Necrotizing pneumonia and sepsis due to Clostridium perfringens: a case report

Clostridia are uncommon causes of pleuropulmonary infection. Clostridial species infecting the pleuropulmonary structures characteristically cause a necrotizing pneumonia with involvement of the pleura. Most cases have iatrogenic causes usually due to invasive procedures into the pleural cavity, such as thoracentesis or thoracotomy, or penetrating chest injuries. Rarely clostridia pleuropulmonary infections are not related to these factors. The clinical course of pleuropulmonary clostridial infections can be very variable, but they may be rapid and fatal. We report a rare case of necrotizing pneumonia and sepsis due to Clostridium perfringens not related to iatrogenic causes or injuries in an 82 years old woman

Sociodemographic determinants of knowledge on the figure of radiologist: results of a survey in large university hospital

Introduction Despite overlaying an irreplaceable role as a key diagnostic tool in modern medicine, the role of radiologist still appears to be unclear to patients. Methods We conducted a survey in outpatient clinic of Radiological Sciences Department of the University Hospital “A. Gemelli” in Rome, aiming to assess how correct patients identify the figure of the radiologist. The patients were interviewed by the trained physician using structured questionnaire. Results We included the number of 259 patients. Majority were female 63.3%, most were 60-69 years old (24.3%), have finished second grade secondary school (35.1%) and were subjected to magnetic resonance (28.6%) while the least were subjected to chest X-ray (8.1%). Only 38.7% answered correctly to question No 1 “Who performed your examination?”, and only 30.9% correctly identified the radiologist as a person interpreting the exam (question No 2 “Who is going to interpret your radiological examination?”). Overall, 16.8% responded correctly to the both questions. Significantly less patients with primary school (OR: 0.18, CI 95% 0.06-0.49) and first grade secondary school (OR: 0.37, CI 95% 0.18-0.75) correctly addressed the question No 1 in compare to those with second grade secondary school. The first grade secondary education (OR: 0.43, CI 95% 0.20-0.92) was inversely associated with correct answer to question No 2.  Patients with primary education were significantly less prone to give both correct answers (OR: 0.12, CI 95% 0.02-0.60). Conclusion We report insufficient knowledge among patients on radiologist’s role in healthcare system. The level of knowledge is associated with level of education

Multislice Spiral Computed Tomography for In-Stent Restenosis

n/

Critical assessment of the sustainability of deep eutectic solvents: a case study on six choline chloride-based mixtures

An outline of the advantages, in terms of sustainability, of Deep Eutectic Solvents (DESs) is provided, by analyzing some of the most popular DESs, obtained by the combination of choline chloride, as a hydrogen bond acceptor, and six hydrogen bond donors. The analysis is articulated into four main issues related to sustainability, which are recurrently mentioned in the literature, but are often taken for granted without any further critical elaboration, as the prominent green features of DESs: their low toxicity, good biodegradability, renewable sourcing, and low cost. This contribution is intended to provide a more tangible, evidence-based evaluation of the actual green credentials of the considered DESs, to reinforce or question their supposed sustainability, also in mutual comparison with one another

Recent advances in the synthesis of inorganic materials using environmentally friendly media

Deep Eutectic Solvents have gained a lot of attention in the last few years because of their vast applicability in a large number of technological processes, the simplicity of their preparation and their high biocompatibility and harmlessness. One of the fields where DES prove to be particularly valuable is the synthesis and modification of inorganic materials—in particular, nanoparticles. In this field, the inherent structural inhomogeneity of DES results in a marked templating effect, which has led to an increasing number of studies focusing on exploiting these new reaction media to prepare nanomaterials. This review aims to provide a summary of the numerous and most recent achievements made in this area, reporting several examples of the newest mixtures obtained by mixing molecules originating from natural feedstocks, as well as linking them to the more consolidated methods that use “classical” DES, such as reline

Usefulness of Ultrasound Imaging in Detecting Psoriatic Arthritis of Fingers and Toes in Patients with Psoriasis

Background. Given that clinical evaluation may underestimate the joint damage and that early treatment can slow down psoriatic arthritis (PsA) progression, screening psoriasis patients with imaging tools that can depict early PsA changes would entail clear benefits. Objective. To compare the ability of X-ray and ultrasound (US) examination in detecting morphological abnormalities consistent with early PsA in patients with psoriasis, using rheumatological evaluation as the gold standard for diagnosis. Methods. Patients with chronic plaque psoriasis and no previous PsA diagnosis attending our outpatient dermatology clinic and reporting finger/toe joint and/or tendon pain underwent X-ray and US evaluation; they were subsequently referred to a rheumatologist for clinical examination and review of imaging findings. Results. Abnormal US and/or X-ray findings involving at least one finger and/or toe (joints and/or tendons) were seen in 36/52 patients: 11 had one or more X-ray abnormalities, including erosion, joint space narrowing, new bone formation, periarticular soft tissue swelling, and periarticular osteoporosis; 36 had suspicious changes on US. Conclusion. US proved valuable in detecting joint and/or tendon abnormalities in the fingers and toes of patients with suspicious changes. The dermatologist should consider US to obtain an accurate assessment of suspicious findings

Intramyocardial Spontaneous Hematoma Mimicking an Acute Myocardial Infarction

n/

Lung nodules: size still matters

The incidence of indeterminate pulmonary nodules has risen constantly over the past few years. Determination of lung nodule malignancy is pivotal, because the early diagnosis of lung cancer could lead to a definitive intervention. According to the current international guidelines, size and growth rate represent the main indicators to determine the nature of a pulmonary nodule. However, there are some limitations in evaluating and characterising nodules when only their dimensions are taken into account. There is no single method for measuring nodules, and intrinsic errors, which can determine variations in nodule measurement and in growth assessment, do exist when performing measurements either manually or with automated or semi-automated methods. When considering subsolid nodules the presence and size of a solid component is the major determinant of malignancy and nodule management, as reported in the latest guidelines. Nevertheless, other nodule morphological characteristics have been associated with an increased risk of malignancy. In addition, the clinical context should not be overlooked in determining the probability of malignancy. Predictive models have been proposed as a potential means to overcome the limitations of a sized-based assessment of the malignancy risk for indeterminate pulmonary nodules

The unseen evidence of reduced Ionicity. The elephant in (the) room temperature ionic liquids

The unambiguous quantification of the proton transfer in Protic Ionic Liquids (PILs) and its differentiation from the concept of ionicity are still unsolved questions. Albeit researchers awfully quickly treat them as synonyms, the two concepts are intrinsically different and imply a dramatic modification in the expected chemical and physical properties of a PIL. Some attempts have been made to shed light on this discrimination, but single-technique-based approaches fail in giving a clear answer. Aiming at definitively figuring out the differentiation between proton transfer and ionicity, we performed a multi-technique analysis (NMR, Raman, IR, thermal and electrochemical analyses, among others). Indeed, thermal and spectroscopic analyses are employed to determine the acid strength's role in ions' complete formation. To overcome the ambiguity between ionicity and formation degree, we introduce a new paradigm where Reduced Ionicity accounts for both the quantities mentioned above. The reduced ionicity directly affects the thermal stability, the phase behavior, and the spectroscopic observations, resulting in particular features in NMR and vibrational spectra. The combination of physical-chemical analyses and Pulsed-Gradient Spin-Echo (PGSE) NMR allows determining the reduced ionicity (and not the ionicity, as reported so far) of the investigated systems. In this context, being the proton transfer not quantitatively accessible directly, the reduced ionicity of a reference series of triethylamine-based PILs is investigated through transport properties as a function of temperature. Our findings point towards a substantial dependence of the reduced ionicity by the acid strength and the anion's coordination power. Furthermore, some interesting insights about the proton transfer are obtained, combining all the findings collected

Image-guided thermal ablation of central renal tumors with retrograde cold pyeloperfusion technique: a monocentric experience

Purpose: To evaluate feasibility, safety and efficacy of image-guided thermal ablations associated with retrograde pyeloperfusion in patients with centrally located renal tumors. Materials and methods: 48 patients (15 women, 33 men, mean age 69.1 ± 11.8) were treated with image-guided thermal ablation associated with pyeloperfusion for 58 centrally located renal tumors (mean diameter 32.3 ± 7.32 mm). 7 patients had a single kidney. Microwave and radiofrequency ablation were used. All treatments were performed with ultrasound, CT, or fusion imaging guidance under general anesthesia and simultaneous retrograde cold pyeloperfusion technique. Results: Procedure was feasible in all cases. Technical success and primary technical efficacy were reached in 51/58 (88%) and 45/54 tumors (83%). With a second ablation performed in 5 tumors, secondary technical efficacy was achieved in 50/50 (100%) tumors. Minor and major complications occurred in 8/58 (13%) and 5/58 (8%) tumors. No significative change in renal function occurred after treatment. During follow-up, 5 recurrences occurred, that were retreated with a second ablation. At last follow up (mean 32.2 ± 22.0 months), 41/48 (85%) treated patients were free from disease. The median TTP and PFS were 27.0 (range, 2.3–80.0) and 26.5 months (range, 2.3–80.0), respectively. Conclusion: Image-guided thermal ablation associated with protective pyeloperfusion is a feasible, safe, and effective treatment option for patients with central renal tumors with a minimal impact on renal function and relevant potential to avoid nephrectomy