Abstract
Background
Fluoropirimidine represents one of the staple treatment of metastatic colorectal cancer; chemoterapy–based cardiotoxicity is unfortunately habitual in clinical practice. ...Raltitrexed could represent a valid alterantive to 5–FU in patients with cardiovascular comorbidities or in which 5–FU Has not been tolerated.
Case Report
Our patient is a 73 years–old woman, who underwent left colon surgical resection due to subocclusion; a whola body staging was not performed. After surgery, patient underwent CT scan,i n which multiple liver, lung and peritoneal metastases were identified. Biomolecular profiling assessment was perfomed (RAS, BRAF Wild type, DPYD*6 heterozigosis mutation). On January 2020, patient began FOLFIRI + PANITUMUMAB scheme as first line treatment (total cycles perfomed: 15). On January 2021, PD was detected though restaging imaging, and patient was subsequently treated with FOLFOX + BEvacizumab as second line. After 5 cycles, patient developed dyspnoea and palpitation; EKG was performed depicting Atrial fibrillation with heart rate: 73bpm, preserved biventricular systolic function and increased BNP and NT–pro–BNP serum concentration. According to patient’s high thromboembolic risk, oral anticoagulation (NOAC) was administered and multidisciplinary discussion was scheduled. NAO were preferred to Vitamin K antagonists due to drug–drug interactions; the treatment–of–choice was Apixaban 2.5 mg bis in die. Given the fact that aforementioned condition could have been attributed to 5–FU cardiologic toxicity, Raltitrexed was administered in lieu thereof 5–FU once synusal rythm was restored (TOMOX scheme). Bevacizumab administration was restored after a longer waiting (ca 2 months); the patient uderwent systematic and serial cardiologic assessment through clinical and EKG consults.
Conclusion
Our case report depicts the undelayable necessity of a Multidisciplinar collaboration in which oncologists and cardiologists could propose personalized treatment strategies which ensure correct antitumoral activities without significant and life–threatening toxicities.
Operation and performance of the MEG II detector Afanaciev, K.; Baldini, A. M.; Ban, S. ...
The European physical journal. C, Particles and fields,
02/2024, Letnik:
84, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The MEG II experiment, located at the Paul Scherrer Institut (PSI) in Switzerland, is the successor to the MEG experiment, which completed data taking in 2013. MEG II started fully operational data ...taking in 2021, with the goal of improving the sensitivity of the
μ
+
→
e
+
γ
decay down to
∼
6
×
10
-
14
almost an order of magnitude better than the current limit. In this paper, we describe the operation and performance of the experiment and give a new estimate of its sensitivity versus data acquisition time.
A prospective study was performed in 19 patients with trigger thumbs to define
the anatomy of the A1 pulley of the thumb in this condition and to evaluate
biomechanical parameters of the thumb after ...complete division of the A1 pulley.
Pre- and postoperatively, flexion of the interphalangeal and metacarpophalangeal
joints, key pinch strength and tip pinch strength were measured and compared
with these measurements on the contralateral thumb. We identified three types of
A1 pulley. The clinical data showed that there is no deficit with respect to
motion and strength of the thumb after completely sectioning any of the three
types of A1 pulley.
aneurysms are focal and permanent dilations of an artery; in pseudoaneurysms, the normal layers of the blood vessel are replaced by fibrous tissue. Due to their low incidence, as well as the ...diagnostic and therapeutic challenge they represent; our objective is to present the clinical case of a pseudoaneurysm of a digital artery of the hand and to carry out a systematic review of this pathology.
literature search in Medline, using the terms "digital artery" and "aneurysm." Studies of vascular dilation pathology affecting the hand and fingers were incorporated. Studies with pathology of proximal involvement of the hand were excluded.
a 79-year-old female patient who, after a sharp force trauma to the fifth finger of the left hand, develops a rapidly growing necrotic tumor. She had ultrasound and angiography that suggested hematoma. Surgical management was decided, during which it was observed that the tumor involved ulnar collateral digital artery of the fifth finger. The lesion and the arterial segment involved were resected. Post-surgical course without complications. The histopathological diagnosis of pseudoaneurysm of the lesion was confirmed.
traumatic etiology is the most frequent cause of digital aneurysms. Risk factors for pseudoaneurysms include sharp force trauma and alterations of the coagulation pathways, as in the case presented.
the pseudoaneurysm of a digital artery is a rare pathology with great variability of therapeutic management. Surgical resection of the lesion with vascular flow reconstruction is the recommended treatment.
Abstract The MEG II experiment, based at the Paul Scherrer Institut in Switzerland, reports the result of a search for the decay $$\upmu ^+ \rightarrow {\textrm{e}}^+ \upgamma $$ μ + → e + γ from ...data taken in the first physics run in 2021. No excess of events over the expected background is observed, yielding an upper limit on the branching ratio of $${\mathcal {B}} (\upmu ^+ \rightarrow {\textrm{e}}^+ \upgamma ) < 7.5 \times 10^{-13}$$ B ( μ + → e + γ ) < 7.5 × 10 - 13 (90% CL). The combination of this result and the limit obtained by MEG gives $${\mathcal {B}} (\upmu ^+ \rightarrow {\textrm{e}}^+ \upgamma ) < 3.1 \times 10^{-13}$$ B ( μ + → e + γ ) < 3.1 × 10 - 13 (90% CL), which is the most stringent limit to date. A ten-fold larger sample of data is being collected during the years 2022–2023, and data-taking will continue in the coming years.
Abstract
Case description: a previously healthy 26–year–old man presented with dyspnea on exertion and dry cough. CT scan revealed a large mediastinal mass with displacement of great vessels and ...trachea and pericardial effusion. Cardiac MRI showed the huge mediastinal mass, literally leaning on the heart with signs of compression of the pulmonary artery (Figure 1) with the typical D–shape of inter ventricular septum. Pericardial effusion did not compress the RV due to high intraventricular pressure. At baseline echo the mass simulated pulmonary artery stenosis as a consequence of pulmonary artery “ab extrinseco” compression. Surgical biopsy showed Ewing sarcoma lately redefined into undifferentiated round cell sarcoma so the patient started chemotherapy with VAI (vincristine, adriblastine, and ifosfamide) x6 followed by maintenance etoposide and ifosfamide (no anthraciclines for risk of cardiac toxicity). After induction phase MRI showed a partial response to treatment; mediastinal mass further reduced at the end of maintenance (Figure 2). Pericardial effusion disappeared and peak velocity of pulmonary artery went back to normal level at echo. Our patient underwent surgery with en–block removal of mediastinal mass with pericardium and anonymous vein and partial pulmonary upper left lobe resection with R0 resection. Pathology report confirmed an undifferentiated round cell sarcoma (possible embryonal origin, FISH analysis for EWS/FUS genes and 12p negative). Adjuvant mediastinal radiotherapy was delivered. The patient is alive without disease recurrence at one–year follow–up.
Conclusions
cardiac MR offer great tissue characterization (differential diagnosis between malignant and benign masses) inside/outside the heart. CMR is non–invasive/non radiation and ideal technique for surgery indication and follow–up imaging.
Abstract
A 78 years old woman presented in our cardio–oncology out–patient clinic to renew apixaban treatment plan. In her medical history she was a former smoker, with a chronic kidney disease in ...IIIb stadium according to KDIGOI guidelines with a creatinine of 1,54 mg/dl, GFR according CKD 32 ml/min/1.73m2 and according Cockcroft e Gault 28 ml/min/1.73m2. In 2010, she had a right lobe pulmonary cancer diagnosis treated in neo–adjuvant with gemcitabine. After chemotherapy, she underwent surgical lobectomy. During hospitalization she had a deep venous thrombosis complicated by pulmonary thromboembolism, heparin sc was given with resolution of the clinical picture. In 2012 she had a recurrence of pulmonary thromboembolism. Heparin and warfarin in a second time was given. In 2016 for cancer disease progression, she underwent various oncological treatments and she found a stability disease with osimertinib and stereotaxic radiotherapy. Warfarin was switched to apixaban low–doses for low weight and chronic kidney disease. In 2021 in osimertinib therapy, cancer was under control. She was continuing low–dose apixaban. One year later, a CT scan demonstrated a disease progression and inferior cava venous thrombosis. A cardiac evaluation in our unit was required: patients was asymptomatic. EKG and Echocardiogram were normal. Apixaban low dose was changed to edoxaban 30 mg. There was a complete vein recanalization. Unfortunately, patient died after 8 months for cancer. It is important, in the direct oral anticoagulation therapy in cancer patient, to consider not only the indication for dose reduction known by the registration studies but also cancer and therapy factors.
Scaphoid fractures are a common wrist injury accounting for 2-7% of all adult fractures. Nonunion is described in 5-12% of cases leading to osteoarthritis. Several classifications have been developed ...focused on this pathology and its complication. We present a case of a 28 years old male patient with a scaphoid fracture and nonunion who spontaneously consolidates without treatment. We performed a literature review to recognize this pathology, its common evolution and possible treatment options.
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