101,979 research outputs found
L'aggregazione dei soggetti aggiudicatori di contratti pubblici fra ragioni di integrità, specializzazione e riduzione della spesa
No full textGli appalti verdi nel codice dei contratti pubblici
No full textIl saggio affronta il tema della conformazione del mercato delle
commesse pubbliche alle esigenze di sostenibilità ambientale. All’analisi relativa all’evoluzione della considerazione degli aspetti ambientali nella legislazione e nella giurisprudenza comunitarie e nazionali in tema di contratti pubblici, con particolare attenzione agli strumenti a tal fine adottati in seno al nuovo codice di cui al d.lgs. n. 50/2016, segue una riflessione conclusiva che mette in luce le contraddizioni ed i potenziali rischi della sempre maggiore
complessità contrattuale – necessitata proprio dalle istanze ambientaliste – sugli stessi obbiettivi di ecoefficienza
Correction to: Validity of the Italian multiple sclerosis neuropsychological screening questionnaire (Neurological Sciences, (2021), 42, 11, (4583-4589), 10.1007/s10072-021-05141-1)
No full textThe original article contains an error in author name. In the published article, author name Girolama Alessandra Marfia was incorrectly captured as GirolamaAlessandraAlessandra Alessandra Marfia. Author name is corrected above. The original article has been corrected
I criteri di aggiudicazione
No full textIl contributo tratta dei criteri di aggiudicazione nel Codice dei Contratti Pubblici, in particolare del criterio del prezzo più basso e dell'offerta economicamente più vantaggiosa
Bickerstaff encephalitis: report of two atypical cases with negative anti GQ1B antibodies
No full textBickerstaff encephalitis with anti gm1-antibodies relapsing as guillain-barre syndrome: a case report
No full textEPIDEMIOLOGY AND POTENTIAL PROGNOSTIC FACTORS IN GUILLAIN-BARRE SYNDROME: TEN-YEAR EXPERIENCE OF "POLICLINICO TOR VERGATA"
No full textMeningomyeloradiculitis mimicking recurrent bilateral neuralgic amyotrophy.
No full textNeuralgic amyotrophy (NA), also known as idiopathic brachial plexopathy or “Parsonage-Turner syndrome”, is a clinical idiopathic unilateral disorder that involves the brachial plexus with monophasic and self-limiting course. Bilateral and/or hereditary forms of NA have been also reported. We discuss the case of a 35-year-old woman with ten-year-history of bilateral recurrent NA. Initially she presented shoulder pain followed by prominent weakness and wasting of shoulder girdle musculature, with asymmetric and asynchronous pattern. Some years later she developed left Aran-Duchenne muscular atrophy. When she came to our attention she complained pain and weakness at lower limbs. Neurophysiologic studies excluded brachial and lumbosacral plexopathy. The cerebrospinal fluid (CSF) examination showed pleocytosis (15 elements/mm3) and hyperproteinorrhachia (7.0 g/l). Neurotropic virus were negative in both serum and CSF. Spinal cord MRI showed abnormal intramedullary hyperintensity of anterior horn on T2-weighted at dorsal tract and contrast-enhancement of the cauda equine roots. Pain and weakness were partially relieved by steroid pulse endovenous therapy. In our patient menigomyeloradiculitis of unknown origin mimicked recurrent bilateral neuralgic amyotrophy involving both upper and lower limbs. Finally, we suggest to perform CSF examination and spinal cord MRI in all cases of NA with atypical course
Central and peripheral nervous system involvement as a manifestation of graft versus host disease after liver transplantation: case report
No full textThe incidence of graft versus host disease (GVHD) after liver trasplantation (LT) has been estimated at 0.1–2%, but the mortality rate is 80–100%. Clinical series show that nervous system (NS) complications following liver trasplantation (LT) occur in 8 to 47% cases and include diffuse encephalopathy, cerebrovascular disorder, infection, immunosuppression-induced neurotoxicity, and peripheral nerve damage; however the involvement of the central and peripheral NS as manifestation of GVHD after LT has not been demonstrated conclusively.
Here we report a 57 years old male patient who received a liver transplant for HBV related-epatocirrosis. On post operative day (POD) 20 he developed a pattern of asymmetric severe painful dysestesias of upper limbs. A week after he presented a stepwise progressive weakness of upper limbs followed days later by numbness and profound weakness in left distal peroneal distribution.
Elettrofisiological findings showed a pattern of axonal sensori-motor multiplex mononeuropathy. High titers of anti-neutrophil cytoplasmic antibodies (ANCA) were detected in his serum. Cerebrospinal fluid examination and serological tests were performed to exclude differential diagnosis such as drug-induced toxicities or opportunistic infections. High dose intravenous metilprednisolone resulted in remission of painful symptomatology and improved overall neurological examination.
His subsequent clinical course was complicated by acute disartria ad emiparesis on POD 246 due to ischaemic stroke detected with diffusion-weighted MRI.
We propose that multineuropathy and ischaemic stroke occured in this patient as major manifestation of recurrent acute GVHD, suggesting that peripheral and central NS can be targets of a vasculitic immunomediated disorder in GVHD
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