A case of primary Hodgkin's lymphoma of the parotid gland. Case report and differentian diagnosis from Kuttner's Syndrom

Abstract We report a rare case of primary Hodgkin’s lymphoma (HL) of the submandibular gland, with initially diagnosis of Kuttner’s Syndrom. A 48 years old man was referred to our hospital foe evaluation of a submandibular mass. Although the initial Fine Needle Aspiration and subsequent cytology was highly suggestive for a cronic sialadenitis with lymphoid cells. After surgical gland removal we obtained a definitive diagnosis of Hodgkin’s lymphoma in submandibular gland a seat where the most common lymphoma tipe is B

Which is the most accurate diagnostic procedure in Tamoxifen treated breast cancer patients

Purpose: The aim of this study was to evaluate the diagnostic accuracy of bi-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound (TVUS), hysterosonography (HSSG) and hysteroscopy in the detection of endometrial pathology in women treated with tamoxifen (TMX) for breast cancer. Methods: Forty-two patients, affected by breast cancer under treatment with TMX, underwent 2D-3D TVUS, HSSG and hysteroscopy completed by biopsy, after abnormal findings following a routine 2D TVUS examination. Results: 3D-TVUS was more accurate than 2D-TVUS in the detection of atrophic endometrium confirmed by biopsy and in the detection of endometrial polyps. HSSG and hysteroscopy detected atrophic endometrium and endometrial polyps significantly better than ultrasound scan. Endometrial carcinoma was detected in two cases, and in both HSSG and hysteroscopy were 100% diagnostic. Conclusion: In TMX treated breast cancer patients, HSSG and hysteroscopy provide more accurate diagnosis than 2D-3D ultrasound in the detection of treatment related endometrial lesions

JCV-specific T-cells producing IFN-gamma are differently associated with PmL occurrence in HIV patients and liver transplant recipients

Aim of this work was to investigate a possible correlation between the frequency of JCV-specific T-cells and PML occurrence in HIV-infected subjects and in liver transplant recipients. A significant decrease of JCV-specific T-cells was observed in HIV-PML subjects, highlighting a close relation between JCV-specific T-cell immune impairment and PML occurrence in HIV-subjects. Interestingly, liver-transplant recipients (LTR) showed a low frequency of JCV-specific T-cells, similar to HIV-PML subjects. Nevertheless, none of the enrolled LTR developed PML, suggesting the existence of different immunological mechanisms involved in the maintenance of a protective immune response in LT

Biodiversity of cultivable psychrotrophic marine bacteria isolated from Terra Nova Bay (Ross Sea, Antarctica)

A set of 146 Antarctic marine isolates from the Ross Sea was characterized by a combination of molecular techniques in order to determine the degree of inter- and intraspecific variability. Isolates were analyzed by amplified rDNA restriction analysis (ARDRA) using the tetrameric enzyme AluI, resulting in 52 different groups, corresponding to at least 52 different bacterial species, indicating a high degree of interspecific variability. The phylogenetic position of bacteria belonging to some ARDRA groups was obtained by sequencing of 16S rDNA. Random amplified polymorphic DNA (RAPD) analysis, carried out on the largest ARDRA groups, revealed a high intraspecific genetic variability, too. The analysis of plasmid content revealed the existence of horizontal gene transfer between strains belonging to the same and to different species. A comparison of the whole body of morphological, physiological and biochemical data was finally carried out

When more is not better: 10 'don'ts' in endometriosis management. An ETIC* position statement

41noETIC Endometriosis Treatment Italian ClubopenA network of endometriosis experts from 16 Italian academic departments and teaching hospitals distributed all over the country made a critical appraisal of the available evidence and definition of 10 suggestions regarding measures to be de-implemented. Strong suggestions were made only when high-quality evidence was available. The aim was to select 10 low-value medical interventions, characterized by an unfavorable balance between potential benefits, potential harms, and costs, which should be discouraged in women with endometriosis. The following suggestions were agreed by all experts: do not suggest laparoscopy to detect and treat superficial peritoneal endometriosis in infertile women without pelvic pain symptoms; do not recommend controlled ovarian stimulation and IUI in infertile women with endometriosis at any stage; do not remove small ovarian endometriomas (diameter <4 cm) with the sole objective of improving the likelihood of conception in infertile patients scheduled for IVF; do not remove uncomplicated deep endometriotic lesions in asymptomatic women, and also in symptomatic women not seeking conception when medical treatment is effective and well tolerated; do not systematically request second-level diagnostic investigations in women with known or suspected non-subocclusive colorectal endometriosis or with symptoms responding to medical treatment; do not recommend repeated follow-up serum CA-125 (or other currently available biomarkers) measurements in women successfully using medical treatments for uncomplicated endometriosis in the absence of suspicious ovarian cysts; do not leave women undergoing surgery for ovarian endometriomas and not seeking immediate conception without post-operative long-term treatment with estrogen-progestins or progestins; do not perform laparoscopy in adolescent women (<20 years) with moderate-severe dysmenorrhea and clinically suspected early endometriosis without prior attempting to relieve symptoms with estrogen-progestins or progestins; do not prescribe drugs that cannot be used for prolonged periods of time because of safety or cost issues as first-line medical treatment, unless estrogen-progestins or progestins have been proven ineffective, not tolerated, or contraindicated; do not use robotic-assisted laparoscopic surgery for endometriosis outside research settings. Our proposal is to better address medical and surgical approaches to endometriosis de-implementing low-value interventions, with the aim to prevent unnecessary morbidity, limit psychological distress, and reduce the burden of treatment avoiding medical overuse and allowing a more equitable distribution of healthcare resources.openAlio, L; Angioni, S; Arena, S; Bartiromo, L; Bergamini, V; Berlanda, N; Bonin, C; Busacca, M; Candiani, M; Centini, G; D’Alterio, M N; Di Cello, A; Exacoustos, C; Fedele, L; Frattaruolo, M P; Incandela, D; Lazzeri, L; Luisi, S; Maiorana, A; Maneschi, F; Martire, F; Massarotti, C; Mattei, A; Muzii, L; Ottolina, J; Perandini, A; Perelli, F; Pino, I; Porpora, M G; Raimondo, D; Remorgida, V; Seracchioli, R; Solima, E; Somigliana, E; Sorrenti, G; Venturella, R; Vercellini, P; Viganó, P; Vignali, M; Zullo, F; Zupi, EAlio, L; Angioni, S; Arena, S; Bartiromo, L; Bergamini, V; Berlanda, N; Bonin, C; Busacca, M; Candiani, M; Centini, G; D’Alterio, M N; Di Cello, A; Exacoustos, C; Fedele, L; Frattaruolo, M P; Incandela, D; Lazzeri, L; Luisi, S; Maiorana, Anna; Maneschi, F; Martire, F; Massarotti, C; Mattei, A; Muzii, L; Ottolina, J; Perandini, A; Perelli, F; Pino, Ida; Porpora, M G; Raimondo, D; Remorgida, V; Seracchioli, R; Solima, E; Somigliana, E; Sorrenti, G; Venturella, R; Vercellini, P; Vigano', Paola; Vignali, M; Zullo, F; Zupi,

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys