Fatty liver diseases are a spectrum of liver pathologies characterized by abnormal hepatocellular accumulations of lipids. This condition may occur in both adults and children, particularly those who are obese or have insulin resistance or following abuse of alcohol consumption. They are classified in Non-Alcoholic Fatty Liver Disease (NAFLD) and Alcoholic Fatty Liver Disease (AFLD). Steatohepatitis is a specific pattern of injury within the spectrum of NAFLD and this pattern is associated with fibrotic pro-gression and cirrhosis. The role of oxidative stress in liver steatosis production and its progression to inflammation leading to steatohepatitis has been discussed in relation to alterations in metabolic and pro-inflammatory pathway. One of the main enzymes responsible for antioxidant activity in the presence of liver damage is the Heme Oxy-genase-1(HO-1).The products of the HO-1-catalyzed reaction, particularly carbon monoxide (CO) and biliverdin/bilirubin have been shown to exert protective effects in several organs against oxidative and other noxious stimuli. In this context, it is inter-esting to note that induction of HO-1 expression contributes to protection against liver damage in various experimental models. The focus of this review is on the significance of targeted induction of HO-1 as a potential therapeutic strategy to protect the liver against fatty liver diseases.
For the benefit of medical students, in this paper we examine the somatotopic organi-zation of the spinal cord, which shows a similar organization in mammalians. The dor-sal horn is comprised of sensory nuclei with deutoneurons; the lateral horn contains preganglionic visceral motoneurons; the ventral horn is subdivided into a medial col-umn innervating the paravertebral muscles, a central column, C3-C6, innervating the diaphragm, and a lateral column innervating the limb muscles. In the lateral column of the ventral horn, the dorsal motoneuron groups innervate the intrinsc arm muscles; the dorsal posterior motoneuron groups innervate hand muscles; the lateroventral motoneuron groups innervate the shoulder. Furthermore, the rostral and caudal moto-neuron groups innervate the proximal and the distal muscles, respectively. In cat spi-nal cord, the medial columns 1-2 innervate the paravertebral muscles, and columns 3-6 are divisible into groups, each innervating specific muscle groups. In human spinal cord, 11 motor columns have been identified: column 1 is located in the medial part and columns 2-11 in the lateral part of the ventral horn. Columns 1-2 extend to S3, while columns 3-8 are confined to the cervical and T1 segments, and columns 9-11 are situated in the lumbosacral segments.
Diabetes Mellitus is regarded as an independent risk factor for cardiovascular disease and is highly prevalent in the Asian Indian community in South Africa. Poor control of blood glucose is associated with an increased risk for coronary artery disease (CAD). We determined the glycaemic control profile in a sample of known diabetic subjects from the Phoenix Lifestyle project cohort, and examined the relationship between gly-caemic control and other biochemical parameters.
This is the first study in the Asian Indian community in Phoenix that determined the relationship between glycaemic control in diabetic subjects and other cardiovascular risk factors. Our study shows that significant dyslipidemia is present in the majority of diabetics with poor glycemic control, as well as in subjects with HBA1c levels demon-strative of good control. Atherogenic dyslipidemia in diabetic subjects is a substrate for the premature development of CAD in diabetes.
Methods: Color Doppler imaging of arterial and venous blood flow was performed on 78 patients with normal tension glaucoma (NTG), 80 patients with high-pressure glau-coma (HPG) and 60 control subjects. The statistical analysis included the calculation of the correlation between clinical data and ocular blood flow parameters, as well as Pearson’s correlation coefficient. The threshold P value for statistical significance was 0.05.
Results: Ocular blood flow (both arterial and venous) was significantly reduced in NTG and HTG, compared to the control group. While the arterial blood flow reduction was more significant in HTG than in NTG, a decrease in venous blood flow had a higher in-cidence in NTG. In contrast to the control group, POAG patients showed a correlation between clinical data and venous blood flow. The correlation was higher in NTG pa-tients.
Pilonidal sinus disease is a complex condition that causes both discomfort and embar-rassment to sufferers. Direct cost through absence from work is high. Controversy still exists regarding the best surgical technique for its treatment in terms of minimizing disease recurrence and patient discomfort. Thus, we conducted this study to evaluate the results of rhomboid excision and Limberg flap reconstruction in the surgical treat-ment of pilonidal sinus disease. This prospective study included 81 patients who had pilonidal sinus and were treated by the rhomboid excision and Limberg flap. The mean follow–up was 18 months and all patients were satisfied with the procedure. There were lower complication rates, minimal discomfort, patients discharged in 2-3 days and only two recurrences. The authors recommend the Limberg Flap procedure for pilonidal sinus disease. It is effective, with short hospitalization, low recurrence rate and shorter time off work.
Distal radius fractures are the most common fractures of the upper limbs and repre-sent 17% of all fractures treated in emergency medicine. The purpose of the present study is to evaluate the correlation between the clinical and radiographic outcomes obtained with surgical osteosynthesis using volar plates for the treatment of articular fractures of the wrist. We evaluated a series of 50 consecutive patients from January 2010 to December 2013 who had undergone surgery, aged 24 to 75, for distal meta-epiphyseal fractures of the radius, with or without distal ulnar involvement. All pa-tients were evaluated clinically and radiographically, pre-operatively and post-operatively. For the clinical evaluation, the DASH score and Mayo Wrist clinical rating scale were used. After one year, the range of movement of the wrist was very satis-factory, and the mean grip strength was 77.5% of the opposite wrist. The Disabilities of the Arm, Shoulder, and Hand (DASH) score was 18 and the Mayo Modified Wrist Score was 82.5. Complex articular distal radius fractures, like those of other sites, needed an appropriate surgical treatment and the fixation with the volar LCP system demonstrated its validity for the stabilization of these fractures, the articular surface reconstruction and prompt mobilization. All the clinical results were related to the pa-tients’ age, the functional needs, the physiotherapy and the individual recovery
In Italy, actually, it is not possible to estimate at national level a reliable ASD occur-rence by using existing health and scholastic data flows. The lack of information has implications on social and healthcare services dedicated to subjects affected by ADS.
The database of the Italian institute in charge of social and security assistance was accessed at the provincial level to investigate the ASD cases occurred in the Palermo province. The official reports of all subjects visited in 2013 by INPS physicians were analyzed by using an automatic software and diagnosis consistent with ASD were ex-tracted and flagged.
Our findings support the choice of alternative use of INPS administrative database in order to define a reliable ASD occurrence estimate as first step to develop an inte-grated epidemiological surveillance system on ASD.
MULTISPECTRAL MICROSCOPY AND COMPUTERIZED IMAGE ANALYSIS: A METHOD TO OBTAIN MORE RELIABLE AND REPRODUCIBLE IMMUNOHISTOCHEMISTRY RESULTSWritten by Giovanni Francesco Spatola et al.
Intra-abdominal desmoplastic small round cell tumors are rare aggressive neoplasms, with a very poor prognosis, observed in young adults with a male predominance. Their etiology is unknown and the diagnosis is based on histopathology, immunohistochem-istry and cytogenetics. Histological analysis shows typically clusters of round cells separated by abundant desmoplastic stroma. These tumors exhibit a multi-marker im-munohistochemistry profile expressing the three embryonic lineages: epithelial, neural and mesenchymal. They are positive for desmin and cytokeratin and are characterized by a specific recurring translocation t (11: 22) (q12 - p13), which involves EWSR1 WT1 gene. They are usually fatal despite an aggressive multidisciplinary therapeutic approach. Hereby we report the case of a 39 year old man who presented with an in-tra-abdominal desmoplastic small round cell tumor. The diagnosis was made by radio-logical, histological and immunohistochemistry profile analyses of a CT scanguided bi-opsy. This article also includes a mini review of the literature.
Retropharyngeal abscesses (RPA) are rare in adults. We report a case of a healthy adult with RPA presenting with clinical symptoms of acute thyroiditis. A 37-yr-old female presented with a painful mass in the anterior region of the neck, sore throat, mild fever and dysphagy for liquids and solids. Neck emergency US dis-closed normal thyroid ventrally displaced by a huge retropharyngeal hypoechoic mass. Direct laryngoscopy revealed erythema of the posterior pharyngeal wall with bulges (8 cm) preventing the correct visualization of the glottic plane. CT confirmed the pres-ence of retropharyngeal abscess and laryngoscopic drainage was performed. The pa-tient was discharged on 11th post-operative day, in good condition. The high mortality rate of retropharyngeal abscess is related to its association with invasion of contiguous structures and mediastinum: once mediastinitis occurs, mortality reaches 50%, even with antibiotic therapy. CT is fundamental for the diagnosis, but in many cases, as our, ultrasonography of the neck may play a pivotal role as quickly as possible. Surgi-cal treatment (intraoral incision and drainage) is the better definitive and resolutive treatment. The clinical diagnosis of retropharyngeal abscess in adult can be difficult because of the lacking and non specificity of clinical presentation. It is recommended to collect accurate clinical history, careful examination of the head and neck and use of early ultrasound examination of the neck, which in real time can give precise indications to guide the diagnosis and therapy. The management of a retropharyngeal abscess depends on the patient’s clinical condi-tion, moving from conservative treatment with steroids and antibiotics to reanimation and aggressive surgical drainage.