Francesco Durante and the first intracranial tumor successfully operated on with long survival (1884)

Francesco Durante was born in Sicily, precisely Letojanni Gallodoro. He contributed to the history of neurosurgery in not only Italy but the whole world. In June 1884, he removed a left frontal meningioma, describing a personal technique of craniotomy with a discontinuous osteotangential section flap. It was the first such operation to be performed in any country after which the patient had a long survival. The important and pioneering contribution made by Durante to the history of neurosurgery is testified by his Treaty on Pathology and Surgical Therapy. Durante's procedure for craniotomy remained the best for several years. His contributions are still valid in medicine today, within not only the neurosurgical community but also other surgical disciplines, because he also developed innovative practices in the fields of oncology, general surgery, and orthopedics in addition to designing special surgical instruments

Esposizione a inquinanti chimici presenti negli ambienti di vita e di lavoro e fertilità umana maschile

In Italia si stima che al 50% di infertilità di coppia è attribuibile a problemi maschili. La fertilità maschile può essere influenzata negativamente da infezioni sessualmente trasmesse, vari tipi di patologie e diversi fattori quali obesità o eccessiva magrezza, sedentarietà o eccessiva attività fisica, abitudine al fumo ed esposizione a inquinanti chimici negli ambienti di vita e di lavoro. Per quanto riguarda quest’ultimo fattore di rischio, negli ultimi anni diversi studi sono stati condotti mediante l’approccio di biomonitoraggio umano. L’obiettivo della revisione è stato valutare l’associazione tra esposizione a inquinanti ambientali e peggioramento della qualità del liquido seminale come indicatore di infertilità maschile, analizzando gli studi che avevano utilizzato il biomonitoraggio

The curfew bell and the COVID-19 pandemic: A historical–medical perspective based on the Italian case

The present communication examines the phenomenon of curfew in relation to the COVID-19 pandemic with special attention being laid on the management of the epidemic by Italian health authorities. A literature review and a historical–medical analysis were performed. A historical–medical excursus on the word curfew is offered and a comparison between military and health scenarios is given. Finally, this article stresses how words connected with wartime events should be contextualized when adopted in unmilitary scenarios such as pandemic emergencies and related public health responses

The role of congenital malformations of the thoracic outlet in the development of the syndrome

Thoracic Outlet Syndrome (TOS) represents a clinical condition caused by compression of the neurovascular structures that cross the thoracic outlet. TOS can be classified in: 1) NTOS (neurogenic TOS), 2) VTOS (venous TOS), 3) ATOS (arterial TOS). Many different causes can determine the Syndrome: Congenital Malformations, Traumas, and Functional Impairments. This manuscript reviews how the congenital malformations play an important role in adult age; however, TOS also affects patients of all ages. Radiological imaging like RX (radiography), MR (Magnetic Resonance) and CT (Computed Tomography) can provide useful information to assess TOS causes and decide a potential surgery.79% of the patientsincluded in the first two stages of NAV staging experienced excellent results with FKT; whereas patients included in the third and fourth stage of NAV staging were subject to surgery.The treatment of acute forms of TOS involves thrombolysis and anticoagulant therapy; surgery is appropriate for true neurogenic TOS, vascular TOS and in some cases when conservative treatment fails

The role of congenital malformations of the thoracic outlet in the development of the syndrome

Background: Thoracic outlet syndrome (TOS) represents a clinical condition caused by compression of the neurovascular structures that cross the thoracic outlet. TOS can be classified in: 1) neurogenic TOS (NTOS), 2) venous TOS (VTOS), 3) arterial TOS (ATOS). Many different causes can determine the syndrome: congenital malformations, traumas, and functional impairments.Materials and methods: This manuscript reviews how the congenital malformations play an important role in adult age; however, TOS also affects patients of all ages.Results: Radiological imaging like X-ray (radiography), magnetic resonance and computed tomography can provide useful information to assess TOS causes and decide a potential surgery. 79% of the patients included in the first two stages of nerve, artery, vein (NAV) staging experienced excellent results with kinesiotherapy; whereas patients included in the third and fourth stage of NAV staging were subject to surgery.Conclusions: The treatment of acute forms of TOS involves thrombolysis and anticoagulant therapy; surgery is appropriate for true NTOS, vascular TOS and in some cases when conservative treatment fails

Growth factors, their receptor expression and markers for proliferation of endothelial and neoplastic cells in human osteosarcoma.

Osteosarcoma is the most common primary malignant tumour of the bone. Although new therapies continue to be reported, osteosarcoma-related morbidity and mortality remain high. Modern medicine has greatly increased knowledge of the physiopathology of this neoplasm. Novel targets for drug development may be identified through an understanding of the normal molecular processes that are deeply modified in pathological conditions. The aim of the present study is to investigate, by immunohistochemistry, the localisation of different growth factors and of the proliferative marker Ki-67 in order to determine whether these factors are involved in the transformation of osteogenic cells and in the development of human osteosarcoma. We observed a general positivity for NGF - TrKA - NT3 - TrKC - VEGF in the cytoplasm of neoplastic cells and a strong expression for NT4 in the nuclear compartment. TGF-beta was strongly expressed in the extracellular matrix and vascular endothelium. BDNF and TrKB showed a strong immunolabeling in the extracellular matrix. Ki-67/MIB-1 was moderately expressed in the nucleus of neoplastic cells. We believe that these growth factors may be considered potential therapeutic targets in the treatment of osteosarcoma, although proof of this hypothesis requires further investigation

Growth factors, their receptor expression and markers for proliferation of endothelial and neoplastic cells in human osteosarcoma.

Osteosarcoma is the most common primary malignant tumour of the bone. Although new therapies continue to be reported, osteosarcoma-related morbidity and mortality remain high. Modern medicine has greatly increased knowledge of the physiopathology of this neoplasm. Novel targets for drug development may be identified through an understanding of the normal molecular processes that are deeply modified in pathological conditions. The aim of the present study is to investigate, by immunohistochemistry, the localisation of different growth factors and of the proliferative marker Ki-67 in order to determine whether these factors are involved in the transformation of osteogenic cells and in the development of human osteosarcoma. We observed a general positivity for NGF TrKA NT3 TrKC - VEGF in the cytoplasm of neoplastic cells and a strong expression for NT4 in the nuclear compartment. TGF-beta was strongly expressed in the extracellular matrix and vascular endothelium. BDNF and TrKB showed a strong immunolabeling in the extracellular matrix. Ki-67/MIB-1 was moderately expressed in the nucleus of neoplastic cells. We believe that these growth factors may be considered potential therapeutic targets in the treatment of osteosarcoma, although proof of this hypothesis requires further investigation

Single‐breath counting test predicts non‐invasive respiratory support requirements in patients with covid‐19 pneumonia

The use of non‐invasive respiratory strategies (NIRS) is crucial to improve oxygenation in COVID‐19 patients with hypoxemia refractory to conventional oxygen therapy. However, the absence of respiratory symptoms may delay the start of NIRS. The aim of this study was to determine whether a simple bedside test such as single‐breath counting test (SBCT) can predict the need for NIRS in the 24 h following the access to Emergency Department (ED). We performed a prospective observational study on 120 patients with COVID‐19 pneumonia. ROC curves were used to analyze factors which might predict NIRS requirement. We found that 36% of patients had normal respiratory rate and did not experience dyspnea at rest. 65% of study population required NIRS in the 24 h following the access to ED. NIRS‐requiring group presented lower PaO2/FiO2 (235.09 vs. 299.02), SpO2/FiO2 ratio (357.83 vs. 431.07), PaCO2 (35.12 vs. 40.08), and SBCT (24.46 vs. 30.36) and showed higher incidence of dyspnea at rest (57.7% vs. 28.6%). Furthermore, SBCT predicted NIRS requirement even in the subgroup of patients without respiratory symptoms (AUC = 0.882, cut‐off = 30). SBCT might be a valuable tool for bedside assessment of respiratory function in patients with COVID‐19 pneumonia and might be considered as an early clinical sign of impending respiratory deterioration