1,720,975 research outputs found
A unique case of miliary pulmonary tuberculosis induced by bacillus Calmette-Guérin intravesical instillation with COVID-19 superinfection
Full text linkIntravesical instillation of Bacillus Calmette-Guérin (BCG) is used as an adjuvant treatment of bladder cancer. Systemic BCG infection occurs in less than 1% of cases, and pulmonary involvement is even rarer (0.3% – 0.7%), with a favourable prognosis. A 78-year-old male developed miliary tuberculosis (TB) secondary to intravesical BCG treatment and subsequent coronavirus disease 2019 (COVID-19) superinfection that led to patient death. High awareness amongst clinicians is needed to proceed with immediate appropriate therapy in these patients, especially during the COVID-19 pandemi
State-of-the-art review on the correlations between pathological and magnetic resonance features of cirrhotic nodules
No full textHepatocellular carcinoma (HCC) has become the second greatest cause of cancer-related mortality worldwide and the newest advancements in liver imaging have improved the diagnosis of both overt malignancies and premalignant lesions, such as cirrhotic or dysplastic nodules, which is crucial to improve overall patient survival rate and to choose the best treatment options. The role of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) has grown in the last 20 years. In particular, the introduction of hepatospecific contrast agents has strongly increased the definition of precursor nodules and detection of high-grade dysplastic nodules and early HCCs. Nevertheless, the diagnosis of liver tumours in cirrhotic patients sometimes remains challenging for radiologists, thus, in doubtful cases, biopsy and histological analysis become critical in clinical practice. This current review briefly summarizes the history of imaging and histology for HCC, covering the newest techniques and their limits. Then, the article discusses the links between radiological and pathological characteristics of liver lesions in cirrhotic patients, by describing the multistep process of hepatocarcinogenesis. Explaining the evolution of pathologic change from cirrhotic nodules to malignancy, the list of analyzed lesions provides regenerative nodules, low-grade and high-grade dysplastic nodules, small HCC and progressed HCC, including common subtypes (steatohepatitic HCC, scirrhous HCC, macrotrabecular massive HCC) and more rare forms (clear cell HCC, chromophobe HCC, neutrophil-rich HCC, lymphocyte-rich HCC, fibrolamellar HCC). The last chapter covers the importance of the new integrated morphological-molecular classification and its association with radiological features
Conservative treatment and radiological follow-up in a case of pneumatosis intestinalis associated with enteral tube feeding
No full textPneumatosis Intestinalis (PI) is a rare radiological finding and is defined as the presence of extra- luminal gas within the intestinal wall. PI can be distinguished in a benign form and a life-threatening form, burdened with high mortality. The correct management of PI must always take into account patient's history, his clinical context, laboratory test results and radiological findings, in order to administrate a proper therapy and avoid unnecessary surgical intervention. The pathogenesis of primary PI is still unknown and several theories have been proposed. Here, we report the case of a man with a previous severe traumatic brain injury who developed a transitory PI secondary to the enteral nutrition through a tube feeding, conservatively treated and underwent a radiological follow- up. Our report strengthens the relationship with enteral tube feeding and PI suggesting that any disaccharide used as pharmacological excipient or sweetener in the formulations for enteral tube feeding can potentially promote PI development, especially if administered in large quantities and in particular predisposing conditions. For this reason, the correct management of PI must always take into account patient's history, his clinical context, laboratory test results and radiological findings, in order to achieve a clear comprehension of its aetiology and administrate a proper therapy, avoiding unnecessary and potentially harmful surgery
Serendipitous Transbiliary Portal Venous Access and Dual Embolization to Resolve a Postoperative Biliary Leak
No full textN/
Morphological, dynamic and functional characteristics of liver pseudolesions and benign lesions
No full textHepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide and one of the most common causes of death among patients with cirrhosis, developing in 1-8% of them every year, regardless of their cirrhotic stage. The radiological features of HCC are almost always sufficient for reaching the diagnosis; thus, histological confirmation is rarely needed. However, the study of cirrhotic livers remains a challenge for radiologists due to the developing of fibrous and regenerative tissue that cause the distortion of normal liver parenchyma, changing the typical appearances of benign lesions and pseudolesions, which therefore may be misinterpreted as malignancies. In addition, a correct distinction between pseudolesions and malignancy is crucial to allow appropriate targeted therapy and avoid treatment delays.The present review encompasses technical pitfalls and describes focal benign lesions and pseudolesions that may be misinterpreted as HCC in cirrhotic livers, providing the imaging features of regenerative nodules, large regenerative nodules, siderotic nodules, hepatic hemangiomas (including rapidly filling and sclerosed hemangiomas), segmental hyperplasia, arterioportal shunts, focal confluent fibrosis and focal fatty changes. Lastly, the present review explores the most promising new imaging techniques that are emerging and that could help radiologists differentiate benign lesions and pseudolesions from overt HCC
Optimization of pineapple juice amount used as a negative oral contrast agent in magnetic resonance cholangiopancreatography
Full text linkTo evaluate the potential variability of Manganese (Mn2+) in commercial pineapple juice (PJ) produced
in diferent years and to identify the optimal Mn2+ concentration in the correct amount of PJ to be
administered prior to Magnetic Resonance Cholangiopancreatography (MRCP) in order to suppress
the gastroduodenal (GD) liquid signal. The Mn2+ concentration in PJ produced in diferent years was
defned using Atomic Absorption Spectrometry. The optimal Mn2+ concentration and the amount
of PJ, were estimated in an in-vitro analysis, and were then prospectively tested in a population of
patients who underwent MRCP. The results were compared with those achieved with the previous
standard amount of PJ used in a similar population. The concentrations of Mn2+ in commercial PJ
produced in diferent years did not difer. A total amount of 150 ml (one glass) of PJ having a high Mn2+
content (2.37 mg/dl) was sufcient for the suppression of the GD liquid signal, despite the additional
dilution caused by GD liquids since it led to a fnal concentration of Mn2+ of 0.5–1.00 mg/dl. The
optimized single-dose oral administration of 150 ml (approximately one glass) of PJ having a high Mn2+
concentration prior to MRCP was adequate to guarantee the correct amount of Mn2+ to suppress the
GD signa
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
An open clinical investigation on clinical dermatoscopy, OCT and RCM visible effects of application of a new topical product for 6 months on brittle nails and weak nails with rough surface and/or tendency to break
Full text linkIntroduction & Objectives
Nail brittleness is a common complaint characterized by weak nails with rough surface and/or tendency to split, flake and crumble. This nail alteration can be a consequence of factors that alter the nail plate production or factors that damage the nail plate, such as cosmetics (permanent and non-permanent nail lacquers), psoriasis, lichen planus, ageing, chemotherapy, other drugs and anaemia.
The aim of our study was to evaluate the effectiveness, tolerability and patient’s compliance of a new water-soluble nail lacquer with silicon and keratin synthesis booster product for brittle and weak nails.
Material & Methods
30 patients of both sexes, aged >18 years, affected by nail brittleness were prescribed a new topical therapy to be applied on the affected nails once a day for 6 months. The new product is dispensed by a pencil unit with a brush and has to be applied on the entire edge of the nail, cuticle included. Periodic evaluation of treatment efficacy was performed by standardized photography and dry video-dermoscopy of the target nail at baseline (V1), after 15 days (V2), 1 month (V3), 3 months (V4) and 6 months (V5). The treatment efficacy was evaluated by the experimentator through Global and Trichoscopy Assessment Scale and by patients through a patient global assessment and a specify questionnaire. 10 patients also underwent to Optical Coherence Tomography (OCT) in order to have a further objective parameter of efficacy evaluation.
Results
All patients concluded the study, with marked improvement of nail weakness and appearance. No side effects were recorded. All patients judged the treatment easy to apply and effective.
Conclusions
This new water-soluble nail lacquer with silicon and keratin synthesis booster is an effective and safe option for the treatment of nail brittleness and damages
Clinical and Instrumental Objective Evidence of the Efficacy of a New Water-Based Nail-Strengthening Solution Containing Pistacia lentiscus and Hyaluronic Acid Applied for Up to 6 Months to Improve the Appearance of Weak, Brittle Nails
Full text linkIntroduction: Brittle nails are fragile or split nails; they affect 20% of the population and may be primary or secondary to different conditions. The aim of our studies was to evaluate the efficacy and tolerability of a new water-based nail-strengthening treatment containing hyaluronic acid and Pistacia lentiscus with daily application for a period of 1-3 months for one study (n = 30) and up to 6 months for a second study (n = 30). Methods: In total, we enrolled 60 patients of both sexes with brittle and weak nails due to primary or secondary causes and evaluated the efficacy of this new product using subjective and objective methods: clinical evaluation, assessment of photographs, onychoscopy evaluation, investigator and patient global assessment, dynamic optical coherence tomography (D-OCT) and reflectance confocal microscopy (RCM). Results: Studies subjects presented a statistically significant improvement in global assessment scale (GAS) scores at 14 days (GAS = 1.7 ± 0.6), 1 month (GAS = 1.4 ± 0.7) and at 3 months (GAS = 1±0.7) versus the GAS score obtained before treatment (1.9 ± 0.5) (p < 0.0001). From the Italian study at 6 months (n = 30) 76% of the patients had an improvement in their nail appearance. Reduction in nail plate roughness with improved nail resistance and decreased distal breakage were the most evident benefits, demonstrated on clinical and instrumental evaluations. No side effects were reported. All patients reported an improvement in nail appearance after using the product for 1 month, 3 months and 6 months, and had a positive opinion on the product. Conclusions: This new product is an effective, safe, and easy-to-use option for topical treatment of brittle nails and primary nail fragility and an adjuvant therapy in secondary nail fragility. Moreover, its ease of application and cosmetic qualities allow good compliance
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