Primary occurrence of Kaposiform hemangioendothelioma (KHE) in bone is extremely rare. We report the radiologic, histopathologic and molecular features of a case of KHE affecting the tibia of an adult male, who presented with pain in the left knee initially associated with previous trauma. Radiographs showed an eccentric well-defined lytic lesion of the tibial epiphysis. On MRI, the lesion showed hypo to isointensity on T1-weighted images and hyperintensity on STIR sequences. A CT-guided biopsy was pathologically inconclusive. MRI performed 11 months later showed lesion progression with cortical erosion and soft tissue extension. Extended curettage was performed and histologically the lesion consisted of irregular nodules permeating bone trabeculae, composed of glomeruloid structures with densely packed capillary-sized vessels lined by flat endothelial cells without nuclear atypia. A second component of bland spindle cells arranged in fascicles with slit-like spaces resembling Kaposi sarcoma was present, together with intermixed dilated lymphatic channels and multiple nodular lymphoid aggregates. Neoplastic cells were positive for CD31 and CD34, whereas podoplanin was positive in the lymphatic component. Using digital droplet PCR, we identified a previously unreported GNAQ T96S mutation, whereas other GNAQ mutations were not detected. Despite its rarity, recognition of intraosseous KHE is crucial because it allows for prompt curative surgical treatment and avoids potential complications.
Blood pressure variability (BPV) predicts cardiovascular risk beyond average BP, but evidence on the role of anxiety/depression on BPV in older adults is limited. To evaluate the association of anxiety and depressive symptoms with short-term BPV and white-coat effect (WCE) in older outpatients undergoing ambulatory blood pressure monitoring (ABPM). Cross-sectional multicenter study of outpatients aged ≥ 65 years undergoing 24-h ABPM across Italian geriatric centers. Anxiety and depressive symptoms were assessed with GAD-7, STAI-Y1/Y2 and GDS-15. Short-term BPV was quantified by daytime systolic average real variability (ARV). The office-daytime BP difference was calculated (ΔSBP and ΔDBP), and WCE was defined categorically as ΔSBP ≥ 20 mmHg and/or ΔDBP ≥ 10 mmHg. Multivariable models were adjusted for clinical and pharmacological confounders. Among 235 outpatients (median age 76.4 years, 60.0
Tofacitinib, filgotinib, and upadacitinib are Janus kinase inhibitors (JAKis) available for ulcerative colitis (UC) refractory or intolerant to at least one advanced therapy; their comparative effectiveness in clinical practice remains uncertain. We conducted a multicenter retrospective study including adult UC patients initiating tofacitinib, filgotinib, or upadacitinib (September 2020–June 2025). Clinical remission (partial Mayo score ≤ 1), steroid-free clinical remission, biochemical remission, and endoscopic remission (Mayo endoscopic score = 0) were assessed at predefined time-points. Baseline differences were controlled using inverse probability of treatment weighting (IPTW), and time-to-event and longitudinal analyses were performed. After IPTW, the pseudo-population included 627 patients (tofacitinib = 179, filgotinib = 138, upadacitinib = 310). In the weighted cohort, clinical remission probabilities at weeks 8, 24, and 52 were 17.5
The production of antibodies against viral structural proteins such as the spike (S) and the nucleocapsid (N) is a hallmark of SARS-CoV-2 infection. The N protein contains several immunogenic regions. In this work we analysed epitope specificity and avidity of anti-N antibodies in COVID-19 patients. Eighty-nine COVID-19 patients were recruited. IgG, IgA, IgM antibodies to recombinant N protein and to 6 different peptides containing predicted B epitopes were measured by ELISA. Antibody avidity was evaluated by chaotropic ELISA. Anti-N IgG, IgA, and IgM were detected in 59
In patients with Graves’ disease, the 2016 American Thyroid Association guidelines and 2018 European Thyroid Association guidelines recommend the administration of Lugol’s solution prior to surgery. The objective of this study was to evaluate whether preoperative administration of this solution in patients undergoing thyroidectomy for Graves’ disease really improves surgical outcomes. Patients who underwent total thyroidectomy for Graves’ disease, performed by high-volume surgeons, in six European centers, between 2019 and 2023, were retrospectively evaluated. Based on preoperative administration of Lugol’s solution, two groups were identified: LS Group, including patients who received this solution, and NoLS Group, including those who did not receive it. Surgical outcomes were assessed after performing propensity score matching (1:1). According to the inclusion criteria, 1380 patients were enrolled: 622 in LS Group and 758 in NoLS Group. After propensity score matching, the study population consisted of 494 patients: 247 in LS Group and 247 in NoLS Group. Regarding complications, neck hematomas managed conservatively were significantly greater in NoLS Group (P = 0.016); while unilateral recurrent laryngeal nerve injury, overall postoperative hypoparathyroidism, and temporary hypoparathyroidism were significantly greater in LS Group (P = 0.026, P < 0.001, P < 0.001; respectively). The duration of surgery and postoperative hospital stay were significantly longer in LS Group (P < 0.001, P < 0.001; respectively). Based on our findings and those of other authors, we believe that the recommendations of existing guidelines should be revised.
