Minimally invasive management of a symptomatic case of Zinner’s syndrome: Laparoscopic seminal vesiculectomy and ipsilateral nephroureterectomy

Introduction: Zinner syndrome is a rare developmental anomaly of the Wolffian (mesonephric) duct which is characterized by a triad of obstruction of the ejaculatory duct, the ipsilateral seminal vesicle cyst, and the ipsilateral renal agenesis. Usually is totally asymptomatic, however it can also determine symptoms such as lower urinary tract symptoms, perineal pain, ejaculatory disorders such as painful ejaculation or hematospermia, and infertility. Case report: We present a case of a 51 years old men with a 3-year history of lower urinary tract symptoms, perineal pain, obstructed defecation, recurrent urinary tract infections and infertility. CT scan showed a voluminous cystic neoformation of the left seminal vesicle, hypoplasia of the left kidney and ipsilateral ureteronephrosis. The mass was removed using laparoscopic “en block” seminal vesiculectomy with associated ipsilateral nephroureterectomy. No post-operative complications occurred. At 2-month post-operative control the patient reported an improvement of urinary and rectal symptoms

Large primary leiomyosarcoma of the seminal vesicle: A case report and literature revision

Primary Leiomyosarcoma of the seminal vesicle is a very rare condition. We report a case of a 74-year-old man with a tumour detected by rectal symptoms with pelvic pain and dysuria at ultrasonography. Computed tomography and magnetic resonance imaging suggest an origin in the left seminal vesicle and did not show a clear cleavage plan with the rectum and a right hydroureteronephrosis was also present. A radical vesiculo-cystoprostatectomy with ileal conduit and bilateral pelvic lymphadenectomy was performed, a sigmoidectomy with end colostomy was performed also. Pathological examination showed a high grade (G3) leiomyosarcoma of the seminal vesicle

MODIFICAÇÕES QUÍMICAS NO SOLO APÓS APLICAÇÃO DE CALCÁRIO SUPERFICIAL E INCORPORADO EM LATOSSOLO VERMELHO SOB CULTIVO DE CANA PLANTA

A aplicação superficial de calcário tem-se mostrado eficiente na correção da acidez do solo no sistema plantio direto. Ao contrário do esperado, os efeitos da aplicação de calcário têm ocorrido em profundidade e em períodos de tempo relativamente curtos, apesar da sua baixa solubilidade no solo. O trabalho teve por objetivo avaliar as alterações nas propriedades químicas de um Latossolo Vermelho em função da granulometria e do modo de aplicação. O delineamento experimental utilizado foi esquema fatorial 2x2, resultantes da combinação de 2 tipos de calcário (PRNT = 70% e PRNT = 103%) com 2 modos de aplicação (incorporado ao solo e aplicado em superfície), mais um tratamento controle adicional, todos com 5 repetições, totalizando 25 parcelas. Foram realizadas análises químicas (pH, M.O., P, K, Ca, Mg, H+Al, CTC e saturação por bases) do solo coletado nas camadas de 0-20 cm e 20-40 cm aos 3 meses após a implantação do experimento. Os resultados evidenciaram que não ocorreram em ambas às profundidades avaliadas. A aplicação em superfície do corretivo da acidez antes da implantação da cultura não foi suficiente para elevar a saturação por bases em nível almejado para a cultura da cana-de-açúcar

Echocardiography may help detect pulmonary vasculopathy in the early stages of pulmonary artery hypertension associated with systemic sclerosis

<p>Abstract</p> <p>Background</p> <p>Pulmonary arterial hypertension (PAH) in patients with systemic sclerosis is associated with a poor prognosis, but this can be improved by early disease detection. Abnormal pulmonary and cardiac function can be detected early by means of echocardiography, whereas right heart catheterization is usually performed later.</p> <p>Objectives</p> <p>The purpose of this prospective study was to detect early the presence of pulmonary artery vasculopathy in patients with verified systemic sclerosis without significant pulmonary fibrosis, normal lung volumes and a mildly reduced lung diffusion capacity of carbon monoxide (DLCO).</p> <p>Methods</p> <p>Nineteen consecutive female NYHA class I-II patients with scleroderma and a PAPs of < 35 mm/Hg measured by echocardiography, were enrolled between September 2007 and September 2009. They had a mean age of 51 ± 13 years, body mass index of 25 ± 5 kg/m²). They all underwent complete Doppler echocardiography, CPET, a pulmonary ventilation test (carbon monoxide lung diffusion, DLCO), HRCT. To investigate PAH by means of complete resting Doppler echocardiography estimates of systolic pulmonary artery pressure (PAPs) derived from tr icuspid regurgitation, mean PAP derived from pulmonary regurgitation, pulmonary vessel resistance (PVR) derived from the acceleration time of the pulmonary outflow tract (ACTpo), and right ventricular function derived from tricuspid annular plane systolic excursion (TAPSE). Right heart catheterisation was conducted only, if pulmonary hypertension was suggested by echocardiography and an abnormal ventilator test.</p> <p>The data are given as mean values ± SD, unless otherwise stated. The correlations between the variables were analysed using Pearson's <it>r </it>coefficient, and the predictive value of the variables was calculated using linear regression analysis. A p value of > 0.05 was considered significant.</p> <p>Results</p> <p>Right heart catheterization detected PAH in 15/19 patients; mean PAP was 30.5 mm/Hg and RVP 3.6 UW. Coronary angiography of the patients aged more than 55 years showed some evidence of significant coronary artery disease. Echocardiography showed high systolic PAP values (46 ± 8 mmHg), whereas right ventricular function was normal (TAPSE 23 ± 3 mm), and in line with the NYHA class. ACTpo was reduced in the patients with a systolic PAP of < 46 mm/Hg (p > 0.001) and positively correlated with DLCO (p > 0.001) and the hemodynamic data.</p> <p>There was a good correlation between ACTpo and PVR (hemodynamic data) (r = -0615; p > 0.01).</p> <p>Conclusions</p> <p>Although they need to be confirmed by studies of larger series of patients, our findings suggest that, in comparison with hemodynamic data, non-invasive echocardiographic measurements are an excellent means of identifying early-stage PAH.</p

Notulae to the Italian alien vascular flora: 14

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, and status changes for Italy or for Italian administrative regions. Nomenclatural and distribution updates, published elsewhere, and corrections are provided as Suppl. materia

Notulae to the Italian alien vascular flora: 14

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, and status changes for Italy or for Italian administrative regions. Nomenclatural and distribution updates, published elsewhere, and corrections are provided as Suppl. material

Notulae to the Italian alien vascular flora: 11

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, exclusions, and status changes for Italy or for Italian administrative regions. Nomenclatural and distribution updates published elsewhere are provided as Suppl. material 1

Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk

Notulae to the Italian native vascular flora: 6

In this contribution, new data concerning the distribution of native vascular flora in Italy are presented. It includes new records, confirmations and status changes to the Italian administrative regions for taxa in the genera Alchemilla, Arundo, Bupleurum, Clematis, Clinopodium, Cota, Crassula, Cytisus, Euphorbia, Hieracium, Isoëtes, Lamium, Leontodon, Linaria, Lychnis, Middendorfia, Ophrys, Philadelphus, Pinus, Sagina, Sedum, Taeniatherum, Tofieldia, Triticum, Veronica, and Vicia. Nomenclature and distribution updates, published elsewhere, and corrigenda are provided as supplementary material