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Purpose To investigate the occurrence of arrhythmias in patients with normocalcemic (NC) primary hyperparathyroidism (PHPT) compared to both hypercalcemic PHPT patients and control subjects by means of 24-h Holter ECG. Methods Thirteen NCPHPT postmenopausal patients were enrolled and age-matched with 13 hypercalcemic PHPT patients and 13 controls. Every subject underwent basal ECG, 24-h Holter ECG and mineral metabolism biochemical evaluation. Results PHPT patients had higher mean serum calcium levels compared to both NCPHPT and controls; there was no difference in mean serum calcium levels between NCPHPT and controls. Both NCPHPT and PHPT patients had significantly higher mean PTH levels compared with controls. There were no differences in ECG parameters between the three groups, except for QTc interval. PHPT patients had normal QTc interval values, but significantly shorter mean values compared with those of controls and NCPHPT patients. During 24-h Holter ECG recording, 100% of PHPT patients had supraventricular premature beats (SVPBs), compared to 46% of NCPHPT ( p  = 0.005) and to 53% of controls ( p  = 0.01). PHPT patients experienced ventricular premature beats (VPBs) (69.2%) vs 15% of NCPHPT patients ( p  = 0.01) and 23% of controls ( p  = 0.04). There was no difference between NCPHPT and controls subjects concerning occurrence of both VPBs and SVPBs. Conclusions NCPHPT patients did not experience an increased occurrence of arrhythmias compared to controls, while PHPT patients showed an increased occurrence compared to both controls and NCPHPT. Our findings are most probably related to the short QTc interval caused by hypercalcemia observed in PHPT patients, but not in NCPHPT.

Purpose To investigate the link between hematopoietic and skeletal tissues in patients with fragility fractures. Methods We retrospectively analyzed the medical records of women older than 40 years who attended the Bone Disease Unit of “Sapienza” University of Rome for their first visit for osteoporosis from January 2020 to June 2022. Results Fragility fractures were found in 61.8% of the sample. In particular, vertebral fractures in 35.5%, femoral fractures in 6.3%, Colles fractures in 16.5% and non-vertebral non-hip in 42.5%. Fractured patients were significantly older compared to non-fractured, had lower mean values of lumbar spine ( p  = 0.01), and femoral neck BMD ( p  = 0.007). A red blood cell distribution width (RDW) value higher than 15% was observed four times more in those with fractures compared to non-fractured patients (8.9% vs 2%, p  = 0.01) and was associated with vertebral fracture after adjusting for age, BMI, menopause, nutritional status, smoking, osteoporosis and anemia (OR = 4.1, 95% CI 1.6–11.4, p  = 0.003). Hematocrit was negatively associated with hip fracture also adjusting for age, BMI, menopause, nutritional status, smoking, osteoporosis ( p  = 0.025). Conclusion Our study demonstrates that RDW values were significantly associated with vertebral fracture and hematocrit with hip fracture. Since both parameters are included in the initial evaluation of patients with suspected bone fragility, our results should push doctors to look at these values with no incremental cost for national health services.

Objectives. We compared complication rates after surgical abortions performed by physician assistants with rates after abortions performed by physicians. Methods. A 2-year prospective cohort study of women undergoing surgically induced abortion was conducted. Ninety-one percent of eligible women (1363) were enrolled. Results. Total complication rates were 22.0 per 1000 procedures (95% confidence interval [CI] = 11.9, 39.2) performed by physician assistants and 23.3 per 1000 procedures (95% CI = 14.5, 36.8) performed by physicians (P = .88). The most common complication that occurred during physician assistant–performed procedures was incomplete abortion; during physician-performed procedures the most common complication was infection not requiring hospitalization. A history of pelvic inflammatory disease was associated with an increased risk of total complications (odds ratio = 2.1; 95% CI = 1.1, 4.1). Conclusions. Surgical abortion services provided by experienced physician assistants were comparable in safety and efficacy to those provided by physicians.

The dual-radiator RICH detector of the ePIC experiment will employ over 300000 SiPM pixels as photosensors, organized into more than 1000 Photon Detection Units. Each PDU is a compact module, approximately 5x5x12 cm^3 in size, including four custom ASICs connected to 256 SiPMs and an FPGA-based readout card (RDO) responsible for data acquisition and control. Considering the moderately harsh radiation environment expected in the dRICH detector, this study reports on proton irradiation tests performed on key components of the RDO card to assess their tolerance to cumulative Total Ionizing Dose (TID) and Single Event Effects (SEE). All tested components demonstrated radiation tolerance beyond the TID levels expected for the dRICH environment, with the exception of the ATtiny417 microcontroller, which showed destructive failure. Furthermore, as expected, the observed Single Event Upset (SEU) rates call for appropriate mitigation strategies in the final system design.

An unusual case of a 32-year-old woman with branch retinal artery occlusion is presented. The patient was affected by Ménière's disease and had a history of occasional migraine headaches. A thorough clinical and laboratory investigation showed a high cholesterol level. Retinal arterial obstruction is rare in young people and it is difficult to establish the precise cause. The presumed multifactorial etiologic factors are discussed.