Comparison of magnetic resonance spectroscopy, proton density fat fraction and histological analysis in the quantification of liver steatosis in children and adolescents

AIM: To establish a threshold value for liver fat content between healthy children and those with non-alcoholic fatty liver disease (NAFLD) by using magnetic resonance imaging (MRI), with liver biopsy serving as a reference standard. METHODS: The study was approved by the local ethics committee, and written informed consent was obtained from all participants and their legal guardians before the study began. Twenty-seven children with NAFLD underwent liver biopsy to assess the presence of nonalcoholic steatohepatitis. The assessment of liver fat fraction was performed using MRI, with a high field magnet and 2D gradient-echo and multiple-echo T1-weighted sequence with low flip angle and single-voxel point-resolved ¹H MR-Spectroscopy (¹H-MRS), corrected for T1 and T2* decays. Receiver operating characteristic curve analysis was used to determine the best cut-off value. Lin coefficient test was used to evaluate the correlation between histology, MRS and MRI-PDFF. A Mann-Whitney U-test and multivariate analysis were performed to analyze the continuous variables. RESULTS: According to MRS, the threshold value between healthy children and those with NAFLD is 6%; using MRI-PDFF, a cut-off value of 3.5% is suggested. The Lin analysis revealed a good fit between the histology and MRS as well as MRI-PDFF. CONCLUSION: MRS is an accurate and precise method for detecting NAFLD in children

Who was thrombogenic: the stent or the doctor?

In 1986, when pioneers such as Jacques Puel and Ulrich Sigwart implanted the first coronary Wallstents, no guidelines were available to determine the treatment after stenting. From the experience acquired with mechanical prosthetic heart valves, it was inferred that chronic anticoagulation with coumarins was indicated. When the first cases of subacute occlusion were encountered, the anticoagulation regimen was further reinforced. The use of heparin, dextran, or thrombolytic agents during the procedure followed by warfarin, aspirin, sulphinpyrazone, and dipyridamole did not eliminate subacute thrombosis, which occurred in 18% of the first 117 stents implanted and was responsible for a higher incidence of hemorrhagic complications and prolonged hospital stay

Treatment of osteolytic solitary painful osseous metastases with radiofrequency ablation or cryoablation: a retrospective study by propensity analysis

The present study aimed to measure the improvement in pain relief and quality of life in patients with osteolytic solitary painful bone metastasis treated by cryoablation (CA) or radiofrequency ablation (RFA). Fifty patients with solitary osteolytic painful bone metastases were retrospectively studied and selected by propensity analysis. Twenty-five patients underwent CA and the remaining twenty-five underwent RFA. Pain relief, in terms of complete response (CR), the number of patients requiring analgesia and the changes in self-rated quality of life (QoL) were measured following the two treatments. Thirty-two percent of patients treated by CA experienced a CR at 12 weeks versus 20% of patients treated by RFA. The rate of CR increased significantly with respect to baseline only in the group treated by CA. In both groups there was a significant change in the partial response with respect to baseline (36% in the CA group vs. 44% in the RFA group). The recurrence rate in the CA and RFA groups was 12% and 8%, respectively. The reduction in narcotic medication requirements with respect to baseline was only significant in the group treated by CA. A significant improvement in self-rated QoL was observed in both groups. The present study seems to suggest that CA only significantly improves the rate of CR and decreases the requirement of narcotic medications. Both CA and RFA led to an improvement in the self-rated QoL of patients after the treatments. However, the results of the present study should be considered as preliminary and to serve as a framework around which future trials may be designed

Effect of airborne particle abrasion on microtensile bond strength of total-etch adhesives to human dentin

Aim of this study was to investigate a specific airborne particle abrasion pretreatment on dentin and its effects on microtensile bond strengths of four commercial total-etch adhesives. Midcoronal occlusal dentin of extracted human molars was used. Teeth were randomly assigned to 4 groups according to the adhesive system used: OptiBond FL (FL), OptiBond Solo Plus (SO), Prime & Bond (PB), and Riva Bond LC (RB). Specimens from each group were further divided into two subgroups: control specimens were treated with adhesive procedures; abraded specimens were pretreated with airborne particle abrasion using 50 mu m Al2O3 before adhesion. After bonding procedures, composite crowns were incrementally built up. Specimens were sectioned perpendicular to adhesive interface to producemultiple beams, which were tested under tension until failure. Data were statistically analysed. Failure mode analysis was performed. Overall comparison showed significant increase in bond strength (p < 0.001) between abraded and no-abraded specimens, independently of brand. Intrabrand comparison showed statistical increase when abraded specimens were tested compared to no-abraded ones, with the exception of PB that did not show such difference. Distribution of failure mode was relatively uniform among all subgroups. Surface treatment by airborne particle abrasion with Al2O3 particles can increase the bond strength of total-etch adhesive

Long-term reproducibility of coronary flow velocity measurements in patients with coronary artery disease

In conclusion, flow velocity measurements repeated after a 6-month interval show a variability, which is larger for baseline velocity and coronary flow reserve. This variability is correlated with the changes in heart rate and can be reduced by a normalization for the cross-sectional area at the site of the measurement (coronary flow) and for the aortic pressure at the time of the measurement (flow resistance)

Imaging-guided chest biopsies: techniques and clinical results

Background This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy. Methods Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive. Results Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy. Conclusion Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications

Treatment of Solitary Painful Osseous Metastases with Radiotherapy, Cryoablation or Combined Therapy: Propensity Matching Analysis in 175 Patients

aim of this study was to identify outcomes in pain relief and quality of life in patients with a solitary painful osseous metastasis treated by radiotherapy, cryoablation or the combination using a propensity score matching study design

Area industrializzata della Rada di Augusta (Siracusa): Relazione Tecnica sulla campagna di campionamenti subacquei Augusta 2012

Nell’ambito del progetto “Dinamica dei processi di evasione, trasporto e deposizione del mercurio nell’area industrializzata della Rada di Augusta e definizione delle mappe di rischio sanitario per le popolazioni residenti” realizzato dall’IAMC-CNR di Capo Granitola in collaborazione con l’ASP di Siracusa, il gruppo di biogeochimica dell’IAMC ha studiato i meccanismi biogeochimici che stanno alla base del fenomeno di rilascio di mercurio dai sedimenti della Rada di Augusta. Nel periodo compreso tra il 2011 e il 2012 l’ IAMC di Capo Granitola ha condotto diverse campagne di campionamenti nella Rada volte a rilevare la presenza e la quantità di mercurio in tutti i comparti ambientali (sedimenti marini, colonna d’ acqua, biota, atmosfera) e ad investigare i flussi di rilascio di mercurio dai sedimenti verso la colonna d’acqua e dalla colonna d’acqua verso l’atomosfera. Il presente documento descrive in maniera approfondita le attrezzature e gli strumenti utilizzati dai tecnici per i campionamenti subacquei di sedimenti ed acqua e all’interfaccia sedimento-acqua e per le misure in situ di mercurio all’interfaccia acqua-atmosfera

Immediate implant loading: a comparison of trabecular metal and tapered screw-vent dental implants

Aims: The aim of the present study is to compare osteointegration and marginal bone loss of immediately loaded Trabecular Metal® and Tapered Screw-Vent® Dental Implants (Zimmer Dental Inc., Carlsbad, CA, USA). Methods: Eighty-seven (87) patients were selected and randomly divided into Group A and Group B. Twenty-six (26) patients were enrolled in Group A, and were rehabilitated using Zimmer Trabecular Metal Dental Implants®. Sixty-one (61) patients were enrolled in Group B, and were rehabilitated using Zimmer Tapered Screw-Vent Dental Implants®. Results: The mean value of marginal bone loss after one year was 0.44 ± 0.40 mm for Group A and 0.95 ± 0.62 mm for Group B (p<.003). Mean marginal bone loss after 18 months was 0.46 ± 0.42 mm for group A and 0.97 ± 0.65 mm for group B (p<.003). No TM implant was lost (Group A), whereas one TSV implant (Group B) was lost before osseointegration and was not included in the statistical analysis. Conclusion: Both Trabecular Metal and Tapered Screw-Vent dental implants showed satisfying levels of osteointegration and marginal bone loss; however, statistical analysis revealed a value significantly lower of marginal bone loss for TM. Thus, it may be deduced that when implants are immediately loaded, the average loss of marginal bone around the TM implants is lower than that of the Tapered Screw-Vent implants