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BACKGROUND: Paracentesis-induced circulatory dysfunction (PICD) is a “silent killer syndrome” occurring after large volume paracenteses (LVPs). We here report an unusual case of PICD induced by right heart failure recognized and managed successfully. CASE PRESENTATION: A 60-year-old woman was admitted to our Emergency Department for worsening dyspnea and hypoxia. Her medical history enclosed a chronic heart failure with reduced ejection fraction and post-stroke dysarthria associated to right hemiplegia. Clinical and laboratory examination defined a severe rightheart failure unresponsive to high-dose diuretic therapy. Diagnostic and therapeutic paracentesis was thus performed determining, initially, a progressive normalization of the abdominal volume, followed, subsequently, by a severe hypotension associated with an acute kidney injury (AKI) combined with severe hyponatremia associated with a normal cardiac output. In the hypothesis of a PICD, abdominal drainage and diuretic therapy were interrupted, reninemia sampling was performed, resulting in diagnostic, and treatment with albumin and norepinephrine was started. The latter was tapered and then replaced with Midodrine that conferred the possibility to reach clinical and laboratory stability, allowing relocation in a cardiological rehabilitation. PICD represents an independent predictor of mortality. Midodrine’s prophylactic use in PICD has been suggested as a cheaper alternative to albumin, as it appears to improve renal perfusion and reduce ascites with better clinical handling, as demonstrated in our patient. CONCLUSIONS: Our clinical case wants to show how not all PICDs are secondary to hepatic dysfunctions with Midodrine playing a possible therapeutic role by counteracting the pathophysiological mechanism in a rapid and non-invasive way, representing a valid therapeutic option in adjunction to albumin. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Microscopic colitis is a not uncommon chronic inflammatory disease of the colon, characterized by watery, nonbloody diarrhea, which is often forgotten and misdiagnosed. CASE PRESENTATION: In this paper, we present a puzzling case of relapsing chronic diarrhea triggered by non-steroidal anti-inflammatory drug (NSAID) abuse, smoking, inappropriate antibiotic use, and secondary Clostridium Difficilis infection. Several tests were performed during hospitalization, all of which were negative apart from fecal calprotectin (> 6,000 mg/kg, normal values < 50 mg/kg) and a positive Clostridium Difficilis toxin test. Since Vancomycin treatment did not bring about the expected response, colonoscopy was performed, which led to diagnosis, targeted therapy, and clinical resolution. Targeted therapy with budesonide and probiotics was initiated leading to resolution of the diarrhea. CONCLUSIONS: This case study shows how actual diagnosis may be delayed not only due to having to perform differential diagnosis with chronic inflammatory diseases, but also because certainty can only come from histological evidence, which takes time to obtain, especially when the disease's multifactorial nature is considered (smoking, NSAID abuse, oral proton pump inhibitors, inappropriate antibiotic use, and Clostridium difficilis infection). [ABSTRACT FROM AUTHOR]

OBJECTIVE: Several mRNA vaccines have been developed to tackle the global pandemic. Despite their remarkable clinical efficacy, they are not devoid of severe short- and longterm adverse events. CASE PRESENTATION: In this paper, we describe a rare delayed adverse event (arterial and venous renal thrombosis with myocardial injury) in an otherwise healthy adult female, which occurred three months after she received a booster shot of Pfizer COVID-19 vaccine. The patient was successfully treated for subacute renal ischemia with intra-arterial urokinase, and her myocardial injury was diagnosed with imaging (contrast-enhanced thoracic CT and cardiac magnetic resonance) and percutaneous coronary intervention. Deferred post-vaccine myocarditis was diagnosed and resolved with steroid therapy. CONCLUSIONS: In this paper, we report a useful clinical case for the pharmacovigilance database. Although scientific evidence confirms that the benefits of vaccination far outweigh the risk of adverse events, we would like to point out how important watchful observation is in the medium and long term, especially when the subject belongs to a specific risk category. [ABSTRACT FROM AUTHOR]

The article presents a study aimed to develop a cost-of-illness model that would investigate the costs associated with the management of patients suffering from asthma and severe asthma in the context of acute episodes managed in the emergency room. It mentions that Asthma and severe asthma impose a high burden on patients and society due to its chronicity, losses of productivity, and an increase in use of healthcare resources.

Abstract: Invasive interfaces with the Peripheral Nervous System (PNS), which currently rely on electric means for both nerves stimulation and signals recording, are needed in a number of applications, including prosthetics and assistive technologies. Recent studies showed that the quality of the signal-to-noise ratio of the afferent channel might be negatively affected by physiological reactions, including fibrosis. In this paper we propose a novel approach to the development of implantable neural interfaces, where the PNS is excited electromagnetically and in situ, while electrical means are used only for neural signals recording. Electromagnetic (EM) waves, capable of overcoming fibrotic capsules, are generated by microfabricated coils. Stimulation coils and registration electrodes are deposited on the same flexible substrate, also provided with a bio-absorbable coating, which releases anti-fibrotic drugs and neurons-specific functionalized magnetic nanoparticles (NPs). The NPs are intended to improve the capability of local EM waves to elicit membranes depolarization, thus enhancing selectivity. This paper details the concept of the proposed technology and provides a preliminary in silico feasibility study. [Copyright &y& Elsevier]

Background: Hearing loss is a common problem in modern society due to the combined effects of noise, aging, disease, and heredity. According to 2005 estimates by the World Health Organization (WHO), 278 million people worldwide have moderate to profound hearing loss in both ears. Incidence increases with age. Approximately 31.4% of people over age 65 have hearing loss and 40% to 50% of people 75 and older have a hearing loss. Only 1 out of 5 people who could benefit from a hearing aids actually wears one. Objective: To review literature for articles that focus on hearing aids. State of the Art: Hearing aids have continuously evolved over the past 50 years, in term of styles and technology. Technological advances in hearing aids and HATS (Hearing Assistive Technologies, and Rehabilitation Services) have expanded the range of options available to improve the success of a device use. Today's hearing aids differ significantly from their analog predecessors because the application of digital signal processing has permitted many adaptive and/or automatic features. Included in the benefits of digital hearing aids are improved sound quality, multiple listening programs for different listening environments, advanced noise reduction strategies, acoustic feedback reduction, compatibility with remote control options, and flexibility in manipulation of the frequency, compression, and gain. Conclusions: The hearing aids continue to be developed to enhance the characteristics in terms of rehabilitation and acceptability. [ABSTRACT FROM AUTHOR]