Focusing on Diabetic Ulcers

Foot ulcers associated with Diabetes mellitus require immediate attention due to risk of amputation if left untreated. Herein we focus on the mitigating risk factors and physiopathology of the diabetic foot, recounting our own surgical approach and revascularization procedures.

Nanostructured P3HT as a Promising SensingElement for Real-Time, Dynamic Detection ofGaseous Acetone

The dynamic response of gas sensors based on poly(3-hexylthiophene) (P3HT) nanofibers (NFs) to gaseous acetone was assessed using a setup based on flow-injection analysis, aimed at emulating actual breath exhalation. The setup was validated by using a commercially available sensor. The P3HT NFs sensors tested in dynamic flow conditions showed satisfactory reproducibility down to about 3.5 ppm acetone concentration, a linear response over a clinically relevant concentration range (3.5-35 ppm), excellent baseline recovery and reversibility upon repeated exposures to the analyte, short pulse rise and fall times (less than 1 s and about 2 s, respectively) and low power consumption (few nW), with no relevant response to water. Comparable responses’ decay times under either nitrogen or dry air suggest that the mechanisms at work is mainly attributable to specific analyte-semiconducting polymer interactions. These results open the way to the use of P3HT NFs-based sensing elements for the realization of portable, real-time electronic noses for on-the-fly exhaled breath analysis.

Endovascular management of a large hepatic artery aneurysm

Visceral arteries aneurysms (VAA) are an increasingly interesting clinical entity due to their challenging diagnosis and treatment options. The more prevalent use and accuracy of enhanced imaging techniques such as ultrasonography and computed tomography have increased the frequency of diagnosis of aneurysmal degeneration of the visceral arteries. Despite there is no statistically significant difference in terms of overall mortality and post-operative complications between endovascular therapy and open repair, interventional strategies present a significantly lower length of stay and less invasiveness and should be preferred in elderly patients, or in case of co-morbidity and poor candidates for surgery. We herein describe the case of a 79-year-old male who presented a common hepatic artery aneurism (CHAA), involving aberrant visceral arteries anatomy.

Successful endovascular treatment of a 13 cm abdominal aortic aneurysm. Case report

There is increasing evidence in the literature that endovascular aneurysm repair is the first-line approach for most of abdominal aortic aneurysms (AAAs). Furthermore aortouniiliac stent graft placement is, in high risk patients or during emergency setting, a safe procedure over the mid- and long-term period and compares well with the results of bifurcated stent grafts. We present a case of a 66 -year-old gentleman, with pneumothorax after therapeutic thoracentesis and a giant AAA, successfully treated with an aortomonoiliac stent grafting and femoro-femoral crossover bypass.

Chest pain due to Pinch-off syndrome: radiological findings and endovascular rescue

Port-a-cath is widely used as a route for administration of drugs in hematology and oncology patients and, recently, has been adapted also for hemodialysis patients. Major complications include infection, thrombosis, arrhythmia, and embolization. The Pinch-off-syndrome (POS) means the clavicle and the first rib compress the long-term central venous catheter. The reported incidence rate ranges from 1.4% to 4.1%. This syndrome can be recognized on chest radiography by observing a thinning of the catheter lumen through the passage between the clavicle and the first rib. Catheter fracture is a rare but potentially life-threatening complication that must be recognized and treated promptly. Management of dislodged ports includes percutaneous transcatheter retrieval, open thoracotomy retrieval and oral anticoagulant therapy. Among these techniques, percutaneous transcatheter retrieval is an easy, safe and efficient method. We report the successful percutaneous endovascular retrieval of dislodged intracardiac catheter, separated from its port, in a 58 year-old male patient who presented with chest pain.

Nutrient oxidation during moderately intense exercise in obese prepubertal boys

The aim of this study was to measure the nutrient oxidation rate during walking at different speeds and to identify the walking speed associated with the highest fat oxidation rate in a group of prepubertal boys with different levels of adiposity. Twenty-four prepubertal boys (age, 10 +/- 1 yr) with different levels of overweight (body mass index, 25.5 +/- 3.5 kg/m(2); sd score of body mass index, 3.4 +/- 1.1) performed a treadmill test. We measured by indirect calorimetry their respiratory exchange while they walked at speeds of 4, 5, and 6 km/h as well as their maximal oxygen uptake. The fat oxidation rate did not change significantly when the speed of walking was increased, whereas carbohydrate oxidation increased significantly (P < 0.001). A significant (P < 0.05) association was found between adiposity (percent fat mass) and the fat to carbohydrate oxidation ratio during walking at 4, 5, and 6 km/h (r = 0.37, r = 0.37, and r = 0.36, respectively), adjusting for exercise intensity (maximal oxygen uptake, percentage). The lowest fat to carbohydrate oxidation ratio, i.e. the highest fat oxidation/carbohydrate oxidation rate, was found at a walking speed of 4 km/h. Moderately intense exercise promoted the highest fat to carbohydrate oxidation ratio. Increasing the exercise intensity did not promote fat oxidation. Therefore, walking at a speed of 4 km/h is recommended as practicable exercise for obese boys and, consequently, for the treatment of childhood obesity.