The efficacy of functional surgery associated with early intensive rehabilitation therapy in Charcot-Marie-Tooth Type 1A disease.

Background: Charcot-Marie-Tooth (CMT) is a genetically and clinically heterogeneous disorder, and it is caused by alterations in genes with different loci that encode for proteins, resulting into metabolic and structural defects. The most common form of the disease is type 1A. Treatment of the disease, due to the absence of an effective pharmacological therapy, mainly relies on surgical treatment and rehabilitative therapy.

Lung Ultrasound in Hemodialysis: A Card to be Played?

The end-stage renal disease is characterized by a profound impairment in the regulation of body fluid distribution, and volume assessment in hemodialysis is one of the challenging goals for the nephrologist. To determine a state of euvolemia, different validated techniques have been employed and among them lung ultrasonography (LUS) has recently attracted growing attention on account of its capacity to estimate accurately extra vascular lung water and to detect lung edema even in its early asymptomatic stage, that is, hidden lung congestion.With its noninvasiveness, freedom from radiation, the ease of use, acceptable intra/inter-operator reproducibility and availability of portable ultrasound devices, LUS can be considered one of the most interesting "cards to play" for the volume assessment in patients on hemodialysis.

Safety of cardioversion in atrial fibrillation lasting less than 48 h without post-procedural anticoagulation in patients at low cardioembolic risk.

Currently, there is no unified consensus on short-term anticoagulation after cardioversion of atrial fibrillation lasting less than 48 h in low-cardioembolic-risk patients. The aim of this study is to evaluate the rate of transient ischemic attacks, stroke and death in this subset of patients after cardioversion without post-procedural anticoagulation. In a prospective observational study, patients with recent-onset AF undergoing cardioversion attempts in the Emergency Department were evaluated over the past 3 years.

An unusual cause of lumbar pain after physical exercise: Caval vein duplicity and its detection by ultrasound.

This paper deals with two recent cases of Inferior Caval Vein (IVC) duplicity, congenital anomaly often but not always asymptomatic that should be considered in the differential diagnosis of flank pain when other more common disorders have been excluded. Here are described the clinical and surgical significance together with the typical sonographic findings useful for the diagnosis of IVC duplicity. Particular attention is given to a peculiar and easily repeatable sonographic aspect associated with IVC duplicity, not previously reported in Literature and that we called the "Neptune's sign".

An Antimicrobial Stewardship Program Based on Systematic Infectious Disease Consultation in a Rehabilitation Facility.

OBJECTIVE To assess the impact of an antimicrobial stewardship program (ASP) on antibiotic consumption, Clostridium difficile infections (CDI), and antimicrobial resistance patterns in a rehabilitation hospital. DESIGN Quasi-experimental study of the periods before (from January 2011 to June 2012) and after (from July 2012 to December 2014) ASP implementation. SETTING 150-bed rehabilitation hospital dedicated to patients with spinal-cord injuries.

Buttonhole Cannulation of the AV Fistula: A Critical Analysis of the Technique.

As a consequence of the central role of the arteriovenous fistula for dialysis (AVF) in the clinical management of the dialysis patient the necessity to limit the puncture-related complications to extend as much as possible the life of the vascular access. Accordingly, the AVF needling technique has gained growing attention. Alongside the traditional rope ladder (RL) puncture method, the buttonhole technique (BH) is increasingly popular; this technique employs the same cannulation sites of AVF in every dialysis associated with the use of dull needles to minimize vessels damage.

Controversial issues in CKD clinical practice: position statement of the CKD-treatment working group of the Italian Society of Nephrology.

This position paper of the study group "Conservative treatment of Chronic Kidney Disease-CKD" of the Italian Society of Nephrology addresses major practical, unresolved, issues related to the conservative treatment of chronic renal disease. Specifically, controversial topics from everyday clinical nephrology practice which cannot find a clear, definitive answer in the current literature or in nephrology guidelines are discussed. The paper reports the point of view of the study group.

Renal Resistive Index: not only kidney.

From growing data from the literature emerges that so-called ecoDoppler "Renal" Resistive Indexes (RRI) are not only specific markers of kidney damage and indicators of renal functional prognosis but they always express more clearly a strong link with the systemic circulation. In fact, some cardiovascular parameters such as aortic pulse pressure, aortic stiffness, abdominal aortic calcifications and clinical settings for instance heart failure progression have shown a great association with RRI. Relationships between renal and inflammatory indexes in hypertensive patients have been found and data from the literature on kidney transplants underline the capability of the graft RRI to change according to host hemodynamic features.

Low-protein diets for chronic kidney disease patients: the Italian experience.

Background: Nutritional treatment has always represented a major feature of CKD management. Over the decades, the use of nutritional treatment in CKD patients has been marked by several goals. The first of these include the attainment of metabolic and fluid control together with the prevention and correction of signs, symptoms and complications of advanced CKD.

Contrast enhancement and elastography in endoscopic ultrasound: an update of clinical applications in pancreatic diseases.

It is well established that endoscopic ultrasound (EUS) is fundamental in the characterization of many diseases concerning different organs, i.e. pancreaticobiliary diseases, gastrointestinal pathologic conditions, and lymph nodes of unknown origin.

Case 230: Congenital Inguinal Herniation of the Left Ureter (Extraperitoneal Form).

History A 52-year-old man with a history of urinary tract infections and a previous clinical diagnosis of left inguinal hernia presented to the nephrologist with recent onset of dysuria and increasing swelling in the left inguinoscrotal region in the absence of fever or scrotal trauma. There was no relevant surgical or family history. The general physical examination findings were unremarkable, with a normal abdomen at both visual inspection and palpation; urogenital examination revealed a small left-sided palpable mass of the testis, compatible with an inguinal hernia or hydrocele.

Isolation of Enterobacter aerogenes carrying blaTEM-1 and blaKPC-3 genes recovered from a hospital Intensive Care Unit.

Enterobacter aerogenes has recently emerged as an important hospital pathogen. In this study, we showed the emergence of E. aerogenes isolates carrying the blaKPC gene in patients colonized by carbapenem-resistant Klebsiella pneumoniae strains.

A rare case of infant sepsis due to the emm-89 genotype of Group A Streptococcus within a community-acquired cluster.

Invasive Group A Streptococcus disease is a severe and sometimes life-threatening infection with only few cases reported in literature. We describe the case of a 49-day-old male infant with invasive Group A Streptococcus infection characterized by acute otitis media and development of septicemia within a probably community-acquired cluster. The causative agent resulted to be a rare emm-89 genotype of Streptococcus pyogenes.

Long-Term Dehydrated Donor Lamella Survival in Anterior Keratoplasty: Keratocyte Migration and Repopulation of Corneal Stroma.

Purpose: The aim of this study was to investigate the ability of host keratocytes to colonize the donor lamella transplanted without viable cells (dehydrated) in Descemetic (deep anterior lamellar keratoplasty) and in pre-Descemetic keratoplasty (excimer laser-assisted lamellar keratoplasty).

Method: A total of 17 eyes (8 deep anterior lamellar keratoplasties and 9 excimer laser-assisted lamellar keratoplasties) were included in this observational retrospective study; patients underwent ophthalmic examinations, and histological staining was performed ex vivo on the graft in cases of failure.

Results: In Descemetic keratoplasty, the long-term survival of the graft is compromised with the central corneal thickness decreasing; corneal pachymetry and in vivo and ex vivo keratocyte densities are significantly reduced (pachymetric reduction of -86 μm in the apex and -87 μm in the thinnest point; density cell reduction of 72% at a depth of 100 μm, 62% at a depth of 250 μm, and -66% at a depth of 400 μm).

Anti-chlamydial IgG Neutralizing Ability in Nonzoonotic Atypical Community Acquired Respiratory Tract Infections.

Chlamydophila pneumoniae is a pathogenic agent, involved in various types of infection. This study has evaluated the ability of IgG antibodies in outpatient, with acute respiratory tract infections from C. pneumoniae, to neutralize in vitro purified elementary bodies of this bacterium, revealing a good neutralizing performance of IgG antibodies.

Selectivity evaluation of a new chromogenic medium to detect group B Streptococcus.

Background: Group B Streptococcus (GBS) is an important pathogen that causes serious infections in newborns. Pregnant screening and intrapartum antibiotic prophylaxis are actually the strategies to prevent GBS disease in neonates because vaccination is under investigation.

Materials And Methods: Simultaneously, 156 isolates of GBS and 156 isolates other than GBS covering 17 different species, were tested to evaluate the selectivity of a new chromogenic medium to screen GBS.

Cytogenetic follow-up of chromosomal mosaicism detected in first-trimester prenatal diagnosis.

Objective: To contribute to the risk assessment of true fetal mosaicism after detection of a mosaic chromosomal anomaly in chorionic villus samples (CVS) in order to enable more effective counseling and pregnancy management.

Methods: We retrospectively reviewed 7112 consecutive CVS analyzed on both direct preparations and cultured cells. In 135 out of the 177 cases of mosaicism, we performed cytogenetic follow-up and determined the frequency of confined placental mosaicism (CPM) and true fetal mosaicism according to type and distribution of the cytogenetic abnormality.

Excimer laser mushroom penetrating keratoplasty: new technique.

Purpose: To evaluate retrospectively the outcomes of 15 consecutive mushroom-shaped penetrating keratoplasties performed by using excimer laser for both the recipient bed and the fresh donor corneas.

Methods: Fifteen eyes of 14 patients who underwent excimer laser mushroom-shaped penetrating keratoplasty from October 13, 2010, to October 14, 2011, were included in our retrospective study. Eight were men and 6 were women, with a mean age of 31.

In vitro antimicrobial profile of Ureaplasma urealyticum from genital tract of childbearing-aged women in Northern and Southern Italy.

Ureaplasma urealyticum is an opportunistic pathogen during pregnancy and in newborns. Other clinical problems related to U. urealyticum infections are: no susceptibility to cell wall-active drugs, limits of antibiotic treatment in pregnancy, and spread of antimicrobial resistance.

Role of cerebral ultrasound and magnetic resonance imaging in newborns with congenital cytomegalovirus infection.

Purpose: To assess the diagnostic and prognostic value of cerebral magnetic resonance imaging (cMRI) in comparison with that of cerebral ultrasound (cUS) in predicting neurodevelopmental outcome in newborns with congenital cytomegalovirus (CMV) infection.

Methods: Forty CMV-congenitally infected newborns underwent cUS and cMRI within the first month of life. Clinical course, laboratory findings, visual/hearing function and neurodevelopmental outcome were documented.

In vitro antimicrobial activity of several antimicrobial agents against Escherichia coli isolated from community-acquired uncomplicated urinary tract infections.

Aim: For frequency Escherichia (E.) coli is the agent of urinary tract infections (UTIs). The objective of the present study was to evaluate in vitro activity of several antimicrobial agents to guide empirical treatment of uncomplicated UTIs.

Human milk, a concrete risk for infection?

Breastfeeding should be considered a public health issue and the reference normative standards for infant feeding at least to the 6th month of life, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant. Numerous studies demonstrate that breastfeeding results in improved infant and maternal health. Moreover the reduction of the risk of severe retinopathy of prematurity, sepsis and necrotizing enterocolitis is particularly evident in preterm infants.

Neuroimaging in CMV congenital infected neonates: how and when.

Neonatal congenital infections are an important cause of mortality, morbidity and long-term neurodevelopmental and sensorineural sequelae. Many pathogens can cause in utero infection, and among them, cytomegalovirus (CMV) plays a prominent role. In developed countries, CMV poses major health problems as it is the most common pathogen leading to congenital infection, and the leading cause of nonhereditary deafness in children.

Laboratory diagnosis of Toxoplasma gondii infection with direct and indirect diagnostic techniques.

Background: Toxoplasma gondii infection, common parasitic zoonoses, is an important cause of spontaneous abortion, mental retardation, encephalitis, ocular disease and death worldwide. Today the major diagnostic techniques for the toxoplasmosis are serological assays, but its have many limitations.

Aim: The goal in this study is to improve the diagnostic accuracy of T.