Double Orifice Fissured Subaortic Membrane in the Adult

Left ventricle outflow tract obstruction is a relatively common form of congenital heart disease, occurring in 2.8 out of 10,000 live births and accounts for 3-6% of congenital heart diseases. Subvalvular aortic stenosis can be either a fixed stenosis resulting from subaortic membrane or a dynamic stenosis because of hypertrophic cardiomyopathy. We described an original and rare image of double orifice fissured subaortic membrane in the adult

Progetto "Acque pulite"

Abstract not availableLe aree montane, soprattutto in territori ricchi di acqua come quello del Verbano Cusio Ossola e del bacino del Lago Maggiore, sono da sempre oggetto di utilizzo per la produzione di energia elettrica da fonti rinnovabili, principalmente attraverso impianti idroelettrici. Il giusto equilibrio tra il mantenimento della qualit? ecologica degli ecosistemi torrentizi e la produzione di energia elettrica da fonti rinnovabili non ? di facile attuazione, soprattutto in assenza di studi e sperimentazioni dedicate. Lo sfruttamento delle acque a scopo idroelettrico pu? determinare l\u27alterazione e, a volte, la perdita di habitat, causando una riduzione della biodiversit?, con effetti negativi maggiori sui taxa pi? sensibili (ad esempio macroinvertebrati e fauna ittica), causando contestualmente, il degrado della qualit? ecologica di parte o addirittura dell\u27intero corso d\u27acqua a seconda delle tipologie di prelievo/i a cui ? stato sottoposto. Diventa quindi importante, nel contesto locale, ma anche nazionale e internazionale, dove le energie rinnovabili sono un punto focale per la futura produzione di energia, trovare il giusto equilibrio tra la qualit? ecologica degli ecosistemi, e la richiesta di energia pulita e di sviluppo economico. E\u27 proprio in questo contesto che nasce l\u27idea del Progetto "Acque Pulite", che grazie alla disponibilit? e al finanziamento di IDROENERGY S.r.l. ha visto la realizzazione di uno studio pilota sul Torrente San Giovanni. Il Torrente San Giovanni ? uno dei principali immissari del Lago Maggiore e per tale motivo risulta importante conoscere la sua qualit? ecologica e gli effetti su di essa delle diverse attivit? umane che insistono all\u27interno del suo bacino. In particolare, con il Progetto "Acque Pulite" si sono voluti verificare gli effetti della presenza di un\u27opera di presa e di una traversa, costruite per scopo idroelettrico, sulla qualit? idro-morfologica, chimica e biologica dei tratti di torrente a monte e a valle di tali opere

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

New perspectives in the diagnosis of cardiac allograft vasculopathy: the CT-scan role in the follow-up of heart transplanted patients

Coronary allograft vasculopathy (CAV) limits long-term survival after heart transplantation, it is documented widely in scientific literature with original articles and reviews. The screening for CAV is generally performed on an annual or biannual basis. It is usually detected by conventional coronary angiography (CCA) but in the last ten years, Coronary Computed Tomography Angiography (CCTA) has spreading more in more in the study of early detection of CAV due to evolution of technologies. Technological advances such as 64-slice dual-source CCTA or 128-slice dual-source CCTA might justify re-evaluation of the current recommendation in the detection of CAV. Inspired by the high quality intravascular CAV detection (IVUS and OCT), I considered the CCTA as new diagnostical procedure with low-technical risk and high technologies and I developed my PhD issue in order to have the following endpoints: improving heart transplant recipient survival and decreasing/controlling the CAV incidence by rapid and early treatment. I conjectured: i) Which would be the new perspectives in CAV diagnostic imaging? ii) Considering the CCTA technological evolution, how could be the comparison with CCA? iii) How is the comparison with other recommended intravascular diagnostic procedures like IVUS? iv) Could I create a prognostic score to calculate indirectly the risk of CAV in heart transplanted patients in order to improve its management

The revolution of cardiac surgery evolution

Riassunto dell'evoluzione della cardiochirurgiano abstract letter to edito

The revolution of cardiac surgery evolution Running head: Cardiac surgery evolution

From the first case of primitive cardiac surgery (CS), treatment of stab wound of the heart (Dr. Daniel Hale Williams, 1893), to recent surgical procedures and device implantations for end-stage heart failure (HF), the CS has grown and emerged in the public health more and more [1]. The heart valve disease had interested immediately since the non-cardiopulmonary era because of the multitude of rheumatic patients and congenital valve disease. In the 1952, Hufnagel implanted the first valve in descending aorta and it was the sign of the first step of the CS evolution. New prosthesis and heart valve techniques were tested between 1970 and 2000 with optimal results in patients’ quality of life and survival, at the same time of CPB evolution. Whilst, the evolution of heart valve surgery had stimulated new devices, prosthesis and the development of minimally invasive surgery, this was partially diminished by the spreading of trans catheter valve implantation. In the 2002, Dr. Alain Crabbier described a non-surgical prosthetic valve implantation firstly: it was the revolution of CS evolution [2]. The transcatheter valve implantation has evolved and spread rapidly with multiple approaches femoral to apical, aortic, axillary and carotid, and many suitable and technological devices. The higher and higher risk patients, the needs to avoid surgical complications, the evolution of available devices and the fabrication of new technologies have increased the efforts to improve trans catheter valve implantation [3]. The recent article of Loyalka et al, described a special case of tricuspid valve in valve replacement with Sapien 3, an innovative and alternative therapeutic choice to a tricuspid valve degeneration [4]. Instead, Sawara et al [5], documented as trans catheter aortic valve implantation for a failing surgical bio prosthesis or native aortic valve regurgitation has become an alternative for patients at high risk for redo surgical aortic valve replacement or aortic regurgitation since now off-label: that was a reliable and significant results in the era of trans catheter valve implantations. What would we attend from the future? In the most surgical centres, the trend were a significant decrease in patients undergoing to open-heart valve surgery compared to trans catheter valve implantation. Maybe the new ongoing studies of lower and mild-risk patients undergone to transcatheter procedure would open either a deeper collaboration of the heart team and a new therapeutic perspectives in the public health with a shift to more minimally invasive procedures, less day of hospitalization and I don’t see why not less costs for public health

Primary Cardiac Hemangioendothelioma in the Adult and Cardiac Involvement in Patient with Non-Cardiac Hemangioendothelioma. Review of the Literature

Background: Cardiac hemangioendothelioma (CHE) in the adult and cardiac involvement in adult patient with non cardiac-hemangioendothelioma (NC-HE) were rare and uncommon in daily clinical experience. Methods: We researched in PubMed, Web of Science, Scopus, Cochrane library, and Medline for identifying relevant studies, case series, review and case reports. Results: We found 33 cases of CHE in the adult and 7 cases of cardiac involvement in NC-HE patients. According to scientific data, the most of CHE patients were female (52%), histological type epithelioid (64%), with main localization in right atrium (41%), and the main clinical diagnosis was incidentally discovered on echocardiogram. The main therapeutic choice was surgical. Otherwise the cardiac metastasis in NC-HE patients (7 cases reported) were most frequent in the hepatic hemangioendothelioma primary localization (57%) than others (spleen, bone, limb, intracranial). The most of patients were female (85.7%) and the main clinical presentation were heart failure (85%). Conclusion: CHE and cardiac metastasis of NC-HE patients in the adult were rare and unusual neoplasms. The early diagnosis and surgical treatment in each case demonstrated an increase of patients’ survival and quality of life. We explained the scientific data to increase physician knowledge about this rare adulthood vascular neoplasm