Surgical approach to multifocal hepatocellular carcinoma with portal vein thrombosis and arterioportal shunt leading to portal hypertension and bleeding: a case report

It is reported the case of a 69 years man who presented to the Emergency Room because of pain and abdominal distension from ascites. After admission and paracentesis placement, he developed a digestive hemorrhage due to oesophageal varices from portal ipertension secondary to the formation of a portal shunt concomitant with a multifocal HepatoCellular Carcinoma (HCC) with portal vein thrombosis (PVT). The patient underwent endoscopic varices ligation, twice transarterial embolization (TAE) of arterial branches feeding the shunt and subsequent left hepatectomy. During the postoperative course he developed mild and transient signs of liver failure and was discharged in postoperative day 16. He is alive and disease free 8 months after surgery

Acute idiopathic pericarditis with transient constriction [4]

The etiology and the clinical pattern of acute pericarditis change frequently and some classic assumption and descriptions are outdated. We report on a case of transient constrictive pericarditis in a healthy young man

Predictors of cut-out after cephalomedullary nail fixation of pertrochanteric fractures: a retrospective study of 813 patients

BACKGROUND: Cut-out is the most common mechanical complication of the osteosynthesis of pertrochanteric fractures. This complication determines a significant increase in morbidity in elderly patient. Cut-out is defined as the varus collapse of the femoral head-neck fragment with the extrusion of the cephalic screw. Surgical treatment of cut-out might lead to further complications, longer rehabilitation, increased social burden and healthcare system costs. The aim of the study is to identify the predictors of cut-out to prevent its occurrence. MATERIALS AND METHODS: Study population included all patients affected by extracapsular fracture of the proximal femur who were admitted and treated with short cephalomedullary nailing at the Cattinara Hospital-ASUITS of Trieste between 2009 and 2014. A retrospective analysis of clinical and radiographic data was carried out and cut-out cases recorded. The data collected on the study population were analyzed to find an eventual correlation with the occurrence of cut-out. The independent variables were age, gender, side of the fracture, ASA class, Evans classification, nailing system, quality of reduction, TAD, CalTAD, and Parker ratio. RESULTS: The study population counted 813 cases, with an F:M ratio of 4:1 and a mean age of 84.7 years. The cut-out was recorded in 18 cases (2.2%). There was no statistically significant association between cut-out and age, sex, side of fracture, ASA class, and nailing system. The Evans classification, the quality of reduction, the TAD, the CalTAD, and the Parker's ratio demonstrated a significant correlation at univariate analysis with cut-out. The results of multivariate analysis confirmed that TAD, Parker AP, and quality of reduction were independently significantly correlated to cut-out. CONCLUSION: The results of the present study demonstrate that good quality of reduction and correct position of the lag screw are likely to decrease the risk of cut-out complication. A nomogram for cut-out prediction is proposed for clinical validation

Calcificazioni coronariche in una popolazione di donne in post-menopausa affette da sindrome metabolica

Background. The aim of this study was to evaluate the burden of coronary calcifications in a subgroup of post-menopausal women with metabolic syndrome (MS) in agreement with the National Cholesterol Educational Program-Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III) definition. Methods. We studied 81 women (43 control subjects and 38 women with MS) in agreement with the NCEP-ATP III definition undergoing multislice computed tomography for evaluation of coronary calcifications. The patients were similar for Framingham risk score. Results. The severity and extent of coronary artery calcifications were higher in individuals with MS (10.8 \uc2\ub1 15.8 vs 3.02 \uc2\ub1 5.6; p = 0.006). In all patients total cholesterol, low-density lipoproteins and triglycerides were correlated with calcium score (p <0.05) while high-density lipoproteins were inversely correlated with coronary calcifications. In women with MS total cholesterol and low-density iipoprotein cholesterol were correlated with calcium score. Conclusions. Women with MS have a higher burden of subclinical coronary atherosclerosis. The correlation between MS and calcium score concerned more the presence rather than the severity of coronary calcifications. Moreover, no correlation was observed among single components of MS in agreement with the NCEP-ATP III definition. \uc2\ua9 2007 AIM Publishing Srl

Application of Ultrasonic Intensification Technology in the Extraction of Bio-actives from Spent Coffee Grounds and Spent Tea Leaves

Spent coffee grounds (SCG) and spent tea leaves (STL) are leftovers of the two most diffused beverages all over the world, coffee and tea. Functional components commonly found within raw materials, i.e. caffeine and phenolic compounds such as chlorogenic acid, gallic acid, and catechin derivatives, are not fully extracted from coffee grounds and tea leaves during beverage preparation. Therefore, SCG and STL can be regarded as a source of bioactives to be valorised in the formulation of various functional foods and beverages. In the present study, ultrasound-assisted extraction (UAE) and conventional solvent extraction aimed at the recovery of natural antioxidants and caffeine from SCG and STL were compared. In particular, ethanol 60% (v/v) and boiling water were used as solvent media and the effects of two different ultrasound (US) waves amplitudes (80 and 152 µm) and treatment time (5 and 10 min) were investigated. This study closes a literature gap on UAE from SCG and STL using GRAS (Generally Recognized as Safe) solvents, in particular with water. US had an evident positive effect on the recovery of natural antioxidants when the solvent media was aqueous ethanol. In particular, applying the US treatment at 152 µm for 10 min, the total phenolic compounds content of SCG (24.01 ±0.01 mgGAE/gTS) and STL (243.67 ±12.36 mgGAE/gTS) extracts doubled and quadrupled, respectively. Likewise, caffeine recovery significantly increased after sonication up to 2.19 ±0.02 mg/gTS from SCG and up to 12.74 ±0.36 mg/gTS from STL

Quantificazione del calcio coronarico (calcium score) attraverso l'utilizzo di nuove tecniche di imaging e suo ruolo prognostico in vari sottogruppi di pazienti

Coronary artery disease is the first cause of mortality in industrialized countries notwithstanding the diagnostic and therapeutic progresses. Electron beam computed tomography and multislice computed tomography with calcium score software seem to have an important role in the early diagnosis of coronary artery disease. Coronary calcium is associated with a high probability of subclinical atherosclerosis. In particular the area of calcification has a positive correlation with the histologically analyzed area of the atheromatous burden plaque. The pathophysiological mechanism may be that the calcium adherent to the plaque makes unstable the plaque with possible rupture. Several studies have analyzed the predictive value of calcium score in various subgroups of patients (asymptomatic, with chest pain, with diabetes) and they have confirmed the presence of large calcific deposits in subjects with a high cardiovascular risk. The correlation of the other risk factors with calcium score is unclear and whether this is due to genetic predisposition requires further investigation. © 2003 CEPI Srl

Comparison between percutaneous and laparoscopic microwave ablation of hepatocellular carcinoma

Background: Based on patient and tumor characteristics, some authors favor laparoscopic microwave ablation (LMWA) over the percutaneous approach (PMWA) for treatment of hepatocellular carcinoma (HCC). We compared the two techniques in terms of technique efficacy, local tumor progression (LTP) and complication rates. Study design: A retrospective comparative analysis was performed on 91 consecutive patients (102 HCC tumors) who underwent PMWA or LMWA between October 2014 and May 2019. Technique efficacy at one-month and LTP at follow-up were assessed by contrast-enhanced CT/MRI. Kaplan–Meier estimates and Cox regression were used to compare LTP-free survival (LTPFS). Results: At baseline analysis, LMWA group showed higher frequency of multinodular disease (p < .001) and average higher energy delivered over tumor size (p = .033); PMWA group showed higher rates of non-treatment-naïve patients (p = .001), patients with Hepatitis-C (p = .03) and BCLC-A1 disease (p = .006). Technique efficacy was not significantly different between the two groups (p = .18). Among effectively treated patients, 75 (83 tumors) satisfied ≥6 months follow-up, 54 (57 tumors) undergoing PMWA and 21 (26 tumors) LMWA. LTP occurred in 14/83 cases (16.9%): 12 after PMWA (21.1%) and 2 after LMWA (7.7%). At univariate analysis, technique did not correlate to LTPFS (p = .28). Subgroup analysis showed a trend toward worse LTPFS after PMWA of subcapsular tumors (p = .16). Major complications were observed in six patients (6.6%), 2 after PMWA and 4 after LMWA (3.2% vs 14.3%, p = .049). Conclusions: Technical approach did not affect LTPFS. Complications were reported more frequently after LMWA. Despite higher complication rates, LMWA seems a valid option for treatment of subcapsular tumors

Nuclear Nox4 Interaction with Prelamin A is Associated with Nuclear Redox Control of Stem Cell Aging

Mesenchymal stem cells have emerged as an important tool that can be used for tissue regeneration thanks to their easy preparation, differentiation potential and immunomodulatory activity. However, an extensive culture of stem cells in vitro prior to clinical use can lead to oxidative stress that can modulate different stem cells properties, such as self-renewal, proliferation, differentiation and senescence. The aim of this study was to investigate the aging process occurring during in vitro expansion of stem cells, obtained from amniotic fluids (AFSC) at similar gestational age. The analysis of 21 AFSC samples allowed to classify them in groups with different levels of stemness properties. In summary, the expression of pluripotency genes and the proliferation rate were inversely correlated with the content of reactive oxygen species (ROS), DNA damage signs and the onset premature aging markers, including accumulation of prelamin A, the lamin A immature form. Interestingly, a specific source of ROS, the NADPH oxidase isoform 4 (Nox4), can localize into PML nuclear bodies (PML-NB), where it associates to prelamin A. Besides, Nox4 post translational modification, involved in PML-NB localization, is linked to its degradation pathway, as it is also for prelamin A, thus possibly modulating the premature aging phenotype occurrence

Triggering CD40 on endothelial cells contributes to tumor growth

Inflammatory cells can either promote or inhibit tumor growth. Here we studied whether CD40, a key molecule for adaptive immune response, has any role in mammary carcinogenesis of BALB/NeuT transgenic tumor-prone mice. We transferred the HER2/neu oncogene into CD40-null background to obtain the CD40-KO/NeuT strain. CD40-KO/NeuT mice showed delayed tumor onset and reduced tumor multiplicity. BM (BM) transplantation experiments excluded a role of BM-derived cells in the reduced tumorigenicity associated with CD40 deficiency. Rather, CD40 expressed by endothelial cells (ECs) takes part to the angiogenic process. Accordingly, large vessels, well organized around the tumor lobular structures, characterize BALB/NeuT tumors, whereas tiny numerous vessels with scarce extracellular matrix are dispersed in the parenchyma of poorly organized CD40-KO/NeuT tumors

Towards a circular project, between architecture and exhibition design. Digital platforms for reuse practices

Sustainable development and digital transition find wide space in the debate around design disciplines that take up the theme at different paces. While architectural and urban design research has long been working towards innovating design and construction paradigms in a sustainable and circular sense, exhibition design has slowly integrated these aspects into its creation and management structures. From this perspective, the digital transition represents an excellent opportunity to develop integrated systems for circular production chains. The text explores the state of arts in architecture and exhibition design, identifying innovation trajectories within cases of emblematic collaborative platforms, and highlighting their limitations and mutual lessons learned