Spinal hydatidosis relapse: a case report

Human cystic echinococcosis (CE) is a zoonosis caused by the larval stage of the Echinococcus granulosus and the most common sites affected are the liver and lung in approximately 80–90% of cases. The hydatid bone represents the 0.5–2.5% of all cases and localization cord is present about 50% of the time. This benign and commonly asymptomatic disease may simulate an aggressive malignancy because of osseous destruction and aggressive extension. We report a case of a 42-year-old male patient, presented with an unusual spinal hydatidosis relapse, related to anthelmintic drug therapy withdrawal after 10-year treatment. The man had previous excision of chest and hepatic hydatid cysts (resp., 10 and 3 years ago) and after primary mediastinal and spinal involvement (3 years ago) he was lost to follow-up and discontinued drug therapy. The patient underwent surgery and the postoperative histopathology confirmed the diagnosis. The patient recovered with no complications. Despite significant progress in diagnostic imaging, pharmacological and surgical therapy, spinal CE remains associated with high morbidity

Arte e Guerra. Storie dal Risorgimento all'età contemporanea

Innumerevoli sono state, nel corso della storia, le situazioni di conflitto che hanno travolto le arti, determinando devastazioni, ma anche piani di protezione, salvataggi rocamboleschi, strumentalizzazioni ideologiche, nonché germinazioni critiche rilevanti. Lungo un orizzonte che va dal Risorgimento alla Guerra Fredda e oltre, fino a raggiungere il nostro tempo, questo volume – che ospita contributi di importanti studiosi del settore – propone una riflessione sulle differenti modalità di coinvolgimento del patrimonio artistico negli assetti di crisi. Le prospettive sono molteplici: tutela, ma anche distruzione; furti d’arte e, di seguito, faticose e lunghissime trattative per le restituzioni; perdite e insieme accordi internazionali per la salvaguardia; eroismo di alcuni a fronte della piccineria di altri; speranza coltivata nell’attivazione didattica delle collezioni museali. Notevole interesse è riservato anche alle cicatrici lasciate sul territorio antropizzato: dalle scritte fasciste che, nelle città e nelle campagne italiane, inneggiano alla vittoria, ai bunker NATO dismessi, giù giù fino alle attuali politiche militari americane. Sono così portati alla luce, nell’inanellarsi dei saggi, i molti effetti della triste relazione fra creatività e distruttività umana

Diagnosis and treatment of paranasal sinus fungus ball of odontogenic origin: case report

In recent years the incidence of fungal sinusitis has increased considerably, due both to increased survival of patients at risk and to improved diagnostic equipment. The pathogen responsible in most cases is the Aspergillus in its forms Fumigatus, Flavus and Niger. The diagnosis is often delayed because the symptoms, characterized by headache, cough, and facial algia, are generally similar to that of chronic bacterial rhinosinusitis. It can be divided into invasive and non-invasive forms based on the clinical evolution and extent of the lesion. We report a case of non-invasive fungal rhinosinusitis in a patient with recurrent sinusitis and pain in the left maxillary region, resistant to antibiotic therapy

Cone Beam CT use in the pre-prosthetic evaluation of endodontically treated of the rear maxilla

With our study we wanted to compare the diagnostic accuracy of conventional radiography (orthopanoramic and intraoral radiography) and Cone Beam CT (CBCT) for the diagnosis of periapical lesions on the posterior elements of the upper maxilla endodontically treated.The images were analyzed by a radiologist and an endodontist whose interpretation of radiological examinations is unique. Were examined 34 molars (23 first molars and 13 second molars) with a total of 102 roots. The CBCT detected a significantly higher number of lesions (43%, p <0.001) compared to conventional radiography. Our results demonstrate that the CBCT can be inserted into the diagnostic routine for the evaluation of all pre-prosthetic posterior elements of the upper jaw endodontically treated in addition to the diagnostic techniques 2D, especially when in the treatment plan is provided the realization of an abutment. The CBCT, which has reduction of cost and absorption of radiation with respect to the conventional CT, is also very useful even when there is a need to perform a surgical treatment-endodontic (apicectomy) of a lesion diagnosed with 2D techniques

Cone Beam CT use in the pre-prosthetic evaluation of endodontically treated of the rear maxilla

With our study we wanted to compare the diagnostic accuracy of conventional radiography (orthopanoramic and intraoral radiography) and Cone Beam CT (CBCT) for the diagnosis of periapical lesions on the posterior elements of the upper maxilla endodontically treated. The images were analyzed by a radiologist and an endodontist whose interpretation of radiological examinations is unique. Were examined 34 molars (23 first molars and 13 second molars) with a total of 102 roots. The CBCT detected a significantly higher number of lesions (43%, p <0.001) compared to conventional radiography. Our results demonstrate that the CBCT can be inserted into the diagnostic routine for the evaluation of all pre-prosthetic posterior elements of the upper jaw endodontically treated in addition to the diagnostic techniques 2D, especially when in the treatment plan is provided the realization of an abutment. The CBCT, which has reduction of cost and absorption of radiation with respect to the conventional CT, is also very useful even when there is a need to perform a surgical treatment-endodontic (apicectomy) of a lesion diagnosed with 2D techniques

Combined use of percutaneous cryoablation and vertebroplasty with 3D rotational angiograph in treatment of single vertebral metastasis: comparison with vertebroplasty

INTRODUCTION: This study aims to assess the effectiveness of combined procedure of cryoablation and vertebroplasty (CVT) for reduction of pain and improvement of the quality of life in patients with single painful metastatic vertebral fractures. METHODS: We retrospectively analyzed data from 23 patients with single vertebral metastasis treated with combined procedure of CVT, compared with those obtained in 23 patients treated by vertebroplasty. Pain intensity was evaluated by a visual analog scale (VAS) score administered before and 1 day, 1 week, and 1, 3, and 6 months after procedure. Quality of life was evaluated by an Oswestry Disability Index (ODI) score administered before and at 3 and 6 months after procedure. RESULTS: Procedural success was achieved in all patients without any complications. The VAS and ODI scores showed a reduction in both groups during follow-up (VAS score, p < 0.05 and p < 0.001, respectively; ODI score, p < 0.0001). No difference of the VAS and ODI scores were observed before treatment (p = 0.33 and 0.78, respectively). VAS score showed a difference at 1 week and 1, 3, and 6 months after treatment (p < 0.001). ODI score showed a difference at 3 and 6 months after treatment (p < 0.001). CONCLUSION: Our findings suggested that combined procedure of CVT is safe and effective for pain relief in single metastatic vertebral fractures, especially when other standard palliative treatments have failed, and improves disability. Careful needle positioning and accurate fluoroscopic and CT guidance are mandatory for a complication-free treatment

Histogram analysis of low- and high-risk prostate cancer . a comparison between Gaussian and non-Gaussian diffusion

Purpose / Introduction Prostate cancer (PCa) is the highest incidence malignancy among men in Europe[1]; however, there aren’t diagnostic tools to provide an accurate assessment of PCa aggressiveness non-invasively. We aimed to investigate the diagnostic ability of Diffusion Kurtosis Imaging (DKI) and Diffusion Tensor Imaging (DTI) in staging PCa with histogram analysis. Since prostate has a heterogeneous glandular structure, a non-Gaussian diffusion model could provide a better description of different tissue compartments[2]. Subjects and Methods In this retrospective study, 31 patients, with 5 different tumor grades, underwent a diffusion-weighted (DW) magnetic resonance imaging exam after two months from the first biopsy, by using a 3T clinical MR scanner (Philips Achieva) and a six-channel phased array SENSE torso coil. DW-images were acquired along 6 directions and with 5 different b-values up to 2500s/mm2, by using a single shot EPI sequence (TR/TE=3000/67ms,voxel size=1.56x1.56x3.3mm^3,NSA=4). The image pre-processing and the reconstruction of the Mean Diffusivity (MD) maps were performed in FSL 5.0. Maps of apparent Kurtosis (K) were obtained by using an in-house algorithm developed in Matlab R2012b. The mean, 25th and 90th percentile were evaluated from the entire-lesion histogram and correlated with the new grade group classification (GG=1,2 and GG=3,4,5 are considered low-risk and high risk PCa, respectively) proposed by ISUP[3] by using the Pearson’s test. Paired t-Test was performed to test statistical significance of differences in histogram-derived parameters between benign and PCa tissue; the ability of each parameter in discriminating low- and high-grade PCa was determined by ANOVA-test. Results Statistically significant differences were found between PCa and benign tissue for each parameter, kurtosis-derived 90th percentile presents the highest significance(p<10-5). A positive correlation was found between K-derived parameters and GG, while a negative correlation was found between MD-derived parameters and GG (Table-1). Among histogram derived parameters, 90th-percentile MD and mean K discriminate between low- and high-risk PCa with the highest significance (p<0.02). Discussion / Conclusion DKI and DTI exhibit similar perfermances in discriminating PCa from benign tissue and in stratifying different tumour grades, nevertheless mean-K showed the strongest correlation with GG. These results demonstrated that Gaussian and non-Gaussian diffusion are sensitive to tissue changes, occurring with tumour progression. Moreover, histogram analysis could represent a useful tool in PCa diagnosis to investigate micro-structural arrangements in PCa more deeply. References [1] Ferlay, J. et al., Int. J. Cancer, (2015): E359–E386. [2] Jensen JH, Helpern JA. NMR Biomed, (2010);23:698-710. [3] Nezzo, M. et al., European Journal of Radiology, (2016); 85:1794-1801