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Nicola Zerbinati,1 Anna P&lstrok;atkowska,2 Stefania Guida,3,4 Giorgio Stabile,3,4 Roberto Mocchi,5 Chiara Barlusconi,6 Sabrina Sommatis,5 Leonardo Garutti,7 Raffaele Rauso,8 Giovanna Cipolla,9 Luca Bettolini,10,&ast; Stefano Bighetti10,&ast; 1Dermatology Unit, University of Insubria, Varese, Italy; 2Dermatology Unit, Anclara Health &Aesthetics, Warsaw, Poland; 3Dermatology Unit, Università Vita-Salute San Raffaele, Milan, Italy; 4Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy; 5Microbiology and Biochemistry Department, UB-CARE S.r.l.-Spin-off, University of Pavia, Pavia, Italy; 6Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy; 7Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy; 8Maxillofacial Surgery Unit, Clinica Parioli, Rome, Italy; 9Dermatology Unit, Centro Medico Polispecialistico, Pavia, Italy; 10Dermatology Unit, University of Brescia, Brescia, Italy&ast;These authors contributed equally to this workCorrespondence: Luca Bettolini; Stefano Bighetti, Dermatology Unit, University of Brescia, Brescia, 25123, Italy, Tel +39 030 3995301, Fax +39 030 399505, Email l.bettolini@unibs.it; s.bighetti@unibs.itPurpose: This prospective, single-center study aims to evaluate the safety and effectiveness of NEAUVIA Intense, a PEG cross-linked polymeric hydrogel, in correcting moderate-to-severe nasolabial folds (NLF) in a routine clinical setting. The study investigates the aesthetic outcomes, patient satisfaction, and adverse events associated with the injectable filler.Patients and Methods: Seventy patients were initially enrolled, with 60 meeting study parameters. The post-market study involved a single session treatment, employing NEAUVIA Intense on each side of the NLF. Assessments utilized the Modified Fitzpatrick Wrinkle Scale (MFWS), Global Aesthetic Improvement Scale (GAIS), and Visual Analogical Scale (VAS).Results: The study demonstrated a statistically significant improvement in tissue depression immediately post-injection (p < 0.001), with sustained effects up to 6 months. MFWS assessments revealed that responder patients were 96.6% immediately after treatment, 76.6% one month, 48.3% after 3 months, and 28.3% at 6 months (p < 0.001). Additionally, there was a significant change in the frequency distribution of MFWS scores post-treatment (p < 0.001), with the majority of patients experiencing improvement in tissue depression. Maximum improvement was observed at 30- and 90-days post-treatment based on GAIS assessments. Patient and physician satisfaction, measured by VAS, remained stable over time, with fluctuations at 4 and 24 weeks after treatment (p < 0.001, Anova; p < 0.05, Wilcoxon). Throughout the entire follow-up duration of the patients enrolled in the study, no adverse effects related to the use of the product were observed.Conclusion: NEAUVIA Intense proved to be an effective solution for correcting NLF, providing significant and lasting improvements in tissue depression and aesthetic outcomes. The study underscores the necessity for continuous assessment in aesthetic medicine to align outcomes with evolving patient expectations and optimize long-term results. The findings contribute to the understanding of this specific hydrogel filler and highlight the broader context of injectable fillers in comprehensive facial aesthetic strategies.Keywords: dermal fillers, nasolabial folds, hyaluronic acid fillers, PEG cross-linked hydrogel, facial aging

The authors describe a case of fetal isolated right atrial enlargement or IDRA (idiopathic dilatations of the right atrium) evident in third trimester, complicated by arrhythmia in the female infant during the 1° month of life with ECG diagnosis of Wolf-Parkinson-White syndrome (WPW). The eldest sister died at 6 years because of an arrhythmia with the same diagnosis of WPW. The review of the literature on IDRA frequently shows a familial genetic aggregation. The pathogenetic mechanism underlying the dilation of the right atrium could consist of a myopathy or electrical conduction disorder. The exclusive involvement of the right atrium may be due to the increased pressure in the fetal right atrium. On the basis of our case and after review of the literature, we must be careful in defining as physiological the enlargement of the right fetal atrium in the third trimester of pregnancy. The ultrasound sign of IDRA may be a fetal prodrome of SIDS (sudden infant death syndrome). [ABSTRACT FROM AUTHOR]

It is estimated that the 25–50% of women who are reaching menopause every year report symptoms related to the genitourinary syndrome of menopause (GSM). The symptoms are not due simply to lack of estrogen. One possible contributing cause of symptoms is the vaginal microbiota. The vaginal microbiota is a dynamic entity and plays a critical role in the pathogenic interplay of postmenopausal changes. Treatment of this syndrome depends on the severity and type of the symptoms and on the preferences and expectations of women. As there are many treatment options, therapy should be individualized. While new evidence on the role of Lactobacilli in premenopause is emerging, the role of Lactobacilli is still unclear in GSM and the impact of microbiota on vaginal health remains conflictual. However, some reports show promising data on the effect of probiotic therapy in menopause. In the literature there are few studies and small population samples on the role of an exclusive therapy with Lactobacilli and further data will be mandatory. Studies involving large numbers of patients and different intervention periods will be necessary to obtain evidence of the preventive and curative role of vaginal probiotics. [ABSTRACT FROM AUTHOR]

The purpose of this work is to introduce a novel POD–Galerkin strategy for the semi-implicit hybrid high order finite volume/finite element solver introduced in Bermúdez et al. (2014) and Busto et al. (2018). The interest is into the incompressible Navier–Stokes equations coupled with an additional transport equation. The full order model employed in this article makes use of staggered meshes. This feature will be conveyed to the reduced order model leading to the definition of reduced basis spaces in both meshes. The reduced order model presented herein accounts for velocity, pressure, and a transport-related variable. The pressure term at both the full order and the reduced order level is reconstructed making use of a projection method. More precisely, a Poisson equation for pressure is considered within the reduced order model. Results are verified against three-dimensional manufactured test cases. Moreover a modified version of the classical cavity test benchmark including the transport of a species is analysed. [ABSTRACT FROM AUTHOR]

Arial fibrillation (AF) ablation outcome is still operator dependent. Ablation Index (AI) is a new lesion quality marker that has demonstrated to allow acute durable pulmonary vein (PV) isolation followed by a high single-procedure arrhythmia-free survival. This prospective, multi-centre study was designed to evaluate the reproducibility of PV isolation guided by the AI. A total of 490 consecutive patients with paroxysmal (80.4%) and persistent AF underwent first time PV encircling and were divided in four study groups according to operator preference in choosing the ablation catheter [a contact force (ST) or contact force surround flow (STSF) catheter] and the AI setting (330 at posterior and 450 at anterior wall or 380–500). Radiofrequency energy was delivered targeting interlesion distance ≤ 6 mm. At 12 months' follow-up a high rate of freedom from AF recurrences was observed in patients with both paroxysmal and persistent AF (91% vs. 83.3%, P = 0.039). There was no difference in the rate of atrial arrhythmias recurrence among the four study groups (4.5% in Group ST330–450, 12.2% in Group ST 380–500, 14.9% in Group STSF330–450, 9.4% in Group STSF380–500, P = 0.083). At 12 months' follow-up, the rate of atrial arrhythmias recurrence was also similar between patients treated with a ST catheter (8%) and STSF catheter (12.1%, P = 0.2), between patients treated with an AI settings of 330–450 (10.9%) and an AI of 380–500 (10.3%, P = 0.64), and among the several operators (P = 0.84 and P = 0.75 respectively in patients with paroxysmal and persistent AF) (Fig. 1). An ablation protocol respecting strict criteria for contiguity and quality lesion resulted in high rate of one-year freedom from AF recurrence, both in patients with paroxysmal and persistent AF, irrespective of the ablation catheters, AI settings, and operator. [ABSTRACT FROM AUTHOR]

Radiofrequency (RF) catheter ablation has been proposed as a treatment of atrial fibrillation (AF). Several approaches have been reported and success rates have been dependent on procedural volume and operator's experience. This is the first report of a multicenter study of RF ablation of AF. We treated 44 men and 25 women with paroxysmal (n = 40) or persistent (n = 29), drug refractory AF. Circular pulmonary vein (PV) ostial lesions were deployed transseptally, during sinus rhythm (n = 42) or AF (n = 26), under three-dimensional electroanatomic guidance. Cavo-tricuspid isthmus ablation was performed in 27 (40%) patients. The mean procedure time was 215 +/- 76 minutes (93-530), mean fluoroscopic exposure 32 +/- 14 minutes (12-79), and mean number of RF pulses per patient 56 +/- 29 (18-166). The mean numbers of separate PV ostia mapped and isolated per patient were 3.9 +/- 0.5, and 3.8 +/- 0.7, respectively. Major complications were observed in 3 (4%) patients, including pericardial effusion, transient ischemic attack, and tamponade. At 1-month follow-up, 21 of 68 (31%) patients had had AF recurrences, of whom 8 required electrical cardioversion. After the first month, over a mean period of 9 +/- 3 (5-14) months, 57 (84%) patients remained free of atrial arrhythmias. RF ablation of AF by circumferential PV ostial ablation is feasible with a high short-term success rate. While the procedure and fluoroscopic exposure duration were short, the incidence of major cardiac complications was not negligible. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) ablation outcome is still operator dependent. Ablation Index (AI) is a new lesion quality marker that has demonstrated to allow acute durable pulmonary vein (PV) isolation followed by a high single-procedure arrhythmia-free survival. This prospective, multi-center study was designed to evaluate the inter-operator reproducibility of acute PV isolation guided by the AI. A total of 490 consecutive patients with paroxysmal (80.4%) and persistent (19.6%) AF underwent first time PV encircling and were divided in four study groups according to operator preference in choosing the ablation catheter (a contact force (ST) or contact force sourrounding flow (SF) catheter) and the AI setting (330 at posterior wall and 450 at anterior wall or 380 at posterior wall and 500 at anterior wall). Radiofrequency energy was delivered to produce a wide area circumferential ablation around the proximal part of each PV's ostium or around ipsilateral PVs. In all patient radiofrequency was delivered targeting interlesion distance ≤ 6 mm. Procedure (ST330 129 ± 44 min, ST380 144 ± 44 min, SF330 120 ± 72 min, SF380 125 ± 73 min, P < 0.001) and fluoroscopy time (ST330 542 ± 285 s, ST380 540 ± 416 s, SF330 257 ± 356 s, SF380 379 ± 454 s, P < 0.001) significantly differed among the four study groups, whereas the rate of first-pass PV isolation (ST330 90 ± 16%, ST380 87 ± 19%, SF330 90 ± 17 min, SF380 91 ± 15 min, P = ns) was similar. A complication was observed in 7 (1,4%) patients without any difference among the four study groups. Ablation protocol respecting strict criteria for contiguity and quality lesion results in high and comparable rate of acute PV isolation among operator with different skill performing ablation with different procedure and fluoroscopy times. [ABSTRACT FROM AUTHOR]

The outcome in 40 patients who underwent colectomy for idiopathic megacolon and megarectum over an 18 year period was evaluated. All patients had a radiologically dilated bowel and a bowel frequency of less than two per week. Twenty two patients had a caecorectal anastomosis, 11 had an ileorectal anastomosis (including one with a previous caecorectal anastomosis and four with a previous sigmoid resection), and seven had a sigmoid resection. The mean (range) age at operation was 35 (17-69) years. All three operations resulted in a normal bowel frequency in more than 80% of patients but no patient with an ileorectal anastomosis experienced recurrent constipation. Thirty four patients experienced pain preoperatively and this was still present in 14 patients postoperatively. One patient died and four required subsequent laparotomy for bowel obstruction. The functional outcome in patients with dilatation of the whole colon and in those with dilatation of the left colon did not differ. Subsequent surgery for constipation was performed in three patients. Colectomy offers good results with few complications in the treatment of idiopathic megacolon, and an ileorectal anastomosis is the preferred operation. [ABSTRACT FROM PUBLISHER]

Background: The role of pulmonary veins (PV) isolation in patients with persistent atrial fibrillation (AF) is still debated. The aim of this study was to evaluate the adjunctive role of PV isolation in patients with persistent AF who underwent circumferential PV ablation (anatomical approach). Methods: We treated 97 consecutive patients presenting with drug-refractory persistent AF by an anatomical approach (group A, n = 36, mean age = 60 ± 8 years, 29 males) or an integrated approach (group B, n = 61, mean age 59 ± 10 years, 48 males). In all patients, radiofrequency (RF) ablation was performed by means of a nonfluoroscopic navigation system, in order to anatomically create circumferential lines around the PV. In group B, the persistence of PV potentials was ascertained with a multipolar circular catheter. If PV potentials persisted, RF energy targeting the electrophysiological breakthroughs was delivered to disconnect the PV. Past a 2-month period of observation, success was defined as absence of any atrial tachyarrhythmia recurrence lasting >30 seconds. Results: Total procedure duration (220 ± 62 minutes vs 140 ± 43 minutes, P < 0.001), fluoroscopy time (35 ± 15 minutes vs 17 ± 9 minutes, P < 0.001), and RF delivery time (48 ± 22 minutes vs 27 ± 9 minutes, P < 0.001) were significantly longer in group B than in group A. One cardiac perforation occurred in group A. After 15 ± 9.1 months, 21 patients in group A (58%) and 34 patients in group B (56%) were free of atrial tachyarrhythmia recurrence (P = 0.9). Conclusions: In patients with persistent AF, who underwent an anatomical approach, electrophysiological confirmation of PV disconnection significantly increased the fluoroscopy and procedural times, without effect on the long-term outcomes. [ABSTRACT FROM AUTHOR]

Cardiac resynchronization therapy (CRT) improves myocardial performance in patients with heart failure (HF) and left bundle-branch block (LBBB). Tissue Doppler echocardiography (TDE) has already been used to guide the selection of candidates for CRT. The objective of this study is to correlate the effects of CRT on left ventricular (LV) systolic function with wall motion synchrony assessed by TDE. High frame TDE data were obtained in 15 patients (mean age = 68.9 years, 11 men) with LBBB (QRS = 163 +/- 13 ms) to derive temporal intraventricular horizontal asynchrony indexes, expressed as the time difference at the onset of shortening between the septum and the lateral (S-L) and antero-inferior (A-I) walls, and measure the amount of delayed longitudinal contraction (DLC) within the LV. All measurements were made at baseline, 24 hours after implantation, and at 1 year of follow-up. The results show that LV ejection fraction (EF) increased from 25 +/- 6.2% at baseline to 36.9 +/- 7.9% at 1 year, and was strongly related to DLC, expressed either by time duration (DLCd, r =-0.51; P < 0.0001) or percent of the basal segments (%DLC, r =-0.50; P < 0.001). New York Heart Association functional class, which decreased from 3.6 +/- 0.5 to 2.3 +/- 0.8, was correlated with %DLC (r = 0.50) and DLCd (r = 0.48, P < 0.001). Weaker correlations were found between LVEF and S-Li (r =-0.40) and between NYHA and S-Li (r = 0.40). It is concluded that DLC was the best among intraventricular asynchrony indexes in predicting increases in LVEF after CRT. DLC may be useful to identify responders to CRT. [ABSTRACT FROM AUTHOR]

Background Recurrence is a frequent complaint of patients with vulvovaginal candidiasis (VVC). Although the pathogenesis of VVC remains a controversial issue, disruption of the balance between the vaginal microbiota may facilitate overgrowth by Candida. Some probiotic bacterial strains can suppress Candida albicans ; Lactobacillus plantarum P17630 is able to attach to vaginal epithelial cells and significantly reduce the adhesion of C. albicans . Objective To evaluate the effect of the application of Lactobacillus plantarum P17630 in restoring the vaginal microbiota and prevention of relapses among women with acute VVC undergoing conventional (azole) local and main therapy. Methods Retrospective comparative study. We recruited 89 women with a diagnosis of VVC, who were placed into two groups on the basis of reported treatment. The control group was treated with a daily dose of 2% clotrimazole vaginal cream at bedtime for 3 days, followed by vaginal application of a capsule containing lubricant once a day for 6 days and then once a week for another 4 weeks. The probiotic group was treated with the same azole-based protocol but followed by vaginal application of a capsule containing Lactobacillus plantarum P17630 (>10 8 CFU) once a day for 6 days and then once a week for another 4 weeks beginning the day following clotrimazole discontinuation. Clinical and diagnostic patterns were monitored for three months of follow-up. Results At the end of study the probiotic-treated women showed a statistically significant increase in Lactobacillus values “+++” (80% versus 40%, p < 0.001) and a better subjective resolution of symptoms such as vaginal discomfort described as burning or itching (90% versus 67.5%, p < 0.03). Among controls there was a non-significant increase at 3 months of recurrence of infection, but a significant increase of women with value of pH = 5 or >5. Conclusion Although the results of different studies are controversial, most have suggested use of probiotics in the prevention or treatment of VVC, and no adverse effects have been reported. Our data with L. plantarum P17630 (Gyno-Canesflor - Bayer) confirm the role of this specific strain as a potential empirical preventive agent for reducing vaginal discomfort after conventional treatment of acute VVC and shifting the vaginal milieu toward a predominance of lactobacilli with an improvement of the vaginal pH value. [ABSTRACT FROM AUTHOR]