Nuove varianti di Bronchite Infettiva negli allevamenti avicoli siciliani

Avian Infectious Bronchitis (IB) is a disease caused by a Coronavirus, included in Coronaviridae family. The disease, endemic in Italy, affects both broilers and laying hens. It represents one of the main health issue in sicilian poultry farms. The presence of new antigenic variants makes problematic the implementation of an adequate prophylaxis through the use of appropriate vaccines. The present work aims to study the spread of IB strains in Sicily by serological and biomolecular tests in order to investigate the presence of "historical" strains as well as new strains and to carry out the genotyping of viruses isolated. The serological results show that the used vaccination protocols are able to develop an adequate antibody titre along all production steps both laying hens and broilers. The virological results underline the presence of QX strain in a broilers farm. This is a strain widespread in Italy but never reported in the regional territory

Ultrasound and cone beam CT fusion for liver ablation : technical note

Purpose: To assess the feasibility of fusion imaging between intraprocedural ultrasound (US) and contrast-enhanced cone-beam CT (CBCT) for small (< 2 cm) hepatocellular carcinoma (HCC). Materials and methods: Six patients (five males, one female, age range 58\u201380, mean 69 years), with small (mean diameter 16.8 mm) HCC poorly visible at US underwent percutaneous microwave ablation under US/CBCT fusion guidance. During general anesthesia with apnea control, a contrast- enhanced CBCT was acquired with an active tracker. Subsequently, real time US images were fused with CBCT images, and treatment performed under fusion imaging guidance. Feasibility of fusion imaging and percutaneous ablation were assessed, correct targeting (distance from center of tumor and center of ablation area <5 mm) and one-month primary technical efficacy were evaluated. Major and minor complications as well as overall procedural time were recorded. Results: US/CBCT fusion was feasible in all cases, allowing for completion of the treatment as previously planned (technical success 100%). Correct targeting was achieved in 4/6 cases (66%), while in two cases, center of tumor and center of ablated area were respectively 7 and 8 mm distant. At 1 month CT scan, all tumors were completely ablated (primary technical efficacy 100%). No major or minor complications occurred. Mean overall procedure time was 127 min. Conclusions: US/CBCT fusion is a feasible technique for liver ablation, and might represent a useful tool to increase the correct targeting of poorly US-visible HCC nodules in the angio suite

Interventional Radiology in Benign Liver Tumors

Transcatheter arterial embolization (TAE) and radiofrequency ablation (RFA) are interventional radiological techniques widely used in the locoregional treatment of malignant, unresectable lesions confined to the liver

Intraindividual Comparison of Gadobutrol and Gadopentetate dimeglumine for detection of myocardial late enhancement in Cardiac MRI

OBJECTIVE. Gadobutrol is an extracellular macrocyclic gadolinium chelate recently introduced in MRI, and it has already been used for cardiac late enhancement imaging; however, until now it has never been compared with gadopentetate dimeglumine. The purpose of our study was to compare 0.1 mmol/kg gadobutrol to 0.2 mmol/kg gadopentetate dimeglumine for the detection of myocardial late enhancement in the same group of patients. SUBJECTS AND METHODS. This was an exploratory single-blind parallel group study comparing gadobutrol (0.1 mmol/kg) to gadopentetate dimeglumine (0.2 mmol/kg) in 20 adult patients scheduled for cardiac late enhancement MRI with gadopentetate dimeglumine and whose MR images showed late enhancement. MR images were acquired at 10, 15, and 20 minutes after peripheral injection of gadobutrol by using a 3D turbo field echo inversion recovery T1-weighted sequence. Volume and percentage of late enhancement, number of involved segments, late enhancement localization and pattern, and late enhancement signal-tonoise ratio (SNR) and contrast-to-noise ratio (CNR) were compared between contrast agents. RESULTS. Late enhancement was not significantly different with gadobutrol and gadopentetate dimeglumine both in terms of total volume of myocardium (mean \ub1 SD, 37.8 \ub1 56.1 and 35.1 \ub1 46.7 cm 3, respectively; p = 0.33) and percentage of myocardial wall involvement (22.5% \ub1 19.1% and 22.0% \ub1 17.2%, respectively; p = 0.67). The number of segments involved was not different (138 with gadobutrol vs 134 with gadopentetate dimeglumine). Furthermore, SNR and CNR were not different (gadopentetate dimeglumine, 123.8 \ub1 82.9 and gadobutrol, 117.2 \ub1 88.6, p = 0.58 and gadopentetate dimeglumine, 96.2 \ub1 68.9 and gadobutrol, 88.4 \ub1 72.9, p = 0.53, respectively). CONCLUSION. A single dose of gadobutrol seems to be as effective as a double dose of gadopentetate dimeglumine for the detection of late enhancement

Use and safety of nitrous oxide during lumbar puncture for the diagnosis of childhood narcolepsy

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Onset of narcolepsy type 1 in a paraneoplastic encephalitis associated with a thymic seminoma

Narcolepsy type 1 results from probable autoimmune disruption of hypothalamic hypocretinergic neurons. Secondary narcolepsy can occur as a result of other conditions affecting the central nervous system, including limbic paraneoplastic encephalitis. We report the case of a 19-year-old patient presenting with acute-onset diurnal hypersomnolence, hyperphagia, sexual dysfunction, and psychiatric disturbances. Further investigations revealed a limbic paraneoplastic encephalitis associated with mediastinal thymic seminoma. Tumor removal and immunosuppressive treatment resulted in a partial benefit on psychiatric disturbances but did not improve daytime sleepiness. A comprehensive sleep assessment led to the diagnosis of secondary narcolepsy type 1 with reduced cerebrospinal fluid hypocretin-1 levels and revealed the presence of the HLA DQB1*0602 allele, typically associated with idiopathic narcolepsy, for which we hypothesize a possible immunopathogenic role. Sodium oxybate was successfully administered. Narcolepsy is often overlooked in patients with limbic paraneoplastic encephalitis. A prompt assessment and an adequate symptomatic treatment can improve the disease burden. CITATION: Rossi S, Asioli GM, Rizzo G, et al. Onset of narcolepsy type 1 in a paraneoplastic encephalitis associated with a thymic seminoma. J Clin Sleep Med. 2021;17(12):2557-2560