Pocket-sized, wireless-Bluetooth ultrasound system to perform diagnostic and low-complexity interventional procedures in bedridden patients during the COVID-19 pandemic: from intensive care unit to domiciliary service?

The use of a pocked-sized, wireless-Bluetooth ultrasound portable system with display images presented on a tablet facilitated the work of our radiologists during the first wave of coronavirus disease 2019 (COVID-19) to perform diagnostic and interventional procedures in bedridden patients. The device is equipped with a battery-powered probe without cables that transmits images to a tablet (or a cell phone) through a dedicated App. We hypothesise in future to extend diagnostic and low-complexity interventional procedures from hospitalised patients to at-home patients who are not able to mobilise out of bed or are difficult to transport. This domiciliary service might also reduce the overhead of hospital accesses

Dual-layer spectral CT fusion imaging for lung biopsies: more accurate targets, diagnostic samplings, and biomarker information?

The increasingly widespread use of computed tomography (CT) has increased the number of detected lung lesions, which are then subjected to needle biopsy to obtain histopathological diagnosis. Obtaining high-quality biopsy specimens is fundamental for diagnosis and biomolecular characterisation that guide therapy decision-making. In order to obtain samples with high diagnostic potential, fusion imaging techniques, such as fusion between positron emission tomography and CT, have been introduced to target the biopsy where there more viable neoplastic cells can be sampled. Nowadays, dual-layer spectral CT represents a novel technology enabling an increased tissue characterisation. In particular, Z-effective images, i.e., colour-coded images based on the effective atomic number of tissue components, provide a higher level of discrimination than usual imaged based on x-ray attenuation in Hounsfield units and offer the potential of a better tissue characterisation. Our hypothesis is based on the future use of data provided by spectral CT, in particular by Z-effective images, as a guide for appropriate biopsy sampling for histopathological and biomolecular characterisation in the era of patient tailored-therapy

Successful endovascular management with a covered stent of an external iliac pseudoaneurysm following allograft nephrectomy using CO 2 as contrast medium: a case report.

Iodinated contrast agents for angiography in chronic kidney disease (CKD) patients could further deteriorate their renal function leading to adverse sequelae. The use of carbon dioxide (CO2) is reported in the literature and has been safely used for a variety of angiographic procedures, particularly to guide aortic and renal interventions. We report the case of the successful endovascular treatment with a covered stent of a right external iliac artery pseudoaneurysm following graft nephrectomy in a CKD patient, using CO2 as contrast medium

Reassessing the biostratigraphy and the paleobathymetry of the Gonfolite Lombarda Group in the Como area (northern Italy)

Calcareous nannofossil and foraminiferal analyses have been carried out on outcrops from the type-area of the Gonfolite Lombarda Group (Como, northern Italy). In these marine fine- to coarse-grained clastics, rapidly accumulating at the southern front of the uprising Alpine range during the Oligo-Miocene, a scarce, but reliable, sequence of calcareous nannofossil events has been observed, allowing to refine the previous age assignments. Planktonic foraminifera were found to be extremely rare and provided limited biostratigraphic information. The Villa Olmo Conglomerate and the Chiasso Formation contain the Last Occurrence (LO) of Sphenolithus distentus and the First Occurrence (FO) of Triquetrorhabdulus carinatus, which are characteristic of the nannofossil zones NP24 and NP25 (Chattian), respectively. The lower part of the Como Conglomerate was deposited during the zone NP25, whilst the upper part of the Como Conglomerate straddles the Chattian/Aquitanian boundary in zone NN1. The deposition of the Prestino Mudstones also occurred during zone NN1. However, the upper part of this formation has been dated as Burdigalian during nannofossil zone NN2. The deposition of the upper part of the Val Grande Sandstone has been assigned to the NN3 zone owing to the presence of the taxon Sphenolithus belemnos, which is restricted to NN3. The upper part of the investigated section is characterized by the deposition of the Lucino Conglomerate and its fine-grained members (Lucinasco and Lurate Caccivio Mudstones). The Lucinasco Mudstones have been dated as late Burdigalian corresponding to zone NN4, whilst the overlying Lurate Caccivio Mudstones were deposited during the Langhian part of the zone NN5, based on the presence of S. heteromorphus and the absence of H. ampliaperta. On the whole, the base and the top of the outcropping Gonfolite Lombarda Group result from our study to be younger than hitherto proposed, allowing to resolve certain previous conflicts with the few radiometric dates available for clasts from the Gonfolite Lombarda Group. The depth of deposition was upper bathyal during the Chattian and the Aquitanian and shallowed to neritic during the deposition of the Langhian Lurate Caccivio Mudstones

Internal Iliac Artery Embolization within EVAR Procedure: Safety, Feasibility, and Outcome

Background: This study is focused on Internal Iliac Artery (IIA) embolization in patients undergoing Endovascular Aneurysm Repair (EVAR). Our aims were: to establish the feasibility of the procedure; to assess the presence of endoleak (EL) and increase in the size of the sac at follow-up; to define the need for reintervention; and to evaluate mortality rate. Methods: In this retrospective single-center study, EVAR-treated patients with an embolization of IIA were chosen. Coils and vascular plug were used as embolizing agents. Results: A total of 49 participants were enrolled in the study (48 men and one woman) with a median age of 76 +/- 12 years. Patients had no early EL in 87.75% of cases, 8.16% had type 1a EL, 2.04% type 1b EL, and 2.04% type 2 EL, with a comprehensive technical success of 95.91%. In the follow-up, at 1 month 72.22% remained without EL, at 6 months 70.97%, and at 1 year 81.48%. In the same period, the trend of type 1 EL was 5.56% (1 month), 3.23% (6 months), and 0% (1 year). For EL type 2: 22.22% at 1 month, 25.81% at 6 months, and 16.7% at 1 year. The overall mortality was 35.58% and the re-intervention rate was 16.33%. Conclusions: IIA embolization is a feasible and safe procedure. The presence of EL is not superior to EVAR procedures that do not involve embolization

Innovative Experimental Ultrasound and US-Related Techniques Using the Murine Model in Pancreatic Ductal Adenocarcinoma: A Systematic Review

Pancreatic ductal adenocarcinoma (PDAC) is a cancer with one of the highest mortality rates in the world. Several studies have been conductedusing preclinical experiments in mice to find new therapeutic strategies. Experimental ultrasound, in expert hands, is a safe, multifaceted, and relatively not-expensive device that helps researchers in several ways. In this systematic review, we propose a summary of the applications of ultrasonography in a preclinical mouse model of PDAC. Eighty-eight studies met our inclusion criteria. The included studies could be divided into seven main topics: ultrasound in pancreatic cancer diagnosis and progression (n: 21); dynamic contrast-enhanced ultrasound (DCE-US) (n: 5); microbubble ultra-sound-mediated drug delivery; focused ultrasound (n: 23); sonodynamic therapy (SDT) (n: 7); harmonic motion elastography (HME) and shear wave elastography (SWE) (n: 6); ultrasound-guided procedures (n: 9). In six cases, the articles fit into two or more sections. In conclusion, ultrasound can be a really useful, eclectic, and ductile tool in different diagnostic areas, not only regarding diagnosis but also in therapy, pharmacological and interventional treatment, and follow-up. All these multiple possibilities of use certainly represent a good starting point for the effective and wide use of murine ultrasonography in the study and comprehensive evaluation of pancreatic cancer

Peyronie's disease development and management in diabetic men

Background: Peyronie's disease (PD) is a fibrosing disorder of the penis resulting in plaque formation and penile deformity that negatively affect sexual and psychosocial function of patients. A multifactorial etiology of PD is assumed with diabetes mellitus (DM) being a potential risk factor. Objectives: The aim of this narrative review was to investigate diabetes role in PD pathophysiology, diagnosis, and treatment. Materials and methods: A non-systematic narrative review of original articles, meta-analyses, and randomized trials was conducted, including articles in the pre-clinical setting to support relevant findings. Results: Diabetes is one of the most common comorbidity observed in PD patients, with a prevalence of about 11% and a strong association with erectile dysfunction (ED). DM is associated with both a higher risk of developing PD and has also an impact on the outcomes of PD's treatments. Discussion: Evidence from literature underlines that metabolic alterations typical of DM are pivotal factors in the development of PD and resistance to its medical treatment. Conclusion: The role of DM in development of PD is still debated, while its role in PD development is not completely clear, there is a clear impact of DM on PD treatment outcomes

Quaternary capable folds and seismic hazard in Lombardia (Northern Italy): the Castenedolo structure near Brescia.

We identify evidence of late Quaternary compressive tectonics in the Northern sector of the Central Po Plain through a systematic revision of the literature, new field mapping, and a new study of seismic reflection data obtained by ENI E&P. In particular, the reinterpretation of ca. 18.000 km of seismic profiles clearly shows a belt of segmented, 10 to 20 km long, fault propagation folds, controlled by the Plio-Quaternary growth of several out-of-sequence thrusts. As an example of this active structural style, in this paper we focus on a buried fold located just south of the Castenedolo Hill, a few km SE of Brescia. Although the Castenedolo anticline has long ago been described as a young compressional structure (e.g., DESIO, 1965), no detailed structural analysis of this feature has been performed until now. We calculated the uplift rates of this fold through the analysis of its syntectonic sedimentary record as imaged by the extremely high quality ENI E&P subsurface data available in the area. The evolution of this anticline was a discontinuous process characterized by several tectonic uplift pulses (with rates of ca. 0.1 mm/yr) of different duration, separated by periods of variable extent in which no fold growth occurred. The Quaternary growth history of this anticline and the presence of faulted and folded late Pleistocene to Holocene deposits at nearby sites (Ciliverghe and Monte Netto) demonstrate that the significant seismicity of this area (e.g., the December 25, 1222, Io = IX MCS Brescia earthquake, MAGRI & MOLIN, 1986; GUIDOBONI, 1986) must be related to active compressional structures within the Brescia piedmont belt. Our regional investigations show that the structural and paleoseismic setting illustrated near Castenedolo is typical of the whole Lombardia domain of the Southern Alps. This implies that the currently accepted seismotectonic model for this region, and related seismic hazard assessment, should be thoroughly and carefully re-evaluated