Fibroblastic rheumatism: a case without rheumatological symptoms.

Fibroblastic rheumatism is a rare syndrome characterized by the association of multiple cutaneous nodules with symmetric polyarthritis. We report on a patient who presented a 4-year history of pink to skin-coloured nodular lesions symmetrically localized at para-articular sites without evident rheumatological symptoms. Histopathology of a skin nodule led to the diagnosis of fibroblastic rheumatism showing a poorly circumscribed dermal proliferation of spindle and stellate fibroblast-like cells embedded in thickened collagen bundles with a marked reduction of elastic fibres. X-rays of both hands and feet showed metacarpophalangeal, metatarsalphalangeal and interphalangeal erosions, unexpected by patient history. This case of fibroblastic rheumatism appears unique in view of the absence of any clinical manifestation of polyarthritis at 7 years from appearance of skin lesions

Neuro-Oncology Multidisciplinary Tumor Board: The Point of View of the Neuroradiologist

Background: The multi-disciplinary tumor board (MTB) is essential to quality cancer care and currently recommended to offer the best personalized clinical approach, but little has been published regarding MTBs in neuro-oncology (nMTBs). The aim of the present paper is to describe our nMTB, to evaluate its impact on clinical management decisions, and to assess the role of neuroradiologists. Methods: The retrospective evaluation of the cases discussed at our nMTB from March 2017 to March 2020. From the electronic records, we extracted epidemiological, clinical and other specific data of nMTB. From the radiological records, we calculated data relating to the number, time for revision, and other specifications of MRI re-evaluation. Statistical analysis was performed. Results: a total of 447 discussions were analyzed, representing 342 patients. The requests for case evaluations came from radiation oncologists (58.8%) and neurosurgeons (40.5%), and were mainly addressed to the neuroradiologist (73.8%). The most frequent questions were about the treatment's changes (64.4%). The change in patient treatment was reported in 40.5% of cases, 76.8% of these were based on the neuroradiologic assessment. A total of 1514 MRI examinations were re-evaluated, employing approximately 67 h overall. The median of the MRI exams reviewed per patient was 3 (min-max 1-12). Conclusions: Our study supported that the multidisciplinary approach to patient care can be particularly effective in managing brain tumors. A review by an expert neuroradiologist impacts patient management in the context of nMTBs, but has costs in terms of the time and effort spent preparing for it

How the First Year of the COVID-19 Pandemic Impacted Patients’ Hospital Admission and Care in the Vascular Surgery Divisions of the Southern Regions of the Italian Peninsula

Background: To investigate the effects of the COVID-19 lockdowns on the vasculopathic population. Methods: The Divisions of Vascular Surgery of the southern Italian peninsula joined this multicenter retrospective study. Each received a 13-point questionnaire investigating the hospitalization rate of vascular patients in the first 11 months of the COVID-19 pandemic and in the preceding 11 months. Results: 27 out of 29 Centers were enrolled. April-December 2020 (7092 patients) vs. 2019 (9161 patients): post-EVAR surveillance, hospitalization for Rutherford category 3 peripheral arterial disease, and asymptomatic carotid stenosis revascularization significantly decreased (1484 (16.2%) vs. 1014 (14.3%), p = 0.0009; 1401 (15.29%) vs. 959 (13.52%), p = 0.0006; and 1558 (17.01%) vs. 934 (13.17%), p < 0.0001, respectively), while admissions for revascularization or major amputations for chronic limb-threatening ischemia and urgent revascularization for symptomatic carotid stenosis significantly increased (1204 (16.98%) vs. 1245 (13.59%), p < 0.0001; 355 (5.01%) vs. 358 (3.91%), p = 0.0007; and 153 (2.16%) vs. 140 (1.53%), p = 0.0009, respectively). Conclusions: The suspension of elective procedures during the COVID-19 pandemic caused a significant reduction in post-EVAR surveillance, and in the hospitalization of asymptomatic carotid stenosis revascularization and Rutherford 3 peripheral arterial disease. Consequentially, we observed a significant increase in admissions for urgent revascularization for symptomatic carotid stenosis, as well as for revascularization or major amputations for chronic limb-threatening ischemia

Search for low Energy solar Axions with CAST

We have started the development of a detector system, sensitive to single photons in the eV energy range, to be suitably coupled to one of the CAST magnet ports. This system should open to CAST a window on possible detection of low energy Axion Like Particles emitted by the sun. Preliminary tests have involved a cooled photomultiplier tube coupled to the CAST magnet via a Galileian telescope and a switched 40 m long optical fiber. This system has reached the limit background level of the detector alone in ideal conditions, and two solar tracking runs have been performed with it at CAST. Such a measurement has never been done before with an axion helioscope. We will present results from these runs and briefly discuss future detector developments.Comment: Paper submitted to the proceedings of the "4th Patras Workshop on Axions, WIMPs and WISPs", DESY, Hamburg Site - Germany, 18-21 June 2008. Author affiliations are reported on the title page of the paper. In version 2: 1 affiliation change, 3 references adde

The integrated care pathway for melanoma: the Istituto Dermopatico dell'Immacolata experience in Rome

Introduction: The Integrated Care Pathway (ICP) represents a multidisciplinary outline of anticipated care, placed in an appropriate timeframe, to support patients with specific conditions or symptoms. The aim of this paper is to define the ICP for patients with melanoma referring to the "Istituto Dermopatico dell'Immacolata-IRCCS di Roma e Villa Paola" ("Center"). Methods and results: A multidisciplinary group (oncologists, dermatologists, surgeons, pathologists etc.) was defined as well as a facilitator to act as a link between all experts. The first step of ICP development was a review of current practice for patients with melanoma referring to the Center. This first step had the scope to define the multidisciplinary process map (a "picture" of the care plan) for patients with melanoma. The process map defined: i) the activities performed during delivery of care to the patients, ii) the responsibilities for these activities and iii) potential problem areas or opportunities for improvements. The process map formed the basis of the final ICP document. Conclusion: The adoption of melanoma ICP will allow the multidisciplinary group to ensure that clinical guidelines and available evidence are incorporated into everyday practice. (Oncology, HTA & Market Access

Annali storici di Principato Citra, A. 7, n. 1.1 (2009)

A. 7, n. 1.1 (2009): G. Guardia, Editoriale, P. 3 ; R. Salati, Le ambre "tipo Roscigno”, P. 5 ; E. Bianco, La viabilità medievale nel Parco Nazionale del Cilento e Vallo di Diano. Il territorio del Comune di Gioi, P. 33 ; D. Petrone, Le case-torri nel territorio ebolitano, P. 51 ; A. Capano, Pollica e i suoi casali nel Catasto provvisorio del 1815. Il Sessantotto a Salerno. In margine ad un Convegno e ad un libro, P. 69 ; Francesco Sofia, Il '68: alcune riflessioni, P. 95 ; G. Acocella, Un '68 "cattolico"? P. 104 ; P. Cantillo, La profezia di una società estetica, P. 108 ; G. Foscari, Il '68, P. 112 ; M. La Via, Dal mito degli anni '60 alla utopie del '68, P. 113 ; P. Lucia, Miti, utopie, speranze di una generazione, P. 117 ; L. Marinucci, Donne, istituzioni, movimenti civili: una questione ancora attuale. La Mostra "Le frodi alimentari nella provincia di Salerno fra '800 e '900" tenutasi a Salerno il 16 ottobre 2008, a cura di Caterina Aliberti e Francesco Innnella, P. 121 ; C. Aliberti - F. Innella, La Mostra "Le frodi alimentari nella Provincia di Salerno tra Ottocento e Novecento", P. 126 ; I. Ascione, Le frodi alimentari nella provincia di Salerno fra Ottocento e Novecento, P. 128 ; A. Vacca, Inganni cibici, P. 131 ; V. Ferrara, Le attività operative del Comando Carabinieri Politiche Agricole e Alimentari e del Nucleo Antifrodi Carabinieri di Salerno. Il XIV Festival "Linea d'ombra" - Festival culture giovani, P. 134 ; P. D'Antonio, Caos: tra Filosofia, Scienza e Arte, P. 150 ; S. Metetich, Al caos, al caos! Così è (se vi piace), P. 151 ; P. Simone Di Chiara, Il caos, P. 153 ; F.M. Iandiorio, M. Autuori, P.S. Di Chiara, Il caos della natura fra letteratura e percezione, P. 154 ; S. Maritato, D. Di Stefano, A. Di Lauro, M. Massa, Caos e/è cinema, P. 156 ; F. Bonifacio, M. Talento, A. Catoio, Obiettivo caotico, P. 158 ; M. Radano, Per una "memoria" del territorio. Le celebrazioni per il Millenario di Guarrazzano di Stella Cilento (1009-2009), P. 160

Selection of the appropriate Limberg flap in the reconstruction of post-excisional nasal defects

Treatment of superficial cutaneous neoplasias involving the nasal pyramid is frequent in plastic surgery. In this article the authors report their experience in the reconstruction of post-excisional nasal defects employing the local rhomboid flap, initially popularized by Alexander Limberg. From 1995 to 2000, 115 patients underwent exeresis for basalioma of the nasal pyramid at the Campus Bio-Medico University in Rome; in 98 cases the Limberg flap was the reconstructive procedure of choice. In spite of its simplicity, the flap requires accurate planning according to the location. The flap is designed for the repair of equilateral rhomboid defects and is marked extending the short diagonal of the defect in either direction for a distance equal to its own length. Two sides of the flap are thus obtained; the third side is designed at an angle of 60°, always with the same length. The fundamental principle for the application of this technique is that the flap has to be rotated and advanced along the lines of maximum extensibility which are perpendicular to the relaxed skin tension lines. Thus the short diagonal part of the flap has to be parallel to the lines of maximum extensibility; only by this careful planning is it possible to easily close the donor site where the major degree of cutaneous tension occurs. At the level of the nasal pyramid the relaxed skin tension lines are placed transversely; the lines of maximum estensibility, which are perpendicular to them, are oriented vertically, thus the rhomboid flap has to be rotated and advanced vertically in the direction of the caudal cranium. The different aesthetic nasal subunits are disthinguished and some guidelines are suggested according to the location. The simplicity of the execution and the minor trauma with respect to the other procedure, as well as the excellent aesthetic results in both young and elderly patients, make the Limberg flap a valid reconstructive procedure for nasal defects