Neuropathic pain features suggestive of small fibre neuropathy in fibromyalgia syndrome: a clinical and ultrasonographic study on female patients.

Objectives: To evaluate the performance of two screening tools, respectively Pain Detect Questionnaire (PDQ) and Douleur Neuropathique 4 questions (DN4), and the optimal cut-off point of the sural nerve cross-sectional area (CSA), in identifying the neuropathic pain features suggestive of a small fiber neuropathy (SFN), in patients with fibromyalgia syndrome (FM).

Methods: Consecutive adult female FM patients fulfilling the American College of Rheumatology (ACR) 2016 criteria have been enrolled. Patients underwent a clinical assessment and ultrasound examination of the sural nerve CSA.

Sural Nerve Size in Fibromyalgia Syndrome: Study on Variables Associated With Cross-Sectional Area.

Increased cross-sectional area (CSA) of sural nerve, documented by ultrasound (US), has been revealed in small fibers neuropathy, condition present in about half of patients with fibromyalgia (FM). The aims of this study were to evaluate sural nerve CSA and to establish the variables associated with increased CSA in FM patients. A cross-sectional assessment was conducted in consecutive FM patients.

[The treatment of ST-elevation acute myocardial infarction on the ground and in hospital: avoidable delays and basic organisation models].

Pharmacological or mechanical reperfusion is the cornerstone for the treatment of acute myocardial infarction and success depends on early treatment. Analysis of avoidable delays and the setting up of suitable organisation models are thus of fundamental importance. Primary angioplasty, provided it is carried out on the basis of the criteria recommended in the international guidelines, is more effective than fibrinolysis but is not practicable on a wide scale.

[Transfer of high-risk patients with acute myocardial infarct for subsequent coronary angioplasty. Some considerations].

For invasive therapeutic options in patients with acute myocardial infarction admitted to hospitals without angioplasty facilities, immediate transfer to a referral "tertiary" center is needed. The background for this therapeutic strategy is the benefit in clinical outcome of primary coronary angioplasty when compared with thrombolysis, especially for high risk patients with acute myocardial infarction. Rescue coronary angioplasty also is interesting, because of additional delay due to transfer.

Cardiac tamponade in thalassemia.

We report a case of acute cardiac tamponade without concurrent myocardial disease occurring in a thalassemia patient early after bone marrow transplantation. The pericardial effusion was preceded by an episode of junctional tachycardia. Repeated evaluation by echocardiography was done shortly after the patient developed the arrhythmia and permitted a detailed, timed observation of the event and description of the symptoms.

Cardiac study by dobutamine stress echocardiography in thalassemic patients.

In patients with Thalassaemia Major the iron overload with alteration both of systolic and diastolic properties of left and right ventricles finally leads to symptoms of cardiac failure and is the most frequent cause of death in these patients. In the majority of asymptomatic thalassemic patients with normal myocardial mass it is possible to demonstrate an alteration of the diastolic function both with echocardiographic study and with radionuclide angiography (subclinical cardiac disease). We have also demonstrated in "ex thalassemics" with stable and heavy iron overload in the subclinical cardiac disease phase a subnormal systolic function and a slight impairment of the contractility state.

Calcium ion independent membrane leakage induced by phospholipase-like myotoxins.

The two snake venom myotoxins ammodytin L and myotoxin II, purified respectively from Vipera ammodytes ammodytes and Bothrops asper, have phospholipase-like structures but lack an Asp-49 in the active site and are without normal phospholipase activity. The interaction of these proteins with different types of liposomes indicated that the myotoxins were able to provoke rapid and extensive release of the aqueous content of liposomes. Leakage was measured by two different methods: fluorescence dequenching of liposome-entrapped carboxyfluorescein and ESR measurement of intravesicular TEM-POcholine reduction by external ascorbate.

Sudden cardiac tamponade after chemotherapy for marrow transplantation in thalassaemia.

Published work suggests that cardiac tamponade occurs only occasionally after bone-marrow transplantation (BMT) but the worrying number of cases encountered in the transplant programme in Pesaro, Italy, has led to an analysis of this complication. Cardiac tamponade occurred in 8 (2%) of 400 consecutive thalassaemic patients during conditioning for or within a month of BMT. 6 cases were fatal; these represented 9% of all causes of death and 29% of those occurring between start of conditioning regimen and 30 days post transplant.