The use of perforator flaps in face reconstruction is becoming increasingly common. They are particularly useful in nose reconstruction, where they can be tailored to match the complex three-dimensional structure of the nasal concave and convex subunits.
Literature on this topic is still limited, with only 12 studies reporting data on 129 recon-structions. Reconstruction of nasal defects with pedicled perforator flaps is a novel and expanding field. It allows for the achievement of good aesthetic results, with a single op-eration and low donor site morbidity. Temporary venous congestion frequently occurs, but resolves spontaneously without leaving sequelae. Also, perforator flaps have precipi-tated a novel approach to nose reconstruction, allowing for the modification of both ran-dom and axial flaps according to a "perforator-like technique".
SUPERIOR MESENTERIC VEIN THROMBOSIS AND CYTOMEGALOVIRUS: A DIAGNOSTIC DILEMMA. A CASE REPORT AND REVIEW OF THE LITERATUREWritten by Vincenzo Davide Palumbo et al.
Superior mesenteric vein thrombosis (SMVT) is a rare condition, usually caused by infec-tions, intra-abdominal inflammatory diseases, portal hypertension, hypercoagulable states, or contraceptive therapy. Due to its vague symptomatology, SMVT is often diag-nosed only after an abdominal contrast-enhanced computed tomography (CT) scan. In this article, we present a case of SMVT in a patient with a history of contraceptive drug use and a recent cytomegalovirus infection. A 36-year-old female was admitted to our department with the clinical symptoms of an acute appendicitis. The patient was a smoker and had been using hormonal contracep-tives for over a year. Surgery was deemed the best course of action. Before the operation, blood tests showed a mild lymphocytosis and altered liver enzyme levels, while coagula-tion values were normal. A contrast-enhanced CT scan revealed a complete superior mes-enteric vein thrombosis without signs of bowel ischemia. Anticoagulants were immedi-ately administered. A thrombophilia panel did not highlight any noteworthy elements. Cytomegalovirus (CMV) tests resulted positive.
Since CMV is a rare, but potentially significant cause or precipitating factor for thrombo-sis in immunocompetent hosts, all patients with an unexplained fever and seemingly spontaneous thrombosis should be screened for CMV infection.
This review offers an overview of the synthesis of phosphonated isoxazolidinyl nucleo-sides, a new class of interesting and potentially antiviral/antitumor agents. The synthetic methodology relies on a 1,3-dipolar cycloaddition reaction as a key step. The cycloaddi-tion process involves substituted nitrones, phosphonated nitrones, or nitrones containing functional groups easily convertible into a phosphonated group. Biological assays are pre-sented, which show that phosphonated isoxazolidinyl nucleosides represent a new prom-ising template of nucleoside analogues.
Case presentation: we report a case of spontaneous aortic arch thrombosis in a term new-born, who presented with suggestive signs of aortic coarctation immediately after birth. Despite the initiation of anticoagulant therapy, a massive increase in size of thrombus with evidence of coronary involvement was noted. Thrombolytic treatment was performed with thrombus resolution. Death occurred after a few days due to widespread brain haem-orrhage.
Conclusion: To date, no definitive guidelines have been published for the treatment of neonatal aortic arch thrombosis, and only anecdotal reports are available. A multidiscipli-nary approach is fundamental in order to evaluate the risk:benefit ratio of proposed medical and surgical interventions. Further studies are needed to improve consensus evi-dence based guidelines and ensure appropriate approaches to this condition.
INVASIVE PNEUMOCOCCAL DISEASES IN CHILDREN AGED 1-59 MONTHS IN SICILY, ITALY: IMPORTANCE OF ACTIVE FAMILY PAEDIATRICIAN SURVEILLANCE AND VACCINATION COVERAGEWritten by Emanuele Amodio et al.
Methods: The study was carried out in Sicily and involved about 30,000 children, aged 1-59 months, actively monitored by 100 family pediatricians during 2010 and 2011. All children who met the inclusion criteria were considered eligible, recorded using a stan-dardized case report form and investigated for the presence of S. pneumoniae in speci-mens from sterile sites.
Results: None of the 40 eligible children was confirmed as a case of invasive pneumococ-cal disease. The incidence rate of invasive pneumococcal disease cases was 0.0/100,000 in both years. Regional childhood pneumococcal vaccination coverage rates were 90.7% in 2010 and 92.0% in 2011.
Conclusions: Our results show that during the study period invasive pneumococcal dis-ease cases were rare in Sicilian children, suggesting a very effective control of the disease in a region with very high vaccination coverage against S. pneumoniae.
In January 2006, a new journal, Capsula Eburnea, was born in the Italian scientific pub-lishing scene, with the initial goal of creating, at the same time, "an open scientific forum and a blog". Until December 2009, the vast majority of manuscripts was still published in Italian, restricting the number of readers.
From the end of 2009, the journal has undergone extensive changes, becoming indexed in the main scientific search engines (Scopus, Directory of Open Access Journal, Google Scholar, Ulrich Periodical Directory), and renewing its Editorial Team with a role reassign-ment and expanding the Editorial Board to up to 40 young doctors with proven scientific experience from 15 countries around the world, working as researchers, PhD students, senior medical staff, research fellows or doctors in specialist training.
Finally, the journal has progressively encouraged the publication of articles in English, through an endorsed English translation service provided by native English speaking translators. This service became mandatory for all peer-reviewed articles accepted by the Journal in 2011.
At the same time, the Editorial Board unanimously decreed to change the name of the journal into "Euromediterranean Biomedical Journal for young doctors (formerly: Capsula Eburnea)" from January 2012.
Today, the journal is fully open access (including the archives of Capsula Eburnea) with the possibility to download articles for free, and the publication process involves a blind peer review of each article by at least two scientists. During its first two years of activity, the Euromediterranean Biomedical Journal (EMBJ) published 48 scientific articles (17 origi-nal articles, 14 reviews, 13 case report, two technical reports and two commentaries) and one edition of Conference Proceedings.
Muscle wasting is a degeneration of the muscle tissue that can derive from several patho-logical situations, but most of the times is caused by a condition of cachexia in patients with cancer or other diseases. This degeneration results from a decrease in protein syn-thesis and an increase in protein degradation. This is caused mainly by the overexpres-sion of ubiquitin-proteosome-system (UPS) elements, under the control of factors re-leased in cachexia that lead cells toward a catabolic rather than an anabolic pathway. Both skeletal and cardiac muscles can be affected by muscle wasting and until now an effective treatment is unknown. Only experimental trials of exercise training bring to a recovery of mass loss, but many researchers think that a potential future treatment may be represented by stem cells.
Targeting epigenetics may offer the potential for achieving therapeutic selectivity in dis-orders of the central nervous system, by simultaneously modulating the expression of multiple genes involved in disease mechanisms. Histone acetylation, regulated by histone acetyltransferases and deacetylases, affects chromatin condensation and gene transcrip-tion. DNA methylation is also involved in histone modification. Methylation of CpG islands in promoter regions is associated with gene silencing. The development and functions of the human central nervous system are largely shaped by postnatal experiences, indicat-ing that both genetic and epigenetic information are indispensable. The epigenetic regu-latory mechanisms in the central nervous system have recently been object of intense re-search. As a result, mutations of epigenetic modulator genes have been implicated in sev-eral neurodegenerative and psychiatric disorders. This article reviews some common dis-orders, such as Alzheimer’s disease, mood disorders and Attention Deficit Hyperactivity Disorder, where epigenetic mechanisms may offer potential targets for experimental therapeutics.
PERMANENT PACEMAKER IMPLANTATION IN A 1200G-PRETERM SUFFERING FROM CONGENITAL ATRIOVENTRICULAR BLOCKWritten by Antonio Di Mauro et al.
Congenital third-degree (complete) atrioventricular block requires pacemaker implantation where prenatal hydrops, low ventricular rate (<45 bpm) non-response to inotropes, and/or left ventricular dysfunction is present. A permanent pacemaker was implanted in a 1200g 9 day old preterm: the smallest newborn successfully subjected to this procedure, according to literature.