Emergency endovascular management of the common femoral artery rupture due to radiotherapy for scrotal carcinoma

We describe the case of a 72-year-old man with massive hemorrhage and shock resulting from rupture of the left common femoral artery as a complication of radiotherapy in the groin for cancer of the scrotum. This complication is extremely rare, presents dramatically, and is usually fatal. The patient was successfully treated with a stent graft deployment in order to achieve immediate hemostasis maintaining blood flow to the leg. Open surgery is not ideal in those cases especially when there is extensive tumor involvement of the groin causing altered anatomy and increasing the risk of re-bleeding

Comparative study of virulence potential, phylogenetic origin, CRISPR-Cas regions and drug resistance of Escherichia coli isolates from urine and other clinical materials

IntroductionUrinary tract infections (UTI), among which the main etiological factor is uropathogenic Escherichia coli (UPEC, E. coli), remain an important issue for clinicians. The aim of the study was to demonstrate clear differences in the pathogenic properties of urine-derived E. coli compared to other extraintestinal E. coli clinical isolates (derived from: blood, lower respiratory tracts, sputum, reproductive tract, body fluids, perianal pus, other pus, wound, postoperative wound and other sources).MethodsThe collection of 784 E. coli isolates was collected from various materials of hospitalized patients. They were analyzed in terms of virulence-associated genes (papC, sfaD/sfaE, cnf1, usp., fimG/H, hlyA), belonging to phylogenetic groups and the presence of CRISPR-Cas regions using PCR. In addition, the epidemiological data and the antibiotic resistance profiles provided by the hospital’s microbiology department were included for statistical analyses.ResultsUrine-derived E. coli showed significantly greater virulence potential compared to other isolates, but they were generally unremarkable in terms of drug resistance. The isolates most often belonged to phylogenetic group B2. Drug resistance was negatively correlated with CRISPR 2 presence and high average virulence score, but positively correlated with CRISPR 4 presence. To the best of our knowledge, we are the first to report significant differences in sputum-derived isolates—they revealed the lowest virulence potential and, at the same time, the highest drug resistance.DiscussionIn conclusion, we demonstrated significant differences of urinary-derived E. coli compared to other clinical E. coli isolates. We would like to suggest excluding penicillins from use in E. coli infection at this time and monitoring strains with a high pathogenicity potential

Harmonic focus versus conventional electrocautery for femoral artery exposure: a "direct" comparison on the same patients

Surgical access complications during endovascular aneurysm repair (EVAR) are reported relatively frequent. HARMONIC FOCUS® (HF; Ethicon EndoSurgery Inc., Cincinnati, Ohio, USA) is a device developed to improve bleeding control and reduce heat-related damage stemming from surgical preparation. The aim of this study was to evaluate outcomes and safety of HF versus conventional haemostasis with electrocautery, both techniques used in the same patient. Five patients developed bilateral wound’s thickening (13.9%) demonstrated at the CT scan, two of whom had no clinical manifestation while in three cases the thickening was associated with lymphocele (4.54%), 2 of which were in the side where the EC was used (5.5%), and 1 case (2.7%), in the HF applied side. One isolated lymphocele occurred at the left groin (2.7%) (tables n.2-3). A Fisher’s exact test was conducted between EC and HF on the occurrence of wound healing complications (3/36 for EC and 1/36 for HF) that resulted statistically significant at p<0.05. Focus Harmonic Scalpel has certain advantages than conventional haemostasis in avoiding surgical access complications

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Comparison of in vitro activity of doripenem, imipenem and meropenem against clinical isolates of Enterobacteriaceae, Pseudomonas and Acinetobacter in Southern Poland

In the study we tested drug sensitivity to 3 carbapenems (doripenem, imipenem and meropenem) of Gram-negative clinical isolates from Southern Poland. Material and methods. 89 strains were examined: 42 from Pseudomonas genus, 16 Acinetobacter baumannii strains and 31 Enterobacteriaceae strains. Etests were used according to the producers instructions, MIC values were interpreted using EUCAST criteria. Results. Highest in vitro activity against Pseudomonas spp. was shown for doripenem, then meropenem and the lowest for imipenem (MIC values were definitely lower for doripenem; differences were statistically significant); A. baumannii strains showed similar sensitivity to doripenem, meropenem and imipenem (differences non-significant); all Enterobacteriaceae strains showed sensitivity to the tested antimicrobials. Conclusions. As a conclusion-doripenem, which has high in vitro activity (almost the same as imipenem and meropenem) as well as beneficial pharmacologic properties, may be an alternative solution in the treatment of multiresistant Gram-negative bacteria, especially in patients in severe status who require restrictive antibiotic regimens

Tumori multipli maligni primitivi coinvolgenti il colon-retto: revisione casistica ed ipotesi eziopatogenetiche”.

XIV CONGRESSO NAZIONALE S.P.I.G.C. ISCHIA 10-12 MAGGIO 2001

“VALUTAZIONE FUNZIONALE A DISTANZA DI UN PAZIENTE AFFETTO DA ATRESIA ANORETTALE TRATTATO CON ‘ABS’: CASE REPORT.

CONGRESSO 2002 - SOCIETÀ NAPOLETANA DI CHIRURGIA (S.NA.C.).STROMBOLI 13-16GIUGNO 2002