Caseous calcification of the mitral annulus: A multi-modality imaging perspective.

Mitral annulus calcification is a common echocardiographic finding, particularly in the elderly and in end-stage renal disease patients under chronic dialysis. Caseous calcification or liquefaction necrosis of mitral annulus calcification is a rare evolution of mitral annular calcification. Early recognition of this entity avoids an invasive diagnostic approach, since it is benign and, unlike intracardiac tumors and abscesses, has a favorable prognosis. The authors present the case of an 84-year-old woman with a suspicious large, echodense mass at the level of the posterior mitral leaflet with associated severe mitral regurgitation. Cardiac magnetic resonance imaging demonstrated a hypoperfused mass with strong peripheral enhancement 10 minutes after gadolinium administration. Multislice computed tomography showed the calcified nature of the mass. A multi-modality imaging approach confirmed the diagnosis of caseous calcification of the posterior mitral annulus. The patient refused surgical treatment

Years of life that could be saved from prevention of hepatocellular carcinoma

BACKGROUND: Hepatocellular carcinoma (HCC) causes premature death and loss of life expectancy worldwide. Its primary and secondary prevention can result in a significant number of years of life saved. AIM: To assess how many years of life are lost after HCC diagnosis. METHODS: Data from 5346 patients with first HCC diagnosis were used to estimate lifespan and number of years of life lost after tumour onset, using a semi-parametric extrapolation having as reference an age-, sex- and year-of-onset-matched population derived from national life tables. RESULTS: Between 1986 and 2014, HCC lead to an average of 11.5 years-of-life lost for each patient. The youngest age-quartile group (18-61 years) had the highest number of years-of-life lost, representing approximately 41% of the overall benefit obtainable from prevention. Advancements in HCC management have progressively reduced the number of years-of-life lost from 12.6 years in 1986-1999, to 10.7 in 2000-2006 and 7.4 years in 2007-2014. Currently, an HCC diagnosis when a single tumour <2 cm results in 3.7 years-of-life lost while the diagnosis when a single tumour 65 2 cm or 2/3 nodules still within the Milan criteria, results in 5.0 years-of-life lost, representing the loss of only approximately 5.5% and 7.2%, respectively, of the entire lifespan from birth. CONCLUSIONS: Hepatocellular carcinoma occurrence results in the loss of a considerable number of years-of-life, especially for younger patients. In recent years, the increased possibility of effectively treating this tumour has improved life expectancy, thus reducing years-of-life lost

Effetto antiossidante o pro-ossidante di sostanze naturali in condizioni di ossidazione forzata

Questo lavoro di tesi si prefigge l'obiettivo di valutare l'effetto antiossidante o pro-ossidante di sostanze naturali in condizioni di ossidazione accelerata addizionate ad un olio di girasole commerciale. Il metodo di analisi si basa sull’OXITEST®️: test ad ossidazione accelerata che permette di determinare la stabilità di una matrice rispetto a delle condizioni di deterioramento (temperatura e pressione di ossigeno) ben definite. La valutazione della stabilità ossidativa viene espressa attraverso il tempo di induzione (IP). Dai risultati ottenuti si nota come i tempi di induzione varino in funzione dell’antiossidante addizionato e delle quantità aggiunte. Partendo da un olio di girasole commerciale con IP di 11:49 ore, hanno mostrato un incremento significativo i campioni aggiunti di phenolea. Al contrario, invece, i campioni arricchiti con estratto di rosmarino hanno mostrato valori di IP significativamente uguali a quello ottenuto per l’olio di girasole tal quale, il motivo potrebbe essere la scarsa solubilità di questo estratto nell’olio stesso. L’aggiunta di WGO ha mostrato valori (11:17 ore) non significativamente differenti da quelli dell’olio tal quale. Per poter stilare delle considerazioni, invece, sull’utilizzo della frazione insaponificabile del WGO sarebbero necessarie prove che prevedano l’aggiunta di percentuali maggiori. In conclusione, gli aspetti benefici legati al consumo dell’olio di germe di grano e la sua applicabilità industriale sono le ragioni per tentare di raggiungere una migliore utilizzazione del prodotto, meritevole sotto tanti aspetti

Le medicine partenenti alle infermità delle donne di Giovanni Marinello «opera a beneficio e conservatione delle donne […] così esse la leggano & vedano volentieri»

This paper briefly introduces the venetian physician Giovanni Marinello and his vernacular treatise Le medicine partenenti alle infermità delle donne. This popular and widely circulated book can be taken as an example of the growing number of works devoted to women's health and diseases that were published in Europe between xvi and the first half of xvii centuries. Although controversial, the new attention for gynecological subjects in early modern medical literature emphasizes the specificity of female bodies and contributes to challenge the conventional view of woman as imperfect male, monster or error of nature.Questo articolo introduce brevemente il trattato in volgare dal titolo Le medicine partenenti alle infermità delle donne, scritto dal medico erudito Giovanni Marinello e pubblicato per la prima volta a Venezia nel 1536. Si tratta di un testo di grande successo che può essere preso ad esempio di quel ricco corpo di trattati e manuali dedicati alle malattie delle donne che circolano in Europa nel xvi secolo e fino alla prima metà del xvii e che, tra contraddizioni e controversie, testimoniano un rinnovato e forte interesse della medicina per la specificità del corpo femminile iniziando a prendere le distanze dalla visione scolastica della donna come maschio imperfetto, mostro o errore di natura

HBV DNA suppression and HBsAg clearance in HBeAg negative chronic hepatitis B patients on lamivudine therapy for over 5 years

BACKGROUND & AIMS: In long-term responder patients, it is unclear whether lamivudine (LAM) monotherapy should be continued or switched to a high-genetic-barrier analogue. This study aims at assessing LAM efficacy over a 5-year period and the residual risk of drug resistance. The rate of HBsAg clearance and LAM long-term safety profile were also evaluated. METHODS: One hundred and ninety-one patients with chronic HBeAg-negative hepatitis B successfully treated with LAM monotherapy for at least 5years were included. Biochemical and virological tests were assessed every 3months in all patients and HBsAg quantification was performed in 45/191. Reverse-transcriptase (RT) region was directly sequenced in virological breakthrough patients. RESULTS: One hundred and ninety-one patients (148 males, median age 53years, 72 with compensated cirrhosis) responding to 60-month LAM monotherapy continued to receive LAM monotherapy beyond the initial 5years and were followed for an additional 36-month median period (range 1-108). Virological response was maintained in 128/191 patients (67%) and HBsAg clearance was observed in 15/128 (11.7%) after a 32-month median period (range 1-65). The 63 remaining patients (33%) showed virological breakthrough after a 15-month median treatment (range 1-78). RT region analysis was performed in 38/63 breakthrough patients and LAM resistant mutations were found in 37/38. No significant side effects were observed. CONCLUSIONS: In long-term responder patients, continuation of LAM monotherapy resulted in persistent viral suppression in most cases with undetectable HBV DNA by real-time PCR; moreover, 11.7% of these patients cleared HBsAg. Selection of LAM resistance, however, can still occur even after successful long-term therapy, thus emphasising the importance of a careful virological monitorin

Echocardiographic History of an Asymptomatic Congenital Cardiac Tumor

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Yeast-Derived Formulations Are Differentially Fermented by the Canine and Feline Microbiome As Assessed in a Novel in Vitro Colonic Fermentation Model

The current study evaluated the effect of five yeast-derived formulations (T1-T5) on microbial metabolism and composition of the canine and feline gut microbiota using a novel in vitro colonic incubation approach. This novel in vitro model allowed for growth of the entire spectrum of dog- and cat-derived bacteria from the inoculum, thus offering an excellent platform to evaluate effects of nutritional interventions on the gut microbiota. Further, yeast-derived ingredients differentially increased production of acetate, propionate, butyrate, ammonium, and branched short-chain fatty acids, with T5 and T1 consistently stimulating propionate and butyrate, respectively. 16S-targeted Illumina sequencing coupled with flow cytometry provided unprecedented high-resolution quantitative insights in canine and feline microbiota modulation by yeast-derived ingredients, revealing that effects on propionate production were related to Prevotellaceae, Tannerellaceae, Bacteroidaceae, and Veillonellaceae members, while effects on butyrate production were related to Erysipelotrichaceae, Lachnospiraceae, Ruminococcaceae, and Fusobacteriaceae. Overall, these findings strengthen the health-promoting potential of yeast-derived ingredients