The MOnitoring Resynchronization dEvices and CARdiac patiEnts (MORE-CARE) study: rationale and design.

Background: With the advent of remote monitoring, current models of implantable cardioverter defibrillators (ICDs) have the possibility of sending automatic alert messages that allow early diagnosis of events such as lung fluid overload, atrial fibrillation and device integrity issues. Timely treatment of these events has the potential to improve patient outcome, but this has not as yet been proven.

Methods: The MORE-CARE study is a multicenter randomized controlled trial evaluating the efficacy of advanced device diagnostics and remote monitoring in improving the outcome of patients with biventricular ICDs.

Adherence to guidelines for atrial fibrillation management of patients referred to cardiology departments: Studio Italiano multicentrico sul Trattamento della Fibrillazione Atriale (SITAF).

Aims: The purpose of this study was to evaluate adherence to national guidelines on the non-pharmacologic (ablative) treatment of atrial fibrillation (AF).

Methods And Results: This prospective, observational, transversal study enrolled 1256 consecutive in- and outpatients referred to 43 cardiology departments between 1 and 31 October 2008 for the management of AF as a primary diagnosis. A rhythm-control strategy (cardioversion, antiarrhythmic medication, pace-maker implantation, substrate ablation, alone or in combination) was prescribed in 865 (69%) of the patients and a rate-control strategy [drugs, atrioventricular junction ablation and pace-maker implantation (Ablate and Pace)] in 285 (23%).

Test of "crab-waist" collisions at the DAPhiNE Phi factory.

The electron-positron collider DAPhiNE, the Italian Phi factory, has been recently upgraded in order to implement an innovative collision scheme based on large crossing angle, small beam sizes at the crossing point, and compensation of beam-beam interaction by means of sextupole pairs creating a "crab-waist" configuration in the interaction region. Experimental tests of the novel scheme exhibited an increase by a factor of 3 in the peak luminosity of the collider with respect to the performances reached before the upgrade. In this Letter we present the new collision scheme, discuss its advantages, describe the hardware modifications realized for the upgrade, and report the results of the experimental tests carried out during commissioning of the machine in the new configuration and standard operation for the users.

Giant Merkel cell carcinoma of the left arm. Case report.

Merkel cell carcinoma is a rare tumor of dermal origin generally found in sun exposed skin. We report the case of a woman of 76 years old presenting a large vascularized Merkel cell carcinoma (MCC) of the left arm lateral to the elbow joint, infiltrating the muscolo-fascial plane who was treated with surgical therapy and post operative radiotherapy.

Circulating procalcitonin in aseptic carcinoma patients: a specificity study with (18)F-fluorodeoxyglucose positron-emission tomography/computed tomography as benchmark.

Background: The goal of the study was to evaluate the specificity of serum procalcitonin (PCT) in a large cohort of patients with solid carcinomas at different stages.

Methods: The study involved 447 patients having histologically confirmed carcinoma of the breast, head and neck, ovary, cervix or non-small cell lung carcinoma. Patients with a history of small cell lung cancer, neuroendocrine tumors, medullary thyroid carcinoma, sepsis, systemic inflammatory syndrome, renal failure and/or serum C-reactive protein above 5 ng/mL were excluded.

A comparison of the clinical manifestations of feeding whole and hydrolysed chicken to dogs with hypersensitivity to the native protein.

Twenty-six dogs with known adverse food reactions were fed whole chicken for 14 days. From this group, 12 dogs with cutaneous manifestations following exposure to chicken meat were selected and randomly divided into two groups (n = 6). Each group was then fed hydrolysed chicken or hydrolysed soy for 14 days in a blinded crossover design with a 17-day washout period between each diet.

Long-term patient acceptance of and satisfaction with implanted device remote monitoring.

Aims: To evaluate patients' acceptance and satisfaction of the Home Monitoring (HM) remote control system after 1 year of follow-up by a self-made questionnaire (HM Acceptance and Satisfaction Questionnaire, HoMASQ) specifically designed for this purpose.

Methods And Results: The HoMASQ contains 12 items designed to investigate five different aspects strictly connected to patient's acceptance and satisfaction of remote monitoring: (i) relationship with their healthcare provider, (ii) easy of use of HM technology, (iii) related psychological aspects, (iv) implications on general health, and (v) overall satisfaction. Each item was rated on a five-point scale: from 0 to 4 with favourable responses score > or =2.

Interleaved transcranial magnetic stimulation and fMRI suggests that lamotrigine and valproic acid have different effects on corticolimbic activity.

Rationale: Combined transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) can be used to study anticonvulsant drugs. A previous study showed that lamotrigine (LTG) inhibited brain activation induced when TMS was applied over motor cortex, whereas it increased activation induced by TMS applied over prefrontal cortex.

Objectives: The present double-blind, placebo-controlled, crossover study in 30 healthy subjects again combined TMS and fMRI to test whether the effects seen previously with LTG would be confirmed and to compare these with a second anticonvulsant drug, valproic acid (VPA).

Cerebral cortex plasticity after 90 days of bed rest: data from TMS and fMRI.

Introduction: Microgravity animal models have demonstrated corticospinal plasticity; however, little is understood of its functional significance. In this pilot study, we explored corticospinal plasticity in a bed rest model. We hypothesized that the lack of weight bearing would induce cortical reorganization correlating with performance.

Obscure gastrointestinal bleeding as first symptom of eosinophilic jejunitis in a liver transplant recipient: diagnosis and treatment with single balloon enteroscopy.

The small bowel is only partially accessible to traditional endoscopic techniques. The recently introduced push-and-pull enteroscopy technique allows endoscopists to examine the small bowel in its entirety and enables them to take biopsy specimens and administer treatment. We report the case of a liver transplant recipient presenting with obscure gastrointestinal bleeding, whose diagnosis of eosinophilic enteritis was achieved following a single balloon enteroscopy examination.

Polarimetry as a valid means to reduce optical noise in underwater 3D imaging by means of amplitude-modulated laser optical radar systems.

We report the results of a series of underwater imaging experiments in the visible, carried out at ENEA (Frascati, Rome) by using a bistatic, amplitude-modulated laser optical radar system. In these experiments, polarimetry is used for minimizing the water backscattering signal and improving the accuracy of phase measurements directly related to distance. The presented technique enables one to obtain 3D images of underwater real scenes characterized by high quality, space resolution, and contrast.

Multidisciplinary approach to the treatment of bone metastases: Osteo-Oncology Center, a new organizational model.

Aims And Background: Bone metastases are responsible for high morbidity in cancer patients. The frequency of pain and other serious complications associated with such metastases depends on the site and type of lesions and preventive therapy. The present paper aims to inform the scientific community about a new organizational health care model specifically designed for patients with bone metastases, in the hope of stimulating the creation of similar initiatives whose goals are to decrease the high morbidity of this pathology, reduce the frequency of complications, limit psychophysical distress of patients, and improve quality of life.

Home monitoring in patients with implantable cardiac devices: is there a potential reduction of stroke risk? Results from a computer model tested through monte carlo simulations.

Introduction: Patients with pacemakers and implantable defibrillators (ICD) may experience asymptomatic atrial fibrillation (AF), detected with a delay depending on the in-person follow-up schedule. Home monitoring (HM) remote control with automatic alerts for AF may drive early anticoagulation, potentially reducing stroke risk.

Methods And Results: A sample of 136 pacemaker (103) and ICD (33) patients with or without cardiac resynchronization therapy not taking anticoagulation at implant were monitored remotely with HM.

Subcutaneous panniculitis-like T-cell lymphoma with overlapping clinicopathologic features of lupus erythematosus: coexistence of 2 entities?

We observed 5 patients with subcutaneous panniculitis-like T-cell lymphoma (SPTCL) who were unusual, in that they also exhibited features of lupus erythematosus (LE). This observation is in keeping with a recent study that reported an increased rate of autoimmune disease, including systemic lupus erythematosus (SLE), among patients with SPTCL. In all cases, attributes indicating SPTCL included an infiltrate of lymphocytes with pleomorphic nuclei involving subcutaneous lobules exhibiting a cytotoxic T-cell (CD3/CD8/betaF1) immunophenotype.

Plexiform schwannoma of the esophagus in a child with neurofibromatosis type 2.

Schwannoma is a benign neoplasia of the peripheral nerve sheath. Its localization in the gastrointestinal tract, and in particular in the esophagus, is very rare. According to the existing literature esophageal schwannoma has been reported so far only in adult patients.

Primary prevention implantation of cardioverter defibrillator without defibrillation threshold testing: 2-year follow-up.

Background: Even though the intraoperative threshold testing of the implantable cardioverter defibrillator (ICD) may cause hemodynamic impairment or be unfeasible, it is still considered required standard practice at the time of implantation. We compared the outcome of ICD recipients who underwent defibrillation threshold testing (DFT) with that of patients in whom no testing was performed.

Methods: A total of 291 subjects with ischemic dilated cardiomyopathy received transvenous ICDs between January 2000 and December 2004 in five Italian cardiology centers.

Dual-chamber implantable cardioverter defibrillators reduce clinical adverse events related to atrial fibrillation when compared with single-chamber defibrillators: a subanalysis of the DATAS trial.

Aims: The aim of the present analysis of the DATAS study was to compare the impact of dual- vs. single-chamber defibrillators on atrial fibrillation (AF) occurrence and AF-related clinical events in patients with Class I indication for implantable cardioverter defibrillators (ICDs) and no indication for dual-chamber pacing.

Methods And Results: Three hundred and thirty-four patients were randomized, through a centralized assignment, to single-chamber ICDs, dual-chamber ICDs programmed as single-chamber ICDs, and dual ICDs with full diagnostics and AF prevention and therapy capabilities.

[Estimating standard performance measures of opportunistic screening for prostate cancer].

Objective: to estimate the standard performance measures of prostate-specific antigen (PSA) screening as implemented in the existing health care system and to compare the observed results with those fom the European Randomized Screening for Prostate Cancer (ERSPC) trial.

Design: in a consecutive series of men living in two Italian health districts, aged > or = 30 years, with at least one total PSA test between 2000 and 2003, those subjects putatively tested for screening purposes were identified using record linkage with multiple local health databases. This was also used to determine the outcomes of follow-up of subjects with positive test result (PSA > or = 4 ng/ml) at 12 and 24 months of observation.

Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease.

Unlabelled: The role played by the gut in nonalcoholic fatty liver disease (NAFLD) is still a matter of debate, although animal and human studies suggest that gut-derived endotoxin may be important. We investigated intestinal permeability in patients with NAFLD and evaluated the correlations between this phenomenon and the stage of the disease, the integrity of tight junctions within the small intestine, and prevalence of small intestinal bacterial overgrowth (SIBO). We examined 35 consecutive patients with biopsy-proven NAFLD, 27 with untreated celiac disease (as a model of intestinal hyperpermeability) and 24 healthy volunteers.

Arterial access-site-related outcomes of patients undergoing invasive coronary procedures for acute coronary syndromes (from the ComPaRison of Early Invasive and Conservative Treatment in Patients With Non-ST-ElevatiOn Acute Coronary Syndromes [PRESTO-ACS] Vascular Substudy).

Transradial access (TRA) decreased bleeding after coronary interventions compared with femoral access (FA). However, no large study focused on arterial access-related outcomes in patients with acute coronary syndromes, although procedure-related bleeding significantly impaired prognosis. The aim was to evaluate access site-related outcomes of patients who underwent an invasive coronary procedure in the PRESTO-ACS Study.

Stage-specific control of neural crest stem cell proliferation by the small rho GTPases Cdc42 and Rac1.

The neural crest (NC) generates a variety of neural and non-neural tissues during vertebrate development. Both migratory NC cells and their target structures contain cells with stem cell features. Here we show that these populations of neural crest-derived stem cells (NCSCs) are differentially regulated by small Rho GTPases.