P12.14: 4D/3D ultrasound‐guided embryo transfer

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Feast of sacrifice and orf, Milan, Italy, 2015–2018

Orf (ecthyma contagiosum) is an infection of the skin caused by a DNA virus belonging to the genus Parapoxvirus. We recently observed 7 cases of orf in Muslim men living in the metropolitan area of Milan, Italy, who acquired the infection after the Feast of Sacrific

Leptonic decay constants fK, fD and fDs with Nf = 2+1+1 twisted-mass lattice QCD

We present a lattice QCD calculation of the pseudoscalar decay constants fK, fD and fDs performed using the gauge configurations produced by the European Twisted Mass Collaboration with Nf = 2 + 1 + 1 dynamical quarks, which include in the sea, besides two light mass degenerate quarks, also the strange and charm quarks with masses close to their values in the real world. The simulations are based on a unitary setup for the two light mass-degenerate quarks and on a mixed action approach for the strange and charm quarks. We use data simulated at three different values of the lattice spacing in the range 0.06 - 0.09 fm and at pion masses in the range 210 - 450 MeV. Our main results are: fK+ / fpi+ = 1.184 (16), fK+ = 154.4 (2.0) MeV, which incorporate the leading strong isospin breaking correction due to the up- and down-quark mass difference, and fK = 155.0 (1.9) MeV, fD = 207.4 (3.8) MeV, fDs = 247.2 (4.1) MeV, fDs / fD = 1.192 (22) and (fDs / fD) / (fK / fpi) = 1.003 (14) obtained in the isospin symmetric limit of QCD. Combined with the experimental measurements of the leptonic decay rates of kaon, pion, D- and Ds-mesons our results lead to the following determination of the CKM matrix elements: |Vus| = 0.2269 (29), |Vcd| = 0.2221 (67) and |Vcs| = 1.014 (24). Using the latest value of |Vud| from superallowed nuclear beta decays the unitarity of the first row of the CKM matrix is fulfilled at the permille level.Comment: 20 pp., 4 figures; revised version to appear in PRD; improved calculation of IB effects for fK+; minor changes in the final values. arXiv admin note: text overlap with arXiv:1403.450

Amputation of a finger in a patient with multidrug-resistant Mycobacterium marinum skin infection

Mycobacterium marinum is the etiologic agent of fish tank granuloma. The clinical course is usually benign: spontaneous healing is possible within weeks or months. However, fish tank granuloma is sometimes resistant to several antibiotics. We report a case of M. marinum infection of a finger in a 73-year-old cook. The disease was resistant to a number of antibiotics and required the amputation. The history of this patient testifies that M. marinum can be resistant to several antibiotics and that skin infections can be sometimes so severe as to require the amputation of a finger

A case of tinea imbricata in an Italian woman

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Consumer Behaviour, Obesity and Social Costs. the Case of Italy

This study analyses the social impact of obesity, focusing on the direct costs and, in particular,on the health-care expenditure. Using different socio-demographic variables and through theuse of Multiple Correspondence Analysis and Partial Least Squares Regression, the analysis: i)confirms the increase of the incidence of overweight and obesity when moving from Northernto Southern Italy; ii) identifies the main variables related to the growth of obesity; iii) highlightsa positive relationship between BMI and health-care costs and an incidence of 6% on theregional health-care costs. These findings confirm the need to define suitable guidelines fordecision makers and practitioners and to introduce mandatory regulations forcing companiesto effectuate product reformulation and achieve food safety. Indeed, asymmetric informationand consumer behaviour make investing in product reformulation undesirable for companiesbecause the use of attractive brands is more effective in influencing the purchasing decisionseven of a conscious consumer. Uninformed consumers often cling to the national brands,which sometimes, behind an image of familiarity and identity, may hide harmful ingredients(hydrogenated fats) or excessive quantities of certain ingredients (sugar, salt, saturatedfat) responsible for an unbalanced diet. Therefore, this justifies the introduction of bindingregulations.Keywords: Consumer Behaviour; Obesity; Social Costs; Health-Care Expenditure; MultivariateModel

Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial.

Summary Background It is unclear whether radial compared with femoral access improves outcomes in unselected patients with acute coronary syndromes undergoing invasive management. Methods We did a randomised, multicentre, superiority trial comparing transradial against transfemoral access in patients with acute coronary syndrome with or without ST-segment elevation myocardial infarction who were about to undergo coronary angiography and percutaneous coronary intervention. Patients were randomly allocated (1:1) to radial or femoral access with a web-based system. The randomisation sequence was computer generated, blocked, and stratified by use of ticagrelor or prasugrel, type of acute coronary syndrome (ST-segment elevation myocardial infarction, troponin positive or negative, non-ST-segment elevation acute coronary syndrome), and anticipated use of immediate percutaneous coronary intervention. Outcome assessors were masked to treatment allocation. The 30-day coprimary outcomes were major adverse cardiovascular events, defined as death, myocardial infarction, or stroke, and net adverse clinical events, defined as major adverse cardiovascular events or Bleeding Academic Research Consortium (BARC) major bleeding unrelated to coronary artery bypass graft surgery. The analysis was by intention to treat. The two-sided α was prespecified at 0·025. The trial is registered at ClinicalTrials.gov, number NCT01433627. Findings We randomly assigned 8404 patients with acute coronary syndrome, with or without ST-segment elevation, to radial (4197) or femoral (4207) access for coronary angiography and percutaneous coronary intervention. 369 (8·8%) patients with radial access had major adverse cardiovascular events, compared with 429 (10·3%) patients with femoral access (rate ratio [RR] 0·85, 95% CI 0·74-0·99; p=0·0307), non-significant at α of 0·025. 410 (9·8%) patients with radial access had net adverse clinical events compared with 486 (11·7%) patients with femoral access (0·83, 95% CI 0·73-0·96; p=0·0092). The difference was driven by BARC major bleeding unrelated to coronary artery bypass graft surgery (1·6% vs 2·3%, RR 0·67, 95% CI 0·49-0·92; p=0·013) and all-cause mortality (1·6% vs 2·2%, RR 0·72, 95% CI 0·53-0·99; p=0·045). Interpretation In patients with acute coronary syndrome undergoing invasive management, radial as compared with femoral access reduces net adverse clinical events, through a reduction in major bleeding and all-cause mortality. Funding The Medicines Company and Terumo. © 2015 Elsevier Ltd

Sebomic identification of sex- and ethnicity-specific variations in residual skin surface components (RSSC) for bio-monitoring or forensic applications

Background: “Residual skin surface components” (RSSC) is the collective term used for the superficial layer of sebum, residue of sweat, small quantities of intercellular lipids and components of natural moisturising factor present on the skin surface. Potential applications of RSSC include use as a sampling matrix for identifying biomarkers of disease, environmental exposure monitoring, and forensics (retrospective identification of exposure to toxic chemicals). However, it is essential to first define the composition of “normal” RSSC. Therefore, the aim of the current study was to characterise RSSC to determine commonalities and differences in RSSC composition in relation to sex and ethnicity. Methods: Samples of RSSC were acquired from volunteers using a previously validated method and analysed by high-pressure liquid chromatography–atmospheric pressure chemical ionisation–mass spectrometry (HPLC-APCI-MS). The resulting data underwent sebomic analysis. Results: The composition and abundance of RSSC components varied according to sex and ethnicity. The normalised abundance of free fatty acids, wax esters, diglycerides and triglycerides was significantly higher in males than females. Ethnicity-specific differences were observed in free fatty acids and a diglyceride. Conclusions: The HPLC-APCI-MS method developed in this study was successfully used to analyse the normal composition of RSSC. Compositional differences in the RSSC can be attributed to sex and ethnicity and may reflect underlying factors such as diet, hormonal levels and enzyme expression.Peer reviewedFinal Published versio

Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project

Background: Serum uric acid predicts the onset and progression of kidney disease, and the occurrence of cardiovascular and all-cause mortality. Nevertheless, it is unclear which is the appropriate definition of hyperuricemia in presence of chronic kidney disease (CKD). Our goal was to study the independent impact of uric acid and CKD on mortality. Methods: We retrospectively investigated 21,963 patients from the URRAH study database. Hyperuricemia was defined on the basis of outcome specific cut-offs separately identified by ROC curves according to eGFR strata. The primary endpoints were cardiovascular and all-cause mortality. Results: After a mean follow-up of 9.8 year, there were 1,582 (7.20%) cardiovascular events and 3,130 (14.25%) deaths for all causes. The incidence of cardiovascular and all-cause mortality increased in parallel with reduction of eGFR strata and with progressively higher uric acid quartiles. During 215,618 person-years of follow-up, the incidence rate for cardiovascular mortality, stratified based on eGFR (>90, between 60 and 90 and <60 ml/min) was significantly higher in patients with hyperuricemia and albuminuria (3.8, 22.1 and 19.1, respectively) as compared to those with only one risk factor or none (0.4, 2.8 and 3.1, respectively). Serum uric acid and eGFR significantly interact in determining cardiovascular and all-cause mortality. For each SUA increase of 1 mg/dl the risk for mortality increased by 10% even after adjustment for potential confounding factors included eGFR and the presence of albuminuria. Conclusions: hyperuricemia is a risk factor for cardiovascular and all-cause mortality additively to eGFR strata and albuminuria, in patients at cardiovascular risk