Ultrasonographic criteria for the major salivary glands: a perspective for the application of new technologies

It emerges from the interesting recent article by David et al. (4) on high-resolution ultrasound is the first line examination for parotid gland diffuse disease and focal lesions, normally using grey-scale and color-Doppler ultrasound especially using contrast media. Further-more, this working group present a review of the current literature on contrast-enhanced ultrasound for the assessment of parotid gland lesions, considering all characteristics of the technique, evidence of usefulness, future perspectives and limitations. We consider that this type of investigation will be helpful in preoperative treatment planning and reduce the cost to plan the correct treatment of diseases of the parotid glands. I am interested in underlining this article because it shows the advantages of the use of contrast in ultrasound and opens a debate if the non-invasiveness of the ultrasound and the use of the contrast agent have reason to be compared to the use of diagnostics with heavy machines such as CT and MRI. The article is clear on this point the limits are there and it is a challenge to identify new technologies to open unexplored frontiers, to know the disease early and manage it. Making it easier for the patient throughout the diagnosis, therapy, controls and possible follow-up

New method in the age estimation by the spheno-occipital suture. 3D cone-beam CT application

The aim of the present study was to determine the sequence and timing of closure of the spheno-occipital synchondrosis for a large sample of a modern Italian population to assess if this age marker is a useful tool for age estimation for individuals. The sample consisted of 494 individuals in the age range 0-22 years, who were admitted to the Department of Radiology, Oncology and Anatomo-Pathology of "Sapienza" University of Rome - UOC Head and Neck Radiology - and the Department of imaging, University of L'Aquila, and who had undergone multi-slice CBCT imaging. The average age of the spheno-occipital closure in men is 18.3 years, whilst in women is 16.6. Therefore, it is evident that the closure in female people is faster than 1.7 years. The timing of closure of spheno-occipital suture can be used to understand the age, even if the research has to be implemented

Recovery of smell sense loss by mepolizumab in a patient allergic to dermatophagoides and affected by chronic rhinosinusitis with nasal polyps

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) frequently presents with dysfunction or loss of the sense of smell, resulting in a signifcant impairment in quality of life. The medical treatments currently available may improve the olfactory function in patients with CRSwNP, but such an outcome is generally only transitory. We report the case of a patient with CRSwNP who completely recovered from smell sense loss by treatment with mepolizumab. Case presentation: The patient was a 62-year-old female who has severe asthma induced by allergy to Dermatophagoides and concomitant CRSwNP. Any treatment for the latter, including oral and injective corticosteroids, was unsuccessful in the loss of smell. Due to the satisfaction of admission criteria to mepolizumab treatment for severe asthma, treatment was initiated on March 2018, resulting in good clinical control of both asthma and CRSwNP, and particularly in complete recovery of the smell loss after 4 months of treatment and still persisting. Conclusion: In this case report, the treatment with mepolizumab in a patient allergic to Dermatophagoides and afected by CRSwNP was associated with an improvement of anosmia. That fnding may be explained by a reduction of the nasal obstruction by nasal polyp

Practical application of contrast-enhanced magnetic resonance mammography [CE-MRM] by an algorithm combining morphological and enhancement patterns

The purpose of this article is to report our practical utilization of dynamic contrast-enhanced magnetic resonance mammography [DCE-MRM] in the diagnosis of breast lesions. In many European centers, was preferred a high-temporal acquisition of both breasts simultaneously in a large FOV. We preferred to scan single breasts, with the aim to combine the analysis of the contrast intake and washout with the morphological evaluation of breast lesions. We followed an interpretation model, based upon a diagnostic algorithm, which combined contrast enhancement with morphological evaluation, in order to increase our confidence in diagnosis. DCE-MRM with our diagnostic algorithm has identified 179 malignant and 41 benign lesions; final outcome has identified 178 malignant and 42 benign lesions, 3 false positives and 2 false negatives. Sensitivity of CE-MRM was 98.3%; specificity, 95.1%; positive predictive value 98.9%; negative predictive,. value, 92.8% and accuracy, 97.7%. (C) 2008 Elsevier Ltd. All rights reserve

Diagnostic imaging and CEUS findings in a rare case of Desmoid-type fibromatosis. A case report

Desmoid-type fibromatosis (DF), also known as aggressive fibromatosis, is a locally aggressive benign fibroblastic neoplasm that can infiltrate or recur but cannot metastasize. It is rare, with an estimated annual incidence of two to four new cases per million people. Most DFs occur sporadically, but it may also be associated with the hereditary syndrome familial adenomatous polyposis. Treatment is necessary when the disease is symptomatic, especially in case of compression of critical structures. When possible, surgical resection is the treatment of choice; however, recurrence is common. Due to the high rate of recurrence, imaging plays an important role not only in diagnosis, but also in the management of DF. Although there are a number of studies describing CT and MRI findings of DF, there is no description of contrast-enhanced ultrasound findings

An unusual location of hand, foot and mouth disease

Hand, foot, and mouth disease (HFMD) is a childhood febrile disease. Oral lesions and papulovesicular lesions on the hands and feet are the clinical signs of the disease. In our case, a 17-year-old boy presented to the emergency department, where he was diagnosed with HFMD. After 6days, he felt intense pain in his right testicle, and therefore an ultrasound (US) examination was performed. US detected a hypoechoic mass-like area in the right testis. Viral etiology was suspected, and no therapy was prescribed. After a little more than 3months, US examination showed a reduced lesion size. Viral epididymo-orchitis should be suspected in young men with a recent history of HFMD and testicular pain

PODRIJETLO TRANSFUZIJE KRVI

This paper deals with the literary debate on the first experiments regarding blood transfusion on human beings between 1667 and 1668 in Europe, with particular attention to the less-known experimental research, carried out in Italy. The authors examine the details of the experimental developments, focusing on the techniques and instruments used by physicians involved in this new surgical approach, with special attention to the Italian debate and experimentations. The article suggests that transfusion was considered a part of what we could call “emergency surgery”. In this framework, Italian transfusional pioneers played a central role in the improvement and transmission of a discipline that was still in its dawning throughout Europe. Moreover, the manuscript highlights the contribution of the “chirurgia infusoria” as an innovative therapeutic system for an immediate and rapid recovery. From this perspective, blood transfusion represents a surgical practice for reanimation and resuscitation. The objective of this work was to analyze the importance of foreign literature and the English and French disputes presented by Davia in Italy, which made them known. Despite foreign prohibition in Italy, experiments with animal-to-human transfusions continued after 1648. A papal bull excommunicating scientists for conducting such research has never been found.Ovaj članak bavi se književnom raspravom o prvim eksperimentima vezanim uz transfuziju krvi na ljudima između 1667. i 1668. u Europi, s posebnim osvrtom na manje poznata eksperimentalna istraživanja provedena u Italiji. Autori ispituju detalje eksperimentalnog razvoja, fokusirajući se na tehnike i instrumente kojima se koriste liječnici uključeni u ovaj novi kirurški pristup, s posebnim osvrtom na talijansku raspravu i eksperimente. U članku se sugerira da se transfuzija smatra dijelom onoga što bismo mogli nazvati “hitnom operacijom”. U tom su okviru talijanski pioniri transfuzije imali važnu ulogu u poboljšanju i prenošenju discipline koja je još uvijek bila u nastajanju diljem Europe. Štoviše, članak ističe doprinos “chirurgiainfusoria” kao inovativnoga terapijskog sustava za trenutačan i brzi oporavak. Iz te perspektive, transfuzija krvi kirurška je praksa za reanimaciju i oživljavanje. Cilj je ovog rada bio analizirati važnost strane literature i engleskih i francuskih rasprava koje je Davia predstavio u Italiji, čime su oni postali poznati. Unatoč stranoj zabrani u Italiji, eksperimenti s transfuzijama sa životinje na čovjeka nastavljeni su i nakon 1648. Papinska bula koja je ekskomunicirala znanstvenike zbog provođenja takva istraživanja nikada nije pronađena

The medical historical cultural foundations of western nasal surgery from ancient greece to the middle ages

The manuscript aims to clarify the origins of Western rhinosurgery through the ancient texts of the greatest physicians of the past, up to the Byzantine Era, focusing on the "exchange of knowledge" between peoples. This excursus is carried out by quoting the texts of the greatest doctors of the past, such as Hippocrates, Galen and Celsus and by analysing the works of Byzantine authors such as Oribasius, Aetius, Antillus, which, more than others, represent the moment of fusion and interpenetration of Ancient Medical knowledge, paving the way for the Medieval Scholae Medicae in the West. The aim, therefore, is to fill that sort of "great gap" (from the foundation of Constantinople in the 4th century AD to the early Arab culture in the 11th century AD) due to the fact that figures such as Branca, Vianeo and, finally, Tagliacozzi, are considered direct actors of a recovery of the "ancient knowledge" of classic authors. This literature tends to less evaluate, instead, that important and huge cultural exchange -literally osmotic- in medical and surgical knowledge between peoples and civilizations, that find a trait d'union in the application of medical knowledge and surgical practical techniques matured in the Byzantine, Arab and Early Medieval period. In final analysis, through the History of Rhinosurgery, this paper aims to highlight how Western medical knowledge is made up of the ensemble of cultures which are apparently distant and different from each other, which merge themselves in a truly universal and transcultural knowledge: the Medical knowledge

Correlation between onco-suppressors PTEN and NM23 and clinical outcome in patients with T1 breast cancer

The aim of the present work was to evaluate the prognostic significance in patients with T1 breast cancer of tissue expression of the two oncosuppressors phosphatase and tensin homolog (PTEN) and non-metastatic clone 23 (NM23) as detected by immunohistochemistry

Effects of repeated intravitreal injections of dexamethasone implants on intraocular pressure: a 4-year study

Purpose: Dexamethasone and other corticosteroids are administered intravitreally to treat a variety of retinal diseases. As a side effect, they can alter intraocular pressure (IOP). The purpose of this study is to describe the incidence, severity, and management of ocular hypertension following the administration of multiple intravitreal injections of dexamethasone implants. Materials and Methods: A total of 78 eyes of 78 subjects (males 62%; females 38%; mean age 67 ± 13 years SD) received a total of 152 intravitreal injections of 0.7 mg dexamethasone implants over 4 years. Indications included retinal vein occlusion (87%), diabetic macular edema (9%), wet-type age-related macular degeneration (4%). Ocular hypertension was defined as intraocular pressure above 23 mmHg or any pressure increase of 10 mmHg or more from baseline values. IOP was measured by applanation tonometry before the injection (T0), as well as one week (T1), one month (T2), and three months (T3) afterwards. Results: Five percent (4/78) of subjects developed ocular hypertension after the 1st injection. On the second and third rounds, additional 7.2% (3/42) and 4.2% (1/24) of subjects developed the same side effect. Among the 8 subjects who received a fourth injection, none was found with OHT. Pressure elevations were detected at T2 and T3. In all patients, topical medical therapy was sufficient to lower the IOP below threshold. Mean pressure variations following the first injection as compared to previous recorded values were +0.97 mmHg (T1), +0.92 mmHg (T2), and −0.41 mmHg (T3) (p < 0.05). Mean pressure variations following the second injection were +0.54 mmHg (T1), +0.23 mmHg (T2) and −0.66 mmHg (T3) (p < 0.05). Conclusion: Ocular hypertension is a recognized side effect of intravitreal dexamethasone. Some patients develop it right after the first injection, while others develop it subsequently, on the 2nd or 3rd round. This side effect becomes most apparent 30–90 days following the implantation procedure and responds well to topical pressure-lowering medications