8 research outputs found
Gastric leiomyosarcoma: case report and review of literature
True smooth muscle neoplasms of the wall of digestive tract are rare, in particular in the stomach, and the benign ones are prevalent. We report a case of gastric leiomyosarcoma (LMS) that we observed, diagnosed to a 71 years-old man, with important comorbidities, who had already underwent the amputation of the right lower limb. In consequence of the discovery of anaemia and melaena he underwent an endoscopy of the upper GI tract and CT scan, which showed the presence of a neoformation of the gastric wall, but because of the thrombosis of the common iliac artery and the occurrence of the clinical picture of critical ischaemia, at first the patient underwent the amputation of the left lower limb e only then an intervention of atypical gastroresection. Despite the neoplastic infiltration of the resection margins and the impossibility to undertake an adjuvant chemotherapy, the follow-up at 6, 12 and 28 months did not show a recurrence of the disease that remained in phase of clinical remission
A complex case of fatal calciphylaxis in a female patient with hyperparathyroidism secondary to end stage renal disease of graft and coexistence of haemolytic uremic syndrome
Background. Calciphylaxis is a potentially fatal complication of persistent secondary hyperparathyroidism; its cause is still not clear. Unfortunately there is no close relation in severity of clinical picture, serological and pathological alteration. For this reason the prognosis is difficult to establish. Administration of sodium thiosulphate may reduce the precipitation of calcium crystals and improve the general clinical conditions before surgical parathyroidectomy, which seems the only therapeutic approach able to reduce the mortality risk in these patients. Methods and Results. A 60 year old female patient suffering from End Renal Stage Disease, on haemodialysis from 2001 due to the onset of haemolytic uremic syndrome, underwent a kidney transplant in April 2008. After transplantation there was a recurrence of the haemolytic uremic syndrome, with temporary worsening of the graft. Six months later there was a definite loss of graft and return to dialysis treatment. On April 2010 a severe systemic calciphylaxis related to secondary hyperparathyroidism was diagnosed. The patient underwent parathyroidectomy but, because of the unimproved clinical picture, treatment with sodium thiosulphate was initiated. There was only improvement in cutaneous lesions. The worsening general clinical condition of the patient caused death due to general septic complications. Conclusions. The coexistence of haemolytic uremic syndrome and secondary hyperpathyroidism makes the prognosis poor and, in this case, therapy, which counteracts calcium crystals precipitation, has no effect. Preventive parathyroidectomy can be considered as the only possible treatment
Explosive Paroxysmal Events at Etna Volcano of Different Magnitude and Intensity Explored through a Multidisciplinary Monitoring System
Between 13 December 2020 and 21 February 2022, Etna volcano produced a sequence of 66 paroxysmal explosive eruptions, with Strombolian activity at the summit craters climaxing in lava fountains and eruption columns extending several kilometers above the craters, accompanied by minor and short-lasting lava flows from the crater rim. We selected three of these episodes that occurred within a short space of time, between 13 December 2020 and 12 March 2021, of different magnitude (i.e., erupted volume) and intensity (i.e., mass eruption rate or instantaneous eruption rate), and analyzed them from a multidisciplinary perspective. The aim was to gain insights into those parameters that mostly reveal the eruptive process for hazard assessment purposes. The multidisciplinary data consist of calibrated visible images, thermal images, seismic and infrasound data, ground deformation detected from the strainmeters, as well as satellite SEVIRI images. From these data, we obtained the timing of each paroxysmal event, the erupted volume in terms of tephra and lava flows, and the corresponding deflation of the source region, together with the development of the lava fountains and eruption columns with time. The results enabled determining that the smallest episode was that of 13 December 2020, which comprised three distinctive pulses but did not produce an eruptive column detectable from either monitoring cameras or satellites. The 28 February 2021 episode was remarkable for the short amount of time required to reach the climax, and was the most intense, whereas the 12 March 2021 event showed the longest duration but with an intensity between that of the previous two. Our results show that these three paroxysmal events display a typical trend, with the first event also being the smallest in terms of both erupted volume and intensity, the second being the most intense, and the third the one of greatest magnitude but less intense than the second. This is coherent with the end of the first paroxysmal phase on 1 April 2021, which was followed by 48 days of eruptive pause before starting again. In this context, the end of the paroxysmal phase was anticipated by a more effusive episode, thus heralding a temporary decline in the gas content within the feeding magma batch
Explosive Paroxysmal Events at Etna Volcano of Different Magnitude and Intensity Explored through a Multidisciplinary Monitoring System
Between 13 December 2020 and 21 February 2022, Etna volcano produced a sequence of 66 paroxysmal explosive eruptions, with Strombolian activity at the summit craters climaxing in lava fountains and eruption columns extending several kilometers above the craters, accompanied by minor and short-lasting lava flows from the crater rim. We selected three of these episodes that occurred within a short space of time, between 13 December 2020 and 12 March 2021, of different magnitude (i.e., erupted volume) and intensity (i.e., mass eruption rate or instantaneous eruption rate), and analyzed them from a multidisciplinary perspective. The aim was to gain insights into those parameters that mostly reveal the eruptive process for hazard assessment purposes. The multidisciplinary data consist of calibrated visible images, thermal images, seismic and infrasound data, ground deformation detected from the strainmeters, as well as satellite SEVIRI images. From these data, we obtained the timing of each paroxysmal event, the erupted volume in terms of tephra and lava flows, and the corresponding deflation of the source region, together with the development of the lava fountains and eruption columns with time. The results enabled determining that the smallest episode was that of 13 December 2020, which comprised three distinctive pulses but did not produce an eruptive column detectable from either monitoring cameras or satellites. The 28 February 2021 episode was remarkable for the short amount of time required to reach the climax, and was the most intense, whereas the 12 March 2021 event showed the longest duration but with an intensity between that of the previous two. Our results show that these three paroxysmal events display a typical trend, with the first event also being the smallest in terms of both erupted volume and intensity, the second being the most intense, and the third the one of greatest magnitude but less intense than the second. This is coherent with the end of the first paroxysmal phase on 1 April 2021, which was followed by 48 days of eruptive pause before starting again. In this context, the end of the paroxysmal phase was anticipated by a more effusive episode, thus heralding a temporary decline in the gas content within the feeding magma batch
Gastric Syphilis Presenting as a Nodal Inflammatory Pseudotumor Mimicking a Neoplasm: Don’t Forget the Treponema! Case Report and Scoping Review of the Literature of the Last 65 Years
Despite the fact that gastric syphilis is considered rare, it is reported as a type of organic involvement that is present in a large proportion of secondary syphilis cases, even though gastritis presenting with symptoms is extremely rare. Clinical, radiological, and endoscopic findings are non-specific and frequently mimic the symptoms of gastric adenocarcinoma or lymphoma, making diagnosis difficult. Immunostaining is required for this diagnosis. We would like to emphasize the importance of being suspicious of GS when a gastric mass exhibits the histologic features of an inflammatory pseudotumor (IPT), as previously reported for nodal IPT caused by luetic infection. We described a 56-year-old man who presented to the oncology department with a 3-month history of anorexia, epigastric pain, nausea, vomiting, and weight loss, as well as an initial radiological and endoscopic suspicion of gastric adenocarcinoma, in which immune staining allowed us to diagnose GS. In addition, we conducted an updated scoping review of the scientific literature to show the clinical, laboratory, and therapeutic findings in GS patients over the last 65 years
Complications of mechanical thrombectomy for acute ischemic stroke: Incidence, risk factors, and clinical relevance in the Italian Registry of Endovascular Treatment in acute stroke
There are limited data concerning procedure-related complications of endovascular thrombectomy for large vessel occlusion strokes
IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke
European Multicenter Study of ET-COVID-19
International audienceBackground and Purpose: Acute ischemic stroke and large vessel occlusion can be concurrent with the coronavirus disease 2019 (COVID-19) infection. Outcomes after mechanical thrombectomy (MT) for large vessel occlusion in patients with COVID-19 are substantially unknown. Our aim was to study early outcomes after MT in patients with COVID-19. Methods: Multicenter, European, cohort study involving 34 stroke centers in France, Italy, Spain, and Belgium. Data were collected between March 1, 2020 and May 5, 2020. Consecutive laboratory-confirmed COVID-19 cases with large vessel occlusion, who were treated with MT, were included. Primary investigated outcome: 30-day mortality. Secondary outcomes: early neurological improvement (National Institutes of Health Stroke Scale improvement ≥8 points or 24 hours National Institutes of Health Stroke Scale 0–1), successful reperfusion (modified Thrombolysis in Cerebral Infarction grade ≥2b), and symptomatic intracranial hemorrhage. Results: We evaluated 93 patients with COVID-19 with large vessel occlusion who underwent MT (median age, 71 years [interquartile range, 59–79]; 63 men [67.7%]). Median pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score were 17 (interquartile range, 11–21) and 8 (interquartile range, 7–9), respectively. Anterior circulation acute ischemic stroke represented 93.5% of cases. The rate modified Thrombolysis in Cerebral Infarction 2b to 3 was 79.6% (74 patients [95% CI, 71.3–87.8]). Thirty-day mortality was 29% (27 patients [95% CI, 20–39.4]). Early neurological improvement was 19.5% (17 patients [95% CI, 11.8–29.5]), and symptomatic intracranial hemorrhage was 5.4% (5 patients [95% CI, 1.7–12.1]). Patients who died at 30 days exhibited significantly lower lymphocyte count, higher levels of aspartate, and LDH (lactate dehydrogenase). After adjustment for age, initial National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT Score, and successful reperfusion, these biological markers remained associated with increased odds of 30-day mortality (adjusted odds ratio of 2.70 [95% CI, 1.21–5.98] per SD-log decrease in lymphocyte count, 2.66 [95% CI, 1.22–5.77] per SD-log increase in aspartate, and 4.30 [95% CI, 1.43–12.91] per SD-log increase in LDH). Conclusions: The 29% rate of 30-day mortality after MT among patients with COVID-19 is not negligible. Abnormalities of lymphocyte count, LDH and aspartate may depict a patient’s profiles with poorer outcomes after MT. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT04406090