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Non-small-cell Carcinoma Localised within the Pulmonary Artery Misdiagnosed as Pulmonary Thromboembolism
Get PDFIn this case report we describe a 69-year-old male ex-smoker with non-small-cell carcinoma localised within the pulmonary artery, misdiagnosed as pulmonary thromboembolism. This case indicates that non-small-cell carcinoma can be localised within the pulmonary artery. Furthermore, it emphasises the importance of performing a positron emission tomography scan and diagnostic intraluminal biopsy in unexplained lesions in the pulmonary artery to reach the proper diagnosis at the early stages of the disease. The patient is currently undergoing concurrent chemotherapy and radiation therapy
Benzylthiouracil-induced ANCA-associated Vasculitis: A Case Report and Literature Review
Get PDFIatrogenic antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) is not exceptional. Many cases of small vessel vasculitis induced by anti-thyroid drugs (ATD), mainly propylthiouracil (PTU), have been reported. We present a case of AAV related to another ATD: benzylthiouracil (BTU) and review the literature. An 84-year-old man with a 4-year history of multinodular goitre with hyperthyroidism was treated with BTU. He presented an acute syndrome with weakness, fever, epigastric pain and abdominal distension. Lactate and lipase tests were normal. An abdominal scan showed a thrombosis of the splenic artery with splenic infarction. We excluded a hypothesis of associated embolic aetiology: atrial fibrillation, atrial myxoma, intraventricular thrombus or artery aneurysm. Exploration of a possible prothrombotic state (complete blood count, haemostasis tests, activated protein C resistance, factor V Leiden, protein C, S, antithrombin III) gave normal results. Tests for antinuclear antibodies (ANA) and antiphospholipid antibodies (APL) were negative. However, testing for p-ANCA, with antimyeloperoxidase (MPO) specificity, was positive: 120.6 CU (N<20.0). We did not find other systemic manifestations, except a non-specific kidney failure. BTU was discontinued without steroids or immune-modulating drugs. Subsequently, symptoms disappeared progressively and titres of ANCA fell until normalization, 4 months later. Many patients treated with BTU present a high prevalence of ANCA, mainly, but not exclusively, directed against MPO. Vasculitis, however, remains an uncommon complication. The mechanism of this anomaly remains to be elucidated. Some studies suggest the possibility of an autoimmune reaction initiated by drug bioactivation mediated by neutrophil-derived MPO. The present observation is particular because the involved drug was BTU and clinical expression was unusual
Inclusion Body Myositis Treated with Alemtuzumab
Get PDFInclusion body myositis (IBM) is a chronic inflammatory myopathy with a progressive course. It is more common in the later years of life and usually presents with limb weakness. We present the case of a patient who developed proximal weakness in the lower limbs and, four years later, facial asymmetry. Blood analysis revealed high lactate dehydrogenase and creatinine kinase values. The diagnosis was obtained through muscle biopsy which met the histological criteria for IBM. The patient started treatment with alemtuzumab, leading to stabilisation of the symptoms in two years
Hyperglycaemic Hemichorea and Hyperglycaemic Hyperosmolar Syndrome in a Patient with HbA1c levels of 19.9%: A Rare and Potentially Reversible Case
Get PDFHemichorea is a rare clinical manifestation of type 2 diabetes (DMT2). The patient presents with non-ketotic hyperglycemia, hemichorea (characterized by rapid and involuntary movements of a specific part of the body) and the CT imaging reveals the presence of alterations involving the ganglia of the base
The rotation angle distribution underlying magnetic field fluctuations in the 1/f range of solar wind turbulent spectra
Get PDFWe discuss properties of large amplitude magnetic field fluctuations during fast Alfv´eenic solar wind streams, focussing on the statistics of the rotation angle between consecutive magnetic field vector measurements for different scales in the plasma. Since in the fast solar wind fluctuations preserve the modulus of the magnetic field to a good approximation, the tip of the magnetic field vector is observed to move on a sphere of approximately constant radius |B|. We then compare statistics of solar wind measurements with that of a simple model of a random walk bounded on a spherical surface. The analogy consists in the fact that in both systems the geometrical constraint imposes a limiting amplitude at large separations and thus introduces a break scale in the power spectrum of the fluctuations, leading to a shallower slope for scales where the fluctuations amplitude becomes scale-independent. However, while in the case of the random walk the saturation of the fluctuations occurs when the pattern becomes uniform on the sphere (flat distribution of the cosine of the rotation angle), transitioning then to a white noise regime, in the solar wind magnetic field fluctuations saturate in amplitude maintaining a preferential direction. We suggest that this behaviour is due to the presence of the background interplanetary magnetic field, which keeps some long-range memory in the system also when the fluctuations becomes independent of the scale. This long-range correlation is a necessary ingredient in order to produce the 1/f spectrum observed at large scales in the solar wind
On the dynamics of solar polar plumes observed by SoHO/UVCS
Get PDFWe investigate the plasma outflow in solar polar plumes by using SoHO/UVCS observations of May 2005. Despite the fact that data have been acquired more than ten years ago, UVCS spectral observations in the intermediate corona still represent a unique opportunity of studying the plasma dynamics at those heliocentric distances. The Doppler dimming technique is applied to the O VI doublet and H I Lyman-α spectral lines, to infer the outflow speed and the electron density in plumes and interplumes. Our aim is to, investigate if plumes, in the intermediate corona, are to be considered static structures or if they dynamically expand, contributing to the fast solar wind
The consequences of ICME impact on the circumterrestrial environment: A case event
Get PDFThe Solar Wind-Magnetosphere-Ionosphere coupling constitutes an important subject of scientific interest, in particular in the Space Weather context. Briefly, in this process, the energy is transferred from the solar wind to the magnetosphere by means of both the magnetic reconnection at the dayside magnetopause and the viscous-like interaction generated by micro or macro instabilities. On the other hand, the magnetosphere and the ionosphere, strictly connected through the magnetic field lines, can exchange energy and momentum, basically, through three main processes: (1) the transmission of electric fields, (2) the flows of electric charges by means of Field Aligned Current (FAC) and (3) the precipitation and/or outflow of particles. In this work, we study some aspects of the interaction of the interplanetary coronal mass ejections (ICME) of June 21, 2015 event with the magnetosphereionosphere system. In particular, we analyse the response of the magnetosphere to the impact of the interplanetary shock preceding the ICME, the magnetospheric and the ionospheric disturbance currents, and the geomagnetically induced currents (GIC) that developed over the entire northern hemisphere
Forecasting solar proton events by using the ESPERTA model
Get PDFThe ESPERTA (Empirical model for Solar Proton Event Real Time Alert) forecast tool has a Probability of Detection (POD) of 63% for all >10 MeV events with proton peak intensity ≥10 pfu (i.e., ≥S1 events, S1 referring to minor storms on the NOAA Solar Radiation Storms scale), from 1995 to 2014 with a false alarm rate (FAR) of 38% and a median (minimum) warning time (WT) of ∼4.8 (∼0.4) hr. The ESPERTA model modified to predict ≥S2 (i.e., ≥100 pfu) has a POD of 75% and a FAR of 24% for the 1995 - 2014 interval with a median (minimum) WT of ∼1.7 (∼0.2) hr based on predictions made at the time of the S1 threshold crossing. Here, both versions of the ESPERTA model have been applied to forecast recent solar proton events from 2015 to 2017, yielding results consistent with model performance for the 1995 to 2014 interval
The Ionosphere Prediction Service
Get PDFThe Ionosphere Prediction Service (IPS), project funded by European Commission within Horizon 2020 and currently ongoing, provides a prototype for a monitoring and prediction service of potential ionosphere-related disturbances affecting GNSS (Global Navigation Satellite System) user communities, to help these communities cope with the effects of the ionosphere and mitigate the related effects for the specific GNSS-based application/services. The aim of the IPS project is to design and develop a prototype platform able to translate the prediction and forecast of the ionosphere effects into a service customized for specific GNSS user communities. The objective is to alert the GNSS users in due time of an upcoming ionospheric event potentially harmful for GNSS and for the related operations in the given application field. The project team is composed of Telespazio (coordinator), Nottingham Scientific Ltd, Telespazio Vega DE, The University of Nottingham, The University of Rome Tor Vergata and the National Institute of Geophysics and Volcanology. The Joint Research Centre of the European Commission is also involved in the project
The cryogenic stopping cell of the IGISOL facility at ELI-NP
Get PDFAn IGISOL beamline that produces neutron-rich nuclei via photofission induced by a high-brilliance gamma beam is being developed at the Extreme Light Infrastructure - Nuclear Physics (ELI-NP) facility. The core device will be a cryogenic stopping cell with an actinide target system in its center. We report on some of the latest simulation results for an optimal design of this gas cell