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The first vascularized composite allograft (VCA) transplant in the United States was performed in 1998 in a 40-year-old man who received a laryn-geal transplant after experiencing severe trauma to the throat 20 years before. The following VCA was a hand transplant in 1999 in a 37-year-old man who lost his left hand 13 years before. Since then, the field of VCA transplantation has made significant strides. On July 3, 2014, the Or gan Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) oversight of VCA procurement and transplant in the United States went into effect. In the last decade, the number of candidates listed for and transplanted with VCA has increased. While patient demographic data, whether listed candidates or patients undergoing VCA transplant, is limited by sample size, the trend is a predominance toward a young/middle-aged, White population. Overall outcomes data have been promising, with the vast majority of VCA transplants resulting in functioning grafts.

BACKGROUND Chronic cough is a common symptom, addressed in the clinical setting by empirical treatment together with some laboratory investigations. Purpose of the present study is to investigate the value of testing eosinophilic cationic protein (ECP) serum levels combined with other diagnostic procedures and empirical treatment in the diagnostic workup of chronic cough. METHODS In this study, we evaluated 194 patients with chronic cough. No subject had received any anti-inflammatory treatment before clinical evaluation, and none was an active smoker. ECP was measured with a commercially available fluoroenzyme immunoassay and results were expressed as µg/L. RESULTS The analysis of variance showed that mean ECP level differs among the various diagnosis categories (p < 0.001). Mean ECP level was significantly higher in asthmatic patients, particularly in the active disease. CONCLUSIONS Serum ECP concentration could represent a useful biomarker in the clinical work-up of chronic cough, managing to differentiate asthma from other chronic disorders.

Background Tofacitinib is a small oral molecule approved to treat moderate to severe ulcerative colitis (UC), which effectiveness and safety is still poorly known in UC patients. Recent concerns have been raised regarding its administration at high dosage in UC patients because of a likely higher incidence of drug-related thromboembolic events. Methods The aim of this study was to evaluate short-term effectiveness and safety of tofacitinib. As secondary aim, we analyzed the state of blood coagulation at baseline in order to evaluate whether it could predict thromboembolic events in relation to demographic, clinical and biochemical characteristics. A multicenter, retrospective, observational study was conducted, including patients from March 2021 to October 2022; a prospective single-centre sub-study concerning the thromboembolic risk was performed. At baseline, demographic, clinical, biochemical and endoscopic data, and previous therapies were recorded; quality of life was evaluated through IBD-Disability Index (IBD-DI) and Pittsburgh Sleep Quality Index (PSQI). In a subgroup of patients, a thrombophilic screening and a Rotational Thromboelastometry (ROTEM) were performed at baseline. Patients were reassessed after 8 weeks, 6 months and 1 year, evaluating for each timepoint clinical and biochemical characteristics, IBD-DI and PSQI, and reporting adverse events (AEs) and discontinuation of therapy. The following clinical outcomes were considered: benefit, steroid-free remission and response. Results 44 adult patients were enrolled. The overall clinical benefit was 54.2%, summing up 45.8% of subjects in steroid-free clinical remission and 8.3% with clinical response; significant short-term improvement of IBD-DI and PSQI scores (p=0.000 in both cases after 6 months of therapy) was observed. Patients previously treated with less than two different biological therapies had major rates of clinical benefit at 6 months (p=0.045). Ten AEs, including one venous thrombosis, were reported; global therapy failure rate was 31.4%. In the subgroup with additional data on coagulation (17 patients), we did not observe significant alterations of coagulating factors or inhibitors, nor of ROTEM parameters, although some coagulation features were significantly increased in obese patients (FII, p=0.030; FIX, p=0.000; FX, p=0.000; fibrinogen blood levels, p=0.030) and subjects older than 40 years old (FVIII, p=0.020). We did not find significant correlation with gender, smoking habit, concomitant steroid therapy, CRP, fecal calprotectin. Conclusion Our data confirm literature ones on effectiveness and safety of tofacitinib in UC patients, while the risk of thrombosis needs to be better evaluated in larger longitudinal studies.

The spread of SARS-CoV-2 has fueled the COVID-19 pandemic with its enduring medical and socioeconomic challenges due to subsequent waves and long-term consequences of great concern. Here we charted the molecular basis of COVID-19 pathogenesis, by analysing patients’ immune response at single-cell resolution across disease course and severity. This approach uncovered cell subpopulation-specific dysregulation in COVID-19 across disease course and severity and identified a severity-associated activation of the receptor for advanced glycation endproduct (RAGE) pathway in monocytes. In vitro experiments confirmed that monocytes bind the SARS-CoV-2 S1-RBD via RAGE and that RAGE-Spike interactions drive monocyte infection. Our results demonstrate that RAGE is a novel functional receptor of SARS-CoV-2 contributing to COVID-19 severity.One-Sentence SummaryMonocyte SARS-CoV-2 infection via the receptor for advanced glycation endproduct triggers severe COVID-19.

Introduction Heart failure (HF) is a risk factor for postoperative mortality in major non–cardiac surgery. Collaboration between the Multimodal Preoperative Prehabilitation unit (MPP) and Heart Failure Clinic (HFC) could allow optimization of heart failure therapy and negative prognostic factors such as reduced functional capacity (FC), malnutrition, and sarcopenia to improve the prognosis of these patients. Case report: Mrs. C.M. is a 58–year–old patient who presents to the MPP unit in anticipation of total colectomy for drug–refractory ulcerative colitis. Mrs. C.M. has a past medical history significant for heart failure with reduced ejection fraction (EF 25%) of presumably valvular–arrhythmic etiology. She underwent tricuspid annuloplasty and mitral replacement surgery some years ago and is affected by atrial fibrillation. At the MPP unit, Mrs. C.M. had a reduced FC and was malnourished and sarcopenic. Blood tests showed iron deficiency anemia. Heart failure therapy (NYHA II) was not optimized according to guidelines. Therefore, the patient started multimodal prehabilitation consisting of aerobic and resistance exercise, nutritional intervention, intravenous iron infusion, and optimization of HF therapy. After the patient was evaluated at the HFC, she started empagliflozin, sacubitril/valsartan, and ranolazine; intermittent levosimendan therapy was also performed. She also underwent cardiac NMR, which showed non–ischemic fibrosis, and coronary angiography, which was negative. Finally, she underwent PM–ICD implantation. After six months of multimodal prehabilitation, there was an increase in EF (38% vs. 25%), a reduction in NT–proBNP (700 vs 4988 pg/mL), and mitigation of HF symptoms. There was also a marked improvement in FC (383 vs 269 meters at 6–minute walking test), nutritional status (stage B vs stage C at PG–SGA test), and muscle strength (handgrip strength test 14.6 vs 8.5 kg). Considering the excellent preoperative optimization response, it was decided to proceed with surgery after a collegial discussion (anesthetist, heart failure cardiologist, surgeon, and patient). Conclusions Multimodal preoperative prehabilitation, based on the collaboration between the Multimodal Preoperative Prehabilitation Unit and Heart Failure Clinic, can effectively improve the preoperative functional capacity of HF patients.

Allergy to natural rubber latex emerged as one of the main allergies at the beginning among some professional groups and the general population. Sensitization and development of latex allergy have been attributed to exposure to products containing residual latex proteins. The prevailing cross-reactivity of latex proteins with other food allergens is of great concern. Numerous purified allergens are currently available, which greatly help in patient management, thus determining their specific profile. We conducted a multicenter study to investigate changes, from the ROC analysis, in the characteristics of patients with latex allergy by measuring its major protein components. Sensitization to latex proteins is crucial because it highlights the cross reactivity to inhalants (pollen) and food (fruit). It is very essential in an accurate and specific clinical setting.

The novel HLA-B*44:532 allele differs from HLA-B*44:02:01:01 by one nucleotide substitution in Exon 3. This article is protected by copyright. All rights reserved.

Estimated to represent less than 5% of all asthmatic patients, children with severe asthma experience troublesome persistent symptoms, life-threatening attacks and side effects by oral corticosteroid treatment, that significantly impact on the quality of life and on economic costs. An accurate understanding of the mechanisms of the disease has been crucial for the discovery and development of biological therapies, for which children with severe asthma are candidates. The aim of this review is to discuss the use of approved biologics for severe asthma, providing updated evidence of novel targeted therapies in the pediatric age range.

Uncontrolled inflammation plays a relevant role in the pathogenesis of coronavirus disease-19 (COVID-19). Here, we studied the time trend of inflammatory markers in a population of hemodialysis (HD) patients affected by COVID-19, undergoing two different dialysis approaches. In a prospective study, thirty-one maintenance HD patients with COVID-19 were randomized to expanded HD (HDx), performed using a medium cut-off membrane, or standard treatment using a protein-leaking dialyzer (PLD). Circulating levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), soluble TLR4 (sTLR4), and interferon-gamma (IFN-γ), were collected at diagnosis, and one and two weeks after. Compared with 14 non-infected HD patients, COVID-19 patients showed lymphopenia and higher ferritin and lactate dehydrogenase levels. Moreover, COVID-19 patients had higher levels of IL-10 (15.2 (12.5) vs. 1.2 (1.4) pg/mL, p = 0.02). Twenty-nine patients were randomized to HDx (n = 15) or PLD (n = 14). After a single treatment, IL-8 showed a significant reduction in both groups, whereas IL-10 decreased only in HDx. All over the study, there were no significant modifications in circulating cytokine levels between the two groups, except for a parallel increase of IL-8 and IL-10 at one week control in the HDx group. No correlations were found between cytokine levels and clinical outcomes. In maintenance HD patients, COVID-19 is not related to a sustained inflammatory response. Therefore, modulation of inflammation seems not to be a suitable therapeutic target in this specific population.

In the framework of structural health monitoring, a ‘model-free’ approach has been gaining increasing attention to describe the structural behavior without building a numerical model but adopting the so-called artificial neural networks (ANNs) that must be trained on data (e.g., accelerations) recorded on the existing structure. However, the lack of complete ‘real-life’ applications is the biggest current shortcoming to the use of ANNs. Indeed, the application of ANNs is often limited to medium-scale structures. The few applications on full scale structures are rarely run for a time interval sufficient to recognize structural deterioration due to material degradation and/or damage due to external loads. Moreover, the formulation of a methodology to design the sensor network serving a neural network is necessary.

Inclusive electron scattering from nuclear targets has been measured to extract the nuclear dependence of the inelastic cross section in Hall C at the Thomas Jefferson National Accelerator facility. Results are presented for 2H, 3He, 4He, 9B, 12C, 63Cu and 197Au at an incident electron beam energy of 5.77 GeV for a range of momentum transfer from Q^2 = 2 to 7 (GeV/c)^2. These data improve the precision of the existing measurements of the EMC effect in the nuclear targets at large x, and allow for more detailed examinations of the A dependence of the EMC effect., Comment: 28 pages, 23 figures, archival paper for Jefferson Lab experiment E03-103

Made available in DSpace on 2019-10-04T12:34:27Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-02-10 CONICET Argentina ANPCYT Argentina Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Olanzapine (OLZ), a drug for the treatment of schizophrenia, presents in more than 60 crystal forms. Polymorphs I, II and III were reported, however, the preparation conditions for pure II and III have not been reported. Polymorph IV was reported but this form is actually polymorph II described at different temperature. The diversity of solid forms of OLZ, the change in the nomenclature found in the literature and the presence of polymorphic mixture in samples, increase the difficulty for a correct solid state characterization. Therefore, the goal was the polymorphic identification of three OLZ raw materials, highlighting the limitation of conventional techniques (typically used in analytical control) and the necessity to use a combination of advanced ones to solve this challenge. The samples were studied by conventional techniques such as powder X-ray diffraction, thermoanalytical techniques, infrared spectroscopy. In apart from that, synchrotron powder X-ray diffraction (SPXRD) and solid state nuclear magnetic resonance (ss-NMR) were used. All samples were in accordance with the pharmacopoeia criteria. However, the conventional techniques were not specific for the complete polymorphic identification. Therefore, a combination of advanced techniques (SPXRD and ss-NMR) was necessary to identify the mixture of polymorphs (I, II and III) in all samples. Lab Farmaceut Marinha, Av Dom Helder Camara 315, BR-20911291 Rio De Janeiro, Brazil Farmanguinhos Fiocruz, Mestrado Profiss Gestao Pesquisa & Desenvolvirnen, Av Cmte Guaranys 447, BR-22775903 Rio De Janeiro, Brazil Univ Fed Fluminense, Programa Posgrad Quim, Outeiro Sao Joao Batista S-N, BR-24210130 Niteroi, RJ, Brazil Farmanguinhos Fiocruz, Lab Micro & Nanotecnol, Av Brasil 4036, BR-21040361 Rio De Janeiro, Brazil Univ Fed Sao Paulo, Programa Posgrad Engn & Ciencia Mat, Rua Talim 330, BR-12231280 Sao Jose Dos Campos, Brazil Univ Estadual Paulista, Dept Mat & Tecnol, Av Dr Ariberto Pereira Cunha 333, BR-12516410 Guaratingueta, Brazil Univ Nacl Cordoba, Fac Matemat Astron Fis & Computat, Ciudad Univ,X5000HUA, Cordoba, Argentina Consejo Nacl Invest Cient & Tecn, Inst Fis Enrique Gaviola, Ciudad Univ,X5016LAE, Cordoba, Argentina Univ Estadual Paulista, Dept Mat & Tecnol, Av Dr Ariberto Pereira Cunha 333, BR-12516410 Guaratingueta, Brazil CONICET Argentina: 11220130100746CO ANPCYT Argentina: PICT 1095/2014 CNPq: 305492/2017-9

The only curative treatment for chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA). PEA requires cardiopulmonary bypass (CPB) which is associated with a high acute kidney injury (AKI) risk. Circulating endothelin-1 (ET-1) levels are elevated in CTEPH, and ET-1 plays a pivotal role in AKI. Because AKI is burdened by high morbidity and mortality, we aimed to evaluate the association between preoperative ET-1 and the risk to develop AKI in CTEPH individuals who undergo PEA. We also evaluated the association of AKI and ET-1 with kidney function and mortality at 1 year after PEA. In 385 consecutive patients diagnosed with CTEPH who underwent PEA at the Foundation IRCC Policlinico San Matteo (Pavia, Italy) from January 2009 to April 2015, we assessed preoperative circulating ET-1 by ELISA and identified presence of AKI based on 2012 KDIGO criteria. AKI occurred in 26.5% of the 347 patients included in the analysis, and was independently associated with preoperative ET-1 (p = 0.008), body mass index (BMI) (p = 0.022), male gender (p = 0.005) and duration of CPB (p = 0.002). At 1-year post PEA, estimated glomerular filtration rate (eGFR) significantly improved in patients who did not develop AKI [ΔeGFR 5.6 ml/min/1.73 m2 (95% CI 3.6–7.6), p

Congenital Growth Hormone Deficiency (GHD) in newborn is an infrequent condition, which can cause threat to life due mainly to hypoglycemia that begins in the first week of life. Severe neonatal GHD needs a fast diagnosis and the substitution with recombinant human GH because of the risk the morbi-mortality. A GH basal level (whether random or associated with spontaneous hypoglycemia) that distinguishes infants with GHD from those with GH sufficiency in the neonatal period is not conclusive. Few data have been reported about the GH measurements in serum and dried blood spots on filter paper samples in healthy neonates born appropriate for gestational age (AGA). Aims: To compare and correlate the GH values in serum and blood spots on filter paper samples in infants until 60 days of life. To establish GH reference values in healthy newborn until 15 days of life. To analyzed the correlation between GH concentrations in serum and blood spot and with hormones of the hypothalamic-pituitary-gonadal and adrenal axis. Subjects and methods: We analyzed 301 serum and whole blood spots samples obtained from AGA neonates between 2-60 days of life (2-15 days n=216, 16-30 days n=65 and 31-60 days n=20 (F: 154, M: 147). GH concentrations were measured by ECLIA Roche C600, which is calibrated against the 2nd International Standard Code 98/574 in serum as well as eluted from filter paper samples. The mean and SD GH value, P 5.0 and P 95.0 were calculated. The statistical analysis was performed by Spearman correlation coefficient. Results: 2-5 days: serum GH (ng/mL) mean value (SD): 20.81(15.8); P5: 6.30, P95: 42.30; 6-15 days: mean GH value 8.78 (4.34); P5: 3.29, P95: 15.19; 16-30 days: mean GH value: F: 10.55 (4.58), M: 7.72 (3.75) and 31-60 days: mean GH value: F: 4.67 (2.75), M 6.82 (4.57). Blood spots GH (ng/mL) mean value (SD): 2-5 days: 17.58 (9.95); P5: 5.68, P95: 33.60; 6-15 days: mean GH value: 10.31 (5.88), P5: 3.0, P95: 21.02; 16-30 days: mean GH value: F: 10.41 (6.01), M: 10.99 (7.78) and 31-60 days: mean GH value: 7.02 (5.25), M 9.12 (8.08). The Spearman correlation obtained between both techniques in parallel measurements was r2=0.85 (p< 0.0001). Conclusions: In agreement with different reports, our results showed high average GH levels in the first few days of life. Human GH secretion is pulsatile from the very beginning, however, newborn screening card spotted with blood during the first week of life, when neonatal hypersomatotropism is present, provides such high levels that, even at the nadir of GH pulsatility a basal value could contribute to detect GHD accurately. The good correlation obtained between both type of samples would indicate that the measurement of GH in dried blood spot samples is an appropriate and reliable method which can be incorporated in the diagnosis of neonatal GHD. The newborn screening samples may be a valuable resource for retrospectively assessing GH sufficiency if this neonatal window has passed. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Present-day environments are replete with tempting foods and the current obesity pandemic speaks to humans' inability to adjust to this. Pavlovian processes may be fundamental to such hedonic overeating. However, a lack of naturalistic Pavlovian paradigms in humans makes translational research difficult and important parameters such as implicitness and acquisition speed are unknown. Here we present a novel naturalistic conditioning task: an image of a neutral object was conditioned to marzipan taste in a single trial procedure by asking the participant to eat the 'object' (made from marzipan). Relative to control objects, results demonstrate robust pre- to post-conditioning changes of both subjective ratings and early as well as late event related brain potentials, suggesting contributions of implicit (attentional) and explicit (motivational) processes. Naturalistic single-trial taste-appetitive conditioning is potent in humans and shapes attentional and motivational neural processes that might challenge self-regulation during exposure to tempting foods. Thus, appetitive conditioning processes might contribute to overweight and obesity.

Primary eosinophilic gastrointestinal disorders (EGIDs) are emerging chronic/remittent inflammatory diseases of unknown etiology, which may involve any part of the gastrointestinal (GI) tract, in the absence of secondary causes of GI eosinophilia. Eosinophilic esophagitis is the prototype of eosinophilic gastrointestinal disorders and is clinically characterized by symptoms related to esophageal inflammation and dysfunction. A few studies have assessed the nutritional status of patients with eosinophilic gastrointestinal disorders, showing conflicting results. This review summarizes the current evidence on the nutritional status of patients with EGIDs, focusing on the pediatric point of view and also speculating potential etiological mechanisms.

De 2004 a 2014, dix ans ont ete necessaires a la Suisse pour faire l’etat des lieux des moyens de protection de sa population contre les effets d’un evenement atomique/radiologique, biologique ou chimique de grande envergure, d’en identifier les lacunes et proposer des solutions pour les combler, et finalement pour mettre en place les strategies, les structures et les procedures necessaires. Cet article decrit le montage de la structure qui gere aujourd’hui la protection ABCN au niveau de la Confederation suisse et des vingt-six cantons souverains qui la composent.

Concepts and experimental procedures to obtain different types of YBa 2 Cu 3 O 7 grain boundaries Josephson junction through the biepitaxial technique have been developed. Various seed layers (MgO, CeO 2 and SrTiO 3) and substrates (MgO, SrTiO 3) have been used providing, for the biepitaxial technique, additional flexibility in circuit design. A detailed investigation on transport properties evidenced good performances for both junctions and superconducting quantum interference devices. Experimental evidence is given of a conventional magnetic field behavior in 45° tilt Artificial Grain Boundary (AGB) for which no π-loops are predicted along the interface.

Spectroscopic sensors of liquid represent a fundamental tool in different research areas as for instance biology, chemistry, forensics, pharmaceutical research and environmental monitoring. The persistent efforts towards the miniaturization of such devices are driven by two fundamental advantages: the sensor portability which makes it possible its use for in situ applications, and the ability to strongly limit the use of large amounts of solutions and reagents which are necessary to perform the measurements. In this paper, an on-chip implementation of jet waveguide based optofluidic spectroscopic detection scheme is reported. The adopted detection scheme exploits total internal reflection arising in a microjet leading to highly efficient signal collection in fluorescence spectroscopy [1]. The same approach can be used also for Raman spectroscopy [2]. More specifically, the sensor is designed so that the water jet ejecting from a capillary is intercepted from a 7 optical fiber probe in circular arrangement. Each fiber has a diameter of 50?m. The central fiber is used to excite the analyte present in the microjet waveguide produced by means of a micro-pump. An alternative choice is an orthogonal excitation of the liquid waveguide. The surrounding 6 fiber of the bundle are used to collect the signal in both of the cases. The micro-pump provides a flow rate of 250 ml/hr. This value has been chosen to ensures adequate stability of the jet and it corresponds to a breakup length (i.e. the maximum length of the jet possible at this specific liquid velocity) around 10mm, which is superior to the distance between the optical probe and the capillary nozzle (7mm) i.e. the jet portion exploited as optical waveguide. This high flow rate allows to horizontally arrange the sensor. The alignment between the microjet and the optical fiber probe is provided by means of a frame composed by two layers of Polymethylmethacrylate (PMMA). These layers are suitably micro-machined to house the capillary and the fiber probe. This results in a microfluidic chip with totally alignment-free spectroscopic detection scheme, which avoids any background from the sample containers. The schematic of the microjet waveguide on chip sensor is shown in figure 1. As it is necessary to shield the sensor from external light, otherwise present in the detected signal, a housing structure of the chip has been expressly designed and fabricated by means of a 3D printing system. But the most important feature of this housing structure of the chip is related to the fact of being able to provide a recirculation of the solution under analysis. For this reason, within the housing structure, it is present an inner reservoir which is connected to the inlet tube of the micro-pump. As fluorescent dyes are commonly used to label cells, proteins, nucleic acids and antibodies. [3], in order to apply the on-chip spectroscopic sensor on fluorescence spectroscopy, measurements of eosin Y in water solutions have been considered. A diode laser emitting at 532nm with a power of 10 mW has been used as excitation source, whereas a mini-spectrometer connected to a laptop has been used as detector. The limit of detection, determined with eosin Y solution, has been 38 pM by employing an integration time of only 40 ms. As the typical concentration ranges considered in fluorescence labelling is often several order of magnitudes higher than the one explored in this work, the proposed approach appears as a valid strategy in fluorescence spectroscopy. For instance an optimum concentration of eosin B for protein estimation was worked out to be 0.01% in [4], whereas more limited quantity of eosin Y (10-7 mol/l) are necessary in an eosin Y-based fluorescent sensor which is used for detection of perfluorooctane sulfonate [5]. Due to the versatility of the design, the system is appropriate also for Raman spectroscopy. In this case, probe excitation configuration, exploiting the microjet waveguide capability also for the excitation represents a valid strategy due to the well-known weak sensitivity offered by Raman spectroscopy.

Background The independent prognostic impact of diabetes mellitus ( DM ) and prediabetes mellitus (pre‐ DM ) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre‐ DM on survival outcomes in the GISSI ‐HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca‐Heart Failure) trial. Methods and Results We assessed the risk of all‐cause death and the composite of all‐cause death or cardiovascular hospitalization over a median follow‐up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI ‐ HF trial, who were stratified by presence of DM (n=2852), pre‐ DM (n=2013), and non‐ DM (n=2070) at baseline. Compared with non‐ DM patients, those with DM had remarkably higher incidence rates of all‐cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non‐ DM patients and those with pre‐ DM . Cox regression analysis showed that DM , but not pre‐ DM , was associated with an increased risk of all‐cause death (adjusted hazard ratio, 1.43; 95% CI , 1.28–1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI , 1.13–1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all‐cause death: adjusted hazard ratio, 1.21; 95% CI , 1.02–1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI , 1.01–1.29, respectively). Conclusions Presence of DM was independently associated with poor long‐term survival outcomes in patients with chronic heart failure. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 00336336.

A paralisia facial pode resultar de uma variedade de etiologias, sendo a mais comum a idiopática. A avaliação e o tratamento são particularmente complexos. O tratamento da paralisia facial aguda pode envolver cirurgia de descompressão do nervo facial. Qualquer estrutura perto do trajeto do nervo facial está em risco durante a cirurgia de descompressão via transmastoidea. OBJETIVO: Estudo retrospectivo que irá avaliar a perda auditiva após descompressão via transmastoidea e a evolução do grau de paralisia nos casos idiopáticos dos últimos 15 anos. MATERIAL E MÉTODO: Foram selecionados prontuários de 33 pacientes submetidos à descompressão do nervo facial via transmastoidea nos últimos 15 anos e avaliou-se a perda auditiva e a paralisia facial. RESULTADOS: Observou-se alta porcentagem (61%) dos pacientes com algum grau de perda auditiva após o procedimento e, em todos os casos, houve melhora da paralisia. CONCLUSÃO: O procedimento cirúrgico não é isento de riscos. Indicações, riscos e benefícios devem ser esclarecidos aos pacientes por meio de consentimento informado.Facial paralysis can result from a variety of etiologies; the most common is the idiopathic type. Evaluation and treatment are particularly complex. The treatment of acute facial paralysis may require facial nerve decompression surgery. Any structure near the path of the facial nerve is at risk during transmastoid decompression surgery. AIM: This is a retrospective study, carried out in order to evaluate hearing loss after transmastoid decompression and how idiopathic cases evolved in terms of their degree of paralysis in the last 15 years. MATERIALS AND METHODS: We selected the charts from 33 patients submitted to transmastoid facial nerve decompression in the past 15 years and we assessed their hearing loss and facial paralysis. RESULTS: There was a high percentage (61%) of patients with some degree of hearing loss after the procedure and in all cases there was improvement in the paralysis. DISCUSSION: The values obtained are similar to those reported in the literature. One possible explanation for this hearing loss is the vibration transmission by drilling near the ossicular chain. CONCLUSION: The surgical procedure is not risk free; indications, risks and benefits should be explained to patients through an informed consent form.

In a double diffusion chamber (DC) culture system bone marrow cells elaborated diffusible factor(s) that prevented spleen colony-forming cells (CFU-S), but not PHA stimulated lymphocytes, from entering cell cycle. Mature granulocytes and macrophages did not produce such factor(s). Various numbers of steady-state or regenerating mouse bone marrow cells were cultured in single diffusion chambers for periods up to 7 d. After the initial cell loss, the net growth of CFU-S was inversely related to both total cell number and CFU-S number in DC. Diffusible factors rather than cell-to-cell contact appeared to be involved in the inhibition, even though we were not able to demonstrate inhibition of net growth of CFU-S with the double chamber approach.

Osteoporosis is the most common bone disease, affecting millions of people and causing a high risk of fractures and a loss of quality of life. It is characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. A primary method of prevention, in order to reduce the risk of fractures, is represented by an appropriate lifestyle and a correct diet. There are potentially numerous nutrients and dietary components that can influence bone health, and these range from macronutrients to micronutrients as well as bioactive food ingredients. The purpose of this review is to overview osteoporosis, including its definition, etiology, and incidence, and then provide some information on possible dietary strategies for optimizing bone health and preventing osteoporosis. A correct diet to prevent osteoporosis should contain adequate amounts of calcium, vitamins D and K, protein, and fatty acids. The effects of these elements are briefly discussed, reporting on their correlation with bone benefits.