Search

Plant protection products (PPPs) play a fundamental role in the maintenance of agricultural fields and private/public green areas, however they can contaminate zones nearby the application point due to wind drift, resuspension, and evaporation. Several studied have deepened the relationship between PPPs and living beings' health, suggesting that these products might have a negative influence. Some PPPs belong to the class of Emergent Contaminants, which are compounds whose knowledge on the environmental distribution and influence is limited. These issues are even more stressed in urban aerosol, due to the high residential density that characterizes this area. Therefore, this study assessed the contamination caused by polar PPPs, such as herbicides (i.e., Glyphosate), fungicides (i.e., Fosetyl Aluminium), and growth regulators (i.e. Maleic Hydrazide), in size-segregated urban aerosol and evaluated their concentration variability with respect to atmospheric parameters (humidity, temperature, rain). Moreover, hypotheses on possible sources were formulated, exploiting also back-trajectories of air masses. A total of six PPPs were found in the samples: glyphosate was more present in the coarse fraction (2.5–10 μm), Fosetyl Aluminium, chlorate and perchlorate were more present in the coarse/fine fractions (10-1 μm), while cyanuric acid and phosphonic acid were mostly concentrated in the fine/ultrafine fractions (<1 μm). While for the first four we suspect of local sources, such as private gardening, the two latter might derive from the entire Po Valley, a highly polluted area in the North of Italy, and from degradation of other substances. [Display omitted] • Size-segregated urban aerosol was sampled with a cascade impactor for two months. • Glyphosate, Fosetyl Aluminium, Chlorate and Perchlorate were in the 10-1 μm range. • Cyanuric acid and Phosphonic acid were most in the fine/ultrafine range (<1 μm). • Sources are hypotized to be local for Glyphosate and Fosetyl Aluminium. • A strong contributor is expected to be the Po Valley for the fine fractions. [ABSTRACT FROM AUTHOR]

Among extreme environments, bioaerosol includes a wide range of primary atmospheric organic particles associated with and emitted by living and dead organisms. Bioaerosol samples were collected along two transects at a subArctic Atlantic spatial scale, including the eastern Fram Strait and the Greenland, Norwegian, and North Seas. This study was aimed at first estimating microscopically the prokaryotic abundance, biomass and phenotypic traits, along with the number of potential viable and respiring cells. Moreover, physiological profiles at community level were assessed. Prokaryotic abundance ranged from 104 to 107 cells m−3, with the predominance of small sized cells (0.1 μm3). Prokaryotic biomass reached higher values (mean value 233 μg C m−3) in relation to the occurrence of large sized rods. Overall, the percentage of the viable cells was lower than the dead ones, while respiring cells were in lower abundance than total cells. The physiological profiles revealed various potential metabolic pathways among the samples, highlighting the utilization of phosphate-carbon, carboxylic and amino acids. These first results on the metabolism and physiology of microbes, which survived transport in the atmosphere of the Northern Hemisphere, suggest that bioaerosol constitutes an extremely dynamic environment of remarkable ecological interest, also considering future global warming scenarios. [ABSTRACT FROM AUTHOR]

Transplante renal é o tratamento padrão‐ouro na doença renal em estágio terminal. Embora diferentes variáveis hemodinâmicas, tais como pressão venosa central e pressão arterial média, têm sido usadas para orientar a estratégia de reposição volêmica durante a cirurgia, a melhor estratégia ainda não foi determinada. A Variação da Pressão de Pulso (VPP) durante o ciclo respiratório é reconhecida como um bom preditor da resposta à infusão de volume para otimização hemodinâmica perioperatória no centro cirúrgico. O objetivo do estudo foi estudar se a estratégia de reposição de volume orientada por VPP é melhor do que a estratégia liberal de reposição de volume durante cirurgia de transplante renal. O principal objetivo do estudo foi identificar diferença no débito urinário na primeira hora do pós‐operatório. Realizamos estudo prospectivo, unicego, randomizado, controlado. Incluímos 40 pacientes submetidos a transplante renal de doador cadáver. Pacientes randomizados para o Grupo VPP receberam volume quando a VPP estava acima de 12%, e os pacientes no Grupo Reposição Liberal receberam volume de acordo com o nosso protocolo institucional padrão de assistência para transplante renal (10 mL.kg‐1.h‐1). O débito urinário foi semelhante em todos os tempos nos dois grupos, a ureia foi estatisticamente diferente a partir do terceiro dia do pós‐operatório com pico no quarto dia do pós‐operatório e a creatinina apresentou tendência semelhante, tornando‐se estatisticamente diferente a partir do segundo dia do pós‐operatório. Ureia, creatinina e débito urinário não estavam diferentes na alta hospitalar. A terapia orientada por VPP durante transplante renal melhorou de forma significativa os níveis de ureia e creatinina na primeira semana pós‐transplante renal. Kidney transplantation is the gold‐standard treatment for end stage renal disease. Although different hemodynamic variables, like central venous pressure and mean arterial pressure, have been used to guide volume replacement during surgery, the best strategy still ought to be determined. Respiratory arterial Pulse Pressure Variation (PPV) is recognized to be a good predictor of fluid responsiveness for perioperative hemodynamic optimization in operating room settings. The aim of this study was to investigate whether a PPV‐guided fluid management strategy is better than a liberal fluid strategy during kidney transplantation surgeries. Identification of differences in urine output in the first postoperative hour was the main objective of this study. We conducted a prospective, single blind, randomized controlled trial. We enrolled 40 patients who underwent kidney transplantation from deceased donors. Patients randomized in the PPV Group received fluids whenever PPV was higher than 12%, patients in the Free Fluid Group received fluids following our institutional standard care protocol for kidney transplantations (10 mL.kg‐1.h‐1). Urinary output was similar at every time‐point between the two groups, urea was statistically different from the third postoperative day with a peak at the fourth postoperative day and creatinine showed a similar trend, being statistically different from the second postoperative day. Urea, creatinine and urine output were not different at the hospital discharge. PPV‐guided fluid therapy during kidney transplantation significantly improves urea and creatinine levels in the first week after kidney transplantation surgery. [ABSTRACT FROM AUTHOR]

The Arctic region is threatened by contamination deriving from both long-range pollution and local human activities. Polycyclic Aromatic Hydrocarbons (PAHs) are environmental tracers of emission, transport and deposition processes. A first campaign has been conducted at Ny-Ålesund, Svalbard, from October 2018 to May 2019, monitoring weekly concentrations of PAHs in Arctic surface snow. The trend of the 16 high priority PAH compounds showed that long-range inputs occurred mainly in the winter, with concentrations ranging from 0.8 ng L−1 to 37 ng L−1. In contrast to this, the most abundant analyte retene, showed an opposite seasonal trend with highest values in autumn and late spring (up to 97 ng L−1), while in winter this compound remained below 3 ng L−1. This is most likely due to local contributions from outcropping coal deposits and stockpiles. Our results show a general agreement with the atmospheric signal, although significant skews can be attributed to post-depositional processes, wind erosion, melting episodes and redistribution. [Display omitted] • PAH concentrations in Arctic surface snow change at seasonal scale. • Long-range deposition of PAHs occurs mainly during winter. • The strong seasonality detected for retene reflects local coal inputs. • The signal obtainable from snow deposition is detached from atmospheric trends. [ABSTRACT FROM AUTHOR]

• Although careful selection of transplant candidates, the risk of cardiovascular events is still present after transplantation. • Hemodynamic instability represents a leading cause of post-transplant morbidity and mortality. • Different strategies are reported to prevent and manage these events. [ABSTRACT FROM AUTHOR]

Compromised liver function, as a consequence of acute liver insufficiency or severe chronic liver disease may be associated with various neurological syndromes, which involve both central and peripheral nervous system. Acute and severe hyperammoniemia inducing cellular metabolic alterations, prolonged state of “neuroinflammation”, activation of brain microglia, accumulation of manganese and ammonia, and systemic inflammation are the main causative factors of brain damage in liver failure. The most widely recognized neurological complications of serious hepatocellular failure include hepatic encephalopathy, diffuse cerebral edema, Wilson disease, hepatic myelopathy, acquired hepatocerebral degeneration, cirrhosis-related Parkinsonism and osmotic demyelination syndrome. Neurological disorders affecting liver transplant candidates while in the waiting list may not only significantly influence preoperative morbidity and even mortality, but also represent important predictive factors for post-transplant neurological manifestations. Careful pre-transplant neurological evaluation is essential to define severity and distribution of the neurological impairment, to identify the abnormalities still responsive to current treatment, and to potentially predict the inherent post-operative prognosis. The preferred specific indices of neurological pre-transplant assessment may vary among centers, however, even with the aid of the current biochemical, neurophysiological, neuropsychological and neuroimaging diagnostic tools, the correct diagnosis and differential diagnosis of various syndromes may be difficult. In this article the relevant pathophysiological and clinical aspects of the most frequent brain and peripheral nervous system diseases affecting liver transplant candidates with acute or advanced chronic liver failure are briefly reported. The practical diagnostic findings useful for the preoperative assessment and treatment, as well as the expected neurological evolution after liver transplantation are also evaluated. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) increases the risk of non-neoplastic portal vein thrombosis (PVT) in cirrhosis. However, data on its natural history and prognostic role in HCC-patients are lacking. Cirrhotic HCC-patients undergoing laparoscopic ablation were consecutively enrolled (2015-2018) and followed until transplantation or up to 36months. HCC and PVT (baseline and incident) characteristics, and their evolution in the first 12months, were reviewed by a single radiologist. PVT evolution was categorized according to changes in occlusion (cut-off 20%) and extension to other segments as: 'complete/progressive': partial-PVT progressing to complete, complete-PVT not improving or, PVT extending to other segments; 'partial/ameliorated': partial-PVT improving or remaining stable, complete-PVT improving. Variables associated with presence of PVT and evolution patterns were analyzed, as well as its impact on survival. Seven-hundreds-fifty patients were included, 88 with PVT (78.4% partial, 43.2% extended to mesenteric and/or splenic vein). On multivariate analysis, presence of PVT was associated with pre-treatment total-tumor-volume (TTV) (OR1.10, p<.0001) and clinically-significant portal hypertension (OR2.90, p=.0046). During follow-up, 46 incident PVT occurred, 27/46 (58.7%) in the presence of viable tumor. Among total 115 PVT diagnosed in presence of HCC, 83 had available radiological follow-up (77.1% partial, 41% extended to the mesenteric and/or splenic vein), and 22 were anticoagulated. The 'complete/progressive' evolution pattern was associated with occlusive PVT at diagnosis and absence of anticoagulation in all PVT; whereas to Child C score and non-response to HCC treatment in non-anticoagulated patients. Overall survival was lower in presence of PVT, specifically for 'complete/progressive' PVT [HR3.9, p<0.001]. A higher cumulative risk of death emerged for 'complete/progressive' PVT, both for HCC-related (p<0.001) and non-HCC-related (p<0.001) death. Non neoplastic PVT in HCC seems to be characterized by a higher risk of progression when not anticoagulated, correlated with the HCC activity. Complete/progressive PVT is an independent factor associated with mortality, regardless of HCC evolution. [ABSTRACT FROM AUTHOR]

The management of gastric varices (GV) depends on anatomical and hemodynamic features and balloon-occluded retrograde transvenous obliteration (BRTO) is recommended for the occlusion of GV-associated with gastro-renal shunts (GRS). We report a prospective case-series in which we used the trans-splenic route to perform occlusion of GV for prophylaxis of variceal bleeding or refractory encephalopathy. Trans-splenic access was obtained by puncturing a splenic venous branch under ultrasound/fluoroscopic guidance. Through a 5-Fr sheath a 2.7"microcatheter was introduced into the varices and embolization was performed using detachable microcoils +/- a mixture of N-butyl-cyanoacrylate (NCBA)-Lipiodol. A venography was performed to assess technical success. The percutaneous tract was embolized using a NBCA-Lipiodol mixture. All patients underwent upper gastrointestinal-endoscopy at follow up to evaluate worsening of esophageal varices and amelioration of GV. Ten patients with different indications were enrolled: 3 for primary prophylaxis (1 GOV1, 2 IGV1), 6 for secondary prophylaxis (1 GOV1, 5 GOV2) of GV bleeding and 1 for post-transplant shunt-related persistent encephalopathy (IGV1). In all patients, the GRS [median size 22mm (range 15-32mm)]was accessed by trans-splenic route and the GV was embolized with a median of 10 microcoils (range 5-18), with addition of NBCA-Lipiodol in 6patients. The mean time in the angiography suite was 135min (range 105-180min), while the mean procedure-time was 75min (range 45-120min). Besides mild local abdominal pain at access, 3 patients presented acute partial splenic +/- portal thrombosis, which regressed in all with anticoagulation. During follow-up (median 5months, range 1-12months) no bleeding was observed, liver function remained stable and no patient developed/worsened ascites. Endoscopic follow-up showed a significant reduction of GV or filling with coils (Fig.1), without worsening of esophageal varices. TACATO seems to be a safe and efficient method to obliterate GV associated with GRS and it can be considered as alternative to BRTO in the algorithm of treatment. [ABSTRACT FROM AUTHOR]

North-Eastern Italy and in particular Veneto Region, stands out as a major centre of agriculture and viticulture which has rapidly expanded in the last decade with high productivity indexes. In this context, assessing atmospheric pollution caused by crop spraying with pesticides in rural areas and their transport to high-altitude remote sites is crucial to provide a basis for understanding possible impacts on the environment and population health. We aim to improve existing methods with a highly sensitive technique by using high pressure anion exchange chromatography coupled to a triple quadrupole mass spectrometer. Thus, a total of fourteen polar pesticides were determined in aerosol samples collected from August to December 2021 at Roncade (Venetian plain) and Col Margherita Observatory (Dolomites). The observatory was chosen as the background site as it is representative of the surrounding alpine region. Some samples revealed a substantial amount of cyanuric acid mainly at Roncade (mean concentration of 10 ± 10 ng m−3), glyphosate and fosetyl-aluminium (0.1 ± 0.2 and 0.1 ± 0.1 ng m−3, respectively). Surprisingly, some pesticides have been also found at Col Margherita, a high mountain background site, with concentrations an order of magnitude lower than at Roncade. This is the first time that fourteen polar pesticides have been assessed in the aerosol phase of the Po' Valley and detected at a high-altitude remote site, and consequently this study provides the first data on their occurrences in Italian aerosols. It represents a basis for the assessment of risks for humans. [Display omitted] • A sensitive method was developed for fourteen pesticides in atmospheric aerosol. • The spray drift is likely the main atmospheric source of pesticides at rural site. • Both valley breeze and boundary layer affected the pesticides load in the Alps. • Preliminary assessments are provided on the risk posed by pesticide drift to human. [ABSTRACT FROM AUTHOR]

Background Acupuncture is a safe and well-tolerated treatment for pain relief. Previous studies supported the effectiveness of several acupuncture techniques for postoperative pain. The aim of this randomized, controlled trial was to evaluate the efficacy of acupuncture in reducing pain after thyroid surgery. Methods We randomized 121 patients to a control group (undergoing only standard postoperative analgesic treatment with acetaminophen) and an acupuncture group, undergoing also either electroacupuncture (EA) or traditional acupuncture (TA). Pain was measured according to intraoperative remifentanil use, acetaminophen daily intake, Numeric Rating Scale (NRS), and McGill Pain Questionnaire on postoperative days (POD) 1–3. Results Acupuncture group required less acetaminophen than controls at POD 2 ( P = .01) and 3 ( P = .016). EA patients required less remifentanil ( P = .032) and acetaminophen than controls at POD 2 ( P = .004) and 3 ( P = .008). EA patients showed a trend toward better NRS and McGill scores from POD 1 to 3 compared with controls. EA patients had a lower remifentanil requirement and better NRS and McGill scores than TA patients. No differences occurred between TA patients and controls. Conclusion Acupuncture may be effective in reducing pain after thyroid surgery. EA is more useful; TA achieves no significant effects. [ABSTRACT FROM AUTHOR]

Objective: To identify all interventions that increase or reduce mortality in patients with acute kidney injury (AKI) and to establish the agreement between stated beliefs and actual practice in this setting. Design and Setting: Systematic literature review and international web-based survey. Participants: More than 300 physicians from 62 countries. Interventions: Several databases, including MEDLINE/PubMed, were searched with no time limits (updated February 14, 2012) to identify all the drugs/techniques/strategies that fulfilled all the following criteria: (a) published in a peer-reviewed journal, (b) dealing with critically ill adult patients with or at risk for acute kidney injury, and (c) reporting a statistically significant reduction or increase in mortality. Measurements and Main Results: Of the 18 identified interventions, 15 reduced mortality and 3 increased mortality. Perioperative hemodynamic optimization, albumin in cirrhotic patients, terlipressin for hepatorenal syndrome type 1, human immunoglobulin, peri-angiography hemofiltration, fenoldopam, plasma exchange in multiple-myeloma-associated AKI, increased intensity of renal replacement therapy (RRT), CVVH in severely burned patients, vasopressin in septic shock, furosemide by continuous infusion, citrate in continuous RRT, N-acetylcysteine, continuous and early RRT might reduce mortality in critically ill patients with or at risk for AKI; positive fluid balance, hydroxyethyl starch and loop diuretics might increase mortality in critically ill patients with or at risk for AKI. Web-based opinion differed from consensus opinion for 30% of interventions and self-reported practice for 3 interventions. Conclusion: The authors identified all interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI and found that there is discordance between participant stated beliefs and actual practice regarding these topics. [Copyright &y& Elsevier]

Background: Our initial experience in applying robotic-assisted technologies for the treatment of myasthenia gravis (MG) in patients without thymoma is reported. Methods: from April 2002 to October 2004, 33 patients (24 females and 9 males; mean age, 41 years), with clinical nonthymomatous myasthenia gravis, underwent robotic thoracoscopic thymectomy using the “da Vinci” (Intuitive Surgical, Inc, Mountain View, CA) system and adopting a 3 port, left-sided approach. Results: Mean operative time was 120 minutes. No intraoperative complications or surgical mortality is reported and postoperative complications occurred in two patients (6%). Mean hospital stay was 2.6 days (range, 2–14 days). Histologic analysis of surgical specimens revealed 23 hyperplasia, 4 normal thymus, 4 atrophy, and 2 thymomas; in 12 patients (36.3%) ectopic thymic tissue was found. Follow-up evaluation of the first 24 patients (mean, 23.8 months; range, 12–31 months) showed that 4 patients (16.7%) had complete remission and 18 (75%) had significant clinical improvement for a global benefit rate of 91.7%. Conclusions: In patients with MG, robot-assisted thymectomy can be performed safely and efficiently. The improved visualization and dexterity of this instrument and its advanced technology may facilitate the minimally invasive approach to the thymus. We prefer to use the left-sided approach because it provides an enhanced visualization of the aortic window and it reduces the probability of phrenic nerves injury. A longer follow-up is necessary to verify long-term clinical results. [Copyright &y& Elsevier]

Background: The links between the internet and teenager behavior are difficult situations to control and may lead to the development of new and excessive methods of drinking alcohol during alcoholic games. Findings indicate that reported cases are very useful sources for better understanding of alcoholic games, yielding successful measures promoting health among adolescents. Admittance of adolescents to hospital emergency departments (EDs) after consumption of excessive amounts of alcohol has become the norm in developed countries. The harmful effects of acute alcohol abuse are reported in this paper. Objective: The aim of this work was to investigate the close connections between new drinking behaviors among adolescents and study the increase in new alcoholic games, together with the challenges that cause acute alcohol intoxication, the influence of the internet and social networks, and their consequences for public health services. Methods: Data came from prehospital and intrahospital admissions attributable to alcohol consumption. From 2013 to 2015, 3742 patients were admitted to EDs due to acute alcohol intoxication: 830 of them were aged 15 to 30 years, and 225 were adolescents and young adults between 15 and 20 years who had been playing alcoholic games. Retrospectively, diagnostic data associated with extrahospital anamneses were selected by one of the hospital management information systems, Qlik. As a result of our previous experience, questionnaires and face-to-face interviews were performed at a later stage, when a clinical audit for intoxicated adolescent patients was described, with the overall goal of establishing a potential methodological workflow and adding important information to research carried out so far. Results: Between 2013 and 2015, 830 young patients aged 15 to 30 years were admitted to EDs for acute alcohol intoxication. About 20% (166/830) of the sample confirmed that they had drunk more than 5 alcoholic units within 2 hours twice during the past 30 days as a result of binge drinking. Referring to new alcoholic games, 41% of the sample stated that they knew what neknomination is and also that at least one of their friends had accepted this challenge, describing symptoms such as vomiting, headache, altered behavior, increased talkativeness, and sociability. The median value of the weighted average cost of the diagnosis-related group relating to interventions provided by hospitals was the same for both genders, €46,091 (US $56,497; minimum €17,349 and maximum €46,091). Conclusions: Drinking games encourage young people to consume large quantities of alcohol within a short period of time putting them at risk of alcohol poisoning, which can potentially lead to accidental injuries, unsafe sex, suicide, sexual assault, and traffic accidents. The spread of these games through the internet and social networks is becoming a serious health problem facing physicians and medical professionals every day, especially in the ED; for this reason, it is necessary to be aware of the risks represented by such behaviors in order to recognize and identify preliminary symptoms and develop useful prevention programs. The strategic role of emergency services is to monitor and define the problem right from the start in order to control the epidemic, support planning, coordinate the delivery of assistance in the emergency phase, and provide medical education. Hospital-based interdisciplinary health care researchers collected specific data on hazardous drinking practices linked to evaluation of increased alcohol-related consequences and cases admitted to the ED. [ABSTRACT FROM AUTHOR]

Background: Cases of trauma resulting from the use of mobile phones while driving motor vehicles have become quite common in recent years. Road injuries incurred by people playing video games on mobile phones (or other media devices) while walking have also become a cause for concern. Pokémon Go has been the world's most popular game since it was launched in July 2016, with more than 15 million players trying to catch all Pokémon available in the game; however, the case detailed here is the first reported accident in the medical literature caused by a pedestrian distracted by the game while crossing a street.Objective: We aim to provide additional information on the innovative nature of distractions that generate risks in road-users, and to explore the underreporting of pedestrian-motor vehicle collisions due to mobile device usage.Methods: We included in this case report a 25-year-old male who suddenly crossed a road while playing Pokémon Go and was hit by a van, reporting several injuries and being assisted by the Emergency Medical Service of our hospital (Padova, Italy). The patient's history, the circumstances in which the collision happened, imaging data, and clinical course information were recorded per our hospital's privacy policy.Results: The patient hit by the van was playing Pokémon Go on his mobile phone while crossing a street, despite red traffic lights, which he did not notice due to of the distraction induced by the game.Conclusions: Mobile videogames that imply movement (ie, walking, running, cycling) to play are an effective way to improve physical activity practice, especially in adolescents and young adults. Nevertheless, cases like the one presented here point out that these games could pose a significant risk to users who play while walking, cycling, or driving in unsafe areas such as city streets, because players become distracted and may ignore surrounding hazards. Comprehensive, multilevel interventions are needed to reduce accidents caused by distraction, and to stress findings on the positive and negative effects of video games, which are becoming a source of public health concern. Health care providers should be aware of their chief role in these possible prevention strategies, based on their direct interactions with road incident victims. [ABSTRACT FROM AUTHOR]

Background: The monitoring and management of risks regarding children and young people admitted to the emergency department as a result of dangerous behaviors distributed via the Internet should be based on clinical reasoning and knowledge about these social media-related phenomena. Here we examine 2 cases of teenagers who reported severe injuries while performing the "planking" craze, a challenge that consists in lying face-down stiffly like a board on any kind of surface. Objective: Our objective is to examine and describe the Internet craze called planking, also known as the "lying-down game," through 2 case reports from our experience, enriching this study with information gained through discussions with secondary school teenagers. Methods: Details of the 2 case reports were taken from electronic medical records giving information on care support processes, care management, and the costs of traumatic episodes. Demographic data, hemoglobin and serum lactate values, and Injury Severity Scores were evaluated. The study took place in secondary schools of our city from 2013 to 2014 during medical education courses, with the aim of analyzing the influence of social media on teenagers' activities and behaviors. Results: Both patients suffered multiple trauma injuries and needed high-level health assistance. The first patient underwent a splenectomy and the second one a nephrectomy; both of them required a long hospital stay (14 and 20 days, respectively), and the costs for their management have been estimated at US $27,000 and US $37,000, respectively. Their decision to perform the planking in dangerous locations was due to their ambition to gain peers' acclaim through shared videos and pictures. Conclusions: Reporting and understanding these cases may potentially help prevent future events occurring in similar circumstances: the scientific community cannot leave this problem unaddressed. There is also a role of education resources for health care professionals; for this, we must identify and follow up strange or misleading information found on websites. A key element of this research study was to report physicians' misperceptions concerning planking and, with these cases used for teaching purposes, improve knowledge of the clinical and forensic aspects of this emerging problem. [ABSTRACT FROM AUTHOR]

Treatment of many inherited disorders of hepatic metabolism is still challenging. Hepatocyte transplantation was done in a 47-year-old woman who had glycogen storage disease type 1a and severe fasting hypoglycaemia. 2 billion viable hepatocytes were infused via an indwelling portal-vein catheter, followed by a triple immunosuppression regimen with mycophenolate mofetil, tacrolimus, and steroids. 9 months after transplantation, on only tacrolimus, she eats a normal diet and can fast for 7 h without experiencing hypoglycaemia. Our results show that hepatocyte transplantation might be an alternative to liver transplantation in glycogen storage disease type 1a. [Copyright &y& Elsevier]