Analyses of rare collection samples as conservation tool for the last known Italian population of Graphoderus bilineatus (Insecta: Coleoptera)

Graphoderus bilineatus is a predacious diving beetle, widely distributed across Europe. Its poor dispersal ability and the fragmentation and deterioration of its habitats have been indicated as the major causes of decline. In several western European countries, the species is extinct, justifying its inclusion as "vulnerable" in the IUCN red list. Aiming for the conservation of the last known population of G. bilineatus in the northern Italian region of Emilia Romagna, at the lake Pratignano, we surveyed its genetic diversity at the mitochondrial COI gene and compared it to that of other European populations. Two fixed COI haplotypes were found in the Italian and Austrian populations, respectively. Both haplotypes were unique among the European populations surveyed, suggesting these populations suffered a bottleneck and geographic isolation. Populations in western Europe showed lower genetic diversity and higher degree of differentiation than eastern populations. The uniqueness of Pratignano haplotype makes it difficult to choose a source population from which to transfer animals for a possible restocking. Selection of the source population should be based mainly on ecological considerations, but at the same time ensuring a good genetic diversity to maximize the adaptive potential

Anticoagulant treatment in patients with pulmonary arterial hypertension associated with systemic sclerosis: More shadows than lights

Pulmonary arterial hypertension is a chronic and progressive disease characterized by elevated pulmonary artery pressure and pulmonary vascular resistance leading to heart failure and premature death. Pulmonary arterial hypertension is characterized by proliferative and obstructive lesions in the distal pulmonary arteries and some descriptions include also thrombotic lesions. Despite this, in an era when multiple effective pulmonary arterial hypertension therapies are available, the role of anticoagulation in the treatment of pulmonary arterial hypertension remains uncertain. In particular, anticoagulant treatment in pulmonary arterial hypertension associated with connective tissue disease seems to be associated with unfavorable risk to benefit ratio due to an increased rate of bleeding from the gastrointestinal tract. However, anticoagulation may be required in conditions with increased thrombophilia like in the presence of lupus anticoagulant phenomenon or in the presence of anticardiolipin antibodies

Transanal total mesorectal excision (TaTME) : tips and tricks of a new surgical technique

Laparoscopic total mesorectal excision (TME) can be technically challenging especially in obese and patients with narrow pelvis. Transanal TME (TaTME) is a technique that combines abdominal and transanal endoscopic approach to overcome limitations and facilitate standard laparoscopic TME. The authors present some specific tips and tricks to perform this complex procedure using a double team approach and a new reusable transanal port

Incomplete echocardiographic recovery at 6\ua0months predicts long-term sequelae after intermediate-risk pulmonary embolism. A post-hoc analysis of the Pulmonary Embolism Thrombolysis (PEITHO) trial

Introduction: Symptoms and functional limitation are frequently reported by survivors of acute pulmonary embolism (PE). However, current guidelines provide no specific recommendations on which patients should be followed after acute PE, when follow-up should be performed, and which tests it should include. Definition and classification of late PE sequelae are evolving, and their predictors remain to be determined. Methods: In a post hoc analysis of the Pulmonary Embolism Thrombolysis (PEITHO) trial, we focused on 219 survivors of acute intermediate-risk PE with clinical and echocardiographic follow-up 6 months after randomisation as well as over the long term (median, 3 years after acute PE). The primary outcome was a composite of (1) confirmed chronic thromboembolic pulmonary hypertension (CTEPH) or (2) \u2018post-PE impairment\u2019 (PPEI), defined by echocardiographic findings indicating an intermediate or high probability of pulmonary hypertension along with New York Heart Association functional class II\u2013IV. Results: Confirmed CTEPH or PPEI occurred in 29 (13.2%) patients, (6 with CTEPH and 23 with PPEI). A history of chronic heart failure at baseline and incomplete or absent recovery of echocardiographic parameters at 6 months predicted CTEPH or PPEI at long-term follow-up. Conclusions: CTEPH or PPEI occurs in almost one out of seven patients after acute intermediate-risk PE. Six-month echocardiographic follow-up may be useful for timely detection of late sequelae

Conventional Medical Therapies in the treatment of pulmonary hypertension

Evaluation of conventional therapes in Pulmonary Arterial Hypertensio

Pulmonary hypertension

Evaluation of the acute complications of pulmonary hypertensio