[Cardiac compression of hydatid origin]. / Compression cardiaque d'origine hydatique.

INTRODUCTION: Cardiac hydatid disease is uncommon and occurs in 0.5 to 2% of patients with hydatidosis. Isolated intrapericardial hydatid cystic disease is extremely rare. OBSERVATION: We report the case of a young woman with cardiac compression due to multiple primary intrapericardial hydatid cysts. Since 1 year, she had gradual general health deterioration including dyspnoea, sweats and weight loss of 8kg. A widening of the mediastinum was observed on chest X-ray. The CT-scan, echocardiography and the dynamic IRM showed multiple mediastinal cysts with mass effect on the heart and main pulmonary artery. The size of the main pulmonary artery was reduced to 5 mm in diameter and the right upper pulmonary vein was nearly closed by posterior cysts. The right and left ventricular ejection fractions were estimated at about 34%. A complete resection of the cysts was performed by sternotomy. The surgical procedure was technically difficult because of major local inflammatory process. The postoperative outcome after an initial pulmonary embolism event was finally favourable. CONCLUSION: Hydatidosis can lead to severe cardiac involvement. These rare forms of hydatid cystic disease must be known even in non endemic regions by surgeons because of increasing mobility of the world's population.

Lung cancer screening with low dose CT: experience at Campus Bio-Medico of Rome on 1500 patients.

AIM: The main purpose of our project was to evaluate the prevalence of lung cancer in high risk, asymptomatic individuals in addition to quantifying the rate of surgically resectable tumors, and evaluating the role of lung cancer with low dose computed tomography (LDCT) as a tool for lung cancer screening. METHODS: Between June 2011 and March 2014, 1500 volunteers at high risk for lung cancer were enrolled in our study and underwent LDCT in our institution. The subsequent diagnostic and therapeutic steps were planned in relation to the results emerging from LDCT. To evaluate speed and type of growth, solid nodules ≤4 mm were reassessed with annual LDCT, those >4-6 mm or >6-8 mm were reassessed with LDCT in 6 or 3 months while nodules suspicious for malignancy were investigated with PET-CT or biopsy according to NCCN guidelines. RESULTS: Non-calcified nodules were detected in 525 subjects (35% of population): among these 42% had a diameter ≤4 mm, 43% had a diameter >5 mm but <10 mm, 3% appeared as "ground glass" lesions, and 63 (12% of detected nodules) had malignant characteristics (irregular margins, retraction of the surrounding parenchyma, diameter >10 mm). Among the 63 patients who underwent PET-CT or biopsy, 25 cases resulted positive for lung cancer (1.7% of population). These patients underwent surgical treatment with histological detection of tumors in stages IA, IB or IIB. CONCLUSION: Our study confirmed the emerging data on the use of LDCT as a screening tool for lung neoplasm in individuals at risk. Due to the LDCT low rate of specificity complementary biomarkers are required to properly define patients at risk and to reduce the number of further radiological examinations.

[Lung cancer surgery in solid organ transplanted patients]. / Chirurgie du cancer du poumon chez les greffés d'organe solide.

BACKGROUND: The incidence of lung cancer is reputed to be higher and prognosis worse in solid organ transplant recipients than in the general population. Our purpose was to review the results of surgery in this group of patients. METHODS: We retrospectively reviewed 49 male and 6 female patients; mean aged 60.6 years (38-85). Transplanted organ was heart (n = 37), kidney (n=12), liver (n = 5) and both-lungs (n = 1); 48 patients had smoking habits and 42 heavy comorbidities (76.4%). Lung cancer was diagnosed during surveillance (78.2%, n = 43) or because of symptoms (21.8%, n = 12). We reviewed TNM and other main characteristics, among them histology (squamous-cell-carcinoma n = 23, adenocarcinomas n = 24, others n = 8). RESULTS: Surgery consisted of: exploratory thoracotomy (n = 2), wedge resections (n = 6), segmentectomy (n = 1), lobectomy (n = 42), pneumonectomy (n = 4). Postoperative mortality was 7.4% (n = 4) and complication rate 34.5% (n = 19). Five-year survival rate was 46.4% (65.4% for stage I patients, n = 25). Among the 35 dead patients during follow-up, 14 died of their lung cancer (40%). Two had been re-operated from another lung cancer: one after 3 and 8 years who survived 16 years, and the other after 2 years who survived 70 months. CONCLUSIONS: Surgery results are good and postoperative events acceptable despite theoretically increased risks. This also supports performing a close follow-up of transplanted patients and particularly those with smoking history in view of detecting lung cancer appearing at an early stage.

[Sleep problems explainable by elements of cybernetic culture]. / Le problematiche del sonno declarabili mediante elementi di cultura cibernetica.

A study of sleep in the light of Pavlovian conditioned reflexes is proposed. Sleep and its disturbances would appear to reflect different cell metabolic biorhythms, coinciding with intracellular states interdependent of extracellular chemical and physical values and strictly determined by reflexological factors. Reference is made to a personal paper ("Metodica psicoterapica su elementi di cultura cibernetica") for the view that the DNA memorising function, which is responsible for conditioned reflex patterns, genetic metabolism and new valid or non-valid metabolic equilibria via the synapses, could, by conditioning, lead to normal, eurhythmic sleep in terms of the subject's own pattern or that of the statistical mean of the population to which he belongs. Reharmonisation of subjectively disturbed sleep rhythms by new hetero- or autoinduced conditioning is suggested.

[Cybernetic conceptualization of the levels of hypnosis]. / Concettualizzazione cibernetica dei livelli dell'ipnosi.

The synaptic function of the different associational levels of cortex and cortico-subcortical depending on inputs memorised in synchronism at each level, is probably responsible, on a broad scale of values, for auto- or heteroinducible levels of hypnosis due to inputs solicited by extraneuronal values determining feed-back with inputs recorded in neuronal DNA. This hypothesis is outlined here with reference to the same Author's "Metodica psicoterapica su elementi di cultura cibernetica" (Minerva Medica, 63, 968, 1972). Sophronic levels, and levels of hypnosis and hypnotism are, in the light of elements of cybernetic culture, neurophysiologically referrable not only to qualitatively different causes, and more specifically to the final cause triggering electrobiochemical reactions. They are, in other words, referrable to the electron and its dynamics, increasingly well known today to students of cybernetics.