Massive pulmonary embolism as a rare complication of a stab in the inguinal region in a HIV-positive patient: a case report

Venous thromboembolism (VTE) is a severe preventable disease; HIV-infection represents a prothrombotic condition, because of specific factors due to the virus itself, the host response and the antiretroviral therapy. Our aim is to raise awareness of thromboembolic risk when dealing with HIV-positive patients presenting to the Emergency Department for treatment of injuries, even though small

Opportunistic communication in smart city: Experimental insight with small-scale taxi fleets as data carriers

How to deliver data to, or collect data from the hundreds of thousands of sensors and actuators integrated in "things" spread across virtually every smart city streets (garbage cans, storm drains, advertising panels, etc.)? The answer to the question is neither straightforward nor unique, given the scale of the issue, the lack of a single administrative entity for such tiny devices (arguably run by a multiplicity of distinct and independent service providers), and the cost and power concerns that their direct connectivity to the cellular network might pose. This paper posits that one possible alternative consists in connecting such devices to their data collection gateways using "oblivious data mules", namely transport fleets such as taxi cabs which (unlike most data mules considered in past work) have no relation whatsoever with the smart city service providers, nor are required to follow any pre-established or optimized path, nor are willing to share their LTE connectivity. We experimentally evaluate data collection and delivery performance using real world traces gathered over a six month period in the city of Rome. Results suggest that even relatively small fleets, such as an average of about 120 vehicles, operating in parallel in a very large and irregular city such as Rome, can achieve an 80% coverage of the downtown area in less than 24 h. (C) 2016 Elsevier B.V. All rights reserved

Radioembolisation with 90Y-labelled resin microspheres in the treatment of liver metastasis from breast cancer

Metastatic breast cancer is a heterogeneous disease, commonly affecting the liver. We report our experience with Y-90 radioembolisation (RE) and its effects on the survival of patients with treatment-refractory breast cancer liver metastases. A total of 77 female patients affected by breast cancer were accepted into our department for RE. Inclusion criteria were inoperable and chemotherapy-refractory hepatic metastases, acceptable performance status, sufficient residual liver, no significant hepato-pulmonary shunts. Patients were divided in two groups: group 1 (29 patients) included those with Eastern Cooperative Oncology Group (ECOG) score 0, liver involvement (0-25 %) and no extrahepatic disease (EHD); group 2 (23 patient) included patients with ECOG score 1-2, liver involvement (26-50 %) and evidence of EHD. A total of 25 patients were considered ineligible. The median age of the remaining 52 patients was 57.5 years. The median overall survival was 11.5 months and better in those whose performance status and liver function were preserved (14.3 versus 8.2 months). According to Response Evaluation Criteria in Solid Tumor (RECIST), partial response (PR) was achieved in 29 patients (56 %), stable disease (SD) was achieved in a further 18 patients (35 %) and 5 patients showed progressive disease (PD) (10 %). Y-90 RE is effective in the treatment of liver metastases from breast cancer. We demonstrated a relevant survival and encouragingly high response rate in patients with treatment-refractory disease. aEuro cent Interventional radiological techniques are increasingly used for metastatic disease in the liver. aEuro cent (90) Y radioembolisation (RE) seems effective for treating hepatic metastases from breast cancer. aEuro cent RE is safe and well tolerated when performance status and liver function are preserved

Treatment of Thyroid Nodules with Radiofrequency: a 1\u2013year follow up experience

Purpose The aim of this study is to assess the efectiveness and safety of radiofrequency ablation (RFA) in debulking benign solid thyroid nodules. Materials and methods This is a retrospective review of 77 patients with predominantly solid thyroid nodules treated with RFA in a single center between 2013 and 2016. All patients declined or were not eligible for surgery. Benign proven thyroid nodules causing compressive symptoms and cosmetic concerns were considered for treatment. Nodule volume, thyroid nodule related compressive symptoms, cosmetic concerns and thyroid function were evaluated. Results All patients underwent a single treatment session. Mean nodule volume decreased from 17.9\ub115.6 mL at baseline to 5.2\ub17.4 after 12 months with a volume reduction ratio (VRR) of 70.9%\ub120.8%. There were no identifable factors predictive of response to RFA. Median cosmetic and symptom scores of the entire population decreased from 3 [2\u20134] and 3 [0\u201310] to 1 [1\u20133] (p<0.001) and 0 [0\u20135] (p<0.001), respectively. No major complications occurred and RFA did not afect thyroid function when normal. Conclusion RFA induces substantial volume reduction of predominantly solid thyroid nodules and improves compressive symptoms and cosmetic concerns. RFA does not impact normal thyroid function and has an acceptable safety profle