Notes

Encounters involving interventions along with rehab actions regarding the return-to-work from a sexual category standpoint. A focus team review among staff on ill keep with regard to widespread mental problems.
Meningeal infiltration by malignant metastasis process without brain parenchymal involvement is very unusual event in patients with bronchogenic carcinoma. This manuscript describes a case of adenocarcinoma right lung in a 48-year old male having persistent headache. The cerebrospinal fluid cytology revealed the presence of metastatic deposits of adenocarcinoma lung that confirmed the diagnosis of meningeal carcinomatosis.Paolo Gava, (Conegliano, Treviso, September 1, 1946 - Stra, Venezia, Italy, July 19, 2021) was a sustainable resources engineer, who worked in Italy, France and England, leading research programs well before the current international interest in countering global warming. Passionate about Tango, Paolo kept himself in shape for many decades by running or pedaling or roller-skating, after years of training as a semi-professional athlete, competing and winning Italian and European short distance races in the Master classes. Then, Paolo applied his engineering skills to optimize comparisons between the results of the different Classes of Master Athletes, questioning the rules used by Italian and World Master Sports Associations. Friendly discussing during an after-dinner, he shocked us claiming that, in absence of diseases and trauma (Early Aging), the aging decay is a linear process from 30 to 110 years. Under our friendly pressure he was able to publish his first biomedical article, detailing his mathematical approaches and results in a 2015 issue of Experimental Aging Research, titled Age-associated power decline from running, jumping and throwing male master world records. To honor his other legacies during his last six years of life, we add here further examples of Paolo's scientific studies and his relationships with senior colleagues and young students of sports and aging sciences.
The aim of this pilot, registry study was to evaluate the prophylactic effects of oral supplementation with Pycnogenol
(150 mg/day) in subjects with previous history of recurrent (urinary tract infections (UTI) in a 2-month open follow-up.

subjects with recurrent-UTIs, defined by 1) at least three symptomatic UTIs over the past year; 2) two episodes of UTI's in the past six months; 3) symptoms of UTIs with urinalysis without bacterial presence, were included in the study. Pycnogenol
was supplemented at the dose of 150 mg/day for 2 months.

The two groups of subjects (supplement and controls, each including 25 subjects) were demographically and clinically comparable at baseline. No side effects or tolerability problems were observed. The registry evaluated the number of recurrent UTIs in two months; there was a limited decrease in the rate of recurrent UTIs, in comparison with the period before inclusion of 9.93% in the standard management group in comparison with a more important decrease in the Pycnry component (UTI without infection or with a minimal bacterial component due to bacterial fragments) is present and maintains the inflammatory process.
This pilot registry indicates that prophylaxis with Pycnogenol® decreases the occurrence of UTIs both in men and women without side effects and with a good tolerability. The effects of Pycnogenol® in these patients - including the control of oxidative stress - may be very important, particularly when a predominantly inflammatory component (UTI without infection or with a minimal bacterial component due to bacterial fragments) is present and maintains the inflammatory process.
New messenger RNA (mRNA) and adenovirus-based vaccines (AdV) against Coronavirus disease 2019 (COVID-19) have entered large scale clinical trials. Since healthcare professionals (HCPs) and armed forces personnel (AFP) represent a high-risk category, they act as a suitable target population to investigate vaccine-related side effects, including headache, which has emerged as a common complaint.

We investigated the side-effects of COVID-19 vaccines among HCPs and AFP through a 38 closed-question international survey. click here The electronic link was distributed via e-mail or via Whatsapp to more than 500 contacts. Responses to the survey questions were analyzed with bivariate tests.

A total of 375 complete surveys have been analyzed. More than 88% received an mRNA vaccine and 11% received AdV first dose. A second dose of mRNA vaccine was administered in 76% of individuals. No severe adverse effects were reported, whereas moderate reactions and those lasting more than 1 day were more common with AdV (P=0.002 and P=0.024 respectively). Headache was commonly reported regardless of the vaccine type, but less frequently, with shorter duration and lower severity that usually experienced by participants, without significant difference irrespective of vaccine type.

Both mRNA and AdV COVID-19 vaccines were safe and well tolerated in a real-life subset of HCPs and AFP subjects.
Both mRNA and AdV COVID-19 vaccines were safe and well tolerated in a real-life subset of HCPs and AFP subjects.
Recurrence is the most frequent complication following acute pericarditis and may occur in 30% patients, rising to 50% in case of multiple recurrences, lack of colchicine treatment or use of glucocorticoids. Available treatments include aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, glucocorticoids, immunosuppressive agents, immunoglobulins, anti-interleukin-1 (IL-1) agents.

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to assess the efficacy of pharmacological treatments for acute and recurrent pericarditis. Bibliographic databases were searched (PubMed, MEDLINE, Embase, Scopus, and the Cochrane Library) using the terms "acute pericarditis" or "recurrent pericarditis" and "colchicine" or "NSAIDs" or "glucocorticoids" or "immunosuppressive agents" or "immunoglobulins" or "anti-IL1 agents." Random-effects meta-analysis was used to assess the risk of recurrent pericarditis. Publication bias was assessed using the Egger test, and meta-regressionnt of pericarditis is key to prevent recurrences. Colchicine is the mainstay of treatment in acute and recurrent pericarditis, while anti-IL1 agents are a valuable option in case of recurrent pericarditis refractory to conventional drugs.Post cardiac injury syndromes (PCIS) are becoming increasingly common, due to the growing number of cardiovascular procedures (cardiac surgery, percutaneous interventions) and the high burden of cardiovascular diseases such as acute coronary syndromes. This review aims to provide an overview of the main clinical characteristics of PCIS, along with their management in clinical practice.Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. CHI is a challenging disease to diagnose and manage. Moreover, complicating the course of the disease with another metabolic disease like Maple syrup urine disease (MSUD) adds more challenges to the already complex management. We report a term neonate who developed symptomatic non-ketotic hypoglycemia with a blood glucose (BG) level of 1.9 mmol/L at 21-hours of life. A critical sample at that time showed high serum insulin and C-peptide levels confirming the diagnosis of CHI. Tandem mass spectrometry done at the same time was suggestive of MSUD which was confirmed by high performance liquid chromatography (HPLC). The diagnosis of both conditions was subsequently confirmed by molecular genetic testing. His hypoglycemia was managed with high glucose infusion with medical therapy for CHI and branched chain amino acids (BCAA) restricted medical formula. At the age of four months, a near-total pancreatectomy was done due to the failure of conventional therapy. Throughout his complicated course, he required meticulous monitoring of his BG and modified plasma amino acid profile aiming to maintain the BG at ≥ 3.9 mmol/L and levels of the three BCAA at the disease therapeutic targets for his age. The patient is currently 29 months old and has normal growth and development. This patient is perhaps the only known case of the co-occurrence of CHI with MSUD. Both hypoglycemia and leucine encephalopathy can result in death or permanent neurological damage. The management of CHI and MSUD in combination is very challenging.
The purpose of this paper was to determine the complementarity between the Canadian Medical Education Directions for Specialists (CanMEDS) physician competency and LEADS leadership capability frameworks from three perspectives epistemological, philosophical and pragmatic. Based on those findings, the authors propose how the frameworks collectively layout pathways of lifelong learning for physician leadership.

Using a qualitative approach combining critical discourse analysis with a modified Delphi, the authors examined "How complementary the CanMEDS and LEADS frameworks are in guiding physician leadership development and practice" with the following sub-questions What are the similarities and differences between CanMEDS and LEADS from An epistemological and philosophical perspective? The perspective of guiding physician leadership training and practice? How can CanMEDS and LEADS guide physician leadership development from medical school to retirement?

Similarities and differences exist between the two f is the first paper to map the CanMEDS (physician competency) and LEADS (leadership capabilities) frameworks. By determining the complementarity between the two, synergies can be used to influence physician leadership capacity needed for today and the future.Vitamin D deficiency is so frequent in older patients (aged 65 years and older) that the international consensus does not recommend routine vitamin D measurement. Assessment of overall health status is a cornerstone before considering vitamin D supplementation, as the effect of vitamin D supplementation has only been demonstrated in vulnerable or dependent but not for robust older patients. The effect of the different modalities of oral vitamin D supplementation are equivalent 800-1'200 IU/day, 10'000 IU/week or 30'000-50'000 IU/month. Monitoring of vitamin D blood level monitoring is not necessary because of a large therapeutic margin. In the presence of osteoporosis, a dietary or supplementation intake of 1'200 mg per day of calcium should be added.The increasing life expectancy, the earlier detection of terminal illnesses and the increasing complexity of care pathways led us to propose an innovative response within the Neuchâtel Hospital Network (RHNe), in the form of a mixed intra-hospital mobile team (GSPmob), composed of doctors and nurses from geriatrics and palliative care. Through geriatric and palliative assessment, we are able to highlight the patient's different medical problems. Our team, after two years of existence, has met our patients' needs as well as the hospital teams' needs. And yet we encountered certain challenges. Our current objective is to describe our experience by presenting our results and difficulties.Improving glycaemia level is helpful to the clinician in diabetes management. Elderly diabetics make up a group that is non-homogeneous and with a very varied health status, whose treatment must be adjusted to take into account comorbidities, degree of frailty and both functional and mental disability, in addition to their life expectancy and personal preferences. Thus, the target of treatment should be defined along three categories of patients robust, vulnerable and dependent. This article reviews information from the literature high-lighting current recommendations for treatment, the clear inclination towards overtreatment of the elderly diabetic and the resulting noxious effects of occurring hypoglycemia, that are often not recognized by the patient and his doctor.
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