Management of Symptomatic Venous Aneurysm

Venous aneurysms (VAs) have been described in quite of all the major veins. They represent uncommon events but often life-threatening because of pulmonary or paradoxical embolism. We describe our twelve patients' series with acute pulmonary emboli due to venous aneurysm thrombosis. Our experience underlines the importance of a multilevel case-by-case approach and the immediate venous lower limbs duplex scan evaluation in pulmonary embolism events. Our data confirm that anticoagulant alone is not effective in preventing pulmonary embolism. We believe that all the VAs of the deep venous system of the extremities should be treated with surgery as well as symptomatic superficial venous aneurysm. A simple excision can significantly improve symptoms and prevent pulmonary embolism

Rupture of an isolated true superficial femoral artery aneurysm: case report

True isolated atherosclerotic aneurysm of the superficial femoral artery is a rare patology. We report a case of ruptured superficial femoral artery aneurysms (SFAA) not associated with aortic, common femoral or popliteal artery aneurysms. An emergency surgical procedure was performed and, after endoaneurysmal branches ligation, a ePTFE graft interposition was performed. The litterature review shows a prevalence of rupture as compared with ischemic complications and the need for surgical repair in case of SFAA with diameter twice the normal vessel size. Early diagnosis and management are recommended because of the lower morbility and mortality rates associated with elective surgery by comparison with emergency procedures

A novel body mass index reference range - an observational study

OBJECTIVE: To generate a new body mass index curve of reference values and ranges for body mass index and weight gain during pregnancy and to compare the new curve and weight gain ranges with the currently used references. METHODS: A prospective observational study was conducted with a total of 5,656 weight and body mass index measurements in 641 women with single pregnancy who attended their first prenatal visit before 12 weeks. All the women were over 18 years old and had no medical conditions that would influence body mass index. Data were collected using prenatal charts and medical records during hospitalization for childbirth. A linear regression method was used for standard curve smoothing in the general population and for specific curves according to the baseline body mass index classification. Curves were obtained for the 5th, 10th, 50th, 85th, 90th and 95th percentiles. Concordance between the classification of women using the newly generated and currently used curves was evaluated by percentages and kappa coefficients. The weight gain was compared with the reference values of the Institute of Medicine using Student’s T test. The data were analyzed using SAS software version 9.2, and the significance level was set at 5%. RESULTS: A general reference curve of percentiles of body mass index by gestational age was established. Additionally, four specific curves were generated according to the four baseline body mass index categories. The new general curve offered percentile limits for women according to their initial body mass index and according to the Centers for Disease Control and Prevention limits, showing poor agreement with the currently used curve (48.3%). Women who were overweight or obese when starting prenatal care had higher weight gain than the Institute of Medicine recommendation. CONCLUSIONS: The new proposed curve for body mass index during pregnancy showed weak agreement with the currently used curve. The new curve provided more information regarding body mass index increase using percentiles for general and specific groups of body mass index. Overweight pregnant women showed an upward body mass index trend throughout pregnancy that increased more dramatically than those of other groups of pregnant women, and they also presented a major mean difference between weight gain and the Institute of Medicine recommendation

Mechanical properties of the most common European woods: a literature review

Wood is an orthotropic material used since ancient time. A literature research about the mechanical properties of density, fracture toughness, modulus of elasticity, and Poisson’s ratio has been done to have a broader view on the subject. The publications relating to the topic were found through the two search engines Scopus and Google Scholar that have yielded several papers, including articles and book sections. In general, there is no standardization on the method of analysis carried out on wood, underlining the great difficulty in studying this complex material. The parameter of density has a great variability and needs a deeper investigation; fracture toughness is not always available in literature, not even in the different directions of the wood sample. Interesting is the modulus of elasticity, which provides a correlation with density, especially in longitudinal section but, again, it needs to be studied in detail. The parameter of Poisson’s ratio is provided as single values in three different directions, but mainly for softwood. All the parameters require a more in-depth study for both softwood and hardwood. Furthermore, the type of analysis, whether experimental or modelling, needs to be standardized to have more comparable results

The role of cross-over bypass graft in the treatment of acute ischaemia of the lower limb

Introduction. The Authors reports their experience with the use of femoro-femoral cross-over bypass graft in the management of acute lower limb ischaemia. Patients and methods. Fourteen femoro-femoral bypass graft were performed for acute lower limb ischaemia due to unilateral thrombosis of iliac and femoral artery in 8 cases, late unilateral occlusion of a branch of previous aortobifemoral bypass in 3 cases, acute thrombosis of abdominal aorta in 2 cases and in the last one for an injury of common iliac artery during urological procedure. In all the cases the operations were carried out under local anaesthesia and a subcutaneous bypass with “C” shape type configuration with 8 mm Dacron prosthesis were performed. The first and second year primary and secondary patency rates and limb salvage rates were evaluated. Results. One and two year patency rate was 83.3 (10/12) and 70% (7/10) respectively. Secondary patency rate and limb salvage rate was 91.6% (11/12) and 80% (8/10) respectively. A tight amputation had to performed in 3 failed reconstruction (3/12, 25%). Two patient died within 30 days after surgery from acute myocardial infarct. In 1 case infection occurred and re-do femorofemoral cross-over bypass with saphenous vein was carried out (8.3%). Conclusions. Cross-over bypass is an attractive technique, especially in case of acute ischemia because of its simplicity, low morbidity and mortality, and good long term results

Open Conversion after EVAR: Indications and Technical Details

Endovascular aortic aneurysm repair (EVAR) is widely used for the treatment of abdominal aortic aneurysms. Complications secondary to EVAR are also treated with endovascular techniques. When this is not applicable, open surgical repair is mandatory. Surgical re-intervention following EVAR is considered to be more demanding compared with primary open repair and it is related to the type of endograft implanted (infra renal vs. suprarenal fixation), to the indications for surgical conversion (infection vs. non infection), to the setting of presentation (elective vs. emergency) and type of conversion (total vs. partial). While technically challenging, delayed open conversion of EVAR can be accomplished with low morbidity and mortality in both the elective and emergent settings. These results reinforce the justification for long-term surveillance of endografts following EVAR

Aortic Graft Complicated by a Corynebacterium Striatum Infection Due to Previous Type IV Thoraco Abdominal Aortic Aneurysm Repair

Abstract We report successful management of aortic graft infection without graft explanation or extra-anatomic bypass. A 61 year-old male who had undergone surgical repair of a type IV thoraco-abdominal aortic aneurysm presented with left flank pain and raised inflammatory markers following graft implantation. CT scanning revealed a left psoas fluid collection. Graft infection was diagnosed. A radio-guided drainage and conservative management, with irrigation drain placement was undertaken with preservation of the aortic graft. There was no evidence of recurrent infection after follow-up at 34 months. Aortic endograft infection may be managed by surgical or radio-guided drainage, antibiotic irrigation of the graft and systemic antibiotic therapy without graft removal

Strategies for the deployment of microclimate sensors in spaces housing collections

[EN] The study of the microclimate is pivotal for the protection and conservation of cultural heritage. This paper describes specifc procedures aimed at the deployment of microclimate sensors in spaces housing collections (e.g., museums) under diferent scenarios. The decision making involves a multidisciplinary discussion among museum manager, con¿ servator and conservation scientist and implies fve steps. Since the sensor¿s deployment depends on the number of available sensors, we have identifed two possible circumstances: (a) artwork-related deployment (i.e., there are as many sensors as the number of artworks) and (b) artwork-envelope-related deployment (i.e., the number of available sensors is less than the number of artworks). The former circumstance is advisable when the artwork is often moved from a museum to another one. The latter circumstance is usually the case of permanent collections, and, according to the Museum Scenario (MS), the related procedures can be further subdivided into basic (MSI and MSII) and advanced (MSIII and MSIV). Advanced procedures are preferable over basic procedures when several time series of microcli¿ mate data have been collected for at least one calendar year in several sampling points. All these procedures make it possible to design where to deploy sensors both in the case of an initial deployment and of optimisation of already installed sensors.This research was funded by the European Union's Horizon 2020 research and innovation program under grant agreement No.814624.Frasca, F.; Verticchio, E.; Peiró-Vitoria, A.; Grinde, A.; Bile, A.; Chimenti, C.; Conati Barbaro, C.... (2022). Strategies for the deployment of microclimate sensors in spaces housing collections. Heritage Science. 10(1):1-17. https://doi.org/10.1186/s40494-022-00831-111710

Calcium l‐methylfolate as a source of folate added for nutritional purposes to infant and follow‐on formula, baby food and processed cereal‐based food

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the extension of use of calcium l-methylfolate to be used as a source of folate added for nutritional purposes to infant and follow-on formula, baby food and processed cereal-based food pursuant to Regulation (EU) 609/2013. In 2004, EFSA assessed the use of calcium l-methylfolate as a source of folate in foods for particular nutritional uses, food supplements and foods intended for the general population. The new alternative synthetic step proposed to produce the nutrient source, using platinum as a catalyst, did not raise any safety concern and the production process was found to consistently yield a product in line with the proposed specifications. Based on the studies assessed in the previous evaluation, it was concluded that calcium l-methylfolate is non-genotoxic and that subchronic and embryotoxicity/teratogenicity studies in rats did not reveal any adverse effects up to the highest doses tested. The Panel considered that no additional toxicological studies are required on the nutrient source. The intervention study in healthy infants provided by the applicant did not indicate differences in growth and tolerance parameters in infants who consumed either an infant formula supplemented with calcium l-methylfolate or with folic acid, and did not raise concerns regarding safety or tolerability of the infant formula with the proposed nutrient source. The study also provided further supporting evidence for the bioavailability of calcium l-methylfolate. The Panel considers that calcium l-methylfolate is a source from which folate is bioavailable and concludes that calcium l-methylfolate is safe under the proposed uses and use levels for infants and young children