ACTH-secreting neuroendocrine pancreatic tumor: a case report.

AbstractIntroductionIncidence of neuroendocrine tumor (NET) is increased in the last thirty years from 1.1 to 5.2 cases per 100,000 people in the United States. They can originate from the pancreatic gland and for the majority of cases are not functioning (80%). A small percentage of functioning may produce adrenocorticotropic hormone (ACTH) and lead to ectopic ACTH Syndrome (EAS), responsible of Cushing-Syndrome.ResultsWe present a case of a 30 year-old woman suffering from EAS due to a neoformation of the pancreatic tail of the maximum diameter of 4 cm. The lesion was resectable at preoperatory imaging. The patient was subjected to distal splenopancreasectomy. Histological examination showed a well-differentiated neuroendocrine carcinoma pT3N0. The postoperative course was regular. At two years of follow-up patient is almost completely asymptomatic for Cushing's but she has developed multiple liver metastases, for which she began chemotherapy.Discussionp-NET responsible for EAS is usually malignant and the radical treatment of excision of the lesion is not possible because they occur at the time of diagnosis with liver metastases or unresectable. Our patient had a mass at the time of diagnosis resectable but despite radical surgery, she has developed multiple liver metastases at two years and she was undergoing chemotherapy.ConclusionsIn agreement with previous literature we confirm the aggressive nature of pancreatic tumors secreting ACTH, despite radical surgery. Conversely, surgical treatment is effective on the resolution of clinical symptoms

ASPERGILOSIS DISEMINADA CON IMPORTANTE AFECTACION CUTANEA

La Aspergilosis es una infección micótica oportunista que afecta principalmente a pacientes inmunodeprimidos con neutropenia, en quienes produce a menudo enfermedad invasiva de curso fulminante. Las manifestaciones cutáneas de la Aspergilosis son infrecuentes, apareciendo en el 5 a 10% de los casos diseminados.Comunicamos un caso de Aspergilosis en una mujer adulta con neutropenia severa por enfermedad hematológica, con afectación pulmonar y sinusal, que presenta múltiples lesiones ulceronecróticas en piel y mucosas, con evolución fatal.Las lesiones mucocutáneas de la Aspergilosis no son específicas, obligan a varios diagnósticos diferenciales y, como en este caso, la biopsia para estudio histopatológico y micológico es necesaria para el diagnóstico

Leishmaniasis Cutánea Atípica por L. Infantum (Chagasi)

Las leishmaniasis son infecciones crónicas causadas por diversas especies de leishmanias, transmitidas de animales al humano por insectos flebotomineos hematófagos, con formas mucocutáneas y viscerales. En el Paraguay, las formas mucocutáneas están producidas preferentemente por L. braziliensis y las viscerales por L. infantum (chagasi). Comunicamos un caso de un adulto inmunocompetente con lesiones no ulceradas en la piel, sin evidencias de afectación visceral, que por la técnica de PCR se determina que son producidas por L. infantum

The integrated action framework of Rete Natura 2000 Basilicata

Basilicata Natura 2000 network consists of 50 Sites of Community Importance (SCI) and 17 Special Protection Zones (SPZs), covering alltogether more than 17% of the regional area. This network, partially overlapping other forms of land protection, represents a valuable environmental, agricultural and cultural heritage, in which the safeguard of natural resources and landscapes has to be coupled with the needs of the local population; especially in relation to development and social welfare. The Natura 2000 project involved a panel of experts belonging to 15 different institutions, to form a steering committee with the following professional and scientific skills: vegetation, landscape, fauna, geology, agriculture, forestry, sea, architecture and planning, territorial analysis and representation. Along the 4 years project, the steering committee designed and coordinated the activities of over 150 professionals, mostly from Basilicata, who carried out field surveys and data analysis aimed at assessing the environmental conditions in the SCI and SPZs, proposing measures and plans, implementing thematic databases. SCI/SPZ management plans, by themselves, may not be sufficient to fulfill the requirements of an effective environmental policy, which has to go along with the awareness of people, citizens and local administrators about the instances of a sustainable policy. For this reason, the activities of surveying and management have been coupled with a communication project that involves all the experts and a relevant part of professionals who participated to the Natura 2000 project. The communication activity implies the use and the creation of several tools (publishing, video, websites, meetings, photo contests, social networks ...) targeted to different groups: policy makers (local, regional, national, European ), organizations, citizens, schools, farmers, small and medium enterprises (www.natura2000basilicata.it). A further goal is to feature the environmental highlights of Basilicata which are linked to a specific and often surprising integration of an ancient human presence with the natural elements, and the role performed by the traditional farming activities in the maintenance of ecosystem dynamics and services (in particular with agriculture). In fact, a good number of Natura 2000 sites can be considered High Nature Value Farmlands (HNVF, sensu E. Andersen, 2003), in which a virtuous relationship was established a long time ago between traditional practices and the environment itself. In this context, it combines the convergence between the activities carried on the Natura 2000 network and the project Agrival (http://utagri.enea.it/projects/agrival), a research project led by ENEA in Val d'Agri, in order to experimentally contribute to the methodology for the identification of the High Nature Value Farmlands and make them cohabit with the other economic activities in the local context. The process started with the project Basilicata Natura 2000 Network is therefore an interesting methodological model that, in coherence with the financial planning of the European Community for the period 2014-2020 (Brussels, 12.12.2011, COMM. 874) puts together projects on environmental issues to boost the meeting of agricultural, environmental, cultural and productive policies, fostered by the EC, and enhancing the implementation of the "Prioritized Actions Frameworks" (PAF), pointed out by the European Commission as the optimal tools for the management of Natura 2000 networks

Yield response to water and stress indexes on tomato.

Results of a research carried out in Gaudiano area in 1993 to study the influence of different irrigation regimes on some ecophysiological and yield characteristics of different cultivars of tornato ('Ponderosa' for long time storage; 'Brigade Hy' for processing; 'Pomored 1232 Hy' for fresh market;) are reported. Four irrigation regimes were compared: unirrigated control (U.C.) supplementary irrigation whenever the soil water potential dropped up to - 1.5 MPa (S.I.) and restoration of water volumes equal to 50% and 100% of crop maximum evapotranspiration (ETc). Soil water potential, leaf water potential and diffusive resistance of lower leaf surface were measured during the crop cycle; total and marketable yield were measured at the harvest. Dry matter accumulation and water use were also measured in order to evaluate the water use efficiency. Results show that tomato crop water status was strongly influenced by the water regime; diffusive resistance to gaseous exchange increased with water shortage, and stomata were almost fully closed during the most of unirrigated control crop cycle. As consequence of stomatal behaviour, dry matter accumulation was gradually reduced with the increase of water deficit; total biomass dry matter values ranged tram 935.7 to 267.5 gm-2, as average of the three cultivars, passing tram the most irrigated treatment to the unirrigated control. The highest marketable yield was obtained with a restoration of 100% of ETc with a value of 66.4 t ha-l, as average of the three cultivars, while only 6.21 t ha-1 were obtained in the unirrigated control. However yield water use efficiency (YWUE) exhibited in average, higher values in the treatment with a restoration of 50% of ETc (1.09 kg m-3) Slight differences were observed among the three cultivars in the leaf water potential trend. The 'Ponderosa' diffusive resistance resulted lower than 'Brigade' and 'Pomored' only under water stress conditions, giving a better performance of this cultivar in water limiting situations

Water use, water use efficiency and yield response of "Long Time Storage" tomato (Lycopersicon esculentum Mill.)

In 1992-1993 'Ponderosa', 'Fiaschetto' and 'Appendere d'inverno', tornato cultivars for "long rime storage", were grown at an experimental farm, 'Gaudiano' (41°03'N, 15°42'E, Southern Italy), under four irrigation regimes: unirrigated control and restoration of maximum crop evapotranspiration (100 % of ETc) in both years: 66 and 33 % of ETc in the first year only: 50% of ETc and supplementary irrigation (whenever the soil water potential dropped below -1.5. MPa) in the second year. In 1992 marketable fruits ranged from 28 t ha-1, as average without irrigation and with restoration of 33 % of ETc, to 42 t ha-l when restoration of 66 and 100 % of ETc were applied, without difference among the three cultivars. Dry matter content of fruits ranged from 8.5% in the unirrigated control to 7.2% as an average of all irrigated treatments. In the second trial (1993), unirrigated control yielded 13 t h-1, an increase of 178 - 309 and 100% was recorded when 50 - 100% of ETc and supplementary irrigation were applied. Among cultivars, 'Fiaschetto' was the most productive in the irrigation regime, with restoration of 50% of ETc and with supplementary irrigation; ‘Appendere d'inverno' yieIded more in the best watered treatment. 'Ponderosa' showed higher soluble solids content. The highest yield was recorded in the most irrigated treatment, however the restoration of 50% of ETc was the most efficient in water use