In vivo
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The aim of the study was to investigate patients with undefined chest pain and moderately increased troponin based on the results of cardiac computed tomographic (CT) angiography (CCTA). ⋯ CCTA accurately identifies or rules out patients with undefined chest pain and moderately elevated troponin, which require PCA and allows detection of other significant clinical findings.
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The number of ambulatory surgical procedures is growing and local anesthesia represents the technique of choice for outpatients undergoing minor surgery. The aim of this study was to verify whether differences exist in postoperative pain relief using equipotent doses of two long-acting local anesthetics, ropivacaine and levobupivacaine, in patients who underwent minor breast surgery. A series of 86 consecutive women (median age=55, range=39-75 years) with small (<2 cm in size) breast masses requiring surgical excision were prospectively enrolled in the study. ⋯ Transient adverse effects were observed in 5 (11.9%) and 4 (9.1%) patients (p=0.49) of groups A and B, respectively. The pain VAS four (t4) and 24 (t24) hours from the end of surgery was significantly (p<0.05) different between the groups, but an inversion of pain relief efficacy and a crossing point of the two pain-time lines at the sixth hour was observed. In conclusion, ropivacaine results in more effective pain relief at time t4, while levobupivacaine should be the drug of choice when long-term postoperative analgesia is required.
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Case Reports
Incidentally discovered asymptomatic splenic hamartoma with rapidly expansive growth: a case report.
Splenic hamartoma (SH) is a very rare benign vascular lesion, usually asymptomatic. Although infrequent, it must be differentiated from malignant lesions, such as lymphoma or metastases, or other vascular neoplasms of the spleen. We present the case of a solid lesion of the spleen discovered incidentally in a 42-year-ol women, characterized by an unusual rapid expansive growth during four-month follow-up. ⋯ On immunohistochemical staining the tissue was CD34 - and CD8 + and the final diagnosis was SH. In conclusion, when SH is suspected and malignancy cannot be ruled out, hand-assisted splenectomy should be considered the procedure of choice. Partial splenectomy should be preferred in children, to avoid potential risks of total splenectomy.