Synchronous Bilateral Paget's Disease of the Nipple Associated with Bilateral Breast Carcinoma

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A new risk stratification score for the management of ultrasound‐detected B3 breast lesions

To develop a predictive scoring system for ultrasound-detected B3 lesions at ultrasound-guided core needle biopsy (US-CNB). A total of 2724 consecutive US-CNBs performed in our Institution (January 2011 to December 2014) were retrospectively reviewed. Inclusion criteria were as follows: (a) histopathological examination of the entire lesion or (b) availability of radiologic follow-up (FUP) ≥24 months. Patient- and lesion-related variables-patients' age, lesion consistency, lesion size, vascularization, BI-RADS category, and US-CNB result-were analyzed. Positive predictive values (PPVs) for malignancy were calculated correlating US-CNB results with excision histology or FUP. A scoring system for underlying malignancy was developed using risk factors weighting. A total of 102 B3 lesions were included: 27 atypical ductal hyperplasia (26.5%), 5 lobular intraepithelial neoplasia (4.9%), 32 radial scar (31.4%), 37 papillary lesions (36.3%), and 1 fibroepithelial lesion (0.9%). Surgery was performed on 71/102 (69.6%) lesions, and 22/71 were malignant; the remaining 31/102 lesions (30.4%) were unchanged at FUP. The overall PPV for malignancy was 21.6%. Patients' age (odds ratio [OR] = 3.63, P = 0.008), lesion consistency (OR = 5.96, P = 0.001), BI-RADS category (OR = 17.52, P < 0.001), and CNB result (OR = 3.6, P = 0.008) were associated with a higher risk of malignancy underestimation and selected as risk factors in the score definition. Two risk groups were identified: low (0-2 points) and high risk (3-5 points), with significantly different risk of malignancy underestimation (8.0% vs 59.3%, P < 0.001). The proposed score helps to predict the risk of malignancy underestimation and choose the management of B3 lesions at US-CNB

The current spectrum and prevalence of intestinal parasitosis in Campania (region of southern Italy) and their relationship with migration from endemic countries

Background: In Italy, the current clinical–epidemiological features of intestinal parasitosis and the impact of recent massive migration flows from endemic areas on their distribution are not very well known. Methods: An analysis was carried out involving 1766 patients (720 natives and 1046 immigrants) observed during the period 2009–2010 (the 'current group') and 771 native patients observed during the period 1996–1997 (the 'historical group'), a time at which immigration in the area was minimal. Patients were analyzed for intestinal parasitosis at four healthcare centres in Campania. Results: A wide variety of intestinal parasites was detected in the study subjects. Immigrants had a significantly higher prevalence of parasitosis and multiple simultaneous infections than natives in both groups. In both study groups of natives, the detection of at least one parasite was significantly associated with a history of travel to endemic areas. Among immigrants, we found an inverse correlation between the frequency of parasite detection and the amount of time spent in Italy. No circulation of parasites was found among contacts of parasitized patients. Conclusions: Intestinal parasites are still a cause of intestinal infection in Campania. Although immigrants have a significantly higher prevalence of parasitosis than natives, this does not increase the risk of infection for that population. This is likely due to the lack of suitable biological conditions in our area

The Future role of inorganic crystal scintillators in dark matter investigations

Crystal scintillators and in particular inorganic scintillators play an important role in the investigation of Dark Matter (DM) and other rare processes. The investigation of a DM signature, as the annual modulation, or the directionality technique requires the use of highly radiopure detectors able to explore the very low energy region maintaining a high stability of the running conditions. In this paper, the cases of NaI(Tl), ZnWO4 and SrI2(Eu) crystal scintillators are described in the framework of our activities at the Gran Sasso National Laboratory of the INFN. Their role, the obtained results in DM investigation, as well as their potential and perspectives for the future are reviewed

OCT4 and the acquisition of oocyte developmental competence during folliculogenesis

The role that the transcription factor OCT4 plays during oocyte growth is yet unknown. In this review, we summarise the data on its potential role in the acquisition of oocyte developmental competence in the mouse. These studies describe the presence in MII oocytes and 2-cell embryos of an OCT4 transcriptional network that might be part of the molecular signature of maternal origin on which the inner cell mass and the embryonic stem cell-associated pluripotency is assembled and shaped. The Oct4-gene regulatory network thus provides a connection between eggs, early preimplantation embryos and embryonic stem cells

Investigation on rare nuclear processes in Hf nuclides

In this work, a review of recent studies concerning rare nuclear processes in Hf isotopes is presented. In particular, the investigations using HP-Ge spectrometry and Hf-based crystal scintillators are focused; the potentiality and the results of the "source = detector" approach are underlined. In addition, a short introduction concerning the impact of such kind of research in the context of astroparticle and nuclear physics is pointed out. In particular, the study of α decay and double beta decay of 174Hf, 176Hf, 177Hf, 178Hf, 179Hf, 180Hf isotopes either to the ground state or to the lower bounded levels have been discussed. The observation of α decay of 174Hf isotope to the ground state with a T1/2=7.0(1.2)×1016 y is reported and discussed. No decay was detected for α decay of 174Hf isotope at the first excited level of daughter and of 176Hf, 177Hf, 178Hf, 179Hf, 180Hf isotopes either to the ground state or to the lower bounded levels. The T1/2 lower limits for these decays are at the level of 1016–1020 y. Nevertheless, the T1/2 lower limits for the transitions of 176Hf→172Yb (0+→0+) and 177Hf→173Yb (7/2−→5/2−) are near to the theoretical predictions, giving hope to their observation in the near future. All the other experimental limits (∼1016–1020 y) are absolutely far from the theoretical expectations. The experiments investigating the 2ϵ and ϵβ+ processes in 174Hf are also reported; the obtained half-life limits are set at the level of 1016–1018 y. Moreover, we estimate the T1/2 of 2ν2ϵ of 174Hf decay at the level of (0.3–6) × 1021 y (at now the related measured lower limit is 7.1×1016 y)

Linear Accelerator Test Facility at LNF Conceptual Design Report

Test beam and irradiation facilities are the key enabling infrastructures for research in high energy physics (HEP) and astro-particles. In the last 11 years the Beam-Test Facility (BTF) of the DA{\Phi}NE accelerator complex in the Frascati laboratory has gained an important role in the European infrastructures devoted to the development and testing of particle detectors. At the same time the BTF operation has been largely shadowed, in terms of resources, by the running of the DA{\Phi}NE electron-positron collider. The present proposal is aimed at improving the present performance of the facility from two different points of view: extending the range of application for the LINAC beam extracted to the BTF lines, in particular in the (in some sense opposite) directions of hosting fundamental physics and providing electron irradiation also for industrial users; extending the life of the LINAC beyond or independently from its use as injector of the DA{\Phi}NE collider, as it is also a key element of the electron/positron beam facility. The main lines of these two developments can be identified as: consolidation of the LINAC infrastructure, in order to guarantee a stable operation in the longer term; upgrade of the LINAC energy, in order to increase the facility capability (especially for the almost unique extracted positron beam); doubling of the BTF beam-lines, in order to cope with the signicant increase of users due to the much wider range of applications.Comment: 71 page

Design of the EnVisS instrument optical head

The EnVisS (Entire Visible Sky) instrument is one of the payloads of the European Space Agency Comet Interceptor mission. The aim of the mission is the study of a dynamically new comet, i.e. a comet that never travelled through the solar system, or an interstellar object, entering the inner solar system. As the mission three-spacecraft system passes through the comet coma, the EnVisS instrument maps the sky, as viewed from the interior of the comet tail, providing information on the dust properties and distribution. EnVisS is mounted on a spinning spacecraft and the full sky (i.e. 360°x180°) is entirely mapped thanks to a very wide field of view (180°x45°) optical design selected for the EnVisS camera. The paper presents the design of the EnVisS optical head. A fisheye optical layout has been selected because of the required wide field of view (180°x45°). This kind of layout has recently found several applications in Earth remote sensing (3MI instrument on MetOp SG) and in space exploration (SMEI instrument on Coriolis, MARCI on Mars reconnaissance orbiter). The EnVisS optical head provides a high resolved image to be coupled with a COTS detector featuring 2kx2k pixels with pitch 5.5µm. Chromatic aberration is corrected in the waveband 550-800nm, while the distortion has been controlled over the whole field of view to remain below 8% with respect to an Fθ mapping law. Since the camera will be switched on 24 hours before the comet closest encounter, the operative temperature will change during the approaching phase and crossing of the comet’s coma. In the paper, we discuss the solution adopted for reaching these challenging performances for a space-grade design, while at the same time respecting the demanding small allocated volume and mass for the optical and mechanical design. The view expressed herein can in no way be taken to reflect the official opinion of the European Space Agency

Minimally invasive spleen-preserving distal pancreatectomy: real-world data from the italian national registry of minimally invasive pancreatic surgery

Aim: Minimally invasive distal pancreatectomy has become the standard of care for benign and low malignant lesions. Spleen preservation in this setting has been proposed to reduce surgical trauma and long-term sequelae. The aim of the current study is to present real-world data on indications, techniques, and outcomes of spleen-preserving distal pancreatectomy (SPDP). Methods: Patients who underwent SPDP and distal pancreatectomy with splenectomy (DPWS) were extracted from the 2019-2022 Italian National Registry for Minimally Invasive Pancreatic Surgery (IGoMIPS). Perioperative and pathological data were collected. Results: One hundred and ten patients underwent SPDP and five hundred and seventy-eight underwent DPWS. Patients undergoing SPDP were significantly younger (56 vs. 63.5 years; P &lt; 0.001). Seventy-six percent of SPDP cases were performed in six out of thirty-four IGoMIPS centers. SPDP was performed predominantly for Neuroendocrine Tumors (43.6% vs.23.5%; P &lt; 0.001) and for smaller lesions (T1 57.6% vs. 29.8%; P &lt; 0.001). The conversion rate was higher in the case of DPWS (7.6% vs. 0.9%; P = 0.006), even when pancreatic cancer was ruled out (5.0% vs. 0.9%; P = 0.045). The robotic approach was most commonly used for SPDP (50.9% vs. 29.7%; P &lt; 0.001). No difference in postoperative outcomes and length of stay was observed between the two groups, as well as between robotic and laparoscopic approaches in the SPDP group. A trend toward a lower rate of postoperative sepsis was observed after SPDP (0.9% vs. 5.2%; P = 0.056). In 84.7% of SPDP, splenic vessels were preserved (Kimura procedure) without an impact on short-term postoperative outcomes. Conclusion: In this registry analysis, SPDP was feasible and safe. The Kimura procedure was prevalent over the Warshaw procedure. The typical patient undergoing SPDP was young with a neuroendocrine tumor at an early stage. Robotic assistance was used more frequently for SPDP than for DPWS

Early onset lactating adenoma and the role of breast MRI: a case report

<p>Abstract</p> <p>Introduction</p> <p>Lactating adenoma is a benign condition, representing the most prevalent breast lesion in pregnant women and during puerperium; in this paper, a case of a woman with lactating adenoma occurring during the first trimester of pregnancy is reported. There have been no reports in the literature, according to our search, focusing on magnetic resonance imaging findings in cases of lactating adenomas. Also the early onset of the lesion during the first trimester of pregnancy is quite unusual and possibly unique.</p> <p>Case presentation</p> <p>We report the case of a primiparous 30-year-old Caucasian woman, who noted an asymptomatic lump within her left breast during the 9^thweek of gestation, slightly increasing in size over the next few weeks. Ultrasound demonstrated a hypoecoic solid mass, hypervascularized and measuring 4 cm. On magnetic resonance imaging, performed in the first month after delivery, the lesion appeared as an ovoidal homogeneous mass, with regular margins and a significant contrast enhancement indicative of a giant adenoma.</p> <p>Conclusion</p> <p>Magnetic resonance imaging could play an important role in the differential diagnosis of pregnancy-related breast lumps, particularly during puerperium, thus avoiding unnecessary surgical biopsies.</p