SICOB Italian clinical practice guidelines for the surgical treatment of obesity and associated diseases using GRADE methodology on bariatric and metabolic surgery.

Obesity is a chronic disease associated with increased morbidity and mortality and reduced quality of life. Pharmacotherapy can be associated with life style changes in increasing and maintaining weight loss and ameliorating obesity-related complications and comorbidities. In patients affected by obesity and uncontrolled obesity-associated complications or high degrees of BMI (> 40 Kg/m), metabolic bariatric surgery can be a valid therapeutic option.

Thyroid nodules with indeterminate cytology: association between nodule size, histopathological characteristics and clinical outcome in differentiated thyroid carcinomas - a multicenter retrospective cohort study on 761 patients.

A great number of surgical diagnostic procedures are performed every year for thyroid nodules that are included in undetermined cytological classes that reveal to be malignant thyroid carcinomas in one-third of cases. In the most recent guidelines, lobectomy is the most recommended surgical approach for this classes of nodules, but total thyroidectomy is the recommended treatment for undetermined nodules larger than 4 cm. The main study aim is to support or question the dimensional criteria as an independent clinical decision element for undetermined thyroid nodules management.

It could suddenly happen: delayed rupture of the trachea after total thyroidectomy. A case report.

Introduction: We report the case of a patient who presented with subcutaneous emphysema, dyspnea and cough 7 days after total thyroidectomy for cancer. In addition we review the Literature and discuss the therapeutic challenges as well as management options.

Case Report: A 17-year old female patient underwent a total thyroidectomy with right cervical lymph adenectomy for papillar cancer.

Quality Assurance and measurement errors in monitoring tree crown conditions in Italy.

The adoption of a comprehensive Quality Assurance (QA) programme for tree condition monitoring resulted in a rapid and steady improvement of data consistency in crown transparency assessment. On the other hand, the assessment of damage due to insects and fungi remains problematic and requires further training and control efforts. While our findings demonstrated the benefits arising from a QA programme and even the need to reinforce it, recent financial constrains have resulted in a severe reduction of the field checks.

The analgesic efficacy of continuous elastomeric pump ropivacaine wound instillation after appendectomy.

Study Objective: To evaluate the analgesic efficacy and safety of ropivacaine 0.2% when administered continuously via elastomeric pump after appendectomy.

Design: Prospective, randomized, double-blinded study.

Crown condition surveys in Italian forests: issues in reporting findings.

This study examines defoliation and discoloration findings collected throughout the Italian Level I network between 1997 and 2000. Prior to this period no Quality Assurance procedures had been implemented, so that earlier findings cannot be considered reliable. The aim of the study is to compare different indices used in reporting findings, in order to determine the full potential and limitations of each.

Technetium-99m-sestamibi scintigraphy: an alternative approach for diagnosis and follow-up of active myeloma lesions after high-dose chemotherapy and autologous stem cell transplantation.

Technetium-99m-sestamibi (MIBI) is a radionuclide tracer taken up by different malignant tumors. A total of 88 MIBI scans were carried out in 20 individuals with monoclonal gammopathy of unknown significance (MGUS) and 10 patients during follow-up for other cancers. Of these 58 MIBI scans were carried out in 46 myeloma patients: 15 at diagnosis, 14 during conventional chemotherapy, and 29 following high-dose sequential therapy and autologous peripheral blood progenitor support.

Pachyonychia congenita with late onset of nail dystrophy--a new clinical entity?

Pachyonychia congenita syndrome (PCS) is a genetic disease with an autosomal dominant mode of transmission in which the main sign, pachyonychia, usually arises at birth or in childhood together with other disorders of keratinization. A 28-year-old woman developed subungual hyperkeratosis of all toe-nails and thumb-nails associated with pain on pressure and walking. She had a scrotal tongue with leucokeratotic areas, blister formation, plantar hyperkeratosis, palmoplantar hyperhidrosis and dental cavities since childhood.

[The adenosine test in association with 99m-technetium sestamibi tomoscintigraphy in the diagnosis of coronary pathology].

Background: The exogenous adenosine is able to provoke a coronary vasodilation, which is the same as the one provoked by the papaverine and greater than the one provoked by the dipyridamole. We report our experience in using exogenous adenosine in association with technetium-99m-sestamibi tomoscintigraphy for a diagnostic test on the coronary artery disease (CAD).

Methods: We considered 22 patients (18 male and 4 female, mean age 57 years) affected by angiographically demonstrated coronary artery disease (stenoses > or = 50%).