Polyostotic fibrous dysplasia: imaging findings of a controversial case

Fibrous dysplasia is a rare non-neoplastic tumor-like congenital bone disease that is most likely associated with GNAS gene mutations, with a broad spectrum of clinical presentations, ranging from isolated monostotic and polyostotic forms to other extra-skeletal associated manifestations as in McCuneAlbright syndrome. It is responsible for bones weakening and increased fragility, making it prone to fractures. A 65-year-old female patient was referred to our radiology department for cervical and dorsal pain, with a previous diagnosis of incidental cervical and dorsal bone lesions that are suspected for metastases. X-ray, computed tomography, and magnetic resonance imaging were performed with a precise diagnostic suspicion of fibrous dysplasia that is confirmed by bone biopsy. Fibrous dysplasia principally affects the bone and is characterized by bone replacement itself by dysplastic fibrous tissue. According to the number of affected bones and their association to endocrine alterations, it is classified into three categories monostotic, polyostotic, and Albrights disease. Differential diagnosis with multiple myeloma among others and the best treatment decision was made

Lung ultrasonography for long-term follow-up of COVID-19 survivors compared to chest CT scan

Background: While lung ultrasonography (LUS) has utility for the evaluation of the acute phase of COVID-19 related lung disease, its role in long-term follow-up of this condition has not been well described. The objective of this study is to compare LUS and chest computed tomography (CT) results in COVID-19 survivors with the intent of defining the utility of LUS for long-term follow-up of COVID-19 respiratory disease. Methods: Prospective observational study that enrolled consecutive survivors of COVID-19 with acute hypoxemic respiratory failure (HARF) admitted to the Respiratory Intensive Care Unit. Three months following hospital discharge, patients underwent LUS, chest CT, body plethysmography and laboratory testing, the comparison of which forms the basis of this report. Results: 38 patients were enrolled, with a total of 190 lobes analysed: men 27/38 (71.1%), mean age 60.6 y (SD 10.4). LUS findings and pulmonary function tests outcomes were compared between patients with and without ILD, showing a statistically significant difference in terms of LUS score (p: 0.0002), FEV1 (p: 0.0039) and FVC (p: 0.012). ROC curve both in lobe by lobe and in patient's overall analysis revealed an outstanding ILD discrimination ability of LUS (AUC: 0.94 and 0.95 respectively) with a substantial Cohen's coefficient (K: 0.74 and 0.69). Conclusions: LUS has an outstanding discrimination ability compared to CT in identifying an ILD of at least mild grade in the post COVID-19 follow-up. LUS should be considered as the first-line tool in follow-up programs, while chest CT could be performed based on LUS findings

SARS-CoV-2 pneumonia and Eisenmenger’s Syndrome: doubling the challenge

Eisenmenger’s syndrome (ES) is the most severe phenotype of pulmonary arterial hypertension (PAH) secondary to congenital heart disease. In these cases, a significant systemic-to-pulmonary (left-to-right) shunting triggers the development of pulmonary vascular disease (PVD) and pulmonary hypertension. In cases of acute hypoxemic respiratory failure in patients with ES, high flow nasal cannula (HFNC) oxygen therapy should be considered as a first-line approach in order to avoid pulmonary complications and right ventricular overload related to positive pressure ventilation. Here, we report a case of HFNC use in a patient with COVID-19 infection and ES

Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

Dysregulated systemic inflammation is the primary driver of mortality in severe COVID-19 pneumonia. Current guidelines favor a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg·day-1. A comparative RCT with a higher dose and a longer duration of intervention was lacking

El private enforcement del derecho comunitario de la competencia en acción. Análisis crítico de la decidión del Tribunal de Justícia en los asuntos acumulados C 295-298/04

La sentencia del Tribunal de Justicia de las Comunidades Europeas en el caso Manfredi reafirma el derecho de los particulares a obtener la indemnización del daño patrimonial sufrido en consecuencia de una violación de los artículos 81 y 82 del Tratado. Además, a falta de una normativa comunitaria que regule en detalle la materia, el Tribunal ha solucionado algunos de los aspectos procesales más relevantes acerca de la aplicación privada (private enforcement) de las reglas comunitarias de competencia (como la legitimación activa, la determinación del daño, el cómputo del plazo de prescripción de la acción y los daños punitivos o ejemplares) aplicando los consolidados principios comunitarios de efectividad, equivalencia y proporcionalidad. Este artículo analiza críticamente cada una de las soluciones adoptadas por el Tribunal de Justicia a la luz del llamado proceso de modernización del derecho antitrust comunitario

L'azione di risarcimento del danno per violazione delle regole comunitarie sulla concorrenza

Al fine di promuovere la conoscenza del diritto antitrust comunitario tra i Giudici italiani, la Commissione Europea1 e la Regione Autonoma Trentino-Alto Adige, hanno co-finanziato la pubblicazione del presente Volume a latere del Convegno di studio sul Private enforcement del diritto comunitario della concorrenza: ruolo e competenze dei Giudici nazionali, che si è tenuto a Trento gli scorsi 15 e 16 giugno 2007, i cui Atti sono stati pubblicati in questa stessa Collana. Questo Volume si presenta, nelle intenzioni della Commissione Europea e negli auspici degli Autori, come uno strumento didattico volto ad orientare il Giudice nazionale nello studio e nell’approfondimento delle problematiche antitrust comunitarie relative all’azione di risarcimento del danno. Il Volume ha una finalità divulgativa ed un destinatario privilegiato: il Giudice nazionale