Chronic hyponatremia in a patient with renal salt wasting and without cerebral disease: relationship between RSW, risk of fractures and cognitive impairment

Renal salt wasting syndrome (RSW) is defined as a renal loss of sodium leading to hyponatremia and a decrease in extracellular fluid volume (ECV). Differentiation of this disorder from the syndrome of inappropriate antidiuretic hormone secretion (SIADH), a common cause of hyponatremia, can be difficult because both can present with hyponatremia and concentrated urine with natriuresis. Our clinical case about a 78-year-old woman with a recent fracture of the right femur not only confirms that this syndrome can occur in patients without intracranial pathologies (CT documented), but depicts how the hyponatremia caused by RSW can show a chronic, oscillating course. This is an interesting point of view because it suggests to us to consider RSW in the differential diagnosis of patients with chronic hyponatremia

The use of ultrasound in clinical setting for children affected by NAFLD. is it safe and accurate?

Non-alcoholic fatty liver disease (NAFLD) has become over the last decade the most common form of chronic liver disease in children and adults. Thus, establishing the diagnosis of NAFLD is of utmost importance and represents a major challenge as the disease is generally silent and the current gold standard for diagnosis is an invasive liver biopsy, a procedure that is not suitable for screening purposes. Many non-invasive diagnostic tools have been evaluated so far. Recently the utility of ultrasonography for non-invasive diagnosis and estimation of hepatic steatosis has been demonstrated in a large prospective pediatric study

Atherosclerosis and Its Related Laboratory Biomarkers

Atherosclerosis constitutes a persistent inflammatory ailment, serving as the predominant underlying condition for coronary artery disease (CAD), peripheral artery disease (PAD), and cerebrovascular disease. The progressive buildup of plaques within the walls of medium- and large-caliber arteries characterizes the atherosclerotic process. This accumulation results in significant narrowing that impedes blood flow, leading to critical tissue oxygen deficiency. Spontaneous blockage of thrombotic vessels can precipitate stroke and myocardial infarction, which are complications representing the primary global causes of mortality. Present-day models for predicting cardiovascular risk incorporate conventional risk factors to gauge the likelihood of cardiovascular events over a ten-year span. In recent times, researchers have identified serum biomarkers associated with an elevated risk of atherosclerotic events. Many of these biomarkers, whether used individually or in combination, have been integrated into risk prediction models to assess whether their inclusion enhances predictive accuracy. In this review, we have conducted a comprehensive analysis of the most recently published literature concerning serum biomarkers associated with atherosclerosis. We have explored the potential utility of incorporating these markers in guiding clinical decisions

The Natriuretic Peptide System: A Single Entity, Pleiotropic Effects

In the modern scientific landscape, natriuretic peptides are a complex and interesting network of molecules playing pleiotropic effects on many organs and tissues, ensuring the maintenance of homeostasis mainly in the cardiovascular system and regulating the water-salt balance. The characterization of their receptors, the understanding of the molecular mechanisms through which they exert their action, and the discovery of new peptides in the last period have made it possible to increasingly feature the physiological and pathophysiological role of the members of this family, also allowing to hypothesize the possible settings for using these molecules for therapeutic purposes. This literature review traces the history of the discovery and characterization of the key players among the natriuretic peptides, the scientific trials performed to ascertain their physiological role, and the applications of this knowledge in the clinical field, leaving a glimpse of new and exciting possibilities for their use in the treatment of diseases

Photometry of the Oort Cloud comet C/2009 P1(Garradd): pre-perihelion observations at 5.7 and 2.5 AU

The aim of this paper is to contribute to the characterization of the general properties of the Long Period Comets (LPCs) family, and in particular to report on the dust environment of comet C/2009 P1 (Garradd). The comet was observed at two epochs pre-perihelion, at ~6 AU and at ~2.5 AU: broad-band images have been used to investigate its coma morphology and properties and to model the dust production rate. Comet C/2009 P1 (Garradd) is one of the most active and “dust producing” LPCs ever observed, even at the large heliocentric distance rh~6 AU. Its coma presents a complex morphology, with subtle structures underlying the classical fan-shaped tail, and, at rh~2.5 AU, also jet-like structures and spiralling outflows. In the reference aperture of radius ρ=5°×104 km, the R-Afρ is 3693±156 cm and 6368±412 cm, in August 2010 (rh~6 AU) and July 2011 (rh~2.5 AU), respectively. The application of a first order photometric model, under realistic assumptions on grain geometric albedo, power-law dust size distribution, phase darkening function and grain dust outflow velocity, yielded a measure of the dust production rate for the two epochs of observation of Qd=7.27×102 kg/s and Qd=1.37×103 kg/s, respectively, for a reference outflow dust velocity of vsmall=25 m/s for small (0.1–10 µm) grains and vlarge=1 m/s for large (10 µm–1 cm) grains. These results suggest that comet Garradd is one of the most active minor bodies observed in recent years, highly contributing to the continuous replenishment of the Interplanetary Dust Complex also in the outer Solar System, and pose important constraints on the mechanism(s) driving the cometary activity at large heliocentric distances

Paediatric non-alcoholic fatty liver disease: impact on patients and mothers' quality of life

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the causes of fatty liver in adults and is currently the primary form of chronic liver disease in children and adolescents. However, the psychological outcome (i.e. the behavioural problems that can in turn be related to psychiatric conditions, like anxiety and mood disorders, or lower quality of life) in children and adolescents suffering of NAFLD has not been extensively explored in the literature. Objectives: The present study aims at evaluating the emotional and behavioural profile in children suffering from NAFLD and the quality of life in their mothers. Patients and Methods: A total of 57 children (18 females/39 males) with NAFLD were compared to 39 age-matched control children (25 females/14 males). All participants were submitted to the following psychological tools to assess behavior, mood, and anxiety: the Multidimensional Anxiety Scale for Children (MASC), the Child Behavior Checklist (CBCL), and the Children's Depression Inventory (CDI). Moreover, the mothers of 40 NAFLD and 39 control children completed the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Results: NAFLD children scored significantly higher as compared to control children in MASC (P = 0.001) and CDI total (P < 0.001) scales. The CBCL also revealed significantly higher scores for NAFLD children in total problems (P = 0.046), internalizing symptoms (P = 0.000) and somatic complaints (P < 0.001). The WHOQOL-BREF revealed significantly lower scores for the mothers of NAFLD children in the overall perception of the quality of life (P < 0.001), and in the "relationships" domain (P = 0.023). Conclusions: Increased emotional and behavioural problems were detected in children with NAFLD as compared to healthy control children, together with an overall decrease in their mothers' quality of life. These results support the idea that these patients may benefit from a psychological intervention, ideally involving both children and parents, whose quality of life is likely negatively affected by this disease

On the similarity of dust flows in the inner coma of comets

The atmosphere of a comet is formed by the sublimation, due to solar illumination, of its volatile component and the dust particles ejected from its nucleus and entrained by the gas flow. Contemporary dusty-gas coma models take into account numerous physical processes occurring in the coma and a complex geometry of the nucleus. For the description of the dusty-gas flow in the coma, such models introduce a large number of governing parameters characterizing physical properties and processes. The relative role of these processes is not easy to ascribe therefore a relevant inter-comparison of model results becomes difficult. The present work introduces a set of universal, dimensionless parameters, which characterize the dust motion in the inner cometary coma. This approach allows one to: (i) reduce the number of parameters for analysis; (ii) reveal dust flows similarities; (iii) rescale the available numerical solutions. The present work demonstrates application of this approach to a realistic coma model. Description of dust motion with dimensionless parameters allows us to make a parametric study for a broad range of conditions and to find simple analytic approximations (via a polynomial function) of the numerical results suitable for rough estimations of dust density in the coma

Advances in paclitaxel combinations for treating cervical cancer

Introduction: Cervical cancer is the fourth common cancer in women worldwide. While, in the past, locally advanced stage disease was treated by pelvic radiotherapy, nowadays the National Cancer Institute strongly recommends chemoradiation protocols. Weekly cisplatin was previously the standard of care in this setting; however, the low response rate and the short median progression-free survival (PFS) of patients have led researchers to investigate combinatory regimens. Area covered: This article is based on literature searches up until April 2019, with current trial registers also analyzed. All data available on this topic has been summarized in this narrative review. Expert opinion: In recent years, it has been demonstrated that cisplatin-based doublets, and in particular, cisplatin plus paclitaxel, are superior to cisplatin as a monotherapy in terms of response rate and progression-free survival of patients with advanced cervical cancer. This double regime combined with bevacizumab is also considered the first-line option for metastatic or recurrent disease. Dose-dense paclitaxel in neo-adjuvant chemotherapy combinations is a promising option in patients with locally advanced cervical cancer. Exploration of novel biological therapies and in vitro combinations based on the use of paclitaxel is warranted