Descending Aortic Translocation and Right Pulmonary Artery Reimplantation for Midline Descending Aorta and Crossed Pulmonary Arteries in an Infant.

Left mainstem bronchial compression by a midline descending thoracic aorta is a rare anatomic variant. Translocation of the descending thoracic aorta to the ascending aorta has recently been described to treat this condition. We performed an aortic translocation and right pulmonary artery reimplantation in a 4-month-old infant with severe pulmonary hypertension secondary to right pulmonary artery stenosis and left bronchial compression by a midline descending thoracic aorta.

OSF-Builder: A New Tool for Constructing and Representing Evolutionary Histories Involving Introgression.

Introgression is an evolutionary process which provides an important source of innovation for evolution. Although various methods have been used to detect introgression, very few methods are currently available for constructing evolutionary histories involving introgression. In this article, we propose a new method for constructing such evolutionary histories whose starting point is a species forest (consisting of a collection of lineage trees, usually arising as a collection of clades or monophyletic groups in a species tree), and a gene tree for a specific allele of interest, or allele tree for short.

Nonalcoholic Fatty Liver Disease: Status Quo.

Nonalcoholic liver disease (NAFLD) is a hot topic for gastroenterologists and hepatologists and clinical practitioners must be kept abreast with the rapid progress of knowledge in this field. The Romanian Society of Gastroenterology and Hepatology (RSGH) has elaborated this review dedicated to evidence-based data on pathogenesis, diagnosis and therapy of this condition. The term NAFLD includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH), the second with the highest risk of evolution to cirrhosis and its complications, including hepatocellular carcinoma (HCC).

Clinical, histological and therapeutic modern approach of Ledderhose disease.

Ledderhose disease or plantar fibromatosis is a rare hyperproliferative disorder of the plantar aponeurosis, clinically characterized by nodules situated especially on the medial border of the foot. It is histopathologically associated with Dupuytren's disease. This disease has some risk factors, like old age, alcohol or nicotine abuse, liver dysfunction, trauma or exposure to vibrations and autoimmune disorders, but the exact etiology is still unknown.

Laparoscopic sleeve gastrectomy and gastroesophageal reflux.

The prevalence of obesity is rising, becoming a medical problem worldwide. Also GERD incidence is higher in obese patients compared with normal weight, with an increased risk of 2.5 of developing symptoms and erosive esophagitis.

MR angiography and 2-D phase-contrast imaging for evaluation of meso-rex bypass function.

Background: The meso-Rex bypass restores blood flow to the liver in patients with extrahepatic portal vein thrombosis. Stenosis occurs in some cases, causing the reappearance of portal hypertension. Complications such as thrombocytopenia present on a spectrum and there are currently no guidelines regarding a threshold for endovascular intervention.

Value of ejection fraction/velocity ratio in the prognostic stratification of patients with asymptomatic aortic valve stenosis.

Background: The ejection fraction/velocity ratio (EFVR) is a simple function-corrected index of aortic stenosis severity with a good correlation with aortic valve area measured using the Gorlin formula at cardiac catheterization. It is calculated by dividing left ventricular ejection fraction (LVEF) to 4 × (peak jet velocity) .

Objective: Our aim was to evaluate the value of EFVR in predicting adverse events in patients with asymptomatic aortic stenosis.

Comparative study between four ultrasound Shear Waves Elastographic methods for liver fibrosis assessment.

Aims: Non-invasive methods to assess the severity of chronic liver diseases have become more and more popular. The aim of our study was to evaluate the correlation of four Shear Waves Elastographic methods in a cohort of patients with chronic liver diseases of mixed etiologies and to compare their performances for liver fibrosis evaluation.

Material And Methods:  A prospective study was conducted on 127 consecutive patients with chronic liver diseases of mixed etiologies.

Gastrointestinal endoscopy in patients on direct oral anticoagulants. A consensus paper of the Romanian Society of Gastroenterology and Hepatology.

Management of patients undergoing endoscopy and under treatment with the newer direct oral anticoagulants (DOACs) is a common and a complex clinical issue that gastroenterologists have to face more and more often these days. The increasing use of DOACs in patients requiring both short- and long-term anticoagulation is mostly due to the advantages these agents offer, among which the lack of monitoring requirements and the reduced need of dose adjustments are perhaps the most important ones. Managing these patients in the peri-endoscopic period implies balancing the risk for thrombosis that a certain patient carries and the bleeding risk associated with the endoscopic procedure itself.

Intra- and Inter-Observer Reproducibility of a 2-D Shear Wave Elastography Technique and the Impact of Ultrasound Experience in Achieving Reliable Data.

The aim of the study described here was to evaluate the reproducibility of a new shear-wave elastography (SWE) technique, 2-D SWE.GE, and the impact of ultrasound experience in acquiring reliable measurements, as no official recommendations are available for this system. Elastographic measurements (EMs) were obtained in 60 patients using 2-D-SWE with the GE Logiq E9.

Correlation of Point Shear Wave Velocity and Kidney Function in Chronic Kidney Disease.

Objectives: Point shear wave elastography is a quantitative ultrasound-based imaging method used in the assessment of renal disease. Among point shear wave elastographic options, 2 techniques have been studied considerably: Virtual Touch quantification (VTQ; Siemens AG, Erlangen, Germany) and ElastPQ (EPQ; Philips Healthcare, Bothell, WA). Both rely on the tissue response to an acoustic beam generated by the ultrasound transducer.

New classification of geometric ventricular patterns in severe aortic stenosis: Could it be clinically useful?

Background: In severe aortic stenosis, different left ventricle (LV) remodeling patterns as a response to pressure overload have distinct hemodynamic profiles, cardiac function, and outcomes. The most common classification considers LV relative wall thickness and LV mass index to create 4 different groups. A new classification including also end-diastolic volume index has been recently proposed.

Obesity, Cardiac Remodeling, and Metabolic Profile: Validation of a New Simple Index beyond Body Mass Index.

Aim: The body mass index (BMI), the most used anthropometric index of obesity, has an important limitation, not taking into consideration the distribution of body fat. We developed a new simple index: the waist-corrected BMI (wBMI), calculated as waist circumference (WC) × BMI. The study aim was to assess the role of wBMI, compared to BMI, WC, and Waist-to-Height Ratio (WHtR) in predicting abnormal cardiac geometry, insulin resistance, increased arterial stiffness, and dyslipidemia.

Tyrosine-kinase Inhibitors Treatment in Advanced Malignant Melanoma.

Objective: To put in perspective recent advances in the treatment of malignant melanoma with novel tyrosine-kinase inhibitors.

Methods: We reviewed the largest trials that support the treatment with tyrosine-kinase inhibitors (TKIs) in cutaneous malignant melanoma, the base of the current guideline recommendations.

Conclusions: Mitogen-activated protein-kinase (MAPK) pathway inhibition via modern TKIs is a major breakthrough in the treatment of melanoma, with a very high benefit for patients with disease harboring BRAF-gene mutations, in terms of rates of response and survival.

Brom Aortoplasty for Supravalvular Aortic Stenosis.

Background: Controversy remains regarding the optimal surgical approach for children with supravalvular aortic stenosis (SVAS).

Methods: Since 1997 we have used Brom three-patch aortoplasty for patients with SVAS. We prefer computed tomography (CT) imaging for preoperative evaluation rather than cardiac catheterization as it avoids the well-known morbidity of general anesthesia.

Scope and Nature of Pain- and Analgesia-Related Content of the United States Medical Licensing Examination (USMLE).

Background: "The ongoing opioid crisis lies at the intersection of two substantial public health challenges-reducing the burden of suffering from pain and containing the rising toll of the harms that can result from the use of opioid medications" [1]. Improved pain education for health care providers is an essential component of the multidimensional response to both still-unmet challenges [2,3]. Despite the importance of licensing examinations in assuring competency in health care providers, there has been no prior appraisal of pain and related content within the United States Medical Licensing Examination (USMLE).

Laser-direct writing by two-photon polymerization of 3D honeycomb-like structures for bone regeneration.

A major limitation of existing 3D implantable structures for bone tissue engineering is that most of the cells rapidly attach on the outer edges of the structure, restricting the cells penetration into the inner parts and causing the formation of a necrotic core. Furthermore, these structures generally possess a random spatial arrangement and do not preserve the isotropy on the whole volume. Here, we report on the fabrication and testing of an innovative 3D hierarchical, honeycomb-like structure (HS), with reproducible and isotropic arhitecture, that allows in 'volume' migration of osteoblasts.

Thermally driven anomalous Hall effect transitions in FeRh.

Materials exhibiting controllable magnetic phase transitions are currently in demand for many spintronics applications. Here we investigate from first principles the electronic structure and intrinsic anomalous Hall, spin Hall and anomalous Nernst response properties of the FeRh metallic alloy which undergoes a thermally driven antiferromagnetic-to-ferromagnetic phase transition. We show that the energy band structures and underlying Berry curvatures have important signatures in the various Hall effects.