Amyloidosis is an important cause of infiltrative cardiomyopathy and is often diagnosed lately in the course of the disease; radiolabeled bisphosphonates bone scan is highly sensitive in detecting transthyretin (TTR) cardiac amyloidosis; data on the true prevalence of cardiac involvement in TTR amyloidosis are lacking. The aim of the present retrospective observational, monocentric study was to estimate the prevalence of positive bone scan suspect for TTR cardiac amyloidosis in the population of Piedmont -a region in the north-west of Italy -retrospectively assessing unexpected cardiac emissions in bone scan scintigraphy among an all-comers population who underwent a bone scan at San Luigi Gonzaga University Hospital between January 2015 and May 2020. ECG, echocardiography and clinical status of patients with positive cardiac emission have been collected in order to better characterize their clinical features.Background. Amyloidosis is a group of diseases characterized by deposition in human tissues of protein aggregates [1]. A subtype of amyloidosis is characterized by accumulation of transtyretin (TTR), either in its natural (wild type ATTR amyloidosis, ATTRwt) or mutated (hereditary ATTR amyloidosis, hATTR) form. In this disease TTR tetramer, mutated or natural with age, becomes instable and dissociates into single monomers [2]. Clinically, the disease causes heart failure, orthostatic hypotension, neurological and autonomic dysfunctions, renal insufficiency, carpal tunnel syndrome and lumbar spinal stenosis [3].

Aims: The response surface methodology was used to evaluate the effect of operating variables (acetic acid concentration, spraying time and temperature) on the reduction of Escherichia coli populations on poultry breast skin in a laboratory showering process, as well as to identify the best conditions that are required to develop this operation. Methods and Results: Skin samples were inoculated with a 24-h E. coli culture and afterwards treated according to experimental design under selected acetic acid concentration, spraying time, and solution temperature. The E. coli reduction model was significantly affected by the acetic acid concentration and spraying time (P £ 0AE05 and £0AE01), while temperature did not show a significant effect (P > 0AE05). Conclusion: The predictive model obtained was validated through additional confirmatory experiments and showed to be adequate, and it could be used as an approach to optimize the acetic acid spray washes during poultry carcasses processing. Significance and Impact of the Study: The use of acetic acid washes in the processing of poultry does not have the capability of eliminating E. coli populations from carcasses. However, significant reductions in the initial load could be achieved.

No abstract

The occurrence of renal cell carcinoma is an exceptional phenomenon in an ectopic kidney. We describe a patient with renal cell cancer of the pelvic kidney who underwent radical nephrectomy at our institute. Preoperatively the patient underwent paramagnetic medium-enhanced magnetic resonance that provided an accurate description of the ectopic renal vessels. During surgery the anatomy of the vessels appeared exactly as described by the MR examination. Histological examination revealed a pT2N0GIV renal cell cancer. Nine months later the patient underwent control examinations, and no delayed complications had occurred. In our experience magnetic resonance provided an exact description of the ectopic kidney vascularization as confirmed by the surgical findings. Preoperative knowledge is important both for the surgeon during the dissection of the vessels and to plan correct lymphadenectomy on the basis of the vessel source identified at imaging.

Aims Dual antiplatelet therapy (DAPT) reduces the incidence of thrombotic complications at the cost of an increase in bleedings. New antiplatelet therapies focused on minimizing bleeding and maximizing antithrombotic effects are emerging. The aim of this study is to collect the current evidence coming from randomized controlled trials (RCTs) on early aspirin interruption after percutaneous coronary intervention (PCI) and current drug-eluting stent (DES) implantation and to perform a meta-analysis in order to evaluate the safety and efficacy of this strategy. Methods and results MEDLINE/PubMed was systematically screened for RCTs comparing P2Y12 inhibitors (P2Y12i) monotherapy after a maximum of 3 months of DAPT (S-DAPT) vs. DAPT for 12 months (DAPT) in patients undergoing PCI with DES. Baseline features were appraised. Major adverse cardiac and cerebrovascular events (MACCE: all causes of death, myocardial infarction, and stroke) and its single composites, stent thrombosis (ST) and Bleeding Academic Research Consortium (BARC) type 3 or 5 were considered and pooled with fixed and random-effects with inverse-variance weighting. A total of four RCTs including a total of 29 089 patients were identified. Overall, the majority of included patients suffered a stable coronary artery disease, while ST-elevation myocardial infarction was the least represented clinical presentation. Complex anatomical settings like left main intervention, bifurcations, and multi-lesions treatment were included although representing a minor part of the cases. At 1-year follow-up, MACCE rate was similar [odds ratio (OR) 0.90; 95% confidence intervals (CIs) 0.79–1.03] and any of its composites (all causes of death rate: OR 0.87; 95% CIs 0.71–1.06; myocardial infarction: OR 1.06; 95% CIs 0.90–1.26; stroke: OR 1.12; 95% CIs 0.82–1.53). Similarly, also ST rate was comparable in the two groups (OR 1.17; 95% CIs 0.83–1.64), while BARC 3 or 5 bleeding resulted significantly lower, adopting an S-DAPT strategy (OR 0.70; 95% CIs 0.58–0.86). Conclusion After a PCI with current DES, an S-DAPT strategy followed by a P2Y12i monotherapy was associated with a lower incidence of clinically relevant bleeding compared to 12 months DAPT, with no significant differences in terms of 1-year cardiovascular events.