Raphe-Type Bicuspid Aortic Valve as a Risk Factor for Transcatheter Aortic Valve Replacement Failure: Improving Outcomes Using the LIRA Method and the Medtronic FX Prosthesis.

Transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis and raphe-type bicuspid aortic valve (BAV) is still associated with poor outcomes in terms of increased risk of paravalvular regurgitation, stroke, and permanent pacemaker implantation. There is no definitive consensus on the optimal sizing method for prosthesis selection in this setting. The LIRA method is a supra-annular tailored sizing method specifically designed for bicuspid anatomy that might increase accuracy of prosthesis choice in BAV patients and improve TAVR outcomes.

Preoperative Antibiotic Administration Does Not Improve the Outcomes of Operated Diabetic Foot Infections.

Many patients with community-acquired diabetic foot infections (DFI) receive systemic (empirical) antibiotic treatments before surgical interventions, often by the general practitioner. Sometimes, hospital clinicians prescribe them before surgery to reduce the infection inoculum and preserve soft tissue for immediate wound closure in case of residual infection after surgery. In contrast, the international guidelines (IWGDF) advocate against presurgical antibiotic use in routine situations without severe progredient soft tissue infections and/or sepsis.

Computed tomography derived predictors of left ventricular obstruction after TAVR.

Background: Left ventricular obstruction (LVO) is an infrequent complication following transcatheter aortic valve replacement (TAVR) that can lead to severe hemodynamic decompensation. Previous studies have analyzed the pathophysiology of this clinical entity; however, little is known about the anatomical characteristics as assessed by computational tomography (CT) of patients at risk.

Methods: Data from 349 patients were retrospectively analyzed from a single center registry of patients undergoing TAVR at San Raffaele Hospital, Milan, Italy, between January 2020 and December 2021.

Ecteinascidin synthetic analogues: a new class of selective inhibitors of transcription, exerting immunogenic cell death in refractory malignant pleural mesothelioma.

Background: Malignant pleural mesothelioma (MPM) is a highly chemo-refractory and immune-evasive tumor that presents a median overall survival of 12-14 months when treated with chemotherapy and immunotherapy. New anti-tumor therapies as well as the concomitant reactivation of immune destruction are urgently needed to treat patients with this tumor. The aim of this work is to investigate the potential effect of ecteinascidin derivatives as lurbinectedin as new first-line treatment option in MPM, alone and in combination with immunotherapy.

Actionable NSCLC Mutation Identification by Comprehensive Genomic Profiling for Clinical Trial Enrollment: The European Program for the Routine Testing of Patients With Advanced Lung Cancer (EPROPA).

Introduction: The advocacy Women Against Lung Cancer in Europe (WALCE) promoted the European Program for the Routine Testing of Patients With Advanced Lung Cancer (EPROPA) and provided a free-of-charge molecular profiling platform for NSCLC sample characterization with the aim of increasing the detection of targetable drivers and improving patients' access to clinical trials in Europe.

Methods: From January 2021 to December 2023, 20 centers located at five different European countries (Greece, Slovenia, Romania, Albania, and Italy) joined EPROPA, with 555 patients with advanced NSCLC registered to the program. Anonymized patients' clinical-pathological data were shared through the EPROPA web platform and tissue samples were collected at the Molecular Pathology Unit of the Reference Center (University of Turin) for molecular analyses.

Clinical Outcomes of Patients With Bicuspid Aortic Valve Undergoing a Targeted Transcatheter Aortic Valve Replacement Approach: The LIRA Method.

Background: Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve (BAV) disease is still burdened by a non-negligible rate of stroke and permanent pacemaker implantation (PPI). These suboptimal results, possibly related to the unique BAV anatomy, may suggest the use of a different sizing method in this setting. The aim of our study is to evaluate whether the application of the supra-annular LIRA method may improve clinical outcomes in this population.

SPISE INDEX (Single point insulin sensitivity estimator): indicator of insulin resistance in children and adolescents with overweight and obesity.

Background: Insulin resistance in children and adolescents with obesity is linked to increased risk of type 2 diabetes mellitus and cardiovascular disease. The SPISE index, based on values of fasting triglycerides (mg/dL), HDL cholesterol (mg/dL), and BMI (kg/m2), shows promise in predicting insulin resistance in children.

Methods: This study aimed to identify a SPISE cut-off for detecting insulin resistance and evaluate its relationship with pubertal development, anthropometrics, and glycometabolic profile in 232 children and adolescents, 105 males and 127 females (median age 13.

Microphthalmia and Disrupted Retinal Development Due to a Knock-in/Knock-Out Allele at the Locus.

Purpose: Visual System Homeobox 2 () is a transcription factor expressed in the developing retina that regulates tissue identity, growth, and fate determination. Several mutations in the gene exist in mice, including a spontaneous nonsense mutation and two targeted missense mutations originally identified in humans. Here, we expand the genetic repertoire to include a reporter allele ( ) designed to express beta-Galactosidase (bGal) and simultaneously disrupt function (knock-in/knock-out).

The posterior mitral leaflet overhang: A rare yet possible complication of percutaneous mitral valve procedures.

The two surgical options for mitral valve regurgitation are replacement and repair, with annuloplasty being the cornerstone of correction. In cases of repair failure, especially in high surgical risk patients, transcatheter mitral valve-in-ring (MViR) procedures represent emerging and challenging options. Among the several complications linked to this treatment, this paper delves into the role that native mitral leaflets may play in precipitating acute bioprosthesis dysfunction in the MViR procedure.

Active thymus in adult with lung cancer: preliminary results from the Adult Thymic Project.

Thymus is considered a non-functional remnant in adults, but some evidence suggest that it may harbor residual activity. Lung cancer patients represent the ideal model to study thymic residual activity, as their thymus can be easily harvested during surgery. This study was designed to confirm the presence of residual thymic activity both in adult mice (step 1) and in humans (step 2).

Approach to the child and adolescent with Adrenal Insufficiency.

The management of adrenal insufficiency is challenging, and the overall goals of treatment are to prevent life-threatening adrenal crises, to optimize linear growth, to control androgen levels without overdosing in subjects with congenital adrenal hyperplasia (CAH) and to improve quality of life in affected individuals. Standard glucocorticoid formulations fail to replicate the circadian rhythm of cortisol and control the adrenal androgen production driven by adrenocorticotropic hormone. In order to personalize and tailor glucocorticoid therapy and to improve patient outcomes, new pharmacological strategies have been developed that best mimic physiological cortisol secretion.

TFEB controls sensitivity to chemotherapy and immuno-killing in non-small cell lung cancer.

Background: In non-small cell lung cancer (NSCLC) the efficacy of chemo-immunotherapy is affected by the high expression of drug efflux transporters as ABCC1 and by the low expression of ABCA1, mediating the isopentenyl pyrophosphate (IPP)-dependent anti-tumor activation of Vγ9Vδ2 T-lymphocytes. In endothelial cells ABCA1 is a predicted target of the transcription factor EB (TFEB), but no data exists on the correlation between TFEB and ABC transporters involved in the chemo-immuno-resistance in NSCLC.

Methods: The impact of TFEB/ABCC1/ABCA1 expression on NSCLC patients' survival was analyzed in the TCGA-LUAD cohort and in a retrospective cohort of our institution.

Aluminum Alkyl Induced Isomerization of Group IV meso Metallocene Complexes.

The synthesis of group IV metallocene precatalysts for the polymerization of propylene generally yields two different isomers: The racemic isomer that produces isotactic polypropylene (iPP) and the meso isomer that produces atactic polypropylene (aPP). Due to its poor physical properties, aPP has very limited applications. To avoid obtaining blends of both polymers and thus diminish the mechanical and thermal properties of iPP, the meso metallocene complexes need to be separated from the racemic ones tediously-rendering the metallocene-based polymerization of propylene industrially far less attractive than the Ziegler/Natta process.

Accuracy of Glucagon Testing Across Transition in Young Adults With Childhood-Onset GH Deficiency.

Context: The 2019 American Association of Clinical Endocrinologists guidelines suggested peak GH-cutoffs to glucagon test (GST) of ≤3 and ≤1 µg/L in the diagnosis of permanent GH deficiency (GHD) during the transition phase.

Objective: The aim of the study was to evaluate the accuracy of GST compared to insulin tolerance test (ITT) in the definition of GHD at adult height achievement.

Patients And Methods: Ninety-seven subjects with childhood-onset GHD (median age, 17.

Microphthalmia and disrupted retinal development due to a knock-in/knock-out allele at the locus.

Visual System Homeobox 2 () is a transcription factor expressed in the developing retina that regulates tissue identity, growth, and fate determination. Several mutations in the gene exist in mice, including a spontaneous nonsense mutation and two targeted missense mutations originally identified in humans. Here, we expand the genetic repertoire to include a reporter allele ( ) designed to express beta-Galactosidase (b-GAL) and simultaneously disrupt function (knock-in/knock-out).

The dual prevalence of advanced degrees of obesity and heart failure: a study from the National Inpatient Sample database.

Background: National prevalence rates for obesity and heart failure (HF) have been steadily increasing, which predisposes patients to higher morbidity and mortality rates.

Objectives: The purpose of this study was to evaluate the prevalence of HF stages in hospitalized patients according to their body mass index (BMI).

Setting: Academic institution.

Diabetes Insipidus Complicating Diabetes Mellitus Type 1: A Pituitary Abscess Diagnosis.

In this report we present a case of a 14-year-old girl with type 1 diabetes mellitus (T1DM) who experienced glycemic instability and multiple hormonal deficits, including diabetes insipidus, central hypothyroidism, and central adrenal insufficiency. Brain and sellar magnetic resonance imaging revealed a mass in the suprasellar region, which was confirmed to be a pituitary abscess through transsphenoidal biopsy. T1DM is a chronic systemic disease that can lead to suboptimal glycemic control and increased susceptibility to infections.

Rheumatic and Degenerative Mitral Stenosis: From an Iconic Clinical Case to the Literature Review.

Mitral stenosis (MS) poses significant challenges in diagnosis and management due to its varied etiologies, such as rheumatic mitral stenosis (RMS) and degenerative mitral stenosis (DMS). While rheumatic fever-induced RMS has declined in prevalence, DMS is rising with aging populations and comorbidities. Starting from a complex clinical case of DMS, the aim of this paper is to review the literature on mitral stenosis by analyzing the available tools and the differences in terms of diagnosis and treatment for rheumatic and degenerative stenosis.

NEDA-3 achievement in early highly active relapsing remitting multiple sclerosis patients treated with Ocrelizumab or Natalizumab.

Background: in the early stages of Multiple Sclerosis (MS), initiating high-efficacy disease-modifying therapy (HE DMTs) may represent an optimal strategy for delaying neurological damage and long-term disease progression, especially in highly active MS patients (HAMS). Natalizumab (NAT) and Ocrelizumab (OCR) are recognized as HE DMTs with significant anti-inflammatory effects. This study investigates NEDA-3 achievement in treatment-naïve HAMS patients receiving NAT or OCR over three years.

CT-Guided Core Needle Biopsy of Pulmonary Lesions Associated With Cystic Airspaces: A Case-Control Study.

Concern may exist that pulmonary lesions associated with cystic airspaces are at risk of increased biopsy complications or lower biopsy accuracy given challenges in targeting tissue abutting or intermingled with the cystic airspaces. The purpose of this study was to evaluate the safety and diagnostic performance of CT-guided core needle biopsy (CNB) of pulmonary lesions associated with cystic airspaces. This retrospective study included 90 patients (median age, 69.

Blood-brain barrier damage associates with glia-related cytokines in the cerebrospinal fluid of patients with Multiple Sclerosis.

Background: The presence of Blood-Brain Barrier (BBB) dysfunction is defined by albumin quotient (Q) and characterize a group of Multiple Sclerosis (MS) patients at clinical onset. We evaluated the concentration in cerebrospinal fluid (CSF) of 87 cytokines, to better characterize the CSF inflammatory pattern in presence of BBB damage.

Materials And Method: In an exploratory cohort, CSF cytokines were evaluated by means of Multiplex technology (Bio-Plex Pro-Human Cytokine, GF and Diabetes 27-Plex Panel, Bio-Plex Pro-Human Chemokines 40-Plex Panel, Bio-Plex Pro-Human Inflammation Assays 37-Plex Panel) in a cohort of Other Not Inflammatory Neurological Disorders (ONIND) and in cohort of patients with MS, stratified according to BBB damage into Q and Q MS patients.