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Purpose Recently coronavirus disease (COVID-19) caused a global pandemic, characterized by acute respiratory distress syndrome (ARDS). The aim of our study was to detect pulmonary embolism (PE) in patients with severe form of COVID-19 infection using pulmonary CT angiography, and its associations with clinical and laboratory parameters. Methods From March to December 2020, we performed a prospective monocentric study collecting data from 374 consecutive patients with confirmed SARS-CoV-2 infection, using real-time reverse-transcriptase polymerase-chain-reaction (rRT-PCR) assay of nasopharyngeal swab specimens. We subsequently selected patients with at least two of the following inclusion criteria: (1) severe acute respiratory symptoms (such as dyspnea, persistent cough, fever > 37.5 °C, fatigue, etc.); (2) arterial oxygen saturation ≤ 93% at rest; (3) elevated D-dimer (≥ 500 ng/mL) and C-reactive protein levels (≥ 0.50 mg/dL); and (4) presence of comorbidities. A total of 63/374 (17%) patients met the inclusion criteria and underwent CT angiography during intravenous injection of iodinated contrast agent (Iomeprol 400 mgI/mL). Statistical analysis was performed using Wilcoxon rank-sum and Chi-square tests. Results About, 26/60 patients (40%) were found positive for PE at chest CT angiography. In these patients, D-dimer and CRP values were significantly higher, while a reduction in SaO2 P P P P P = 0.041). Conclusions Our results pointed out that patients affected by severe clinical features of COVID-19 associated with comorbidities and significant increase of D-dimer levels developed acute mono- or bi-lateral pulmonary embolism in 40% of cases. Therefore, the use of CT angiography rather than non-contrast CT should be considered in these patients, allowing a better evaluation, that can help the management and improve the outcomes.

Purpose The differential diagnosis between primary adenocarcinoma of the pancreas head and distal cholangiocarcinoma remains a clinical challenge. Recent studies have shown important differences in terms of survival between these tumors. Therefore, different treatments should be considered, but the preoperative histological diagnosis is still difficult. Aim of this study is to create a preoperative diagnostic score for differential diagnosis between primary pancreatic adenocarcinoma and primary distal cholangiocarcinoma. Methods One hundred eighty consecutive patients who underwent pancreaticoduodenectomy at Sapienza University of Rome from January 2010 to December 2019 were retrospectively analyzed. Inclusion criteria were pancreatic or biliary histologic origin obtained by definitive postoperative histological examination. Exclusion criteria were diagnosis of ampullary carcinoma, non-ampullary duodenal adenocarcinoma, pancreatic metastasis, and benign disease. One hundred one patients were considered eligible for the retrospective study. Preoperative biological, clinical, and radiological parameters were considered. Results CRP > 10 mg/dL (p = 0.001), modified Glasgow Prognostic Score 2 (p = 0.002), albumin p = 0.05), CA 19-9 > 230 U/mL (p = 0.001), and Wirsung diameter > 3 mm (p < 0.001) were significant at univariate logistic analysis. Multivariate logistic analysis has shown that parameters independently associated with primary pancreatic adenocarcinoma were CRP > 10 mg/dL (p = 0.012), CA 19-9 > 230 U/mL (p = 0.043), and diameter of the Wirsung > 3 mm (p = 0.005). Through these parameters, a diagnostic score has been developed to predict a primary pancreatic adenocarcinoma when > 1 and a primary distal cholangiocarcinoma when Conclusion This feasible and low-cost diagnostic score could have a potential impact to differentiate pancreatic cancer histologic origin and to improve target therapeutic strategy.

Background/Aim: Survival of patients with pancreatic cancer remains poor despite improvements in therapeutic strategies. This study aims to create a novel preoperative score to predict prognosis in patients with tumors of the pancreaticobiliary head. Patients and Methods: Data on 190 patients who underwent to pancreaticoduodenectomy at Sapienza University of Rome from January 2010 to December 2018 were retrospectively analyzed. After exclusion criteria, 101 patients were considered eligible for retrospective study. Preoperative biological, clinical and radiological parameters were considered. Results: Pancreatic ductal adenocarcinoma [hazard ratio (HR)=1.995, 95% confidence intervaI (CI)=1.1-3.3; p=0.01], carbohydrate antigen 19.9 (CA 19.9) >230 U/ml (HR=2.414, 95% CI=2.4-1.5, p3 mm (HR=1.592, 95% CI=1.5-0.9; p=0.08) were the only parameters associated with poor prognosis. Through these parameters, a prognostic score (PHT score) was developed which predicted worst survival when exceeding 2 and better survival when ≤2. Conclusion: The PHT score may have a potential impact on predicting overall survival and consequently modulate the timing and type of treatment (up-front surgery vs. neoadjuvant therapy) patients are offered.

Understanding the formation of biogenic molecules in abiotic conditions is a prerequisite in the origin-of-life studies. Determining the conditions allowing an efficient one-pot synthesis of the largest possible panel of biogenic compounds may shed light on the plausible scenario in which the processes that kick-started life might have occurred. We report a set of experiments describing the syntheses taking place from formamide (NH2CHO) and thermal water in the presence of meteorites, in the hydrothermal physical-chemical environment of the Phlegrean Fields. The results show that meteorites catalyse the synthesis of a large panel of organic compounds of biological relevance, including carboxylic acids, nucleobases, amino acids and sugars. The simplicity of the system (a one-carbon molecule as starting compound, a volcanic hydrothermal environment, meteorites as catalysts) hints to a possible extension of the results to similar environments present in other planetary bodies and space objects.

The purpose of our study was to assess the potential role of chest CT in the early detection of COVID-19 pneumonia and to explore its role in patient management in an adult Italian population admitted to the Emergency Department.Three hundred and fourteen patients presented with clinically suspected COVID-19, from March 3 to 23, 2020, were evaluated with PaO2/FIO2 ratio from arterial blood gas, RT-PCR assay from nasopharyngeal swab sample and chest CT. Patients were classified as COVID-19 negative and COVID-19 positive according to RT-PCR results, considered as a reference. Images were independently evaluated by two radiologists blinded to the RT-PCR results and classified as "CT positive" or "CT negative" for COVID-19, according to CT findings.According to RT-PCR results, 152 patients were COVID-19 negative (48%) and 162 were COVID-19 positive (52%). We found substantial agreement between RT-PCR results and CT findings (p 0.000001), as well as an almost perfect agreement between the two readers. Mixed GGO and consolidation pattern with peripheral and bilateral distribution, multifocal or diffuse abnormalities localized in both upper lung and lower lung, in association with interlobular septal thickening, bronchial wall thickening and air bronchogram, showed higher frequency in COVID-positive patients. We also found a significant correlation between CT findings and patient's oxygenation status expressed by PaO2/FIO2 ratio.Chest CT has a useful role in the early detection and in patient management of COVID-19 pneumonia in a pandemic. It helps in identifying suspected patients, cutting off the route of transmission and avoiding further spread of infection.

A crystallisation process of biological macromolecules in gel-matrix was studied by Mach-Zehnder interferometer and the results were compared with a numerical model of periodic precipitation. This investigation is focused on the coupling between transport phenomena, nucleation and crystal growth, which may lead to non-linear behaviour. In general, transport phenomena involve double diffusion of the two main solutes (protein and precipitant agent) and buoyant convection that may arise due to density gradients in the liquid. Both transport conditions were addressed. In absence of convection, in pure diffusive regime, non-uniform crystal distributions have been observed. The results can be described in terms of a modulation in space and in time of supersaturation that leads to a nucleation front that propagates inside the protein solution. The experimental data are in good agreement with numerical simulations. When convection is not negligible, it leads to a deformation of the diffusive solutal distribution, characterised by a periodic wave-like pattern observed by interferometry. The observed instabilities are driven by double diffusion and agree with a stability model of double diffusive systems.

1. Indicano la presenza di materiale denso nel lume di un’ansa ileale distesa, da riferire a materiale ematico. 2. Indicano la presenza di sanguinamento in fase attiva nel lume di un’ansa ileale. 3. E indispensabile eseguire l’esame con scansioni di strato sottile sia senza che con mdc e.v., con alti flussi (3-4,5 mL/sec) e tecnica bifasica. 4. Nell’emergenza, specie nel paziente acuto.

We report an unusual cause of the pleural effusion due to extravasation of urine from the retroperitoneal space into the thoracic cavity. In our case, the urinoma occurred owing to obstructing urinary tract lesion due to opaque stone. Although rare, urinothorax should be considered when pleural effusion occurs in patients with urinary tract obstruction accompanied by retroperitoneal urinoma.

This paper reports experimental results and modelling on the crystallisation processes induced by counter diffusion method of a precipitant agent in a lysozyme protein solution. Comparison between experimental observations and numerical simulations in the presence of convection and sedimentation and without them (suppressed using gel) provides a validation of the model. Different values of the initial protein concentration are used, in order to investigate the effects of supersaturation conditions on the process, and in particular on nucleation. The model and the experimental approach may represent a useful methodology for the determination of the parameters and conditions that may lead to protein crystallisation. A Mach-Zehnder interferometer is used to monitor the transport dynamics in situ in the fluid phase by observing the compositional field. The effect of the solute transport gives rise to a "nucleation front" that propagates inside the protein solution. The crystal formation, caused by progressing of the front, results in a modulation in time and in space (similar to Liesegang patterns), due to the non-linear interplay among transport, crystal nucleation and growth. Both experimental observation and numerical modelling show spatial and size distributions of crystals that demonstrate comparable evidences of the phenomena.

Single chains of the collagen model polypeptide with sequence (Pro-Pro-Gly)10, hereafter referred to as (PPG)10, aggregate to form rod-shaped triple helices. Crystals of (PPG)10 were grown in the Advanced Protein Crystallization Facility (APCF) both onboard the International Space Station (ISS) and on Earth. The experiments allow the direct comparison of four different crystallization environments for the first time: solution in microgravity (μg), agarose gel in μg, solution on earth, and gel on earth. Both on board and on ground, the crystal growth was monitored by a CCD video camera. The image analysis provided information on the spatial distribution of the crystals, their movement and their growth rate. The analysis of the distribution of crystals reveals that the crystallization process occurs as it does in batch conditions. Slow motions have been observed onboard the ISS. Different to Space-Shuttle experiment, the crystals onboard the ISS moved coherently and followed parallel trajectories. Growth rate and induction time are very similar both in gel and in solution, suggesting that the crystal growth rate is controlled by the kinetics at the interface under the used experimental conditions. These results provide the first data in the crystallogenesis of (PPG)10, which is a representative member of non-globular, rod-like proteins.

The SAGACE experiment consists of a mm/sub-mm telescope with a 3-m diameter primary mirror, coupled to a cryogenic multi-beam differential spectrometer. SAGACE explores the sky in the 100-760 GHz frequency range, using four diffraction-limited bolometer arrays. The instrument is designed to perform spectroscopic surveys of the Sunyaev-Zeldovich effects of thousands of galaxy clusters, of the spectral energy distribution of active galactic nuclei, and of the [CII] line of a thousand galaxies in the redshift desert. In 2008 a full phase-A study for a national small mission was completed and delivered to the Italian Space Agency (ASI). We have shown that taking advantage of the differential operation of the Fourier Transform Spectrometer, this ambitious instrument can operate from a Molniya orbit, and can be built and operated within the tight budget of a small mission., Proceedings of the 12th Marcel Grossman Meeting