Knowledge of the vascular anatomy of the upper abdomen is important in the daily practice of surgeons specialized in the hepatobiliary and pancreatic area, and for general surgeons and radiologists, ...mainly those involved in interventional radiology. Since anatomical variants of the celiac axis and hepatic arteries are common, an accurate description of vascularization is required before procedures to avoid iatrogenic vascular changes.
We reported a case of a young male patient with HBV related cirrhosis, who came to our institution for the treatment of 2 HCC nodules. The preprocedural contrast-enhanced CT examination showed combined variations of celiac trunk, hepatic arteries, gastroduodenal artery, and right inferior phrenic artery. The careful pre- and intraprocedural evaluation of vascularization allowed us to perform transarterial chemoembolization of the 2 nodules without complications.
The incidence and developmental and clinical significance of this variation is discussed with a detailed review of the literature. Knowledge of such a case has important clinical significance in abdominal operations or invasive arterial procedures.
Significant advances in medical imaging have been made in the past decades, enabling physicians to reach high precision in diagnosing patients’ diseases by means of sophisticated imaging tools. ...However, the use of sophisticated tools is limited by the high costs and, in some cases, by the utilization of ionizing radiation, which have both great impact on the economy of a nation and on citizens’ health, respectively. Guidelines have been published among countries to provide physicians with structured rules to be followed to suggest the correct imaging technique, suiting better the diagnostic question and avoiding inappropriate imaging requests. The COLLABORADI is a research project that addressed the phenomenon of inappropriate imaging prescriptions in Sicily (Italy) and proposed the design and implementation of a clinical decision support system to help physicians to set up the most appropriate diagnostic route for their patients. The aim of this paper is to describe the characteristics of the COLLABORADI software and its potential impact in diminishing inappropriate imaging.
Abstract Alzheimer's disease (AD), the most common form of dementia in elderly individuals, is characterized by neurofibrillary tangles, extracellular amyloid-β (Aβ) plaques and neuroinflammation. ...New evidence has shown that the lysosomal system might be a crossroad in which etiological factors in AD pathogenesis converge. This study shows that several lysosomal enzymes, including Cathepsin B, D, S, β-Galactosidase, α-Mannosidase, and β-Hexosaminidase, were less expressed in monocytes and lymphocytes from patients with a clinical diagnosis of AD dementia compared with cells from healthy controls. In vitro experiments of gain and loss of function suggest that down-regulation is a direct consequence of miR-128 up-regulation found in AD-related cells. The present study also demonstrates that miR-128 inhibition in monocytes from AD patients improves Aβ(1-42) degradation. These results could contribute to clarify the molecular mechanisms that affect the imbalanced Aβ production/clearance involved in the pathogenesis of AD.
Nanotechnology has underpinned vital progress in current research and has immensely promoted the food production chain. This review projected the critical intervention of nano-based technologies like ...modern advancements of nano-based biosensors in detecting mycotoxins, microbial contaminations, antibiotics, pesticides, food additives, and dyes. It also highlighted the starring roles of nanotechnology in terms of active, intelligent food packaging and food safety. These approaches have certainly intensified the strength of food processing technology and improved food quality and maintenance standards during shelf life. Apart from these trending facets, this review throw light on the utilisation of food waste for the biogenic synthesis of nanoparticles and the application of nano-based materials for the recycling process in food production units to ensure a complete cleaner technology. However, monitoring the chronic exposure of food contact nanomaterials should be critically evaluated to ensure food safety. Nanotechnology embraced an influential role in the food sector by providing effective avenues for energy conservation, sustainability, and cues to improve the capital funds well.
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•Role of nano-biosensors for detection of toxic residues in food.•Naturally occurring nano-foods as models to understand the penetrable properties.•Utilisation of food waste for energy sustainability through eco-waste management.•Nanomaterials in recycling units of food factories ensure cleaner production.•Improved bioavailability of nutrients and food safety through active packaging.
The lysosomal system is up-regulated in the brain of patients with Alzheimer's Disease (AD), as demonstrated by previous experiments carried out in postmortem samples of brain patients. In this paper ...we provide evidence that an up-regulation of lysosomal glycohydrolases (α-d-mannosidase, β-d-hexosaminidase, and β-d-galactosidase) takes place in skin fibroblasts from AD patients affected either by sporadic or familial forms and is detectable also in presymptomatic subjects carrying the above mutations but healthy at the time of skin biopsy. This increase of enzyme activity is consequent to a transcriptional up-regulation. The oncogene Ras appears to be involved in the regulation of enzymatic activity. A parallel increase of Ras transcript and Ras protein, without an increase of p44/p42 MAPK activation was revealed in the same AD fibroblasts. An activation of p38 MAPK already described to occur in neurodegenerative diseases such as Alzheimer's, was also found in fibroblasts derived from AD patients. High levels of expression of the constitutively active form of Ras in normal or AD fibroblasts induced glycohydrolases up-regulation. Overall results demonstrated that glycohydrolases up-regulation, as well as Ras up-regulation, are early markers of AD, detectable at peripheral level, and good candidates to be exploited for diagnostic purposes. These data also provide the first proof for a role of Ras in regulating lysosomal glycohydrolases expression.
Purpose
The authors analysed the impact of nonmedical costs (travel, loss of productivity) in an economic analysis of PET–CT (positron-emission tomography–computed tomography) performed with standard ...contrast-enhanced CT protocols (CECT).
Materials and methods
From October to November 2009, a total of 100 patients referred to our institute were administered a questionnaire to evaluate the nonmedical costs of PET–CT. In addition, the medical costs (equipment maintenance and depreciation, consumables and staff) related to PET–CT performed with CECT and PET–CT with low-dose nonenhanced CT and separate CECT were also estimated.
Results
The medical costs were 919.3 euro for PET–CT with separate CECT, and 801.3 euro for PET–CT with CECT. Therefore, savings of approximately 13 % are possible. Moreover, savings in nonmedical costs can be achieved by reducing the number of hospital visits required by patients undergoing diagnostic imaging.
Conclusions
Nonmedical costs heavily affect patients’ finances as well as having an indirect impact on national health expenditure. Our results show that PET–CT performed with standard dose CECT in a single session provides benefits in terms of both medical and nonmedical costs.
Abstract
Background
Mutations and deletions in the SPG4/SPAST gene cause for up to 50% of the autosomal dominant forms of hereditary spastic paraplegia (HSP) and for up to 15% of the sporadic cases. ...Affected individuals have pyramidal signs in the lower limbs and some present additional features. Cognitive impairment is common in late‐onset forms of HSPs.
Methods
This study examined the cognitive abilities of 20 sporadic late‐onset patients with HSP using next‐generation sequencing. We also used a combination of the Mini‐Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) to assess their cognition.
Results
The present study led to the discovery of three new pathogenic mutations of the SPG4 gene through evolutionary conservation and analysis of structural models. We also confirmed mild cognitive impairment (MCI) with normal MMSE scores (≥27) and reduced MoCA scores (<26) in these HSP‐SPG4 mutant patients. Such individuals mainly present with impaired executive function, delayed memory, abstraction and language.
Conclusions
The results broaden the mutational space of SPG4‐associated HSP with sporadic late‐onset modality and indicate a combination of reduced MoCA and normal MMSE for diagnosis, indicating that clinicians should consider performing a MoCA to detect MCI in patients with HSP, particularly those with sporadic onset SPG4/SPAST‐HSP.
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