Endovascular treatment of pulmonary artery aneurysm: Single case experience

A peripheral pulmonary artery aneurysm (PAA) is a dilatation involving all 3-vessel wall layers (the intima, media, and adventitia) of a distal pulmonary artery. It represents a rare but potentially life-threatening condition. There are only some reviews of transcatheter embolization of unruptured idiopathic peripheral PAAs. Association with cardiac diseases, infections, vascular anomalies, pulmonary hypertension, and vasculitis has been noted. We report a case of a 38-year-old woman, with a history of third-degree atrioventricular (AV) block, treated with pacemaker placement, who presented a PAA in the left pulmonary lobe. Transcatheter coil embolization was performed, using a triple coaxial catheter system (a 6F outer, a 5F intermediate, and a 2.4F inner catheter) to prevent rupture and the aneurysm was successfully embolized. Although there is no consensus on the treatment for unruptured idiopathic peripheral PAAs, transcatheter embolization may be a promising treatment option.

Rescue of renal function after endovascular revascularization of acute aorto-renal bypass occlusion in a patient with solitary kidney: a case report

Renal artery occlusion represents an early diagnostic urgency to prevent kidney injury or, even more grave, kidney failure. However, diagnosis is often a challenge due to nonspecific and sporadic symptoms and signs, resulting in misdiagnosis, missed, or delayed diagnosis. The patient ought to be evaluated by a multidisciplinary team to select the best treatment.

We describe a 62-year-old man's case study. The patient had a left solitary kidney with an aortorenal artery bypass thrombosis. The renal function resumes 24 hours after the interventional radiology procedure. Based on our experience, revascularization of aortorenal artery bypass thrombosis may save renal function even after long ischemia times of over 24 hours.

Ureteral metastasis from gastric cancer after two years of subtotal gastrectomy: a case report

True ureteral metastases from gastric cancer are extremely rare. Only a few cases of this condition have been reported. CT is the first-line imaging technique and may aid the diagnosis, even if the definitive diagnosis is histologic. We report a case of a 45-year-old female with a history of gastric cancer who underwent subtotal gastrectomy and presented 2 years later with ureteral metastasis and subsequently renal pelvis metastasis in absence of peritoneal involvement. A biopsy was required to rule out primary urothelial carcinoma and make a well-timed and proper diagnosis. We describe the pathologic and radiological features of this case, followed by a brief review of the literature included in the discussion.

Stenting of the superior vena cava and right pulmonary artery in a woman with a mediastinal mass and acute respiratory distress syndrome (ARDS)

We report the case of a woman with a mass in the anterior and middle mediastinum (a non-small-cell lung carcinoma), determining significant compression of both superior vena cava and right pulmonary artery. The patient developed acute respiratory distress syndrome , necessitating intubation and admission to the Intensive Care Unit . Radiotherapy sessions to reduce the mass effect were attempted, without significant clinical improvement. Due to the persistence of severe hypoxemia, stenting of the superior vena cava and the right pulmonary artery was performed, the latter resulting in a significant improvement of the arterial blood gas parameters, allowing extubation of the patient. In our opinion, stenting of the superior vena cava and the pulmonary artery (or its branches) is an effective and safe treatment; it should be considered in similar cases, especially if other - less invasive - treatments fail.

Specific detection of Arcobacter spp. in estuarine waters of Southern Italy by PCR and fluorescent in situ hybridization

AIM

To evaluate the reliability of culture-independent methods in comparison with culture-dependent ones for the detection of Arcobacter spp. in estuarine waters of Southern Italy.

METHODS AND RESULTS

PCR and fluorescent in situ hybridization (FISH) procedures were used to detect arcobacters directly in water samples and after enrichment cultures. The samples totally were positive by molecular methods (PCR and FISH) but only 75% were culture positive, confirming the limitation of these latter to detect Arcobacter spp. in natural samples. Culturable arcobacters were retrieved in all times except in July, and isolated species were ascribed only to Arcobacter cryaerophilus.

CONCLUSIONS

Culturable and nonculturable forms of Arcobacter in the estuarine environment were present. PCR assays were more sensitive than traditional culture in detecting Arcobacter butzleri and A. cryaerophilus. FISH comparatively to PCR technique may provide information about cell morphology and viability of single cells.

SIGNIFICANCE AND IMPACT OF THE STUDY

Our investigation indicates the existence of an environmental reservoir of potential pathogenic arcobacters in an estuarine Italian area, which may survive under a viable but not culturable state.

Molecular detection of Bartonella henselae and Bartonella clarridgeiae in clinical samples of pet cats from Southern Italy

Bartonella henselae is considered an emerging pathogen of veterinary and medical interest that can be occasionally transmitted to humans. Cats are considered to be the only reservoir host for B. henselae. In this study, we used a nested-PCR assay to investigate the prevalence of B.henselae and Bartonella clarridgeiae DNA in peripheral blood samples, fine needle lymph node aspirate specimens and oral swabs from 85 cats in order to develop an easy diagnostic strategy for the selection of infection-free cats that are being considered as pets, especially for immunocompromised patients. Overall, molecular analysis showed that 71 cats (83.5%) tested PCR positive for the presence of B. henselae DNA. PCR amplification of DNA B. henselae produced positive products from lymph node aspirate specimens (62/85; 72.9%) similar to those obtained from blood samples (60/85; 70.6%) and higher than those from oral swabs (51/85; 60%) of cats. No PCR product was obtained for B. clarridgeiae. The simultaneous analysis of three different clinical samples in our study increased the diagnostic possibilities for B. henselae infection in the examined cats from 60-72.9% to 83.5%. Lymph node aspirates were found to be the most effective clinical samples for the detection of B. henselae and blood samples were the next best. Oral swab samples were used in this study with good results when considered in combination with blood and/or lymph node aspiration. The use of nested-PCR assay on these three clinical samples may enhance the diagnostic sensitivity for bartonellosis in cats irrespective of the clinical status of animals.

[Transverse hemimelia of the lower right limb associated with sysmetrical malformations of the hands in a newborn infant]

The authors report a newborn infant affected by terminal transverse hemimelia of the right lower limb, associated with symmetric malformations of the hands, simulating the "amniotic bands syndrome". The symmetric hand anomalies and the presence of slight malformations of the left lower limb lead us to think that the etiology of this case is genetic, probably related to a new mutation.