625 research outputs found
Correlation between magnetic resonance imaging with 1H-spectroscopy, PSA levels and gleason score in the diagnosis of locally recurrent prostate cancer
No full textMASSIMILIANO RENDINA, HOFLAB, IODICEARCHITETTI, DANILO LISI, SANDRO RAFFONE, SACU STUDIO, TUZZOLINO + MARGAGLIOTTA
No full textUse of 3D T2-Weighted MR Sequences for the Assessment of Neurovascular Bundle Changes after Nerve-Sparing Radical Retropubic Prostatectomy (RRP): A Potential Diagnostic Tool for Optimal Management of Erectile Dysfunction after RRP
No full textErectile dysfunction (ED) is one of the complications after radical retropubic prostatectomy (RRP), and recovery of erectile function is quantitatively related to the preservation of the neurovascular bundles (NVBs). The aim of our study was to assess, in patients submitted to a nerve-sparing RRP, the capability of a dedicated 3D isotropic magnetic resonance imaging (MRI) T2-weighted sequence in the depiction of postsurgical changes of NVB formation. Fifty-three consecutive patients underwent a bilateral nerve-sparing RRP. Two postoperative magnetic resonance (MR) examinations and International Index of Erectile Function Five-Item (IIEF-5) questionnaire were carried out at 6 and 12 months. Morphological imaging of the postprostatectomy fossa was performed by first acquiring turbo spin echo T2-weighted sequences in the axial and coronal planes and then with 3D T2-weighted isotropic sequence on axial plane. Image findings were scored using a relative 5-point classification (0 = normal; I = mild; II = mild to moderate; III = moderate; IV = severe alterations) and correlated with postoperative IIEF-5 score questionnaire. The degree of association between the alteration score values obtained by postoperative MR morphologic evaluation for MR sequence and IIEF-5 score. Image interpretation was performed by two radiologists, that scoring MR alterations by the use of axial and multiplanar reconstruction 3D T2 isotropic sequence. The radiologists placed 43.30% of patients in class 0 (23/53 normal or quite normal), 32.00% in class I (17/53 mild), 11.40% in class II (6/53 mild to moderate), 7.50% in class III (4/53 moderate), and 5.70% in class IV (3/53 severe). In all cases, the correlation and regression analyses between the 3D T2 isotropic sequence and IIEF-5 score, resulted in higher coefficient values (rho = 0.45; P = 0.0010). The MRI protocol and NVB change classification score proposed in this study would represent an additional tool in the postoperative phase of those patients with ED. Sciarra A, Panebianco V, Salciccia S, Alfarone A, Gentilucci A, Lisi D, Passariello R, and Gentile V. Use of 3D T2-weighted MR sequences for the assessment of neurovascular bundle changes after nerve-sparing radical retropubic prostatectomy (RRP): A potential diagnostic tool for optimal management of erectile dysfunction after RRP. J Sex Med 2009;6:1430-1437
COMPLETE RESPONSE TO THE COMBINATION THERAPY WITH ANDROGEN BLOCKADE AND SOMATOSTATIN ANALOGUE IN A PATIENT WITH ADVANCED PROSTATE CANCER: MAGNETIC RESONANCE IMAGING WITH 1H-SPECTROSCOPY: Part 2
No full textSerum prostate-specific antigen and chromogranin A levels steadily decreased over a 12-mo follow-up period, at which time the patient is alive without disease progression and with a complete objective and symptomatic response
Which kind of philosopher was Danilo Pejović?
No full textU ovom kratkom prilogu autorica pokušava opisati narav Danila Pejovića kao filozofa. Njegovo bitno obilježje bila je filozofijska i svetovna suverenost.In this short contribution the author tries to describe the nature of Danilo Pejović as a philosopher. His main characteristic was a philosophical and secular sovereignity
Over-the-scope clip and self-expandable metal stent: a comprehensive treatment for failed peroral endoscopic myotomy and fibrosis complications in idiopathic achalasia
No full textAchalasia is a rare esophageal motility disorder that affects both sexes and all ages. Peroral endoscopic myotomy (POEM) has been reported as an optional treatment since 2010 [1]. Frequently associated adverse events include pneumoperitoneum, pneumomediastinum, and pneumothorax, which are usually asymptomatic and managed conservatively [2, 3]. Perforation, bleeding, mediastinitis, and peritonitis rarely occur and are often symptomatic. Mucosal injuries (including dehiscence, ulcer, and ischemia) do not alter the post-procedural course [4]. A 31-year-old man, affected by idiopathic achalasia, was admitted as an outpatient to our Gastroenterological Unit owing to symptom recurrence and weight loss (Eckardt score 8). Two years before, he had undergone POEM, which was complicated by pneumomediastinum and ischemic damage of the distal esophagus with residual fibrosis. An esophagogram revealed a dilated
esophagus (maximum diameter 60mm) and supracardial stricture extending 15 mm above. His dysphagia was most likely worsened by post-POEM complications. We planned to place a fully covered removable metal stent (SEMS; 60 × 27mm) to achieve progressive, effective dilation of the distal esophagus . The SEMS would be firmly fixed by means of an over-the-scope (OTS) clip. This novel OTS clip device has demonstrated success in reducing SEMS migration even in benign diseases [5]. The SEMS was released 10mm above the post-POEM stricture, 25 mm above the cardia, and fixed by means of the OTS
clip. The patient was discharged uneventfully on the same day. An alternative approach (Heller myotomy) was ready to be employed in case of failure. At the 4-week follow-up, dysphagia had improved and the patient had gained weight. Both the OTS clip and the SEMS were removed using the remOVE device (Ovesco Endoscopy AG, Tübingen, Germany) . The patient was discharged uneventfully 12 hours later. After a further 4 weeks, an esophagogram revealed a significant reduction in the esophagus dilation and the patient’s clinical condition had significantly improved (Eckardt score 0)
64-detector row CT cystography with virtual cystoscopy in the detection of bladder carcinoma: preliminary experience in selected patients
No full textThis study was conducted to evaluate the role of computed tomography cystography (CTC) and virtual cystoscopy (VC) with 64-slice CT in diagnosing bladder lesions using flexible cystoscopy as the reference standard. Twenty-eight patients with suspected bladder cancer and ten patients who had undergone transurethral resection of the bladder were studied by CTC and VC in both the supine and prone positions after distending the bladder with air. The patient population was divided into three groups based on lesion size at flexible cystoscopy. Results of the CT study were compared with those of flexible cystoscopy. Flexible cystoscopy depicted 88 bladder lesions in the 38 patients examined. Sensitivity and specificity values of CTC and VC alone were constantly lower than those of the combined-approach (group 1: 93.10% and 92.31%; group 2: 100% and 100%; group 3: 100% and 100%, respectively). Receiver operating characteristic (ROC) curve analysis showed that the combined approach decreases the lower dimensional threshold for lesion detection (1.4 mm). VC and CTC with 64-slice CT are promising diagnostic techniques for bladder cancers measuring 1-5 mm. Further studies on larger patient populations are required to validate our results
Changes in neurorehabilitation management during the COVID-19 pandemic: A scoping review
No full textBACKGROUND: The SARS-CoV-2 infection (COVID-19) has generated a threat to global health, determining the need for healthcare for large numbers of people in an extremely short time.OBJECTIVE: To investigate the management changes in the neurorehabilitation services during the COVID-19 pandemic.METHODS: An electronic search was conducted in September 2021 by 2 independent reviewers in the following databases: MEDLINE (PubMed), the Physiotherapy Evidence Database, and the Cochrane Database of Systematic Reviews. All studies on organizational and welfare changes resulting from the COVID-19 pandemic in neurorehabilitation services were included. Screening of titles, abstracts, and full texts and data extraction were undertaken independently by pairs of reviewers.RESULTS: The summary of results was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Electronic searches after the screening of title and abstract identified 80 studies, 13 studies met the inclusion criteria. A narrative summary of results of all included studies were reported in a tabular format.CONCLUSIONS: Different organizational models were adopted in neurorehabilitation during the COVID-19 pandemic impacting the therapies time frame, the physical and mental health of healthcare professionals and the caregiver's workload. There is still uncertainty about the effectiveness of these new therapeutic strategies on the management of neurorehabilitation services and future studies should explore the effect on the patients' needs
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