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The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage.Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively.Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality.

BACKGROUND: Stump appendicitis is a rare delayed complication post-appendectomy and it represents a diagnostic problem as clinicians are often not very familiar with this pathology. MATERIALS AND METHODS: One case of stump appendicitis has been reported in a 54 year old woman, whose acute phase was conservatively treated in our Department. A review of Medline literature was also carried out, from 1945 to 2015, showing 111 cases of stump appendicitis. RESULTS: Stump appendicitis has been reported after either open or laparoscopic appendectomy, in a range between days to several years from the first procedure. Nowadays, it is not considered yet as a possible differential diagnosis in patients with pain in the right iliac fossa previously undergone appendectomy. For this reason, the diagnosis can be delayed and complications such as acute abdomen, perforation, sepsis can occur. Completion appendectomy is the treatment of choice for stump appendicitis. CONCLUSIONS: The aim of this article is to underline the importance of stump appendicitis. Clinicians should be aware of the possibility of SA and they should confirm any clinical suspicion throughout radiologic images, in order to promptly recognize this entity and to avoid the related complications.

Objectives. Laparoscopic cholecystectomy (LC) is today the "gold standard" treatment of gallbladder stones. Role of LC is still debated in the presence of abdominal scars due to the frequent post-operative adhesions which make access to the peritoneal cavity difficult. This study aim to assess role and outcomes of LC on a previous abdominal surgery on the scarred abdomen. Materials and Methods. we have carried out a retrospective study on 499 consecutive patients who had undergone LC from 2009 to 2015; 21 of these (4.2%) undergone previous abdominal surgery. In all 21 cases the pneumoperitoneum was established with Veress needle at the Palmer's point and the procedure was carried out after adhesiolysis in 62% of cases. Results. the mean operative time was 79±12 minutes; none of the patients with previous abdominal surgery required conversion to open cholecystectomy and there were no postoperative complications related to Veress introduction or to the adhesiolysis. The difficult dissection and adhesiolysis were more frequent in the patients with upper abdomen scar (62%) respect to lower abdomen scar (38%). Conclusion. patients with scarred abdomen for previous abdominal surgery had obviously more adhesions in the abdomen than patients without preceding surgery, but today previous abdominal surgery should not constitutes absolute contraindications to LC. Moreover, patients with previous lower abdominal incisions had fewer adhesions in the upper abdomen than did patients with upper incision and, probably, in these cases adhesiolysis is unnecessary, if the surgical field is well exposed whereas adhesiolysis is mandatory when the adhesions are thick and widespread, to the anterior and posterior abdominal wall.

L’ipocalcemia post-operatoria è la più frequente tra le complicanze della chirurgia tiroidea. Si manifesta in un’elevata percentuale di pazienti nel periodo post-operatorio immediato come ipoparatiroidismo transito-rio, e rimane in modo permanente soltanto nei pazienti che hanno subito una paratiroidectomia accidentale durante la tiroidectomia conformando un quadro di vero ipoparatiroidismo. Nella forma definitiva raggiunge un’incidenza compresa tra 0,2 e 32% a seconda del-le casistiche. Il rischio di sviluppare ipocalcemia post-operatoria dipende principalmente dall’indicazione chirurgica (i.e., rischio superiore per malattia di Graves, inferiore in caso di carcinoma tiroideo e di gozzo nodulare) e dalla estensione chirurgica (i.e., inferiore per tiroidectomia totale, superiore per svuotamento linfatico del compartimento centrale e del compartimento laterale). L’approccio terapeutico può essere preventivo, predittivo o reattivo. Quest’ultimo, è il più diffuso e prevede l’intervento solo al manifestarsi della prima ipocalcemia significativa. Il trattamento convenzionale si basa sulla somministrazione di calcio gluconato per via venosa nei casi severi e di somministrazione orale di calcitriolo e di calcio per via orale in casi meno severi e come mantenimento nel post-operatorio tardivo. I diuretici tiazidici, aumentando il riassorbimento renale di calcio, possono essere presi in considerazione come adiuvanti. In quei casi rari dove, nonostante la terapia descritta, continuano a manifestarsi gravi episodi di ipocalcemia ed ipomagnesemia, è disponibile il frammento 1-34 dell’or-mone umano paratiroideo denominato teriparatide, inserito nell’elenco dei medicinali erogabili a totale cari-co del SSN ai sensi della legge 23 dicembre 1996, n. 648 (Determina n. 507 pubblicata sulla G.U. n. 141 del 18/06/2013), quale terapia sostitutiva ormonale per la cura dell’ipoparatiroidismo cronico grave. Presentiamo il caso clinico di una donna di 60 anni, affetta da ipoparatiroidismo cronico grave post-tiroidectomia.

Loboppia covarrubiasi (Hammer, 1968) Oppia covarrubiasi: Hammer, 1968 [New Zelaand]. Material studied. Guacho Lake (2). Distribution. Australasian (New Zealand). Remarks. The species was described as Oppia covarrubiasi in New Zealand (Hammer, 1968). The specimens were collected come from moist penguin dung, mixed with herbs from their nests, collected in Dunedin, New Zealand. Balogh (1983) erected the genus Loboppia and transferred Oppia covarrubiasi to it. At present, the genus remains monospecific (Subías 2004, updated 2017)., Published as part of Ruiz, E. V., Rizzuto, S. & Martinez, P. A., 2018, New records of oribatid mites (Acari: Oribatida) from Argentina, pp. 194-200 in Zootaxa 4370 (2) on page 197, DOI: 10.11646/zootaxa.4370.2.8, http://zenodo.org/record/1143855, {"references":["Hammer, M. (1968) Investigations on the Oribatid fauna of New Zealand. Part III. Biologiske Skrifter Danske Videnskabernes Selskab, 16 (2), 1 - 96.","Balogh, J. (1983) A partial revision of the Oppida Grandjean, 1954 (Acari: Oribatei). Acta Zoologica Academiae Scientiarum Hungaricae, 29, 1 - 79.","Subias, L. S. (2004) Listado sistematico, sinonimico y biogeografico de los Acaros Oribatidos (Acarifomes, Oribatida) del mundo (1748 - 2002). Graellsia, 60, 3 - 305. https: // doi. org / 10.3989 / graellsia. 2004. v 60. iExtra. 218"]}

Lamellozetes pseudoareolatus Covarrubias, 1967 Material studied. Huemules (1). Distribution. Andean (Chile). Remarks. The species was described by Covarrubias, 1967. His specimens were collected on Isla Mu��oz Gamero, Province of Magallanes, Chile, in cold forests., Published as part of Ruiz, E. V., Rizzuto, S. & Martinez, P. A., 2018, New records of oribatid mites (Acari: Oribatida) from Argentina, pp. 194-200 in Zootaxa 4370 (2) on page 196, DOI: 10.11646/zootaxa.4370.2.8, http://zenodo.org/record/1143855

Graptoppia (Stenoppia) multicorrugata (Hammer, 1962a) Oppia multicorrugata: Hammer, 1962a:39 [Chile]. Material studied. Guacho Lake (1) and La Plata Lake (2). Distribution. Andean (Chile). Remarks. The species was described as Oppia multicorrugata (Hammer 1962a) in Puerto Montt and Cueva del Milodón, Chile. The individuals collected in Puerto Montt were found in a small cave near the city, on humid ferns and liverworts., Published as part of Ruiz, E. V., Rizzuto, S. & Martinez, P. A., 2018, New records of oribatid mites (Acari: Oribatida) from Argentina, pp. 194-200 in Zootaxa 4370 (2) on page 198, DOI: 10.11646/zootaxa.4370.2.8, http://zenodo.org/record/1143855, {"references":["Hammer, M. (1962 a) Investigations on the Oribatid Fauna of the Andes Mountains III. Chile. Biologiske Skrifter Danske Videnskabernes Selskab, 13 (2), 1 - 96."]}

Crotonia chiloensis Wallwork, 1978 Material studied. Estancia Ushuaia (9) and Reserva Coraz��n de la Isla (2). Distribution. Andean (Chile). Remarks. The species was originally collected in Chile, in Chepu, Isla de Chilo��. This material was found in a terrestrial collection by Dr. Holdgate that was donated to the British Museum, it is a small collection containing the species of Crotonia sp., only represented by a single individual. This specimen was cited by Wallwork as Crotonia chiloensis and the description was made from this single adult, designated as holotype., Published as part of Ruiz, E. V., Rizzuto, S. & Martinez, P. A., 2018, New records of oribatid mites (Acari: Oribatida) from Argentina, pp. 194-200 in Zootaxa 4370 (2) on page 196, DOI: 10.11646/zootaxa.4370.2.8, http://zenodo.org/record/1143855

Ruiz, E.V., Rizzuto, S., Martinez, P.A. (2018): New records of oribatid mites (Acari: Oribatida) from Argentina. Zootaxa 4370 (2): 194-200, DOI: https://doi.org/10.11646/zootaxa.4370.2.8

Kokoppia rafalskii (Hammer, 1968) Brachioppiella rafalskii: Hammer, 1968:61 [New Zealand]. Material studied. Guacho Lake (5). Distribution. Australasian (New Zealand). Remarks. The species was described by Hammer in 1968 as Brachioppiella rafalskii, which was collected near the Rotoiti Lake in New Zealand in mosses growing on Nothofagus sp. Balogh (1983) proposed the new genus Kokoppia, and Subías & Balogh (1989) transferred rafalskii to it., Published as part of Ruiz, E. V., Rizzuto, S. & Martinez, P. A., 2018, New records of oribatid mites (Acari: Oribatida) from Argentina, pp. 194-200 in Zootaxa 4370 (2) on page 196, DOI: 10.11646/zootaxa.4370.2.8, http://zenodo.org/record/1143855, {"references":["Hammer, M. (1968) Investigations on the Oribatid fauna of New Zealand. Part III. Biologiske Skrifter Danske Videnskabernes Selskab, 16 (2), 1 - 96.","Balogh, J. (1983) A partial revision of the Oppida Grandjean, 1954 (Acari: Oribatei). Acta Zoologica Academiae Scientiarum Hungaricae, 29, 1 - 79.","Subias, L. S. & Balogh, P. (1989) Identification keys to the genera of Oppiidae Grandjean, 1951 (Acari: Oribatei). Acta Zoologica Academiae Scientiarum Hungaricae, 35 (3 - 4), 355 - 412."]}

Acutoppia crassiseta (Hammer, 1968) Operculoppia crassiseta: Hammer, 1968:24 -25 [NewZealand]. Material studied. Estancia Ushuaia (2) and Reserva corazón de la Isla (3) Distribution. Australasian (New Zealand). Remarks. The species was described as Operculoppia crassiseta by Hammer in 1968 found at Arthur's Pass, in the New Zealand Alps of the South Island of New Zealand; the specimens were collected from a nest of Nestor notabilis, a psitaciform bird species. Then Balogh (1983) proposed the new genus Acutoppia, which Acutoppia crassiseta as type species., Published as part of Ruiz, E. V., Rizzuto, S. & Martinez, P. A., 2018, New records of oribatid mites (Acari: Oribatida) from Argentina, pp. 194-200 in Zootaxa 4370 (2) on page 197, DOI: 10.11646/zootaxa.4370.2.8, http://zenodo.org/record/1143855, {"references":["Hammer, M. (1968) Investigations on the Oribatid fauna of New Zealand. Part III. Biologiske Skrifter Danske Videnskabernes Selskab, 16 (2), 1 - 96.","Balogh, J. (1983) A partial revision of the Oppida Grandjean, 1954 (Acari: Oribatei). Acta Zoologica Academiae Scientiarum Hungaricae, 29, 1 - 79."]}

Membranoppia (Membranoppia) tuxeni (Hammer, 1968) Oppia tuxeni: Hammer, 1968:52 [New Zealand]; Sanyal, 2000:71 [India]. Material studied. Huemules (12); La Plata Lake (8); Estancia Ushuaia (2) and Reserva Corazón de la Isla (1). Distribution. Australasian (New Zealand), Oriental (India). Remarks. The species was described as Oppia tuxeni by Hammer (1968), found at Lake Rotoiti, New Zealand, on Leucobryum moss under Nothofagus sp. There are also records of the species in Tripura (India) (Sanyal, 2000)., Published as part of Ruiz, E. V., Rizzuto, S. & Martinez, P. A., 2018, New records of oribatid mites (Acari: Oribatida) from Argentina, pp. 194-200 in Zootaxa 4370 (2) on page 197, DOI: 10.11646/zootaxa.4370.2.8, http://zenodo.org/record/1143855, {"references":["Hammer, M. (1968) Investigations on the Oribatid fauna of New Zealand. Part III. Biologiske Skrifter Danske Videnskabernes Selskab, 16 (2), 1 - 96."]}

Lanceoppia (Baioppia) luxtoni Hammer, 1968 Lanceoppia luxtoni: Hammer, 1968:37 [New Zealand]. Material studied. Huemules (3) and Guacho Lake (1). Distribution. Australasian (New Zealand). Remarks. The species was described as Lanceoppia luxtoni by Hammer in 1968. The specimens were collected from mosses, grasses and remains of wooden logs in Waitakere, Keri-Keri, Christchurch, Fox Glacier and Milford, New Zealand. Luxton (1985) erected the genus Baioppia to accomodate Lanceoppia moritzi Hammer, 1968 but did not transfer L. luxtoni to it. Sub��as & Balogh (1989) considered Baioppia as a subgenus of Lanceoppia, and hence included moritzi and luxtoni., Published as part of Ruiz, E. V., Rizzuto, S. & Martinez, P. A., 2018, New records of oribatid mites (Acari: Oribatida) from Argentina, pp. 194-200 in Zootaxa 4370 (2) on page 197, DOI: 10.11646/zootaxa.4370.2.8, http://zenodo.org/record/1143855, {"references":["Hammer, M. (1968) Investigations on the Oribatid fauna of New Zealand. Part III. Biologiske Skrifter Danske Videnskabernes Selskab, 16 (2), 1 - 96.","Luxton, M. (1985) Cryptostigmata (Arachnida: Acari) - a concise review. Fauna of New Zealand, 7, 1 - 106.","Subias, L. S. & Balogh, P. (1989) Identification keys to the genera of Oppiidae Grandjean, 1951 (Acari: Oribatei). Acta Zoologica Academiae Scientiarum Hungaricae, 35 (3 - 4), 355 - 412."]}

Le ulcere da decubito rappresentano una condizione frequente in popolazioni ad alto rischio quali gli anziani e i soggetti con compromissione dell’autonomia funzionale, dall’ipomobilità sino all’allettamento. Esse si con-figurano come un indicatore negativo dell’assistenza sanitaria erogata in quanto potenzialmente prevenibili attraverso l’applicazione di alcune regole fondamentali per la cura e la corretta gestione del paziente non autonomo. L’invecchiamento della popolazione, con il conseguente aumento dei soggetti con deficit funzionali, multimorbilità e comorbilità complesse e, quindi, in ultima analisi, fragili, ha contribuito e continuerà a determinare un aumento dell’incidenza e della prevalenza delle ulcere da pressione. Definire le dimensioni del fenomeno sul piano epidemiologico, tuttavia, è difficile; la stima delle ulcere da decubito, inoltre, varia nei diversi setting assistenziali (reparto per acuti, reparti di area medica o chirurgica, lungodegenza, residenze sanitarie assistenziali). È necessaria una gestione multidisciplinare del fenomeno con particolare attenzione rivolta non solo alla diagnosi e alla cura, ma anche e soprattutto alla prevenzione. Descriviamo il caso di un paziente di sesso maschile, di 66 anni, con ulcera da decubito giunto alla nostra osservazione per la necessità di riattivazione funzionale geriatrica.

L’idrocefalo consiste in una dilatazione del sistema ventricolare dovuta ad un disturbo della circolazione liquorale. Nell’anziano l’idrocefalo è di frequente riscontro in associazione a demenza, come forma ex vacuo. L’idrocefalo normoteso colpisce prevalentemente soggetti d’età superiore ai 65 anni con un esordio clinico subdolo, che spesso è causa di ritardo nella diagnosi. Le sindromi neurologiche alterne sono espressione di lesioni di varia natura a carico del tronco encefalico, caratterizzate dalla coesistenza di un deficit neurologico centrale controlaterale alla lesione ed un deficit neurologico periferico omolateralmente alla lesione. Descriviamo il caso di un paziente di sesso maschile, di 72 anni, giunto alla nostra osservazione per episodi ricorrenti di caduta.

Ontogenetic dietary shifts are widespread across the animal kingdom, and often involve associated morphological changes in foraging phenotype. These changes may differ between sexes or vary between individuals, and are important factors in the ecology of species. While such factors have received much attention in terrestrial systems, they are much less well understood in marine taxa. The white shark Carcharodon carcharias is a marine apex predator that is accepted to provide a classic example of an ontogenetic dietary shift, with an associated change in tooth morphology from cuspidate to broad. Our results however, which include measurements obtained using a novel photographic method, reveal significant differences between the sexes in the relationship between tooth cuspidity and shark total length (TL), and a novel ontogenetic change in male tooth shape. Males exhibit broader upper first teeth and increased distal inclination of upper third teeth with increasing length, while females do not present a consistent morphological change. Substantial individual variation, with implications for pace of life syndrome, was present in males, and tooth polymorphism was suggested in females. Sexual differences and individual variation may play major roles in ontogenetic changes in tooth morphology in white sharks, with potential implications for their foraging biology. Such individual and sexual differences should be included in studies of ontogenetic shift dynamics in other species and systems.

Heat shock proteins (Hsps) assist other proteins in their folding and drive the degradation of defective proteins. During evolution, these proteins have also acquired other roles. Hsp10 is involved in immunomodulation and tumor progression. Hsp90 stabilizes a range of "client" proteins involved in cell signaling. The present study evaluated the expression levels of Hsp10 and Hsp90 in normal mucosa and adenocarcinoma samples of human large bowel.Samples of normal mucosa and adenocarcinoma were collected and Reverse transcriptase-polymerase chain reaction RT-PCR, western blotting (WB) analyses, as well as immunohistochemistry were performed to evaluate the expression levels of Hsp10 and Hsp90.RT-PCR showed a higher gene expression of Hsp10 and Hsp90 in adenocarcinoma samples compared to healthy mucosa. WB results confirmed these findings. Immunohistochemistry revealed higher levels of Hsp10 in adenocarcinoma in both the epithelium and the lamina propria, while Hsp90 expression was higher in the adenocarcinoma samples only in the lamina propria.Hsp10 and Hsp90 may be involved in large bowel carcinogenesis.

A case of congenital toxoplasmosis is reported in which the patient died at 32 days following seizures, coma and respiratory disturbances. Neuropathological examination showed numerous foci of softening throughout the brain. Histological examination disclosed widespread areas of inflammatory necrosis. Circumscribed areas of granulomatous inflammation were also found. Cysts containing a variable number of microorganisms and toxoplasmas free in the damaged areas were frequently observed. Small calcifications were scattered in the cerebral cortex and basal ganglia. Electron microscopy of postmortem brain specimens demonstrated toxoplasmas at various stages of development. The microorganism is enveloped by a two-layered membrane, the pellicle. Replication occurs in a vacuole inside the host cell. Following replication the newly formed parasites, the trophozoites, are released. Several replications without release may also occur with consequent cyst formation. The motile form of the toxoplasma, the tachyzoite, is fusiform with truncated cone shape of the anterior ending which is the presenting surface modified for host cell penetration. The modality of transplacental transmission and the clinical syndromes associated with toxoplasma infection are discussed. EM even of post mortem material contributes to knowledge of the structure of the parasite and of its life cycles.

Sural or superficial peroneal nerve biopsies of patients with clinical diagnosis of Friedreich's ataxia were studied. Patients were divided in two groups, typical and abortive forms: loss of fibers accompanied by axonal atrophy and segmental demyelination are the basic changes in both groups, although the decrease in number of myelinated fibers was most severe in typical FA. In the cases with slower progression there is a tendency to form onion bulb complexes.