Anatomic features in SCAD assessed by CCT: A propensity score matching case control study.

PURPOSE: Spontaneous coronary artery dissection (SCAD) may occur in middle age population without any cardiovascular risk factor. We retrospectively evaluated anatomic features of 11 patients with SCAD using a coronary arteries computed tomography (CCT), compared to age and sex balanced patients who underwent CCT. MATERIAL AND METHODS: CCT was performed in 11 patients (7 females and 4 males) as follow-up in patients with SCAD (left anterior descending - LAD or circumflex artery - Cx) and compared, using the propensity score matching analysis, with 11 healthy patients. Several anatomic features were evaluated: Left main (LM) length, angle between descending coronary artery (LAD) and its first branch, angle between LAD and LM, distance from the annulus to RCA (a-RCA distance) and LM (a-LM distance) ostia and their ratio; ratio between LM length and length a-LM and tortuosity score of the vessel with SCAD. A fluid dynamic analysis has been performed to evaluate the effects on shear stress of vessels wall. RESULTS: LM length was significantly shorter in patients with SCAD versus healthy subjects (P=0.01) as well as LM length/a-LM (P=0.03) and the angle between LAD and the first adjacent branch was sharper (P<0.01). Tortuosity score showed a statistically significant difference between groups (P<0.001). Fluid dynamic analysis demonstrates that, in SCAD group, an angle<90 degree is present at the first bifurcation and it can be a cause of increased strain on vessel wall in patients with high tortuosity of coronary artery. CONCLUSION: Tortuosity and angle between the LAD and the adjacent arterial branch combined may determine increased shear stress on the vessel wall that increases the risk of SCAD.

Endermologie: humoral repercussions and estrogen interaction.

Endermologie is a motorized rhythmic folding-unfolding and suction technique of the panniculus adiposus. Our study shows that one 40-min Endermologie session produces no noticeable changes in biological parameters, except for plasma estradiol levels, which vary significantly, first by decreasing during the session, then by increasing afterward. Such an Endermologie/estrogen interaction can be compared to the clinical effects observed in some patients undergoing regular Endermologie treatment: return of menses in amenorrheal patients and a trophic effect on skin and subcutaneous connective tissue comparable to that observed during postmenopausal hormone replacement therapy. Understanding such an interaction with the estrogen metabolism requires additional studies and opens many paths for research on therapeutic applications before and after menopause beyond refinement of the body contour and improvement of the appearance of the panniculus adiposus.

[Temporary caval filters. Our experience. Preliminary analysis of 24 cases]. / Filtres caves temporaires. Notre expérience. Analyse préliminaire de 24 cas.

The AA. utilized temporary vena cava filters (16 Filcard and 8 Lysofilters) in 24 patients affected by deep venous thrombosis (DVT) of the lower limbs for the prevention of primary and recurrent pulmonary embolism (PE). The diagnosis of thromboembolic disease was always achieved by means of Ultrasounds (echo-color doppler) and was punctually confirmed by a retrograde cavagram during the insertion of the device. 19 patients presented large free-floating thrombi at inferior caval, iliac or common femoral vein level whereas 5 patients presented thrombi mostly of occlusive aspect. There was clinical or scintigraphic evidence of PE in 6 of the patients enrolled. 20 patients, without contraindications, were treated by fibrinolysis (F) with Urokinase (2-10 days) whereas 4 patients underwent surgical thrombectomy (T) because of short time relation with surgical intervention or trauma. All of them were protected by temporary vena cava filters and heparinized. All the filters were removed within 10 days. The results were considered "very good" (complete regression of floating thrombi) in 16 cases (14 F + 2 T), "good" (nearly complete regression of floating thrombi) in 3 cases (2 F + 1 T) and "poor" (unchanged) in the remaining 5 cases (4 F + 1 T). We didn't observe any new case or relapse of PE in the whole group and, furtherly, in 2 cases (1 F and 1 T) we demonstrated the capture of big emboli by the filter's basket. These clots were subsequently dissolved by fibrinolysis. To achieve the diagnosis of thromboembolic disease the following methods were used: 1--Screening: echo-color doppler of lower limbs extended to iliac and inferiora cava veins for detection of DVT and echocardio-color doppler for the detection of cardiac signs of PE. 2--DIAGNOSIS: pulmonary scintigram, retrograde cavogram and, rarely, angioCT scan. 3--FOLLOW-UP: echo-color doppler of lower limbs and pulmonary scintigram. The percutaneous insertion sites were the basilic vein (Filcard) and the right jugular vein (Lysofilter). Left jugular vein was used in 1 case with a big thyroid goitre. In the present experience we had no accidents during filters introduction or removal and no thrombosis at the insertion site (1 case of phlebitis of basilic vein). Indications and effectiveness: our results seem to be favorable to the use of inferior vena cava temporary filters for primary and recurrent pulmonary embolism prevention in the cases with floating thrombi both on fibrinolysis and embolectomy. In the cases of occlusive thrombotic diseases they proved to be effective to prevent PE during surgical embolectomy.(ABSTRACT TRUNCATED AT 400 WORDS)

Contamination of human milk with ochratoxin A.

Ochratoxin A is a mycotoxin frequently found as a contaminant both in food and in animal feed. It can reach humans through the food chain and can then be excreted in biological fluids, one of which is human milk; it can therefore be transmitted from mother to child during breast-feeding. This fact prompted us to carry out the present study, aimed at the determination of ochratoxin A in human milk in Italy, as done elsewhere. Fifty samples of human milk were collected randomly over one year and analysed by a high-performance liquid chromatography method. Nine samples were found to contain levels in the range of 1.7-6.6 ng/ml.

[Effects of hypertrophy on cardiac systolic and diastolic performance in athletes with mild hypertension]. / Effetti dell'ipertrofia sulla performance cardiaca sistolica e diastolica in atleti con ipertensione lieve.

Aims of the study has been the evaluation of morphological and functional aspects of left ventricle in subjects undergoing mild hypertension and sport adaptation effects. These evaluations have been carried out by Echo-Doppler both at rest and during sharp increase in after load induced by isometric stress. Together with the morphological parameters represented by mass index and by radius to thickness ratio, we have studied stroke volume and transmitral flow pattern assessing the maximum flow velocity during rapid filling phase (E), during atrial contraction phase (A) and their ratio (E/A). We have studied 31 male subjects from 39 to 60 (average 47) exercising twice or three times a week (in the main, aerobic sports such as road cycling). They were subdivided into two groups, the first included 16 subjects with mild hypertension (AP = 155 +/- 9/97 +/- 5 mmHg) the second included 15 normotensive subjects without known pathologies, comparable for age and body surface (AP = 125 +/- 15/77 +/- 10 mmHg). Hypertensive subjects exercising regularly, showed a mass index (164 +/- 42 g/m2) significantly higher than the controls (139 +/- 35 g/m2, P less than 0.01) but they ke a normal filling pattern at rest and similar stroke volume values. During isometric exercise instead, the velocities of E and A waves showed a different trend in the two groups with a higher reduction in E/A ratio in hypertensive subjects. The per cent decrease in this ratio turned out to be 15% in the control group and 33% in hypertensive subjects (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

A new periareolar mammaplasty: the "round block" technique.

The "round block" acts as a keystone supporting the mammary cone. The keystone lies in the dermodermic, glandulo-glandular, and glandulo-musculoperiosteal unions fixed definitively with nonresorbable suture, by a crisscross mastopexy, and by a circular nonresorbable suture of woven nylon included in the periareolar circular dermo-dermic scar block. This technique can be used in numerous types of breast surgery: In cases of ptosis or hypertrophy, it allows the scar to go up to the periareolar circle which is in itself generally inconspicuous. In cases of hypotrophy, the use of the round block technique permits easy access for insertion of the prosthesis as it simultaneously corrects ptosis. In cases of tumoral excision, the round block produces a discreet scar and a more regular breast contour. In all types of mammoplasty, the main goal is to limit the scar. The scar in the submammary fold is visible, particularly when one is lying down. The ideal result is confining the scar to the periarolar area.

Long term administration of low doses of mycotoxins in poultry. 2. Residues of ochratoxin A and aflatoxins in broilers and laying hens after combined administration of ochratoxin A and aflatoxin B1.

The effects of combined administration of ochratoxin A (OA) and aflatoxin B1 (AFB1) on the occurrence and the levels of residues of mycotoxins in poultry have been investigated. Male broilers and laying hens were fed from 14 days old with standard diets contaminated with 50 micrograms/kg OA and 50 micrograms/kg AFB1. Two groups of broilers and hens were withdrawn from contaminated feed at 37 and 88 days, respectively. At the time of sacrifice no significant lesions were found. Residues were compared with those found after administration of either toxin alone in former trials. Combined treatment resulted in higher content of OA in broiler livers (40 versus 5.0 micrograms/kg) and, to a lesser extent, in kidneys and skin, and of AFB1 in broiler liver and kidney (0.15 versus 0.02 microgram/kg and 0.40 versus 0.05 microgram/kg respectively). Laying hens showed smaller differences (0.20 versus 0.10 microgram/kg in liver and 0.32 versus 0.08 in kidneys). Withdrawal from treatment led to the almost complete disappearance of OA residues in broilers and in hens. These results show a synergistic effect of OA and AFB1, particularly in broilers.