Il microcarcinoma papillare della tiroide. Implicazioni cliniche e strategia terapeutica

Gli Autori riportano la propria esperienza sulle implicazioni cli - niche e le strategie terapeutiche del microcarcinoma papillare della tiroide, valutando 412 pazienti sottoposti ad intervento chirurgico per patologia tiroidea. Essi sottolineano l’attuale problematica della diagnosi “incidentale” postoperatoria, la relativa strategia terapeutica adiuvante, il frequente riscontro di una patologia tiroidea benigna associata, fattori che giustificano, oltre le note motivazioni oncologi - che, la scelta della tiroidectomia totale di principio

Observing the Evolution of the Universe

How did the universe evolve? The fine angular scale (l>1000) temperature and polarization anisotropies in the CMB are a Rosetta stone for understanding the evolution of the universe. Through detailed measurements one may address everything from the physics of the birth of the universe to the history of star formation and the process by which galaxies formed. One may in addition track the evolution of the dark energy and discover the net neutrino mass. We are at the dawn of a new era in which hundreds of square degrees of sky can be mapped with arcminute resolution and sensitivities measured in microKelvin. Acquiring these data requires the use of special purpose telescopes such as the Atacama Cosmology Telescope (ACT), located in Chile, and the South Pole Telescope (SPT). These new telescopes are outfitted with a new generation of custom mm-wave kilo-pixel arrays. Additional instruments are in the planning stages.Comment: Science White Paper submitted to the US Astro2010 Decadal Survey. Full list of 177 author available at http://cmbpol.uchicago.ed

Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis: a meta-analysis of randomized clinical trials

Te study aimed to explore the hypothesis that adopting immediate cholecystectomy performed within 24 h of admission as early timing could reduce post-operative complications when compared to delayed cholecystectomy

Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis revised: Protocol of a systematic review and meta-analysis of results

Background Early laparoscopic cholecystectomy has been adopted as the treatment of choice for acute cholecystitis due to a shorter hospital length of stay and no increased morbidity when compared to delayed cholecystectomy. However, randomised studies and meta-analysis report a wide array of timings of early cholecystectomy, most of them set at 72 h following admission. Setting early cholecystectomy at 72 h or even later may influence analysis due to a shift towards a more balanced comparison. At this time, the rate of resolving acute cholecystitis and the rate of ongoing acute process because of failed conservative treatment could be not so different when compared to those operated with a delayed timing of 6-12 weeks. As a result, randomised comparison with such timing for early cholecystectomy and meta-analysis including such studies may have missed a possible advantage of an early cholecystectomy performed within 24 h of the admission, when conservative treatment failure has less potential effects on morbidity. This review will explore pooled data focused on randomised studies with a set timing of early cholecystectomy as a maximum of 24 h following admission, with the aim of verifying the hypothesis that cholecystectomy within 24 h may report a lower post-operative complication rate compared to a delayed intervention. Methods A systematic review of the literature will identify randomised clinical studies that compared early and delayed cholecystectomy. Pooled data from studies that settled the early intervention within 24 h from admission will be explored and compared in a sub-group analysis with pooled data of studies that settled early intervention as more than 24 h. Discussion This paper will not provide evidence strong enough to change the clinical practice, but in case the hypothesis is verified, it will invite to re-consider the timing of early cholecystectomy and might promote future clinical research focusing on an accurate definition of timing for early cholecystectomy for acute cholecystitis

The need for new "patient-related" guidelines for the treatment of acute cholecystitis

Heterogeneity of patients affected by acute cholecystitis, and their co-morbidities make very difficult to standardize the therapy for this very common condition. The staging system suggested in the recent "Tokyo guidelines", did not show a relevant impact on the management of patients and on the outcome of the disease. The relation among local pathological picture, patient clinical status and treatment algorithm, has to be better studied

Fluorescence-Activated Cell Sorting of EGFP-Labeled Neural Crest Cells From Murine Embryonic Craniofacial Tissue

During the early stages of embryogenesis, pluripotent neural crest cells (NCC) are known to migrate from the neural folds to populate multiple target sites in the embryo where they differentiate into various derivatives, including cartilage, bone, connective tissue, melanocytes, glia, and neurons of the peripheral nervous system. The ability to obtain pure NCC populations is essential to enable molecular analyses of neural crest induction, migration, and/or differentiation. Crossing Wnt1-Cre and Z/EG transgenic mouse lines resulted in offspring in which the Wnt1-Cre transgene activated permanent EGFP expression only in NCC. The present report demonstrates a flow cytometric method to sort and isolate populations of EGFP-labeled NCC. The identity of the sorted neural crest cells was confirmed by assaying expression of known marker genes by TaqMan Quantitative Real-Time Polymerase Chain Reaction (QRT-PCR). The molecular strategy described in this report provides a means to extract intact RNA from a pure population of NCC thus enabling analysis of gene expression in a defined population of embryonic precursor cells critical to development

How to manage the COVID-19 diffusion in the angiography suite. experiences and results of an Italian interventional Radiology Unit

Introduction: The management of the diffusion of Coronavirus disease 2019 (COVID-19) pandemic represents a massive problem for healthcare systems worldwide and Interventional Radiology (IR) is a fundamental hospital unit which must continue to provide its service. The aim of this article is to summarize the preventive measures taken in our IR unit and to report the results of these measures over a 7 weeks period. Material and Methods: Between the 25th of February, when we started to apply the recommended containing measures, and the 6th of April 2020, when all the IR staff started to undergo nasopharyngeal and oropharyngeal swabs screening, a total of 25 healthcare operators worked at our IR unit. Operators who, during this period, also worked in other hospital units such as diagnostic emergency department or other healthcare facilities, were excluded. Nasopharyngeal and oropharyngeal swabs screening and blood samples for specific SARS-CoV-2 IgG-IgM were retrospectively evaluated. Results: The overall procedures number decreased by a rate of 33% and twenty-three (16%) were performed in confirmed or strongly suspected COVID-19 patients. Two procedures were performed in non-suspected ones, who revealed positive in the following hospitalization days. Seventeen operators were included in the study. Only one of them resulted positive at the swabs, with an estimated infection rate in our IR unit of 6%. Specific SARS-CoV-2 IgG-IgM resulted negative in all the operators included. Conclusion: Our experience demonstrates that applying adequate measures to limit SARS-CoV-2 infection spread can efficiently reduce the viral transmission among IR healthcare workers