Effectiveness and Safety of Transthoracic Ultrasound in Guiding Percutaneous Needle Biopsy in the Lung and Comparison vs. CT Scan in Assessing Morphology of Subpleural Consolidations

(1) Background: The aim of this study was to conduct a prospective analysis on the diagnostic accuracy of transthoracic ultrasound-guided percutaneous needle biopsy (TUS-PNB) for the histological assessment of peripheral lung lesions and to assess the performance of transthoracic ultrasound (TUS) examination vs. chest CT (gold standard) in the differentiation between malignant and benign peripheral lung lesions. (2) Methods: A total of 961 consecutive patients with subpleural pulmonary lesions were enrolled. All the patients received a CT scan with contrast; 762 patients underwent TUS-PTNB for suspicion of malignancy, and the remaining 199 enrolled patients underwent only TUS examination as a part of routine follow-up for known non-malignant subpleural consolidations. (3) Results: Among the 762 TUS-guided biopsies, there were 627 (82.28%) malignant lesions, 82 (10.76%) benign lesions, and 53 (6.96%) indeterminate lesions. The overall diagnostic accuracy was 93.04%. The rates of pneumothorax not requiring chest-tube insertion and self-limited hemoptysis were 0.79 and 0.26%, respectively. Patients were divided into two groups based on the benign or malignant nature of the subpleural consolidations. On TUS, both malignant and benign lesions showed mostly irregular margins and a hypoechoic pattern, but no differences were assessed in terms of sonographic margins and pattern between the two groups. There was poor agreement between TUS and chest CT in assessing air bronchograms and necrotic areas. The only finding in the detection of which TUS showed superiority compared to chest-CT was pleural effusion. (4) Conclusions: TUS-PNB was confirmed to be an effective and safe diagnostic method for peripheral pulmonary consolidation, but their sonographic pattern did not allow to rule out a malignant nature. A pre-operative evaluation on CT images, combined with the possibility of performing additional immunohistochemical and cytological investigations and the experience of the medical staff, may improve the diagnostic yield of TUS-guided biopsies

Contributi alla flora vascolare di Toscana. VII (357-439)

New localities and/or confirmations concerning 83 specific and subspecific plant taxa of Tuscan vascular flora, belonging to 71 genera and 33 families are presented: Carpobrotus (Aizoaceae), Alternanthera (Amaranthaceae), Leucojum (Amaryllidaceae), Anacyclus, Andryala, Carduus, Centaurea, Cichorium, Erigeron, Helichrysum, Helminthotheca, Hieracium, Limbarda, Pilosella, Scolymus, Sonchus, Tagetes, Urospermum, Xanthium (Asteraceae), Mahonia (Berberidaceae), Myosotis (Boraginaceae), Biscutella, Ionopsidium, Raphanus, Rapistrum (Brassicaceae), Buxus (Buxaceae), Vaccaria (Caryophyllaceae), Cistus (Cistaceae), Calystegia, Cuscuta (Convolvulaceae), Cymodocea (Cymodoceaceae), Cyperus (Cyperaceae), Amorpha, Emerus, Lathyrus, Lotus, Ononis, Trifolium, Vicia (Fabaceae), Quercus (Fagaceae), Geranium (Geraniaceae), Myriophyllum (Haloragaceae), Malva (Malvaceae), Epipogium, Himantoglossum (Orchidaceae), Orobanche (Orobanchaceae), Osyris (Santalaceae), Oxalis (Oxalidaceae), Pinus (Pinaceae), Anisantha, Avellinia, Avena, Corynephorus, Crypsis, Cutandia, Elytrigia, Lolium, Panicum, Polypogon, Sporobolus (Poaceae), Rumex (Polygonaceae), Lysimachia (Primulaceae), Eranthis, Ranunculus (Ranunculaceae), Rubus (Rosaceae), Crucianella, Galium (Rubiaceae), Verbascum (Scrophulariaceae), Solanum (Solanaceae), Tamarix (Tamaricaceae), Viola (Violaceae). In the end, the conservation status of the units and eventual protection of the cited biotopes are discussed

Contributi per una flora vascolare di Toscana. XI (664-738)

Vengono presentate nuove località e/o conferme relative 75 taxa specifici e sottospecifici di piante vascolari della flora vascolare toscana, appartenenti a 67 generi e 41 famiglie: Delosperma (Aizoaceae), Dysphania (Amaranthaceae), Leucojum, Nothoscordum (Amaryllidaceae), Bupleurum, Coriandrum (Apiaceae), Araujia (Apocynaceae), Lemna (Araceae), Hydrocotyle (Araliaceae), Aristolochia (Aristolochiaceae), Bellevalia (Asparagaceae), Asphodelus (Asphodelaceae), Artemisia, Crepis, Eclipta, Erigeron, Hieracium, Senecio, Symphyotrichum, Tolpis (Asteraceae), Symphytum (Boraginaceae), Alyssum, Cardamine, Eruca, Isatis (Brassicaceae), Valerianella (Caprifoliaceae), Petrorhagia, Scleranthus (Caryophyllaceae), Commelina (Commelinaceae), Dichondra (Convolvulaceae), Sedum (Crassulaceae), Diospyros (Ebenaceae), Moneses (Ericaceae), Euphorbia (Euphorbiaceae), Medicago, Trifolium (Fabaceae), Myriophyllum (Haloragaceae), Juncus (Juncaceae), Salvia, Teucrium (Lamiaceae), Broussonetia (Moraceae), Spiranthes (Orchidaceae), Phelipanche (Orobanchaceae), Papaver (Papaveraceae), Passiflora (Passifloraceae), Cedrus, Pseudotsuga (Pinaceae), Bromopsis, Calamagrostis, Cenchrus, Drymochloa, Melica, Oloptum, Phleum, Sporobolus, Tragus (Poaceae), Stuckenia (Potamogetonaceae), Lysimachia (Primulaceae), Anemone, Aquilegia (Ranunculaceae), Eriobotrya (Rosaceae), Crucianella (Rubiaceae), Verbascum (Scrophulariaceae), Typha (Typhaceae), Urtica (Urticaceae), Viola (Violaceae). Infine, viene discusso lo status di conservazione delle entità e gli eventuali vincoli di protezione dei biotopi segnalati.New localities and/or confirmations concerning 75 specific and subspecific plant taxa of Tuscan vascular flora, belonging to 67 genera and 41 families are presented: Delosperma (Aizoaceae), Dysphania (Amaranthaceae), Leucojum, Nothoscordum (Amaryllidaceae), Bupleurum, Coriandrum (Apiaceae), Araujia (Apocynaceae), Lemna (Araceae), Hydrocotyle (Araliaceae), Aristolochia (Aristolochiaceae), Bellevalia (Asparagaceae), Asphodelus (Asphodelaceae), Artemisia, Crepis, Eclipta, Erigeron, Hieracium, Senecio, Symphyotrichum, Tolpis (Asteraceae), Symphytum (Boraginaceae), Alyssum, Cardamine, Eruca, Isatis (Brassicaceae), Valerianella (Caprifoliaceae), Petrorhagia, Scleranthus (Caryophyllaceae), Commelina (Commelinaceae), Dichondra (Convolvulaceae), Sedum (Crassulaceae), Diospyros (Ebenaceae), Moneses (Ericaceae), Euphorbia (Euphorbiaceae), Medicago, Trifolium (Fabaceae), Myriophyllum (Haloragaceae), Juncus (Juncaceae), Salvia, Teucrium (Lamiaceae), Broussonetia (Moraceae), Spiranthes (Orchidaceae), Phelipanche (Orobanchaceae), Papaver (Papaveraceae), Passiflora (Passifloraceae), Cedrus, Pseudotsuga (Pinaceae), Bromopsis, Calamagrostis, Cenchrus, Drymochloa, Melica, Oloptum, Phleum, Sporobolus, Tragus (Poaceae), Stuckenia (Potamogetonaceae), Lysimachia (Primulaceae), Anemone, Aquilegia (Ranunculaceae), Eriobotrya (Rosaceae), Crucianella (Rubiaceae), Verbascum (Scrophulariaceae), Typha (Typhaceae), Urtica (Urticaceae), and Viola (Violaceae). In the end, the conservation status of the units and eventual protection of the cited biotopes are discussed

Contributi per una flora vascolare di Toscana. VIII (440-506)

New localities and/or confirmations concerning 67 specific and subspecific plant taxa of Tuscan vascular flora, belonging to 59 genera and 37 families are presented: Alisma (Alismataceae), Amaranthus (Amaranthaceae), Leucojum, Sternbergia, Tristagma (Amaryllidaceae), Aloe (Asphodelaceae), Erigeron, Galinsoga, Hieracium, Rhagadiolus, Silybum, Soliva, Taraxacum (Asteraceae), Impatiens (Balsaminaceae), Berberis (Berberidaceae), Cardamine (Brassicaceae), Opuntia (Cactaceae), Cephalaria, Sixalix, Succisa (Caprifoliaceae), Silene (Caryophyllaceae), Convolvulus, Ipomoea (Convolvulaceae), Aeonium (Crassulaceae), Scirpus (Cyperaceae), Equisetum (Equisetaceae), Euphorbia (Euphorbiaceae), Astragalus, Trifolium (Fabaceae), Quercus (Fagaceae), Crocus (Iridaceae), Juncus (Juncaceae), Utricularia (Lentibulariaceae), Peplis (Lythraceae), Maclura (Moraceae), Nymphaea (Nymphaeaceae), Oenothera (Onagraceae), Anacamptis, Orchis (Orchidaceae), Orobanche (Orobanchaceae), Callitriche, Veronica (Plantaginaceae), Alopecurus, Eleusine, Glyceria, Phleum (Poaceae), Persicaria, Polygonum (Polygonaceae), Groenlandia (Potamogetonaceae), Clematis, Pulsatilla, Ranunculus (Ranunculaceae), Rhamnus (Rhamnaceae), Fragaria, Potentilla, Pyracantha (Rosaceae), Galium (Rubiaceae), Sparganium (Typhaceae), Vitis (Vitaceae). In the end, the conservation status of the units and eventual protection of the cited biotopes are discussed

Contributi per una flora vascolare di Toscana. VIII (440-506) [Contributions for a vascular flora of Tuscany. VIII (440-506)]

Contributions for a vascular flora of Tuscany. VIII (440-506). New localities and/or confirmations concerning 67 specific and subspecific plant taxa of Tuscan vascular flora, belonging to 59 genera and 37 families are presented: Alisma (Alismataceae), Amaranthus (Amaranthaceae), Leucojum, Sternbergia, Tristagma (Amaryllidaceae), Aloe (Asphodelaceae), Erigeron, Galinsoga, Hieracium, Rhagadiolus, Silybum, Soliva, Taraxacum (Asteraceae), Impatiens (Balsaminaceae), Berberis (Berberidaceae), Cardamine (Brassicaceae), Opuntia (Cactaceae), Cephalaria, Sixalix, Succisa (Caprifoliaceae), Silene (Caryophyllaceae), Convolvulus, Ipomoea (Convolvulaceae), Aeonium (Crassulaceae), Scirpus (Cyperaceae), Equisetum (Equisetaceae), Euphorbia (Euphorbiaceae), Astragalus, Trifolium (Fabaceae), Quercus (Fagaceae), Crocus (Iridaceae), Juncus (Juncaceae), Utricularia (Lentibulariaceae), Peplis (Lythraceae), Maclura (Moraceae), Nymphaea (Nymphaeaceae), Oenothera (Onagraceae), Anacamptis, Orchis (Orchidaceae), Orobanche (Orobanchaceae), Callitriche, Veronica (Plantaginaceae), Alopecurus, Eleusine, Glyceria, Phleum (Poaceae), Persicaria, Polygonum (Polygonaceae), Groenlandia (Potamogetonaceae), Clematis, Pulsatilla, Ranunculus (Ranunculaceae), Rhamnus (Rhamnaceae), Fragaria, Potentilla, Pyracantha (Rosaceae), Galium (Rubiaceae), Sparganium (Typhaceae), Vitis (Vitaceae). In the end, the conservation status of the units and eventual protection of the cited biotopes are discussed

Contributi per una flora vascolare di Toscana. XII (739-812)

Vengono presentate nuove località e/o conferme relative a 74 taxa specifici e sottospecifici di piante vascolari della flora vascolare to- scana, appartenenti a 69 generi e 28 famiglie: Bunium, Trinia (Apia- ceae), Nerium (Apocynaceae), Lemna (Araceae), Artemisia, Bidens, Centaurea, Crupina, Gazania, Hieracium, Rhagadiolus, Symphyotri- chum, Tagetes, Tripleurospermum (Asteraceae), Impatiens (Balsami- naceae), Anredera (Basellaceae), Cynoglottis, Phacelia (Boraginaceae), Cardamine, Diplotaxis, Hornungia (Brassicaceae), Campanula, Lobe- lia (Campanulaceae), Cerastium, Dianthus, Polycarpon, Spergularia, Stellaria (Caryophyllaceae), Commelina (Commelinaceae), Fallopia (Convolvulaceae), Sempervivum (Crassulaceae), Dryopteris (Dryopte- ridaceae), Euphorbia (Euphorbiaceae), Lathyrus, Medicago, Ononis, Trigonella (Fabaceae), Geranium (Geraniaceae), Lycopus, Stachys (Lamiaceae), Malva (Malvaceae), Anacamptis, Cephalanthera, Epi- pactis, Orchis (Orchidaceae), Linaria (Plantaginaceae), Ceratochloa, Eragrostis, Festuca, Gastridium, Hyparrhenia, Molineriella, Phalaris, Phyllostachys, Setaria, Sporobolus, Stipellula (Poaceae), Anogramma (Pteridaceae), Anemonoides, Ranunculus (Ranunculaceae), Reseda (Resedaceae), Alchemilla, Kerria, Pyracantha, Rosa, Rubus (Rosa- ceae), Galium, Valantia (Rubiaceae), Thesium (Santalaceae). Infine, viene discusso lo status di conservazione delle entità e gli eventuali vincoli di protezione dei biotopi segnalati

Contributi per una flora vascolare di toscana. IX (507-605)

Contributions for a vascular flora of Tuscany. IX (507-605). New localities and/or confirmations concerning 98 specific and subspecific plant taxa of Tuscan vascular flora, belonging to 81 genera and 42 families are presented: Alisma, Baldellia (Alismataceae), Chenopodium (Amaranthaceae), Sternbergia (Amaryllidaceae), Bupleurum (Apiaceae), Vinca (Apocynaceae), Muscari, Polygonatum (Asparagaceae), Carlina, Centaurea, Chondrilla, Filago, Pallenis, Tagetes, Tr a - gopogon, Tyrimnus (Asteraceae), Impatiens (Balsaminaceae), Campsis (Bignoniaceae), Cardamine, Iberis, Isatis, Lepidium, Rorippa (Brassicaceae), Humulus (Cannabaceae), Centranthus (Caprifoliaceae), Atocion, Paronychia, Sabulina, Scleranthus (Caryophyllaceae), Euonymus (Celastraceae), Fumana (Cistaceae), Phedimus, Sedum (Crassulaceae), Juniperus (Cupressacesae), Carex, Cyperus, Schoenus (Cyperaceae), Erica (Ericaceae), Euphorbia (Euphorbiaceae), Astragalus, Cytisus, Gleditsia, Lotus, Trifolium, Vicia (Fabaceae), Geranium (Geraniaceae), Philadelphus (Hydrangeaceae), Phacelia (Hydrophyllaceae), Hermodactylus, Iris, Romulea (Iridaceae), Salvia, Ziziphora (Lamiaceae), Gagea, Lilium (Liliaceae), Lindernia (Linderniaceae), Mirabilis (Nyctaginaceae), Nymphaea (Nymphaeaceae), Ligustrum (Oleaceae), Oenothera (Onagraceae), Oxalis (Oxalidaceae), Plantago, Veronica (Plantaginaceae), Armeria (Plumbaginaceae), Eleusine, Festuca, Phleum, Setaria, Stipa, Tragu s (Poaceae), Stuckenia (Potamogetonaceae), Anemonoides, Ranunculus (Ranunculaceae), Reseda (Resedaceae), Aphanes, Cotoneaster, Eriobotrya, Malus, Rosa (Rosaceae), Galium (Rubiaceae), Nicotiana, (Solanaceae). In the end, the conservation status of the units and possible protection of the cited biotopes are discussed

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice