Peritoneal Hydatidosis

Secondary peritoneal hydatidosis is caused by spontaneous or iatrogenic rupture of hepatic echinococcal cysts. We describe the case of a 65-year-old Tunisian male patient with previous history of liver hydatidosis who presented to our attention with subocclusive status. Imaging revealed a retrovesical hydatid cyst, adherent to the sigmoid colon. The treatment of choice was surgical removal of the cyst and the sigmoid colon. The patient is now being closely followed up

Radical Prostatectomy and Intraoperative Radiation Therapy in High-Risk Prostate Cancer

Intraoperative electron beam radiotherapy (IOERT) for prostate cancer (PC) is a radiotherapeutic technique, giving high doses of radiation during radical prostatectomy (RP). This paper presents the published treatment approaches for intraoperative radiotherapy analyzing functional outcome, morbidity, and oncological outcome in patients with clinical intermediate-high-risk prostate cancer. A systematic review of the literature was performed, searching PubMed and Web of Science. A “free text” protocol using the term intraoperative radiotherapy and prostate cancer was applied. Ten records were retrieved and analyzed including more than 150 prostate cancer patients treated with IOERT. IOERT represents a feasible technique with acceptable surgical time and minimal toxicity. A greater number of cases and longer follow-up time are needed in order to assess the long-term side effects and oncological outcome

Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes: insights from the optical coherence tomography (OCT)-FORMIDABLE registry

Aims Chronic pre-treatment with statins may reduce mortality and morbidity in patients experiencing acute coronary syndromes (ACS), but mechanisms accounting for these findings are not completely understood. Methods and results The optical coherence tomography (OCT)-Formidable registry retrospectively enrolled 285 consecutive patients with ACS undergoing OCT in 9 European centres. Mean age was 60.4 ± 12.8 years, 148 (51.9%) patients had hyperlipemia, 45 (15.8%) diabetes mellitus and 142 (49.8%) presented with ST Segment Elevation Myocardial Infarction (STEMI). Patients were stratified according to statin prescription: 150 (52.6%) were on chronic pre-treatment with statins before ACS and were more likely to present with non-ST segment elevation acute coronary syndromes (NSTE-ACS) at admission (111, 74%) rather than STEMI, while the opposite was observed for patients not on statins. The primary end-point of ruptured plaque at OCT occurred significantly less frequently in the patients on chronic pre-treatment with statins [odds ratio (OR) 0.375, 95% confidence interval (CI) 0.185-0.759, P = 0.006]. The secondary end-point of thin-cap fibro-atheroma (TCFA) at any site was significantly less frequent in the statin group (OR 0.423, 95%CI 0.213-0.840, P = 0.014). No differences were observed for the secondary end-point of not-ruptured TCFA as the culprit lesion. Pre-specified sensitivity analysis was conducted according to the pattern of ACS: the reported differences were confirmed for NSTE-ACS patients, with a trend towards less plaque rupture and a significant reduction of TCFA at any site with statins, but not for STEMI. Conclusions Chronic pre-treatment with statins is associated with a reduced prevalence of ruptured plaques in patients presenting with ACS, particularly in those with NSTE-ACS. Statins bear hence the potential to reduce morbidity during the acute phase of ACS

Carità: dalle scritture al welfare (e oltre)

Catturata nell\u2019atto materno di allattare due neonati gemelli, la statua della Carit\ue0 effigiata nell\u2019arca di Agostino a Pavia rivolge lo sguardo verso l\u2019alto. Come la Speranza, anche la Carit\ue0 appare subito come virt\uf9 che guarda oltre, non limitandosi alla contingenza. Prosegue con questo volume l\u2019esplorazione dell\u2019attualit\ue0 delle virt\uf9, un patrimonio valoriale che dall\u2019antichit\ue0 e dalla tradizione cristiana giunge fino a oggi. Per comprendere cosa possa oggi significare il concetto di Carit\ue0 sono state raccolte dieci prospettive multidisciplinari. Ogni autore, da una angolatura diversa, offre una riflessione sulla Carit\ue0: dai suoi intrecci con la politica e la giustizia al suo significato teologico, dal suo ruolo come principio morale alla sua evoluzione tra medioevo ed et\ue0 dei lumi. Ne emerge, alla fine, uno sfaccettato ritratto che conferma la potenzialit\ue0 della Carit\ue0 come lievito per un rinnovamento positivo e condiviso della societ\ue0

Twenty‐four‐month real‐life treatment outcomes of polypoidal choroidal vasculopathy versus type 1 macular neovascularization in Caucasians

Background To compare 24‐month real‐world outcomes of Vascular Endothelial Growth Factor (VEGF) inhibitors for Polypoidal Choroidal Vasculopathy (PCV) and type 1 Macular Neovascularization (MNV) in a Caucasian population.MethodsRetrospective analysis from a prospectively designed observational database. Data from Italian centres participating in the Fight Retinal Blindness! (FRB!) project were collected. Treatment‐naïve PCV or type 1 MNV commencing treatment after January 2009 were included. The primary outcome was 24‐month visual acuity (VA) change; other outcomes included baseline characteristics, number of anti‐VEGF injections, time to lesion inactivation and proportion of active visits.ResultsA total of 322 eyes (114 PCVs) from 291 patients were included. Median [Q1, Q3] VA at baseline was comparable (70 [55, 75.8] vs. 70 [58.8, 75] letters, p = 0.95). Adjusted VA change at 2 years was higher in PCV (mean [95% CI], +1.2 [−1.6, 4.1] vs. −3.6 [−6, −1.2] letters, p = 0.005). PCV received fewer anti‐VEGF injections over the first 24 months of treatment than type 1 MNV (median [Q1, Q3], 8 [5, 10] vs. 9 [7, 12.2] injections, p = 0.001), inactivated earlier (median [Q1, Q3], 235 [184, 308] vs. 252 [169, 343] days, p = 0.04) and was less frequently graded ‘active’ (62% vs. 68% of visits, p = 0.001). Conclusions PCV had slightly better VA outcomes over 24 months of treatment than type 1 MNV after receiving less anti‐VEGF injections. These results suggest a possible overlap of the two clinical entities with similar visual prognosis in Caucasians

An unusual cutaneous infection caused by Mycobacterium marinum

Introduction. Mycobacterium marinum is a non-tubercular mycobacterium residing in fresh or salt water (in tropical or temperate areas); it is a fish and human pathogen, and in immunocompromised patients can cause severe cutaneous and subcutaneous infections.Case presentation.A 46-year-old white man who underwent immunosuppressive therapy was admitted to our department in May 2016 for skin lesions previously diagnosed as 'unusual erysipelas'. We rejected the hypothesis of erysipelas, due to the clinical features, and our diagnostic hypotheses were oriented towards sporotrichosis, atypical mycobacteriosis, cutaneous tuberculosis and cutaneous sarcoidosis. Histological examination performed after a skin biopsy was compatible with a diagnosis of sporotrichosis. However, PCR performed on fresh tissue demonstrated the presence ofM. marinum.Conclusion.The case reported is interesting for the unusual clinical localization and modality of infection. The patient became infected by contact with contaminated remains or in the sea, in a geographical area not endemic forM.marinum. The previous state of immunosuppression favoured infection; however, the presence ofM. marinumin this area suggests a possible tropicalization of the water of the Mediterranean Sea. To our knowledge, this case is the only one reported in the literature with this modality of infection and in that geographical area