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We here report the first case of anti-proteinase 3–positive anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis following the severe acute respiratory syndrome coronavirus 2 Pfizer-BioNTech vaccine presenting with prominent liver involvement and alveolar haemorrhage. Two weeks after vaccination, a 49-year-old man developed inflammatory arthralgias and hypertransaminasaemia. Two months later, fever and haemoptysis appeared; the patient tested positive for anti-proteinase 3 autoantibodies. High-dose steroids and rituximab were started, and complete remission was achieved. Systemic autoimmune diseases, including ANCA-associated vasculitis, should always be considered in the differential diagnosis of hypertransaminasaemia, especially when the clinical context is suspicious.

Oral nucleos(t)ide analogues (NUCs) are recommended as first-line therapy for chronic hepatitis B (CHB) due to higher HBV-DNA suppression rates and safety profile. Long-term treatment with NUCs is often necessary to achieve durable viral suppression.This review provides an overview of the long-term safety data that have become available since entecavir (ETV) and tenofovir disoproxil fumarate (TDF) were first approved, and recent data on tenofovir alafenamide (TAF) in patients with CHB.NUCs generally show remarkable safety in patients taking them for long periods. Nevertheless, renal and bone toxicity may occur in a minority of patients on TDF therapy. These effects have been overcome by the recent release of TAF. Moreover, the currently available data do not allow firm conclusions on the superiority of TDF on ETV about hepatocellular carcinoma (HCC) risk reduction. Observational studies involving more homogeneous cohorts are therefore needed; furthermore, long-term studies assessing the impact of TAF on this important topic are warranted.

Alterations in nutritional status, in particular sarcopenia, have been extensively associated with a poor prognosis in cirrhotic patients regardless of the etiology of liver disease. Less is known about the predictive value of myosteatosis, defined as pathological fat infiltration into the skeletal muscle. We retrospectively analyzed a cohort of 151 cirrhotic patients with unresectable hepatocellular carcinoma (HCC) who underwent their first trans-arterial embolization (TAE) between 1 March 2011 and 1 July 2019 at our Institution. Clinical and biochemical data were collected. Sarcopenia was assessed using the L3-SMI method while myosteatosis with a dedicated segmentation suite (3D Slicer), using a single slice at an axial plane located at L3 and calculating the IMAC (Intramuscular Adipose Tissue Content Index). The sex-specific cut-off values for defining myosteatosis were IMAC > −0.44 in males and >−0.31 in females. In our cohort, 115 (76%) patients were included in the myosteatosis group; 128 (85%) patients had a coexistent diagnosis of sarcopenia. Patients with myosteatosis were significantly older and showed higher BMI than patients without myosteatosis. In addition, male gender and alcoholic- or metabolic-related cirrhosis were most represented in the myosteatosis group. Myosteatosis was not associated with a different HCC burden, length of hospitalization, complication rate, and readmission in the first 30 days after discharge. Overall survival was not influenced by the presence of myosteatosis.

Purpose To evaluate the post- coronavirus disease-19 (COVID-19) outcome of thyroid function in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related thyrotoxicosis. Methods This was a single-center prospective study involving 29 patients (11 females, 18 males; median age 64 years, range: 43–85) with thyrotoxicosis diagnosed after hospitalization for COVID-19 and then followed-up for a median period of 90 days (range: 30–120) after hospital discharge. At follow-up, patients were evaluated for serum thyrotropin (TSH), free-thyroxine (FT4), free-triiodiothyronine (FT3), TSH receptor antibodies (TRAb), thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb) and ultrasonographic thyroid structure. Results After recovery of COVID-19, serum TSH values significantly increased (P

In an uneven-aged stand, the stone pine natural regeneration process was studied. Seed dispersal was abundant only under pine canopies. Rate and amount of germinations depended on meteorological conditions and on the presence of shrub cover. Seedling survival during the first two years was depressed by shrub cover, but summer droughts had an overwhelming effect. The presence of such interactions between pine seedling and understorey species populations suggest that past management practices of the pinewood (shrub and tree cutting, game management) affected the probabilities of stone pine seedling recruitment : social, economical and technical evolution of these practices probably changed forest micro-environmental conditions and, consequently, reduced the abundance of stone pine natural regeneration., Nous avons étudié quelques aspects de la régénération naturelle du Pin pignon dans une pinède sur la côte de la mer Tyrrhénienne en Toscane. La production de graine est généralement bonne. Environ 90 % des graines tombent sous le feuillage des arbres-mères. Le couvert arbustif d’un côté permet la germination de nombreuses plantules, mais de l’autre, empêche leur survie. La sécheresse au cours de l’été réduit fortement la survie des plantules pendant les deux premières années. A partir des années 40, l’évolution de l’étage arbustif, qui était auparavant éliminé, peut avoir modifié les conditions de la pinède, ce qui a sûrement altéré les possibilités d’implantation et survie des plantules de Pin pignon., Masetti Chiara, Mencuccini Maurizio. Régénération naturelle de Pin pignon (Pinus pinea L.) dans la Pineta Granducale di Alberese. (Parco Naturale della Maremma, Toscana, Italie). In: Ecologia mediterranea, tome 17,1991. pp. 103-118.