Risultati del trattamento chirurgico del varicocele nella infertilità maschile

To evaluate the results of surgical treatment of varicocele on infertile men, especially regarding sperm count, 245 patients, surgically treated from 1993 to 2003, were evaluated. Patients underwent to ligature and section of the pampiniform plexus, throught the subinguinal approach and local anaesthesia. At the follow-up (3-6-12 months) an improvement of sperm count was relieved in 79.5% of patients and the incidence of complications and relapses was of 3.7% and 1.2%, respectively. The Authors stress the efficacy of surgical treatment of varicocele in male infertility and hold the subinguinal approach as an effective treatment, minimally invasive and low cost

EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Westerlund 1 and 2 Open Clusters Survey

Context. With a mass exceeding several 104 M⊙ and a rich and dense population of massive stars, supermassive young star clusters represent the most massive star-forming environment that is dominated by the feedback from massive stars and gravitational interactions among stars. Aims. In this paper we present the Extended Westerlund 1 and 2 Open Clusters Survey (EWOCS) project, which aims to investigate the influence of the starburst environment on the formation of stars and planets, and on the evolution of both low and high mass stars. The primary targets of this project are Westerlund 1 and 2, the closest supermassive star clusters to the Sun. Methods. The project is based primarily on recent observations conducted with the Chandra and JWST observatories. Specifically, the Chandra survey of Westerlund 1 consists of 36 new ACIS-I observations, nearly co-pointed, for a total exposure time of 1 Msec. Additionally, we included 8 archival Chandra/ACIS-S observations. This paper presents the resulting catalog of X-ray sources within and around Westerlund 1. Sources were detected by combining various existing methods, and photon extraction and source validation were carried out using the ACIS-Extract software. Results. The EWOCS X-ray catalog comprises 5963 validated sources out of the 9420 initially provided to ACIS-Extract, reaching a photon flux threshold of approximately 2 × 10−8 photons cm−2 s −1 . The X-ray sources exhibit a highly concentrated spatial distribution, with 1075 sources located within the central 1 arcmin. We have successfully detected X-ray emissions from 126 out of the 166 known massive stars of the cluster, and we have collected over 71 000 photons from the magnetar CXO J164710.20-455217.Fil: Guarcello, Mario Giuseppe. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; ItaliaFil: Flaccomio, Ettore. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; ItaliaFil: Albacete Colombo, Juan Facundo. Universidad Nacional de Río Negro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Almendros Abad, Víctor. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; ItaliaFil: Anastasopoulou, Konstantina. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; ItaliaFil: Andersen, M.. European Southern Observatory; AlemaniaFil: Argiroffi, C.. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; Italia. Università degli Studi di Palermo; ItaliaFil: Bayo, Amelia. European Southern Observatory; AlemaniaFil: Bartlett, E.S.. European Southern Observatory; AlemaniaFil: Bastian, N.. Donostia International Physics Center; España. Basque Foundation For Science; España. Liverpool John Moores University; Reino UnidoFil: De Becker, Michaël. Université de Liège; BélgicaFil: Best, William M. J.. University of Texas at Austin; Estados UnidosFil: Bonito, R.. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; ItaliaFil: Borghese, Alice. Instituto de Astrofísica de Canarias; España. Universidad de La Laguna; EspañaFil: Calzetti, D.. University of Massachusetts; Estados UnidosFil: Castellanos, R.. Centro de Astrobiología; España. Consejo Superior de Investigaciones Científicas; EspañaFil: Cecchi Pestellini, C.. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; ItaliaFil: Clark, J. S.. The Open University; Reino UnidoFil: Clarke, C. J.. University of Cambridge; Estados UnidosFil: Zelati, Francesco Coti. Instituto de Estudios Espaciales de Cataluña; España. Consejo Superior de Investigaciones Científicas; EspañaFil: Damiani, Jeremy. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; ItaliaFil: Drake, J.J.. Harvard-Smithsonian Center for Astrophysics; Estados UnidosFil: Gennaro, Mario. Space Telescope Science Institute; Estados Unidos. University Johns Hopkins; Estados UnidosFil: Mapelli, M.. Università di Padova; Italia. Ruprecht Karls Universitat Heidelberg; AlemaniaFil: Martinez Galarza, J. R.. Harvard-Smithsonian Center for Astrophysics; Estados UnidosFil: Micela, G.. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; ItaliaFil: Miceli, M.. Istituto Nazionale di Astrofísica. Osservatorio Astronómico di Palermo; Italia. Università degli Studi di Palermo; ItaliaFil: Moraux, E.. Universite Grenoble Alpes; FranciaFil: Winter, A.. Observatoire de la Côte D'azur; Francia. Universite Grenoble Alpes; FranciaFil: Wright, N. J.. Keele University; Reino UnidoFil: Zeidler, Peter. European Southern Observatory; Alemania. Space Telescope Science Institute; Estados Unido

Cancer Genes Hypermethylated in Human Embryonic Stem Cells

Developmental genes are silenced in embryonic stem cells by a bivalent histone-based chromatin mark. It has been proposed that this mark also confers a predisposition to aberrant DNA promoter hypermethylation of tumor suppressor genes (TSGs) in cancer. We report here that silencing of a significant proportion of these TSGs in human embryonic and adult stem cells is associated with promoter DNA hypermethylation. Our results indicate a role for DNA methylation in the control of gene expression in human stem cells and suggest that, for genes repressed by promoter hypermethylation in stem cells in vivo, the aberrant process in cancer could be understood as a defect in establishing an unmethylated promoter during differentiation, rather than as an anomalous process of de novo hypermethylation

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic

Analysis of variables predictive of severity in biliary peritonitis.

To analyze clinical and laboratory findings in order to find variables predictive of severity of Biliary Peritonitis (BP). Patients and methods. Physical findings, course of illness, imaging and laboratory data were evaluated in 22 patients with BP, and statistically analysed to assess their prognostic significance. Serious illness and worse outcome were associated with: age > 60 years (P=0.034), long time between onset of symptoms and treatment (P=0.025), fever > 38°C (P=0.009), WBC count > 17.000 cell/mm³ (P=0.043), diffuse abdominal pain (P=0.034), and infected bile (P=0.048). Most patients become severely ill due to supervening infection, while early bile drainage avoids serious complications. In addition, abdominal pain, fever and WBC count are also predictive of severity of BP

Umbilical metastases: current viewpoint

<p>Abstract</p> <p>Background</p> <p>Umbilical metastases from a malignant neoplasm, also termed Sister Mary Joseph's nodule, are not commonly reported in the English literature, and they have usually been considered as a sign of a poor prognosis for the patient. The present article reports on the current view point on umbilical metastasis besides discussing the epidemiology, clinical presentation, pathophysiology and treatment.</p> <p>Method</p> <p>A search of Pubmed was carried out using the term 'umblic*' and 'metastases' or metastasis' revealed no references. Another search was made using the term "Sister Joseph's nodule" or sister Joseph nodule" that revealed 99 references. Of these there were 14 review articles, however when the search was limited to English language it yielded only 20 articles. Articles selected from these form the basis of this report along with cross references.</p> <p>Results</p> <p>The primary lesions usually arise from gastrointestinal or genitourinary tract malignancies and may be the presenting symptom or sign of a primary tumour in an unknown site.</p> <p>Conclusion</p> <p>A careful evaluation of all umbilical lesions, including an early biopsy if appropriate, is recommended. Recent studies suggest an aggressive surgical approach combined with chemotherapy for such patients may improve survival.</p

Sister Mary Joseph's nodule from adenocarcinoma of the cecum. Report of a case.

Cutaneous metastases of malignant neoplasms are not common, occurring between 0,7 and 9 percent of autopsy evaluations. Those to the umbilicus, also known as Sister Mary Joseph'nodule, are even more rare and represent only 10 percent of all secundaries to the skin. These nodules usually arise from the gastrointestinal or genitourinary tract and may represent the first sign of a previously unknown primary tumor. This case demonstrates a Sister Mary Joseph' s nodule caused by an unknown primary cancer od the cecum

Analysis of variables predictive of severity in biliary peritonitis

Obiettivo. Analizzare le caratteristiche cliniche ed i dati di laboratorio al fine di individuare i fattori prognostici negativi nelle peritoniti biliari (PB). Pazienti e metodi. Analisi delle caratteristiche cliniche, decorso della malattia, dati di laboratorio e radiologici di 22 pazienti affetti da PB e successiva analisi statistica per valutarne il loro significato prognostico. Risultati. Un decorso grave con prognosi infausta e associato a: età maggiore di 60 anni (P=0.034), maggior tempo intercorso tra inizio della sintomatologia e trattamento (P=0.025), febbre > 38°C (P=0.034), conta dei globuli bianchi maggiore di 17,000 cell/mm3 (P=0.043), dolore addominale diffuso (P=0.034) e presenza di bile infetta (P=0.048). Conclusioni. Il decorso clinico di molti pazienti peggiora in seguito al verificarsi di una infezione; pertanto un rapido drenaggio della bile diminuisce la comparsa di serie complicanze. Inoltre, dolore addominale diffuso, febbre alta e marcata leucocitosi sono predittivi di una prognosi peggiore. KEY WORDS: Biliary peritonitis - Bile drainage