Metabolic syndrome and idiopathic sudden sensori-neural hearing loss

The purpose of this study was to evaluate the association between the presence of Metabolic Syndrome (MetS) and idiopathic sudden sensorineural hearing loss (ISSHL) and the impact of MetS on recovery of patients with ISSHL. 39 Patients with ISSHL and 44 controls were enrolled in this study. Demographic, clinical characteristics and hearing recovery were evaluated. MetS was defined according to the diagnostic criteria of International Diabetes Federation (IDF) consensus definition. Patients affected by ISSHL presented a body mass index (BMI), waist circumference, waist hip ratio (WHR), fasting glucose and blood pressure significantly higher compared to controls. Considering patients with central obesity, 5 controls and 15 ISSHL patients met the criteria of MetS. According to Siegel criteria, a complete or partial recovery was observed in 60% of patients with MetS and in 91,66% of patients without MetS. MetS was associated with ISSHL and this association negatively influenced the hearing recovery of these patients

Diagnosis and endovascular treatment of an internal mammary artery injury

Internal mammary artery (IMA) disruption after blunt chest trauma is rare. In some instances, it may occur after mild chest trauma with minor external physical findings. However, prompt diagnosis and treatment are necessary, as it can be associated with vascular and parenchymal injuries. We report a case of blunt chest trauma resulting in a sternal fracture associated with an IMA injury, active anterior mediastinal bleeding, bilateral lung contusions, and a left hemothorax. It was successfully treated by selective embolization to the left IMA branch and chest tube placement

Inflammatory markers as prognostic factors of survival in patients affected by hepatocellular carcinoma undergoing transarterial chemoembolization

Transarterial chemoembolization (TACE) is a good choice for hepatocellular carcinoma (HCC) treatment when surgery and liver transplantation are not feasible. Few studies reported the value of prognostic factors influencing survival after chemoembolization. In this study, we evaluated whether preoperative inflammatory factors such as neutrophil to lymphocyte ratio and platelet to lymphocyte ratio affected our patient survival when affected by hepatocellular carcinoma. Methods. We retrospectively evaluated a total of 72 patients with hepatocellular carcinoma that underwent TACE. We enrolled patients with different etiopathogeneses of hepatitis and histologically proven HCC not suitable for surgery. The overall study population was dichotomized in two groups according to the median NLR value and was analyzed also according to other prognostic factors. Results. The global median overall survival (OS) was 28 months. The OS in patients with high NLR was statistically significantly shorter than that in patients with low NLR. The following pretreatment variables were significantly associated with the OS in univariate analyses: age, Child-Pugh score, BCLC stage, INR, and NLR. Pretreated high NLR was an independently unfavorable factor for OS. Conclusion. NLR could be considered a good prognostic factor of survival useful to stratify patients that could benefit from TACE treatment

A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours

OBJECTIVES: Up to 20 % of incidentally found testicular lesions are benign Leydig cell tumours (LCTs). This study evaluates the role of contrast-enhanced magnetic resonance imaging (MRI) in the identification of LCTs in a large prospective cohort study. MATERIALS AND METHODS: We enrolled 44 consecutive patients with at least one solid non-palpable testicular lesion who underwent scrotal MRI. Margins of the lesions, signal intensity and pattern of wash-in and wash-out were analysed by two radiologists. The frequency distribution of malignant and benign MRI features in the different groups was compared by using the chi-squared or Fisher's exact test. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were calculated. RESULTS: The sensitivity of scrotal MRI to diagnose LCTs was 89.47 % with 95.65 % specificity; sensitivity for malignant lesions was 95.65 % with 80.95 % specificity. A markedly hypointense signal on T2-WI, rapid and marked wash-in followed by a prolonged washout were distinctive features significantly associated with LCTs. Malignant lesions were significantly associated with blurred margins, weak hypointense signal on T2-WI ,and weak and progressive wash-in. The overall diagnostic accuracy was 93 %. CONCLUSIONS: LCTs have distinctive contrast-enhanced MRI features that allow the differential diagnosis of incidental testicular lesions. KEY POINTS: • MRI is able to characterize testicular lesions suggesting a specific diagnosis. • Rapid and marked wash-in is a common feature of Leydig cell tumours. • Markedly hypointense T2-WI signal is significantly correlated with benign lesions. • Blurred margins and weak hypointense T2-WI signal are correlated with malignant tumours. • Weak and progressive wash-in features are present in 85 % of seminomatous lesions

The utility of the 3D imaging software in the macroscopic rendering of complex gynecologic specimens

A new generation of three dimensional (3D) imaging software for the anatomical rendering of the human body, and related surgical pathologies, is postulated. Its practical application is underlined

Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma.

In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children

MOKA3D: An innovative approach to 3D gas kinematic modelling. I. Application to AGN ionized outflows

Studying the feedback process of Active Galactic Nuclei (AGN) requires characterising multiple kinematical components, such as rotating gas and stellar disks, outflows, inflows, and jets. To compare the observed properties with theoretical predictions of galaxy evolution and feedback models and to assess the mutual interaction and energy injection rate into the interstellar medium (ISM), one usually relies on simplified kinematic models. These models have several limitations, as they often do not take into account projection effects, beam smearing and the surface brightness distribution of the emitting medium. Here, we present MOKA3D, an innovative approach to model the 3D gas kinematics from integral field spectroscopy observations. In this first paper, we discuss its application to the case of AGN ionised outflows, whose observed clumpy emission and apparently irregular kinematics are only marginally accounted for by existing kinematical models. Unlike previous works, our model does not assume the surface brightness distribution of the gas, but exploits a novel procedure to derive it from the observations by reconstructing the 3D distribution of emitting clouds and providing accurate estimates of the spatially resolved outflow physical properties (e.g. mass rate, kinetic energy). As an example, we demonstrate the capabilities of our method by applying it to three nearby Seyfert-II galaxies observed with MUSE at the VLT and selected from the MAGNUM survey, showing that the complex kinematic features observed can be described by a conical outflow with a constant radial velocity field and a clumpy distribution of clouds.Comment: 17 pages, 14 figure

Prophylactic arterial catheterization in the management of high risk patients for obstetric haemorrhage

OBJECTIVES: Post-partum haemorrhage still remains one of the major causes of maternal morbidity and mortality. In case of abnormal placentation it is possible to carry out preventive and therapeutic actions. To maintain fertility in reproductive-aged women and to avoid a more radical surgery, embolization has been introduced in patients at high risk for haemorrhage. To describe a new option in the management of patients with abnormal placentation by an elective, preventive arterial catheterization and selective embolization of pelvic arteries. PATIENTS AND METHODS: A retrospective study including thirty six patients with abnormal placental invasion. All patients were prepared in the angiographic room and preventive arterial catheterization was performed before elective caesarean delivery. Materials for interventional angiography were transferred to the operating room. During surgery, selective embolization of pelvic arteries was realized in case of uncontrolled bleeding. RESULTS: Thirty-six elective arterial catheterizations were performed: 4 cases (11.1%) required embolization, haemorrhage was stopped in 2 patients. Hysterectomy was performed in two cases (5.5%). No death was reported. Two humeral thrombosis (5.5%) were registered. CONCLUSIONS: Prophylactic arterial catheterization appears to be safe. The main advantage is the reduction of the interval between the onset of bleeding and the embolization. This new option of management may contribute to reduce the risk of hysterectomy and maternal death

MUSE AO spectroscopy confirms five dual AGNs and two strongly lensed QSOs at sub-arcsec separation

The novel Gaia Multi Peak (GMP) technique has proven to be able to successfully select dual and lensed AGN candidates at sub-arcsec separations. Both populations are important because dual AGNs represent one of the central, still largely untested, predictions of lamdaCDM cosmology, and compact lensed quasars allow to probe the central regions of the lensing galaxies. In this work, we present high spatial resolution spectroscopy of twelve GMP-selected systems. We use the the adaptive-optics assisted integral-field spectrograph MUSE at VLT to resolve each system and study the nature of each component. All the targets reveal the presence of two components confirming the GMP selection. We classify five targets as dual AGNs, two as lensed systems, and five as a chance alignment of a star and and AGN. Having separations between 0.30" and 0.86", these dual and lensed systems are, to date, among the most compact ever discovered at z >0.3. This is the largest sample of distant dual AGNs with sub-arcsec separations ever presented in a single paper.Comment: 11 pages, 9 figure

A new model for the characterization of infection risk in gunshot injuries:Technology, principal consideration and clinical implementation

<p>Abstract</p> <p>Introduction</p> <p>The extent of wound contamination in gunshot injuries is still a topic of controversial debate. The purpose of the present study is to develop a model that illustrates the contamination of wounds with exogenous particles along the bullet path.</p> <p>Material and methods</p> <p>To simulate bacteria, radio-opaque barium titanate (3-6 μm in diameter) was atomized in a dust chamber. Full metal jacket or soft point bullets caliber .222 (n = 12, v₀= 1096 m/s) were fired through the chamber into a gelatin block directly behind it. After that, the gelatin block underwent multi-slice CT in order to analyze the permanent and temporary wound cavity.</p> <p>Results</p> <p>The permanent cavity caused by both types of projectiles showed deposits of barium titanate distributed over the entire bullet path. Full metal jacket bullets left only few traces of barium titanate in the temporary cavity. In contrast, the soft point bullets disintegrated completely, and barium titanate covered the entire wound cavity.</p> <p>Discussion</p> <p>Deep penetration of potential exogenous bacteria can be simulated easily and reproducibly with barium titanate particles shot into a gelatin block. Additionally, this procedure permits conclusions to be drawn about the distribution of possible contaminants and thus can yield essential findings in terms of necessary therapeutic procedures.</p