Leiomyoma of oral cavity: case report and literature review

Leiomyoma is a benign smooth muscle tumour, that occurs most frequently in the uterine myometrium, gastrointestinal tract, skin and lower extremities of middle-aged women. Leiomyomas are uncommon in the oral cavity, but in this location are usually localized on the tongue, lips and palate. Most lesions are asymptomatic, although occasional tumours can be painful. The diagnosis is mainly determined by histological studies due to its unspecific clinical appearance.The purpose of this article is to present a case report of 49-year-old male patient with a lesion of the lower lip. After surgical resection hematoxylin-eosin staining confirmed the diagnosis of leiomyoma.     

Validity of preoperative ultrasound-guided aspiration in the revision of hip prosthesis

Preoperative diagnosis of septic loosening hip prosthesis is often challenging. Culture test on joint samples obtained during revision surgery is the diagnostic gold standard while the role of preoperative hip aspiration is still controversial. The aims of this prospective randomized study were to compare the sensitivity, specificity and accuracy of preoperative ultrasound-guided and fluoroscopic-guided aspiration, and to identify associated laboratory parameters or scintigraphy that could help in predicting septic loosing hip prosthesis. Sixty patients affected by persistent pain after hip prosthesis randomly received fluoroscopic-guided or ultrasound-guided hip aspiration before revision surgery. The results of culture tests of joint fluid presurgically and at surgery were compared. In addition, associated blood inflammatory markers and scintigraphy were evaluated. Ultrasound-guided aspiration showed a better sensitivity (69% vs. 27%), specificity (94% vs. 75%) and accuracy (83% vs. 40%) than fluoroscopic-guided aspiration. The combination of ultrasound-guided aspiration and C-reactive protein represents the best model to predict septic loosening hip prosthesis preoperatively.     

Agrypnia excitata

The concept of Agrypnia excitata (AE) was originally proposed as a concept deriving from the clinical and anatomo-pathological observations obtained in three different diseases, Fatal familial insomnia (FFI), Delirium tremens (DT), and Morvan syndrome (MS). Agrypnia refers to a condition of severely reduced or absent sleep due to organic disorders. Excitata refers to the association of agrypnia with generalized motor and autonomic hyperactivation. AE is a syndrome that has been claimed to relate to a dysfunction in the thalamo-limbic circuits that govern sleep-wake cycles and autonomic activities.