A Decisive Role of [18F] Fdg PET/CT for Diagnosis of Neoplastic Vascular Thrombosis: Report of A Case

The combined use of PET scan with CT and fluorodeoxyglucose ([18F]FDG) can modify, in selected oncologic patients, the clinical management and care. We report here the case of a 63-year old female who showed increase serum level of CEA 3 years following left colectomy for cancer. Ultrasound and CT (computed tomography) of the abdomen showed a single lesion in the segment II of the liver with portal thrombosis. [18F] FDG PET/CT revealed two lesions (the first area was histologically proven to be a colorectal carcinoma metastasis, the second one corresponded to the portal thrombosis). No antithrombotic drugs were administered and patient underwent chemotherapy for 4 courses (eloxatin plus 5-fluorouracil anf leucovorin). Liver resection was performed 2 weeks after the end of chemotherapy, and intraoperative ultrasound revealed a normal portal flow

Mariticide in Milan between 1990 and 2017 : a criminological and medico-legal analysis

Most murder victims in a romantic relationship are women but sometimes they will kill their husbands or partners (mariticide). This paper focuses on these rarer cases using a sample taken from the autopsy reports of the Department of Legal Medicine of the University of Milan whose territory includes the municipality of Milan and part of the province of Milan and Monza \u2013 approximately four million inhabitants

The pathological diagnosis of the height of fatal falls: A mathematical approach

The authors analyzed the injury pattern of 385 victims of fall from a height which underwent a complete autopsy, with the objective to investigate whether it was possible to construct a mathematical model to be used for height of the fall diagnosis. The cases were selected and enrolled according to a balanced stratification of the heights of the fall, allowing a subdivision into seven classes consisting of 55 subjects each: 6 m or less, 9 m, 12 m, 15 m, 18 m, 21 m, 24 m or more (maximum 36 m). For each case anthropologic and necroscopic data was collected and analysed to obtain a standardized description of the injury pattern was obtained, dividing the body into 4 major anatomical areas (Head, Thorax, Abdomen, Skeleton), each of them further divided in 5 major organs. Every organ was finally divided into 5 objective degrees of injury. Statistical analysis was performed on all the available data using IBM SPSS Statistics 20, to test the performance of the \u201cinjury pattern assessment table\u201d in the diagnosis of the height of the fall and to develop a related mathematical model. Our findings confirm that the height of the fall is significantly associated with age, weight of the body and the injury pattern. An Injury Pattern Assessment Table and two mathematical models which correlates the height of the fall with analyzed variables are presented

The expert and the foreigner: Reflections of forensic transcultural psychopathology on a total of 86 reports by experts on criminal liability

In recent times Italy has been experiencing massive migration flows, therefore the attention on the issue of crimes committed by foreigners is increasing. But within trials, in the evaluation of criminal liability of foreigners, how do experts deal with them? Do the performed evaluations take cultural diversity into account? The present study took origin from these questions and examined a total of 86 reports by experts on criminal liability of foreign persons (16 females and 70 males). Examinees have been declared indictable in 31 cases (36%), totally mentally ill in 40 cases (45%) and with diminished liability in 15 cases (17%); when liability was excluded, examinees were diagnosed in 11 cases with mood disorders, in 23 cases with personality disorders, in 4 cases with adaptation disorders and post-traumatic stress disorder and in 10 cases with different diagnoses (in some cases more than one diagnosis was present). None of the reports used the section of the DSM concerning \u201ccultural framing\u201d. Tests were used in 48 surveys (56% of cases), with more tests for each examinee, for a total of 39 Rorschach, 14 Raven test, 8 Minnesota Multiphasic Personality Inventory - MMPI - 4 Wechsler Adult Intelligence Scale - WAIS - level test, 8 Thematic Apperception test. When subjects were diagnosed with mental disorder and with diminished liability, 42 (79%) were also socially dangerous. Results highlight the importance of the relationship between the expert and the foreigner. Many factors ought to be critically considered by experts dealing with foreigners, like cultural awareness, knowledge of verbal communication, critical consideration of meanings and diagnosis, knowledge of the foreigners' personal story, presence of tests with inexact information and cultural fallacy

BREEDING PERFORMANCE IN RELATION TO NEST-SITE SUBSTRATUM IN A BUFF-NECKED IBIS (THHWTICUS CA UDATUS) POPULATION IN PATAGONIA'

Abstract. In northern Argentinean Patagonia, Buff-necked Ibis (Theristicus caudatus) nest on different substrata: cliffs, trees, and marsh vegetation. According to the ideal-free distribution hypothesis, this polymorphism may be due to the occupation ofthe best breeding habitats by dominant individuals and the relegation of the subdominant birds to marginal substrata with a lower probability of achieving successful breeding. We investigated whether there were any variations in the breeding performance among colonies and whether these variations were related to the breeding substratum. Laying date varied from the third week of September to the last week of October, laying occurring earlier in colonies at lower elevations. Clutch size per colony varied between 1.8 and 2.0 (X 1.9, n = 106), but significant differences were not detected among colonies. Brood size per colony varied significantly, ranging between 1.3 and 2.0 (52 = 1.8, n = 164). The substratum of breeding did not influence variations in any of these three parameters. The physical condition of the chicks did not vary among substrata, but there was inter-colony variation in broods of two chicks. Daily rates of nest losses were similar among colonies reaching 6.2% (n = 856) during incubation and 1.4% (n = 966) during the nestling period. Brood reduction was low; the daily mortality rate of chicks (0.7%, n = 934) did not vary among colonies. The most common known cause of nest and chick losses was predation. These results indicate that breeding success varied only slightly from one colony to the other and that these variations are independent of the nesting substratum. In consequence, birds would not prefer one substratum over another

Intensified ChlVPP/ABVVP chemotherapy regimen and pegfilgrastim support in advanced Hodgkin lymphoma

We present feasibility, toxicity and efficacy results of an intensified six-cycle ChlVPP/ABVVP regimen in advanced Hodgkin lymphoma (HL). From February 2004 to August 2007, 82 consecutive eligible patients were enrolled. According to the Hasenclever index, 64 patients (78%) were considered at low risk, 15 (18%) at intermediate and 3 (4%) at high risk. The most relevant toxicity was haematological: grade 3–4 neutropenia occurred in 32% of patients, grade 3–4 anaemia in 26% of patients. Severe infections and febrile neutropenia were observed in 8% of patients. With a median follow-up of 35 months (range 12–55), the three-year freedom from treatment failure (FFTF) and overall survival (OS) were 75% (95% CI 65%–86%) and 94% (95% CI 87%–99%), respectively. The intensified ChlVPP/ABVVP regimen in advanced HL is effective, does not seem to differ from standard regimens in terms of FFTF and OS and showed a favourable toxicity profile

Diseño de un programa de seguimiento de poblaciones de cánidos silvestres en ambientes esteparios de la Patagonia, Argentina

Wildlife management decisions should be based on solid baseline information, with monitoring populations as a necessary activity whenever the management objective is maintaining abundance at a previously stated level. Developing a monitoring program requires careful experimental and statistical considerations in order to get confidence about its capability in detecting predefined trends. Our objective was to develop a monitoring program for two canid species (the Grey Fox Pseudalopex griseus and the Culpeo Fox P. culpaeus), based on visitation indices to bait stations. Using MONITOR software we estimated the sampling effort necessary to detect a 50% decrease in their populations during the next 5 years (annual rate of –12,94%) and during the next 10 years (annual rate of –6,70%), with a minimum power of 80%. We assume that the environmental cost of making a Type II error (failing to detect a real population trend) is greater than that of making a Type I error (sounding a false alarm) and used three alpha levels 0.05, 0.10 and 0.15. We also tested an increasing sampling effort (number of bait stations lines), and activating them during one, two and up to three times in a single year. We fed the MONITOR program with the mean visitation index to the 20 transects activated on several occasions during the previous year in the study area. In order to detect a 50% decrease over the next 5 years, any monitoring program should be based on at least two annual replicates of the bait stations. A monitoring program accessible to the protected area manpower and financial resources and considering the conservation status of the target species would be one developed to detect a 50% decrease over the next 10 years, activating 16 lines once a year, during two or three consecutive nights and an alpha of 0.10. We also discuss alternatives to use only the first nigh of visit in order to assimilate bait stations to scent stations and make these results comparable with other studiesin Patagonia, Argentina. Monitoring programs like the one presented here would be valuable to help managers when deciding about harvest quotas for the fur trade, or anticipating conflicts and solutions with sheep rangers by detecting increasing trends in Culpeo populations. La gestión de la fauna silvestre debe basarse en sólida información de base. Ello incluye el seguimiento de poblaciones para ayudar a mantenerlas en tamaños próximos a aquellos previamente fijados. El desarrollo de programas de seguimiento requiere de una considerable planificación y evaluación estadística antes de su implementación. El objetivo de nuestro trabajo fue desarrollar un programa de seguimiento para dos especies de cánidos silvestres en Patagonia: el zorro colorado (Pseudalopex culpaeus) y el zorro gris (P. griseus). Tratamos de averiguar, utilizando el programa MONITOR, cual debería ser el esfuerzo de muestreo anual para detectar una disminución del 50% de la población actual en los próximos 5 años (esto es una tasa anual de –12,94%), o en los próximos 10 años (una tasa anual de –6.70%), satisfaciendo una potencia mínima del 80%. El trabajo de campo se realizó en el área protegida “Monumento Natural Bosques Petrificados”, Provincia de Santa Cruz, Argentina. Como estimador de la abundancia de los zorros se utilizaron las visitas a líneas de estaciones de cebado. El costo ambiental de cometer un error de Tipo II es mayor que el de cometer uno de Tipo I, por lo que utilizamosalternativamente tres niveles de α: 0.05, 0.10 y 0.15. Probamos también un esfuerzo de muestreo (número de líneas de estaciones de cebado) creciente, activándolas una, dos y hasta tres veces por año. Como valores iniciales para alimentar el programa MONITOR utilizamos la media y desviación estándar del índice de visita a cada una de las 20 líneas que se instalaron en el área de estudio. Para detectar una disminución del 50% en cinco años cualquier programa de seguimiento poblacional deberá basarse al menos en dos repeticiones anuales de las estaciones de cebado. Un programa de seguimiento accesible a las disponibilidades del área protegida sería aquel diseñado para detectar una disminución del 50% en diez años (-6.7% anual), con un α de 0.10 y un esfuerzo de 16 líneas, activadas una vez por año y revisadas durante dos o tres noches consecutivas. Se proponen alternativas para utilizar solo la primer noche de muestreo, de forma que los resultados sean luego comparables con los de experiencias de estaciones de olor en otras regiones de la Patagonia. La puesta en marcha de programas como el aquí presentado servirán para la toma de decisiones a organizaciones encargadas de la gestión de la fauna silvestre, autorizando o prohibiendo extracciones destinadas al mercado peletero. Servirían también para conocer a tiempo incrementos poblacionales, permitiendo así tomar medidas preventivas tendentes a disminuir conflictos con la actividad ganadera.&nbsp

Does a 6-point scale approach to post-treatment 18F-FDG PET-CT allow to improve response assessment in head and neck squamous cell carcinoma? A multicenter study

Abstract Purpose Response assessment to definitive non-surgical treatment for head and neck squamous cell carcinoma (HNSCC) is centered on the role of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET-CT) 12 weeks after treatment. The 5-point Hopkins score is the only qualitative system available for standardized reporting, albeit limited by suboptimal positive predictive value (PPV). The aim of our study was to explore the feasibility and assess the diagnostic accuracy of an experimental 6-point scale ("Cuneo score"). Methods We performed a retrospective, multicenter study on HNSCC patients who received a curatively-intended, radiation-based treatment. A centralized, independent qualitative evaluation of post-treatment FDG-PET/CT scans was undertaken by 3 experienced nuclear medicine physicians who were blinded to patients' information, clinical data, and all other imaging examinations. Response to treatment was evaluated according to Hopkins, Cuneo, and Deauville criteria. The primary endpoint of the study was to evaluate the PPV of Cuneo score in assessing locoregional control (LRC). We also correlated semi-quantitative metabolic factors as included in PERCIST and EORTC criteria with disease outcome. Results Out of a total sample of 350 patients from 11 centers, 119 subjects (oropharynx, 57.1%; HPV negative, 73.1%) had baseline and post-treatment FDG-PET/CT scans fully compliant with EANM 1.0 guidelines and were therefore included in our analysis. At a median follow-up of 42 months (range 5-98), the median locoregional control was 35 months (95% CI, 32-43), with a 74.5% 3-year rate. Cuneo score had the highest diagnostic accuracy (76.5%), with a positive predictive value for primary tumor (Tref), nodal disease (Nref), and composite TNref of 42.9%, 100%, and 50%, respectively. A Cuneo score of 5-6 (indicative of residual disease) was associated with poor overall survival at multivariate analysis (HR 6.0; 95% CI, 1.88-19.18; p = 0.002). In addition, nodal progressive disease according to PERCIST criteria was associated with worse LRC (OR for LR failure, 5.65; 95% CI, 1.26-25.46; p = 0.024) and overall survival (OR for death, 4.81; 1.07-21.53; p = 0.04). Conclusions In the frame of a strictly blinded methodology for response assessment, the feasibility of Cuneo score was preliminarily validated. Prospective investigations are warranted to further evaluate its reproducibility and diagnostic accuracy