Chronic Central Serous Chorioretinopathy with Pigment Epithelium Detachment Treated with Sildenafil: A Case Report

Central serous chorioretinopathy (CSCR) is a retinal disease that may be complicated by the development of serous retinal pigment epithelial detachment (PED). The exact molecular mechanisms of CSCR have remained uncertain as well as there is no effective medical therapy. Herein, we describe a case of a 43-year-old male suffering from chronic CSCR with PED and visual acuity reduction (20/40) that showed improvement in visual acuity (20/25) and metamorphopsia 2 weeks after daily intake of 20 mg sildenafil tablets. Optical coherence tomography (OCT) scan showed resolution of PED with residual degeneration of the photoreceptor inner and outer segment layer and retinal pigmented epithelium. The patient continued treatment with sildenafil 20 mg for 2 months. Six months after the discontinuation of therapy, visual acuity was maintained, with absence of PED at OCT. Our case supports the hypothesis that phosphodiesterase type 5 (PDE-5) inhibitors may be an alternative in the treatment of patients with CSCR, alone or combined with other medications

Relation of Birthweight and Ovarian and Uterine Size Prior to Menarche

During pregnancy, supply of nutrients and exposure of the mother to environmental factors can influence fetus phenotype, possibly modifying growth of fetal tissues and organs. Few studies inconsistently reported that fetuses exposed to an insufficient energy supply, as those born small for gestational age, may have a reduced volume of uterus and ovaries. A retrospective analysis was performed on ultrasound data performed between 2012 and 2018 in 69 young premenarchal girls, 5 to 9\ua0years of age, attending our endocrine\u2013gynecologic clinic for a suspect of early puberty. Length of pregnancy and birthweight was also retrieved. When corrected for age, and presence of ovarian follicles, ovarian volume was positively (R2 = 0.210; p = 0.001) related to percentiles of birthweight (beta coefficient 0.012; 95% CI, 0.002\u20130.021). Similarly, uterine volume was positively (R2 = 0.237; p = 0.005) related to percentiles of birthweight (beta coefficient 0.067; 95% CI, 0.021\u20130.114). Ovarian (p = 0.034) and uterine (p = 0.014) volume was higher in the upper 3rd distribution of birthweight percentiles. In conclusion, development of ovarian and uterine volume increases progressively with the increase of birthweight percentiles. The data indicate an association between birthweight and the volume of uterus and ovary at 5\u20139\ua0years of age

Abcès pulmonaires à Salmonella enteritidis chez un patient infecté par le virus de l’immunodéficience humaine

Les pathologies respiratoires infectieuses restent la complication la plus fréquente de l’infection par le virus de l’immunodéficience humaine (VIH) quelle que soit l’importance de l’immunodépression. Les salmonelloses de l’adulte surviennent rarement chez le sujet sain dans les pays industrialisés. Les infections extradigestives dues aux Salmonelles mineures sont rares. Ces formes surviennent chez des malades immunodéprimés. La localisation pulmonaire des abcès à Salmonella enteritidis est rare ainsi que sa survenue au cours de l’infection à VIH. Cette observation rapporte un cas d’abcès pulmonaires à Salmonella avec bactériémie chez un homme ayant une infection à VIH1 en arrêt du traitement antirétroviral (ARV). Le patient a été traité par les bêtalactamines pendant trois semaines. L’évolution a été marquée par une amélioration clinique et radiologique

A Bi-Directional Refinement Algorithm for the Calculus of (Co)Inductive Constructions

The paper describes the refinement algorithm for the Calculus of (Co)Inductive Constructions (CIC) implemented in the interactive theorem prover Matita. The refinement algorithm is in charge of giving a meaning to the terms, types and proof terms directly written by the user or generated by using tactics, decision procedures or general automation. The terms are written in an "external syntax" meant to be user friendly that allows omission of information, untyped binders and a certain liberal use of user defined sub-typing. The refiner modifies the terms to obtain related well typed terms in the internal syntax understood by the kernel of the ITP. In particular, it acts as a type inference algorithm when all the binders are untyped. The proposed algorithm is bi-directional: given a term in external syntax and a type expected for the term, it propagates as much typing information as possible towards the leaves of the term. Traditional mono-directional algorithms, instead, proceed in a bottom-up way by inferring the type of a sub-term and comparing (unifying) it with the type expected by its context only at the end. We propose some novel bi-directional rules for CIC that are particularly effective. Among the benefits of bi-directionality we have better error message reporting and better inference of dependent types. Moreover, thanks to bi-directionality, the coercion system for sub-typing is more effective and type inference generates simpler unification problems that are more likely to be solved by the inherently incomplete higher order unification algorithms implemented. Finally we introduce in the external syntax the notion of vector of placeholders that enables to omit at once an arbitrary number of arguments. Vectors of placeholders allow a trivial implementation of implicit arguments and greatly simplify the implementation of primitive and simple tactics

Stage-related outcome for thymic epithelial tumours

Background: Thymic epithelial tumours (TETs) are characterized by a wide variety of biological behaviors. Radical resection and stage are strong prognostic factors. Aim of this study is to review our Single Center Experience. Methods: One hundred and seventy-seven patients observed in the period from January 2000 to December 2016 were included in the study. Data regarding clinicopathologic features, treatment, and survival were collected. Stage-related clinical standpoints and therapeutic options were also evaluated. Results: Non-surgical treatment was primarily performed in 15 (8.47%), unresectable disease was intraoperatively found in 12 cases (7.4%). The analysis of 150 patients undergoing curative surgery revealed 70 stage I TET (46.66%), 49 stage II (32.66%), 19 stage III (12.66%), 6 stage IVa (4%) and 6 stage IVb (4%) at the first hospital admission. Histology identified 12 A thymoma (8%), 38 AB (25.33%), 24 B1 (16%), 50 B2 (33.33%), 19 B3 (12.66%) and 7 carcinomas (4.66%). The mean follow up time was 84.14 months (sd = 61.68 months). Disease relapse occurred in 13 patients (8.78%) at a mean period of 78.85 months (sd = 60.87 months) after surgery. Exitus due to thymoma happened in 6 cases (4.05%) after a mean survival of 56.02 months (sd = 25.17 months). The 5-year overall survival rate was 0.94 (95%CI 0.88-0.97) and the 5-year disease-free survival rate was 0.90 (95%CI 0.83-0.94). The 5-year overall survival rates were 96.1% (95% CI, 89.9-98.5%) for the early stages and 87.4% (95% CI, 65.6-95.8%) for the advanced stages (p = 0.670). The 5-year disease-free survival rates resulted being 98.8% (95% CI, 92.3-99.8%) for the early stages and 59.8% (95% CI, 37.8-76.2%) for the advanced stages (p < 0.001). Conclusions: Advanced stage TETs are characterized by higher mortality and recurrence rates. Although technically demanding, surgery, as part of multimodality therapy, could prolong survival. Iterative surgical treatment of recurrences is a viable option for selected patients. Trial registration: The study was approved by the Institutional Review Board of Perugia and Terni University Hospitals [Code T1003] and was retrospectively registered

Solvothermal synthesis and photocatalytic performance of Mn4+-doped anatase nanoplates with exposed {001} facets

The photocatalytic activity of TiO2 and manganese doped TiO2 nanoplates with various manganese atomic percentages, in the range of 2-7%, was studied. The undoped and doped nanoplates with exposed {001} facets were produced by a solvothermal method. The crystal structure as well as the shape of the TiO2 and Mn4+/TiO2 anatase nanoparticles was determined with X-ray powder diffraction (XRD) and transmission electron microscopy (TEM). Both techniques revealed that the nanocrystals are in the form of plates. Moreover, the anisotropic peak broadening of the X-ray diffraction patterns was studied using the Rietveld refining method. Chemical analysis of the photocatalyst that was carried out with X-ray photoelectron spectroscopy (XPS) showed the presence of manganese ions in the TiO2 anatase matrix. The Density Functional Theory (DFT) calculations exhibited a decrease in the energy gap and an increase in the density of the electronic stated inside the gap for the doped TiO2. These observations were in agreement with the results of the UV-visible diffuse reflectance spectroscopy (DRS) that demonstrated an adsorption shift towards the visible region for the same samples. The photocatalytic activity of the synthesized catalysts was investigated by the photocatalytic oxidation of the gaseous nitric oxide (NO) and decomposition of the gaseous acetaldehyde (CH3CHO) under visible light irradiation. The optimal concentration of dopant that improves the photocatalytic activity of the nanoplates was determined. © 2014 Elsevier B.V

Flexural strength and elastic modulus evaluation of structures made by conventional PMMA and PMMA reinforced with graphene

Abstract. – OBJECTIVE: The aim of this study was to compare both the elastic modulus (EM) and the flexural strength (FS) of two materials used in dental prosthesis, namely polymethylmethacrylate (PMMA) and polymethylmethacrylate reinforced with graphene (G-PMMA). MATERIALS AND METHODS: Twenty rectangular samples were manufactured by a milling machine and divided into two groups (n= 10/group): Group 1, PMMA; Group 2, G-PMMA. The specimens were subjected to a three-point bending test conducted in the elastic range to evaluate EM. A similar test was protracted until fracture to evaluate FS. Data on EM and FS were statistically analyzed with independent-samples t-test in order to compare the two groups. A scanning electron microscope (SEM) (5.00 kx and 1.00 kx magnification) was used to evaluate the morphology of sample’s fracture. RESULTS: Compared to PMMA samples, each G-PMMA sample showed significantly higher values of FS (p <0.001) and EM (p <0.001). SEM images analysis showed an inhomogeneous fracture morphology in G-PMMA samples. CONCLUSIONS: The results show that G-PMMA is a promising material to be used for prosthetic purposes. This is demonstrated by a significant increase in both peak load and bending stiffness, resulting from the bending test performed on G-PMMA samples. Furthermore, the latter exhibit greater homogeneity in their mechanical behavior, supporting the potential value of this material in dental prosthesis