Perfusion and spectroscopy magnetic resonance imaging in a case of lymphocytic vasculitis mimicking brain tumor.

Background: Lymphocytic vasculitis of the central nervous system is an uncommon subtype of primary angiitis of the central nervous system (PACNS) - a rare inflammatory disorder affecting parenchymal and leptomeningeal arteries and veins.

Case Report: Establishing diagnosis on the basis of neuroimaging only is difficult, as it can mimic a brain tumor. Thus, histological diagnosis is essential for appropriate management.

Medical treatment of hepatocellular carcinoma.

The management of hepatocellular carcinoma (HCC) has substantially changed in the past few decades, the introduction of novel therapies (such as sorafenib) have improved patient survival. Nevertheless, HCC remains the third most common cause of cancer-related deaths worldwide. Decision-making largely relies on evidence-based criteria, as showed in the US and European clinical practice guidelines, which endorse five therapeutic recommendations: resection; transplantation; radiofrequency ablation; chemoembolization; and sorafenib.

Targeted therapy for advanced hepatocellular cancer in the elderly: focus on sorafenib.

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide. Worldwide progressive population aging demands consensus development for decision making when treating elderly patients. Age itself might not be a critical determinant for the selection of a therapeutic option.

Direction-fixed paroxysmal nystagmus lateral canal benign paroxysmal positioning vertigo (BPPV): another form of lateral canalolithiasis.

Benign paroxysmal positioning vertigo (BPPV) is the most frequent vertiginous syndrome. It is caused either by free-floating otoliths in the semicircular canals (canalolithiasis) or by otoconial debris adhering to a canal cupula (cupulolithiasis). The posterior canal is the most frequently involved (80%), while the lateral canal is involved less frequently (15%), and the rarest conditions are anterior canalolithiasis and apogeotropic posterior canalolithiasis (5%).

Do young patients with renal cell carcinoma feature a distinct outcome after surgery? A comparative analysis of patient age based on the multinational CORONA database.

Purpose: We analyzed the distinct clinicopathological features and prognosis of patients with renal cell carcinoma age 40 years or less compared to a reference group of patients 60 to 70 years old.

Materials And Methods: Overall 2,572 patients retrieved from a multicenter international database comprised of 6,234 patients with surgically treated renal cell carcinoma were included in this retrospective study. Clinical and histopathological features of 297 patients 40 years old or younger (4.

Utility of the hyperventilation test in the evaluation of the dizzy patient.

Purpose Of Review: The aim of the review is to value the incidence, patterns and temporal characteristics of hyperventilation-induced nystagmus (HVIN) in patients suffering from vestibular diseases, as well as its contribution to the differential diagnosis between vestibular neuritis and schwannoma of the eighth cranial nerve and its behavior in some central vestibular diseases.

Recent Findings: The hyperventilation test seems to be more useful than other bedside tests in detecting schwannoma of the eighth cranial nerve in the case of sudden monolateral hypacusia. The presence of an excitatory pattern of HVIN in vestibular schwannoma that has undergone to stereotactic surgery reveals that this therapy produces demyelinization in neural fibers.

Pontine extension of a tentorial schwannoma without cranial nerve involvement: a case report.

Introduction: Intracranial schwannomas unrelated to the cranial nerves are uncommon. We report a new case of tentorial schwannoma unrelated to the cranial nerves, with extension into the pons. A literature review with discussion of the most relevant pathogenetic aspects is also performed.

Hyperventilation-induced nystagmus in a large series of vestibular patients.

The Hyperventilation Test is widely used in the "bed-side examination" of vestibular patients. It can either activate a latent nystagmus in central or peripheral vestibular diseases or it can interact with a spontaneous nystagmus, by reducing it or increasing it. Aims of this study were to determine the incidence, patterns and temporal characteristics of Hyperventilation-induced nystagmus in patients suffering from vestibular diseases, as well as its contribution to the differential diagnosis between vestibular neuritis and neuroma of the 8(th) cranial nerve, and its behaviour in some central vestibular diseases.

Diagnostic Workup for Disorders of Bone and Mineral Metabolism in Patients with Chronic Kidney Disease in the Era of KDIGO Guidelines.

KDIGO (KIDNEY DISEASE: Improving Global Outcomes) is an international nonprofit organization devoted to "improve the care and outcomes of kidney disease patients worldwide through promoting coordination, collaboration, and integration of initiatives to develop and implement clinical practice guidelines." The mineral and bone disorder (MBD) in patients with chronic kidney disease (CKD) has been the first area of interest of KDIGO international initiative. KDIGO guidelines on CKD-MBD were published in 2009 with the intent to modify the previous KDOQI guidelines that had failed to consistently change the global outcome of CKD patients.

Retrospective protein expression and epigenetic inactivation studies of CDH1 in patients affected by low-grade glioma.

Aberrant methylation of CpG islands in the promoter regions of tumour cells results in loss of gene function. In addition to genetic lesions, changes in the methylation profile of the promoters may be considered a factor for tumour-specific aberrant expression of the genes.We investigated the methylation status of E-cadherin gene (CDH1) promoter in low-grade glioma and correlated it with clinical outcome.

Age and video capsule endoscopy in obscure gastrointestinal bleeding: a prospective study on hospitalized patients.

Background: The influence of aging on video capsule endoscopy (VCE) in obscure gastrointestinal bleeding (OGIB) has never been prospectively assessed.

Aims: To demonstrate if age is a risk factor for incomplete VCE examination in a setting of ongoing hospitalization for OGIB and if it affects the yield of VCE.

Methods: Forty-eight consecutive patients referred to our unit for obscure-overt GI bleeding from March 2007 to September 2009 were prospectively evaluated.

"Secondary signs of lateralization" in apogeotropic lateral canalolithiasis.

The diagnosis of lateral canalolithiasis is based on the typical finding of the horizontal paroxysmal positional nystagmus induced by the Pagnini-Mc Clure manoeuvre. This technique usually identifies also the affected side, namely, the side where the paroxysmal nystagmus is more intense in geotropic forms and the side where the paroxysmal nystagmus is less intense in apogeotropic forms. However, this method is not always applicable since, especially in apogeotropic forms, the intensity of the nystagmus is not so distinctly different between the two sides.

Preoperative creatinine clearance as a predictor of short-term outcomes after cardiac surgery: a cohort study for the comparison between the Cockroft-Gault and modification of diet in renal disease formulae.

Background: Preoperative renal function is an important risk factor in cardiac surgery for long-term and short-term outcomes. Renal function is best assessed by measuring or calculating the glomerular filtration rate (GFR). Several algorithms using the endogenous marker serum creatinine have been developed to estimate renal function.

Thromboprophylaxis in radical retropubic prostatectomy: efficacy and patient compliance of a dual modality.

Objectives: The risk of developing venous thromboembolism (VTE) in urologic patients undergoing major surgery without thromboprophylaxis is high (up to 40%). The aims were to study the acceptability rate of and overall patient satisfaction with an automatic sequential leg compression system and the short-term effectiveness of a combined VTE prevention modality.

Methods: One-hundred and eighty-four consecutive patients undergoing radical retropubic prostatectomy were postoperatively treated with enoxaparine and intermittent pneumatic compression of the thigh.

Etiopathogenetic mechanisms of fibromyalgia syndrome.

Fibromyalgia syndrome (FMS) is a common chronic condition of widespread pain with causal mechanisms that are largely unknown. It is characterized by moderate to severe musculoskeletal pain and allodynia, but its pathogenesis appears confined to the nociceptive structures of the central nervous system. FMS is often triggered by negative environmental influences, especially if they occur in childhood.

Erlotinib-induced pustular eruption.

The epidermal growth factor receptor (EGFR) inhibitor erlotinib was found to significantly improve overall survival, time to progression, and cancer-related symptoms in locally advanced or metastatic non small cell lung carcinoma (NSCLC). Unfortunately, cutaneous side effects are not rare, the most common one being a follicular acneiform eruption. As it has been observed a positive correlation between rash severity and objective tumor response, it is critical for dermatologists early distinguish it from rashes carrying a different prognosis and needing a different management.

Converting apogeotropic into geotropic lateral canalolithiasis by head-pitching manoeuvre in the sitting position.

Liberatory treatment of lateral canalolithiasis is more effective for the geotropic, than for the apogeotropic forms and, therefore, it is worthwhile attempting to convert the apogeotropic forms into the geotropic forms. In 36 cases of apogeotropic lateral canalolithiasis, one to five Head-Pitch Manoeuvres were performed in the sitting position (Head-Pitch Test) in the attempt to transform apogeotropic into geotropic lateral canalolithiasis. The Head Pitch Test was performed by a quick 60 degrees forward-flexion and a slow maximal backward-extension of the head.

Facial nerve schwannoma presenting as a mass in the middle cranial fossa: typical neuroradiological patterns for a preoperative diagnosis.

Facial nerve schwannoma is a rare primary neurogenic tumour that may originate anywhere along the VII(th) nerve course. The clinical presentation is highly dependent on the location of the lesion along the nerve course and this makes the pre-operative diagnosis difficult without radiologic examination. The most common presentation is facial palsy and even though tumours are responsible for only 5% of facial palsies, if a patient does not recover within six months a complete work-up for neoplasm is recommended.

Giant cystic intraventricular cerebral cavernous malformation: MRI with pathologic correlation. A case report.

The purpose of this case report is to increase awareness of the spectrum of cerebral cavernous malformations (CCMs). We report the MRI findings and histological features of an uncommon case of a single giant (maximum diameter: >6 cm) cystic CCM of the left lateral ventricle occurring in a 26-year-old man who had undergone 30 Gy cranial irradiation for acute leukemia at the age of six years. Large cystic CCMs must be included in the neuroradiological differential diagnosis of intraventricular hemorrhagic cystic lesions.

Primary myxopapillary ependymoma of the cerebellopontine angle: report of a case.

Myxopapillary ependymoma is a rare variant of ependymoma, almost exclusively occurring in the region of the cauda equina and filum terminale. We describe a myxopapillary ependymoma located in the left cerebellopontine angle of a young man suffering from peripheral vertigo and left sensorineural hearing loss for years. The patient underwent surgical removal of the tumour.

Validation by calibration of the UCLA integrated staging system prognostic model for nonmetastatic renal cell carcinoma after nephrectomy.

Background: To the authors' knowledge, calibration of the University of California at Los Angeles (UCLA) Integrated Staging System (UISS) prognostic score in patients nephrectomized for nonmetastatic renal cell carcinoma (RCC) has never been specifically addressed. The objective of the current study was to evaluate the calibration of the UISS prognostic score in a European multicenter retrospective study.

Methods: Six European centers participated in the study.

Neuroendocrine differentiation in prostate cancer: from lab to bedside.

Objectives: To discuss the current knowledge on induction, production, sustenance and promotion of neuroendocrine differentiation in human prostate cancer.

Methods: Review of the literature using PubMed search and scientific journal publications.

Results: Morphological evidence explains some functional relationship between neuroendocrine and neoplastic surrounding cells.

Cancer of the Liver Italian Program (CLIP) score for staging hepatocellular carcinoma.

Aim: To assess the prognostic ability of the Cancer of the Liver Italian Program (CLIP) score in patients with hepatocellular carcinoma after a longer follow up.

Methods: The updated survival data were derived from an analysis that was performed on two joined sets of data. The first set was collected retrospectively in 1995 and was used to perform an exploratory prognostic factor analysis (the CLIP-03 study), that produced the CLIP score.