Free-Floating Thrombi in the Right Atrium Causing Pulmonary Embolism

A 74-year-old man presented to our Emergency Department with acute dyspnoea. His electrocardiogram showed atrial flutter with 2:1 block and a rate of 150 bpm. Initial investigations revealed a D-dimer level of 6.01 mg/dl. Based on the patient’s complaints and the high D-dimer level, computed tomography pulmonary angiography was immediately performed. This showed no evidence of pulmonary embolism, but there were pneumatic changes in the right upper lung lobe. Antibiotics treatment was started with pipracillin/tazobactam, after which the patient’s condition improved. However, on the third day after admission he developed acute dyspnoea, diaphoresis and cardiopulmonary instability immediately after defecation. To promptly confirm our clinical suspicion of pulmonary embolism, a transthoracic echocardiography was carried out. This demonstrated a worm-like, mobile mass in the right heart. The right ventricle was enlarged, and paradoxical septal motion was present, indicating right ventricular pressure overload. The systolic tricuspid valvular gradient was 56 mmHg. The patient was treated with thrombolysis. His condition was greatly clinically improved after 3 hours. After 10 days of hospitalization, the patient was discharged.

Simultaneous Occurrence of Systemic Lupus Erythematosus, Rheumatoid Arthritis, Hashimoto’s Thyroiditis and Membranous Glomerulonephritis

Introduction: Membranous glomerulonephritis is commonly described in systemic lupus erythematosus (SLE) and hypothyroidism. Clinical presentation: We report a case of a 40-year-old woman who presented with a membranous glomerulonephritis associated with SLE, rheumatoid arthritis and hypothyroidism due to Hashimoto’s thyroiditis. Conclusions: The simultaneous occurrence of these three diseases as possible causes of membranous glomerulonephritis is extremely exceptional.

Use of Poppers (Amyl Nitrite): Unpleasant Side Effects in a Brothel

Introduction: Various agents can lead to an acquired methaemoglobinaemia (MHB) with potentially fatal consequences. There is a lack of literature on the formation of methaemoglobin (MH) in the blood after the intake of poppers (amyl nitrite). Poppers are a popular aphrodisiac agent. Case description: A 56-year-old diabetic called an ambulance after using poppers in a brothel with subsequent associated acrocyanosis, confusion and headache. The paramedics reported tachycardia and blood glucose of 3.8 mmol/l. The arterial blood gas analysis in the Emergency Department (ED) revealed a MHB of 23.1%. MH levels decreased rapidly without antidotal therapy. The patient was discharged the next day free of symptoms. Discussion: This case illustrates the potential risks of taking poppers. A wide spectrum of symptoms were present in our patient. For the differential diagnosis of acquired MHB, poppers should be considered.

Haematidrosis: The Rare Phenomenon of Sweating Blood

Objectives: Haematidrosis, also known as haematohidrosis, is a very rare condition where blood is excreted with sweat. As only a few cases have been described in the literature, we present guidelines on management of this rare phenomenon. Case: A 44-year-old man presented with self-limited and spontaneous bleeding episodes from different parts of his body. This had started 2 weeks before admission after an episode of extreme emotional stress. Medical history and laboratory tests were normal. The microscopic examination of a sample of the fluid excreted confirmed all blood elements. Conclusion: The disorder is thought to be related to activation of the sympathetic nervous system. The use of benzodiazepines and beta blockers may be helpful in controlling the bleeding episodes and give some comfort to the patient.

Severe Acute Dyspnoea of Extra-Thoracic Origin: Experience with Three Primary Thyroid Lymphomas (PTL)

Objectives: To recall the common clinical presenting features of and guide the diagnostic procedures of primary thyroid lymphomas (PTL). Materials and methods: We report on three patients developing an acute dyspnoea and fast evolving neck mass in the thyroid caused by a PTL occurring in our regional hospital in Switzerland between 2009 and 2013. Results: PTL causes a neck mass, dyspnoea and dysphonia and responds well to chemotherapy. Mortality is due to relapse or infectious complications. Conclusion: Acute dyspnoea caused by thyroid disease is uncommon. Nevertheless, it is the main symptom in PTL due to rapid growth and compression of the airways. Chemotherapy should be started promptly.

Civita Castellana (VT). Indagini archeologiche di emergenza nel suburbio di Falerii Veteres

In 2013 the works for the construction of the new sewerage network in Civita Castellana have allowed to find a stretch of ancient road paved in via Roma in the suburb of Falerii Veteres. The street was not yet known by archaeologists. It is characterized by a pavement with small lava stones. We know that the Roman conquest of 241 B.C. entailed the abandonment of the Faliscan city and the foundation elsewhere of a new town, called Falerii Novi. However this new discovery joins to other known archaeological evidence documenting the continuity of attendance after this date both the sanctuaries - frequented until the end of II - beginning of I century B.C.- and Falerii Veteres plateau, on which there arose a small Roman burial ground. These testimonies are certainly evidence of the frequenting of the site (although limited) even after the conquest by Rome. A subsequent earthy street with edges in tuff blocks has overlapped on the ancient street: it probably was made when the eastern access to Civita Castellana was built, under the pontificate of Pope Pius VI.

Auricular Chondritis in a Postpartum Flare of SLE and APS

Introduction: Auricular chondritis has been occasionally described in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Materials and methods: We report the case of a woman with a previous history of APS who presented with auricular chondritis with onset of SLE symptoms during the postpartum period. Conclusion: SLE and APS should be taken into consideration in the differential diagnosis of auricular chondritis.

Attività annuale del Gruppo di Lavoro "Gestione e monitoraggio PON 2007/2013"

La presente relazione tecnica si propone di illustrare l’attività svolta dal Gruppo di Lavoro “Gestione e monitoraggio PON 2007/2013”, dalla data di costituzione (18 marzo 2013) alla data odierna rappresentando le esigenze che hanno portato alla sua costituzione, le criticità riscontrate e il rapporto analitico sulla gestione dei PON 7° PQ, concludendo con una proposta organizzativa per il DIITET, finalizzata al proseguimento delle attività di gestione dei progetti, che possa essere valida sia per la prosecuzione, a compimento, di tutte le fattispecie connesse al settimo Programma Quadro in chiusura, che per successivo Horizon 2020.

Long Term Therapy with Lenalidomide in a patient with POEMS Syndrome

Lenalidomide is an effective therapy against malignant plasma cells and a potent agent against proinflammatory and proangiogenic cytokines. The use of lenalidomide in POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein with plasma cells, skin changes) has been reported, but its benefit in long-term use is not well established. A 55-year-old man with POEMS and debilitating polyneuropathy was treated with lenalidomide and dexamethasone followed by maintenance lenalidomide. He remains in haematologic remission and in complete recovery of functional status 3.5 years after diagnosis. This case supports the long-term use of lenalidomide in patients with POEMS syndrome.

Attività di redazione, monitoraggio e rendicontazione dei progetti del Dipartimento

Report sull’attività svolta dal Dipartimento Energia e Trasporti nell’ambito dell’Accordo di Programma tra il Ministero dello Sviluppo Economico e il CNR/DET sulla “Ricerca e sviluppo per il sistema elettrico nazionale”.

La gestione del portafoglio brevettuale del Dipartimento Energia e Trasporti

Prima della presente riforma del CNR, esisteva all’interno dell’Ente un Ufficio Brevetti, che supportava i propri ricercatori, a livello nazionale, nelle fasi di primo deposito, estensione all’estero, nella stipula di contratti di cessione e di licenza. Dal momento in cui è entrato in vigore il decreto di riordino dell’Ente (D.L. 4 giugno 2003, n. 127) e si sono creati e avviati gli 11 Dipartimenti, l’ufficio brevetti è stato soppresso e il portafoglio brevettuale è stato affidato ai Dipartimenti, ognuno con la propria macro area di competenza.

Hashimoto’s Encephalopathy: An Unusual Cause of Autoimmune Encephalopathy in a Clinically and Biochemically Euthyroid Patient

Objectives: To highlight the occurrence of Hashimoto’s encephalopathy – a steroid-responsive encephalopathy associated with elevated antithyroid antibodies. Material and methods: We describe a clinically and biochemically euthyroid patient with an encephalopathy presenting with headache, mild confusion and personality changes for 6 weeks and tonic–clonic seizures upon admission Results: There was no obvious infective or metabolic cause. The patient had a high titre of antithyroid antibodies and responded to steroid therapy. Conclusion: This uncommon disease needs to be considered in patients presenting with neurological symptoms that remain unexplained after routine standard investigations, even when the patient is euthyroid. Early diagnosis is important, as this is a treatable condition.

I progetti del Dipartimento Energia Trasporti nell’ambito del VII Programma Quadro

Descrizione e monitoraggio dei progetti dal 2007 al 2010. Analisi dello stato dell’arte e scenari futuri.

Severe and Symptomatic Calcium Disorders Caused by Secondary Bone Disease in a Patient with a Thyroid Storm

A patient with Graves’ disease was admitted with a thyroid storm. She had severe hypercalcaemia caused by thyrotoxicosis. Treatment was complicated by vomiting and diarrhoea. With intravenous ondansetron, hydration and bisphosphonates, GI symptoms improved and oral thyreostatics could be started. This, combined with bisphosphonate administration, resulted in a mild hungry bone syndrome.

I progetti DET ammessi al finanziamento nell’ambito del Bando Industria 2015. Criticità emerse

Questa relazione tecnica viene redatta per la Giunta dei Direttori che si terrà il giorno 19/01/2010 su richiesta del Direttore, per riassumere lo stato di avanzamento dei progetti ammessi al finanziamento insieme alle criticità emerse in fase di avvio rendicontazione. La relazione si compone di una prima parte con riferimenti normativi e di riepilogo sui progetti totali presentati a livello nazionale, come CNR e come Dipartimento nelle tre Aree Tecnologiche di riferimento: Efficienza Energetica, Mobilità Sostenibile, Made in Italy. Una seconda parte riguarda la rendicontazione, la metodologia applicata e una descrizione delle criticità di due progetti PIACE - MILD. Verranno, inoltre, illustrate in riunione delle schede tecniche (v. all. 1 Ind.)riepilogative dei progetti presentati nelle aree Efficienza Energetica e Mobilità Sostenibile, realizzate in collaborazione della Sig.ra Silvia Presello.