Video-assisted two-stage basilic vein transposition for creation of brachio-basilic arteriovenous fistulae

We report our experience in a mixed minimally-in- vasive technique for the two-stage transposition of basilic vein on a small series of eight patients. The operative tech- nique consisted of a modified endoscopic (1) approach for the two-stage transposition (2). The intervention was performed under Brachial Plexus Block (3)

TLS MODELS GENERATION ASSISTED BY UAV SURVEY

By now the documentation and 3D modelling activities of built heritage concern in an almost usual way terrestrial Lidar techniques (TLS, Terrestrial Laser Scanning), and large scale mapping derived by UAV (Unmanned Aerial Vehicle) survey. This paper refers an example of 3D survey and reality based modelling applied on landscape and architectural assets. The choice of methods for documentation, in terms of survey techniques, depends primarily on issues and features of the area. The achieved experience, allow to consider that the easy handling of TLS has enabled the use in limited spaces among buildings and collapsed roofs, but the topographic measure of GCPs (Ground Control Points), neither by total station nor by GPS/RTK technique, was easily feasible. Even more than proving the ability of the integration of TLS and UAV photogrammetry to achieve a multi-source and multi-scale whole model of a village, the experience has been a test to experiment the registration of terrestrial clouds with the support of control points derived by UAV survey and finally, a comparison among different strategies of clouds registration is reported. Analysing for each approach a number of parameters (number of clouds registration, number of needed points, processing time, overall accuracy) the further comparisons have been achieved. The test revealed that it is possible to decrease the large number of terrestrial control points when their determination by topographical measures is difficult, and it is possible to combine the techniques not only for the integration of the final 3Dmodel, but also to solve and make the initial stage of the drafting process more effective

Central nervous system myeloma and unusual extramedullary localizations: real life practical guidance

Central nervous system localization of multiple myeloma (CNS-MM) accounts for about 1% of all MM during disease course or even rarer at diagnosis. A difference in the origin, i.e., osteodural or primary dural vs leptomeningeal/intraparenchymal, seems to define two distinct types of intracranial myeloma, with different clinical behavior. CNS-MM may occur also as a presentation of MM. Treatment is still unsatisfactory and many treatments have been reported: chemotherapy, intrathecal therapy, and radiotherapy, with dismal prognosis. Other sites of myeloma localization could be also of interest and deserve description. Because of the rarity and aggressiveness of the disease clinicians are often doubtful on how to treat it since there is no general agreement. Moreover, recent drugs such as the anti CD38 monoclonal antibody, immunomodulatory drugs, and proteasome inhibitors have changed the treatment of patients with MM with a significant improvement in overall response and survival. The role of novel agents in CNS MM management and unusual presentations will be discussed as well as the potential role of other new immunomodulatory drugs and proteasome inhibitors that seem to cross the blood-brain barrier. The purpose of this review is to increase awareness of the clinical unusual presentation and neuroradiological findings, give practical diagnostic advice and treatment options algorithm

ILEUS FOLLOWING SPONTANEOUS JEJUNUM INTRAMURAL HEMATOMA: CASE REPORT AND REVIEW OF THE LITERATURE

Anticoagulant therapy may cause the onset of a spontaneous intramural hema- toma of the small bowel, in the jejunum, ileum or duodenum. A 53-year-old woman on therapy with heparin for previous pulmonary embolism was admitted for abdominal pain and vomit. Computed tomography scan visualized an intramural hematoma of the jejunum causing subtotal obstruction of the intestinal lumen. The patient underwent resection of a part of the jejunum, securing intestinal continuity by a mechanical side-to-side anastomosis. The postoperative course was regular, but the initial anticoagulant therapy was reduced to prevent recurrence. In conclusion, spontaneous hema- toma of small bowel can occur as a complication of anticoagulant therapy. The clinical picture and rapid diagnosis indicate medical or surgical therapy

Numerical semigroups with large embedding dimension satisfy Wilf's conjecture

We give an affirmative answer to Wilf's conjecture for numerical semigroups satisfying 2 \nu \geq m, where \nu and m are respectively the embedding dimension and the multiplicity of a semigroup. The conjecture is also proved when m \leq 8 and when the semigroup is generated by a generalized arithmetic sequence.Comment: 13 page

When the associated graded ring of a semigroup ring is Complete Intersection

Let (R, m) be the semigroup ring associated to a numerical semigroup S. In this paper we study the property of its associated graded ring G(m) to be Complete Intersection. In particular, we introduce and characterise beta-rectangular and gamma-rectangular Ap\'ery sets, which will be the fundamental concepts of the paper and will provide, respectively, a sufficient condition and a characterisation for G(m) to be Complete Intersection. Then we use these notions to give four equivalent conditions for G(m) in order to be Complete Intersection.Comment: 24 page

The third dose of mRNA SARS-CoV-2 vaccines enhances the spike-specific antibody and memory B cell response in myelofibrosis patients

Vaccination against SARS-CoV-2 using mRNA-based vaccines has been highly recommended for fragile subjects, including myelofibrosis patients (MF). Available data on the immune responsiveness of MF patients to mRNA SARS-CoV-2 vaccination, and the impact of the therapy with the JAK inhibitor ruxolitinib, are still fragmented. Here, we profile the spike-specific IgG and memory B-cell response in MF patients, treated or not with ruxolitinib, after the second and the third dose of SARS-CoV-2 BNT162b2 (BioNTech) and mRNA-1273 (Moderna) vaccines. Plasma and peripheral blood mononuclear cells samples were collected before vaccination, post the second and the third doses and tested for spike-specific antibodies, ACE2/RBD antibody inhibition binding activity and spike-specific B cells. The third vaccine dose significantly increased the spike-specific IgG titers in both ruxolitinib-treated and untreated patients, and strongly enhanced the percentage of subjects with antibodies capable of in vitro blocking ACE2/RBD interaction, from 50% up to 80%. While a very low frequency of spike-specific B cells was measured in blood 7 days after the second vaccination dose, a strong and significant increase was elicited by the third dose administration, generating a B cell response similar to the one detected in healthy controls. Despite the overall positive impact of the third dose in MF patients, two patients that were under active concomitant immunosuppressive treatment at the time of vaccination, and a patient that received lymphodepleting therapies in the past, remained low responders. The third mRNA vaccine dose strongly increases the SARS-CoV-2 specific humoral and B cell responses in MF patients, promoting a reactivation of the immune response similar to the one observed in healthy controls

THE VALUE OF DIAGNOSTIC ULTRASOUND FOR DETECTING OCCULT INGUINAL HERNIA IN PATIENTS WITH GROIN PAIN

Aims: chronic groin pain caused by an occult hernia can be a difficult clinical diagnosis and may require additional investiga- tive modalities. The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing occult hernia in patients with recurrent inguinal pain and a negative clinical examination. Patients and methods: over a period of three years, a total of 76 patients were referred for ultrasound examination with clini- cally suspected occult inguinal hernia. Patients with positive US scans were offered surgery, while those with negative US findings were offered further imaging or other diagnostic tests. The ultrasound examination of the inguinal region was conducted using a 5- 10 MHz linear probe. The scan was performed with the patient in the supine and erect positions, in a relaxed state, as well as during coughing and during a Valsalva manoeuvre. Results: overall, ultrasound diagnosed 31 inguinal hernias and all 31 patients with positive scans underwent surgery. Surgery confirmed the ultrasound diagnosis in 30 patients, having only 1/31 no hernia at operation (100% ultrasound sensitivity and 96.9% specificity). Patients undergoing surgery showed complete symptom resolution at a three-month follow-up. Conclusions: this study confirms that ultrasound is capable of accurately diagnosing groin hernia and this may justify its use in patients with chronic groin pain due to a suspected occult herni

BIOCOMPATIBILITY AND BIODEGRADABILITY OF ELECTROSPUN PHEA-PLA SCAFFOLDS: OUR PRELIMINARY EXPERIENCE IN A MURINE ANIMAL MODEL

We obtained a nano-fibrillar scaffold starting from a polymeric solution which, through electrospinning, gave a biodegradable material with optimal mechanical features and the capacity to allow cell adhesion. In this paper we report the in-vivo application on a murine animal model of two electrospun biodegradable materials, specifically designed to create tubular structures. In one case PHEA-PLA was co-spun with silk fibroin (Fibro-PHEAPLA) by a parallel electrospinning process to obtain a scaffold with two different polymeric fibers. In the other case, PHEA-PLA was mixed with polycaprolactone (PCLPHEA-PLA) to obtain a hybrid fibers scaffold. The in-vitro assay showed fibroblast colonization in both materials. The scaffolds were implanted in the dorsal fascial pouch of rats to evaluate their in-vivo Biocompatibility and tissue integration. Histopathological findings showed that after implantation a neutrophilic reaction associated to colliquative necrosis was predominant, particularly for PCL-PHEA-PLA. Fibro-PCL-PHEA caused a non organized stromal reaction. Cell adhesion was confirmed at SEM scan. Both materials were totally absorbed after 40 days with an inflammatory reaction. This preliminary study showed that biocompatibility of the scaffolds needs further investigation. The capability of the materials to be functionalized could allow us to modulate the inflammatory host response