Scientific Open-access Literature Archive and Repository
Not a member yet
16397 research outputs found
Sort by
Tuberculosis as a Cause of Rapid Salivary Gland Swelling in the Elderly – A Case Report
Get PDFA 77-year-old man was admitted to the internal medicine department for a 5-day history of progressive preauricular swelling. Two lines of antibiotic treatment failed to achieve any improvement. Fine needle aspiration cytology was conducted and smear staining with the Ziehl-Neelsen stain as well as a PCR test were positive for Mycobacterium tuberculosis. These results were confirmed with culture of the sample. A diagnosis of tuberculosis parotitis was made and anti-tuberculous drugs were initiated
Cough Syncope, a Rare Presenting Symptom of Chiari I Malformation and Atlanto-Occipital Assimilation
Get PDFChiari I malformation and atlanto-occipital assimilation are both fairly uncommon conditions. Symptoms usually present during adolescence or adulthood, typically consisting of headache or neck pain. Cough-associated syncope is an unusual presenting symptom. The diagnosis of this condition in a pulmonology department is even rarer.
We report the case of a 62-year-old male referred to our pulmonology department due to complaints of cough-associated syncope. After several examinations, a pharyngeal CT scan incidentally showed low positioning of the cerebellar tonsils. Cerebral MRI confirmed the diagnosis of Chiari I malformation and atlanto-occipital assimilation and the patient was effectively treated with surgical decompression
Effectiveness of Tocilizumab in the Treatment of Fasciitis with Eosinophilia: Two Case Reports
Get PDFFasciitis with eosinophilia (FE) is a rare connective tissue disease. Due to its rarity, large-scale studies are lacking, which makes its treatment challenging. Systemic corticosteroids (SCSs) are the cornerstone of treatment; however, additional immunosuppressive drugs (ISDs) are frequently necessary (usually methotrexate). We report 2 patients, for whom an SCS and methotrexate were not a viable long-term option. In the first case, we were unable to taper the SCS dose without symptom relapse, the patient showed only a partial response to methotrexate and presented side effects. The second case never fully responded to the SCS and methotrexate and demonstrated serious SCS adverse effects. Both patients were started on tocilizumab with extremely favourable results, making this drug a potential therapeutic weapon for these patients
Oesophageal Variceal-Pulmonary Venous Fistula - A Rare Cause of a Right-to-Left Shunt
Get PDFOesophageal varices are a dilated submucosal venous plexus in the lower third of the oesophagus which result from increased pressure in the portal venous system. The portal system is connected to the systemic circulation in specific locations referred to as sites of portosystemic anastomosis. An increase in portal venous pressure is therefore reflected at these anastomotic sites, causing manifestations such as oesophageal varices, rectal varices, caput medusae and splenorenal shunts. Varices do not cause symptoms until they leak or rupture and this is the main complication which requires prompt treatment. Here, we present a post-liver transplant patient with metastatic hepatocellular carcinoma who had oesophageal varices that fistularized with a left pulmonary vein, thus creating a right-to-left shunt. Right-to-left shunts are usually intracardiac or intrapulmonary in location. The complications of a right-to-left shunt include predominantly hypoxia, cyanosis and, sometimes, paradoxical emboli in the case of intracardiac shunts. This patient had a very uncommon cause of such a shunt caused by a direct fistulous connection
Insulinoma Identified in Puerperium: Association with Pregnancy and Literature Review
Get PDFPostpartum hypoglycemia in non-diabetic women is a rare condition. We report the case of a 34-year-old woman who experienced neuroglycopenia 2 days after delivery. Corresponding to severe hypoglycemia, we found inappropriately elevated insulin and C-peptide levels. Following magnetic resonance imaging a lesion of 10x8 mm was detected in the head of the pancreas. An ultrasound-guided fine needle aspiration of the mass confirmed the diagnostic suspicion of a pancreatic neuroendocrine tumor. Complete surgical enucleation of the insulinoma resulted in immediate and permanent resolution of the hypoglycemia. The postoperative course was uneventful. Histopathological and immunohistochemical analyses were consistent with insulinoma. The diagnostic approach to postpartum hypoglycemia represents a challenge for multidisciplinary teamwork
Hepatic Necrosis after Trans-Arterial Embolization of Metastatic Neuroendocrine Tumour
Get PDFLiver metastases from neuroendocrine tumours (NETs) are usually seen on cross-sectional imaging at presentation. In such cases, curative surgical resection is usually not possible given that most patients have bilobar disease. Various locoregional approaches are now widely available that enable local control of disease and management of systemic symptoms. These include trans-arterial embolization (TAE), trans-arterial chemoembolization (TACE), selective internal radiotherapy and thermal ablation.
We describe a rare case of hepatic necrosis after TAE in a 61-year-old woman with a metastatic NET. Cross-sectional imaging showed extensive necrosis affecting segments VII and VIII of the liver. This occurred secondary to thrombosis in the portal vein branches to these segments, confirmed on a Doppler ultrasound scan. The mechanism of portal vein thrombosis after TAE could be due to the presence of occult arterioportal anastomoses. These allow transit of the embolizing agents into the portal vein branches supplying the treated segments and subsequent thrombosis
Come stai? Conversazioni ai tempi del Covid 19
Get PDFIl volume contiene una raccolta di testimonianze, fatta nella primavera del 2020, durante il periodo di lockdown, introdotto in Italia e nel mondo a causa della pandemia Covid 19. Cento persone, diverse per età, genere, professione, localizzazione geografica, unite dall’inedita esperienza di confinamento, hanno risposto alle domande che ci si porrebbe in una chiacchierata tra amici. Una serie di fili rossi, di temi comuni al di là di tutte le diversità dei rispondenti, legano le varie considerazioni: paura, speranza, dolore, rabbia, solidarietà, rassegnazione o voglia di reagire e impegnarsi si ritrovano vivide attraverso tutto il volume. Ne esce un vivace spaccato dei tempi del Covid19
Edgardo Contini (1914-1990) Ingegnere italiano sulla West Coast. Tra Early Modernism e International Style
No full textEdgardo Contini, seppure per nulla considerato nelle pagine della storia dell’architettura italiana è stato, invece, un grande protagonista negli Stati Uniti, dove ha saputo far dialogare le esigenze di un popolo multiculturale con la bellezza e l’eleganza dello stile italiano. A lui si deve la capacità di aver contribuito a orientare i cambiamenti dei processi produttivi attraverso un linguaggio per nulla convenzionale, ma fondato sulla creatività e sulla spontaneità progettuale. Le pagine del volume, presentando un tema che senz’altro non intende esaurirsi qui, hanno lo scopo di evidenziare il prestigio di progetti di ricerca in grado di valorizzare la storia dell’architettura e dell’ingegneria italiana oltre i confini nazionali e quindi realizzata dagli italiani all’estero. Il libro è un omaggio alla comunità ebraica e a quanti, come Edgardo Contini, hanno contribuito a costruire nuovi orizzonti attraverso il dialogo e la condivisione di paradigmi culturali differenti e il cui incontro ha determinato la nascita di nuove prospettive. Un omaggio a coloro che hanno lasciato le loro terre di origine per andare incontro a nuove opportunità determinando la trasmissione e lo sviluppo di nuove conoscenze. Un omaggio a coloro che sono emigrati o che emigrano, perché solo guardando oltre è possibile sperare in un mondo migliore e inclusivo
Late Erosion of Percutaneous ASD Occlusion Device
Get PDFPercutaneous closure of atrial septal defects (ASDs) is an ever more common treatment modality in selected patients. Device erosion is a rare but often fatal complication of this therapy, which usually presents early in the post-procedure course. We describe the case of a patient presenting with chest pain and shock in whom early recognition and intervention prevented a negative outcome. Awareness of this potentially lethal complication is important as the population of patients undergoing percutaneous procedures for structural heart disease continues to grow
Relapsing Haemothorax as an Unusual Presentation of Primary Angiosarcoma of the Spleen
Get PDFSpontaneous haemothorax (SH) is a rare subcategory of haemothorax that involves the accumulation of blood within the pleural space in the absence of trauma. SH especially occurs in middle-aged or elderly patients, but data are usually limited to case reports and case series. Coagulopathy, aneurysm or aortic dissection, Rendu-Osler-Weber syndrome and malignancy have to be considered among the causes of SH. Aim: We describe a case of primary angiosarcoma of the spleen presenting as relapsing haemothorax.Results: An 81-year-old woman was referred to our hospital because of a 2-month history of relapsing haemothorax after the performance of urgent splenectomy due to active bleeding from large spleen cysts. No evidence of neoplasm was seen after pathological examination of the spleen. On admission, left haemothorax and 2 new cystic masses in the thoracic wall were documented, both in close relation to the scars of previous surgery and chest tubes. After excision of 1 mass, histological examination revealed angiosarcoma, and a final diagnosis of primary angiosarcoma of the spleen with postsurgical metastatic dissemination to the thorax and pleura was made.Conclusion: Primary angiosarcoma should be included in the differential diagnosis of haemorrhagic spleen cysts. Clinical diagnosis and management usually requires splenectomy, but it should be carefully planned in order to avoid local metastatic dissemination or haematogenous spread of the tumour