Background: Doubts about the safety of sexual activity are common among cardiac patients and physicians alike, and are often neglected during routine checkups or on discharge from the hospital following a cardiac event or invasive procedure. Although it varies from society to society, it is considered taboo by most patients, so it is reluctant to ask the doctor about sexual activity. Doctors, on the other hand, remain silent due to the lack of clear information about the effect of sexual activity on coronary artery diseases or the presence of doubts. It is ultimately set aside by professionals and their patients. The patient does not ask and the doctor does not answer. This study, it was aimed to investigate the effect of the frequency of sexual intercourse on coronary artery disease. Methods: After applying the exclusion criteria, the remaining 180 patients were included in the study. A self-administered survey was applied to the patients before coronary angiography and patients were assessed according to the presence of additional diseases, their demographic characteristics, and the frequency of sexual intercourse. Two experienced physicians evaluated the angiographic results. Firstly Patients were grouped as 90 patients with normal coronary anatomy and 90 patients with coronary artery disease. After this, Coronary artery disease severity was evaluated according to syntax score. Results: The mean age of the patients was 58 ± 12.5 years. The distribution of age is not reasonable. According to gender, the female/male ratio the proportion of men was higher in patients with coronary artery disease. İncidence of normal coronary anatomy increased as the frequency of sexual intercourse increased. P - value was 0.037 and the result was statistically significant. The frequency of sexual intercourse was found to be 4.2/per month. The relationship between the Syntax score and frequency of sexual intercourse was not statistically significant (p > 0.05).Conclusion: As a result of the study, it was seen that patients with more frequent sexual intercourse had more normal coronary artery anatomy, and those with coronary artery disease had single coronary artery disease than multiple vascular disorders. it was concluded that the incidence of coronary artery disease and coronary artery disease severity decreased as the frequency of sexual intercourse increased. Sexual intercourse might be a preventive factor in the development of coronary artery disease.

A comprehensive approach to asymptomatic adults with Wolff-Parkinson-White (WPW) pattern discovered incidentally on routine electrocardiography (ECG) is debatable. The objective of this review article is to update the most recent evidence on the management of young patients with asymptomatic WPW patterns. A substantial proportion of adults with WPW patterns on ECG may remain asymptomatic but the lifetime risk for fatal arrhythmias still exists. The inherent properties of the accessory pathway determine the risk of sudden cardiac death. A low-risk pathway is considered when the pre-excitation is intermittent on ambulatory monitoring or when it disappears completely or abruptly during exercise testing. On the other hand, a high-risk pathway in EP study is suggested by the presence of the shortest pre-excited RR interval (SPERRI) during atrial fibrillation of ≤ 250 ms or accessory pathway effective refractory period (APERP) ≤ 240 ms. The cardiac evaluation may thus be considered in asymptomatic patients with WPW to determine the individual risk for future symptomatic arrhythmia. A shared-decision making must be performed before offering catheter ablation whose procedural success rate is high.

Introduction: PCOS is a common cause of female infertility. Although PCOS patients are characterized by producing an increased number of oocytes, they are often of poor quality, leading to lower fertilization, cleavage, and implantation and higher miscarriage rates.Aims: The present study aims to identify the effect of various PCOS phenotypes on oocyte competence in an ART cycle.Settings and design: A retrospective observational study. Methods and material: The study group included 102 women with PCOS as a main cause of infertility. Data was collected over a period of one year (2017-18). These women were divided into four groups on basis of PCOS phenotypes (A-D) and the relevant clinical data and the ART outcome were noted. Statistical analysis was done using SPSS statistical package. Data presented as mean ± SD which was compared using the ANOVA test. A p - value < 0.05 was considered statistically significant.Results: Out of 102 PCOS women, 23.52% women had phenotype A, 11.76% had phenotype B, and 45.09% and 19.60% had phenotype C & D respectively. Good quality embryos formed (p - value 0.01) were lower in Group B vs. other groups. However, clinical pregnancy rates were comparable in all groups.Conclusion: The reproductive potential of women with PCOS varies with the oocyte health and it largely depends on PCOS phenotype. Women with PCOS phenotype B might have poor IVF/ICSI outcomes with regard to the number of oocytes retrieved and embryos formed. PCO morphology might carry an advantage with regards to the number of oocytes retrieved and better quality embryos. It seems that hyperandrogenism in combination with chronic anovulation is associated with poor oocyte competence and hence, a negative impact on embryo quality and clinical pregnancy rate. Further studies with a larger sample size are required to further support it.Key messages: Oocyte competence in various PCOS phenotypes.

Allogeneic hematopoietic cell transplantation often represents the only solution for several poor-prognosis hematologic malignancies. The curative strategy for patients with synchronous hematologic disorders is always difficult and, in most cases, ineffective. Herein, we report an unusual case of synchronous hematologic disorders successfully treated with an “ad-hoc” conditioning regimen followed by allogeneic hematopoietic cell transplantation.

Background: There is a paucity of data on the burden of acute kidney injury (AKI) in hospitalized HIV-infected patients in Sub-Saharan Africa in the “test and treat” era.Objectives: To study the incidence, risk factors, and outcomes of AKI among HIV-positive medical admissions in a secondary hospital.Materials and methods: We prospectively screened adult HIV-positive patients who gave their informed consent and were admitted to the Bamenda Regional Hospital for AKI from February to June 2020. We excluded participants with Chronic Kidney Disease (CKD) Stage 5 and those with confounders of serum creatinine. On admission and after 2-7 days, we extracted a venous blood sample from each participant to evaluate serum creatinine and diagnose AKI. The participants were then followed up on until they were discharged or died. We measured the need for dialysis, access to dialysis, and renal recovery at three months for patients with AKI. The amended KDIGO 2012 criteria were used to define and classify AKI. The University of Bamenda’s institutional review board provided ethical approval.Results: A total of 206 participants (39.8% men) were enrolled, with a mean (SD) age of 45.71(13.13) years. On enrolment, 89.8% (n = 185) of the participants were on combination antiretroviral therapy (c-ART), with 81.6% (n = 151) on tenofovir-containing regimens. The WHO HIV clinical stages 3 and 4 were present in 81.5% (n = 168) of the individuals. The most common reason for hospitalization was opportunistic infections (69.8%; n = 142). AKI was found in 30.6% (n = 63) of the patients, with 58.7% (n = 37) of them being classified as KDIGO stage 3. A total of 12 (42.9%) participants out of the 28 in need, were dialyzed. AKI was independently associated with use of traditional medicines (aOR = 2.9; 95% CI 1.4-6.3; p = 0.006), WHO HIV stages 3 and 4 (aOR = 4.1; 95% CI 1.1-15.7; p = 0.038), hypotension (aOR = 3.3; 95% CI 1.4-7.8; p = 0.008) and low haemoglobin level ≤ 8.0 g/dl (aOR = 3.5; 95% CI 1.7-7.4; p = 0.001). The AKI group used to have a significantly higher mortality rate (42.9% vs. 16.1%; p < 0.001). Renal recovery was complete in 66.7% of the 30 survivors at three months, partial in 13.3%, and no recovery in 20% of the survivors.Conclusion: Despite the growing use of combination antiretroviral medication, significant immunosuppression is still common in hospitalized HIV-positive patients, increasing the risk of AKI and worsening prognosis. In this high-risk population, early detection of AKI with renal function monitoring may improve results.

We investigated the effect of exercise therapy by simultaneously using motor imagery of thumb or all finger extension on the affected side and thumb or all finger extension exercise on the unaffected side by using the F-wave, which is used to measure the excitability of anterior horn cells to devise an appropriate exercise therapy using motor imagery for patients with increased muscle tone of the thumb muscles on the affected side. Tasks 1, 2, 3, and 4 involved motor imagery of thumb extension on the affected side, motor imagery of finger extension on the affected side, motor imagery of thumb extension on the affected side based on thumb extension on the unaffected side, and finger extension on the affected side based on finger extension on the unaffected side, respectively; conducted in three trials, with one week or more between each trial. Each task was performed for one minute, with a five-minute interval between tasks. The F-waves from the thenar muscles were recorded with median nerve stimulation on the affected side before and during the tasks. The relative values of the F-wave data of the task and the F-wave data before (resting state) and during the tasks were calculated. In results, the relative data of the F/M amplitude ratio in task 4 was lower than that in the other tasks in three trials. In conclusion, motor imagery of finger extension on the affected side with finger extension movement on the unaffected side was effective for improving the muscle tone of the thenar muscles on the affected side.

Introduction: The world is currently facing the SARS-CoV-2 pandemic with evolving 2nd wave. The COVID-19 patients present most commonly with Severe Acute Respiratory Illness (SARI) in an emergency room with acute onset fever, cough, and breathlessness. However, not all SARI cases as per definition are due to COVID-19 infection, which is well proven in this case series of 113 cases of SARI. This is just the opposite of the other SARI series done in the pre-COVID-19 era. Also, no previous SARI case series data has shown significant association with Diabetes Mellitus, including new-onset diabetes thus figuring out the major Pathophysiological association of COVID-19 with glucose metabolism and has a bearing on the pathogenesis, treatment, and outcome of COVID-19 infection and perpetuity of pandemic of this magnitude. Here we raise concern for the first time about the growing association of an infectious pandemic with the lifestyle disorders which are non-communicable diseases but carry with them the potential of fertile soil for rapidly spreading epidemics.Aim and objective: To find out the etiology, clinical profile, treatment outcome, and mortality rate in different sub-groups of SARI cases in a tertiary care hospital and the incidence of new-onset Diabetes Mellitus in them and to investigate theoretically the hypothesis that maintaining normal glucose metabolism could prevent progression of a mild Flu-like illness (FLI) to a severe form of Severe Acute Respiratory Illness (SARI) and consequent complications such as Cytokine Storm Syndrome and Multi-Organ failure.Design: Retrospective, single-center case series of 113 SARI patients at a tertiary care hospital in Agra India between 1 March- 30 October 2020.Main outcome: The demographics, clinical, pathological, imaging, and treatment outcome data were collected. The SARI cases analyzed were defined as “Severe acute respiratory infections (SARIs) an acute respiratory illness of recent onset (within seven days) manifested by fever (≥38°C), cough and shortness of breath or difficulty in breathing requiring hospitalization and were sub-classified according to the primary etiology producing SARI in them. The findings were compiled and compared. Conclusion: Of the 113 patients of SARI – 32.7 %were associated with Diabetes, with 9.74% new-onset Diabetes and 26 % previously known Diabetes. This was mainly due to SARS-CoV-2 (24 Diabetics out of 52 COVID-19 cases- 46.1 %).The Average hospitalization stay of SARI cases was 10 days with a maximum in SARS-CoV-2 and a minimum stay of 5.22 days in Bacterial Pneumonia and 5.66 days in Koch’s Lungs.The death rate was maximum (4 out of 26) 15.3%. Hospitalized TB/Koch’s Lung patients who presented as SARI and 3.8% in Bacterial Pneumonia, 2.43% in SARS-CoV-2, and <1% in Sepsis.Those SARI cases who were euglycemic at the time of initial presentation recovered early and carried a good prognosis with less mortality as compared to those who were hyperglycemic on presentation. Also, those FLI cases who maintained euglycemia or did not have any other risk factor which predisposes them to stress (Diabetes, Prolonged fasting, Obesity, major organ disorder, Psychological disorder, and Cancer) did not progress to SARI as the endogenous steroid secretion and sympathetic activation did not occur, the intracellular pH levels remained in the alkaline range.10.18% of cases developed new-onset diabetes (a total of 11 cases) out of which 10 were in COVID-19. Thus 19.2% incidence of new-onset diabetes in SARS-CoV-2 and a prevalence of 26.9% in SARS-CoV-2, making total diabetes 46.1% in SARS-CoV-2, and out of all SARI cases, 26 % of patients developed pulmonary fibrosis with consequent long-term complications. In COVID-19 patients, it was seen only in diabetics SARS CoV-2 male patients, thus no death in non-diabetic females in COVID-19 in this case series.

The overall incidence of meningitis in infants 0-90 days is low; however, it remains a serious cause of morbidity and mortality among affected patients. It is standard of care to perform lumbar punctures as part of the work-up of fever in the first four weeks of life and sick-looking babies up to the age of 90 days. This particular procedure is often refused by parents, and physicians are left to predict the possibility of meningitis based on blood culture results.The aim of this study is to determine whether it would be safe to rule out meningitis based on a negative blood culture in this age group.

Steady-state VEPs, have been used to estimate visual acuity since the 1970s and allow responses to a range of stimulus sizes to be collected rapidly- with particular utility in infants. However, the assessment of children with cortical visual impairment is a bigger challenge that lead to the development of the Step VEP. Its initial evaluation revealed that accuracy and precision were poorer for pediatric patients than for optically degraded normal adults and that it was not necessarily successful in every child. Statistical models generated the equations: VAO = 0.56 VAStep (r2 = 0.75, F = 60.93, p = 0.000) and VAPL = 0.45 VAStep (r2 = 0.82, F = 156.85, p = 0.000), supported by a recent a systematic review of VA comparisons showing that recognition VA (optotypes) agrees more closely than discrimination VA (PL) with VEP VA. In combination, Step VEPS and subjective tests allowed complete assessment in 96% of patients, with incomplete Step VEPS much more likely to be partially successful than not, and more likely to be partially successful than incomplete subjective tests. This supports the rationale that Step VEPs maintain attention by limiting the time spent stimulating away from an individual’s threshold of spatial resolution. For the small number of patients in whom VA cannot be estimated, alternative stimuli and methods of presentation are proposed. 

Background: Posterior pericardiotomy (PP) is helpful to prevent arrhythmia; especially atrial fibrillation (AF), and cardiac tamponade postoperative cardiac valve surgery. The incidence of postoperative AF is increased due to postoperative pericardial effusion (PE). This study aimed to investigate the early outcome of PP after heart valve surgery. Methods: In this prospective study, 120 patients underwent elective valve heart surgery at our center from January 2020 until April 2022. Patients were followed up for AF and pericardial effusion, and reopening due to tamponade. Results: The mean age of patients was 35.26 years, 70.2% were female and 29.8% were male. Surgery was elective and all were valve surgery. The incidence of postoperative AF was 2%, and pericardial effusion was seen in 1% of patients. Tamponade was not seen in any case. Left PE needed intervention tube drainage of 2%. Conclusion: Posterior pericardiotomy is a simple and safe procedure during valve heart surgery, and it is effective in reducing the incidence of atrial fibrillation, pericardial effusion, and tamponade.

Objective: Sentinel lymph node mapping is an acceptable standard for lymph node evaluation in patients with endometrial cancer. The purpose of this study was to evaluate the adoption of this technique at two academic institutions, including which patient and disease features are associated with rates of successfully identifying sentinel lymph nodes with fluorescent mapping. In addition, we sought to characterize if and how surgeons experience the technique related to successful bilateral sentinel lymph node mapping. Methods: A retrospective chart review was performed of patients at two academic institutions who underwent sentinel lymph node mapping prior to a minimally invasive hysterectomy for endometrial cancer over the first 30 months during which the technique was adopted at each institution. A modified Poisson regression model was used to determine the relationships between patient, disease, and surgeon factors on outcomes of sentinel lymph node mapping. Results: A total of 460 charts were reviewed. The mean age was 64 and the median body mass index was 34.2. The most disease was stage I (83%), endometrioid (89%), and Grade I (64%). The bilateral sentinel lymph node mapping success rate was 65%, while unilateral or bilateral success occurred in 91% of cases. Sentinel lymph node mapping was significantly more likely to be successful in premenopausal women (RR 1.25; 95% CI 1.07 - 1.46; p = 0.005) and Asian women (RR 1.48; 95% CI 1.3-1.68; p < 0.001). BMI was not significantly predictive of mapping success (RR 1.03; 95% CI 1.00 - 1.07; p = 0.05). Increasing surgeon experience with the technique did predict successful bilateral sentinel lymph node mapping (RR 1.02; 95% CI 1.00 - 1.03; p = 0.02).Conclusion: Premenopausal status and surgeon experience with the technique increases the likelihood of bilateral sentinel lymph node detection for endometrial cancer.

Diseases - diabetes mellitus (especially type 1) and autoimmune diseases are incurable diseases. In type 1 diabetes, the beta cells of the tail of the pancreas die. It is in the beta cells of the tail of the pancreas that insulin is located, a hormone that maintains normal blood sugar levels in patients with type 1 diabetes. Until now, no methods have been known to restore dead pancreatic beta cells. Methods for restoring the lymphoid system in patients with autoimmune diseases were not known. With these diseases, the normal properties of the lymphoid system are lost. This review aims to present materials on the effective treatment (cure) of these diseases. For the treatment, the resonance therapy method was used, which has been known for at least 25 years and which has been modified in our work since 2016. The essence of our modification was that the author began to use 1. Not only low (previously known) but also high potencies of resonant drugs. 2. We have created a direction in resonance therapy, which is called “resonance of creation.” So far, only the direction is known as “resonance of destruction” is known, with the help of which oncological tissues, infectious processes, cysts, stones, etc. are treated - destroyed. With the help of the resonance of creation, various biological structures that have undergone degeneration and death are restored - the myelin sheath of the nerves in multiple sclerosis, nerve cells in Parkinson’s disease and Alzheimer’s disease, etc. With the help of the resonance of creation, the beta cells of the tail of the pancreas are restored in type 1 diabetes and restoration of the lymphoid system in autoimmune diseases. So, in patients with autoimmune diseases, organ preparations were tested: “lymph nodes”, “lymphocytes”. It turned out that in all patients with various autoimmune diseases, lymph nodes, and lymphocytes were tested as being in a degenerative state. There was not a single patient whose lymph nodes and lymphocytes were tested as normal. The task was to normalize the functional state of the lymph nodes and lymphocytes in our patients and thereby take an important step towards curing their autoimmune disease. To this end, it was necessary to increase the potency of the lymph nodes and lymphocytes in the same way as we did it in relation to the beta cells of the pancreas in patients with diabetes mellitus, in relation to the substantia nigra of the midbrain in patients with Parkinson’s disease and in relation to the myelin sheath. Nerves in multiple sclerosis. After testing organ preparations: “lymph nodes”, and “lymphocytes” in patients with autoimmune diseases, the potency was selected, which led to the fact that lymph nodes and lymphocytes were no longer tested as degenerated formations. It was this potency of lymph nodes and lymphocytes that was the basis for the treatment of patients. Thus, as a result of the treatment of diabetes mellitus (especially type 1) and autoimmune diseases by resonance therapy, these diseases become curable.

Background: Control of increased athrogenic index of plasma and lipid parameters in the early stage of diabetes mellitus helps diabetic patients to improve their quality of life and treatment outcomes. Limited studies were conducted on the assessment of dyslipidemia and its correlation with clinical and anthropometric variables among diabetes patients but no study was conducted on the correlation of the athrogenic index of plasma with anthropometric measurements among diabetes patients in this study area. The objective of this study was to assess the correlation of dyslipidemia and athrogenic index of plasma with anthropometric measurements and clinical variables among diabetic patients in Dessie Compressive specialized hospital, Northeast Ethiopia.Methods: Institution-based comparative cross-sectional study was conducted from August 2020 to June 2021. A total of 250 diabetic and healthy control respondents were included in the study with convenience sampling. Semi-structured questionnaire of a modified WHO stepwise Approach to Surveillance for chronic disease was used to collect data. Finally, descriptive statistics and correlation analysis were conducted to assess the correlation between variables. A P-value of less than 0.05 was declared as the level of significance.Results: Athrogenic Index of Plasma, Triglyceride to High-density Lipoprotein Ratio, Very-Low-Density Lipoprotein, systolic blood pressure, diastolic blood pressure, triglyceride, waist circumference, WHtR and BMI were statistically significantly higher among type 2 DM groups. There was a significant positive linear correlation between triglycerides and waist circumference, between TG / HDL and WHtR, and between cholesterol and WHtR, but a significant negative linear correlation between HDL and waist circumference among the Type 2 DM group. Systolic blood pressure and pulse showed a significant positive linear correlation with WC, BMI, and WHtR among diabetics groups only. Our study showed that the pattern of lipid abnormalities observed among DM patients was high AIP in 68%, moderate AIP in 16% and all four groups of hyperlipidemia were found in 9% of diabetic patients. All lipid profiles showed a significant very strong positive linear correlation with AIP, but DHL has a significant very strong negative linear correlation with AIP among type 2 DM groups.Conclusion: The proportions of high athrogenic index of plasma and lipid profile disorders were higher in DM patients compared to healthy controls. Dyslipidemia and a high athrogenic index of plasma had a considerable correlation with anthropometric measurements and clinical outcomes of type II DM patients. DM patients who have a higher athrogenic index of plasma and higher lipid parameters should be strictly followed based on their anthropometric measurements.

Introduction: The World Health Organization (WHO) strategy for leprosy control from 2021 to 2030 focuses on interrupting transmission, reducing autochthonous cases to zero, and using a safe and effective vaccine and chemoprophylaxis. In 2020, 127,396 new cases were registered in the world, 19,195 new cases in the Americas, and, of these, 17,979 cases in Brazil, about 93.66% of the total in the Americas. Brazil is classified as a country with a high burden of the disease, occupying the 2nd place in the world, behind only India (WHO, 2020). Análise do período de 2010-2015 em publicação recente9, apresenta as seguintes cidades no estado do Pará nas quais se observou maiores taxas de incidência (detecção): Marituba, Belém, Marabá, Parauapebas e Altamira [9]. Material and method: This is an analytical retrospective study carried out in a database - Epi-Info resulting from records of Surveillance and Seroprevalence actions in five endemic municipalities for leprosy located in the Southeast and West of Pará. The following variables were analyzed: age, sex, Clinical Classification, vaccination status with BCG, and the result of the search for IgM antibodies against PGL-1 of Mycobacterium leprae by the “In house” ELISA technique. Results: We evaluated 1551 records examined in the laboratory from 2014 to 2016, which were classified into 123 Multibacillary -MB patients (123/1551 = 7.93%); 71 Paucibacillary-PB patients (71/1551 = 4.57%); 451 Intradomicilliary Consanguineous Contacts - CCOSI (451/1551 = 29.07%) and 906 Non Consanguineous Contacts - CNCOS (906/1551 = 58.41%). 57 MB patients (13.47%), 13 PB patients (3.07%), 133 CCOSI (31.44%) and 220 CNCOS (52.00%) were positive for PGL-1. The correlation of the Classification with the vaccination status showed 57 MB patients without any BCG (57/125 = 45.6%) and only 3 patients with two doses of BCG (3/125 = 2.4%); 17 PB patients without any dose of BCG (17/69 = 24.63%); 80 CCOSI without any BCG (80/455 = 17.58%) and 171 CNCOS (171/906 = 18.87%). The odds ratio (OR) in the analysis between unvaccinated MB patients compared to CCOSI was statistically significant (OR = 14.25; p ˂ 0.0001). The study shows the importance of using the BCG vaccine in healthy contacts of patients with leprosy, as it shows the probability of unvaccinated individuals being 14.25 times more likely to become ill with Multibacillary forms compared to CCOSI. In addition, the BCG vaccine has been in use for 80 years and is the only vaccine that we can use in leprosy control programs. Conclusion: Although the leprosy epidemiological data analyzed recently (2010 - 2015) show a downward trend in the main indicators in Pará, such as the detection of new cases and prevalence, the endemic municipalities are still classified as hyperendemic for the population under 15 years of age and This proves that Surveillance is essential, as well as BCG vaccination according to the Ministry of Health Standards.

Background and aim of the study: Sutureless aortic valves are used to reduce operation time. However, the stent implantation might cause postoperative ECG alterations and a higher risk of paravalvular leakage. In literature, some cases of thrombocytopenia are described after implantation. We investigated the Sorin Perceval S Sutureless Valve and the Edwards Intuity Sutureless Valve.Material and methods: Seventy-nine patients underwent aortic valve replacement using a sutureless valve in a single center between 2015 - 2018. Thirty-seven patients received Sorin Perceval S (Group A) and 42 Edwards Intuity (Group B). Simultaneous bypass surgery was performed in 23 patients in Group A and 22 patients in Group B. We compared the groups regarding postoperative TTE and paravalvular leakage, postoperative ECG alterations, need for pacemaker implantation, postoperative platelet count, and 30-day mortalityResults: Only in Group B 2 patients had paravalvular leakage, and one was reoperated within the same hospital stay. In Group A, nine patients suffered from postoperative atrial fibrillation, and in Group B, 16 patients. Left bundle branch block (LBBB) was observed in 5 patients in Group A, and 13 patients in Group B. Two patients in Group A needed a definite pacemaker, and five patients in Group B. Tachy-Brady Syndrome and LBBB were observed more frequently in Group B as well as ECG alterations. One patient died within 30 days in Group A due to multiorgan failure. This patient was older and multimorbid compared to the average. Regarding platelet count, we saw a statistically significant decrease in both groups. There were no major bleeding complications or reoperations due to hemorrhage.Conclusion: Our data shows that sutureless aortic valve replacement is associated with new postoperative ECG alterations, which are self-limiting in most cases. Compared to the literature pacemaker implantation rate in Group B is higher.

Introduction: Even after surgical resection and adjuvant chemotherapy in pancreatic cancer the 5-year disease-free survival times (DFS), as well as overall survival rates (OS), are still low and median survival times are below 2 years. Here we retrospectively analyzed the outcome of immunotherapy in the additional adjuvant treatment of pancreatic cancer with long antigen exposition dendritic cell therapy (LANEX-DC®) in 28 patients who were treated at our institution. Patients: Data were available from 28 patients. Dendritic cells (LAEX-DC®) were produced according to a recently published protocol.Results: Therapy was well tolerated and no serious side effects were observed. The median disease-free survival times and the median survival times were 16,9 months and 29,4 months respectively. Five-year DFS and OS were 14,3% and 17,9%. Conclusion: We were able to show in a small cohort of patients that additional treatment with dendritic cells (LANEX-DC®) is highly effective and extends the median disease-free survival times as well as the median survival in the adjuvant treatment of pancreatic cancer, whereas the five-year overall survival still remains unsatisfactory.

Atherosclerosis is the most important factor that leads to the high risk of atherothrombotic cases in patients with diabetes mellitus (DM). High morbidity and mortality in these patients are firstly caused by cardiovascular disease, mostly coronary artery disease (CAD) along with acute coronary syndrome (ACS) [1].

Carbonic anhydrase VI (CA VI) catalyzes the reversible hydration of carbon dioxide in saliva with possible pH regulation, taste perception, and tooth formation effects. Objective: The aim of this work was to undertake a systematic review regarding the relationship between the expression/activity of CA VI in saliva and in dental biofilm and caries experience. Study design: Five databases were searched until February 2020. The composition was based on the PRISMA statement and on the PICOS model. First author, year, subject characteristics, analysis performed, outcome, measures & variables were extracted. The used terms were “carbonic anhydrase VI”, “saliva”, “dental biofilm” and “dental caries”.Results: Five studies in the English language were selected for this systematic review and the main discussed topics were the expression/activity of CA VI in saliva and/or in the dental biofilm of children, and its relationship with dental caries. Conclusion: Salivary carbonic anhydrase plays an important role in the caries dynamics process since there is an association between the expression/activity of CA VI in saliva and the experience of caries. Thus, this protein can predict the risk of dental caries in young patients.

Background: Intracerebral hemorrhage (ICH) is one of the most feared complications after brain tumor surgery. Despite several factors being considered to influence bleeding, an increasing number of clinical studies emphasize that hemostatic disorders, developed during surgical aggression and tumor status, could explain unexpected ICH. The objective of this prospective study was to evaluate the influence of perioperative D-dimer levels on ICH after brain tumor surgery. Methods: This prospective, observational, 18-month study, at a single third-level hospital, included all consecutive adults operated on brain tumors and postoperative stay in an intensive care unit. Three blood samples evaluated D-dimer levels (A-baseline, B-postoperative and C-24 hours after surgery). The normal range considered was 0-500ng/ml. ICH, as a primary outcome, was defined as bleeding that generates radiological signs of intracranial hypertension either by volume or by mass effect on the routine CT scan 24 hours after surgery. Other tumor features and hemostasis variables were analyzed. Chi-squared and Fisher’s exact test were used in the inferential analysis for qualitative variables and Wilcoxon and T-Test for quantitative ones. P-value < 0.05 was considered significant for a confidence interval of 95%. Results: A total of 109 patients operated on brain tumor surgery were finally included, 69 male (63,30%) and 40 female (36,70%), with a mean age of 54,60 ± 14,75 years. ICH was confirmed in 39 patients (35,78%). Their average of DDimer was A-1.526,70 ng/dl, B-1.061,88 ng/dl, and C-1.330,91 ng/dl (A p0.039, B p0,223 C p0.042, W-Wilcoxon test). The male group was also associated with ICH (p0,030 X2 test). Of those 39 patients with ICH, 30 in sample A (76,9%), 20 in sample B (51,28%) and 35 in sample C (89,74%) had a D-dimer > 500 ng/dl (p0,092, p1, p0,761 X2 test) and the relative risk of developing a postoperative hematoma in this patients was increased 0,36-fold presurgery, 0,25-fold postsurgery and 0,40-fold 24hours after surgery. D-dimer variation, had no statistical significance (p0,118, p0,195, p0,756 T-test). Platelets and prothrombin activity were associated with D-dimer levels only in sample A (p 0,02 and p 0,20, W Wilson). Conclusion: High levels of perioperative D-dimer could be considered a risk marker of ICH after brain tumor surgery. However, more studies would be worthwhile to confirm this association and develop primary prevention strategies for stroke. 

Purpose: The purpose of the study was to evaluate which ocular parameters have an impact on visual results obtained after an extended depth of focus (EDF) wavefront-designed intraocular lens (IOL). Setting: The study was conducted in three Italian centers (private practice in Lucca and two ambulatory surgical centers in Pisa and in Rome) from 01/09/2014 to 30/09/2015.Design: The study population included 178 eyes of 91 patients who had cataract surgery and implantation of an EDF wavefront - designed IOL (Mini Well Ready - SIFI Med Tech S.r.l.).Methods: Preoperative and postoperative refractive corneal spherical aberration (SA), ocular axial length, or anterior chamber depth were measured.Results: The majority of patients were spectacle-independent for near, intermediate, and distance vision and no one reported disturbing halos or glare. No overall significant differences were observed when stratifying anterior chamber depth (ACD) and ocular axial length (AL) by uncorrected distance visual acuity (UCDVA); p = 0.465 and 1.000 respectively, corrected distance visual acuity (CDVA); p = uncorrected near visual acuity (UCNVA); p = 1.000 and 0.728 respectively; p = 1.000 under both parameters and halos; 1.000 under both parameters. Still, there was a statistically significant difference when stratifying SA with 5 mm only by UDVA (p = 0.040).Conclusion: These results are consistent with similar outcomes in the scientific literature as measured with tests of visual acuity, either with or without optical correction. We also demonstrated that these IOLs can be used in myopic and hyperopic eyes, although it may be useful to evaluate the preoperative corneal SA to achieve better results.