A rare case of vulvar superficial myofibroblastoma associated with ambigous and unusual differential diagnosis

•Superficial myofibroblastoma of the Labia Majora.•Differential diagnosis between vulvar superficial myofibroblastoma and cyst/hydrocele of Nuck duct.•Differential diagnosis between vulvar superficial myofibroblastoma and inguinal/crural hernia

Surgical treatment of post-menopausal ovarian hyperandrogenism improves glucometabolic profile alongside clinical hirsutism

Hyperandrogenism during menopause is often underestimated by clinicians and attributed to the natural aging process. Hyperandrogenism can be associated with some metabolic abnormalities linked together in a vicious circle by insulin resistance. We present the case of an elderly woman affected with type 2 diabetes and obesity who reported the occurrence of clinical hirsutism after physiological menopause at the age of 47 years. At presentation, physical examination and Ferriman-Gallwey score revealed a condition of moderate hirsutism, with markedly increased levels of plasma testosterone and delta-4-androstenedione, obesity (body mass index 31.9), and inadequate glycemic control (glycated hemoglobin 65 mmol/mol). The patient underwent a thorough differential diagnosis by a multidisciplinary team approach, including the various causes of hyperandrogenism during menopause. After choosing surgical option as the appropriate treatment, clinical resolution of hirsutism was observed alongside patient satisfaction and marked improvement of the glucometabolic profile

Research and Development for Near Detector Systems Towards Long Term Evolution of Ultra-precise Long-baseline Neutrino Experiments

Document submitted to the European Strategy For European Particle PhysicsDocument submitted to the European Strategy For European Particle PhysicsDocument submitted to the European Strategy For European Particle PhysicsWith the discovery of non-zero value of $\theta_{13}$ mixing angle, the next generation of long-baseline neutrino (LBN) experiments offers the possibility of obtaining statistically significant samples of muon and electron neutrinos and anti-neutrinos with large oscillation effects. In this document we intend to highlight the importance of Near Detector facilities in LBN experiments to both constrain the systematic uncertainties affecting oscillation analyses but also to perform, thanks to their close location, measurements of broad benefit for LBN physics goals. A strong European contribution to these efforts is possible

Research and Development for Near Detector Systems Towards Long Term Evolution of Ultra-precise Long-baseline Neutrino Experiments

With the discovery of non-zero value of $\theta_{13}$ mixing angle, the next generation of long-baseline neutrino (LBN) experiments offers the possibility of obtaining statistically significant samples of muon and electron neutrinos and anti-neutrinos with large oscillation effects. In this document we intend to highlight the importance of Near Detector facilities in LBN experiments to both constrain the systematic uncertainties affecting oscillation analyses but also to perform, thanks to their close location, measurements of broad benefit for LBN physics goals. A strong European contribution to these efforts is possible

La chirurgia mininvasiva dell’incontinenza urinaria da sforzo femminile sintomatica: studio randomizzato TVT (transvaginal tape) vs. TOT (transobturator tape)

Obiettivo: L’obiettivo dello studio è stato quello di comparare le tecniche chirurgiche TVT (tension free vaginal tape) vs. TOT (trans obturator tape) con un trial doppio cieco randomizzato per valutare il tasso di guarigione, le complicanze, la percentuale complessiva di soddisfazione e infine considerare le indicazioni in base alla severità della sintomatologia. Metodologia: Abbiamo reclutato tutte pazienti affette da incontinenza urinaria da stress sintomatica di grado 1 e 2 con Q-tip test > 1. I criteri di esclusione sono stati: pazienti con SUI di grado 3, Q-tip test =1, incontinenza urinaria da urgenza, prolasso associato, alterazioni neurovegetative, pregressa chirurgia o terapie medicali o riabilitative per SUI. La severità e il grado dell’incontinenza veniva presunta dai dati clinici. Le pazienti sono state randomizzate per ricevere un trattamento chirurgico con TVT o TOT e i risultati sono stati valutati ad un mese e ad un anno. Risultati: Abbiamo arruolato 104 donne. Differenze significative sono state trovate sui due gruppi per quanto riguarda, i tempi operatori, il numero di giorni di cateterizzazione e il dolore postoperatorio (maggiore per la TVT; p<0.05). Sebbene le complicanze nel postoperatorio, le percentuali di recidive e reinterventi sono risultati simili nei due gruppi, il grado di soddisfazione delle pazienti ad un mese e ad un anno dall’intervento è risultato significativamente differente se analizzato in accordo alla severità dell’incontinenza: le paziente con SUI 1 hanno apprezzato maggiormente la tecnica chirurgica della TOT e le pazienti con SUI 2 maggiormente la TVT (p<0.001). Conclusioni: La scelta tra TOT e TVT non è completamente simile. In accordo al grado di soddisfazione, il TOT sembra più indicato nella SUI di tipo 1 e la TVT nella SUI di grado 2. Sebbene la percentuale di ostruzione urinaria e di recidiva di malattia nelle due tecniche non siano risultati differenti queste hanno influenzato significativamente il grado di soddisfazione delle pazienti in base al grado di severità della SUI.Objective: The aim of our study was to compare tension-free vaginal (TVT) vs. trans-obturator tape (TOT) technique on a double blind randomised trial to evaluate cure rates, complications, overall satisfaction rates and after stratification according to symptoms severity. Methods: We recruited all patients affected by symptomatic SUI grade 1 and 2 and Q tip test > I. Exclusion criteria consisted in patients with SUI grade 3, Q tip test =1, urge incontinence, associated prolapses, neurovegetative disorders, previous surgery for SUI or under rehabilitative or medical therapies. SUI grade of severity was recorded as well as clinical data. Patients were randomized to receive TOT or TVT and results assessed at one month and one year. Results: We analysed 104 women. Significant differences were found between TOT and TVT groups regarding the operating times, number of catheterization days, postoperative pain (all greater for TVT; p<0.05). Although postoperative complications, recurrences and reoperations were similar among techniques, patients’ satisfaction rates at one month and one year were significant different when analysed according to the severity of SUI: SUI 1 patients appreciated more the TOT operation and SUI 2 patients more the TVT (p<0.001). Conclusions: The choice of TOT vs. TVT is not completely similar. According to satisfaction rates, TOT could be more indicated in SUI 1 and TVT in SUI 2. Although recurrences or bladder obstructions rates are not different among techniques, they can influence patients’ satisfaction and could be avoided with accurate and proper indications according to the SUI severity

Ovarian metastasis from thyroid carcinoma: A case report and literature review

Papillary thyroid carcinoma is rarely associated with metastatic disease. The most common sites of metastasis are the lungs and bones, while only few cases of ovarian metastasis are described in literature

Robotic transperitoneal aortic lymphadenectomy in gynecologic cancer: a new robotic surgical technique and review of the literature

Lymph node status is a prognostic factor for gynecologic cancer. We describe a new developing strategy for robotic transperitoneal aortic lymphadenectomy without relocating the robotic column or the patient