Diagnosing Fabry nephropathy: the challenge of multiple kidney disease.

Fabry disease (FD) is an X-linked inherited lysosomal disorder due to a deficiency of the enzyme alpha-galactosidase A (α-gla) due to mutations in the GLA gene. These mutations result in plasma and lysosome accumulation of glycosphingolipids, leading to progressive organ damage and reduced life expectancy. Due to the availability of specific disease-modifying treatments, proper and timely diagnosis and therapy are essential to prevent irreversible complications.

A Novel Muco-Gingival Approach for Immediate Implant Placement to Obtain Soft- and Hard-Tissue Augmentation.

The aim of this article is to describe a novel approach combining muco-gingival, regenerative and prosthetics concepts for immediate implant insertion that overcomes the limits traditionally considered as contraindications for Type 1 flapless implant positioning, simultaneously obtaining soft- and hard-tissue augmentation. After pre-surgical CBCT evaluation, the surgical technique consisted in the execution of a lateral-approach coronally advanced envelope flap, with oblique submarginal interproximal incisions directed towards the flap's center of rotation (the tooth to be extracted); after buccal-flap elevation, the atraumatic extraction of the tooth was performed. Following guided implant insertion, a mixture of biomaterial and autologous bone was placed, stabilized by a pericardium membrane and a connective-tissue graft sutured in the inner aspect of the buccal flap.

A reliable fossa ovalis impedance mapping for safer transseptal puncture: A new vision beyond voltage.

Introduction: Transseptal puncture (TSP) is widely used in clinical practice but is negatively affected by a nonneglectable rate of complications and X-ray exposure. To address these problems, we investigated whether or not impedance mapping could correctly identify fossa ovalis (FO) and safely guide TSP.

Methods And Results: Electroanatomic mapping was performed with CARTO 3 system version 7 and a ThermoCool® SmartTouch® mapping catheter was employed.

Management of patients with cervical spine trauma in the emergency department: a systematic critical appraisal of guidelines with a view to developing standardized strategies for clinical practice.

Several guidelines on the evaluation of patients with suspected cervical spine trauma in the Emergency Department (ED) exist. High heterogeneity between different guidelines has been reported. Aim of this study was to find areas of agreement and disagreement between guidelines, to identify topics in which further research is needed and to provide an evidence-based cervical spine trauma algorithm for ED physicians.

The role of lung ultrasound as a frontline diagnostic tool in the era of COVID-19 outbreak.

The diffusion of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) worldwide prompted the World Health Organization to declare the status of pandemic. The molecular diagnosis of SARS-CoV-2 infection is based on the detection of viral RNA on different biological specimens. Unfortunately, the test may require several hours to be performed.

Peri-implant Papillae Reconstruction at an Esthetically Failing Implant.

This case report aimed to describe a soft tissue approach to restore a buccal soft tissue dehiscence (BSTD) combined with the loss of peri-implant papillae and loss of periodontal attachment on the adjacent teeth. The first step of the proposed approach was the removal of the crown and abutment to leave the interproximal soft tissue to fill the space previously occupied by the crown. After 3 months, during which time the patient was wearing a provisional restoration (a temporary Maryland bridge), the implant site was treated as an edentulous area with a soft tissue augmentation procedure: the most substantial modification with respect to the original connective tissue platform technique was the use of the wide mesial and distal papillae of the implant, once de-epithelialized on the occlusal surface, as a "partial" connective platform to suture the connective grafts and submerge the implant.

Prevalence, risk factors and outcomes of patients coming from the community with sepsis due to multidrug resistant bacteria.

Background: Although previous studies showed an increasing prevalence of infections due to multi-drug resistant (MDR) bacteria in the community, specific data on sepsis are lacking. We aimed to assess prevalence, risk factors and outcomes of patients with sepsis due to MDR bacteria.

Methods: An observational, retrospective study was conducted on consecutive adult patients coming from the community and admitted to the Policlinico Hospital, Milan, Italy, with a diagnosis of sepsis between January 2011 and December 2015.

Esthetic treatment of altered passive eruption.

Altered passive eruption is described as a condition in which the relationship between teeth, alveolar bone and soft tissues creates an excessive display of gingiva, commonly known as a 'gummy smile'. While there are authors who consider altered passive eruption to be a risk to periodontal health, its impact is greatest in terms of oral esthetics. The aim of periodontal management in such cases is not only to improve patient esthetics but also to restore periodontal health by re-establishing the normal relationship between the gingival margin, alveolar bone crest and cemento-enamel junction.

Drug-coated balloon: Long-term outcome from a real world three-center experience.

Objectives: In-stent restenosis (ISR) and diffuse small vessel disease still represent challenging subsets for percutaneous coronary interventions, also in the new-generation DES era. We aim at reporting on the long-term clinical outcome of drug-coated balloons (DCB) in all-comers population.

Methods: Consecutive patients treated with DCB between January 2011 and December 2014 were retrospectively studied in three centers of northern Italy.

The connective tissue graft wall technique to improve root coverage and clinical attachment levels in lingual gingival defects.

The present case report describes the application of the connective tissue graft wall (CTGW) technique for the treatment of deep lingual gingival recessions associated with probing pockets and bone loss. Two deep lingual gingival recessions affecting the mandibular central incisors associated with severe lingual attachment and bone loss were treated. The surgical technique comprised a connective tissue graft (CTG) placed below a trapezoidal-type coronally advanced flap (CAF) acting as a lingual soft tissue wall of the infrabony defect.

The connective tissue graft wall technique and enamel matrix derivative to improve root coverage and clinical attachment levels in Miller Class IV gingival recession.

The case reports in this article describe a surgical approach for improving root coverage and clinical attachment levels in Miller Class IV gingival recessions. Two gingival recessions affecting maxillary and mandibular lateral incisors associated with severe interdental hard and soft tissue loss were treated. The surgical technique consisted of a connective tissue graft (CTG) that was placed below a coronally advanced envelope flap and acted as a buccal soft tissue wall of the bony defect treated with enamel matrix derivative (EMD).

Assessing the role of eptifibatide in patients with diffuse coronary disease undergoing drug-eluting stenting: the INtegrilin plus STenting to Avoid myocardial Necrosis Trial.

Background: The optimal antiplatelet regimen in elective patients undergoing complex percutaneous coronary interventions (PCIs) is uncertain. We aimed to assess the impact of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibition with eptifibatide in clinically stable subjects with diffuse coronary lesions.

Methods: Patients with stable coronary artery disease undergoing PCI by means of implantation of >33 mm of drug-eluting stent were single-blindedly randomized to heparin plus eptifibatide versus heparin alone.

Reduced antiplatelet therapy after drug-eluting stenting: multicenter Janus Flex carbostent implantation with short dual antiplatelet treatment for 2 or 6 months-MATRIX study.

Objectives: The Multicentre registry with Antiplatelet TReatment two-sIX months (MATRIX) evaluated safety and efficacy at 12-month follow-up of Janus Flex stenting with 2- or 6-month dual antiplatelet therapy (DAT) period.

Background: There are no data of Janus Flex stent (Carbostent and Implantable Devices-CID, Saluggia, Italy), a polymer-free, tacrolimus-eluting coronary stent, followed by short-term DAT, in daily practice.

Methods: Patients were prospectively enrolled at 12 high-volume procedures centres.

A rare case of idiopathic spontaneous coronary artery dissection causing acute myocardial infarction.

Spontaneous coronary artery dissection is a rare clinical event and often a fatal cause of ischaemic heart disease occurring predominantly in young or middle-aged otherwise healthy patients. We present the case of a 59-year-old female patient who was admitted to our coronary care unit with acute anterior myocardial infarction. Coronary angiography showed a long dissection involving the left coronary artery.

Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy.

Objectives: We sought to assess the occurrence and clinical significance of stroke and peripheral arterial embolizations at non-central nervous system sites in a large, community-based cohort with hypertrophic cardiomyopathy (HCM).

Background: Such vascular events are insufficiently appreciated complications of HCM for which there is limited information on occurrence, clinical profile and determinants.

Methods: We assessed the clinical features of patients with stroke and other peripheral vascular events in a consecutive group of patients with HCM from four regional cohorts not subject to significant tertiary referral bias.