Sequential Use of CO2 Laser Prior to Nd:YAG and Dye Laser in the Management of Non-Facial Warts: A Retrospective Study

Background and Objectives: Warts are benign lesions of viral etiology characterized by a hyperkeratotic appearance tending to spread across the skin surface. Various treatments have been proposed to manage this condition, such as acids, imiquimod, photodynamic therapy, cryotherapy, and various lasers. Materials and Methods: In this paper, we describe a combination protocol using CO2 laser prior to Nd:YAG laser for lesions interesting the palmoplantar areas or dye laser for lesions on other skin surfaces in the management of non-facial warts resistant to traditional therapies. In total, 34 patients with 103 warts suffering from wart infection resistant to traditional therapies treated from 1 January 2019 to 1 June 2020 were retrospectively enrolled at the Dermatological Unit of Magna Graecia University (Catanzaro, Italy). Two dermatologists measured clinical results, classifying lesions with complete resolution, partial resolution, or non-responding. Patients at four months follow-up were asked to evaluate their degree of satisfaction with a visual analog scale (VAS). Results: Almost all patients reported the complete resolution of lesions, with no patient reporting scarring. Five patients reported hypopigmentation in the treated areas. The mean satisfaction level was high. Only three patients experienced a relapse of the condition. Conclusions: Using a vascular laser following a CO2 superficial ablation of warts may help reduce the risk of scarring and decrease the incidence of relapses for lesions resistant to traditional therapies. Therefore, more extensive studies will be necessary to confirm the obtained results.

Visitors to Leuke Island

This article is the publication of the plates compiled by N.N. Murzakevich, secretary of the Odessa Society for History and Antiquities. It contains tracings of 241 Classical coins and lists of coin finds from the island of Fidonisi (known as Leuke in antiquity), which had been excavated in the 1840s and early 1850s. Recent data have led to a doubling of the list of Greek centres (up to 202) and the rulers of a number of states and peoples, whose coins made their way to the island. Details of these finds and the dates of the emissions illustrate clearly the development and chronological framework of the religious and economic ties between the northern coast of Pontus with the various regions of the Classical oikumene. The geographical range of the coin finds (from Magna Graecia, Sicily and the Levant to the Aegean, the Balkans, the Pontic region and Asia and as far away as Mesopotamia) demonstrates that the sanctuary of Achilles on the island of Leuke situated at a meeting point of Black Sea trade routes, enjoyed enormous popularity in the Classical world. The publication of these plates compiled by N.N. Murzakevich makes available new information on the maritime trade in the Pontus area between the 5th century BC and the 5th century AD.

774 Young adults with acute coronary syndrome: still a long road ahead

Aims Acute coronary syndrome (ACS) are a leading cause for mortality and morbility worldwide. Despite ACS usually affects the older population, it also occurs in younger individuals. Young ACS patients (YACS) have a significantly worse prognosis compared to their age-mates in the general population. Despite YACS are characterized by a different risk profiles compared to their older mates, many aspects still remain elusive. Aim of this study was to describe the clinical profile of young adults with Acute Coronary Syndrome. Methods and results Young patients (≤50 years) with the first diagnose of Acute Coronary Syndrome admitted to the Magna Graecia University Hospital were enrolled in the ongoing GENEPAMY registry. Over 7 years, a total of 675 eligible patients with Acute Coronary Syndrome aged 44 ± 8 years were included. Men accounted for 84.9% of all patients. Overall, 11.9% of patients had diabetes, 69.1% hypertension, 17.6% obesity, 93.6% dyslipidemia, while 75.5% were smokers. In the overall cohort, 44.1% were first diagnosed with STEMI, 45.9% with NSTEMI, while the remaining had been admitted for Unstable Angina. Cardiogenic shock was present at admission in 2.7% of cases. Multivessel disease was present in 39% of cases and was significantly less frequent in women (P < 0.001). Thrombolysis was administered as the initial treatment in 15.1% of cases but was ineffective in 66.7% of patients. Percutaneous coronary angioplasty was performed in 79.1% of patients, while 1.9% of patients underwent surgical myocardial revascularization. Spontaneous coronary dissection was present in 0.7% of men and 17.2% of women (P < 0.001). At admission, 98.9% of patients had been treated with ASA, 17.9% with clopidogrel, 49.1% with ticagrelor and 28.4% with prasugrel. A complete revascularization was achieved in 81.6% during the index hospitalization but was significantly more frequent in women compared to men (86.3% vs. 80.8; P < 0.001). Conclusions Our data highlight that YACS present a peculiar clinical profile. In particular, the high cardiovascular risk profile demands attention. Finally, despite most patients were men, young women with ACS present several relevant differences compared to men, needing a more careful clinical management.

809 Frequency and determinants of haemoglobin drop without overt bleeding in patients undergoing transcatheter aortic valve replacement

Aims Post-procedural bleedings have a significant impact on mortality in patients undergoing transcatheter aortic valve replacement (TAVR). Unfortunately, the source of these bleedings is often undetermined, causing difficulties in diagnosis and related treatment. Furthermore, the frequency and determinants of ‘non-overt’ bleeding are largely lacking in TAVR studies. Accordingly, in this analysis, we aimed to assess the frequency and determinants of haemoglobin drop without overt bleeding in patients undergoing TAVR. Methods Patients undergoing TAVR at Magna Graecia University in Catanzaro from September 2008 to November 2020 were included in this study. Post-procedural haemoglobin (Hb) drop was calculated subtracting the lowest value observed after the procedure to the one obtained at admission (Hb drop). The association between baseline clinical and procedural variables with Hb drop was investigated with a linear regression model. Results Out of 407 patients undergoing TAVR at our institution, 119 (29.2%) were excluded because experiencing overt bleeding, red blood cells transfusion, were treated with only balloon angioplasty, or for procedural unsuccess. Among the 288 patients included in the final analysis, 239 (83.0%) were older than 74 y.o., 148 (51.4%) were female, 94 (32.6%) were diabetics, and 69 (24.0%) had CKD. All the patients were deemed at intermediate/high operatory risk and treated using the transfemoral approach. After TAVR, Hb significantly decreased (12.6 ± 1.6 g/dL to 9.7 ± 1.3 g/dL, P < 0.001), with an absolute mean reduction of 2.9 ± 1.23 g/dL 126 patients (43.8%) had Hb drop ≥ 3 g/dL, while 11 (3.8%) had Hb drop ≥ 5 g/dL. The table below summarizes the determinants of Hb drop. Among them, the new generation of self-expandable and balloon-expandable devices were associated with a lower post-procedural Hb drop compared to the previous generation of self-expandable devices, alongside, higher body mass index and hypertension. Conclusions Post-procedural reduction of Hb without overt bleeding or RBC transfusion is frequent, involving almost half of the patients undergoing TAVR. The introduction in clinical practice of new-generation valve devices is significantly associated with a reduction of this adverse event. However, further and thorough investigation should be accomplished to reclassify this large part of patients into a well-defined category.

Wandering wives or foreign fillies? The women of archaic Greek colonisation

<p>Greek colonisation in the archaic period encompassed an enormous geographical area. But for all its prevalence, the textual evidence is limited in both quantity and quality and the archaeological evidence goes only some way towards helping decipher social change and ethnicity. These issues become even more apparent when considering the position of women in the new city foundations. Did Greek colonists take their own wives with them to their new homes? Were Greek women sent out at a later date once the colony had become established? Did Greek colonists intermarry with indigenous women on arrival? Or did something else happen, including a mix of these options? The weight of scholarly opinion currently falls in favour of intermarriage, though frequently little evidence is proffered to support this view. This thesis focuses on this hypothesis and examines the evidence (or lack thereof) to support this conclusion. Chapter One examines the problems associated with archaic Greek colonisation generally, particularly those issues connected with the ‘language of colonisation’. The study of Greek colonisation has been complicated by imprecise and ambiguous terminology, which frequently draws comparison with more modern (although altogether different) instances of the phenomenon. A major repercussion of this is the tendency to overlook both women and any indigenous peoples. The opening chapter also examines the various reasons behind the foundation of colonies, as well as the different types of settlements, so that an assessment can be made as to whether Greek women might have been more likely to accompany colonising expeditions in some instances over others. Chapter Two looks at the concept of intermarriage more closely and assesses Greek attitudes towards foreign women. It also evaluates the evidence typically called upon by scholars to argue for and against intermarriage in Greek colonisation. Chapter Three assesses the evidence for the presence of women in ten different colonies. Presented roughly in chronological order, these colonies were selected for their geographical scope, covering different regions from the Western Mediterranean, Magna Graecia, North Africa, and the Black Sea. This discussion explores both the literary and archaeological evidence (where possible) for each of these colonies and assesses the potential for intermarriage. This thesis demonstrates that broad conclusions about intermarriage as a widespread practice are unsustainable and concludes that colonisation in the archaic period cannot be considered a uniform phenomenon.</p>

Wandering wives or foreign fillies? The women of archaic Greek colonisation

<p>Greek colonisation in the archaic period encompassed an enormous geographical area. But for all its prevalence, the textual evidence is limited in both quantity and quality and the archaeological evidence goes only some way towards helping decipher social change and ethnicity. These issues become even more apparent when considering the position of women in the new city foundations. Did Greek colonists take their own wives with them to their new homes? Were Greek women sent out at a later date once the colony had become established? Did Greek colonists intermarry with indigenous women on arrival? Or did something else happen, including a mix of these options? The weight of scholarly opinion currently falls in favour of intermarriage, though frequently little evidence is proffered to support this view. This thesis focuses on this hypothesis and examines the evidence (or lack thereof) to support this conclusion. Chapter One examines the problems associated with archaic Greek colonisation generally, particularly those issues connected with the ‘language of colonisation’. The study of Greek colonisation has been complicated by imprecise and ambiguous terminology, which frequently draws comparison with more modern (although altogether different) instances of the phenomenon. A major repercussion of this is the tendency to overlook both women and any indigenous peoples. The opening chapter also examines the various reasons behind the foundation of colonies, as well as the different types of settlements, so that an assessment can be made as to whether Greek women might have been more likely to accompany colonising expeditions in some instances over others. Chapter Two looks at the concept of intermarriage more closely and assesses Greek attitudes towards foreign women. It also evaluates the evidence typically called upon by scholars to argue for and against intermarriage in Greek colonisation. Chapter Three assesses the evidence for the presence of women in ten different colonies. Presented roughly in chronological order, these colonies were selected for their geographical scope, covering different regions from the Western Mediterranean, Magna Graecia, North Africa, and the Black Sea. This discussion explores both the literary and archaeological evidence (where possible) for each of these colonies and assesses the potential for intermarriage. This thesis demonstrates that broad conclusions about intermarriage as a widespread practice are unsustainable and concludes that colonisation in the archaic period cannot be considered a uniform phenomenon.</p>

Risk of autoimmune diseases in patients with RASopathies: systematic study of humoral and cellular immunity

Background Abnormalities of the immune system are rarely reported in patients affected by RASopathies. Aim of the current study was to investigate the prevalence of immune system dysfunction in a cohort of patients affected by RASopathies. Study design A group of 69 patients was enrolled: 60 at the Federico II University, Naples, 7 at University Magna Graecia of Catanzaro, 2 at “Scuola Medica Salernitana”, Salerno. An age- and sex-matched control group was also enrolled. Autoimmune disorders were investigated according to international consensus criteria. Immune framework was also evaluated by immunoglobulin levels, CD3, CD4, CD8, CD19, CD56 lymphocyte subpopulations, autoantibodies levels and panel of inflammatory molecules, in both patients and controls. Results Frequent upper respiratory tract infections were recorded in 2 patients; pneumonia, psoriasis and alopecia in single patients. Low IgA levels were detected in 8/44 patients (18.18%), low CD8 T cells in 13/35 patients (37.14%). Anti-tg and anti-TPO antibodies were detected in 3/24 patients (12.5%), anti r-TSH in 2 cases (8.33%), all in euthyroidism. Serum IgA and CD8 levels were significantly lower in patients than in controls (p 0.00685; p 0.000656 respectively). All tested patients showed increased inflammatory molecules compared to controls. These findings may anticipate the detection of overt autoimmune disease. Conclusions Patients affected by RASopathies are at risk to develop autoimmune disorders. Routine screening for autoimmunity is recommended in patients with RASopathy.

Nanosecond Q-Switched 1064/532 nm Laser to Treat Hyperpigmentations: A Double Center Retrospective Study

(1) Benign hyperpigmentations are a common problem in cosmetic dermatology. Melasma, solar lentigo, and other acquired hyperpigmentations represent an aesthetic issue for an increasing number of patients. The gold standard in managing this condition is currently 1064/532 nanometers (nm) Q-Switched lasers. This study reports our experience on the use of a Q-switched laser with a nanosecond pulse to treat these conditions. (2) Methods: A total of 96 patients asking for benign hyperpigmentation removal were consecutively enrolled at the Magna Graecia University of Catanzaro and Tor Vergata University of Rome. Treating parameters were the following: 1064 nm with a pulse duration of 6 nanoseconds (ns) for dermic lesions and 532 nm with 6 ns for epidermal ones. Up to five treatments with a minimum interval between laser treatments of thirty days were performed. A follow-up visit three months after the last session assessed patient satisfaction with a Visual Analogue Scale (VAS). Two blinded dermatologists assessed the cosmetic result using a five-point scale comparing pictures before treatment and at follow-up. (3) Results: 96 patients were included; 47 participants were women (49.0%) and 49 men (51.0%). The mean reported age was 50.0 ± 17.3 years. All patients reached a good to complete hyperpigmentation removal at the dermatological evaluation with a mean VAS score of 8.91 ± 1.07. (4) Conclusions: Q Switched 1064/532 nm laser may be considered the gold standard treatment for benign hyperpigmentations. Our results confirm the literature findings on the effectiveness of these devices.

Greek Festivals in the Hellenistic Era

The Hellenistic era incorporated new city foundations in Egypt and the Near East, as well as the ancient Greek cities of mainland Greece, Asia Minor, and Magna Graecia. This chapter examines Greek festivals and athletic contests amid the struggles of cities and individuals for recognition and self-identity. Relying especially on epigraphic and archaeological evidence, it will look at the Olympic Games during this period, and at the widening geographical origins of its victors. New festivals were established and played crucial roles in inter-city politics; note especially the new isolympic and isopythian games such as the Ptolemaia in Alexandria and the festival of Artemis Leucophyene at Magnesia on the Maeander. The guilds of performers played important roles in the Hellenistic period. We consider how the experience of an athletic victor now compared with that in the past.