1,720,964 research outputs found
Pulse inversion US with echographic contrast media (Levovist®) in the evaluation of hepatic metastases
No full textPurpose. To evaluate if Pulse Inversion Harmonic Imaging with contrast agent injection (Levovist) is able to determine an increase of echogenicity in normal hepatic parenchyma, and to compare its capability to detect metastatic focal lesions with that of standard US and spiral CT. To define and standardize the technical and methodological aspects of this new technique. Material and methods. A selected group of 72 patients (42 males and 30 females) with clinical and instrumental suspect of hepatic metastatic lesions was included in the prospective study. Each patient was examined by conventional ultrasound (US), Pulse Inversion Harmonic Imaging (PI) and spiral-CT (spCT). US examination was performed using an HDI 5000 (ATL, Bothell, USA) equipped with a broadband probe (5,0-2,0 MHz). 2.5 g Levovist® (Schering AG-Berlin) was administered intravenously, at concentration of 300 mg/ml and a flow rate of 7 ml/min. Video clips obtained with the acquired images before and after contrast medium administration were transferred to a magnet optic disk unit. Examinations were evaluated by an experienced radiologist blindly on a workstation that allowed a qualitative-quantitative analysis. SpCT images were evaluated separately by another experienced radiologist. US images were evaluated qualitatively (number of lesions, site of lesion, diameter of the smallest lesion detectable) and quantitatively (increase in parenchymal echogenicity 20′′, 40′′, 60′′ and 5′ after the injection of contrast agent). Results. In all cases examined, the echogenicity of normal hepatic parenchyma increased after contrast agent administration, reaching a peak of about 250% (1DS) at 60 s and decreasing gradually in 5 minutes. Conventional US detected 195 focal lesions, CT 231, and US with pulse inversion technique and contrast agent (US-PI) 287. Mean differences among the number of lesions detected by the different techniques per each patient were also calculated. Wilcoxon Signed Rank Test showed a statistically significant difference between US-PI and US (p<.0001), CT and US (p=.0052) and US-PI and CT (p=.0121). US-PI detected the smallest lesions, which went undetected by the CT and conventional US examinations. Discussion and conclusions. In 10 cases (14.3%) contrast enhanced US-PI demonstrated the presence of a number of lesions greater than 5 (diffuse metastatization and inoperability) in comparison to that detected by spCT). The greater echogenicity of normal hepatic parenchyma using pulse inversion technique after Levovist infusion allowed to better demonstrate hepatic metastases. This technique showed a higher identification rate of small lesions in comparison to basal examination and to spiral CT. Contrast enhanced US-PI demonstrated a remarkable increase in echogenicity of hepatic parenchyma in portal phase. The technique significantly improves the detection of focal lesions allowing visualization of smaller lesions compared to CT and US. These results indicate that the technique could be used in the staging of liver metastasis. However, large multicentric trials are required to validate US-PI and better define its role in the work-up of patients with neoplastic disorder
Inactive Residents Living in Nursing Homes and Associated Predictors: Findings From a Regional-Based, Italian Retrospective Study.
Full text linkObjectives: It has been amply reported that nursing home (NH) residents are largely inactive, a condition that may further increase functional decline, behavioral disorders, and risk of death. To date, studies have mainly focused on individual characteristics that may decrease residents' involvement in activities. Therefore, the aim of this study is to describe the prevalence of inactive NH residents in an Italian context, identifying predictors of inactivity at the individual and NH levels. Design: Retrospective regional-based study performed in 2014. Setting: All NHs (n = 105) located in the Friuli Venezia Giulia Region, northeastern region of Italy. Participants: A total of 8875 residents with at least 1 nursing assessment and living in an NH for at least 1 year. Measurements: The dependent variable was inactivity in the last week, defined as the resident not being involved in any socially or individually based, or meaningful recreational (eg, gardening) activities. The independent variables were set at individual and NH levels. Aiming at identifying predictors of inactivity, a hierarchical generalized linear (mixed-effects) model incorporating both fixed-effect parameters and random effects, was performed. Results: A total of 4042 (45.6%) residents were inactive during the week before the evaluation. At the resident level, those with severe cognitive impairment [odds (OR) 4.462, 95% confidence interval (CI) 3.880-5.132], unsociable behavior (OR 2.961, 95% CI 2.522-3.473), night restlessness (OR 1.605, 95% CI 1.395-1.853), lack of cooperation in daily care (OR 1.408, 95% CI 1.199-1.643), pressure sores (OR 1.314, 95% CI 1.065-1.622), depressive disorders (OR 1.242, 95% CI 1.089-1.416), and clinical instability (OR 1.110, 95% CI 1.037-1.188) reported an increased risk of being inactive. At the NH level, for each additional hour of care offered by professional educators, there was 1% less likelihood of inactive residents (OR .964, 95% .933-.996). Conclusions: Approximately one-half of the residents in this study living in Italian NHs are inactive. Inactivity is significantly associated with the presence of severe cognitive impairment, behavioral disorders (eg, unsociability, night restlessness, and lack of cooperation in daily care), pressure sores, depressive symptoms, and clinical instability. Moreover, receiving care from professional educators whose aim in their training program and professional mission is to improve individual and social engagement, decreased the likelihood of resident inactivity. © 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine
[Angiographic signs of the small intestine (two cases) (author's transl)]
No full textThe authors describe 2 cases of ileal carcinoid. They evaluate the advantages of selective angiography over the traditional radiologic methods, considering their cases and the 39 found in the literature. The angiographic signs of the lesions localized to the bowel wall are rather scarse and non-specific. The signs of mesenteric infiltration, which is precocious and conspicuous in this type of tumour, are more significant. Liver metastases, which are very frequent, are hypervascularized. The angiographic pattern may be similar to that found in some inflammatory diseases, but can be differentiated from that of other neoplasms of the small intestine
Inactive residents living in nursing homes and associated predictors: findings from an Italian regional-based retrospective study
No full textObjectives: It has been amply reported that nursing home (NH) residents are largely inactive, a condition
that may further increase functional decline, behavioral disorders, and risk of death. To date, studies have
mainly focused on individual characteristics that may decrease residents’ involvement in activities.
Therefore, the aim of this study is to describe the prevalence of inactive NH residents in an Italian
context, identifying predictors of inactivity at the individual and NH levels.
Design: Retrospective regional-based study performed in 2014.
Setting: All NHs (n 1⁄4 105) located in the Friuli Venezia Giulia Region, northeastern region of Italy.
Participants: A total of 8875 residents with at least 1 nursing assessment and living in an NH for at least
1 year.
Measurements: The dependent variable was inactivity in the last week, defined as the resident not being
involved in any socially or individually based, or meaningful recreational (eg, gardening) activities. The
independent variables were set at individual and NH levels. Aiming at identifying predictors of inactivity,
a hierarchical generalized linear (mixed-effects) model incorporating both fixed-effect parameters and
random effects, was performed.
Results: A total of 4042 (45.6%) residents were inactive during the week before the evaluation. At the
resident level, those with severe cognitive impairment [odds (OR) 4.462, 95% confidence interval (CI)
3.880e5.132], unsociable behavior (OR 2.961, 95% CI 2.522e3.473), night restlessness (OR 1.605, 95% CI
1.395e1.853), lack of cooperation in daily care (OR 1.408, 95% CI 1.199e1.643), pressure sores (OR 1.314,
95% CI 1.065e1.622), depressive disorders (OR 1.242, 95% CI 1.089e1.416), and clinical instability (OR
1.110, 95% CI 1.037-1.188) reported an increased risk of being inactive. At the NH level, for each additional
hour of care offered by professional educators, there was 1% less likelihood of inactive residents (OR .964,
95% .933-.996).
Conclusions: Approximately one-half of the residents in this study living in Italian NHs are inactive.
Inactivity is significantly associated with the presence of severe cognitive impairment, behavioral disorders
(eg, unsociability, night restlessness, and lack of cooperation in daily care), pressure sores,
depressive symptoms, and clinical instability. Moreover, receiving care from professional educators
whose aim in their training program and professional mission is to improve individual and social
engagement, decreased the likelihood of resident inactivity
Colangiocarcinoma in paziente con atrofia epato-splenica successiva a somministrazione di Thorotrast.
No full text
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
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