Hemorrhage from primitive rectal varices in patient with idiophatic thrombosis of portal vein: case report

Introduction. Rectal varices, primitive or secondary to hypertensive or thrombotic disorders of mesenteric-portal circle, represent an uncommon cause of lower digestive bleeding. The presence of rectal varices associated to idiopathic venous portal thrombosis represents a distinct nosologic entity, with important clinical and therapeutic problems related to it. Case report. Patient of young age, with positive anamnesis for primitive rectal varicies, admitted to our department for a serious rettorragy. The laboratory underlined moderate anaemia and the endoscopy documented the presence of multiple rectal varices, without evident signs of bleeding; the endoscopy documented the presence of two esophageal small varicose cords F1. The hepatobiliary sonography and the portography showed the massive thrombosis of the portal vein. The new serious episode of rectal bleeding induced us to subject the patient to a surgical operation of Hartmann recto-sigmoid resection. Conclusion. Because of the slight number of reported cases of primitive rectal varices and because of the scattering of many dates it’s difficult to draw an univocal diagnostic and therapeutic algorithm. Clinical framing and subsequent therapeutic approach rise often up from personal experience rather than well defined guidelines. The treatment is controversial, time by time many therapeutic options are reported either conservative or interventist. The failure of conservative therapy and the recurrent episodes of bleeding give indication to surgical treatment, that is represented by Hartmann colonic resection and/or the porto-systemic shunts in the cases of portal hypertension; in our case we made colonic resection sec. because of lapsed performing status of the patient

Coupled Plasma Filtration Adsorption in Patients with a History of Kidney Transplantation: Report of Two Cases

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Solid-state stability of Z′ < 1 and Z′ = 2 polymorphs of N,N,N′,N′-tetrabenzylethylenediamine: a combined experimental and theoretical study

The synthesis and structural analysis by means of single crystal X-ray diffraction (SC-XRD) and DFT calculations, of two additional new polymorphs of the flexible organic molecule N,N,N′,N′-tetrabenzylethylenediamine (L) which is used as first sphere ligand in outer sphere adducts are reported. Slow crystallization of L in the solution-state yields two polymorphs (Lα-phase and Lβ-phase) with Z′ = 0.5, while fast crystallization by rapid cooling from solution and directly from melt, allows a third, less stable polymorph with Z′ = 2 (Lγ-phase). The latter structure can be seen as a low-density metastable phase obtained by trapping L molecules after they reached high mobility by thermal treatment (i.e., high energy state). The three L polymorphs have been also studied using quantum mechanical (QM) calculations specific for the solid state by comparing the sublimation energy for each polymorph, and by comparing the experimental X-ray structures against the optimized structures from DFT, showing that Lβ-phase is the most stable and Lγ-phase is the least stable phase. The high Z′ structure can be considered as a “crystal on the way” of a more stable form. These results provide insights about crystallization mechanisms and polymorphism in organic crystals. The potential use of conformational polymorphs of flexible ligands to prepare second sphere adducts with marked polymorphism is commented

Acute acalculous cholecystitis during the course of primary Epstein-Barr virus infection: a new case and a review of the literature

OBJECTIVE: The aim of this study was to describe a case of acute acalculous cholecystitis occurring in the course of primary Epstein-Barr virus (EBV) infection. METHODS: The clinical features of the case were analyzed and compared to those of three other similar cases reported in the international literature. RESULTS: All cases occurred in European females with cholestatic hepatitis, presented with gallbladder wall thickening, and recovered uneventfully without the need for surgical intervention. CONCLUSIONS: Acute acalculous cholecystitis may occur during the course of acute EBV infection, especially in patients with cholestatic hepatitis. Clinicians should be aware of the possible involvement of the gallbladder during EBV infection to avoid unnecessary invasive procedures or the overuse of antibiotics

Preface

ON BEHALF of SITO, The Italian Society of Organ Transplantation, I am honored, as Chair, to have welcomed all of you at the 39th Congress of the Italian Transplantation Society. The meeting took place for the first time in L’Aquila from 24 to 26 September 2015. We thank Prof. Franco Citterio, President of SITO, for his invaluable guidance for the Congress organization, and all councilors of SITO whom selected quite 300 presentations that dealt with the hottest topics in transplantation. More than 500 Organ Transplants Specialists from the most prestigious Italian universities and hospitals joined the Congress, one of the largest attendances in the last few years