Inferior vena cava septic thrombosis due to gut perforation after accidental toothpick ingestion.

A 57-year-old male patient was referred to our emergency department complaining of irremediable abdominal pain associated with mild fever. Abdominal CT scan revealed the presence of a small bowel perforation caused by an ingested toothpick, in association with a subsequent inferior vena cava thrombosis.

Long-Term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography.

Rationale: Screening for lung cancer with low-dose spiral computed tomography (LDCT) has been shown to reduce lung cancer mortality by 20% compared with screening with chest X-ray (CXR) in the National Lung Screening Trial, but uncertainty remains concerning the efficacy of LDCT screening in a community setting.

Objectives: To explore the effect of LDCT screening on lung cancer mortality compared with no screening. Secondary endpoints included incidence, stage, and resectability rates.

Preserving the left subclavian artery patency in challenging proximal neck during thoracic endovascular aortic repair.

Coverage of the left subclavian artery in thoracic endovascular aortic repair is still a controversial procedure. We report a case of 30-year-old patient with a chronic rupture of the aortic isthmus and short proximal lending zone (10 mm) treated by thoracic endovascular aortic repair using a balloon catheter inflated at the origin of the left subclavian artery (and protruding in the aortic arch) to both preserve the arterial branch patency and fully exploit the proximal neck.

Interval breast cancers: absolute and proportional incidence and blinded review in a community mammographic screening program.

Purpose: To evaluate the performance of the first years since the beginning of a mammographic population-based screening program.

Materials And Methods: Women aged 49-69 were invited biennially for two-view film-screen mammography and double reading without arbitration was performed. Interval cancers (ICs) from 2001 to 2006 were identified using screening archives, local pathology archives, and hospital discharge records.

Endovascular treatment of an anastomotic iliac pseudoaneurysm after surgical aortic repair using a Cardiatis multilayer stent.

The Cardiatis multilayer stent (Cardiatis, Isnes, Belgium) is a cobalt, self-expandable bare stent made of two interconnected layers without any covering that allows a pressure decrease and thrombus formation into an aneurysmal sac, while improving laminar flow in the main artery and surrounding vital branches. We report a case of an anastomotic iliac pseudoaneurysm successfully treated with the deployment of a Cardiatis multilayer stent.

Percutaneous transhepatic biliary drainage and occlusion balloon in the management of duodenal stump fistula.

Background: Duodenal stump fistula (DSF) after gastrectomy is a complication with a high mortality rate. We report a series of patients with postoperative DSF treated with percutaneous transhepatic biliary drainage and occlusion balloon (PTBD-OB). The aim of this study is to explore the feasibility and efficacy of PTBD-OB in the treatment of DSF.

Compliance of the Valsalva graft's pseudosinuses at midterm follow-up with cardiovascular magnetic resonance.

Background: In previous studies, the Valsalva graft's compliance at the level of the Dacron pseudosinuses was found similar to that of normal sinuses shortly (2±1 months) after the operation. We sought to investigate with cardiac magnetic resonance the compliance of the Valsalva graft pseudosinuses at midterm follow-up.

Methods: Seven patients (group A) and 7 age-matched controls (group B) were studied with steady-state free precession and phase-contrast cardiac magnetic resonance for aortic root and ascending aorta evaluation.

Management of post-surgical biliary leakage with percutaneous transhepatic biliary drainage (PTBD) and occlusion balloon (OB) in patients without dilatation of the biliary tree: preliminary results.

Objective: To compare the outcome of patients affected by biliary leak after major biliary surgery and treated with percutaneous transhepatic biliary drainage (PTBD) alone with that of similar patients treated with PTBD and concurrent positioning of an occlusion balloon (PTBD-OB).

Methods: We retrospectively reviewed the results of the use of PTBD or PTBD-OB performed at our institution from 2004 to 2008 in patients with post-surgical biliary leak. Sixteen patients entered the evaluation.

Molecular alterations in spontaneous sputum of cancer-free heavy smokers: results from a large screening program.

Purpose: The high mortality rate for lung cancer is likely to be reduced by the development of a panel of sensitive biological markers able to identify early-stage lung cancers or subjects at high risk. The aim of this study was to establish the frequency of K-ras and p53 mutations and p16(INK4A), RASSF1A, and NORE1A hypermethylation in sputum of a large cohort of cancer-free heavy smokers and to assess whether these markers are suitable for a routine use in the clinical practice for the early diagnosis of pulmonary cancer.

Experimental Design: Sputum samples were collected from 820 heavy smokers.

Lung cancer screening with spiral CT: baseline results of the randomized DANTE trial.

Background: Despite the high survival rates reported for screening-detected cases, the potential of screening of high-risk subjects for reducing lung cancer mortality is still unproven. We herewith present the baseline results of a randomized trial comparing screening for lung cancer with annual spiral computed tomography (CT) versus a yearly clinical review.

Methods: Male subjects, 60-74 years old, and smokers of 20+ pack-years were enrolled.

Cisplatin plus gemcitabine on days 1 and 4 every 21 days for solid tumors: result of a dose-intensity study.

Background: Three and 4-week cisplatin-gemcitabine schedules have shown similar dose-intensity (DI) and activity in non-small-cell lung cancer (NSCLC). The 3-week schedule is generally preferred because it enables better treatment compliance. To improve DI and compliance further, we delivered gemcitabine plus cisplatin over 4 days every 21 days.

Long-term, tunneled, noncuffed central venous catheter in cancer patients (Vygon): safety, efficacy, and complications.

Background: Totally implantable or partially cuffed central venous catheters (CVC) are commonly used in cancer patients, but they are often expensive and may produce complications. To minimize costs, we have been using a low-cost, partially tunneled, silicone elastomer catheter with no Dacron cuff or antireflux valve (Vygon) since 2001. This study is a retrospective investigation of our experience using the Vygon catheter as a long-term CVC in patients with malignancy.

Prophylaxis of central venous catheter-related thrombosis with minidose warfarin in patients treated with high-dose chemotherapy and peripheral-blood stem-cell transplantation: retrospective analysis of 228 cancer patients.

Patients with a central venous catheter (CVC) undergoing high-dose chemotherapy (HDC) followed by peripheral-blood stem-cell transplantation (PBSCT) for malignancies are at high risk of thrombosis, but the use of anti-coagulant prophylaxis remains debatable in this setting of patients. We analyzed the efficacy and the safety of minidose warfarin in 228 patients in whom CVCs had been placed and who had received 292 HDC courses of therapy. The catheters remained in place for a mean of 173 (range 40-298) days.