Acute heart failure after Caesaerean section: peri-partum or tako-tsubo cardiomiopathy?

A young woman undergoes Caesarean section at the 39th week of pregnancy: shortly after she develops acute cardiorespiratory failure. The electrocardiography shows sinus tachycardia and right bundle branch block. The ventriculography confirms the decrease of the pump function and the mid-ventricular ballooning of the left ventricle; the differential diagnosis is between peri-partum cardiomyopathy and stress induced tako-tsubo cardiomyopathy: the sudden onset, the results of the ventriculography and the complete recovery after 11 days of treatment for acute heart failure led the diagnosis towards tako-tsubo cardiomyopathy

Changes in emergency psychiatric consultations in time of COVID-19: a retrospective observational study in the Verona Academic Hospital over the two pandemic years 2020-2021

Background: During the first months of the COVID-19 pandemic, local health authorities in most Italian regions prescribed a reduction of ordinary outpatient and community mental health care. The aim of this study was to assess the impact of the COVID-19 pandemic on access to the emergency departments (ED) for psychiatric consultation in the pandemic years 2020 and 2021 compared to 2019. Methods: This is a retrospective study conducted by using routinely collected administrative data of the two EDs of the Verona Academic Hospital Trust (Verona, Italy). All ED psychiatry consultations registered from 01.01.2020 to 31.12.2021 were compared with those registered in the pre-pandemic year (01.01.2019 to 31.12.2019). The association between each recorded characteristic and the year considered was estimated by chi-square or Fisher's exact test. Results: A significant reduction was observed between 2020 and 2019 (-23.3%) and between 2021 and 2019 (-16.3%). This reduction was most evident in the lockdown period of 2020 (-40.3%) and in the phase corresponding to the second and third pandemic waves (-36.1%). In 2021, young adults and people with diagnosis of psychosis showed an increase in requests for psychiatric consultation. Conclusions: Fear of contagion may have been an important factor in the overall reduction in psychiatric consultations. However, psychiatric consultations for people with psychosis and for young adults increased. This finding underlines the need for mental health services to implement alternative outreach strategies aimed to support, in times of crisis, these vulnerable segments of the population

Peripartum cardiomyopathy

Peripartum cardiomyopathy is an uncommon form of congestive heart failure associated with systolic dysfunction of left ventricle. The onset is characterised by symptoms of heart failure occurring between the last month of pregnancy and 5-6 months postpartum. The early diagnosis and the institution of medical treatment for this disease are essential because the inadequate management may affect the patient’s long-term prognosis and can lead to severe complications, including death.Currently its aetiology is not completely understood. Many aetiopathogenetic hypotheses have been formulated: inflammation, viral agents, autoimmune processes. In the last years, evidences aroused for a role of prolactin and its 16 kDa metabolite in reducing cardiomyocite metabolic activity and contraction. In this article we have reviewed the current literature with special emphasis on the role of prolactin and the related current treatment strategies. In particular, bromocriptine appears promising, even if women need to be informed that the drug stops the production of breastmilk. Further researchers, such as large multicenter trials, are needed to decide the best treatment for the women suffering of this disease

Sigma Receptors as Endoplasmic Reticulum Stress “Gatekeepers” and their Modulators as Emerging New Weapons in the Fight Against Cancer

Despite the interest aroused by sigma receptors (SRs) in the area of oncology, their role in tumor biology remains enigmatic. The predominant subcellular localization and main site of activity of SRs are the endoplasmic reticulum (ER). Current literature data, including recent findings on the sigma 2 receptor subtype (S2R) identity, suggest that SRs may play a role as ER stress gatekeepers. Although SR endogenous ligands are still unknown, a wide series of structurally unrelated compounds able to bind SRs have been identified. Currently, the identification of novel antiproliferative molecules acting via SR interaction is a challenging task for both academia and industry, as shown by the fact that novel anticancer drugs targeting SRs are in the preclinical-stage pipeline of pharmaceutical companies (i.e., Anavex Corp. and Accuronix). So far, no clinically available anticancer drugs targeting SRs are still available. The present review focuses literature advancements and provides a state-of-the-art overview of SRs, with emphasis on their involvement in cancer biology and on the role of SR modulators as anticancer agents. Findings from preclinical studies on novel anticancer drugs targeting SRs are presented in brief

Looking into the faintEst WIth MUSE (LEWIS): on the nature of ultra-diffuse galaxies in the Hydra-I cluster.I. Project description and preliminary results

Looking into the faintEst WIth MUSE (LEWIS) is an ESO large observing programme aimed at obtaining the first homogeneous integral-field spectroscopic survey of 30 extremely low-surface brightness (LSB) galaxies in the Hydra I cluster of galaxies, with MUSE at ESO-VLT. The majority of LSB galaxies in the sample (22 in total) are ultra-diffuse galaxies (UDGs). The distribution of systemic velocities Vsys ranges between 2317 km/s and 5198 km/s and is centred on the mean velocity of Hydra I (Vsys = 3683 $\pm$ 46 km/s). Considering the mean velocity and the velocity dispersion of the cluster, 17 out of 20 targets are confirmed cluster members. To assess the quality of the data and demonstrate the feasibility of the science goals, we report the preliminary results obtained for one of the sample galaxies, UDG11. For this target, we derived the stellar kinematics, including the 2-dimensional maps of line-of-sight velocity and velocity dispersion, constrained age and metallicity, and studied the globular cluster (GC) population hosted by the UDG. Results are compared with the available measurements for UDGs and dwarf galaxies in literature. By fitting the stacked spectrum inside one effective radius, we find that UDG11 has a velocity dispersion $\sigma = 20 \pm 8$ km/s, it is old ($10\pm1$ Gyr), metal-poor ([M/H]=-1.17$\pm$0.11 dex) and has a total dynamical mass-to-light ratio M$/L_V\sim 14$, comparable to those observed for classical dwarf galaxies. The spatially resolved stellar kinematics maps suggest that UDG11 does not show a significant velocity gradient along either major or minor photometric axes. We find two GCs kinematically associated with UDG11. The estimated total number of GCs in UDG11, corrected for the spectroscopic completeness limit, is $N_{GC}= 5.9^{+2.2}_ {-1.8}$, which corresponds to a GC specific frequency of $S_N = 8.4^{+3.2}_{-2.7}$.Comment: Accepted for publication in Astronomy and Astrophysic

Galaxy populations in the Hydra i cluster from the VEGAS survey:I. Optical properties of a large sample of dwarf galaxies

At ~50 Mpc, the Hydra I cluster of galaxies is among the closest cluster in the z=0 Universe, and an ideal environment to study dwarf galaxy properties in a cluster environment. We exploit deep imaging data of the Hydra I cluster to construct a new photometric catalog of dwarf galaxies in the cluster core, which is then used to derive properties of the Hydra I cluster dwarf galaxies population as well as to compare with other clusters. Moreover, we investigate the dependency of dwarf galaxy properties on their surrounding environment. The new Hydra I dwarf catalog contains 317 galaxies with luminosity between -18.5<$M_r$<-11.5 mag, a semi-major axis larger than ~200 pc (a=0.84 arcsec), of which 202 are new detections, previously unknown dwarf galaxies in the Hydra I central region. We estimate that our detection efficiency reaches 50% at the limiting magnitude $M_r$=-11.5 mag, and at the mean effective surface brightness $\overline{\mu}_{e,r}$=26.5 mag/$arcsec^2$. We present the standard scaling relations for dwarf galaxies and compare them with other nearby clusters. We find that there are no observational differences for dwarfs scaling relations in clusters of different sizes. We study the spatial distribution of galaxies, finding evidence for the presence of substructures within half the virial radius. We also find that mid- and high-luminosity dwarfs ($M_r$<-14.5 mag) become on average redder toward the cluster center, and that they have a mild increase in $R_e$ with increasing clustercentric distance, similar to what is observed for the Fornax cluster. No clear clustercentric trends are reported with surface brightness and S\'ersic index. Considering galaxies in the same magnitude-bins, we find that for high and mid-luminosity dwarfs ($M_r$<-13.5 mag) the g-r color is redder for the brighter surface brightness and higher S\'ersic n index objects.Comment: Accepted for publication in A&A. 25 pages, 21 figure

How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study

Background: Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis: We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods: We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results: Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions: Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice