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Hearing Loss and Sixth Cranial Nerve Paresis after COVID-19
Get PDFAn 80-year-old patient was admitted to the internal medicine department for binocular diplopia and hearing loss with sudden onset. The patient had presented with SARS-CoV-2 infection 3 weeks previously and had been admitted to hospital. Complete work-up including autoimmunity, serum and LCR viral serology and MRI did not allow a diagnosis to be established. The hypothesis of a microvascular origin or the previous SARS-CoV-2 infection was considered. The latter was retained in light of the temporal relationship, the absence of other pathologies after exhaustive work-up, and the clinical evolution
Misdiagnosis Due to False-Positive Detection of Pneumococcal Urinary Antigen
Get PDFIntroduction: The detection of pneumococcal antigens in urine is an alternative to gram staining, and their culture is central to the diagnosis of pneumococcal pneumonia. We present a case of the false-positive detection of urinary Streptococcus species pneumococcal antigen with a BinaxNOW test. This resulted in delayed diagnosis of a liver abscess. Case description: A 70-year-old woman presented to the emergency department with a 1-day history of chills and difficulty walking. She had a fever and her physical examination was normal. Non-contrast chest computed tomography (CT) revealed a slight ground-glass opacity in the left lower lobe. Laboratory tests revealed liver injury and elevated C-reactive protein levels. A urinary pneumococcal antigen test was positive, and she was diagnosed with acute bronchopneumonia caused by Streptococcus pneumoniae. She was treated with ceftriaxone. However, abdominal contrast-enhanced CT performed the next day revealed portal vein thrombus and a left lobe liver abscess. Streptococcus constellatus was detected in a puncture specimen of the liver abscess. It was concluded that the positive urinary pneumococcal antigen test was a false-positive owing to Streptococcus infection. Discussion: False-positive results might be explained by the presence of C-polysaccharide antigens in the cell wall of S. pneumoniae. The positive urinary antigen test together with the finding of slight ground-glass opacity in the left lung on chest CT initially led to misdiagnosis. False positives may result in misdiagnosis and unnecessary antimicrobial therapy.Conclusion: The overuse of the pneumococcal urinary antigen tests can lead to false positives and misdiagnosis
McKittrick-Wheelock Syndrome: A Neoplastic Cause of Electrolyte Imbalance
Get PDFThe authors present the case of a 79-year-old woman who presented with chronic secretory diarrhoea and severe electrolyte imbalance. A large rectal tubulovillous adenoma was discovered, leading to surgical resection of the tumour with complete resolution of the diarrhoea and electrolyte imbalance. The diagnosis of McKittrick-Wheelock syndrome was made.We hope this case report will contribute to a greater awareness among health professionals about this clinical condition. A multidisciplinary approach is essential for the best outcome
Candida Cardiac Tamponade Secondary to Oesophageal-Pericardial Fistula: A Rare Presentation of Oesophageal Squamous Cell Carcinoma
Get PDFCandida is a rare cause of purulent pericarditis. Oesophago-pericardial fistula is an uncommon and potentially life-threatening complication of both benign and malignant oesophageal tumours. Here we report the case of 40-year-old woman who presented with symptoms and signs suggestive of acute pericarditis complicated by cardiac tamponade which required acute management with paracentesis. Pericardial fluid analysis was positive for Candida albicans. Oesophagogastroduodenoscopy was performed and revealed a small fistula in the proximal oesophagus extending into the retrocardiac space. Multiple biopsy specimens of the fistula site and oesophageal stricture were obtained. Histopathological findings were consistent with poorly differentiated squamous cell carcinoma of the oesophagus complicated by fistulation to the retrocardiac space
On quadratic gravity
No full textWe provide a brief overview of what is known about quadratic gravvity, which includes terms quadratic in the curvatures in the fundamental action. This is proposed as a renormalizeable UV completion for quantum gravity which continues to use the metric as the fundamental dynamical variable. However, there are unusual field-theoretic consequences because the propagators contain quartic momentum dependence. At the present stage of our understanding, quadratic gravity continues to be a viable candidate for a theory of quantum gravity
String cosmology and the breakdown of local effective field theory
No full textMost current cosmological models of the very early universe are based on local point particle effective field theories coupled to gravity. I will discuss some conceptual limitations of this approach and argue that an improved description
of the early universe needs to go beyond this framework. I will outline a couple of ideas based on superstring theory
La traduzione dei concetti e del linguaggio dell'integrità nella ricerca
Get PDFNella presente relazione tecnico-scientifica vengono analizzate le caratteristiche linguistiche e approfondite le problematiche di traduzione del linguaggio internazionale dell’integrità nella ricerca prendendo spunto dalla terminologia presente nei documenti ufficiali del Centro Interdipartimentale per l’Etica e l’Integrità nella Ricerca (CID Ethics) del Consiglio Nazionale delle Ricerche (CNR) e della Commissione per l’Etica e l’Integrità nella Ricerca (Commissione) del CNR. Un’analisi più dettagliata riguarda la traduzione in inglese del documento “Linee guida per l’integrità nella ricerca”, pubblicato dalla Commissione nel 2019, come anche le traduzioni nelle diverse lingue dei documenti internazionali sulla materia al fine di confrontare il lessico e i diversi approcci linguistici sottesi all’etica e alla integrità nella ricerca
Il mausoleo di Cecilia Metella tra documentazione grafica analogica e digitale: un approccio metodologico multidisciplinare
Get PDFThe paper presents the first results of the Cecilia Metella Project, at the Parco dell'Appia Antica. The prominent monument is dedicated to the noble Roman woman, whose life can only be deduced from what can be read from the epigraph carved in marble. Although the monument is probably the most famous and characteristic one of the regina viarum near the city, even today the knowledge of the mausoleum at least from the point of view of digital acquisition and analysis of the graphic documentation appears incomplete and therefore deserves to be deepening. The new technological frontiers and their integrated use in the field of cultural heritage allow scholars to have more accurate and complete tools at their disposal. These multidisciplinary applications make it possible to acquire, in a rapid and quick way, the physical and spatial dimension of very complex and stratified archaeological contexts such as the mausoleum of Cecilia Metella. In this context, the richness of the graphic evidence of the mausoleum allowed for in-depth comparative analyses regarding the iconographical documentation and its relationship with the physical monument acquired with modern survey techniques. This study therefore aims to update the state of the art of the tomb and to define a methodological protocol for the acquisition and critical analysis of the monument
I pareri del Comitato Etico come strumento di supporto per le future sperimentazioni. Il caso del CE dell'Azienda Sanitaria dell'Alto Adige nel biennio 2020-2021
Get PDFIl Comitato Etico per la Sperimentazione Clinica (CE) costituisce un fondamentale organo di tutela e garanzia circa l'integrità etica e scientifica della ricerca clinica. In questo contributo vogliamo approfondire l'esperienza locale del Comitato dell'Azienda Sanitaria dell'Alto Adige, indagandone nello specifico l'attività svolta nel biennio 2020-2021. L'indagine qui condotta permette di evidenziare come i dati relativi agli studi approvati dal CE siano in linea con i dati AIFA nazionali. L'analisi qualitativa delle osservazioni più frequenti poste dal CE agli presentati, consente di riequilibrare il pregiudizio che imputa ai Comitati un eccessivo ruolo di 'ostacolo' alla ricerca clinica, fornendo altresì un valido spunto agli sperimentatori che si accingono a presentare un progetto di studio al Comitato altoatesino. Uno specifico approfondimento è stato dedicato al Covid e all'impatto che che la pandemia ha avuto anche nel lavoro del Comitato. Lo studio dei pareri emanati dal CE permette infine di analizzare i principali trend all'interno della ricerca clinica locale. Si raccomandano ulteriori ricerche estese sul territorio nazionale
Fulminant Haemolysis Following Endoscopic Retrograde Cholangiopancreatography
Get PDFWe report the case of a 77-year-old-man with a history of type 2 diabetes mellitus who underwent endoscopic retrograde cholangiopancreatography (ERCP) because of a gallstone in the common bile duct. Thirty-six hours after the procedure, the patient developed persistent fever and epigastric pain associated with de novo jaundice. Massive haemolysis (with exuberant spherocytosis) occurred and patient died in 3 hours. Clostridium perfringens was isolated in the blood cultures. Massive haemolysis associated with C. perfringens has a high mortality rate. Management involves a high index of suspicion after gastrointestinal procedures like ERCP, surgical consultation, antibiotic therapy, transfusion of red cell concentrates and, potentially, hyperbaric oxygen therapy