Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis : results of the SPRi.MACC study

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COVID-19 atypical Parsonage-Turner syndrome: a case report

Background Neurological manifestations of Sars-CoV-2 infection have been described since March 2020 and include both central and peripheral nervous system manifestations. Neurological symptoms, such as headache or persistent loss of smell and taste, have also been documented in COVID-19 long-haulers. Moreover, long lasting fatigue, mild cognitive impairment and sleep disorders appear to be frequent long term neurological manifestations after hospitalization due to COVID-19. Less is known in relation to peripheral nerve injury related to Sars-CoV-2 infection. Case presentation We report the case of a 47-year-old female presenting with a unilateral chest pain radiating to the left arm lasting for more than two months after recovery from Sars-CoV-2 infection. After referral to our post-acute outpatient service for COVID-19 long haulers, she was diagnosed with a unilateral, atypical, pure sensory brachial plexus neuritis potentially related to COVID-19, which occurred during the acute phase of a mild Sars-CoV-2 infection and persisted for months after resolution of the infection. Conclusions We presented a case of atypical Parsonage-Turner syndrome potentially triggered by Sars-CoV-2 infection, with symptoms and repercussion lasting after viral clearance. A direct involvement of the virus remains uncertain, and the physiopathology is unclear. The treatment of COVID-19 and its long-term consequences represents a relatively new challenge for clinicians and health care providers. A multidisciplinary approach to following-up COVID-19 survivors is strongly advised

The Contribution of Oxidative Stress to <i>NF1</i>-Altered Tumors

The neurofibromatosis-1 gene (NF1) was initially characterized because its germline mutation is responsible for an inherited syndromic disease predisposing tumor development, in particular neurofibromas but also various malignancies. Recently, large-scale tumor sequencing efforts have demonstrated NF1 as one of the most frequently mutated genes in human cancer, being mutated in approximately 5–10% of all tumors, especially in malignant peripheral nerve sheath tumors and different skin tumors. NF1 acts as a tumor suppressor gene that encodes neurofibromin, a large protein that controls neoplastic transformation through several molecular mechanisms. On the other hand, neurofibromin loss due to NF1 biallelic inactivation induces tumorigenic hyperactivation of Ras and mTOR signaling pathways. Moreover, neurofibromin controls actin cytoskeleton structure and the metaphase–anaphase transition. Consequently, neurofibromin deficiency favors cell mobility and proliferation as well as chromosomal instability and aneuploidy, respectively. Growing evidence supports the role of oxidative stress in NF1-related tumorigenesis. Neurofibromin loss induces oxidative stress both directly and through Ras and mTOR signaling activation. Notably, innovative therapeutic approaches explore drug combinations that further increase reactive oxygen species to boost the oxidative unbalance of NF1-altered cancer cells. In our paper, we review NF1-related tumors and their pathogenesis, highlighting the twofold contribution of oxidative stress, both tumorigenic and therapeutic

Micrometastasi al linfonodo sentinella in pazienti con carcinoma della mammella: quando \ue8 possibile evitare la dissezione del cavo ascellare?

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LAPAROSCOPIC SPLENECTOMY IN HEMATOLOGIC MALIGNANCIES

Aims: Although laparoscopic splenectomy (LS) for benign hematologic disease is well accepted, its role in the treatment of haematological malignancies is still controversial. The aim of this study is to compare efficacy and feasibility of LS for hematologic malignancies and patients outcome with benign disease patients wgo underwent thesame procedure.Methods: Between January 2001 and December 2007 in two affiliated university hospital 141 patients underwent to LS for hematologic disease. 104 for benign hematologic disorders (HB) and 37 (26,2%) for malignancies (HM). Results: Median splenic weight was greater in the HM group (mean 787 gr range 205-2500 gr) than in the HB group (mean 350 ge range 150-110 gr) with a statistically significant difference (p<0.005). The conversion rate is significantly greater in the HM group (22,2% versus 2,9% p<0.001) instead the mean operation time (150 minutes in HM group vs 125 in HB) and the mean blood loss are similar in the two groups of patients. Considering the postoperative course, morbidity (13.8% in HM vs 11,5% in HB group) and mean hospital stay (5,5 days in HM vs 4,4 in HB) were not different among the two groups. No mortality occurred.Conclusions: The analysis of our data highlights that LS for hematologic malignancies is effective and feasible even if associated to a higher conversion rate compared with LS for benign disorders. Besides, no differences in the outcome of patients (blood loss, morbidity, mortality and hospital stay) was noted among the two group

Knowledge and Use of Novel Psychoactive Substances in Italy: a Survey-Based Study in the General Population

© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1007/s11469-021-00683-zIn this study, we aimed to identify the current trend of novel psychoactive substance (NPS) consumption in Italy and the level of knowledge about NPS in the general population and to explore the presence of risk factors for a lifetime NPS misuse. We conducted an anonymous online survey, administered to a large sample of people of any age living in Italy, asking for their knowledge about NPS as well as their history of drug use. Descriptive statistics were reported, and regression analyses were performed to identify risk factors for lifetime use of NPS. A total of 1097 individuals gave a valid response to the survey. A lifetime use of NPS was reported by 13.5%. Multivariate regression analysis showed that male gender (OR 2.33, 95% CI 1.52–3.55), homosexual sexual orientation (OR 2.52, 95% CI 1.21–5.27), a use of emergency services due to alcohol (OR 3.38, 95% CI 2.23–5.12) and previous contact with mental health services (OR 1.58, 95% CI 1.04–2.41) were risk factors for a lifetime use of NPS (p < 0.05). An improvement of preventive strategies and simplified access to information on NPS, especially tailored to individuals at increased risk of misuse, could slow diffusion of NPS and avert the consequences of substance use.Peer reviewe