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Background: The Italian National Institute of Statistics (ISTAT) highlights that in 2020 10% of the Italian population could not afford an adequate meal every 2 days. Families with several children were more affected, for these children school meals represented the only access to a healthy diet. The European Commission Farm to Fork Strategy, concerning the COVID-19 pandemic (CP), underlines the need to act to ensure access to a sufficient supply of affordable food for all. In the Province of Trieste (PT) over 90% of pupils eat in school canteens (12,000 meals per day). The aims of the project were to verify the impact of CP on the food security of public school canteens (PSC) and determine any Nutritional Critical Points (NCPs) - Corrective Actions (CAs) to guarantee healthy equity meals for all pupils. Methods: The content of Public food procurement and service polices for a healthy diet (PFP) published by the WHO and the Nutrient Analysis Critical Control Points (NACCP) process as indicated by the Ministry of Health were applied. In the first quarter of 2021, all food procurement contracts (n=6) and all of the school kitchens (n=45) of PT PSC were verified, the University of Trieste analysed the composition of fresh desserts administered in 7 consecutive weeks. Results: The NACCP process showed NCPs on the low quality of afternoon snacks and on the quantitative/qualitative fat profile of fresh desserts, with a content of 69 to 72% of saturated fat, of 5 to 7% of trans fat and of 8 to 12% oxidized fat as a ‘‘dual quality’’ food. CAs were activated to support all PT PSC in reformulating fresh desserts, as well as in aiding the assessment of the food procurement landscape, activating regular monitoring of compliance and designing procurements adherent to PFP. Conclusions: Project outcomes highlight the importance of taking action to continuously support PSC in order to ensure healthy and equitable food environments for all and to contribute to building a resilient food system. [ABSTRACT FROM AUTHOR]

Abstract: This study focuses on the influence of oxygen addition on ethanol steam reforming (ESR) reaction performed in a dense Pd–Ag membrane reactor (MR) for producing hydrogen directly available for feeding a polymer electrolyte membrane fuel cell (PEMFC). In particular, oxygen addition can prevent ethylene and ethane formation caused by dehydration of ethanol as well as carbon deposition. The MR is operated at 400°C, H2O:C2H5OH=11:1 as feed molar ratio and space velocity (GHSV) ∼2000h−1. A commercial Ru-based catalyst was packed into the MR and a nitrogen stream of 8.4×10−2 mol/h as sweep gas was flowed into the permeate side of the reactor. Both oxidative ethanol steam reforming (OESR) and ESR performances of the Pd–Ag MR were analyzed in terms of ethanol conversion to gas, hydrogen yield, gas selectivity and CO-free hydrogen recovery by varying O2:C2H5OH feed molar ratio and reaction pressure. Moreover, the experimental results of the OESR and ESR reactions carried out in the same Pd–Ag MR are compared in order to point out the benefits due to the oxygen addition. Experimentally, this work points out that, overcoming O2:C2H5OH=1.3:1, ethanol conversion is lowered with a consequent drops of both hydrogen yield and hydrogen recovery. Vice versa, a complete ethanol conversion is achieved at 2.5bar and O2:C2H5OH=1.3:1, whereas the maximum CO-free hydrogen recovery (∼30%) is obtained at O2:C2H5OH=0.6:1. [Copyright &y& Elsevier]

Abstract: In this experimental work, a dense tubular Pd–Ag membrane reactor is used for carrying out the acetic acid steam reforming reaction for producing a CO-free hydrogen stream. The influence of the different flow configurations, as well as the sweep factor and the reaction pressure is analysed. A Ni-based commercial catalyst was packed in the lumen side of the membrane reactor and the experimental tests were performed at a reaction temperature of 400°C and at a H2O/acetic acid feed molar ratio of 10/1. Results in terms of CO-free hydrogen recovery, hydrogen yield and products selectivities are proposed. Moreover, a comparison between the performances of the membrane reactor and a traditional reactor working at the same operative conditions is illustrated and discussed. [Copyright &y& Elsevier]

The Nicoladoni-Branham sign may change because of exercise. Both dogs with femoral AVF and patients with lower-extremity AVF showed an increase in the Nicoladoni-Branham reaction after exercise as compared with its magnitude at rest. In both groups the AVFs were located near active muscles. We did not find this behavior in 3 patients with AVFs at points distant from the muscles used in exercise. [ABSTRACT FROM AUTHOR]

Abstract: A catalytic Pd–Ag membrane reactor has been packed with a Co–Al2O3 catalyst to perform the ethanol steam reforming reaction using a simulated bio-ethanol mixture (H2O/C2H5OH feed molar ratio = 18.7/1). In Part I of this work, low hydrogen recovery (≤30%) and CO-free hydrogen yield (≤20%) were obtained. In this second study the influence of higher pressure and sweep-gas flow rate was studied in order to improve the membrane reactor performances in terms of higher ethanol conversion, CO-free hydrogen yield and hydrogen recovery. The counter-current sweep-gas flow configuration was used for studying the effect of the reaction pressure and the sweep factor on the reaction system, while the co-current flow configuration was also considered for analysing the weight hourly space velocity effect. Moreover, a comparison with a traditional reactor working at the same MR operating conditions was also realized. As best results, the membrane reactor showed 100% ethanol conversion, 95.0% CO-free hydrogen recovery and ∼60.0% CO-free hydrogen yield, operating at 400 °C and 3.0 (abs) bar. [Copyright &y& Elsevier]

Abstract: Glycerol as a byproduct of biodiesel production represents a renewable energy source. In particular, glycerol can be used in the field of hydrogen production via gas phase reforming for proton exchange membrane fuel cell (PEMFC) applications. In this work, glycerol steam reforming (GSR) reaction was investigated using a dense palladium–silver membrane reactor (MR) in order to produce pure (or at least CO-free) hydrogen, using 0.5wt% Ru/Al2O3 as reforming catalyst. The experiments are performed at 400°C, water to glycerol molar feed ratio 6:1, reaction pressure ranging from 1 to 5bar and weight hourly space velocity (WHSV) from 0.1 to 1.0h−1. Moreover, a comparative study is given between the Pd–Ag MR and a traditional reactor (TR) working at the same MR operating conditions. The effect of the WHSV and reaction pressure on the performances of both the reactors in terms of glycerol conversion and hydrogen yield is also analyzed. The MR exhibits higher conversion than the TR (∼60% as best value for the MR against ∼40% for the TR, at WHSV=0.1h−1 and 5bar), and high CO-free hydrogen recovery (around 60% at WHSV=0.1h−1 and 5bar). During reaction, carbon coke is formed limiting the performances of the reactors and inhibiting, in particular, the hydrogen permeation through the membrane with a consequent reduction of hydrogen recovery in the permeate side. [Copyright &y& Elsevier]

Abstract: In this experimental work, the ethanol steam reforming reaction is performed in a porous stainless steel supported palladium membrane reactor with the aim of investigating the influence of the membrane characteristics as well as of the reaction pressure. The membrane is prepared by electroless plating technique with the palladium layer around 25μm deposited onto a stainless steel tubular macroporous support. The experimental campaign is directed both towards permeation and reaction tests. Firstly, pure He and H2 are supplied separately between 350 and 400°C in the MR in permeator modality for calculating the ideal selectivity . Thus, the MR is packed with 3g of a commercial Co/Al2O3 catalyst and reaction tests are performed at 400°C, by varying the reaction pressure from 3.0 to 8.0bar. Experimental results in terms of ethanol conversions as well as recovery and purity of hydrogen are given and compared with some results in the same research field from the open literature. As best result of this work, 100% ethanol conversion is reached at 400°C and 8bar, recovering a hydrogen-rich stream consisting of more than 50% over the total hydrogen produced from reaction, having a purity around 65%. [Copyright &y& Elsevier]

Abstract: Nowadays, there is a growing interest towards pure hydrogen production for proton exchange membrane fuel cell applications. Methane steam reforming reaction is one of the most important industrial chemical processes for hydrogen production. This reaction is usually carried out in fixed bed reactors at 30–40 bar and at temperatures above 850 °C. In this work, a dense Pd–Ag membrane reactor packed with a Ni-based catalyst was used to carry out the methane steam reforming reaction between 400 and 500 °C and at relatively low pressure (1.0–3.0 bar) with the aim of obtaining higher methane conversion and hydrogen yield than a fixed bed reactor, operated at the same conditions. Furthermore, the Pd–Ag membrane reactor is able to produce a pure, or at least, a CO and CO2 free hydrogen stream. A 50% methane conversion was experimentally achieved in the membrane reactor at 450 °C and 3.0 bar whereas, at the same conditions, the fixed bed reactor reached a 6% methane conversion. Moreover, 70% of high-purity hydrogen on total hydrogen produced was collected with the sweep-gas in the permeate stream of the membrane reactor. From a modeling point of view, the mathematical model realized for the simulation of both the membrane and fixed bed reactors was satisfactorily validated with the experimental results obtained in this work. [ABSTRACT FROM AUTHOR]

The physical properties of in vitro iron-reconstituted and genetically engineered human heteropolymer ferritins were investigated. High-angle annular dark-field scanning transmission electron microscopy (HAADF-STEM), electron energy-loss spectroscopy (EELS), and 57 Fe Mössbauer spectroscopy were employed to ascertain (1) the microstructural, electronic, and micromagnetic properties of the nanosized iron cores, and (2) the effect of the H and L ferritin subunit ratios on these properties. Mössbauer spectroscopic signatures indicate that all iron within the core is in the high spin ferric state. Variable temperature Mössbauer spectroscopy for H-rich (H 21 /L 3 ) and L-rich (H 2 /L 22 ) ferritins reconstituted at 1000 57 Fe/protein indicates superparamagnetic behavior with blocking temperatures of 19 K and 28 K, while HAADF-STEM measurements give average core diameters of (3.7 ± 0.6) nm and (5.9 ± 1.0) nm, respectively. Most significantly, H-rich proteins reveal elongated, dumbbell, and crescent-shaped cores, while L-rich proteins present spherical cores, pointing to a correlation between core shape and protein shell composition. Assuming an attempt time for spin reversal of τ 0 = 10 -11 s, the Néel-Brown formula for spin-relaxation time predicts effective magnetic anisotropy energy densities of 6.83 × 10 4 J m -3 and 2.75 × 10 4 J m -3 for H-rich and L-rich proteins, respectively, due to differences in surface and shape contributions to magnetic anisotropy in the two heteropolymers. The observed differences in shape, size, and effective magnetic anisotropies of the derived biomineral cores are discussed in terms of the iron nucleation sites within the interior surface of the heteropolymer shells for H-rich and L-rich proteins. Overall, our results imply that site-directed nucleation and core growth within the protein cavity play a determinant role in the resulting core morphology. Our findings have relevance to iron biomineralization processes in nature and the growth of designer's magnetic nanoparticles within recombinant apoferritin nano-templates for nanotechnology., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Testicular cancer is relatively uncommon and accounts for <1% of all male tumors. However, it is the most common solid tumor in men between the ages of 20 and 34 years, and the global incidence has been steadily rising over the past several decades. Several risk factors for testicular cancer have been identified, including personal or family history of testicular cancer and cryptorchidism. Testicular germ cell tumors (GCTs) comprise 95% of malignant tumors arising in the testes and are categorized into 2 main histologic subtypes: seminoma and nonseminoma. Although nonseminoma is the more clinically aggressive tumor subtype, 5-year survival rates exceed 70% with current treatment options, even in patients with advanced or metastatic disease. Radical inguinal orchiectomy is the primary treatment for most patients with testicular GCTs. Postorchiectomy management is dictated by stage, histology, and risk classification; treatment options for nonseminoma include surveillance, systemic therapy, and nerve-sparing retroperitoneal lymph node dissection. Although rarely occurring, prognosis for patients with brain metastases remains poor, with >50% of patients dying within 1 year of diagnosis. This selection from the NCCN Guidelines for Testicular Cancer focuses on recommendations for the management of adult patients with nonseminomatous GCTs.

Exertional rhabdomyolysis is more common in sickle trait due to a predisposition to dehydration and inability to concentrate the urine. Spinning, an indoor cycling workout, has been associated with exertional rhabdomyolysis in recent reports. A consequence of rhabdomyolysis is acute kidney injury, which may be expected to be more common in patients with sickle trait. We report a case of spinning induced rhabdomyolysis in a woman with sickle trait that did not result in renal injury. "Spin rhabdo" is thought to be more severe than other causes of exertional rhabdomyolysis and is associated with higher creatine kinase levels than other causes of exertional rhabdomyolysis. Therefore, individuals with known sickle trait should visit their physician prior to participation in spin classes for the first time. We might also consider voluntary screening for sickle trait in at risk populations prior to enrolling in spin classes given that many patients are unaware of their sickle trait status., Competing Interests: No competing interests were disclosed.

Objectives: To investigate the potential association between body mass index (BMI) and clinicopathological features of clinically localized renal masses., Materials and Methods: An international, multi-institutional retrospective review of patients who underwent surgery for clinically localized renal masses between 2000 and 2010 was undertaken after an institutional review board approval. Patients were divided into 4 absolute BMI groups based on the entire cohort׳s percentiles and 4 relative BMI groups based on their respective population (American or Italian). Renal mass pathological diagnosis, renal cell carcinoma (RCC) subtype, Fuhrman grade (low and high), and clinical stage were compared among groups using Fisher׳s exact test, Kruskal-Wallis test, and the Cochran-Armitage trend test. A multivariate logistic analysis was performed to evaluate independent association between tumor and patient characteristics with tumor pathology (Fuhrman grade)., Results: A total of 1,748 patients having a median BMI of 28 (interquartile range 25-32) were evaluated. Benign masses and RCC cases had similar proportion across BMI groups (P = 0.4). The most common RCC subtype was clear cell followed by papillary carcinoma, chromophobe, and other subtypes. Their distribution was comparable across BMI groups (P = 0.7). Similarly, clinical stage distribution was comparable with the overall cohort. The distribution of Fuhrman grade in RCC, however, demonstrated an increased proportions of low grade with increasing BMI (P<0.05). This trend was maintained in subgroups according to gender, stage and age (P<0.05 in all subgroup analysis). In a multivariable model that included potential confounders (i.e., age, sex, and tumor size) higher BMI groups had lower odds of presenting a high Fuhrman grade., Conclusion: In this study, higher BMI was associated with lower grade of RCC in clinically localized renal masses. This may, in part, explain better survival rates in patients with higher BMI and may correlate with a possible link between adipose tissue and RCC biology., (Copyright © 2017 Elsevier Inc. All rights reserved.)

We completed targeted exome sequencing of the tumors of 50 patients with pTis-pT4b bladder cancer. Mutations were categorized by type, stratified against previously identified cancer loci in the Catalogue of Somatic Mutations in Cancer and The Cancer Genome Atlas databases, and evaluated in pathway analysis and comutation plots. We analyzed mutation associations with receipt of neoadjuvant chemotherapy, nodal involvement, metastatic disease development, and survival. Compared with The Cancer Genome Atlas, we found higher mutation rates in genes encoding products involved in epigenetic regulation and cell cycle regulation. Of the pathways examined, PI3K/mTOR and Cell Cycle/DNA Repair exhibited the greatest frequencies of mutation. RB1 and TP53, as well as NF1 and PIK3CA were frequently comutated. We identified no association between mutations in specific genes and key clinical outcomes of interest when corrected for multiple testing. Discovery phase analysis of the somatic mutations in 50 high-risk bladder cancer patients revealed novel mutations and mutational patterns, which may be useful for developing targeted therapy regimens or new biomarkers for patients at very high risk of disease metastasis and death., Patient Summary: In this report we found known, as well as previously unreported, genetic mutations in the tumors of patients with high-risk bladder cancer. These mutations, if validated, may serve as actionable targets for new trials., (Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Mutations in the gene HR coding for the hairless protein are associated with atrichia with papular lesions (APL), an autosomal recessive form of alopecia universalis that is characterized by generalized scalp and body atrichia with papular lesions. We here describe a South Italian family of ancient Albanian heritage. The full phenotype with complete atrichia was expressed in 2 siblings, whereas the parents and one sister were unaffected. Direct sequencing of the gene coding for the hairless protein allowed the identification of a new mutation in exon 17. Consistent with the recessive inheritance of the disease, both the siblings were homozygous for the mutation, whereas the parents and the unaffected sister where heterozygous. A relevant discrepancy with a haplotype linkage study is reported, stressing the importance of gene sequencing in genetic diagnosis and counseling because linkage studies can be biased by recombination events.

Plasma C-reactive protein (CRP) concentration is a biomarker of systemic atherosclerosis and may also be associated with vein graft disease. It remains unclear whether CRP is also an important modulator of biological events in the vessel wall. We hypothesized that CRP influences vein graft healing by stimulating smooth muscle cells (SMCs) to undergo a phenotypic switch. Distribution of CRP was examined by immunohistochemistry in prebypass human saphenous veins (HSVs, n = 21) and failing vein grafts (n = 18, 25-4,400 days postoperatively). Quiescent HSV SMCs were stimulated with human CRP (5-50 microg/ml). SMC migration was assessed in modified Boyden chambers with platelet-derived growth factor (PDGF)-BB (5-10 ng/ml) as the chemoattractant. SMC viability and proliferation were assessed by trypan blue exclusion and reduction of Alamar Blue substrate, respectively. Expression of PDGF ligand and receptor (PDGFR) genes was examined at RNA and protein levels after 24-72 h of CRP exposure. CRP staining was present in 13 of 18 diseased vein grafts, where it localized to the deep media and adventitia, but it was minimally detectable in most prebypass veins. SMCs pretreated with CRP demonstrated a dose-dependent increase in migration to PDGF-BB (P = 0.02), which was inhibited by a PDGF-neutralizing antibody. SMCs treated with CRP showed a dose-dependent increase in PDGFRbeta expression and phosphorylation after 24-48 h. Exogenous CRP had no effect on SMC viability or proliferation. These data suggest that CRP is detectable within the wall of most diseased vein grafts, where it may exert local effects. Clinically relevant levels of CRP can stimulate SMC migration by a mechanism that may involve upregulation and activation of PDGFRbeta.

New quaternary ammonium polymers, which in a previous work had shown relevant antibacterial properties, have been investigated as regards to their hemolytic activity (HA) in comparison with a low molecular weight commercial antibacterial agent, Steramine G (SG). All polymers exhibit negligible, or at most modest, HA at dosages and contact times at which SG is strongly hemolytic.

Hitherto the size of abdominal aortic aneurysms (AAA) has been considered the most important factor in determining the risk of rupture. For this reason most interest has been devoted to physical, echographic and tomographic analyses of the shape of AAA. However, it is known that rupture can also occur in small AAA. Other factors must be considered to have an important role in the natural history of aneurysms. The aim of this study was to characterise the mechanical stress in the wall of an AAA due to pressure in the presence of atherosclerosis, intraluminal thrombus and anatomical restraints. The Finite Elements Method (FEM) was used to determine wall stress distribution. Due to the simplicity of the AAA structure an axisymmetric model has been built. The results of the structural analysis confirms that maximum stress increases with diameter. These effects may be reduced by the presence of intraluminal thrombus, which in the models reduces maximum stress by up to 30%; however this is not the case for dissecting thrombus. On the other hand atherosclerotic plaques cause stress concentration and a significant increase in maximum wall stress. The risk of rupture can increase by about 200%. Finally the investigation shows the FEM is a versatile tool for studying the mechanics of vascular structures. It enables the influence of various parameters on wall stress to be quantified in diagnostic settings, and so could be useful for predicting the rupture of AAA, although at present such predictions are limited by data leakage and by the approximations used in the model.

A study was carried out to see if in patients with atherosclerotic lesions of the lower limbs the percentage of abdominal aneurysms is higher than in the general population. One hundred twenty five consecutive patients were studied in two different hospitals and compared with a control group. In the two groups with peripheral vascular diseases the patients had a prevalence of aneurysms of 12%, while in the control group the prevalence was of 3%. All patients were operated on successfully except two of them who are now in follow up with regular ultrasound assessment, one with an aortic aneurysm of 3.2 cm and the other with an aortic diameter of 4 cm and moderate liver failure.

Two cases of aorto-bisiliac aneurysms in monocorial twins in their sixties were observed. We report experimental and clinical data from the literature about genetic involvement in the formation of aneurysms, especially when associated with other risk factors. In addition to the genetic factors in the twins we studied, we also found other risk factors, such as hypertension and smoking, which took a long time to affect the patients before the aneurysms were detected.

The evaluation of atherosclerosis requires the definition of the object to be measured and of the questions the investigation is required to answer. In the first part of this paper some of the problems that arise when planning and defining evaluation of atherosclerosis are discussed. The second part is a review of the principal methods based on ultrasound technology. The working principles and clinical applications of each method are discussed. The rationale of each type of instrument with respect to others is highlighted.

The "quality" of poly(glycolic acid) as an absorbable suture material was investigated in comparison with catgut. Tissue reactions to poly(glycolic acid) and plain catgut were examined histomorphologically at different time intervals after implantation in rats, and compared. Four mechanical properties were also examined as relevant quality factors: elastic stiffness, tensile strength, toughness, and percent elongation at rupture of the suture material per se (unknotted). The variation of these properties in poly(glycolic acid) implants was followed since their insertion in the tissues. Histological behavior and mechanical properties appear to be more closely correlated in the case of poly(glycolic acid) than in the case of catgut, as a consequence of a greater regularity of tissue reaction towards the synthetic material. Both tissue reaction and tensile properties variation are independent of size in the case of the braided poly(glycolic acid) sutures examined. Elastic stiffness and tensile strength decrease steadily in time; toughness and ultimate elongation display an increase up to a maximum within one day since implantation, and then decrease.

Recordings of blood velocity profiles and their behavior in the time domain in some peripheral human vessels (carotid arteries and limb vessels) are reported. Measurements have been obtained with a pulsed ultrasonic instrument based on the analysis of the cross-correlation function of blood-diffused echoes. The alterations of blood velocity profiles and of the velocity in the time domain, induced by known stenosis, have been studied in vitro as a function of the distance between stenosis and measuring point, and the position of the sample volume along the diameter. These studies may be useful for a better comprehension of blood velocity measurements made with ultrasound equipment for clinical noninvasive diagnostic purposes.

Latero-lateral femoro-femoral arteriovenous fistulae (AVFs) were surgically created in mongrel dogs. After 7-9 months during which the dogs were trained on a treadmill, devices suitable for recording arterial pressure and aortic and coronary flow were chronically implanted. Haemodynamic parameters of the dogs were controlled either at rest or after effort, keeping AVFs open or manually closed. The results, when statistically processed, showed that haemodynamic changes induced by occlusion of AVFs at rest and under effort are similar from a qualitative point of view, but considerably more marked after muscular exercise. Under effort the shunt index calculated rose to a higher extent than cardiac output. The decrease in heart rate after AVFs occlusion was significantly correlated with flow in the fistulae. However, the Nicoladoni-Branham phenomenon ought to be used for indirect evaluation of the shunt flow.

We have investigated the influence of changes of perfusion pressure and local peripheral resistance on blood flow velocity waveform and profile in normal human peripheral arteries. Blood flow velocity and profile were recorded from the distal end of the left brachial artery in ten normal subjects by means of an ultrasonic device. The records were obtained in basal conditions and after blood pressure in the brachial artery and local peripheral vascular resistance were changed, separately or together, by progressive inflation of two arm cuffs, one encircling the proximal half of the left arm and the other the middle part of the left forearm. Both blood flow velocity waveform and profile were shown to be markedly modified by changes in perfusion pressure and local peripheral vascular resistance. Reduction of perfusion pressure decreased both forward and reverse peak velocities, but had the largest effect upon reverse velocity. The upslope and the downslope of the forward velocity wave were left unchanged. Increase in local peripheral vascular resistance markedly augmented reverse peak velocity, whether perfusion pressure was normal or reduced. Increased resistance only slightly influenced peak forward velocity.

Numerous authors reported a significant deterioration of heart function induced by aortic cross-clamping. Nevertheless, the aorta has been clamped during various surgical procedures without any complication. We studied the hemodynamic and metabolic variations induced by 20 min thoracic aorta cross-clamping in 6 open-chest dogs. During clamping the most striking modifications were an increase in coronary blood flow of over 65%, an increase in cardiac work of over 77% and an increase in total peripheral resistances of over 68% compared to base values. No significant variations were found in the heart rate and cardiac index. Metabolic parameters, such as O2 consumption and lactate consumption increased significantly during the clamping period. The increase in lactate consumption and the progressive and continuous improvement in oxygenation indexes (lactate/pyruvate, redox potential, excess of lactate) proved the absence of any myocardial anoxia during this period. Within 15--30 min after declamping all hemodynamic and metabolic parameters reverted to values close to basal values. These data strongly suggest that the mammalian heart can tolerate this procedure satisfactorily for a limited period of time. In clinical settings, one should consider the base conditions of the cardiovascular system before transposing these conclusions.

An anatomical study shows that the vascular junctions are always very well rounded in accordance with the direction of the blood flow. When performing an anastomosis, the further one departs from this configuration, which we can define as perfect, the more flow disturbances are likely to arise. This may jeopardize the satisfactory outcome of surgery.

A rare case of persistent primitive sciatic artery with a small aneurysm in its proximal part is reported. The occlusion of this artery caused extensive lower limb ischemia which called for amputation. The diagnostic difficulties are stressed out.