Case Report: False aneurysm as a late unusual complication of the aortofemoral bypass graft in a patient with critical leg ischemic symptoms: interesting case.

Aortofemoral bypass surgery is a common procedure for treating aortoiliac occlusive disease, also known as Leriche syndrome, which can cause lower extremity ischemic symptoms. Diagnostic imaging techniques play a crucial role in managing pseudoaneurysms (PSAs), with Duplex ultrasound and Computed Tomography-angiography (CTA) being effective tools for early diagnosis. Pseudoaneurysms (PSAs) present as pulsating masses with various symptoms, and prompt intervention is essential to avoid complications. A case report is presented involving an 82-year-old male who underwent aorto-bifemoral bypass surgery and later developed a pseudoaneurysm (PSA) of the left branch. Surgical treatment involved the removal of the pseudoaneurysm (PSA) and graft replacement. Other cases from the literature are also described, emphasizing the rarity and potential severity of non-anastomotic pseudoaneurysms (PSAs) in reconstructive vascular surgery. Periodic screening of patients who undergo reconstructive vascular surgery is crucial to detect pseudoaneurysms (PSAs) early and prevent complications. Asymptomatic pseudoaneurysms (PSAs) can grow significantly and become life-threatening if not identified in a timely manner. Regular post-operative imaging, such as annual Computed Tomography-angiography (CTA) and/or Duplex ultrasound, is recommended to ensure early diagnosis and appropriate management of complications.

Total Severity Score (TSS) comparison in vaccinated and unvaccinated patients during the fourth wave (December 2021 - January 2022) of COVID-19 in Italy.

OBJECTIVE: This study aims at comparing the severity score assessed using high-resolution computed tomography (HRCT) in vaccinated and unvaccinated COVID-19 patients. PATIENTS AND METHODS: From the first of December 2021 to first of February 2022, we conducted a single-center retrospective analysis on COVID-19 patients who accessed ED services. The hospital in question is a level II facility with a catchment area of around 200,000 people. According to the Italian recommendations, patients were divided into four groups based on the CT score of Micheal Chung. The sum of acute inflammatory lung lesions involving each lobe was scored as 1 (0-25%), 2 (26-50%), 3 (51-75%) or 4 (76-100%) on a visual quantitative assessment of CT. The total severity score (TSS) was determined by summing the five lobe scores. RESULTS: The study included 134 patients divided into two groups: 67 vaccinated and 67 unvaccinated people. 53 people had incomplete (single dose/double dose) immunization, while 14 people completed the vaccination cycle. It was discovered that the mean CT severity score was lower in fully vaccinated patients compared to partially vaccinated or unvaccinated patients. The mean CT score was significantly lower in fully vaccinated patients aged 60 compared to older patients. The mean CT score was higher in unvaccinated patients compared to fully vaccinated patients. CONCLUSIONS: Individuals who received three doses of COVID-19 vaccination had lower CT severity scores than patients who received only one dose of vaccine or no vaccines at all.

Screening, brief intervention, and referral to treatment (SBIRT) curriculum integration and sustainability: Social work and nursing faculty perspectives.

BACKGROUND: The Substance Abuse and Mental Health Services Administration (SAMHSA) has funded grants to universities to provide training and conduct research on the dissemination of Screening, Brief Intervention, and Referral to Treatment (SBIRT) to health care professionals. However, when it comes to integrating SBIRT content into an existing curriculum, difficulties can arise. When there is so much content already in the curriculum, adding more can be challenging. Additionally, some faculty believe that course curricula should be driven by the expertise and knowledge of faculty, not by opportunities afforded because of grant funding. METHODS: Using qualitative semi-structured faculty interviews and thematic data analysis, this study explored the process and content issues surrounding the integration of SBIRT content into the Masters of Social Work (MSW) and Masters of Science in Nursing (MSN) curricula at one university. RESULTS: Guidelines for the successful integration of SBIRT content into MSW and MSN curricula fall into two thematic areas: 1. Encourage buy-in and ownership of SBIRT curriculum development by current faculty. 2. Use a scaffolded approach. SBIRT includes several unique content areas which should be integrated per competencies addressed in each course. SBIRT content areas lend themselves to integration into a range of courses, employing an array of learning techniques and teaching materials. Scaffolding content requires creativity, which serves as the basis of the six subthemes that guide a scaffolded SBIRT integration approach. CONCLUSIONS: SBIRT offers an evidence based intervention that uses a public health approach to reduce harm from substance use. As such, professional nursing and social work education programs should teach SBIRT to their master's level practitioners. This paper proposes guidelines for integrating that content into existing curricula.

Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial.

The LUMIRA trial evaluated the effectiveness of radiofrequency (RFA) and microwave ablation (MWA) in lung tumours ablation and defining more precisely their fields of application. It is a controlled prospective multi-centre random trial with 1:1 randomization. Fifty-two patients in stage IV disease (15 females and 37 males, mean age 69 y.o., range 40-87) were included. We randomized the patients in two different subgroups: MWA group and RFA group. For each group, we evaluated the technical and clinical success, the overall survival and complication rate. Inter-group difference was compared using Chi-square test or Fisher's exact test for categorical variables and one-way ANOVA test for continuous variables. For RFA group, there was a significant reduction in tumour size only between 6 and 12 months (p value = 0.0014). For MWA group, there was a significant reduction in tumour size between 6 and 12 months (p value = 0.0003) and between pre-therapy and 12 months (p value = 0.0215). There were not significant differences between the two groups in terms of survival time (p value = 0.883), while the pain level in MWA group was significantly less than in RFA group (1.79 < 3.25, p value = 0.0043). In conclusion, our trial confirms RFA and MWA are both excellent choices in terms of efficacy and safety in lung tumour treatments. However, when compared to RFA therapy, MWA produced a less intraprocedural pain and a significant reduction in tumour mass.

Foot soft tissue myopericytoma: Case-report and review.

INTRODUCTION: Myopericytoma is a rare tumor of deep soft tissues, originating from pericytes and characterized by numerous thin walled blood vessels. CASE REPORT: We report a case of myopericytoma found at the level of the second toe of the right foot.A patient came to the Endocrinology Surgery Department of Catania Polyclinic because of a presence of a small swelling in the plantar region, between the 2nd and 3rd toe of the right foot. At the anatomopathological examination, the escalated lesion showed a neoformation of 0.6 cm in diameter, well circumscribed, capsulated, with myopericytoma diagnosis. DISCUSSION: Its histopathological appearance is similar to myofibromatic lesions from glomic and angiomyoma tumors. It is a rare tumor that affects all ages with a peak after 50 years 3. The most frequent localization is at the lower extremities, particularly in soft subcutaneous tissues, but can rarely occur in other sites. CONCLUSION: At the anatomopathological evaluation, the immunohistochemical examination for the correct formulation of the diagnosis is essential and an adequate surgical excision is important.

Patients' survival in lung malignancies treated by microwave ablation: our experience on 56 patients.

OBJECTIVES: We retrospectively evaluated percutaneous CT-guided microwave (MW) ablation safety and efficacy in unresectable lung malignancies focusing on patients' survival. MATERIALS AND METHODS: All procedures were approved by the hospital ethical committee. From 2008 to 2012 we treated 69 unresectable lesions (44 lung cancer, 25 lung metastases) in 56 patients (35 men/21 women; mean age: 61.5 years). Treatment was performed under CT guidance using 14 G needles with a 3 cm active tip and a 55 W MW generator (Vivawave Microwave Coagulation System; Valley Lab). Treatment was performed at 45 W for 6-10 min. Patients were scheduled for a 3 and 6 month CT follow-up to evaluate lesion diameter and enhancement. Survival rate was evaluated by Kaplan-Meier analysis. RESULTS: Ablation procedures were completed according to protocol in all patients. Pneumothorax occurred in 18 patients and 8 required chest tube. Four lesions (all >4.3 cm) were retreated 20 days after the ablation because of peripheral focal areas of residual tumor. Follow-up CT evaluation showed a decrease in maximum diameter in 44/69 lesions (64%) and in 42/59 lesions (71%) at 3 and 6 months, respectively. In all cases no pathologic enhancement was observed. Cancer-specific mortality yielded a survival rate of 69% at 12 months, 54% at 24 months and 49% at 36 months, respectively. An estimate mean for survival time was 27.8 months with a standard error of 2.8 months (95% confidence interval: 22.4-33.2 months). CONCLUSION: Based on our experience, MW ablation seems to represent a potential safe and effective percutaneous technique in the treatment of lung malignancies. MW ablation may improve survival in patients not suitable to surgery.

Spontaneous regression of dilated virchow-robin spaces. A case report.

We describe a 28-year-old woman with a dilated perivascular spaces in the right pre-rolandic district. The purpose of this article is to provide an in-depth overview of the MR imaging features of VR spaces and to describe magnetic resonance imaging evidence of complete regression of dilated perivascular spaces (2).

Radiofrequency ablation of bone metastases induces long-lasting palliation in patients with untreatable cancer.

INTRODUCTION: In oncological patients, life quality can be greatly impaired by the presence of painful bone metastases, as standard forms of treatment often achieve inadequate palliation. The aim of our study was to evaluate the clinical efficacy of radiofrequency ablation (RFA) with respect to pain relief in patients with refractory bone metastases or who are ineligible to conventional treatments. METHODS: 12 patients with 13 painful osteolytic skeletal metastases, and who were unresponsive to analgesic drug therapy, underwent one (seven lesions) or two (five lesions) RFA sessions under computed tomography (CT) guidance. The RFA procedure was completed in all patients without complications. One patient also received cementoplasty after the RFA procedure. To obtain semiquantitative pain scores, the brief pain inventory (BPI) was administered before treatment and during follow-up. The local effects of RFA were monitored for at least one year in eight of 12 patients with CT and/or magnetic resonance imaging. RESULTS: Immediate pain relief after treatment was experienced by nine of 12 patients, but in two cases, pain recurred within the first week. Long-lasting palliation was obtained in seven of 12 patients. BPI mean scores for worst and average daily pain decreased from 7.7 and 5.0, respectively, at baseline, to 3.1 and 1.8, respectively, at one year. Imaging follow-up showed large areas of necrosis in nine of 12 lesions. CONCLUSION: In our preliminary experience, RFA showed good and long-lasting efficacy for pain control in bone metastases. A possible role of RFA as a coadjuvant palliative treatment in these cases is suggested.

RNA and sex determination in Caenorhabditis elegans. Post-transcriptional regulation of the sex-determining tra-2 and fem-3 mRNAs in the Caenorhabditis elegans hermaphrodite.

The Caenorhabditis elegans hermaphrodite sequentially produces sperm and oocytes from a single pool of precursors. Therefore, the hermaphrodite's germ line is the site of two major cell fate decisions: a germ cell precursor first undergoes a mitosis/meiosis decision and then a sperm/oocyte decision. While the mitosis/meiosis decision is governed by Notch/GLP-1 signalling, the sperm/oocyte decision relies on post-transcriptional regulation of two key mRNAs, tra-2 and fem-3. This review focuses on factors that are required for the silencing of these mRNAs, which results in the sequential production of sperm and oocytes. Most factors that regulate the expression of tra-2 and fem-3 are homologous to proteins involved in RNA regulation in yeast, mammals or Drosophila, suggesting that at least some of the molecular mechanisms regulating the two worm mRNAs have been conserved throughout evolution.

The impact of basic fibroblast growth factor on photoreceptor function and morphology.

PURPOSE: To assess the impact of basic fibroblast growth factor (bFGF) on photoreceptor function and morphology. METHODS: Impact was assessed in two models. In one, the endogenous expression of bFGF in photoreceptors was raised by sectioning one optic nerve of rats 3 to 4 weeks before study. In the other, bFGF was injected into the vitreous chamber in rats and cats. Retinal function was assessed from the electroretinogram (ERG), and retinal morphology was studied using DNA dyes, immunolabeling, and in situ hybridization. RESULTS: In both models of bFGF upregulation, the ERG b-wave was suppressed over a wide stimulus range and in light- and dark-adapted conditions. The a-wave was not suppressed by either procedure and at the brightest intensities was enhanced by both procedures. In nerve-sectioned eyes, outer retina appeared normal histologically, but levels of bFGF protein in the inner and outer nuclear layers were raised, whereas bFGF mRNA levels remained unchanged. In both models, levels of synaptophysin in the outer plexiform layer and of cytochrome oxidase in inner segments were raised in association with increases in bFGF protein levels. CONCLUSIONS: bFGF increased the ability of photoreceptors to respond to light but attenuated the transmission of this response to inner retinal cells, presumably by blocking the photoreceptor-bipolar synapse. If the expression of bFGF protein is upregulated in human photoreceptor dystrophies, it may contribute a reversible component to the loss of vision. The relationship between these actions of bFGF and its ability to protect photoreceptors from stress remains to be established.

3 alpha-hydroxy-5 alpha-pregnan-20-one modulation of solubilized GABA/benzodiazepine receptor complex.

The allosteric modulation of the progesterone metabolite 3 alpha- hydroxy-5 alpha-pregnan-20-one (DHP) on [3H]Flunitrazepam and [35S]t-butylbicyclophosphorothionate (TBPS) binding was investigated on a soluble receptor preparation. Better results in the solubilization occurred by the use of the zwitterionic detergent CHAPS with the inclusion of the phospholipid asolectin: this treatment was found suitable to study the steroidal modulation on [3H]Flunitrazepam and [35S]TBPS binding. We found that DHP was able to enhance [3H]Flunitrazepam binding in the presence of Cl- ions, while [35S]TBPS binding was inhibited by DHP. Scatchard analysis of specific [35S]TBPS and [3H]Flunitrazepam binding yielded in a single straight line both in the controls and in the presence of the hormone; DHP increased the apparent affinity of [3H]Flunitrazepam binding without altering the apparent Bmax value. In the case of [35S]TBPS, DHP decreased the apparent Bmax value whereas the Kd value remained nearly the same.