Bowel parasitosis and neuroendocrine tumours of the appendix. A report from the Italian TREP project

Five children with a neuroendocrine tumour (NET) of the appendix associated with a parasitic bowel infection are described, and the possibility of inflammation-triggered carcinogenesis is discussed. Schistosoma haematobium is linked primarily to bladder cancer but it has been reported in association with several other histotypes, including NETs of the gastrointestinal tract. Conversely, Enterobius vermicularis has not yet been claimed to participate in the onset of pre-cancerous conditions or tumours. The rare occurrence of contemporary appendiceal NETs and parasitic infection, raises the intriguing hypothesis of an inflammation-related carcinogenesis, although a cause-effect relationship cannot be established. Larger international series of childhood appendiceal NETs, which also include countries with higher prevalence of parasitic bowel infections, are needed to further clarify this possible cause-effect relationshi

Quality of life in spina bifida patients: results of an Italian survey

Background The objectives were: 1. to investigate the major topics on the Quality of Life (QOL) of Spina Bifida patients; 2. to evaluate attitudes, the experienced and the behaviours concerning everyday activities, social life participation and familial relationship; 3. to evaluate the information needs; 4. to evaluate the physical and psychological problems related to vesical and intestinal management

Role of Management Strategies in Reducing Mortality From Invasive Fungal Disease in Children With Cancer or Receiving Hemopoietic Stem Cell Transplant

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Does surgery have a role in the treatment of local relapses of non-metastatic rhabdomyosarcoma?

PURPOSE: Patients with non-metastatic rhabdomyosarcoma (RMS) have a cure rate of 50-90%, but up to one-third of them experience mostly a local recurrence. Second-line treatment is not standardized as for newly diagnosed tumors. We evaluated the role of surgery on local relapses in a series of patients with RMS. METHODS: This retrospective analysis involves 70 patients enrolled in two consecutives Italian Studies, RMS88 and RMS96, who presented local recurrence. After relapse, 40/70 underwent a surgical excision (Surgery Group, SG), that was demolitive in 10/40; 24/40 had radiotherapy, 16/40 did not receive radiotherapy or data are not known. Thirty patients out of 70 did not receive any surgical treatment (No-Surgery Group, NSG), and 20/30 received radiotherapy. RESULTS: Overall survival (OS) after local relapse was 41.6% (mean follow-up 59 months, range 1-226). OS of SG patients was 54% versus 24.7% of the NSG patients (P = 0.0117). Furthermore, OS among the SG was 61.4% with and 41.8% without radiotherapy, and 37.1% with and 0% without radiotherapy among the NSG (P < 0.0001). One patient developed a second local relapse after excision without radiotherapy for the first one, and was cured with further treatment. Demolitive surgery did not improve survival compared to conservative surgery (40% vs. 58.4%, P = 0.1462). CONCLUSION: The treatment of recurrent RMS represents a challenge. In our experience, patients with local relapse had a poor prognosis. SG patients had a better outcome than NSG patients and those treated with resection plus radiotherapy had the best outcome; patients who did not receive any local treatment had an unfavorable outcome

Epithelial Tumors of the Ovary in Children and Teenagers: A Prospective Study from the Italian TREP Project

STUDY OBJECTIVE: To report the clinical findings and treatment results of a series of patients with epithelial tumors of the ovary, registered and treated prospectively in a multi-institutional Italian network (TREP project) on rare tumors in children and adolescent between 2000 and 2014. DESIGN, SETTING, AND PARTICIPANTS: Data on 16 patients, aged 22 to 206 months, from 7 centers were reviewed. All patients were grouped on the basis of the results of the first surgical approach, according to the Children Oncology Group staging system. RESULTS: The most frequent symptom was abdominal pain; 3 patients were hospitalized for acute pain after ovarian torsion. Initial surgical treatment was complete in 15 of 16, and a biopsy was performed in 1 of 16. The histology examination revealed 8 benign tumors (7 mucinous cystadenomas and 1 serous cystadenoma) and 8 borderline tumors (2 serous and 6 mucinous). Fifteen of 16 patients maintained the complete remission after surgical treatment alone; 1 affected by Proteus syndrome died consequent to the progression of a synchronous Wilms tumor, after a delayed incomplete surgery. CONCLUSION: Our analysis documented the rarity of these tumors in children and adolescents. No malignant histologies were found. Surgery alone was effective to cure the majority of patients. Considering the rarity of malignant entities, ovary-sparing surgery may be planned when an epithelial tumor is suspected on the basis of the preoperative work-up and intraoperative findings

Transperitoneal Laparoscopic Approach to the Perinephric Area in Children: Technical Report and Lessons Learned

reserved8noPurpose: This study presents a technical report of a standardized approach to the perinephric area in a series of pediatric patients, demonstrating that whatever renal or suprarenal surgery is planned, this can be approached and accomplished laparoscopically with an identical or very similar port triangulation, thus facilitating the learning curve within the same surgical team. Patients and Methods: All patients undergoing renal and adrenal gland surgery with a minimally invasive approach in the period from October 2008 to November 2013 were retrospectively reviewed and included in the study. Technical details and clinical outcomes are described. Results: In total, 68 patients matched the inclusion criteria and were therefore retrospectively examined. No major intraoperative complication occurred. Two patients developed recurrent pelvic-ureteric junction obstruction and were managed with double J stent positioning and laparoscopic dismembered pyeloplasty, respectively. Two patients presenting with adrenal mass experienced a moderate bleeding that could be treated conservatively. Conclusions: Thanks to the reproducibility of the procedure and on the grounds of the presented experience, we support the proposal that the transperitoneal laparoscopic approach to the kidney and the adrenal gland could represent a relatively easy and safe way to quickly achieve confidence and skill in the management of related diseases.mixedMattioli, Girolamo; Avanzini, Stefano; Pio, Luca; Costanzo, Sara; Faticato, Maria Grazia; Montobbio, Giovanni; Disma, Nicola; Buffa, PieroMattioli, Girolamo; Avanzini, Stefano; Pio, Luca; Costanzo, Sara; Faticato, MARIA GRAZIA; Montobbio, Giovanni; Disma, NICOLA MASSIMO; Buffa, Pier

Improved confinement and transport studies in the reverse field experiment (RFX)

This paper presents results obtained on the Reversed Field eXperiment, RFX [G. Rostagni, Fusion Engineering and Design 25, 301 (1995)], on the study of local transport properties of the RFP configuration both in the standard regime and during improved confinement phases obtained with poloidal current drive. The plasma core is dominated by magnetic turbulence, as indicated by both energy and particle transport analysis. Diffusivity decreases toward the edge and is reduced in the core at high Lundquist number. The edge region is apparently not affected by dynamo mode turbulence and determines global confinement in standard operation. Particle and heat diffusivity in this region show a favorable dependence with increasing density. The most interesting feature of the edge region of RFX consists of a sheared radial electric field with shearing rate comparable to that observed in tokamaks. Indications of turbulence reduction in the shear layer have been obtained. Enhanced energy confinement has been produced by pulsed poloidal current drive (PPCD). A clear reduction of the dynamo activity has been observed with a decrease of core thermal diffusivity to level comparable to the edge and global confinement improvement up to a factor of 3. \ua9 1999 American Institute of Physics

State of Water in Hydrating Tricalcium Silicate Pastes: The Effect of a Cellulose Ether

Time-dependent quasi-elastic neutron scattering (QENS) and differential scanning calorimetry (DSC) were applied to study water dynamics and hydration kinetic of the hydration reaction of tricalcium silicate in the presence of a methyl hydroxyethyl cellulose (MHEC) additive. The translational dynamics of the water confined in the developing hydrated calcium silicate matrix was probed at the molecular scale by QENS during the first 4 days, while the evolution of the matrix porosity and the hydration kinetics were determined up to 28 days of hydration by differential scanning calorimetry. The application of the boundary nucleation and growth model consistently improved the hydration kinetics picture, usually obtained from the application of the classical Avrami-Erove’ev model, allowing the evaluation of the individual contributions of nucleation and growth over the entire hydration process. In the presence of the cellulose ether the nature of the nucleation process is strongly modified, approaching a “spatially random” hydration mechanism. The water contained in the nanometric porosity of the hydrated calcium silicate matrix, which is fundamental for the efficiency of the hydration process, results increased when MHEC is added, leading to a delay of the onset of the hydration process and the enhancement of the efficiency of the reaction

Quasi-single helicity states in the reversed field pinch:beyond the standard paradigm

This paper reports experimental results showing that coherent helical structures are formed in the reversed field pinch (RFP) self-organizing plasma core as a result of transitions to states where the n-spectrum of the m=1 modes is dominated by a single (1,n(max)) geometrical helicity. These states are dubbed quasi-single helicity (QSH) states. Their magnetic and thermal properties measured in the reverse field experiment (RFX) [G. Rostagni, Fusion Eng. Des. 25, 301 (1995)] device are described. The present theoretical understanding of QSH states is discussed and some recent theoretical results are presented. The role of aspect ratio is discussed. These results represent a significant step to open a path beyond the standard paradigm that a bath of magnetohydrodynamic (MHD) modes is intrinsic to the RFP. (C) 2000 American Institute of Physics. [S1070-664X(00)97505-0]

SXR and Bolometric Tomography in RFX

The article presents the design and the first results of a new eight camera, soft x-ray (SXR) and bolometric tomography which has been installed in RFX, a large (R=2 m, a=0.46 m), high current reverse field pinch experiment operating in Padova. The main features of the diagnostic, which has been designed with standards compatible with the requirements of large fusion experiments, are: (a) it allows simultaneous reconstruction of both SXR and total radiation emissivity structures with high spatial and time resolution (bandwidth up to 200 kHz for SXR and 10 kHz for bolometry). Moreover, computer controlled remote actions which interchange up to five material filters in front of the detectors allow the exploration of different energy ranges; (b) it can be easily decoupled from the machine without breaking the main vacuum and can be operated during first wall baking up to 300\u2009\ub0C thanks to a cooling circuit; (c) the detection chain is designed to measure very low signals [in the order of 1 nA for SXR diodes and of 100 \u3bcV for bolometers]; (d) it is equipped with a VME based 1 MHz data acquisition system which allows on-line processing of a large amount of data. To accomplish these features the diagnostic consists of eight fully remotely controlled manipulators which can insert eight photocameras, carrying 78 top-rated Si SXR and 48 miniaturized metal film bolometric detectors in their operating positions. Initial results are presented. \ua9 1997 American Institute of Physics