Aim

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The global pandemic of the infectious disease coronavirus 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a predominantly respiratory disease. Gastrointestinal symptoms occur in 15-20% of patients with COVID-19, however, there have not been many case reports of acute pancreatitis in patients with COVID-19. We presented the case of a 28-year-old girl suffering from COVID-19 with acute pancreatitis in the absence of other known etiological risk factors for pancreatitis. Laboratory analysis revealed a marked elevation of lipase and amylase. CT of the abdomen showed an edematous pancreas with diffuse enlargement. She was diagnosed with acute pancreatitis due to COVID-19 after carefully ruling out other causes. She was managed symptomatically, and improvement in her clinical condition was observed and was discharged with outpatient follow-up.

Simple Summary Breast cancer is the most common cancer in women and requires early diagnosis and treatment. Although MRI is the most efficient method of detecting breast cancer, its standard protocol is time-consuming and expensive, making it less accessible. The aim of this study was to compare the diagnostic accuracy of the modified abbreviated MRI protocol (AMRP) to that of the standard magnetic resonance protocol. The study shows that both MRI protocols have comparable accuracy (specificity and sensitivity) for detecting breast cancer. These findings suggest that the abbreviated MRI protocol can reduce the examination and image reading time, as well as costs, while maintaining the diagnostic accuracy of a full diagnostic protocol. The key finding is that AMRP can provide appropriate diagnostic accuracy for breast cancer for a much wider population and reduce MRI waiting lists. Abstract Background: Although MRI is the most efficient method of detecting breast cancer, its standard protocol is time-consuming and expensive. The objective of this study was to compare the diagnostic accuracy of the modified innovative abbreviated MRI protocol (AMRP) and the standard magnetic resonance protocol (SMRP) when detecting breast cancer. Methods: The research involved 477 patients referred for breast MRI due to suspected lesions. They were randomly assigned to the AMRP group (N = 232) or the SMRP group (N = 245). The AMRP comprised one native (contrast-free) and four post-contrast dynamic sequences of T1-weighted volume imaging for breast assessment (VIBRANT) and 3d MIP (maximum intensity projection) lasting for eight minutes. All the patients underwent a core biopsy of their lesions and histopathological analysis. Results: The groups were comparable regarding the pre-screening and post-diagnostic characteristics and were of average (±SD) age at breast cancer diagnosis of 53.6 ± 12.7 years. There was no significant difference between the two protocols in terms of specificity or sensitivity of breast cancer diagnosis. The sensitivity (95% Cis) of the AMRP was 99.05% (96.6–99.9%), and its specificity was 59.09% (36.4–79.3%), whereas the sensitivity of the SMRP was 98.12% (95.3–99.5%) and its specificity was 68.75% (50.0–83.9%). Most of the tumors comprised one solid lesion in one of the breasts (77.3%), followed by multicentric tumors (16%), bilateral tumors (4.3%), and multifocal tumors (1.7%). The average size of tumors was approximately 14 mm (ranging from 3 mm to 72 mm). Conclusion: Our innovative AMR protocol showed comparable specificity and sensitivity for the diagnosis of breast cancer when compared to SMRP, which is the “gold standard” for histopathological diagnosis. This can lead to great savings in terms of the time and cost of imaging and interpretation.

Goal : Aim of the article is to present our experience in minimally invasive thoracotomy in relation to the current

Background: In the last decade the association between congenital single functional kidney (cSFK) and increased risk of hypertension, proteinuria and kidney injury has become clear. Regarding CKD long-term outcome, kidney hypertrophy at ultrasound (US) in the early months of life is reported as protective. Kidney US measuring renal lenght (BPL) and renal scintigraphy (RS) measuring GFR (mGFR) are both useful tools for the clinical management. The follow-up is frequently based on local protocols, although clinical recommendations have been proposed recently. The aim of the present study was to assess the utility of RS and to compare it to US in gathering information on kidney function, long term outcome and the appropriate use in the follow-up of patients with cSFK. Methods: Retrospective, monocentric, observational study enrolling pediatric cSKF patients. Demographic, clinical, instrumental and laboratory data were collected from medical records for all the patients included in this study. CKD was considered as composite outcome (at least one: reduced mGFR or eGFR, proteinuria in at least two different examinations, hypertension). Results: 163 cSFK patients were included. The BPL showed a linear increase over time, with curve flattening after 144 months of age. Conversely, mGFR rapidly increased between 0 and 60 months, stabilizing thereafter (Fig.1) and reaching a median value over the threshold of normal function between 24 and 60 months; we observed a slight decrease after 180 months, although not statistically significant. Comparing the trend of BPL and mGFR over time, we observed a significant correlation (R2=0.5, p-value<0.05) between 1 and 60 months of life, that was lot thereafter. Proteinuria, hypertension, impaired eGFR and mGFR were found in 11.7 %, 18.7%, 30.4% and 39.3% patients, respectively, with overall CKD rate of 41.6%. Of note, 25% of these patients were identified only by RS, having no other considered abnormality. Moreover in this subgroup patients only one showed kidney hypertrophy at US before the age of 60 months. Conclusions: RS can be as useful as US in the follow-up of cSFK. It allows to early spot an higher number of CKD patients and probably represent the best option for those with late referral in which early US is not available, to guide the clinicians in defining the risk of CKD and inform prognosis.