Imaging and neurological manifestations of an unusual thymic carcinoma.
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Biomedical subjects
Publications and source records attributed to D Greco.
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We report a 9-year-old boy affected by LEOPARD syndrome, who also had ichthyosis, axillary freckling, two café au lait spots, and one neurofibroma. The diagnosis of LEOPARD syndrome has been made on clinical grounds, whereas the ichthyosis and neurofibroma have been histologically confirmed. The analogies between LEOPARD syndrome and neurofibromatosis have been discussed. Finally, we maintain this case is an example of the multiple lentigines syndrome/LEOPARD syndrome spectrum.
We describe an 8-year-old boy with Rubinstein-Taybi syndrome, a multiple congenital anomaly/mental retardation syndrome characterized by broad thumbs and great toes, peculiar facies, and mental retardation caused by mutations in the transcriptional coactivator CREB binding protein (CBP). He had on his right side yellowish papular lesions organized in narrow bands according to Blaschko lines, later confirmed by histology as an epidermal nevus. Epidermal nevus syndrome has been ruled out because the patient failed to meet the criteria for inclusion under this designation. This association may be coincidental.
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A microcomputer system has been designed to promote uniform and correct epidemiological data handling in the Local Health Units of the National Health Service in Italy. The system allows to define files of any format, to perform the common data manipulation procedures and to make simple statistical analyses. Two modules, based on artificial intelligence techniques, give the possibility to input from 'experts' and to update domain-specific knowledge concerning facts which characterize the application area covered by the file, and some consultation models which represent the reasoning to follow when solving problems of epidemiological data analysis. A decision support module allows an inexpert user to have access to these models, and to be guided in the choice of the appropriate procedure. The menu-driven interactive approach insures a friendly user-to-system interface, and entails a little training for effective use by health workers inexpert in informatics.
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This paper describes the relationship between medical staff and HIV-1 patients. Important mechanisms can be used by individuals with HIV-1 infection in order to accept their seropositivity to HIV-1. Among them, regression and negation are well-known. These mechanisms are related to countertransference lived by the medical staff. They are various as well as rejected by medical staff to avoid anxious reactions. On the contrary, the medical staff has to accept the experiences of the patients and to be ready to listen to the problems of HIV-1 infected people.
A retrospective study on 52,900 individuals tested in 177 Italian Medical Centres for AIDS and related syndromes is reported. The data confirm that I.V. drug users are the group at highest risk in Italy (46% were seropositive and more than one half of these presented PGL or ARC) and that the epidemic probably started in northern Italy and spread south. One third of the examined subjects resulted seropositive for HIV-1 antibodies. ARC was diagnosed in 19% of the symptomatic seropositives. This study is the first national effort to establish a picture of the diffusion of HIV-1 infection in Italy. To reach this aim a periodical survey for the recognition of seropositives should be added to the already existing AIDS notification system.
Since 1982, 2911 adult AIDS cases have been officially reported in Italy up to December 31, 1988. The clinical presentation of all cases, reported to the Istituto Superiore di Sanità, Rome, and contained into the National AIDS Register, has been analyzed, with particular attention to opportunistic infections. 168 cases (mainly homosexual men) were found exclusively affected at diagnosis by Kaposi's Sarcoma (KS), while the other 2743 patients were affected by opportunistic infections and/or other pathologies. At diagnosis, 23.5% of patients had Pneumocystis carinii pneumonia (PCP), 32% esophageal or pulmonary candidiasis, and 7% cerebral toxoplasmosis. A decrease in frequency of Cytomegalovirus (CMV) diseases has been observed, as well as an increase of HIV encephalopathy from 1982 to 1988. The clinical picture of full-blown AIDS showed stability during the whole period of observation, with slight geographical variations.
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