104 research outputs found

    Tidal heating in a Riemann-Cartan spacetime

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    We consider possible perturbations of the black hole event horizon induced by matter with spin, extending the derivation of the Hawking-Hartle formula (tidal heating) in the presence of torsion. When specialized to theories with a nonvanishing (pseudo-)traceless component of the (con)torsion tensor, we remarkably find that the tidal heating phenomenon gets modified by additional torsion-dependent terms, in agreement with previous investigations based on Jacobson's spacetime thermodynamics approach. These results lead to relevant phenomenological and theoretical consequences: modifications in the Hawking -Hartle term change the Bondi mass associated with the gravitational radiation observed at infinity, and modify the Hawking radiation spectrum of evaporating black holes

    Botulinum Toxin Type A Reconstituted with Lidocaine: A Report of 1000 Consecutive Cases

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    (1) Background: There is an increasing demand for a reversal of the aging process and, nowadays, more patients are seeking minimally invasive methods instead of surgery to meet this goal. The purpose of this paper is to evaluate the predictability of the off-label aesthetic use of botulinum toxin type A (BoNTA) reconstituted with lidocaine. (2) Methods: One thousand treatments, between January 2010 and January 2020, with BoNTA reconstituted with lidocaine for the rejuvenation of the upper third of the face, were performed and retrospectively evaluated. (3) Results: A few seconds after the BoNTA injections, the effect of muscle paralysis was seen in all cases; this allowed providing an optimal symmetric result with no need for a touch-up procedure at the control after three weeks. A burning sensation during the injections was claimed by almost all patients. Major complications were not registered. No touch-up procedures were required. (4) Conclusions: The results of this study show how the reconstitution of BoNTA with lidocaine may avoid imperfect results after the injections; the immediate feedback on the extent of paralysis to be expected from the chemodenervation action of BoNTA allows the physician to have immediate control of the final result

    The temporal correlation between positive testing and death in Italy: From the first phase to the later evolution of the COVID-19 pandemic

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    BACKGROUND AND AIM: After the global spread of the coronavirus disease 2019 (COVID-19), research has concentrated its efforts on several aspects of the epidemiological burden of pandemic. In this frame, the presented study follows a previous analysis of the temporal link between cases and deaths during the first epidemic wave (Phase 1) in Italy (March-June 2020). METHODS: We here analyze the COVID-19 epidemic in the time span from March 2020 to June 2021. RESULTS: The elaboration of the curves of cases and deaths allows identifying the temporal shift between the positive testing and the fatal event, which corresponds to one week from W2 to W33, two weeks from W34 to W41, and three weeks from W42 to W67. Based on this finding, we calculate the Weekly Lethality Rate (WLR). The WLR was grossly overestimated (~13.5%) in Phase 1, while a mean value of 2.6% was observed in most of Phase 2 (starting from October 2020), with a drop to 1.4% in the last investigated weeks. CONCLUSIONS: Overall, these findings offer an interesting insight into the magnitude and time evolution of the lethality burden attributable to COVID-19 during the entire pandemic period in Italy. In particular, the analysis highlighted the impact of the effectiveness of public health and social measures, of changes in disease management, and of preventive strategies over time. (www.actabiomedica.it

    Analysis of the time evolution of COVID-19 lethality during the first epidemic wave in Italy

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    BACKGROUND AND AIM: While the entire world is still experiencing the dramatic emergency due to SARS-CoV-2, Italy has a prominent position since it has been the locus of the first major outbreak among Western countries. The aim of this study is the evaluation of temporal connection between SARS-CoV-2 positive tests (cases) and deaths in Italy in the first wave of the epidemic. METHODS: A temporal link between cases and deaths was determined by comparing their daily/weekly trends using surveillance data of the period March 2–June 2020. RESULTS: The monitoring of the cases/deaths evolution during the first wave of the outbreak highlights a striking correlation between infections of a certain week and deaths of the following one. We defined a weekly lethality rate that is virtually unchanged over the entire months of April and May until the first week of June (≈13.6%). Due to the rather low number of cases/deaths, this parameter starts to fluctuate in the following three weeks. CONCLUSIONS: The analysis indicates that the weekly lethality rate is virtually unchanged over the entire first wave of the epidemic, despite the progressive increase of the testing. As observed for the overall lethality, this parameter uniformly presents rather high values. The definition of a temporal link between cases and deaths will likely represent a useful tool for highlighting analogies and differences between the first and the second wave of the pandemic and for evaluating the effectiveness, even if partial, of the strategies applied during the ongoing outbreak. (www.actabiomedica.it

    Urine concentrating defect as presenting sign of progressive renal failure in Bardet-Biedl syndrome patients

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    Urine concentrating defect is a common dysfunction in ciliopathies, even though its underlying mechanism and its prognostic meaning are largely unknown. This study assesses renal function in a cohort of 54 Bardet-Biedl syndrome (BBS) individuals and analyses whether renal hyposthenuria is the result of specific tubule dysfunction and predicts renal disease progression

    Type of paternal sperm exposure before pregnancy and the risk of preeclampsia: A systematic review

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    Objective The aim of this systematic review was to evaluate the role of paternal sperm exposure before pregnancy on the risk of preeclampsia. Study design The search was conducted using electronic databases from inception of each database through October 2019. Review of articles also included the abstracts of all references retrieved from the search. Only studies evaluating exposure to paternal sperm before pregnancy on the risk of preeclampsia in the subsequent pregnancy were included. Exposure group was defined as significant exposure to paternal sperm, either measured by sexual cohabitation, oral sex habit, or by absence of barrier methods. Control groups was defined as minimal exposure to paternal sperm, either measured by lack of sexual cohabitation or oral sex habit, or by use of barrier methods. Sperm exposure identifiable before pregnancy that may be suspected to modify the risk of preeclampsia was examined. The primary outcome was the incidence of preeclampsia. Subgroup analyses by parity and type of sperm exposure were planned. All analyses were carried out using the random effects model. The pooled results were reported as the OR with 95 % confidence interval (CI). Heterogeneity was measured using I-squared (Higgins I 2). Results Seven studies including 7125 pregnant women were included in this systematic review. Overall, the incidence of preeclampsia was similar in women with a higher overall sperm exposure compared to controls, 774/5512 (14 %) vs 220/1619 (13.6 %); OR 1.04, 95 % CI 0.88–1.22, respectively. The incidence of preeclampsia was significantly reduced in women with a higher overall sperm exposure when including only nulliparous women, 643/3946 (16.1 %) vs 170/725 (23.4 %); OR 0.63, 95 % CI 0.52 to 0.76. Significant lower rate of preeclampsia was also found for ≄12-month sexual cohabitation, 494/3627 (13.6 %) vs 123/691 (17.8 %); OR 0.73, 95 % CI 0.59−0.90. Significantly higher rate of preeclampsia was reported in women not using barrier methods, 315/1904 (16.5 %) vs 103/962 (10.7 %); OR 1.65, 95 % CI 1.30–2.10. Conclusions Paternal sperm exposure in nulliparous women and sexual cohabitation > 12 months before pregnancy are associated with a decreased risk of preeclampsia

    Weight discordance and perinatal mortality in monoamniotic twin pregnancy: analysis of MONOMONO, NorSTAMP and STORK multiple‐pregnancy cohorts

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    Objectives The primary objective was to quantify the risk of perinatal mortality in non‐anomalous monochorionic monoamniotic (MCMA) twin pregnancies complicated by birth‐weight (BW) discordance. The secondary objectives were to investigate the effect of inpatient vs outpatient fetal monitoring on the risk of mortality in weight‐discordant MCMA twin pregnancies, and to explore the predictive accuracy of BW discordance for perinatal mortality. Methods This analysis included data on 242 MCMA twin pregnancies (484 fetuses) from three major research collaboratives on twin pregnancy (MONOMONO, STORK and NorSTAMP). The primary outcomes were the risks of intrauterine (IUD), neonatal (NND) and perinatal (PND) death, according to weight discordance at birth from ≄ 10% to ≄ 30%. The secondary outcomes were the association of inpatient vs outpatient fetal monitoring with the risk of mortality in weight‐discordant pregnancies, and the accuracy of BW discordance in predicting mortality. Logistic regression and receiver‐operating‐characteristics‐curve analyses were used to analyze the data. Results The risk of IUD was significantly increased in MCMA twin pregnancies with BW discordance ≄ 10% (odds ratio (OR), 2.2; 95% CI, 1.1–4.4; P = 0.022) and increased up to an OR of 4.4 (95% CI, 1.3–14.4; P = 0.001) in those with BW discordance ≄ 30%. This association remained significant on multivariate logistic regression analysis for BW‐discordance cut‐offs ≄ 20%. However, weight discordance had low predictive accuracy for mortality, with areas under the receiver‐operating‐characteristics curve of 0.60 (95% CI, 0.46–0.73), 0.52 (95% CI, 0.33–0.72) and 0.57 (95% CI, 0.45–0.68) for IUD, NND and PND, respectively. There was no difference in the risk of overall IUD, single IUD, double IUD, NND or PND between pregnancies managed as an inpatient compared with those managed as an outpatient, for any BW‐discordance cut‐off. Conclusions MCMA twin pregnancies with BW discordance are at increased risk of fetal death, signaling a need for increased levels of monitoring. Despite this, the predictive accuracy for mortality is low; thus, detection of BW discordance alone should not trigger intervention, such as iatrogenic delivery. The current data do not demonstrate an advantage of inpatient over outpatient management in these cases
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