GERD in the elderly: an endoscopic experience.

Analyzing medical issues related to the elderly patients, particularly in the gastroenterological sphere, Gastro-Esophageal Reflux Disease (GERD) seems to be a disease that reaches an important role in terms of diagnosis and therapy, as well as adversely affect the quality of life of these “frail” patients. Comorbidities that affect these patients often lead to reduce the importance of this disease, which in fact, not infrequently, it is difficult to identify because of mild symptom picture compared to younger patients. Is important to remember that GERD, although in most cases provokes only vague dyspeptic symptoms, can also lead to serious complications, such as bleeding especially in patients with impaired hemostasis, aspiration pneumonia, or even to cancerization of Barrett’s esophagus. In addition, there are several factors favoring GERD, for example polypharmacy carried out for other conditions, which can modify the physiology of the anti-reflux mechanisms. This review addresses the problem of GERD, analyzing it in all its aspects

Isolated dissection of the superior mesenteric artery: a case report and literature review

Isolated dissection of the superior mesenteric artery is rare; it is predominantly observed in men with the highest incidence in those over 40 years old. Contrast-enhanced multi-detector computed tomography is considered essential for the diagnosis, therapeutic management and follow-up. The therapeutic approach ranges from conservative medical treatment to surgery or endovascular stent placement, but there are, to date, no approved guidelines. We report the case of a 68-year old man who entered our Emergency Department just for mild abdominal pain, which later proved to be due to acute dissection of the superior mesenteric artery

Molecular typing of a novel canine parvovirus type 2a mutant circulating in Italy

Canine parvovirus (CPV) is the etiological agent of a severe viral disease of dogs. After its emergence in late 1970s, the CPV original type (CPV-2) was rapidly and totally replaced by three antigenic variants named CPV-2a, CPV-2b and CPV-2c. CPV has an evolutionary rate nearest to those of RNA viruses, with consequences on disease diagnosis and epidemiology. This paper reports the molecular characterization of eight CPV-2a strains collected from dogs in Italy in 2016–2017. Genetic analysis was conducted on a CPV genomic region encompassing both open reading frames (ORFs) encoding for nonstructural (NS1-NS2) and structural proteins (VP1-VP2). Sequence analysis indicates new and unreported sequence changes, mainly affecting the VP2 gene, which included the mutation Tyr324Leu. This study represents the first evidence of a new CPV-2a mutant (VP2 324Leu) and illustrates the importance of a continuous molecular survey in order to obtain more information on effective spread of new CPV mutants