Skip metastases to lateral cervical lymph nodes in differentiated thyroid cancer: A systematic review

Papillary thyroid carcinoma is a slow-growing cancer with a generally good prognosis that sometimes have an aggressive behaviour. Metastases to neck lymph nodes is the first step of the diffusion. The central neck compartment is involved most commonly. The ipsilateral lateral neck compartments are usually involved afterwards, and the involvement of the contralateral one is considered a quite rare occurrence. In more rare cases, metastases to lateral neck compartment without central lymph node metastasis (so called skip metastases) could be observed. Aim of this literature review study is to analyse the average incidence, pattern and risk factors of this occurrence.This study was performed according to PRISMA criteria. A final selection of 13 articles published in English language from 1997 to 2017 was performed. Any research article, review or meta-analysis was taken into consideration. Research was expanded considering the related references of articles.The incidence of skip metastases ranged from 1.6 to 21.8%. Risk factors such as age>45years, size <5mm and tumor located in the upper pole or isthmus of thyroid gland were found.Due to the frequency of skip metastases in thyroid cancer, a careful preoperative examination of lateral lymph nodes should be necessary

The italian quaternary volcanism

The peninsular and insular Italy are punctuated by Quaternary volcanoes and their rocks constitute an important aliquot of the Italian Quaternary sedimentary successions. Also away from volcanoes themselves, volcanic ash layers are a common and frequent feature of the Quaternary records, which provide us with potential relevant stratigraphic and chronological markers at service of a wide array of the Quaternary science issues. In this paper, a broad representation of the Italian volcano logical community has joined to provide an updated comprehensive state of art of the Italian Quaternary volcanism. The eruptive history, style and dynamics and, in some cases, the hazard assessment of about thirty Quaternary volcanoes, from the north ernmost Mt. Amiata, in Tuscany, to the southernmost Pantelleria and Linosa, in Sicily Channel, are here reviewed in the light of the substantial improving of the methodological approaches and the overall knowledge achieved in the last decades in the vol canological field study. We hope that the present review can represent a useful and agile document summarising the knowledege on the Italian volcanism at the service of the Quaternary community operating in central Mediterranean area

Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) for Unresectable Peritoneal Metastases. Feasibility, Safety and Efficacy Outcomes

Recently, a novel method for chemotherapy administration inside the abdominal cavity gained wide attention among surgical oncologists dealing with peritoneal surface malignancies. Based on laparoscopy, Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a drug delivery system designed to overcome the known hurdles of intraperitoneal chemotherapy. Preclinical data suggest that the aerosol drug that PIPAC creates and the increased intraabdominal pressure obtained during laparoscopy provide highly effective distribution of cytotoxic compounds into tumor nodules. Several studies have documented the favorable safety profile and promising clinical outcomes of repetitive PIPAC in different types of peritoneal malignancies. The present research assessed the feasibility, safety, and antitumor activity of current PIPAC drug treatment schedules through a systematic review of the literature and two retrospective cohort studies on gastric cancer and pancreatic or biliary tract cancer. In addition, it includes the study protocol of the first phase II trial exploring nabpaclitaxel PIPAC in combination with gemcitabine/nabpaclitaxel systemic chemotherapy. The systematic review of the literature of 668 patients showed an overall pathological response rate of 44% and a severe adverse events rate of 10%. In the single-center cohort of 28 consecutive patients affected by gastric cancer peritoneal metastases undergoing cisplatin/doxorubicin PIPAC and systemic chemotherapy, the pathological response rate, in the Intention-to Treat population, was 29%, with a 7% rate of severe adverse events and 1.7 PIPAC procedures per patient. In the 20 patients cohort of pancreatic and biliary tract cancer PM undergoing oxaliplatin or cisplatin/doxorubicin PIPAC, the pathological response rate was 42% and 62%, respectively. Concerning safety, there was just one intraoperative bowel perforation and no severe postoperative adverse events. PIPAC was feasible and safe, with the pathological response observed suggesting a high antitumoral activity. Despite such encouraging outcomes, the present research, as well as most of the literature, is affected by several biases and the resulting evidence is controversial. More phase I and II trials might be necessary to fill this knowledge gap

Sistemi di Welfare in Europa: trend in atto e sfide per l\u2019Italia

N/

Sistemi di welfare in Europa: trend in atto e sfide per l'Italia

Il saggio confronta i sistemi di welfare complessivi di Francia, Germania, Regno Unito e Italia, indagando i livelli di spesa per abitante complessivi e per singolo comparto. Emerge una forte differenziale di investimento assoluto nella protezione sociale, ma soprattutto allocazione tra comparti profondamente diversi. I tassi di copertura dei bisogni sono superiori nei sistemi di welfare più poveri, denunciando livelli di intensità assistenziale per caso trattato molto più modesti

Hypercalciuria and Nephrocalcinosis as Early Feature of Wilson Disease Onset: Description of a Pediatric Case and Literature Review

BACKGROUND: Wilson’s disease (WD) is a rare autosomal-recessive disorder characterized by a mutation in the ATP7B gene, located on chromosome 13, which encodes a protein involved in the metabolism of copper. CASE PRESENTATION: We described the case of an Indian male with a history of polydipsia and polyuria, related to hypercalciuria and consequent nephrocalcinosis. The symptoms began at the age of five years old, but he was not diagnosed with WD until he reached an adolescent age. We started therapy with D-Penicillamine, B-vitamin complex and recommended a low copper diet. Renal involvement in Wilson’s disease, characterizing by hypercalciuria, was firstly reported by Litin in 1959. CONCLUSION: Our case was different and peculiar from the previously described cases because the patient presented a very long history (10 years) of permanent hypercalciuria without any acute episode of nephrolithiasis

Hypercalciuria and nephrocalcinosis as early feature of Wilson disease onset: Description of a pediatric case and literature review

BACKGROUND: Wilson’s disease (WD) is a rare autosomal-recessive disorder characterized by a mutation in the ATP7B gene, located on chromosome 13, which encodes a protein involved in the metabolism of copper. CASE PRESENTATION: We described the case of an Indian male with a history of polydipsia and polyuria, related to hypercalciuria and consequent nephrocalcinosis. The symptoms began at the age of five years old, but he was not diagnosed with WD until he reached an adolescent age. We started therapy with D-Penicillamine, B-vitamin complex and recommended a low copper diet. Renal involvement in Wilson’s disease, characterizing by hypercalciuria, was firstly reported by Litin in 1959. CONCLUSION: Our case was different and peculiar from the previously described cases because the patient presented a very long history (10 years) of permanent hypercalciuria without any acute episode of nephrolithiasis

Sistemi sociali e sociosanitari a confronto: convergenze e divergenze tra i modelli regionali di Emilia-Romagna e Lombardia

n/