Thoracoscopy in pleural effusion –two techniques: awake single-access video-assisted thoracic surgery versus 2-ports video-assisted thoracic surgery under general anesthesia

Awake single access video-assisted thoracic surgery with local anesthesia improves procedure tolerance, reduces postoperative stay and costs. MATERIALS & METHODS: Local anesthesia was made with lidocaine and ropivacaine. We realize one 20 mm incision for the 'single-access', and two incisions for the '2-trocars technique'. RESULTS: Mortality rate was 0% in both groups. Postoperative stay: 3dd ± 4 versus 4dd ± 5, mean operative time: 39 min versus 37 min (p < 0.05). Chest tube duration: 2dd ± 5 versus 3dd ± 6. COMPLICATIONS: 11/95 versus 10/79. CONCLUSION: Awake technique reduce postoperative hospital stay and chest drainage duration, similar complications and recurrence rate. The authors can say that 'awake single-access VATS' is an optimal diagnostic and therapeutic tool for the management of pleural effusions, but above extends surgical indication to high-risk patients

Nodular histiocytic/mesothelial hyperplasia as consequence of chronic mesothelium irritation by sub-phrenic abscess.

Nodular histiocytic/mesothelial hyperplasia (NHMH) is a benign localized alteration, first described in 1975 by Rosai in the hernia sac [1]. Few pulmonary cases have been reported in literature [2–6]. Sometimes it has been reported in the pericardium [7,8] or presenting as an inguinal mass [9]. The ‘mesothelial/monocytic incidental cardiac excrescence’, first described by Weinot et al. in 1994 [10] is now considered a similar lesion to NHMH [11]. It consists of a reactive proliferation of histiocytes and mesothelium secondary to chronic irritation and it has been observed in pleura-damaging processes, such as pneumothorax [5], or as consequence of cardiac catheterization, inflammation, mechanical or tumor stimulation [11]. The rarity of NHMH and the moderate cytological atypia often present, make this lesion difficult to diagnose. It can be easily confused with primary mesothelial lesions and neoplasms such as adenocarcinomas, granulosa cell tumors or Langerhans’ histiocytosis. We report a case of pleural NHMH in a patient with a subphrenic abscess, in which no pulmonary pathogenic noxa was evident. We hypothesize a transdiaphragmatic chronic irritation as a pathogenetic mechanism underlying NHMH

First report of Tomato leaf curl New Delhi virus affecting zucchini squash in an important horticultural area of southern Italy

omato leaf curl New Delhi virus (ToLCNDV) is a bipartite begomovirus (family Geminiviridae) which infects species in the families Cucurbitaceae and Solanaceae (Padidam et al., 1995; Mizutani et al., 2011). Begomoviruses are transmitted by the whitefly Bemisia tabaci in a persistent manner (Rosen et al., 2015). In October 2015, severe symptoms not previously reported by growers in the horticultural area of the Province of Trapani (Sicily, Italy) were observed on zucchini squash (Cucurbita pepo) in open fields. The symptoms included yellow mosaic, severe leaf curling, swelling of veins of young leaves, shortening of internodes, roughness of the skin of fruit and reduced fruit size; the symptoms were reminiscent of those caused by begomoviruses. Total DNA was extracted from young leaves of 22 plants by phenol/chloroform extraction and ethanol precipitation. PCR was performed with the A1F/A1R primer pair (Mizutani et al., 2011) for the DNA-A component and the pair described by Ruiz et al. (2015) for the DNA-B component to amplify a ~1200-bp fragment of DNA-A and a ~890 bp fragment of DNA-B, respectively. All 10 samples were positive by PCR with both primer pairs. No amplification products were obtained using primers specific for the monopartite begomoviruses Tomato yellow leaf curl virus and Tomato yellow leaf curl Sardinia virus (Davino et al., 2008). DAS-ELISA analysis for Cucumber mosaic virus, Papaya ring spot virus and Zucchini yellow mosaic virus (Loewe Phytodiagnostica, Germany) yielded negative results

Sleep and Chronobiology as a Key to Understand Cluster Headache

: The cluster headache is a primary headache characterized by attacks of unilateral pain associated with ipsilateral cranial autonomic features. These attacks recur in clusters during the years alternating with periods of complete remission, and their onset is often during the night. This annual and nocturnal periodicity hides a strong and mysterious link among CH, sleep, chronobiology and circadian rhythm. Behind this relationship, there may be the influence of genetic components or of anatomical structures such as the hypothalamus, which are both involved in regulating the biological clock and contributing even to the periodicity of cluster headaches. The bidirectional relationship manifests itself also with the presence of sleep disturbances in patients affected by cluster headaches. What if the key to studying the physiopathology of such disease could rely on the mechanisms of chronobiology? The purpose of this review is to analyze this link in order to interpret the pathophysiology of cluster headaches and the possible therapeutic implications

Liquid Dynamics in a Horizontal Capillary: Extended Similarity Analysis

Abstract The topic of this study is an extended similarity analysis for a one-dimensional model of liquid dynamics in a horizontal capillary. The bulk liquid is assumed to be initially at rest and is put into motion by capillarity, that is the only driving force acting on it. Besides the smaller is the capillary radius the steeper becomes the initial transitory of the meniscus location derivative, and as a consequence the numerical solution to a prescribed accuracy becomes harder to achieve. Here, we show how an extended scaling invariance can be used to define a family of solutions from a computed one. The similarity transformation involves both geometric and physical feature of the model. As a result, density, surface tension, viscosity, and capillary radius are modified within the required invariance. Within our approach a target problem of practical interest can be solved numerically by solving a simpler transformed test case. The reference solution should be as accurate as possible, and therefore we suggest to use for it an adaptive numerical method. This study may be seen as a complement to the adaptive numerical solution of the considered initial value problems

First report of Southern tomato virus in tomato crops in Italy

Twenty-five tomato plants (Solanum lycopersicum) showing symptoms of viral disease were sampled from different greenhouses in the Ragusa province (Southern Italy) in summer 2015. Plants showed chlorosis on leaves and fruits and deformation and depressed spots of dark colour which later evolved into necrosis (Fig. 1). These symptoms were observed on the entire cluster of fruit making the product unsaleable. Based on these symptoms, samples were analysed for Cucumber mosaic virus, Pepino mosaic virus (PepMV), Potato virus Y (PVY), Tomato mosaic virus and Tomato spotted wilt virus by DAS-ELISA with polyclonal antibodies (Loewe Phytodiagnostica, Germany), and for the emerging Southern tomato virus (STV) by RT-PCR (Candresse et al., 2013). Three of the 25 samples analysed were positive only for PepMV whereas the rest of the samples had mixed infections: fifteen plants were co-infected with PepMV and PVY, and seven with STV, PepMV and PVY. The amplification product (894 bp) obtained from one STV-infected plant was purified using the UltraClean® PCR Clean-Up kit (Mo-Bio, USA) and the consensus nucleotide sequences were determined in both senses using an ABI 3130XL Genetic Analyzer (Life Technologies, USA) and deposited in GenBank under accession number KT948068. The nucleotide identity of the Italian STV isolate was greater than 99% with STV isolates Mexico1 (EF442780), BD-13 (KT634055), CN-12 (KT438549), MS7 (EU413670) and FR (KC333078) from Mexico, Bangladesh, China, USA and France, respectively

Sporadic Creutzfeldt-Jakob disease: prion pathology in medulla oblongata-possible routes of infection and host susceptibility.

Sporadic Creutzfeldt-Jakob disease (sCJD), the most frequent human prion disorder, is characterized by remarkable phenotypic variability, which is influenced by the conformation of the pathologic prion protein and the methionine/valine polymorphic codon 129 of the prion protein gene. While the etiology of sCJD remains unknown, it has been hypothesized that environmental exposure to prions might occur through conjunctival/mucosal contact, oral ingestion, inhalation, or simultaneous involvement of the olfactory and enteric systems. We studied 21 subjects with definite sCJD to assess neuropathological involvement of the dorsal motor nucleus of the vagus and other medullary nuclei and to evaluate possible associations with codon 129 genotype and prion protein conformation. The present data show that prion protein deposition was detected in medullary nuclei of distinct sCJD subtypes, either valine homozygous or heterozygous at codon 129. These findings suggest that an "environmental exposure" might occur, supporting the hypothesis that external sources of contamination could contribute to sCJD in susceptible hosts. Furthermore, these novel data could shed the light on possible causes of sCJD through a "triple match" hypothesis that identify environmental exposure, host genotype, and direct exposure of specific anatomical regions as possible pathogenetic factors