In-situ laser fenestration of endovascular stent-graft in abdominal aortic aneurysm repair (EVAR)

Endovascular abdominal aortic aneurysms repair (EVAR) involves the minimally invasive implantation of a stent-graft within the aorta to exclude the aneurysm from the circulation thus preventing its rupture. The feasibility of such operation is highly dependent on the aorta morphology and in general the presence of one/both renal arteries emerging from the aneurysm is the absolute limit for the implantation of a standard stent-graft. Consequently, classical intervention methods involve the implantation of a custom-made graft with fenestrations, leading to extremely complicated surgeries with high risks for the patient and high costs. Recent techniques introduced the use of standard grafts (i.e. without fenestrations) in association with mechanical in-situ fenestration, but this procedure is limited principally by the brittleness and low stability of the environment, in addition to the difficulty of controlling the guidance of the endovascular tools due to the temporarily block of the blood flow. In this work we propose an innovative EVAR strategy, which involves in-situ fenestration with a fiber guided laser tool, controlled via an electromagnetic navigation system. The fiber is sensorized to be tracked by means of the driving system and, using a 3D model of the patient anatomy, the surgeon can drive the fiber to the aneurysm, where the stent has been previously released, to realize the proper fenestration(s). The design and construction of the catheter laser tool will be presented, togheter with preliminary fenestration tests on graft-materials, including the effects due to the presence of blood and tissues

An unusual case report on the possible role of Warfarin in migraine prophylaxis

Migraine is a complex disease whose physiopathological mechanisms are still not completely revealed

Life Cycle Assessment of the production and import of Arabica Brazilian coffee

This study aims to apply the Life Cycle Assessment analysis to coffee following the product through its production steps: tillage, harvest, processing and importation. Social issues were also taken into account. The analysis was focused on the Arabica green coffee variety produced in the state of Minas Gerais in Brazil and imported to Italy by Illycaffè S.p.A.. The LCA analysis shows that coffee beans cultivation has the major impact compared with the import phase mainly due to land use

Paraneoplastic lipase and amylase production in a patient with small-cell lung cancer: Case report

Background: Small-cell lung cancer (SCLC) is known to express antigens of both the neural crest and epithelium, and to secrete polypeptide hormones and enzymes. Anecdotal reports correlate lung cancer with marked hyperamylasemia, and a review of the literature reveals only one case of metastatic SCLC linked to high paraneoplastic lipase production. Case presentation: We present the case of a patient with metastatic SCLC who showed both lipase and pancreatic isoamylase elevation in the absence of acute pancreatitis. Chemotherapy resulted in a rapid reduction in serum lipase and in pancreatic isoamylase which was correlated with the radiological response of the tumor to therapy. Lipase and pancreatic isoamylase expression in tumor cells from the lung biopsy was confirmed by immunohistochemical staining. Conclusions: This is a very rare case of paraneoplastic syndrome linked to metastatic SCLC. The enzymes secreted could be used as markers of response to treatment until clonal selection mechanisms and intratumor heterogeneity induce changes in biochemical characteristics and consequently in tumor behavior

The Interplay between Histamine H4 Receptor and the Kidney Function: The Lesson from H4 Receptor Knockout Mice

Previous studies implicated the histamine H4 receptor in renal pathophysiology. The aim here is to elucidate the role of this receptor on renal function using H4 receptor knockout mice (H4R−/−). Healthy and diabetic H4R−/− mice compared to their C57BL/6J wild-type counterpart for renal function and the expression of crucial tubular proteins. H4R−/− and wild-type mice, matched for ages, showed comparable weight gain curves reaching similar median weight at the end of the study. However, H4R−/− mice displayed a higher basal glycemia. H4R−/− mice showed a lower urine 24 h outflow, and albumin-to-creatinine ratio (ACR) compared to wild-type mice. Consistently, H4R−/− mice presented a higher expression of megalin and a lower basal expression of the sodium-hydrogen exchanger (NHE)3 and aquaporin (AQP)2. According to these basal differences, diabetic H4R−/− mice developed more severe hyperglycemia and a higher 24 h urine volume, but a lower increase in ACR and decrease in urine pH were observed. These events were paralleled by a reduced NHE3 over-expression and megalin loss in diabetic H4R−/− mice. The AQP1 and AQP7 patterns were also different between H4R−/− and wild-type diabetic mice. The collected results highlight the role of the histamine H4 receptor in the control of renal reabsorption processes, particularly albumin uptake

APPLICAZIONI DELLA METODOLOGIA LCA NEL CAMPO DELLA GESTIONE E DEL TRATTAMENTO DEI RIFIUTI

L\u2019articolo nasce da un\u2019iniziativa del gruppo di lavoro \u201cGestione e trattamento dei rifiuti\u201d dell\u2019Associazione Rete Italiana LCA (Life Cycle Assessment). L\u2019obiettivo principale del gruppo di lavoro \ue8 quello di ampliare le conoscenze relative alla specificit\ue0 della metodologia LCA applicata ai processi di gestione e di trattamento dei rifiuti. L\u2019articolo riporta otto casi studio condotti da alcuni dei partecipanti al gruppo di lavoro, con il duplice obiettivo di mostrare il vasto campo di applicazione della metodologia LCA pur mantenendosi all\u2019interno del settore rifiuti e le specificit\ue0 dell\u2019applicazione di tale metodologia ai processi di gestione e trattamento dei rifiuti. Gli otto casi studio sono stati raggruppati per macro-finalit\ue0 dell\u2019applicazione, ossia: LCA applicata per valutare i benefici ottenibili dal recupero di varie tipologie di rifiuti, LCA a supporto della pianificazione regionale e/o nazionale e LCA a supporto dell\u2019economia circolare