43 research outputs found
A case of pulmonary dirofilariasis in Ferrara, Italy
No full textThe pulmonary filariasis is a rare entity and it is caused by a dog worm (Dirofilaria) that is transmitted to humans by mosquitoes. The filarial nematode enters the subcutaneous tissue, travels to the right ventricle, dies and then embolizes the pulmonary vessels causing a small pulmonary infarction. Usually it is casually identified by chest radiography, done for other reasons, in asymptomatic patients; the coin-lesion shape is generally presumed to be neoplastic. We reported a case of human pulmonary filariasis in a man who shown multiple lung coin-lesions shaped presumed to be neoplastic. The patient underwent surgery with double-wedge resection of the right lung and he was discharged on the fifth post-operative day. The Dirofilariasis incidence is increasing in the canine population, making human pulmonary dirofilariasis likely to occur. The differential diagnosis of a solitary pulmonary nodule includes primary lung cancer, metastatic cancer, infectious disease, septic embolism, Wegner's granulomatosis, pulmonary echinococcosis and reumatoid nodules. No single preoperative laboratory test has been a diagnostic value. Human pulmonary dirofilariasis should be considered in the differential diagnosis of solitary or multiple subpleural, non calcified pulmonary nodules in the clinical and appropriated epidemiological setting, since more cases of this infectious disease are likely to be found with greater awareness of this condition
Thymic Epithelial Tumors: Prognostic Significance and Relationship between Histology and the New TNM Staging System
No full textBackground This study aims to describe the relationship between the new tumor nodes metastasis (TNM) staging and World Health Organization (WHO) classification and to identify how these two variables relate to each other and whether they possess a prognostic value in predicting survival and recurrence of disease. Methods Medical records of 54 patients who underwent surgery for thymic epithelial tumors between 1996 and 2015 were reviewed. The histologic type of neoplasm was classified according to the criteria of WHO and staging was evaluated using the new TNM classification system. Results A significant correlation between the TNM stages and the histological classification was found (p < 0.001). Complete resection is related to both TNM stage and histological grading (p < 0.001). Evaluation of the 5- A nd 10-year survival curves shows how these are significantly correlated only at the stage (p = 0.03 and = 0.04, respectively). The risk of death at 5 and 10 years for stages III to IV is six and three times higher than in stages I to II, respectively. Regarding the disease-free survival, there is significant correlation with both staging and histology (p = 0.001 and = 0.02, respectively). Conclusions There is a significant correlation between the new TNM staging and the histological grade WHO. The ability to implement a complete resection, the overall and disease-free survival is closely related to the thymoma stage. Furthermore, both histotype and stage correlate with disease-free survival. In fact, the least aggressive stages, both WHO and TNM, have a free time out of disease superior to advanced stages
Linguaggio e natura. Logos e corradicali da Omero ad Aristotele
No full textQuesto lavoro si propone di ripercorrere la storia delle interpretazioni di logos e corradicali da Omero ad Aristotele. Viene anzitutto messa in discussione l’ipotesi etimologica tradizionale, che assegna priorità ai valori ‘razionali e distributivi’, secondo cui lego significa ‘raccogliere’, di qui ‘scegliere’, ‘contare’, poi ‘raccontare’ e ‘dire’. Dalle attestazioni omeriche risulta invece che lego significa: 1.‘raccogliere’ come ‘mettere insieme’; 2. ‘dire’ come ‘mettere insieme i contenuti di un discorso’; 3. ‘raggruppare’, come contare tipico dei popoli senza scrittura, mentre logos è esclusivamente riferito al linguaggio. Con Eraclito, logos diviene per la prima volta termine chiave del lessico filosofico. Nei contesti più pregnanti, come i frr. 1 e 50 DK, esso è retto da verbi di ‘udire’ e ‘comprendere’. Il logos, non solo udito ma compreso, è visto come unità di significato, in cui si esperisce l’unità profonda di tutte le cose. In Parmenide, l’unica via di accesso alla verità risiede non nei sensi ma nel logos, visto come capacità di esprimere (legein) e comprendere (noein) un’unità di senso. Con Gorgia e i Sofisti, la valenza linguistica del logos emerge in primo piano, ma viene meno la sua funzione veritativa. Platone e Aristotele restaurano, ognuno a suo modo, il nesso fra logos e verità tematizzando il rapporto fra il logos e le sue sottocomponenti (onomata). Ciò emerge nel paragone platonico della Linea divisa e nella definizione di logos del Sofista, e conduce a una rilettura dell’incipit del De interpretatione. Da Omero ad Aristotele, logos non indica dunque un’astratta ‘ragione’, ma il linguaggio come potenziale via di accesso alla natura e alla verità
A challenging convergence of conditions in a patient with thalassemia major presenting with thymoma and lymphangioleiomyomatosis: a case report
No full textBackground: β-Thalassemia major is a complex, multisystemic condition. Effective transfusion programs, optimal iron chelation therapy, and progresses in magnetic resonance imaging have significantly improved patient survival. Despite these advancements, the fundamental pathophysiology remains unaltered, leading to an increase in comorbidities and cancer diagnoses with advancing age. We report a unique case of coincidentally discovered thymoma and lymphangioleiomyomatosis in a patient with β-thalassemia major. Case presentation: A 56-year-old Italian female patient with β-thalassemia major underwent magnetic resonance imaging to quantify myocardial, hepatic, and pancreatic iron deposition. Her medical history included transfusion-dependent β-thalassemia, splenectomy, and cholecystectomy. At the time of magnetic resonance imaging, she had no significant endocrine, cardiac, or hepatic complications and was on deferasirox, vitamin D, and luspatercept. Magnetic resonance imaging revealed a lobulated mass in the prevascular mediastinum, which showed mild radiotracer uptake on positron emission tomography. Chest computed tomography revealed multiple thin-walled cysts in the lungs, indicating lymphangioleiomyomatosis. Following multidisciplinary evaluation, the patient underwent thoracoscopic thymectomy and lung wedge resection. Histopathology confirmed type B2 thymoma and pulmonary lymphangioleiomyomatosis. Post-surgery, the patient was recommended for adjuvant radiation therapy and sirolimus treatment. Conclusion: This is the first reported case of the coincidental discovery of thymoma and lymphangioleiomyomatosis in a patient with β-thalassemia major. This case emphasizes the importance of thorough radiologic evaluations in patients with β-thalassemia to detect potential neoplastic conditions early. Enhanced awareness among clinicians and radiologists is crucial for the timely diagnosis and management of these patients
Il logos apophantikos nel De interpretatione. Tra linguistica e logica sullo sfondo della dialettica
No full textIn questo contributo intendo proporre
1. innanzitutto una lettura unitaria del De interpretatione e
2. in secondo luogo una riflessione circa la sua collocazione all’interno
dell’Organon aristotelico, a partire dall’analisi del capitolo 5, in cui Aristotele definisce il logos apophantikos, il discorso enunciativo.
La riflessione intorno al De interpretatione pone numerose ‘sfide’ a chi
cerca di comprendere e interpretare questo testo.
Innanzitutto, sembra difficile cogliere in quest’opera un disegno unitario,
perché in appena 14 capitoli, il testo, dal punto di vista del pensiero moderno,
sembra ‘cambiare pelle’ più volte, passando da una trattazione prettamente
linguistico-grammaticale (capp. 1-4) a una trattazione logica, che si concentra sui rapporti di contraddizione, contraddittorietà e contrarietà tra
proposizioni, per poi trattare dei diversi intrecci possibili tra affermazione e
negazione e delle regole della predicazione. Di fronte a questo complesso e discusso quadro ermeneutico, credo sia
possibile una rilettura in chiave unitaria del testo a partire da una diversa
considerazione del ruolo del logos apophantikos nell’economia di quest’opera. Questa nozione va pensata non più come il fine a cui l’intero testo è ordinato, ma come un passaggio chiave che ne consente e ne spiega lo sviluppo
Endovascular and thoracoscopic treatment for post-lobectomy hemothorax
No full textA male patient underwent lobectomy and partial pleurectomy for non-small-cell lung cancer (NSCLC). After 30 days, chest computed tomography discovered a hemothorax secondary to an intercostal artery leakage (Fig. 1). A thoracic aorta angiography revealed an intercostal pseudo-aneurysm treated successfully with embolization (Fig. 2(A) and (B)). We performed a successful thoracoscopic debridement
Late Epiphrenic-Retroperitoneal Fistula of an Esophageal Diverticulum Ten Years after Surgical Excision: Report of the First Case
No full textBackground: Esophageal fistula is a rare complication of an epiphrenic diverticulum and represents a difficult diagnostic challenge. In the majority of cases in the English literature, the fistula is secondary to the spontaneous perforation of the epiphrenic diverticulum and in only one case an esophagobronchial fistula occurs after resection of an epiphrenic diverticulum. No case of esophageal fistula communicating with the retroperitoneum tissues was found. Case Report: We present a case of 84 years old male admitted in 2017 in our Hospital for the appearance of epigastralgia and cough with traces of blood to sputum, asthenia and night sweats. Ten years before he underwent to a hiatal hernia plastic sec. Nissen and subsequently was reoperated for exeresis of diverticulum of the distal third of the esophagus by thoracotomy. In August 2008, because of esophageal substenosis an operation of posterior gastropexy sec. Hill with the demolition of the previous hiatoplasty was performed. In 2017, a computerized tomography shows a voluminous abscess in the right paravertebral region with development along the muscular plane of the ipsilateral psoas and a fistular path of about 4 cm between the posterior wall of the esophagus and the retroperitoneal collection of the abdomen. Conclusions: Esophageal fistula represents a complex problem of epiphrenic diverticulum and rarely a hidden complication of surgery. Surgery is the treatment of choice in suitable patients
Application of Indocyanine Green Enhanced Fluorescence in Esophageal Surgery: A Mini Review
No full textDespite recent technological innovations and the development of minimally invasive surgery, esophagectomy remains an operation burdened with severe postoperative complications. Fluorescence imaging, particularly using indocyanine green (ICG), offers the ability to address a number of issues faced during esophagectomy. The three main indications for the intraoperative use of ICG during esophagectomy are visualization of conduit vascular supply, allow identification of sentinel nodes and visualization of the thoracic duct. The purpose of this mini review is to present an overview of current practice in fluorescence imaging utilizing ICG during esophagectomy, as well as to demonstrate how this technology can guide lymphadenectomy and reduce surgical morbidity such as anastomotic leaking and chylothorax
Broncopolmonite con empieva pleurico da Streptococcus pluranimalium in paziente tossicodipendente: considerazioni clinico-epidemiologiche.
No full text
