Two-years follow-up of low-dose methotrexate and 6-methylprednisolone therapy in a patient with idiopathic retroperitoneal fibrosis.

Retroperitoneal fibrosis (RPF), also known as Ormond's disease, is a rare fibroinflammatory disease with uncertain etiology. RPF is characterized by the presence of a particular retroperitoneal fibrotic tissue which is white, woody and involving retroperitoneal structures such as the great vessels, ureters and psoas muscle. The main complication of RPF is the obstruction of local structures such as the ureters due to the fibrosis and the treatment of this aspect represents the main challenge for this pathology.

Integrated therapeutic approaches in the treatment of locally advanced non-small cell lung cancer.

Treatment of locally advanced non-small cell lung cancer (NSCLC) remains a significant challenge for oncologists, despite progress made in recent years in early diagnosis and therapy. This review focuses on integrated therapeutic approaches of patients with locally advanced NSCLC, summarizing the available evidence for patients with potentially resectable disease (stage IIIA-0/3) and with unresectable disease (stage IIIA-4/IIIB) and discussing several key questions related to the use of integrated approaches in NSCLC. Based on current evidence, neoadjuvant platinum-based combination chemotherapy is a treatment option in patients with potentially resectable stage IIIA-0/3: a 2-drug combination of platinum combined with a third-generation drug seems preferable, and at least 3 cycles of chemotherapy should be administered.

Remote-controlled, wireless chest drainage system: an experimental clinical setting.

Purpose: This experimental investigation was aimed at verifying the feasibility and safety of a remote-controlled wireless chest drainage system for in-hospital, outpatient, or domiciliary management of prolonged air leaks.

Description: A commercially available digitalized portable vacuum unit was adapted to incorporate a unit for telemetric data transmission and controlling suction levels through Global System for Mobile Communication (GSM) technology.

Evaluation: The system was tested in 1 patient after right upper lobectomy and wedge resection of the right lower lobe.

Second Italian consensus conference on malignant pleural mesothelioma: state of the art and recommendations.

Malignant pleural mesothelioma (MPM) is a relevant public health issue. A large amount of data indicate a relationship between mesothelioma and asbestos exposure. MPM incidence has considerably and constantly increased over the past two decades in industrialized countries and is expected to peak in 2010-2020.

Early and long-term results of pulmonary resection for non-small-cell lung cancer in patients over 75 years of age: a multi-institutional study.

Objectives: Older lung cancer patients with multiple morbidities are increasingly referred to thoracic surgery departments. The aim of this multicenter study was to analyse the prognostic factors for in-hospital morbidity and mortality and to elucidate the predictors of long-term survival and oncological outcomes.

Methods: We identified 319 patients aged ≥ 75 years who underwent intended curative lung resection for lung cancer in three different thoracic surgery departments between January 2000 and December 2010.

Patients' satisfaction: customer relationship management as a new opportunity for quality improvement in thoracic surgery.

Clinical and nonclinical indicators of performance are meant to provide the surgeon with tools to identify weaknesses to be improved. The World Health Organization's Performance Evaluation Systems represent a multidimensional approach to quality measurement based on several categories made of different indicators. Indicators for patient satisfaction may include overall perceived quality, accessibility, humanization and patient involvement, communication, and trust in health care providers.

pH and solvent H/D isotope effects on the thermodynamics and kinetics of electron transfer for electrode-immobilized native and urea-unfolded stellacyanin.

The thermodynamics of Cu(II) to Cu(I) reduction and the kinetics of the electron transfer (ET) process for Rhus vernicifera stellacyanin (STC) immobilized on a decane-1-thiol coated gold electrode have been measured through cyclic voltammetry at varying pH and temperature, in the presence of urea and in D(2)O. Immobilized STC undergoes a limited conformational change that mainly results in an enhanced exposure of one or both copper binding histidines to solvent which slightly stabilizes the cupric state and increases histidine basicity. The large immobilization-induced increase in the pK(a) for the acid transition (from 4.

The use of biomaterials for chest wall reconstruction 30 years after radical surgery and radiation.

The combination of titanium plates and acellular collagen matrix was used to restore anterior chest wall integrity in a 68-year-old woman more than 30 years after a Halsted mastectomy and radiation treatment. A vertical rectus abdominis muscle flap was used for myocutaneous coverage of the reconstructed chest wall. Partial necrosis of the flap caused prolonged exposure of the collagen matrix and the titanium plates, which were then covered with a free skin graft.

Mediastinal parathyroid adenoma: a case report.

Ectopic parathyroid adenomas represent a diagnostic challenge, since they are quite rare in clinical practice. We present a case of a 61 years old man with symptomatic hypercalcemia due to an ectopic parathyroid adenoma in the upper-anterior mediastinum that was not localized by the scintigraphy. Ultrasonography identified a nodule on the left upper-superior lobe of the thyroid gland, consistent with a parathyroid adenoma; scintigraphy showed two focuses of abnormal tracer uptake, one on the left upper-superior lobe of the gland and the other on the right inferior lobe of the gland.

[Psychological wellbeing and risk of anxiety/depression in nursing students measured with the General Health Questionnaire-12 ].

Unlabelled: Psychological wellbeing and risk of anxiety/depression in nursing students, measured with the General Health Questionnaire-12. Introduction. Psychological wellbeing facilitates the learning performance while emotional problems such as anxiety/depression limit it and may impact on future professional practice.

Uniportal video-assisted thoracic resection of a solitary fibrous tumor of the pleura.

We describe the surgical removal of a pedunculated solitary fibrous tumor of the pleura through single-access (uniportal) video-assisted thoracoscopic surgery. At the end of the procedure, no chest drain was inserted and the patient discharged home after an 8-hour observation period. Uniportal video-assisted thoracoscopic surgery can represent a suitable surgical option for small solitary fibrous tumors of the pleura.

Video-assisted paraspinal approach for the stabilization of the complex spine.

Access to complex conditions of the thoracic spine and of the posterior mediastinum offers significant challenges, especially if the surgeon wishes to comply with the principles of minimal invasiveness. We report a successful vertical, paraspinal incision along with the subperiosteal removal of the overlying 2-cm rib segments combined with video assistance through single-access video-assisted thoracic surgery to perform a total T6 and partial T7 corpectomy for a metastatic multiple myeloma in a 50-year old man. This approach appears to provide excellent exposure and minimal morbidity when a reliable approach to the complex spine is needed.

Pulmonary aspergilloma: clinical aspects and surgical treatment outcome.

Aspergillomas are fungal balls within lung cavities. The natural history is variable. Hemoptysis is a dangerous sequela.

Role of Met80 and Tyr67 in the low-pH conformational equilibria of cytochrome c.

The low-pH conformational equilibria of ferric yeast iso-1 cytochrome c (ycc) and its M80A, M80A/Y67H, and M80A/Y67A variants were studied from pH 7 to 2 at low ionic strength through electronic absorption, magnetic circular dichroism, and resonance Raman spectroscopies. For wild-type ycc, the protein structure, axial heme ligands, and spin state of the iron atom convert from the native folded His/Met low-spin (LS) form to a molten globule His/H(2)O high-spin (HS) form and a totally unfolded bis-aquo HS state, in a single cooperative transition with an apparent pK(a) of ~3.0.

Validity and reliability of the caregiver contribution to self-care of heart failure index.

Background: Caregivers make an important contribution to the self-care of patients with heart failure (HF), but few instruments are available to measure this contribution.

Objective: The objective of this study was to test the psychometric properties of the Caregiver Contribution to Self-care of Heart Failure Index (CC-SCHFI), an instrument derived from the Self-care of Heart Failure Index version 6.2.

One-port (uniportal) video-assisted thoracic surgical resections--a clear advance.

One-port (uniportal) video-assisted thoracic surgery (VATS) consists of approaching an intrathoracic target lesion through a sagittal, craniocaudal plane through 1 single-port incision. The use of articulating instruments inserted parallel to the videothoracoscope enables the surgeon to mimic inside the chest the maneuvers that are usually performed during open surgery. Through this VATS approach, several thoracic conditions can be addressed, including lung cancer in selected patients.

The surgeon's role in molecular biology.

The biomolecular era is rapidly becoming shaped around the supreme interest in targeted therapy for patients with non-small cell lung cancer. Tissue analysis has become crucial in the definition of biomarkers and genomic signatures able to predict the response to treatment or even survival. Lung screening programs and minimally invasive thoracic surgery are jointly aimed at increasing the quantity and quality of specimens of non-small cell lung cancer caught at the earliest stages with the attendant, significant, effect on patient survival.

Differences in microparticle release in patients with acute coronary syndrome and stable angina.

Background: Microparticles (MP) are vesicles released from activated or apoptotic cells. Endothelial MP (EMP) are derived from injured endothelium, platelet MP (PMP) from activated platelets, and Annexin V positive MP (AMP) from apoptotic endothelial cells. The aim was to assess the release of MP and its association with inflammation and atherosclerotic burden.

Patient satisfaction after pulmonary resection for lung cancer: a multicenter comparative analysis.

Background: Patient satisfaction reflects the perception of the customer about the level of quality of care received during the episode of hospitalization.

Objective: To compare the levels of satisfaction of patients submitted to lung resection in two different thoracic surgical units.

Methods: Prospective analysis of 280 consecutive patients submitted to pulmonary resection for neoplastic disease in two centers (center A: 139 patients; center B: 141 patients; 2009-2010).