Singular charge fluctuations at a magnetic quantum critical point.

Strange metal behavior is ubiquitous in correlated materials, ranging from cuprate superconductors to bilayer graphene, and may arise from physics beyond the quantum fluctuations of a Landau order parameter. In quantum-critical heavy-fermion antiferromagnets, such physics may be realized as critical Kondo entanglement of spin and charge and probed with optical conductivity. We present terahertz time-domain transmission spectroscopy on molecular beam epitaxy-grown thin films of YbRh2Si2, a model strange-metal compound. We observed frequency over temperature scaling of the optical conductivity as a hallmark of beyond-Landau quantum criticality. Our discovery suggests that critical charge fluctuations play a central role in the strange metal behavior, elucidating one of the long-standing mysteries of correlated quantum matter.

Milk lactoferrin in heifers: influence of health status and stage of lactation.

The objective of the current study was to analyze the variations in lactoferrin (LF) concentrations in primiparous cows with intramammary infection and to study how the lactation stage affects these variations. In addition, we aimed to study the potential of the LF concentration in early lactation as a predictive factor for future infections. To accomplish this goal, a longitudinal analysis was performed for 96 primiparous cows. Milk samples were collected each month from individual quarters, and the LF concentration was determined for each sample. Criteria that included both somatic cell count (SCC) and a microbiological analysis were used to assess the health status of the quarters. Of the diseased quarters (SCC >200,000 or positive for pathogen isolation, or both), 62% corresponded to nonspecific mastitis (SCC >200,000 but microbiologically negative) and 25% corresponded to the category "presence of bacterial growth" (SCC <200,000 but microbiologically positive). Diseased quarters showed increased concentrations of LF compared with healthy quarters. However, this increase was greater during the first days of lactation compared with later periods. Kaplan-Meier analysis of time free of infection demonstrated that quarters with LF concentrations at early lactation (3-10d in milk) greater than 0.1mg/mL are more likely to become infected during the following lactation compared with quarters with lower LF concentrations in early lactation. The results support that LF plays a relevant role in combating intramammary infection, particularly during the first days of lactation. In addition, we present evidence of the potential use of LF as a predictive marker of future infections in the individual quarters of dairy heifers.

Rapidly progressing mycosis fungoides presenting as follicular mucinosis.

Follicular mucinosis can occur as a primary idiopathic disorder or can arise in association with benign or malignant disease, most notably mycosis fungoides. We describe a patient with an aggressive folliculotropic variant of mycosis fungoides that initially presented as follicular mucinosis with alopecia. One month after the diagnosis of follicular mucinosis, a diagnosis of mycosis fungoides was made, and 3 months later inguinal lymph node involvement with mycosis fungoides developed. A skin biopsy specimen demonstrated prominent follicular mucinosis with folliculotropism of atypical cells and intrafollicular Pautrier's microabscesses. As demonstrated in this case, follicular mucinosis can be a presenting sign of rapidly progressive mycosis fungoides. In our review of follicular mucinosis and its association with mycosis fungoides, we found that the folliculotropic variant of mycosis fungoides appears more commonly to have an aggressive course than classic mycosis fungoides.

[Surgical treatment of thyroid microcarcinoma]. / Trattamento chirurgico dei microcarcinomi tiroidei.

Thyroid microcarcinoma is nowaday defined as a tumor of one centimeter or less in the maximum diameter. It occurs in less than five per cent of all thyroid carcinomas. In personal experience four thyroid microcarcinomas have been found in specimens from 121 thyroidectomies and have been retrospectively reviewed clinical data and the long term follow-up of the patients. Total thyroidectomies nor prophylactic lymphadenectomies were never performed. All patients at present are well. Our purpose was to focus on the current surgical treatment of microcarcinoma. Many hypotheses are done to explain pathogenesis and fairly good prognosis of thyroid microcarcinomas, without univocal conclusions. Almost all authors agree that microcarcinoma of the thyroid gland is a low-aggressive tumor, with good biological behaviour, but the therapeutic strategies are not codified yet. Particularly, doubt still exists about the choice between total thyroidectomy and more conservative procedure, and lymphadenectomy, especially when tumor is found in specimens after surgery for benign disease. In conclusion, in our opinion conservative management is the best choice, provided that the patient is included in a correct long-term follow-up.

Effects of 3-chloro-phenyl-1,4-dihydropyridine derivatives on Trypanosome cruzi epimastigotes.

A series of 3-chloro-phenyl-1,4-dihydropyridine derivatives produced different degrees of inhibition of parasite growth and respiration on clone Brener, LQ and Tulahuen strains of Trypanosome cruzi epimastigotes. Respiratory chain inhibition appears to be a posible determinant of the trypanosomicidal activity of this compounds. No difference in the action of these derivatives was found among the different parasite strains. For comparative purposes, the inhibitory effects of felodipine and nicardipine are also reported. A good correlation between toxic effects and the easiness of oxidation of the dihydripyridine ring was found. The presence of a fused ring on the dihydropyridine moiety significantly diminished the inhibitory effects.

[Long-term central venous access. Experience with 173 cases]. / Accessi venosi centrali a lungo termine. Esperienza relativa a 173 casi.

BACKGROUND: Utility of long term central venous accesses. METHODS: Personal experience in 173 long term central venous accesses (a.v.c.) performed from January 1990 to December 1997 in 172 patients mostly affected by neoplastic disease is reported. The device used was totally implantable in 102 cases (59%): 82 Port (80.3%), 20 Chrono-infusors (20.7%); in 71 cases (41%) an external tunnellized catheter (c.v.c.). Percutaneous way with Seldinger procedure was performed in 168 cases (97.3%), left subclavian vein was preferred in 118 cases (68.2%). RESULTS: The overall complications in this series were about 7.4%: early 4% (5 accidental arterial punctures, 2 pneumothoraxes), late 3.4% (1 subcutaneous pocket infection, 3 cutaneous necrosis, 1 venous catheter dislocation and 1 migration). No significative differences in terms of complications were reported between totally implantable devices and external tunnellized catheter. CONCLUSIONS: The reasons of a low rate of complications in our series are to be found in the perfect aseptic condition of the operating room, the positioning of the a.v.c. under constant fluoroscopic control and a good management during the postoperative care of the a.v.c. The indications and the economic aspect for each kind of device used (c.v.c. or totally implantable a.v.c.) are then discussed and the conclusion drawn that for short term therapy, up to six months, (hematologic patients of this series) the external tunnellized catheter should be advisable, while for long term therapy administration (solid tumors and parenteral nutrition) totally implanted device should be recommended.

[On the subject of pancreatic ductal carcinoma]. / In tema di carcinoma duttale pancreatico.

Pancreatic cancer is a dismal disease. The 5-year overall survival ranges from 1% to 5%. Surgery is the only curative treatment available for this cancer, but it is indicated only in selected patients with a less than 4 cm tumor. In these patients, survival rate is about 30%. We have considered several aspects: the very difficult early diagnosis, the correct diagnostic flow chart, actual surgical procedures and new trends in biologic and genetic research. It is likely that better results can be achieved by defining an "early pancreatic cancer" and establishing how to detect it. This could be the wrigth one way is to significantly improve the survival of these patients.

Air medical transport of the injured patient: scene versus referring hospital.

INTRODUCTION: In a rural service area, does the outcome of air medical patients transferred from the scene of injury differ from that of patients transferred from a primary receiving hospital? METHODS: Retrospective review of all injured patients transported by air to a single trauma center during calendar year 1996. Data collected include basic patient demographics, time of injury, revised trauma score (RTS), injury severity score (ISS), probability of survival (PS), hospital length of stay (LOS), complications, disposition, and mortality. RESULTS: Concerning trauma admission, 594 of 1461 (40.7%) were transported by air: 363 from the scene (24.9%) and 231 from referring hospitals (15.8%). These two groups were similar in demographics, injury severity, hospital LOS, and crude mortality: RTS, 6.61 versus 6.68 (P > 0.05); ISS, 16.0 versus 16.0 (P > 0.05); LOS = 6.9 days versus 7.3 days (P > 0.05); mortality = 11.8% versus 10.8% (P > 0.05). The groups differed significantly, however, in time from injury to definitive care (34.2 minutes versus 196.2 minutes, P < 0.001), overall complication rate (39.1% versus 57.6%, P = 0.009), and potentially preventable deaths (PS > 0.5, 11.6% versus 44%, P = 0.02). CONCLUSION: Patient groups were similar, suggesting similar triage criteria. Patients transferred from a referring hospital took almost six times longer to reach definitive care and may have suffered an increased morbidity and mortality on this basis.

Splenic arteriovenous fistula causing massive ascites: a case report.

A case of splenic arteriovenous fistula leading to portal hypertension and ascites is presented. The recognition of this vascular lesion is important. When portal hypertension is secondary to a splenic arteriovenous fistula, the complications of portal hypertension can be avoided by the resection of the lesion. The diagnosis can be suspected by clinical findings and confirmed by angiographic delineation of the fistula. Surgical resection of splenic arteriovenous fistulae must include the fistula and all dilated venous tributaries to prevent thrombosis and recurrent portal hypertension.