305 research outputs found
Mucinous Carcinoma and IPMN
No full textThis book describes the pathways of dissemination of primary liver, biliary, and pancreatic neoplasms and proposes a practical and clinically driven approach to their imaging. The typical dissemination pathways for hepatocellular carcinoma, cholangiocarcinoma, exocrine pancreatic carcinoma, and neuroendocrine pancreatic tumors are systematically reviewed, and more unusual pathways are also documented. The content is presented in an extremely schematic way, with numerous high-quality graphical illustrations and multimodality images (US, CT, MRI, and PET) that are accompanied by clear explanatory text. The clinical significance of findings and potential therapeutic options are explained whenever appropriate. In addition, relevant background information is provided on the role of morphopathological drivers of cancer spread and anatomy
Matilde Serao in Sweden. A Voice of "The New Italy"
No full textThis chapter examines the contemporary reception of Matilde Serao's works in Swedish newspapers from 1885 to the first years of the twentieth century. This analysis provides a historical background for understanding why Serao's masterpiece Il paese di cuccagna (1891) was translated in Swedish as early as 1892. In fact, Serao was already known to the Swedish public through the activity of C.D. af Wirsén, an important conservative critic who reviewed her original work and contributed to establishing Serao's reputation as a major contemporary author. Furthermore, examination of recently digitalized Swedish newspapers shows that Serao's short stories were published on at least twenty occasions from 1888 to 1897. These anonymous translations can be attributed with a high degree of probability to the pen of Ellen Lundberg-Nyblom, the translator of Il paese di cuccagna. Swedish reviewers greeted Serao as a master of vivid description and an insightful painter of human passions. At the same time, the fact that Serao, being a woman, was professionally active as a journalist and a newspaper editor attracted attention of Swedish media, transforming the Neapolitan author into a public figure known to a broader audience.Ce chapitre traite de la réception des œuvres de Matilde Serao dans les journaux suédois, de 1885 aux premières années du xxe siècle. Avant la traduction de son chef-d’œuvre Il paese di Cuccagna (1891) dès 1892, Serao était déjà connue en Suède grâce au critique C.D. af Wirsén, qui l’a présentée comme une autrice contemporaine de premier plan. Les traductions anonymes des nouvelles de Serao, publiées entre 1888 et 1897 et attribuées ici à Ellen Lundberg-Nyblom, ont joué un rôle tout aussi important.</p
Reversal of dabigatran and apixaban-induced coagulopathy using idarucizumab, fibrinogen, and prothrombin complex concentrate: A case report
No full textThis case report examines the combined use of fibrinogen concentrate, four-factor prothrombin complex concentrate (PCC), and idarucizumab, a specific antidote for dabigatran, to reverse the anticoagulant effects of dabigatran and apixaban-induced coagulopathy. An 86-year-old patient, receiving apixaban therapy, presented to the Emergency Department after intentionally ingesting 50 tablets of dabigatran. The combination therapy contributed to the rapid normalization of coagulation parameters and stabilization of the patient's clinical status without subsequent thromboembolic complications. This case adds to the limited evidence on the effectiveness and safety of combining PCC with idarucizumab in cases of multiple anticoagulant intoxication
Delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy: validation of International Study Group of Pancreatic Surgery classification and analysis of risk factors
No full textAbstractObjectivesThis study evaluates the incidence and clinical features and associated risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy, employing the International Study Group of Pancreatic Surgery (ISGPS) consensus definition.MethodsDemographic, pathological and surgical details for 260 consecutive patients who underwent pylorus-preserving pancreaticoduodenectomy at a single institution were analysed using univariate and multivariate models.ResultsPostoperative complications occurred in 108 (41.5%) and DGE was diagnosed in 36 (13.8%) of 260 patients. Among the 36 DGE patients, 16 had grade A, 18 grade B and two grade C DGE. Resumption of a solid diet (P < 0.001), time to passage of stool (P= 0.002) and hospital discharge (P < 0.001) occurred later in DGE patients. The need for total parenteral nutrition was significantly higher in DGE grade B/C patients (P < 0.001). In the univariate analysis, abdominal collections (P≤ 0.001), pancreatic fistula (PF) grades B and C (P < 0.001), biliary fistula (P= 0.002), pulmonary complications (P < 0.001) and sepsis (P= 0.002) were associated with DGE. Only abdominal collections (P= 0.009), PF grade B/C (P < 0.001) and sepsis (P= 0.024) were associated with clinically relevant DGE. In the multivariate analysis, PF grade B/C (P= 0.004) and biliary fistula (P= 0.039) were independent risk factors for DGE.ConclusionsThe ISGPS classification and grading systems correlate well with the clinical course of DGE and are feasible for patient management. The principal risk factors for DGE seem to be pancreatic and biliary fistulas
Laurel but Hardy: unintended poisoning, a case report of oleander misidentification as bay laurel
No full textIntroduction: Nerium oleander is a toxic plant containing cardiac glycosides throughout all its parts, thereby posing severe health risks upon ingestion. The clinical manifestations of oleander poisoning closely resemble those of digoxin toxicity, encompassing a spectrum of gastrointestinal symptoms, neuropsychiatric disorders, and cardiac disturbances. This scientific case report describes a case of accidental intoxication resulting from the consumption of an oleander leaves infusion misidentified as bay laurel leaves. Case report: An 84-year-old patient consumed an oleander leaves infusion, and after four hours experienced gastrointestinal symptoms. He contacted the poison control center (PCC) and was advised to go to the emergency department (ED). Upon arrival, the patient presented stable vital signs without cardiac irregularities. The PCC recommended the administration of activated charcoal, vigilant monitoring, including electrocardiography (ECG). Subsequent ECGs assessments revealed the presence of third-degree atrioventricular block; in consultation with the PCC, digoxin-specific antibodies and external pacing were necessary. The patient was discharged on the eighth day in good hemodynamic condition, and outpatient follow-up visits showed clinical stability. Discussion: This study offers insights for the management of similar cases. The limitations of conventional assays in measuring oleander cardiac glycosides were observed, emphasizing reliance on clinical evaluation. The patient's trajectory, remaining asymptomatic despite severe ECG changes post-ingestion, underscores the importance of prolonged clinical monitoring
Not only Van Gogh: a case of BRASH syndrome with concomitant digoxin toxicity
No full textBackground Bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a potentially life-threatening clinical condition characterized by bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia. It constitutes a vicious circle in which the accumulation of pharmacologically active compounds and hyperkalemia lead to hemodynamic instability and heart failure.Case presentation A 66-year-old Caucasian female patient was admitted to the emergency department presenting with fatigue and bradycardia. Upon examination, the patient was found to be anuric and hypotensive. Laboratory investigations revealed metabolic acidosis and hyperkalemia. Clinical evaluation suggested signs of digoxin toxicity, with serum digoxin concentrations persistently elevated over several days. Despite the implementation of antikalemic measures, the patient's condition remained refractory, necessitating renal dialysis and administration of digoxin immune fab.Conclusion Bradycardia, renal failure, atrioventricular (AV) node blocking, shock, and hyperkalemia syndrome is a life-threatening condition that requires prompt management. It is important to also consider potential coexisting clinical manifestations indicative of intoxication from other pharmacological agents. Specifically, symptoms associated with the accumulation of drugs eliminated via the kidneys, such as digoxin. These manifestations may warrant targeted therapeutic measures
Matilde Espinosa o la Metáfora de la Poesía
No full textThe work written by the Colombian poet Matilde Espinosa de Pérez de serves to be
known and recognized by the literary review, so according to this, the article below is a study
about two of her last works: The dark land and The town gets into dark. This paper analyses the
poetic conception of the female author, the a esthetic connection of her work with her passing
within everyday life as a mother, woman and female writer and, the standing she considers
among pain, life and death as elements that constitutes her poetic ar
Yoroppa, tokuni Itaria ni okeru Encho no juyo ni tsuite
No full textThe essay analyzes the reception of San'yutei Encho, in Europe and in Italy, starting from the fundamental role of Lafcadio Hearn to the most recent translation in Italian, "The Peony Lantern", of the author of the essay. After the stages of presentation of Encho in Europe, the author of the essay points out that in the case of Italy, the contemporary Italian ghosts literature prepared a fertile ground to receive Encho in Italy
Mori Ogai. Il romanticismo e l'effimero. La trilogia tedesca
No full text"Il romanticismo e l’effimero" raccoglie e commenta, con un approccio originale, i primi tre racconti dello scrittore Mori ?gai, conosciuti nell’insieme come “trilogia tedesca”, mettendo in evidenza come l’autore abbia unito il tema romantico europeo con l’estetica dell’effimero giapponese. "Romanticism and the ephemeral" gathers and comments, with an original approach, the first three stories of the author Mori ?gai, known as "German trilogy", highlighting how the author has joined the European romantic theme with the Japanese aesthetics of ephemerality
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