Clinical outcomes for patients with cardiovascular diseases before, during, and after the COVID19 pandemic. A pooled analysis of 600.000 patients.

Background: The unexpected virulence of the COVID19 pandemic brought to significant changes of generally accepted therapeutic approaches. The consequences of these changes were difficult to define during the pandemic period.

Methods: We analyzed the National Registries including 97% of hospital admissions in Italy, regarding data describing number of operations for aortic valve implantation or repair, carotid and coronary revascularization, AAA repair, and lower limb arterial reconstruction performed in the period 2015 to 2019 and in the pandemic years 2020, 2021, and 2022.

Heterogeneous Characteristics of Patients with Inflammatory Abdominal Aortic Aneurysm. Systematic Review of Therapeutic Solutions.

Background: Endovascular repair of inflammatory abdominal aortic aneurysms (IAAAs) has emerged as an alternative to open surgery, but direct comparisons are limited. The aim of the study was to compare clinical outcomes of endovascular and open repair for IAAA according with specific clinical characteristics.

Methods: We performed a literature review of reports describing patients who had open or endovascular repair for IAAA.

A Case Report of Multiple Gastrointestinal Stromal Tumors: Imaging Findings, Surgical Approach, and Review of the Literature.

Introduction: Multiple gastrointestinal stromal tumors (GISTs) are rare tumors. Differential diagnosis between metastatic and multiple GISTs represents a challenge for a proper workup, prediction prognosis, and therapeutic strategy.

Case Presentation: We present the case of 67-year-old man with computed tomography (CT) evidence of multiple exophytic lesions in the abdomen, reaching diameters ranging from 1 to 9 cm, without any signs of organs infiltration, and resulting positive at 18F-FDG-PET/CT.

The impact of experience on recurrence rates after biopsy punch excision for pilonidal disease.

Aim: We present the outcomes and the recurrences of 848 patients with pilonidal disease (PD) treated by biopsy punch excision (BPE) and we weigh our results against progressively obtained operative experience. BPE is a modified 'merged' version of both the Bascom 'pit picking' procedure and the Gips procedure. It employs biopsy punches of different calibre, depending on whether treatment is in the natal cleft (calibre as small as possible) or lateral (larger calibre punches or even small incision).

De Novo Secondary Adenocarcinoma in the Colon Used as Urinary Diversion Not in Contact with the Fecal Stream: Systematic Review and Meta-analysis.

Background: A systematic review with a meta-analysis was performed to determine the prevalence and risk factors for secondary de novo adenocarcinoma in the colon used as a urinary diversion not exposed to the fecal stream.

Methods: The systematic review of the literature identified 47 patients with secondary adenocarcinoma in a colonic urinary diversion not exposed to the fecal stream.

Results: The diagnosis of secondary adenocarcinoma was determined due to the presence major local symptoms and because the cancer in half of the patients was detected at an advanced stage.

National statistics about resection of the primary tumor in asymptomatic patients with Stage IV colorectal cancer and unresectable metastases. Need for improvement in data collection. A systematic review with meta-analysis.

Background: Patients with asymptomatic Stage IV colorectal cancer represent a significant heterogeneous group. National statistics represent an effective method to follow in real time the clinical outcomes of patients, and they may represent an important tool to analyze and to compare different therapeutic approaches. The aim of our study was to analyze the reviews of national data and single institutions reports, which compared the clinical outcomes of patients with asymptomatic Stage IV colorectal cancer and un-resectable metastases who had resection of the primary tumor with those who did not have resection.

Pneumothorax: a rare complication of colonoscopy. A systematic review of literature.

Aim: The purpose of this study is to determine the anatomica! aspects, mechanisms, risk factors and appropriate management of development of pneumothorax during a routine colonoscopy.

Material Of Study: The review has been carried out according to PRISMA statement. The literature search included PubMed and Scopus database.

New prognostic factors in gastric cancer: the role of lympho-plasmacytic infiltrate.

Background: Gastric cancer triggers an immune response, manifested by immunocompetent cells infiltrating the tumor, such as macrophages, NK cells, neutrophils, T and B-lymphocytes, and plasma cells.

Methods: Were viewed 300 patients who received surgery for gastric cancer, with removal of at least 15 regional lymph nodes, from January 1998 through December 2008, at the Policlinico "Umberto I", Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, and at "Santa Maria Goretti" Hospital of Latina, Italy. We selected a subset of 46 patients identified according to the following selection criteria: presence of gastric cancer (both intestinal-type and diffuse-type), early-stage (T1 and T2), absence of nodal metastases (N0), or involvement of less than 8 lymph nodes (N1), absence of distant metastases (M0), stage I and II.

Right pneumothorax secondary to colonoscopic perforation: a case.

Aim: The purpose of this study is to determine the anatomical aspects, mechanisms, risk factors and appropriate management of development of pneumothorax during a routine colonoscopy.

Clinical Case: We report a case of an accidental bowel wall injury during diagnostic colonoscopic with consequent pneumoperitoneum; this was followed by expansion of gas through diaphragmatic fenestration perhaps congenital, in right pleural cavity causing pneumothorax.

Discussion: Rarely, colonic perforation during colonoscopy can occur into the extraperitoneal space, thus leading to the passage and diffusion of air along the fascial planes and large vessels, possibly causing pneumoretroperitoneum, pneumomediastinum, pneumopericardium, pneumothorax, and subcutaneous emphysema.

Densitometric changes of the patella in patients undergoing unilateral knee arthroplasty.

Introduction: Although the intervention of knee arthroplasty became routine, there is no standard reference on the densitometric characteristics of the patella before and after surgery. Scope of this work is the evaluation of patellar bone density before and after unilateral knee arthroplasty.

Patients And Methods: BMD was assessed by DEXA examination in 146 individuals, who have been divided into three distinct groups.

Clinical Benefits of Unilateral Adrenalectomy in Patients with Subclinical Hypercortisolism Due to Adrenal Incidentaloma: Results from a Single Center.

Introduction: This study was designed to evaluate the results of unilateral laparoscopic adrenalectomy in patients with subclinical hypercortisolism (SH) due to adrenal incidentaloma (AI) concerning the main cardiometabolic disorders.

Methods: We have studied between January 2000 to December 2015, 645 patients with AI (283 males and 362 females; mean age 61.9 ± 10 years) and we found 70 patients with SH (27 males and 43 females; mean age 61.

Plasma endothelin-1 levels in patients with resistant hypertension: effects of renal sympathetic denervation.

Introduction: Resistant arterial hypertension (RHT) is defined as poor controlled blood pressure (BP) despite optimal doses of three or more antihypertensive agents, including a diuretic. In the development of RHT, hyperactivity of sympathetic (SNS) and renin-angiotensin-aldosterone (SRAA) systems are involved, and SNS is a potent stimulator of vasoactive endothelin-1 (ET-1) peptide. Renal sympathetic denervation (RSD) through disrupting renal afferent and efferent nerves attenuates SNS activity.

Pancreas divisum: correlation between anatomical abnormalities and bile precipitation in the gallbladder in seven patients.

Pancreas divisum is a genetic defect associated with recurrent acute pancreatitis due to insufficient drainage of the accessory pancreatic duct. Seven young patients diagnosed with pancreatic divisum and thickening of the gallbladder bile as shown on magnetic resonance cholangio-pancreatography without pancreatic ductal changes underwent laparoscopic cholecystectomy. During the mean follow-up of 32 months no episode of pancreatitis was reported.

Curative gastric resection for the elderly patients suffering from gastric cancer.

The improvement of the socio-economic conditions and the progress of medicine have extended the life span of the world's population and as a result, the number of patients with malignant neoplasms has increased. Gastric cancer is the third most common cancer (after lung and prostate) and the second leading cause of death caused by cancer (after lung bronchogenic cell carcinoma) in males; while it's the fifth cancer by frequency and the fourth cause of cancer death in females. It presents a peculiar geographical distribution with a lower incidence in Western Europe and North America, and higher incidence in the Far East, South America and Eastern Europe.

[Monolateral adenopathy of the axilla due to sarcoid-type granulomata: idiopathic granulomatous disease or sarcoidosis? A case report].

The presence of sarcoid-type granulomata in peripheral lymph nodes, with no evidence of other typical lesions, doesn't allow to diagnose sarcoidosis. In fact, sarcoidosis is a systemic disease and two or more organs must be affected to reach a definitive diagnosis. However this involvement could happen even several years later, thus making a correct diagnosis really difficult.

Cervical node metastasis as the first sign of cancer of the caecum.

The unusual case of an adenocarcinoma of the caecum undiagnosed until the appearance of a large neck and axillary mass is reported. To our knowledge, this is the first reported case of cervical node metastasis as the first sign of a caecal cancer, and 18 fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) proved critical in achieving the correct diagnosis. When an adenocarcinoma is found in the neck or axilla, even an abdominal primary location such as the large bowel can be taken into account and employment of FDG-PET should be considered.

[Multimodal treatment complications of post-cholecystectomy intrahepatic lithiasis. Case report].

The Authors presents a case of post-cholecystectomy intrahepatic lithiasis. They focalized their attention to the complications of multimodal treatment.

Space occupying lesions of parotid gland. Comparative diagnostic imaging and pathological analysis of echo color/power Doppler and of magnetic resonance imaging.

Aim of the study was to evaluate the role of echo color/power Doppler and magnetic resonance imaging in the diagnosis of space occupying parotid lesions, in the attempt to establish criteria for differential diagnosis between benign and malignant types. The study population comprised 49 patients (23 male, 26 female), age range 30-85 years, with a space occupying lesion of the parotid gland. Each lesion was carefully studied with ultrasound integrated with colour/power doppler and magnetic resonance imaging; patients were then submitted to echo-guided needle-biopsy and surgical excision.

[Liposarcoma of the leg].

The Authors report an interesting case of liposarcoma of the leg and review the international Literature. Moreover, a particular analysis of different aspects such as anatomy, clinic, diagnosis and treatment has been carried out.

[Spontaneous rupture of duodenum: case report and review].

Although rare, injuries of the duodenum increased in frequency during the past ten years. Careful attention must be paid to them, especially in blunt trauma of the abdomen and lower thoracic regions. Often they occur along with lesions of other related structures in polytraumatized patients.

[Monitoring of consciousness with BIS during induction of anesthesia. Which muscle relaxant?].

The BIS-index data show that an opiate as Fentanyl is advisable with associations Cisatracurium/Propofol or Vecuronium/Propofol. It is possible to use in these cases a drip infusion to avoid the risk of awareness during intubation.

[Magnetic resonance and traditional radiology in the spine localizations of alkaptonuric ochronotic arthropathy].

Aim: To study the spine alterations in alcaptonuria with traditional radiology and magnetic resonance (MR), comparing the results of the two techniques.

Patients And Methods: Five patients (4 males, 1 female, mean age 51 years) underwent the examinations. For the study with X-rays we performed anteroposterior and lateral scan and the images have been studied making reference to a radiographic score; it examines the alterations of the joint space and the presence of calcifications.

[The colecistectomy in primary sclerosing cholangitis: case report and review of literature].

Primary sclerosing cholangitis (PSC) is an idiopathic chronic inflammatory condition affecting intra- and extra-hepatic biliary system. The aim of this study is to stress the importance of cholecystectomy in patients with PSC. Consideration should be given to performing a cholecystectomy in PSC patients with gallbladder adenomyomas or calculi, even asymptomatic; this happens in approximately 15% of cases.

[A case of total spinal block during epidural anaesthesia].

Most cases of total spinal block have been reported in the literature. The displacement of the catheter and the consequent dural perforation are the causes in large percentage of the patients (75%). The Authors describe this case for the importance of the causes and outcome of the patient.