Iatrogenic coronary-right ventricular fistula complicated by coronary thrombosis

AbstractsCoronary perforation is a rare but potentially lethal complication during percutaneous coronary intervention (PCI) and its treatment is challenging when occurring inside or beyond unexpanded stents, where covered stent delivery is difficult. The perforation is a communication that occurs between the coronary lumen and more frequently the pericardial space, much more rarely the right or left ventricle [1]. An immediate recognition of the exact location and of the course of the extravasation is of utmost relevance for a correct management [2]. We here describe a case where excessive maneuvering may have caused a further complication – coronary thrombosis – the pharmacological management of which is cumbersome in the setting of a coronary perforation

Necrosis of the columella associated with nasal continuous positive airway pressure in a preterm infant

[No abstract available

The Role of Trust in Disaster Risk Reduction: A Critical Review

: In recent years, there has been a growing interest in the concept of trust within the domain of natural disaster management. Trust can be defined as a state of vulnerability where one party relies on another party with the expectation that the latter will carry out entrusted responsibilities without exploiting this inherent vulnerability. This comprehensive literature review is dedicated to the examination of research concerning community and institutional trust in the field of disaster risk reduction (DRR). Particular emphasis is placed on elucidating the influence of trust throughout the distinct phases of natural disaster management, namely prevention, preparedness, response, and recovery. The critical examination of the pertinent body of the literature demonstrates that trust plays a central role across the different phases of DRR, being positively associated with effective community responses and resilience. Hence, it becomes imperative to actively foster the development of trust at both institutional and community levels within the realm of DRR. This endeavor is essential for adequately preparing communities to confront natural disasters, crafting effective protocols to enhance community responsiveness and mitigate adverse consequences, and advancing strategies for successful reconstruction and recovery

Female pseudohermaphroditism: strategy and bias in a fast diagnosis. How tricky could be a diagnosis with a wrong anamnesis

Congenital genitalia anomalies are a spectrum of malformation, difficult to classify because similar or identical phenotypes could have several different aetiology; therefore it's essential to assess an efficient diagnostic algorithm for a quick diagnosis and to develop an efficient therapeutic strategy. The aim of this study is to underline the importance of imaging in case of ambiguous genitalia due to its high sensitivity and specificity in detecting internal organs and urogenital anatomy

Female pseudohermaphroditism: strategy and bias in a fast diagnosis. How tricky could be a diagnosis with a wrong anamnesis

Congenital genitalia anomalies are a spectrum of malformation, difficult to classify because similar or identical phenotypes could have several different aetiology; therefore it's essential to assess an efficient diagnostic algorithm for a quick diagnosis and to develop an efficient therapeutic strategy. The aim of this study is to underline the importance of imaging in case of ambiguous genitalia due to its high sensitivity and specificity in detecting internal organs and urogenital anatomy

Genetic determinants of blood pressure responses to caffeine drinking

The widely observed between-subject variability in cardiovascular responses to coffee may have a genetic basis. OBJECTIVE: We evaluated acute blood pressure (BP) responses to caffeine and explored whether they are influenced by candidate gene variants affecting caffeine metabolism (for cytochrome P450 1A2), adenosine metabolism (for adenosine receptor and AMP deaminase), or catecholamine receptors. METHODS: We recruited 110 healthy male habitual moderate coffee drinkers who refrained from drinking coffee on the day preceding the study. Each subject underwent ambulatory BP monitoring at 6-min intervals for 2 h. Each participant was administered, in a double-blind design, 40 mL of either a decaffeinated coffee preparation plus 3 mg caffeine/kg (caf) or the corresponding vehicle (decaf). The protocol was repeated 24 h later with the alternative preparation. Blood samples were collected for genetic and plasma caffeine and catecholamine evaluations. RESULTS: Compared with decaf, caf was associated with a mean (± SD) significant increase in systolic BP of 4 ± 12 mm Hg and in diastolic BP of 3 ± 10 mm Hg (P < 0.001 for both). Plasma caffeine and adrenaline increased after caf, but not after decaf. Of 11 gene polymorphisms analyzed, a relation was observed between the ADORA2A TT variant and the change in SBP peak and between the ADRA2B I variant and the changes in both SBP mean and peak; mean peak change in SBP; these variants were associated with increased SBP responses to caf. CONCLUSIONS: Variability in the acute BP response to coffee may be partly explained by genetic polymorphisms of the adenosine A2A receptors and α(2)-adrenergic receptors. This trial is registered at clinicaltrials.gov as NCT01330680

Concretezza ed attualità delle esigenze cautelari

La verifica della presenza di situazioni, che legittimano, in concreto ed in termini specifici, l'emanazione di un'ordinanza coercitiva, rappresenta la precondizione di quella delicata operazione di contemperamento tra interessi attinenti all'esercizio della potestà di giustizia, indicati nella richiesta cautelare del pubblico ministero, l'inviolabilità della libertà personale. Tuttavia, il valore nominale della locuzione 'esigenza cautelare' e l'articolazione delle relative situazioni di pericolo, di cui all'art. 274 c.p.p., sono suscettibili di un autonomo apprezzamento inerente al concorso di elementi oggettivi e soggettivi, ed impongono al giudice, in motivazione, un iter argomentato giuridicamente corretto ed ispirato ad un criterio logico e convincente. Si tratta di un giudizio ex post effettuato nell'osservanza dei casi e modi previsti dalla legge

Concretezza e attualità delle esigenze cautelari

La verifica della presenza di situazioni, che legittimano, in concreto ed in termini specifici, l'emanazione di un'ordinanza coercitiva, rappresenta la precondizione di quella delicata operazione di contemperamento tra interessi attinenti all'esercizio della potestà di giustizia, indicati nella richiesta cautelare del pubblico ministero, e l'inviolabilità della libertà personale. Tuttavia, il valore nominale della locuzione esigenza cautelare e l'articolazione delle relative situazioni di pericolo, di cui all'art. 274 c.p.p., sono suscettibili di un autonomo apprezzamento inerente alla sussistenza di elementi oggettivi e soggettivi, ed impongono al giudice, in motivazione, un iter argomentativi giuridicamente corretto ed ispirato ad un criterio logico e convincente. Il principio di legalità processuale orienta l'esercizio della discrezionalità del potere cautelare, ma esso non può essere inteso nei termini fissati dagli stilemi classici dello stato di diritto; il pluralismo delle fonti ha avviato il moto di trasformazione degli assetti ordinamenti, determinando interventi settoriali e frammentari sulle regole del processo