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Diaphragmatic injury accompanied by herniation through the thoracic cavity is a well documented complication of penetrating or blunt abdominal trauma. It occurs in 3% of abdominal lesions, with strong prevalence for blunt trauma. In the acute setting the diagnosis may be difficult because of the lack of peculiar clinical signs or the wrong interpretation of radiological findings. For this reason, medical history taking should be very accurate, in order to underline the correlation between a past traumatic event and the present symptoms. If the defect is not promptly recognized, the patient has a considerable increase in morbidity and mortality risk. In our case the presentation of the diaphragmatic injury was delayed and the correct diagnosis was not suspected initially. We report the case of a 28 years old man presenting to our department for sudden abdominal pain associated with bowel obstruction. Patient underwent an urgent laparotomy that revealed a postero-lateral diaphragmatic hernia with incarcerated colon and omentum, which appeared ischemic and were therefore resected, with successive closure of the diaphragmatic breach. During medical history taking the patient signaled a penetrating trauma occurred eleven years before symptoms presentation. .

The authors describe a paradigmatic case of a large renal angiomyolipoma not associated with tuberous sclerosis. The lesion was discovered as an incidental finding during abdominal ultrasound for other pathology. Owing to the extent of the lesion and the appreciable risk of spontaneous rupture and bleeding, we opted for surgical treatment. The impossibility of dissecting the angiomyolipoma from the right kidney obliged us to perform a nephrectomy. The clinical interest of angiomyolipoma is in its rapid growth, the difficulty of distinguishing it from malignant lesions, the association with tuberous sclerosis, the presence of numerous aspecific symptoms and the difficulty of establishing the correct diagnosis and treatment strategy.

Intraoperative neuro-monitoring was introduced in thyroid surgery several years ago resulting in a facilitated identification of the recurrent laryngeal nerve and less recurrent laryngeal nerve injuries. Between 1999 and 2005 data of all patients undergoing thyroid resection were recorded and analyzed yearly. The intraoperative identification of recurrent laryngeal nerve succeeded in 99.2% (1768 nerves at risk). The percentage of complete resecting surgical procedures raised from 17% to 84%. Minimal vocal cord dysfunction, associated with hematoma and edema in most cases, was diagnosed laryngoscopically in 2.9%. The permanent palsy rate of 0.8% in the first year decreased down to 0.32%. Routinely introduction of intraoperative neuro-monitoring in thyroid surgery is associated with a demonstrable decreased palsy rate. Anyway, the rate of minimal vocal cord movement disorders and transient recurrent laryngeal nerve palsies is not changed.

Four female subjects were admitted to our Department for a form of severe systo-diastolic hypertension, recalcitrant to previous anti-hypertensive treatment, accompanied by marked hypokalemia. Patients had a common history of the continuous use, for pleasure or medicinal purposes, of liquorice-based preparations. In all cases, suspension led to normalisation of kalemia in a period varying from six to fifteen days, while arterial pressure values and all other essential parameters examined (plasma reninic activity, aldosteronuria, etc.) recovered their balance more slowly.

Fifteen professional football players have been examined with basal electrocardiography, M-mode echocardiography, bicycle ergometry, Holter dynamic electrocardiography; in six of them also, the electrocardiogram has been recorded by during a match. The aim of the research was to evaluate, by non-invasive tests, the cardiovascular status of an athletic team, with particular consideration to rhythm disturbances. The methods employed have given valuable informations. The echocardiographic investigation has frequently shown left ventricular dilation and/or hypertrophy. Dynamic electrocardiography has revealed in many subjects rhythm and conduction disturbances. No athlete has displayed severe rhythm disturbances during the bicycle ergometer test, except one, who had paroxysmal ventricular tachycardia, of complex etiopathogenetic and prognostic significance. Telemetric recording has been very useful to follow the heart action during a match, but its use was often hampered by technical difficulties.

The acrocephalosyndactylia III is a syndrome, which follows an autosomal dominant mode of inheritance, characterized by premature fusion of the cranial sutures in association with mild cutaneous syndactyly. The authors describe two cases recently come to their observation and point out the usefulness of the imaging diagnostics (CT, MRI) in finding anomalies specific of this affection.