Search results for: Ina Nasto

Authors: Luciano Tarantino, Emanuele Balzano, Paolo Tarantino, Riccardo Aurelio Nasto, Aurelio Nasto

Abstract:

Liver transplantation (OLT) is contraindicate in Portal Vein tumor Thrombosis (PVTT) from Hepatocellular Carcinoma at hepatic hilum(pH-HCC) Surgery,Thermal ablation and chemotherapy show poorer outcomes Electrochemotherapy (ECT) has been successfully used in patients with pH-HCC with PVTT. We report the results of ECT as downstaging aimed to definitive cure by OLT. F.P. 53 years HBV related Cirrhosis Child-Pugh B7 class; EGDS F2 aesophageal Varices. Diabetes. April 2016 : Enhanced Computed Tomography (CT) detected HCC(n.3 nodules in VII-VIII-VI;diameter range=25 cm) and PVTT of right portal vein. The patient was considered ineligible for OLT. May 2016: first ablation session with percutaneous Radiofrequency-ablation(RFA) of 3 HCC-nodules . August 2016: second ablation session with ECT of PVTT. CT october 2016: disappearance of PVTT and patent right portal vein. No intraparenchymal recurrence. CT march 2017: No recurrence in portal vein and in the left lobe. local recurrence in the VII-VIII segments. May 2017 : transarterial chemoembolization (TACE) of right lobe recurrences. CT October 2017: patent right portal vein. No recurrence. The patient was reconsidered for OLT. He underwent OLT in April 2018. At 36-months follow-up , no intrahepatic recurrence of HCC occurred. March 2021: enhanced CT and PET/CT detected a single small nodule (1.5 cm) uptaking tracer in the left upper pulmonary lobe, no hepatic recurrence . CT-guided FNB showed metastasis from HCC . June 2021: left lung upper lobectomy . At the current time the patient is alive and recurrence-free at 64 months follow-up. ECT Could be aneffective technique as pre-OLT dowstaging in HCC with PVTT.

Keywords: liver tumor ablation, interventional ultrasound, electrochemotherapy, liver transplantation

Procedia PDF Downloads 80

Authors: Ina Nasto, Denada Sota, Pudrila Haskoçelaj, Mariola Ismailaj, Hajdar Kicaj

Abstract:

Most of the fishing areas of the Mediterranean Sea are considered to be overfished, consequently fishing has decreased or is static. Considering the continuous increase in demand for fish, the option of aquaculture production has had a growing development in recent decades. The environmental impact of aquaculture in the marine ecosystem has been a subject of study for several years in the Mediterranean. In the case of the Albanian waters, and in particular the Gulf of Vlora, have had a progressive growing of aquaculture activity in the last twenty years. Given the convenient and secluded location for tourist activities, the bay of Ragusa was considered as the most suitable area to install the aquaculture cage system for the breeding of sea bass and sea bream. The impact of aquaculture in on the soft bottom benthic communities has been assessed at the biggest commercial fish farm (Alb-Adriatico Sh.P.K) established in coastal waters of Ragusa bay 30–50 m deep, in the southern part of the Gulf of Vlora. In order to determine if there is a possible impact on the aquaculture cage in benthic communities, a comparative analysis was undertaken between transects and samples with differences in distances between them and with a gradient of distance from the fish cages. A total of 275 taxa were identified (1 Foraminifera, 1 Porifera, 3 Cnidaria, 2 Platyhelminthes, 2 Nemertea, 1 Bryozoa, 171 Mollusca, 39 Annelida, 35 Crustacea, 14 Echinodermata, 1 Hemichordata, and 5 Tunicata). The anaysis showed three main habitats in the area: biocoenosis of terrigenous mud, residual areas with Possidonia oceanica and also residual assemblages of algal coralligenous. Four benthic biotic indexes were calculated (Shannon H ’, BENTIX, Simpson's Diversity and Peilou’s J’) also benthic indicators as total abundance, number of taxa and species frequency to evaluate possible ecological impact of fish cages in Ragusa bay.

Keywords: Bentix index, Benthic community, invertebrates, aquaculture, Raguza bay

Procedia PDF Downloads 62

Authors: Luciano Tarantino, Emanuele Balzano, Aurelio Nasto

Abstract:

S.R. 53 years. January 2009: HCV-related cirrhosis, Child-Pugh A5 class, EGDS no aesophageal Varices. No important comorbidities. Treated with PEG-IFN+Ribavirin (march-november 2009) with subsequent sustained virologic response. HCVRNA absent overtime. October 2016 :CT detected small HCC nodule in the VIII segment (diam.=12 mm). Treated with US guided RF-ablation. November 2016 CT: complete necrosis. Unfortunately, the patient dropped out US and CT follow-up controls.September 2018: asthenia and weight loss. CT showed a large tumor infiltrating V-VII-VI segments and complete PVTT of right portal vein and its branches . Surgical Consultation excluded indication to Liver resection and OLT . 23 october 2018: ECT of a large peri-hilar area of the tumor including the PVTT. 1 and 3 months post-treatment CT showed complete necrosis and retraction of the thrombus and residual viable tumor in the peripheral portion of the right lobe . Therefor, the patient was reevaluated for OLT and considered eligible in waiting list . March 2019: CT showed no perihilar or portal vein recurrence and distant progression in the right lobe . March 2019 : Trans-arterial-Radio-therapy (TARE) of the right lobe. Post-treatment CT demonstrated no perihilar or portal vein recurrence and extensive necrosis of the residual tumor . December 2019: CT demonstrated several recurrences of HCC infiltrating the VI and VII segment . Howewer no recurrence was observed at hepatic hilum and in portal vessels . Therefore, on February 2020 the patient received OLT. At 44 months follow-up, no complication or recurrence or liver disfunction have been observed.

Keywords: hepatocellular carcinoma, portal vein tumor thrombosis, interventional ultrasound, liver tumor ablation, liver transplantation

Procedia PDF Downloads 33

Authors: Ina Nasto, Denada Sota, Kerol Sacaj, Brunilda Veshaj, Hajdar Kicaj

Abstract:

Rocky shores are often used as models to describe the dynamics of biodiversity around the world, making them one of the most studied marine habitats and their communities. The variability in the number of species and the abundance of hard-bottom benthic animal communities on the coast of Triporti, north of the Bay of Vlora, Albania is described in relation to environmental variables using multivariate analysis. The purpose of this study is to monitor the species composition, quantitative characteristics, and seasonal variations of the benthic macroinvertebrate populations of the shallow rocky shores of the Triportit-Vlora area, as well as the assessment of the ecological condition of these populations. The rocky coast of Triport, with a length of 7 km, was divided into three sampling stations, with three transects each of 50m. The monitoring of benthic macroinvertebrates in these areas was carried out in two seasons, spring and summer (June and August 2021). In each station and sampling season, estimates of the total and average density for each species, the presence constant, and the assessment of biodiversity were calculated using the Shannon–Wiener and the Simpson index. The species composition, the quantitative characteristics of the populations, and the indicators mentioned above were analyzed in a comparative way, both between the seasons within one station and between the three stations with each other. Statistical processing of the data was carried out to analyze the changes between the seasons and between the sampling stations for the species composition, population density, as well as correlation between them. A total of 105 benthic macroinvertebrate taxa were found, dominated by Molluscs, Annelids, and Arthropods. The small density of species and the low degree of stability of the macrozoobenthic community are indicators of the poor ecological condition and environmental impact in the studied areas. Algal cover, the diversity of coastal microhabitats, and the degree of coastal exposure to waves play an important role in the characteristics of macrozoobenthos populations in the studied areas. Also, the rocky shores are of special interest because, in the infralittoral of these areas, there are dense kelp forests with Gongolaria barbata, Ericaria crinita as well as fragmented areas with Posidonia oceanica that reach the coast, priority habitats of special conservation importance in the Mediterranean.

Keywords: Macrozoobenthic communities, Shannon–Wiener, Triporti, Vlore, rocky shore

Procedia PDF Downloads 58