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PET TAC and Resting state EEG-fMRI in Evaluation of the Ability to Understand and want in Patients Affected by Dementias with Neuro-psychiatric Disorders and other Mental Disorders

Published on: 11th January, 2024

Introduction: We strongly believe that rs-fMRI using independent component analysis (ICA) must be considered as a technique to be systematically used in the near future, as positron emission tomography (PET TC) is today. Unfortunately, this technique is not yet used in Italy because, despite the studies just summarized, it is considered “experimental” and not routine without reasonable justification!Aim of the Study: We present two cases studied with these techniques, after the informed consent obtained by the patients1) A young woman from Sicily, in whom an rs-fMRI revealed her severe personality disorder, was found capable of insight and strong-willed and was therefore found guilty by the criminal court of the murder of her young son, with a strange motive: rs-fMRI cannot be considered part of the assessment because it is so far considered experimental. PET-TAC was also classified as routine in Italy after a long legal discussion. We hope that all these studies, which are now summarized in this review, will be considered useful, at least in Europe, when a judge has to decide whether to sentence a person with psychological or psychiatric problems or to consider them as a person to be treated in a specific residential home (called REMS in Italy).2) Another woman from Bergamo, after having killed a neighbor of hers, was, instead, considered not guilty because of her inability to want to kill him, and so admitted to a particular structure (REMS: residence to execution of security measures) to treat her problem, front temporal dementia, with a severe neuropsychiatric disorder (NPS), diagnosed after the crimen was fulfilled.Conclusions: These two interesting cases demonstrate that in Italy nowadays, we do not have a homogeneous methodology to investigate the ability to understand and want, limiting the study only to personality tests. Here we describe new techniques that may help in this objective.
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Pediatric Dysgerminoma: Unveiling a Rare Ovarian Tumor

Published on: 19th January, 2024

Background: Dysgerminomas, account for only 1% - 2% of all malignant ovarian neoplasms.Objective: This case report aims to present a rare occurrence of dysgerminoma in a pediatric patient, highlighting the clinical characteristics, diagnosis, and management.Case presentation: We present a case of dysgerminoma in a 12-year-old girl who presented with a three-week history of pelvic pain and progressive abdominal swelling. Physical examination revealed a distended abdomen with evident suprapubic fullness, and a palpable abdominopelvic mass measuring approximately 20 weeks in size. Imaging studies confirmed the presence of a solid heterogeneous mass originating from the pelvis. The patient underwent a right salpingo-oophorectomy without complications. Histological examination coupled with an immunohistochemical study confirmed the diagnosis of dysgerminoma. The patient had an uneventful postoperative course and was discharged without adjuvant treatment. Regular follow-up visits, physical examinations, ultrasound scans, and lactate dehydrogenase assays were initiated for monitoring. Conclusion: Prompt recognition and appropriate surgical intervention, followed by regular monitoring, are crucial for optimal outcomes in pediatric dysgerminoma cases.
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Statistical Study of Membrane Performance for Different Pharmaceutical Compounds Removal

Published on: 31st January, 2024

One of the most important emerging pollutants is pharmaceutical active compounds, which may be responsible, for example, for ecotoxicological changes and microbiological resistance. Wastewater treatment plants are not adequately equipped to remove all of the emerging pollutants contained in the wastewater. The ultrafiltration process has been proven to be effective in traditional wastewater treatment, so it is important to assess the performance of such a technique in the partial elimination of pharmaceutical compounds to avoid contamination. In this work, an assessment of ultrafiltration process operating conditions for eliminating six pharmaceutical compounds: Ibuprofen, Acetaminophen, Naproxen, Diclofenac, Caffeine, and trimethoprim, present in different types of water is performed. Experimental design is a systematic and structured approach to conducting experiments, and its application can significantly improve the study of membrane technology, reducing the number of assays necessary to obtain meaningful results. The statistical principles application ensures that the results obtained are reliable and representative of the true effects of the variables being studied. Its application helps to obtain valid conclusions from the data and provides a solid basis for making decisions or recommendations regarding the tests and variables to take into account. Membrane processes can involve complex interactions between several factors. Experimental design helps to identify and understand these interactions, allowing researchers to discern the combined effects of different variables. This is crucial to accurately predict and optimize membrane performance.In this work, ANOVA analysis has been carried out in order to determine the influence of membrane cut-off, solution pH, and feed concentration, as well as their interactions, in permeate flux and the rejection index. The results obtained show similar behavior for Ibuprofen, Naproxen, Diclofenac, and Trimethoprim, being the pH the most important factor. However, no significant factors were found for the acetaminophen and the Caffeine.
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Towards A 21st Century Systematize the Ideas; COVID-19, Sustainability and Discourse of SDG, (Sustainable Development Goals), The Cities and Housing Models

Published on: 12th February, 2024

The research creates a theoretical basis for examining the metamorphic changes and transformations in urban and housing planning with the interaction created by the latest epidemic in the world, which is moving towards a period related to climate problems. The first quarter of the 21st century witnessed an unexpected event: Humanity found itself in the middle of a pandemic considered temporary, it would be permanent and change the world dramatically. The post-COVID-19 period has led to significant and permanent changes in our lives, from urban planning to housing typologies. The study aims to understand the changing dynamics in the post-pandemic period that converges on the same goal with SDG, (Sustainable Development Goals), as continuity by updated dialogues, and discourses on literature. This research focuses on the SDG, (Sustainable Development Goals), and the post-pandemic period, analysis of two phenomena separated, analogous paradigms or intertwined. The findings of the public perception are there is a distinction between sustainability and pandemics considered dissimilar processes, they contain similarities. Contrary to common ideas, the pandemic was a catalyst for sustainability, and these two concepts contain analogous ideas and principles. In conclusion, it is revealed that they both concentrated on similar ideas; SDG, (Sustainable Development Goals) is “health”, and pandemic is the “healthy city” concept like; clean air, zero carbon, living healthy and safely in airy and green areas, etc.
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Endoscopic Endonasal total Removal of a Suprasellar, Preinfundibular Retro Chiasmatic Craniopharyngioma: A Surgical Case Report

Published on: 26th March, 2024

Craniopharyngiomas are benign tumors (WHO Grade I), seen in children and adults. Because of their location, they can require challenging clinical and surgical management. In fact, often, because of the presence of calcifications, of a capsule very strongly adherent to neurovascular structures, of the relationship with hypophysis, pituitary stalk, chiasm, carotids, the circle of Willis, basilar artery, and third ventricle, risk of mortality and morbidity is still mandatory. Various surgical techniques have been proposed: transcranial, transsphenoidal, and supraorbital approaches for surgical resection and treatment of craniopharyngiomas. Still, there is no common consent, but often the endonasal transsphenoidal extended procedures are considered the gold standard in many cases. We present a surgical technique of a case of complete surgical removal of an infundibular and retro chiasmatic craniopharyngioma, via an endoscopic endonasal transphenoidal transplanum approach.
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Navigating Diagnostic Dilemmas in Subacute Subdural Hemorrhage: A Case Report

Published on: 26th March, 2024

In this case report a 64-year-old male patient with recent past medical history of head injury complicated by zygomatic arc fracture and mild subarachnoid hemorrhage is studied. He had been presented to the Emergency Department because of progressive neurological symptoms and neurological deficits in the physical examination that could have been indicating subcacute subdural hemorrhage. However, the patient was reluctant to undergo diagnostic imaging due to concerns about radiation exposure. After several explanations, a CT scan was done, which revealed a bilateral subacute subdural hematoma. Neurosurgical management was initiated and intravenous corticosteroid therapy was administered to reduce local edema. The challenge of this case is based on the subtlety of symptoms that might cause patients to delay seeking medical attention. Additionally, patient reluctance to undergo diagnostic tests can complicate management, emphasizing the importance of patient education and therapeutic alliance. Multidisciplinary management involving Neurology and Neurosurgery is crucial for optimal patient care in such cases. This report underscores the significance of effective communication and collaborative decision-making between healthcare providers and patients to ensure timely and appropriate management of complex medical conditions.
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