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https://www.selleckchem.com/products/dual-specificity-protein-phosphatase-1-6-Inhibitor-bcl.html Differences in people's living conditions and unequal opportunities have become more visible than before (others are still hidden) and create an opportunity for changes that we must face together.Monomelic amyotrophy, also known as Hirayama disease, is a rare lower motor neuron syndrome due to localized lower motor neuron loss in the spinal cord at the cervical level. Clinically, monomelic amyotrophy is defined by the insidious onset of unilateral atrophy and weakness involving the hand and forearm, typically beginning in the second or third decade of life. We report 19-year-old man with a two years history of slowly progressive unilateral weakness and atrophy of his right-hand muscles. Neurological examination revealed weakness and atrophy in his intrinsic hand muscles, with sparing of the abductor pollicis brevis muscle. Also, mild atrophy of the ulnar aspect of the forearm was detected with sparing of the brachioradialis muscle. Electromyography showed active and chronic neurogenic changes affecting C8 and T1 myotomes, with mild chronic neurogenic changes on C7 myotome. Magnetic resonance imaging of his cervical spine revealed spinal cord atrophy involving C5 to C7 segments, associated with forward displacement of the posterior wall of the dura in cervical spine flexion. The clinical features associated with the imaging and electrophysiological findings support the diagnosis of monomelic amyotrophy.Reintervention of a mitral degenerated bioprosthesis has a high surgical risk, especially in elderly patients with multiple comorbidities. We report a 74 years old female with two previous cardiac surgical procedures and a new structural mitral bioprosthesis deterioration with severe mitral regurgitation. Considering her high-surgical risk, a fully percutaneous treatment was performed with a balloon-expandable aortic valve in mitral position (valve-in-valve) through a trans

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