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Introduction In literature there are few studies reported on follow–up of post infarction using telemedicine. Objective and Methods Considering recent pandemic and thanks to the development of digital also in its regulations, it was decided to organize a televisit service with a dedicated team (cardiologist, nurse, cardiology technician) for patients (pt) discharged after a myocardial infarction. The platform of Regione Lazio SISMED has been used to carry out all the necessary procedures (dematerialised recipe, booking, videoconference, digital signature reporting and sending to FSE). We selected pt with: ST elevation myocardial infarction (STEMI), myocardial infarction with no obstructive coronary atherosclerosis (MINOCA) or Takotsubo syndrome, non ST elevation myocardial infarction (NSTEMI) with high–risk, providing a follow–up to 1 and 4 months to monitor cardiovascular events, adherence to therapy, achievement of therapeutic targets and level of satisfaction. An Access file was designed for reporting and data collection. Results From 23–11–21 to 2–11–22, we followed 58 pt (average age 64±10 years, 73% males). Figure 1 represents the cardiovascular risk factors and Figure 2 the type and location of the myocardial infarction; at discharge (average stay 7±2 days), the ejection fraction of the left ventricle was 53±9%. At the televisit control at 1 month, 5 pt reported symptoms (4 dyspnea, 1 cardiopalm), all continued the antiaggregant therapy; Figure 3 shows those who have reached the target for LDL cholesterol (average 56±34 mg/dl), blood pressure (average 124±10 mmhg) and blood sugar level (average 107±19 mg/dl); 6 pt had no target LDL cholesterol (three stopped hypolipidaemic therapy). One pt showed intense pallor, asthenia and reduced hemoglobin (6 g/dl): after hospitalization, we found colon diverticulosis with bleeding (he took oral anticoagulant due to prior atrial fibrillation, suspended, with benefit). The 4–month follow–up was performed for 42 pt, with overlapping results, without reospedalizations. No pt died. Conclusions The televisit showed itself safe as an option in the follow–up of these pt, with a high approval rating. This was possible through the structuring of a health coordination center with a dedicated team, which also supported pt in the new path.

Funding Acknowledgements Type of funding sources: None. Introduction Heart involvement in systemic sclerosis patients is frequent and represents a negative prognostic factor with around 25% of SSc patients dying from cardiovascular related causes. Cardiac arrhythmias represent 6% of the overall causes of death in SSc patients. Not only a plethora of conditions typical of the disease seem to favour the presence of an arrhythmic substrate such as microvascular disease or fibrosis but autoimmunity itself has been recognized as a pathogenic mechanism for cardiac arrhythmias. Purpose The aim of our study was to investigate the incidence of arrhythmias in patients with systemic sclerosis and identify potential predictors. Methods Prospective longitudinal study enrolling all consecutive patients with a diagnosis of SSc and no overt cardiac disease nor pulmonary hypertension. Echocardiographic parameters and GLS were obtained at baseline and at each follow up as well as 12 lead ECG. Presence of atrial fibrillation (AF), atrial tachycardia (AT), ventricular ectopic beats >1000/24 h (VEB), supraventricular ectopic beats (SVEB), bundle branch block (BBB) and atrioventricular block (AVB) was registered. Results 160 patients (144 females, 90%, mean age 59±14 years) were enrolled from June 2016 to December 2021. At enrolment, 11.3% of patients with SSc presented a previous history of supraventricular arrhythmia (5.6% supraventricular ectopic beats, 3.1% atrial fibrillation, 2.5% atrial flutter) and 5.6% a history of ventricular arrhythmia (5.0% ventricular ectopic beats, 0.6% ventricular tachycardia). After a median follow-up of 3.1 years (95% CI 1.4-4.8 years), five patients (3.1%) died of cardiovascular causes, of which three (1.8%) experienced a sudden cardiac death. During the same period, 16 patients (10%) presented a new diagnosis of supraventricular arrythmia (8.7% atrial fibrillation, 1.3% atrial flutter) and two patients (1.2%) a new diagnosis of ventricular tachycardia. PR interval significantly increased during the 3.1-year follow-up (154±27 vs. 178±32 ms; p=0.013), as well as corrected QT interval (420±23 vs. 436±19 ms; p=0.001). New diagnosis of complete right and left bundle branch block was made in 18 (11.2%) and two (1.2%) of all SSc patients. Diagnosis of pulmonary arterial hypertension was associated with a 4-fold and a 10-fold increased risk of supraventricular and ventricular arrhythmias, respectively (Figure 1). A diffuse SSc variant (p=0.049), indexed right (p=0.020) and left atrial volumes (p=0.035), and E/E’ ratios (p=0.016) were all associated with an increased risk of supraventricular arrhythmias. TAPSE (p=0.040), as well as right (p=0.030) global longitudinal strain were associated with an increased risk of ventricular arrhythmias. Conclusions Ssc patients are often by an arrhythmic profile with an increased risk of supraventricular and ventricular events as well as sudden cardiac death. A comprehensive cardiological work up may help in lowering the risk of arrhythmic complications.

The Italian Space Agency, within the frame of the mission “Beyond” has promoted the "YiSS—Youth ISS Science" competition, to involve secondary school students in the process of conception and execution of a space experiment. The XENOGRISS experiment was selected by the Italian Space Agency to fly onboard the ISS. The project foresees an active involvement of students into a multi-disciplinary activity aimed at studying the effect of microgravity on growth and regeneration processes, using an animal model (Xenopus laevis) that allows both processes to be observed simultaneously. The project involves the preparation of a Xenopus laevis tadpole culture within a Xenopus Experiment Unit (XEU). The XEU has been integrated into a powered metallic sealed container called Biokon. The activation on the ISS ensured the feeding of the tadpoles, the recirculation of water and the acquisition of images. The control electronics, including the acquisition system, was designed and realized by the students under teacher supervision in collaboration with engineers from Kayser Italia. The integration process of the experiment onboard the ISS was provided by the UTISS Team (Argotec/Telespazio) that supported safety evaluation, requirements verification, payload manifesting, delivery, operations and recovery. The facility has been launched with Space-X CRS-19 and recovered after 30 days. The information derived from this experiment will help to understand the mechanisms underlying the effect of microgravity upon the processes of growth, repair and regeneration of tissues. A better knowledge of these processes is important in defining protocols for the management of traumatic injuries, wounds and chronic ulcers both in Space and on Earth.

A parameterized model order reduction technique is investigated for the efficient frequency-domain uncertainty quantification of circuits obtained by the Partial Element Equivalent Circuit method. The parameterized model order reduction technique is coupled with a standard MC analysis and it is able to provide accurate uncertainty quantification results at a significantly reduced computational cost. Choosing the order of the parameterized model order reduction model is an important step depending on the detail of statistical information needed from the uncertainty quantification process. A practical approach is used for order selection. Numerical results for correlated random variables have validated the efficiency and accuracy of the proposed uncertainty quantification method.

The long term production planning for a large chemical production site, where 10+ different chemical plants share raw materials, infrastructure (e.g., tank farm, filling stations) and utilities (e.g. steam, electricity, technical gasses) might prove to be a challenging task. This paper introduces a data driven approach to build a digital twin of a chemical production site to aid the relevant decision makers in defining and evaluating the economic impact of a long term (i.e. several months ahead) production planning. Each chemical plant and energy production unit on site is represented by simple regression models relating the consumption of raw materials and utilities to its products. The resulting system of algebraic equations has been inserted in an optimization environment with the objective of maximizing the profit. In the optimization, also the electricity and steam generation were introduced to obtain a global energy balance of the production site. This combination resulted in a multi period Mixed-Integer Linear Programming (MILP) problem. The effect of electricity price and external temperature on the optimization results are also investigated.

In this paper, we present the first realisation and experimentation of a new eye tracking system using an infrared (iR) laser pointer embedded into a wireless smart contact lens. We denote this contact lens prototype as the cyclops lens, in reference to the famous hero of the X-Men comics. The full eye tracker device combines the smart contact lens and its eyewear, which provides a primary source of energy and the beam detection system. We detail the assembling and encapsulation process of the main functionalities into the contact lens and present how a gaze tracking system is achieved, compared to existing conventional eye-tracking ones. Finally, we discuss future technical improvements.

Archeological and archaeometric studies on Capo Graziano pottery (Aeolian Islands, Early and Middle Bronze Age), focussed on patterns of decoration

Large-scale landslides at volcanic islands are one of the most dangerous geological phenomena, able to generate tsunamis whose effects can propagate far from the source. However, related deposits are scarcely preserved on-land in the geologic records, and are often difficult to be interpreted. Here we show the discovery of three unprecedented well-preserved tsunami deposits related to repeated flank collapses of the volcanic island of Stromboli (Southern Italy) occurred during the Late Middle Ages. Based on carbon datings, on stratigraphic, volcanological and archaeological evidence, we link the oldest, highest-magnitude investigated tsunami to the following rapid abandonment of the island which was inhabited at that time, contrary than previously thought. The destructive power of this event is also possibly related to a huge marine storm that devastated the ports of Naples in 1343 (200 km north of Stromboli) described by the famous writer Petrarch. The portrayed devastation can be potentially attributed to the arrival of multiple tsunami waves generated by a major landslide in Stromboli island, confirming the hypothetical hazard of these phenomena at a regional scale.

A novel method is presented for time-domain statistical analysis of large active circuits with multiple stochastic parameters. It is based on a stability-preserving model order reduction algorithm coupled with stochastic collocation schemes. Pertinent numerical results validate the proposed method.

Rapporto di scavo

Inquadramento del villaggio di San Vincenzo a Stromboli nell'ambito dei traffici mediterranei dell'età del Bronzo

illustrazione sintetica dei risultati della campagne di scavo nel villaggio dell'età del Bronzo di San Vincenzo a Stromboli

The membrane-substrate interactions have a topological valence and represent a level of information exchange between the cell and the extra-cellular matrix and/or between cells. The interactions can vary with boundary conditions and can be altered by varying the chemical and/or physical properties of the substrate. The alteration can presumably result in differentiation or specialization of the cells, but this fundamental aspect must still be fully understood. In such a frame, we investigated the levels of transcriptional coactivators YAP/TAZ throughout C2C12 differentiation on standard two-dimensional substrates and on polyethylene glycol-fibrinogen three-dimensional microenvironment. In detail, we observed that the use of a three-dimensional matrix permits an earlier differentiation in muscular cells when compared to standard bidimensional substrates. On such a basis, we want to investigate the modulation of a more regular threedimensional pattern on cells proliferation response and we propose a matrix, generable with multiphoton absorption, with regular aligned channels in order to overcome the current limitation in muscle regeneration techniques, so a possible tool to improve the myofibers formation and alignment.

Relazione preliminare sulle campagne di scavo nell'insediamento dell'età del Bronzo di San Vincenzo a Stromboli

Rapporto di scavo

A metamodelling technique for the efficient design optimisation of the electromagnetic response of metasurfaces is proposed. Metamodels are built starting from data samples of design performance parameters properly extracted from a few electromagnetic simulations using a system identification approach. The metamodels are then used to optimise the metasurface electromagnetic response with respect to some design specifications. Numerical results validate the efficiency and accuracy of the proposed metamodelling technique.

The Way We Walk: from Crati to Po passing through the Tiber, fifty years of walks through fields - After WW II, land reforms implied the beginning of a dramatic and fast change in the Italian farmland. This occurrence gave rise to systematic survey projects, among which the most significant appears to be the South Etruria Survey of Ward Perkins. This project has been the model for a huge number of subsequent survey, carried out mainly by foreign institutes with great availability of resources. Other significant researches have been carried out by Italian individual archaeologists or groups of freelance researchers with great familiarity with the specific territories and archaeological questions. These two traditions characterized the entire progress of the pre-protohistoric Italian landscape archaeology. It doesn't seem correct to identify the availability of resources as the only reason for the occurring of differences, which is instead to be found in three parallel levels: 1) the methodological choices, whether depending or not on the object of study ; 2) the object of research, i.e. specific situations or entire territorial districts; 3) the interpretive categories of data.

Aspetti archeologici e vulcanologici dell'isola di Stromboli, con particolare riguardo all'età del Bronzo

Rapporto di scavo

The formation reaction of chiral racemic and diastereoisomeric title complexes, (Lambda, Delta)-[Cr{(+/-)-Mebdtp}(3)] and Lambda-(-)(589)-[Cr{(+)-(S)(S)-Mebdtp}(3)], was monitored by absorption, UV/Vis, and Circular Dichroism, CD, spectroscopy, in the presence of either an excess of the racemic, (+/-)-Mebdtp(-), or the enantiopure ligand, (+)-(S)(S)-Mebdtp- = O,O'-bis[(+)-(S)-2methylbutyl] dithiophosphate ion, at 25 degrees C in various solvents (ethanol, tetrahydrofuran, chloroform/ethanol = 9:1) and at various pH values and reactant concentrations. The kinetics of the formation reaction of the racemic complex, (Lambda, Delta)[Cr{(+/-)-Mebdtpl(3)], shows three consecutive reaction steps. The relative pseudo first-order rate constants depend in different ways on the ligand and H+ concentrations. Circular dichroism measurements during the formation reaction using the enantiopure ligand, as well as in the final equilibrium state, show a prevalence of the Lambda-(-)(589)-[Cr{(+)-(S)(S)-Mebdtp}3] over the Lambda-(+)(589)-[Cr{(+)-(S)(S)-Mebdtp}(3)] diastereoisomer in all solvents used. A mechanism is proposed which involves two parallel pathways each consisting of three consecutive reactions of solvent substitution by a chiral chelated ligand, interconnected by some reversible inversion reactions to obtain in solution the thermodynamic and kinetic Lambda-(-)(589)-[Cr{(+)-(S)(S)-Mebdtp}(3)] as the major diastereoisomeric compound. From the equilibrated solution the more stable solid (Lambda, Delta)-[Cr{(+)-(S)(S)-Mebdtp}3] crystallizes as a ca. 1:1 compound of a pair of the two diastereoisomers, undergoing a crystallization-induced second-order asymmetric transformation. Lambda-[Cr{(+)-(S)(S)-Mebdtp}3] is the thermodynamically stable diastereoisomer in the solid state, though in solution this inverts to the more stable Lambda-(-)(589)-[Cr{(+)-(S)(S)Mebdtp}3].

Total mesorectal excision (TME) is the cornerstone of a correct surgical therapy for extraperitoneal rectal cancer. Aim of the study is to evaluate our 5 years experience confronting retrospectively laparoscopic (lap) TME in respect to its laparotomic (open) counterpart.30 patients were treated laparoscopically for stage I-III extraperitoneal rectal cancer and retrospectively compared to a homogeneous group, stratified for sex, age, comorbidities and stage of disease.30 days mortality was zero for both groups, while morbidity was 20% for the lap group and 36.6% for the open group. Mean lymph nodes harvested was 24 ± 12 for the lap group, 26 ± 14 for the open group (p0.05). Five years overall and disease free survival was respectively 82.2% and 81.4% in the lap group, 79.9% and 79.6% in the open group, without statistical significance (p0.05). Discussion. Minimally invasive TME resulted a safe, effective and oncologically adequate procedure when retrospectively compared to its laparotomic counterpart, with 5 years overall survival and disease free survival reaching no statistical significance compared to the open approach, but with all the advantages of the laparoscopy such as less pain and blood loss, faster recovery, less morbidity and better cosmetics.Our study has retrospectively demonstrated that laparoscopic TME is feasible and oncologically effective, even if it remains a complex minimally invasive procedure, requiring adequate skill. More prospective, randomized studies are necessary to define such a procedure as the new gold standard in treatment of stage I-III extraperitoneal rectal cancer.

Laparoscopic gastrectomy is becoming a minimally invasive procedure widely accepted by laparoscopic surgeons; yet, many doubts remain about its oncologic efficacy in treating malignant neoplasia. Aim of this study was to analyze our experience comparing completely laparoscopic total gastrectomy to its laparotomic counterpart, about safety, efficacy and five-year oncologic outcome.From January 2003 to October 2009, 25 patients with stage I-III/C gastric cancer (TNM Seventh Edition, 2010) were operated on and retrospectively compared to an homogeneous group of patients, stratified for age, stage of disease and comorbidities. Length of surgery, estimated blood loss, postoperative ileus, resumption of oral intake, morbidity, 30 days mortality, number of lymph nodes harvested, five years overall and disease free survival were analyzed, comparing the two groups.There was no conversion. Thirty days mortality was zero for both groups, while morbidity was 16% in the lap group, 32% in the open group (P0.05). Length of operation was 211±23 min for the lap group, and 185±19 min for the open group (P0.05); the estimated blood loss was 250±150 mL for the lap group, 495±190 mL for the open group (P0.05). Number of lymph nodes harvested was 35±18 for the lap group, 40±16 for the open group (P0.05). No port site metastatic implantation occurred in any patient treated laparoscopically; five years overall and disease free survival were 55.7% and 54.2% for the lap group, 52.9% and 52.1% for the open group, respectively, with no statistical difference (P0.05). Completely laparoscopic total gastrectomy represents a new challenge for the laparoscopic surgeon. In spite of clear advantage for patients, some debate remains about its oncologic efficacy in the middle and long period, even if many authors report comparable results to open total gastrectomy. In our experience, it is a safe and valid alternative to its open counterpart, with no statistically different number of lymph nodes harvested, five years overall and disease free survival in respect to the open gastrectomy. Yet, it remains a complex procedure requiring high laparoscopic skill.In our opinion, completely laparoscopic total gastrectomy is a safe and effective procedure, with long term oncologic results not statistically different from the open procedure; yet, it requires high laparoscopic experience, especially to carry out an extended lymphadenectomy and to fashion the anastomosis. More randomized prospective trials are needed to state this procedure as a new gold-standard in treating stage I-III/C non metastatic gastric cancer.

Laparoscopic Appendectomy (LA) is widely performed for the treatment of acute appendicitis. However the use of laparoscopic approach for complicated appendicitis is controversial, in particular because it has been reported an increased risk of postoperative IntraAbdominal Abscess (IAA). The aim of this study was to compare the outcomes of LA versus Open Appendectomy (OA) in the treatment of complicated appendicitis, especially with regard to the incidence of postoperative IAA.A retrospective study of all patients treated at our institution for complicated appendicitis, from May 2004 to June 2009, was performed. Data collection included demographic characteristics, postoperative complications, conversion rate, and length of hospital stay.Thirty-eight patients with complicated appendicitis were analysed. Among these, 18 (47,3%) had LA and 20 (52,7%) had OA. There were no statistical differences in characteristics between the two groups. The incidence of postoperative IAA was higher (16,6%), although not statistically significant, in the LA compared with OA group (5%). On the other hand the rate of wound infection was lower (5%) in the LA versus OA (20%).Our study indicated that LA should be utilised with caution in case of perforated appendicitis, because it is associated with an increased risk of postoperative IAA compared with OA.

metodologia di archiviazione elettronica dei dati di uno scavo archeologico

Since 1990 when it was firstly performed, radical laparoscopic nephrectomy has gained wide popularity because of its less morbidity and adequate oncologic outcome. The aim of this study was to report our experience about oncologic 5-year outcome of laparoscopic radical nephrectomy.Fifteen patients were treated laparoscopically and retrospectively compared to a group of patients treated laparotomically, omogeneous for age, stage of disease and comorbidities.There was no conversion in the laparoscopic group and duration of both procedure showed no statistical difference. Laparoscopic procedures showed less intraoperative blood loss, less postoperative ileus, shorter hospitalization and less morbidity, all with statistical significance. Overall 5 years survival showed no statistical significant difference in the two groups (88.9% laparoscopic group vs. 86.2% laparotomic group).Laparoscopic radical nephrectomy has clear advantages compared to the traditional surgery, especially about less morbidity, less blood loss, shorter hospitalization, with an oncologic outcome absolutely comparable to the laparotomic procedure. Laparoscopic radical nephrectomy is a safe and oncologically adequate surgical procedure with clear advantages compared to the its open counterpart, so it must be considered as a valid alternative to laparotomic surgery in case of non metastatic T1-T2 kidney cancer.

The conformational and packing properties of two encapsulated cobalt(III) complexes containing cyclo-triphosphate have been investigated. Compound (I), (1,3,6,8,10,13,16,19-octaazabicyclo[6.6.6]icosane)cobalt(III) cyclo-triphosphate-water (2/7) has the trivial name cobalt(III) sepulchrate cyclo-triphosphate-water (2/7) and chemical formula [Co(sep)](P 3 O 9 ).3.5H 2 O. The cation shows an lel 3 geometry very similar to those found in other sepulchrate complexes

The complex (1,3,6,8,10,13,16,19-octaazabicyclo[6.6.6]-icosane)cobalt(III) perchlorate thiosulfate, [Co(C 12 H 30 N 8 )](ClO 4 )(S 2 O 3 ), crystallizes in the hexagonal space group P6 3 22. Cations and anions occupy special-site positions with the anions disordered as a result of symmetry requirements. Co(sep) 3+ (sep=C 12 H 30 N 8 ) adopts the optically active D 3 crystallographic geometry. The packing consists of layers of interacting Co(sep) 3+ and S 2 O 3 2- ions, intercalated by isolated ClO 4 - anions. The second complex, rac-(1,3,6,8,10,13,16,19-octaazabicyclo[6.6.6]icosane)cobalt trichloride monohydrate, rac-[Co(C 12 H 30 N 8 )]Cl 3 .H 2 O, crystallizes in themonoclinic space group P2 1 /a.

Our aim was to evaluate the desmin content in the myocardial tissue of patients with end-stage heart failure of ischaemic origin and to assess its role on cardiac function. We studied 18 explanted hearts from patients transplanted for end-stage heart failure due to ischaemic cardiomyopathy (ICM). Control myocardial tissue was obtained from the cardiac biopsies of six women with breast cancer taken prior to commencing chemotherapy with anthracyclines, four male donors for heart transplantation and two autoptic hearts from patients who died due to non-cardiac events. Myocardial tissue, obtained from the left ventricle (remote zone from infarcted area), was analyzed by light and confocal immunochemistry (desmin) microscopy. The desmin content of myocardial tissue was obtained by real-time PCR. Cardiac function was evaluated by echocardiographic and right heart catheterization data, obtained before heart transplantation. Confocal microscopy evaluation showed a significant decrease in the number of desmin-positive myocytes (P

The experience with a totally implanted venous system (TIVS) in 27 cancer patients (15 males and 12 women) is reviewed, stressing simplicity of the cut down technique, which was successfully performed in 92.7% of patients. The common: est complications are described; port infection (7.4%), subclavian vein thrombosis (3.7%), and cutaneous necrosis (3.7%) at the port level. It is concluded that TIVS is a useful device for prolonged drugs administration and the cut down technique is indicated especially in the outpatients setting.

Previous research focusing on one-time screening rather than repeat adherence, have largely pointed out that anxiety levels and pain expectation are the most common factors which may act as a barrier to mammography. These studies also show that anxiety pain and depression are very often associated with the experience of mammography. The aim of this study was to evaluate whether a supportive psychological intervention can be effective in reducing these feelings in patients undergoing follow-up mammographyThe study was performed on 60 women who had already received a diagnosis of breast cancer. In order to detect the variables of depression, anxiety and pain before and after mammography the following questionnaires were administered to the patients: State-Trait Anxiety Inventory (STAI), Self-rating Depression Scale (SDS), Visual Analog Scale (VAS).The results of this study show that our psychological intervention significantly lowered the levels of state anxiety and pain but it had no effect on depression. A psychological approach giving patients both emotional and informational support about the examination, may significantly reduce state anxiety levels and the pain felt during mammography.

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. The majority of MD cases are asymptomatic although they can, occasionally, cause complications such as bleeding, intestinal obstruction and/or inflammatory process. The diagnosis is difficult and it is usually made at surgery. The treatment of choice in the patients with symptomatic MD is surgical resection while difference of opinion there are about the treatment of asymptomatic MD. The present study concerns 9 cases of MD, 7 symptomatic and 2 incidentally found during surgical abdominal operations. Six patients was males and 3 females with 2:1 male: female ratio. The mean age was 14.7 years. The most common complication was the diverticulitis with the perforation of MD in 1 patient. All patients, symptomatic and asymptomatic, was operated. The diverticulectomy was made in 7 patients while in 2 cases we had to perform an intestinal resection. There was not operative mortality, while there were 2 cases of postoperative complications which occurred only in the patients with symptomatic MD. The Authors believe that there is no factor predictive of the development of diverticular complications. They recommend, in light of the low postoperative mortality and morbidity, the surgical treatment also in the cases of asymptomatic MD, in the absence of absolute contraindications.

The Klippel-Trenaunay syndrome is a rare syndrome of uncertain etiology. The characteristic elements are flat angiomatosis, hypertrophy of soft tissue and bone tissue and alterations of the venous system, with the exclusion of hemodynamically significant arteriovenous fistulae. The authors report a clinical case and review the international literature. Treatment is conservative in the majority of cases; surgery is reserved for patients with disabling morphological and functional alterations.

Leiomyosarcoma of the mesentery is a rare neoplasm. The clinical manifestation is non-specific and preoperative diagnosis is often late. Mitotic activity shows no significant correlation with the biological behavior of neoplasm. The surgical excision is the therapy of choice but local recurrence is high. The authors report a case of leiomyosarcoma which was treated by surgical removal and underline the diagnostic difficulties.

The authors present 14 cases of enterobiasis of appendix observed between 1991-94, on a total of 1093 appendectomies. The presence of the parasite was associated, in the majority of cases, to a chronic appendicitis. The symptomatology imitates an attack of acute appendicitis, but the true nature of the disease is diagnosed only through a histological examination. There is probably an etiopathogenic relationship between. E. vermicularis and chronic appendicitis, whereas the relationship between the parasite and acute appendicitis is rare and very disputed.

The authors describe two cases of cecal diverticulitis pointing out the rarity of the disease in particular in Western countries. The disease is often asymptomatic although in the case of diverticulitis, which represent the most frequent complication of the disease, the patient becomes symptomatic. The symptomatology in these cases is similar to an acute appendicitis with which it is constantly confused. Surgery is the most common therapy and the type of operation is based on the clinical condition of the patient and local anatomical-surgical situation.

The authors report a clinical case and review the international literature. After an analysis of the incidence and the predisposing factors causing this disorder, they focus attention on the question of therapy. In forms with vital loop non-surgical derotation must be attempted. In the event of the failure of non-invasive treatment and to prevent recidivation these forms are treated surgically, also using videolaparoscopy. In forms with non-vital loop, surgery consists of the section of the necrotic segment and preparation of anastomosis which may be immediate or deferred depending on general and local conditions.