Reversal of the Anticoagulation Effects of Dabigatran Etexilate by Idarucizumab in Three Patients Needing Urgent Surgical Intervention and One Case of Intravenous Thrombolysis in Ischaemic Stroke

Objective: To describe the benefits of reversal of the anticoagulation effects of dabigatran etexilate in patients requiring urgent surgery or thrombolysis for ischaemic stroke. Materials and methods: Four patients, treated with dabigatran etexilate and presenting with cholecystitis, tibial fracture, lower limb ischaemia and ischaemic stroke, respectively. Results: Administration of idarucizumab normalized bleeding parameters and provided safe conditions for surgery and, in one case, successful thrombolysis of an ischaemic stroke. Conclusion: The introduction of an effective reversal agent for dabigatran etexilate allows physicians perform surgery under conditions of normal coagulation and permits thrombolysis in patients with ischaemic stroke despite being treated with dabigatran etexilate

Unusual paraneoplastic neurological syndrome secondary to a well differentiated pancreatic neuroendocrine tumor: A case report and review of the literature

BACKGROUND: Paraneoplastic neurological syndrome (PNS) is a heterogeneous group of disorders affecting any part of the nervous system, in a patient affected by cancer. PNS is estimated to occur in 0.01 to 8 % of cancer patients, with higher incidence in those with small cell lung cancer, gynecological tumours or hematological disease. Paraneoplastic cerebellar degeneration (PCD) is the most common PNS, but it has never been reported in patients with pancreatic well-differentiated neuroendocrine tumours. CASE PRESENTATION: A 61-year-old man presented with an unusual PNS and absence of circulating neural auto-antibodies. Subsequently, contrast-enhanced computed tomography revealed a large pancreatic mass, together with multiple liver metastases, histologically diagnosed as a well-differentiated neuroendocrine tumor. Initial treatment with long-acting somatostatin analogue (octreotide LAR) and prednisone achieved a biochemical response (reduction of chromogranin A level) and a radiological disease control, but patient experienced only a brief improvement of neurological symptoms. Seven months after the onset of the symptoms, he died from neurological impairment. CONCLUSIONS: PNS can be associated with metastatic non-functioning well-differentiated pancreatic neuroendocrine tumors. These tumors may be unresponsive to treatment with somatostatin analogues and an early neurological treatment should be considered for the optimal management of these uncommon cases

Breast Cancer Preoperative Staging: Does Contrast-Enhanced Magnetic Resonance Mammography Modify Surgery?

Women with newly diagnosed breast cancer may have lesions undetected by conventional imaging. Recently contrast-enhanced magnetic resonance mammography (CE-MRM) showed higher sensitivity in breast lesions detection. The present analysis was aimed at evaluating the benefit of preoperative CE-MRM in the surgical planning. From 2005 to 2009, 525 consecutive women (25–75 years) with breast cancer, newly diagnosed by mammography, ultrasound, and needle-biopsy, underwent CE-MRM. The median invasive tumour size was 19 mm. In 144 patients, CE-MRM identified additional lesions. After secondlook, 119 patients underwent additional biopsy. CE-MRM altered surgery in 118 patients: 57 received double lumpectomy or wider excision (41 beneficial), 41 required mastectomy (40 beneficial), and 20 underwent contra lateral surgery (18 beneficial). The overall false-positive rate was 27.1% (39/144). CE-MRM contributed significantly to the management of breast cancer, suggesting more extensive disease in 144/525 (27.4%) patients and changing the surgical plan in 118/525 (22.5%) patients (99/525, 18.8% beneficial)

Off-design study of a waste heat recovery ORC module in gas pipelines recompression station

This study investigates the use of an ORC as heat recovery unit in a natural gas pipeline compression station powered by a gas turbine with the aim of increasing the process energy efficiency. A flexible Matlab® suite, able to investigate both subcritical and supercritical cycle, has been developed for the plant sizing and for the part-load simulation. The methodology to compute the system energetic performance is discussed. The ORC configuration that guarantees the maximum power output (7.22 MWe) is identified. The yearly electricity yield (42615.9 MWh) reveals good perspectives of implementing ORC with the aim of reducing the environmental impact of gas compression stations

Synthesis of pyrazolo[1,5-a]pyrimidine ring as a possible bioisosteric replacement of the 5-(1H-pyrrol-1-yl)pyrazole scaffold

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FOLFOX activity in a rare case of metastatic colonic adenocarcinoma of the tongue: A case report

Abstract Background Adenocarcinomas of the oral cavity are rare neoplasms, and only four cases of primary colonic adenocarcinoma of the tongue have ever been described in literature. Very few information about chemotherapy sensitiveness of this type of neoplasia is available, with only one regimen that showed some activity in a metastatic patient. Case presentation We describe the case of a patient bearing a metastatic colonic adenocarcinoma of the tongue submitted to a first-line chemotherapy with oxaliplatin, 5-fluorouracil and folinic acid (FOLFOX regimen). After chemotherapy the patient obtained the complete disappearance of the primitive neoplasia located in the body of the tongue, and a tumor size reduction > 50% of liver and lung metastases. Conclusions This case demonstrated the activity of the combination of oxaliplatin and 5-fluorouracil in this very rare neoplasia. The FOLFOX regimen might be considered either in advanced and especially in the neoadjuvant setting, when the reduction of the primary tumor is highly needed

The MIPAS2D database of MIPAS/ENVISAT measurements retrieved with a multi-target 2-dimensional tomographic approach

Abstract. We present a multi-year database of atmospheric fields of the upper troposphere, stratosphere and lower mesosphere retrieved from satellite measurements adopting a 2-dimensional tomographic approach. The full mission of the Michelson Interferometer for Passive Atmospheric Sounding (MIPAS) instrument, on board the European Space Agency ENVISAT satellite, is analyzed with the Geofit Multi-Target Retrieval (GMTR) system to obtain the MIPAS2D database with atmospheric fields of pressure, temperature and volume mixing ratio of MIPAS main targets H2O, O3, HNO3, CH4, N2O, and NO2. The database covers both the MIPAS nominal observation mode measured at Full Resolution (FR) from July 2002 to March 2004 and the nominal observation mode of the new configuration, measured at Optimized Resolution (OR) and introduced in 2005. Further to the main targets, minor species N2O5, ClONO2, COF2, CFC-11, and CFC-12 for the FR mission only have been included in MIPAS2D to enhance its applicability in studies of stratospheric chemistry. The database is continuously updated with the analysis of the ongoing measurements that are planned to last until the end of 2013 and extended to other targets. The GMTR algorithm is operated on a fixed vertical grid coincident with the tangent altitudes of the FR nominal mode, spanning the altitude range from 6 to 68 km. In the horizontal domain, FR measurements are retrieved on both the observational grid and an equispaced 5 latitudinal-degrees grid which is made possible by the 2-dimensional retrieval algorithm. The analysis of MIPAS OR observations is operated on the same altitude-latitude fixed retrieval grid used for the FR measurements. This choice provides a database with a homogeneous altitude and latitude grid, over the whole globe, covering to date about seven years of measurements. The equispaced latitude grid provides a new and convenient layout for the much needed synergetic studies of data from various instrumental and modeling sources. MIPAS2D is available to the scientific community through the two web sites http://www.mbf.fci.unibo.it/mipas2d.html, and http://www.isac.cnr.it/~rss/mipas2d.ht