. Similarly, the beneficial effect of training on blood pressure via its action on sympathetic activity and on other factors such as improvement of endothelial function and reduction of oxidative stress can have played a role in preventing hypertension development in active subjects. The main international guidelines on prevention of CVD suggest to encourage and to increase physical activity to improve lipid pattern, hypertension and others cardiovascular risk factor. An active action is required to the National Society of Cardiology together with the Italian Society of Sports Cardiology to improve the prescription of organized physical activity in patients with CVD and/or cardiovascular risk factors

Innate immunity changes in soccer players after whole-body cryotherapy

Whole-body cryotherapy (WBC) consists of short exposure (up to 2-3 min) to dry air at cryogenic temperatures (up to -190 degrees C) and has recently been applied for muscle recovery after injury to reduce the inflammation process. We aimed to determine the impact of cryotherapy on immunological, hormonal, and metabolic responses in non-professional soccer players (NPSPs). Nine male NPSPs (age: 20 +/- 2 years) who trained regularly over 5 consecutive days, immediately before and after each training session, were subjected to WBC treatment (WBC-t). Blood samples were collected for the evaluation of fifty analytes including hematologic parameters, serum chemistry, and hormone profiles. Monocytes phenotyping (Mo) was performed and plasmatic markers, usually increased during inflammation [CCL2, IL-18, free mitochondrial (mt)DNA] or with anti-inflammatory effects (IL2RA, IL1RN), were quantified. After WBC-t, we observed reduced levels of ferritin, mean corpuscular hemoglobin, mean platelet volume, testosterone, and estradiol, which however remain within the normal ranges. The percentage of the total, intermediates and non-classical Mo increased, while classical Mo decreased. CXCR4 expression decreased in each Mo subset. Plasma IL18 and IL2RA levels decreased, while IL1RN only exhibited a tendency to decrease and CCL2 showed a tendency to increase. Circulating mtDNA levels were not altered following WBC-t. The differences observed in monocyte subsets after WBC-t may be attributable to their redistribution into the surrounding tissue. Moreover, the decrease of CXCR4 in Mo subpopulations could be coherent with their differentiation process. Thus, WBC through yet unknown mechanisms could promote their differentiation having a role in tissue repair

The Eye And The Hand: Neural Mechanisms And Network Model For Oculomanual Coordination

The coordinated action of the eye and the hand is necessary for the successful performance of a large variety of motor tasks based on visual information. Although at the output level the neural control systems for the eye and the hand are largely segregated, in the parietal cortex of the macaque monkey there exist populations of neurons able to combine ocular and manual signals on the basis of their spatial congruence. An expression of this congruence is the clustering of eye- and hand-related preferred directions of these neurons into a restricted region of the workspace, defined as field of global tuning. This domain may represent a neural substrate for the early composition of commands for coordinated oculo-manual actions. Here we study two different prototypical network models integrating inputs about retinal target location, eye position and hand position. In the first one, we model the interaction of these different signals, as it occurs at the afferent level, in a feed-forward fashion. In the second model, we assume that recurrent interactions are responsible for their combination. Both models account surprisingly well for the experimentally observed global tuning fields of parietal neurons. When we compare them with the experimental findings, no significant difference emerges between the two. Experiments potentially able to discriminate between these models could be performed

Surgical treatment and predictive factors for atypical meningiomas: a multicentric experience

INTRODUCTION: Atypical meningiomas (AMs) are characterized by a high rate of recurrence and a lesser Overall Survival (OS), compared to grade I meningioma. Nowadays, it is still controversial which are the predictive parameters for OS and the Recurrence free survival (RFS). METHODS: Data regarding age, gender, localization of the tumor, pre-operative symptoms, tumor localization, size, Simpson grade, postoperative complications, the extent of the resection (EOR), the number of mitoses, the proliferation index (MIB1), the brain invasion, the post-operative Radiotherapy (RT) treatment and clinical outcome (Karnofsky performance status, KPS, post-operatively and long-time follow-up) were evaluated. In addition, data regarding the recurrence rate, the mortality, OS and RFS at 1-year, 3-year and 5-year follow-up were collected. The median follow-up was 76 months, all patients had at least 3-year follow-up. RESULTS: Between 2007 and 2017, 73 patients underwent a surgical procedure for AMs (WHO grade II) in Ospedali Riuniti Center of Ancona and Sestre Milosrdnice University Hospital Centre. A preoperative KPS> 80 resulted to be related to a better OS, also at the one-month follow-up, six-month and one-year follow-up KPS. The post-operative complications did not modify the OS and the RFS. A Gross total removal (GTR, Simpson grade I, II) was achieved in the 80,8% of patients. The RFS was statistically influenced by the EOR (p=0,002). A MIB-1>8 was a negative predictive factor for recurrence at univariate and multivariate analysis (p=0,001, p=0,021). RT was statistically related to a worse outcome. The incidence of recurrence was 38%. The RFS was 98,6% at 1-year follow-up, 81,1% at 3-year and, only 57,5% at 5-year follow-up. All patients were alive after 1-year follow-up. The OS at 3-year follow-up was 90, 5% and 78,8 % at 5-year follow-up. CONCLUSIONS: Despite some limitations, our study demonstrate that an aggressive surgical treatment, achieving a GTR is a positive predictive parameter for the RFS, as well as a good clinical outcome (KPS > 80) is related to a longer overall survival