The reported incidence of pregnancy‐related carpal tunnel syndrome (PRCTS) ranges from 0.8% to 70%, and little is known of its natural history. We systematically reviewed the reported incidence of ...PRCTS and evaluated its natural history. We identified 214 studies that fulfilled our selection criteria. Six publications fulfilled the inclusion criteria. Five fulfilled the incidence criteria, 3 fulfilled the natural history criteria, and 2 of the 6 publications satisfied both. The reported incidence of neurophysiologically confirmed PRCTS ranged from 7% to 43%, whereas the incidence of clinically diagnosed PRCTS ranged from 31% to 62%. Symptoms persisted in more than 50% of the patients after 1 year and in about 30% after 3 years. Our review suggests that variations in the reported incidence of PRCTS largely depend on the methods used to detect this syndrome. Our data also suggest that symptoms persist in a substantial number of patients 1 or more years after delivery. Muscle Nerve 42: 697–702, 2010
Abstract We report on a 6-year-old child presenting with subacute foot drop. Neurophysiologic and radiologic studies revealed a peroneal nerve compression secondary to fibular exostosis. Before ...undergoing surgical removal of the exostosis, the patient underwent further neurophysiologic and ultrasonographic evaluation that showed the presence of an accessory peroneal nerve branch that caused gastrocnemius involvement. Findings at surgery confirmed the supposed anatomical variant. Both nerve components were carefully preserved during the operative procedure. The association of ultrasonographic and neurophysiologic studies was crucial in identifying the etiopathologic mechanism and anatomical picture and provided clinicians and surgeons with important information in planning the procedure.
The third edition of Flow Cytometry Guidelines provides the key aspects to consider when performing flow cytometry experiments and includes comprehensive sections describing phenotypes and functional ...assays of all major human and murine immune cell subsets. Notably, the Guidelines contain helpful tables highlighting phenotypes and key differences between human and murine cells. Another useful feature of this edition is the flow cytometry analysis of clinical samples with examples of flow cytometry applications in the context of autoimmune diseases, cancers as well as acute and chronic infectious diseases. Furthermore, there are sections detailing tips, tricks and pitfalls to avoid. All sections are written and peer‐reviewed by leading flow cytometry experts and immunologists, making this edition an essential and state‐of‐the‐art handbook for basic and clinical researchers.
Hepatitis C virus (HCV) predominantly infects hepatocytes, although it is known that receptors for viral entry are distributed on a wide array of target cells. Chronic HCV infection is indeed ...characterized by multiple non-liver manifestations, suggesting a more complex HCV tropism extended to extrahepatic tissues and remains to be fully elucidated. In this study, we investigated the gastrointestinal mucosa (GIM) as a potential extrahepatic viral replication site and its contribution to HCV recurrence.
We analyzed GIM biopsies from a cohort of 76 patients, 11 of which were HCV-negative and 65 HCV-positive. Of these, 54 biopsies were from liver-transplanted patients. In 29 cases, we were able to investigate gastrointestinal biopsies from the same patient before and after transplant. To evaluate the presence of HCV, we looked for viral antigens and genome RNA, whilst to assess viral replicative activity, we searched for the replicative intermediate minus-strand RNA. We studied the genetic diversity and the phylogenetic relationship of HCV quasispecies from plasma, liver and gastrointestinal mucosa of HCV-liver-transplanted patients in order to assess HCV compartmentalization and possible contribution of gastrointestinal variants to liver re-infection after transplantation.
Here we show that HCV infects and replicates in the cells of the GIM and that the favorite hosts were mostly enteroendocrine cells. Interestingly, we observed compartmentalization of the HCV quasispecies present in the gastrointestinal mucosa compared to other tissues of the same patient. Moreover, the phylogenetic analysis revealed a high similarity between HCV variants detected in gastrointestinal mucosa and those present in the re-infected graft.
Our results demonstrated that the gastrointestinal mucosa might be considered as an extrahepatic reservoir of HCV and that could contribute to viral recurrence. Moreover, the finding that HCV infects and replicates in neuroendocrine cells opens new perspectives on the role of these cells in the natural history of HCV infection.
Background: Severe asthma patients are those suffering from asthma exacerbations despite adherence to maximal optimized asthma treatment such as high dose inhalant corticosteroids and long-acting ...beta2 agonists (ICS-LABA). It is estimated that about 300 million people in the world are affected from asthma and among them a percentage between 3-10% suffer from severe asthma. The prevalence of Alexithymia in chronic illness is notably high and it is strictly related to clinical severity of chronic diseases. Methods: Pub Med and Google Scholar databases were consulted using the terms “severe asthma” AND “alexithymia” to search English-language articles. According to inclusion criteria 37 articles were finally included and analyzed. Alexithymia may interfere with the perception of the disease and the patients’ awareness of the need of a strict follow-up, to adhere to the physicians’ treatment plans. Results: Alexithymia and related psychological distress as anxiety and depression may compromise the patient’s compliance and adherence, leading to a severe clinical presentation and pathologies’ course. This review highlights a potential relationship between alexithymia and severe asthma as a chronic inflammatory disease and the ways this correlation can be assessed and managed in the Outpatient Asthma Clinic to ensure a global approach to SA patients. Findings reported in literature suggest that, among severe asthma patients, alexithymia is present even if the prevalence of this disorder has not yet been defined. Conclusions: It is likely that the introduction of a gold standard clinical psychological evaluation in medical settings, such as clinical allergy and immunology, may allow to support suffering patients helping them to adequately elaborate their particular condition developing useful strategies to control and to manage with their severe asthma.
Acromegaly is associated with somatic disfigurements which impair self-perception of well-being and quality of life. Nowadays, limited data are available on the interplay between hormonal excess and ...psychological discomfort. The study aimed at investigating the psychological profile, sleep quality, sexual function, cognitive functions, and quality of life in patients with acromegaly.
In 223 acromegaly patients from 5 referral centres, global psychological profile, sleep quality, sexual function, cognitive function, and quality of life were investigated.
Depression was found in ~30% of patients, and anxiety in two-thirds, together with severe discomfort in body image mainly in women. Obstructive sleep apnoea syndrome risk and sleep disorders were found in >50% of patients and daily sleepiness in ~20%. Sexual dysfunction was reported in most of the patients, with the most severe impairment in women. Cognitive functions were compromised in ~10% of cases. Disease duration and patient's age and gender were the main determinants of these psychopathological conditions. Depression (P = 0.047), somatic-affective mood lowering (P = 0.021), state (P < 0.001) and trait (P = 0.013) anxiety, and body image distortion in body uneasiness test A (P < 0.001) and B (P = 0.006) were significantly worsened in patients <45 years and slightly worsened in those with disease duration less than 2 years. Male (P < 0.001) and female (P < 0.001) sexual function scores were significantly worsened in patients aged >64 years and slightly worsened in those with disease duration for more than 10 years, particularly in presence of cardiometabolic and respiratory complications. Cognitive symptoms were slightly worsened in older patients and in those with long disease duration.
Acromegaly is associated with a relevant impairment of psychological profile persisting despite remission and long-term medical treatment.
•Finding of HP-LT metamorphism in Elba Island.•Implications for the geodynamic evolution of N. Apennines.•Revision of the tectonic units involved in the N. Appennine stacking.
The inner Northern ...Apennines belt (i.e., northern Tyrrhenian Sea and Tuscany) is an Alpine chain affected by high-P metamorphic conditions during its evolution. Although Elba Island is structurally located close to the Adria-Europe suture zone, for several authors it represents a sector of the orogen affected by low-P metamorphism. The involvement of Elba Island tectonic units in high-P metamorphism was only suspected for the sparse presence of phengitic white mica in the metasedimentary rocks. This paper presents the first clear evidence of high-P and low-T metamorphism found in metabasite rocks embedded in the Cretaceous calcschist of eastern Elba Island. Mineral composition of metabasite includes Gln+Cpx+Ep+Ab+Act+Qtz+Ilm±Ti-oxide±Spn and is indicative of a former equilibration in the epidote blueschist subfacies and subsequent retrogression in the greenschist facies. Recorded metamorphic conditions are P=0.9–1.0GPa and T=330–350°C. Tectonic discrimination using immobile elements in the metabasite does not point to an oceanic setting. As a consequence, the metasedimentary succession containing metabasite is explained as belonging to the Tuscan continental domain and not to the Ligurian-Piedmont Ocean, as previously interpreted. Our results have two significant implications: (i) it is confirmed and strengthened that the tectonic stacking of the Elba Island units did not occur in a low-pressure context; (ii) Elba Island is now completely reconciled in the tectonic and metamorphic evolution of the inner Northern Apennines.
Primary graft dysfunction (PGD) and ischemia-reperfusion injury (IRI) occur in up to 30% of patients undergoing lung transplantation and may impact on the clinical outcome. Several strategies for the ...prevention and treatment of PGD have been proposed, but with limited use in clinical practice. In this study, we investigate the potential application of sevoflurane (SEV) preconditioning to mitigate IRI after lung transplantation. The study included two groups of swines (preconditioned and not preconditioned with SEV) undergoing left lung transplantation after 24-hour of cold ischemia. Recipients’ data was collected for 6 hours after reperfusion. Outcome analysis included assessment of ventilatory, hemodynamic, and hemogasanalytic parameters, evaluation of cellularity and cytokines in BAL samples, and histological analysis of tissue samples. Hemogasanalytic, hemodynamic, and respiratory parameters were significantly favorable, and the histological score showed less inflammatory and fibrotic injury in animals receiving SEV treatment. BAL cellular and cytokine profiling showed an anti-inflammatory pattern in animals receiving SEV compared to controls. In a swine model of lung transplantation after prolonged cold ischemia, SEV showed to mitigate the adverse effects of ischemia/reperfusion and to improve animal survival. Given the low cost and easy applicability, the administration of SEV in lung donors may be more extensively explored in clinical practice.
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