Transient global amnesia as the first symptom of primary antiphospholipid syndrome: a case report.

We describe the case of a 45-year-old woman who had drawn our attention for some recent episodes of transient global amnesia that, upon further examination, resulted from ischemic events caused by multiple arterial thrombosis (bilateral internal carotid occlusion, significant stenosis of the right external carotid, mild stenosis of the right vertebral artery, right anterior cerebral artery occlusion and severe stenosis of the anterior descending coronary artery) due to primary antiphospholipid syndrome. Revascularisation of either carotid was not attempted. A percutaneous intervention in the anterior descending coronary artery stenosis was performed successfully. Due to severe arterial thrombosis, the patient was discharged with only duplex antiplatelet treatment and subcutaneous anticoagulant therapy, since immunotherapy is not indicated in primary APS. The occurrence of transient global amnesia should raise the suspicion of APS.

Prostacyclin in sepsis: a systematic review.

According to current literature, infective processes greatly modify both vascular hemodynamics and anti-oxidant properties of affected tissues, causing a change in homeostasis that regulates the correct functioning of all cells responsible for the physiological and metabolic balance of various organs. As a consequence, the response to the infection that has caused the change is also likely to be weaker and, in the case of septic shock, ineffective. In this review, we will take into consideration these mechanisms and then focus on a group of vasodilator drugs (prostacyclin and its analogs) which, though have been used for over 20 years mainly to treat obstructive vascular diseases, have such hemodynamic and anti-inflammatory properties which prevent homeostatic changes. It is obvious that prostacyclin does not definitively have anti-infective characteristics; however, in association with anti-infective drugs (antibiotics, etc.), the effectiveness of the latter appears improved, at least in some circumstances. Similarly, the fact that prostacyclin and its analogs have a cytoprotective effect on the liver and reduce the ischemia-reperfusion damage following liver transplant is not a novelty and evidence that they improve hepatic hemodynamics suggests their use in those pathologies characterized by possible reduced perfusion or ascertained ischemia of the liver.

[Subcutaneous human dirofilariasis]. / Dirofilariasi umana sottocutanea.

After a short review of the literature, starting from the last decades of the past century, the current classification of the Dirofilaria genus is shown with its two subgenera: D. immitis and D. nochtiella (repens, tenuis and ursi). The first case of subcutaneous and pulmonary dirofilariasis caused in Italy by D. repens is then shown as well as a research on dog populations in which D. immitis is prevalent. The fact that D. immitis has not yet been isolated in humans, in Italy, is probably due to D. repens vectors being more anthropophile. Finally, the latest cases of dirofilariasis from D. repens reported in Italy are taken into consideration along with the one isolated by the Authors, complete with illustrations. The case presented has been diagnosed on the basis of the histological examination carried out on a soft nodule detected in the right pectoral region; furthermore, eosinophilia and an elevated value PRIST were present.