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Pasquali M, Leonardo S, Morsiani M, Zompatori M. Oesophageal pneumatosis in a case of bowel ischaemia. BJR Case Rep 2017; 3:20170039. [PMID: 30363192 PMCID: PMC6159176 DOI: 10.1259/bjrcr.20170039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 06/21/2017] [Accepted: 07/03/2017] [Indexed: 12/18/2022] Open
Abstract
Pneumatosis intestinalis (PI) is a condition in which cystic collections of gas develop within the gastrointestinal wall, forming submucosal or subserosal "bubbles". The radiologic manifestations are often dramatic and most notably are associated with life-threatening bowel ischaemia. PI may occur as a primary type but is usually secondary in nature, attributable to a wide spectrum of causes (benign and fulminant), ranging from immunosuppression to bowel infarction. Herein, we report a case of massive and extensive PI in a patient with small bowel ischaemia, having both benign and serious clinical origins.
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Mariani F, Gatti B, Rocca A, Bonifazi F, Cavazza A, Fanti S, Tomassetti S, Piciucchi S, Poletti V, Zompatori M. Pleuroparenchymal fibroelastosis: the prevalence of secondary forms in hematopoietic stem cell and lung transplantation recipients. Diagn Interv Radiol 2017; 22:400-6. [PMID: 27460284 DOI: 10.5152/dir.2016.15516] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Pleuroparenchymal fibroelastosis (PPFE) is a rare form of interstitial pneumonia, characterized by elastotic fibrosis involving the pleura and subpleural parenchyma, predominantly in the upper lobes. PPFE can be either idiopathic or secondary and mostly occurs as a late complication of lung or hematopoietic stem cell transplantation (HSCT). The aim of this study was to evaluate the prevalence of secondary forms in transplant recipients. METHODS An expert thoracic radiologist retrospectively reviewed high-resolution computed tomography exams of 700 HSCT recipients and 53 lung transplant recipients from the database of the Radiology Department of S. Orsola-Malpighi Hospital dating back from 2007. For each case that radiologically fulfilled PPFE criteria, the following details were retrieved: clinical characteristics, laboratory and functional data, pathologic findings (obtained from one patient) and metabolic data (obtained from three patients). RESULTS Six cases clinically and radiologically consistent with PPFE were identified: two HSCT recipients (0.28%) and four lung transplant recipients (7.54%). CONCLUSION In this study, PPFE was strongly associated with lung transplants as a late complication, with a prevalence of 7.54%.
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Croci Chiocchini AL, Sportoletti C, Brocchi S, Comai G, Bruno PF, Conti F, Serra C, Zompatori M, La Manna G. SP714SHEAR WAVE ELASTOGRAPHY IN KIDNEY TRANSPLANTATION: NONINVASIVE ALTERNATIVE TO ALLOGRAFT BIOPSY? Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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54
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Pirodda A, Savastio G, Stagni S, Ferri GG, Brandolini C, Zompatori M. The role of high-resolution computed tomography in the diagnostic protocol of cochleo-vestibular disorders. HEARING, BALANCE AND COMMUNICATION 2017. [DOI: 10.1080/21695717.2017.1286085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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55
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Frakulli R, Salvi F, Balestrini D, Palombarini M, Panni V, Dionisi V, Zamagni A, Ferioli M, Farina E, Deodato F, Mascia I, Ciabatti S, Cammelli S, Arcelli A, Morganti A, Zompatori M, Frezza G. Radiological differential diagnosis between fibrosis and recurrence after SBRT in early stage NSCLC. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30665-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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56
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Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M. 2015 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension. ACTA ACUST UNITED AC 2017; 69:177. [PMID: 26837729 DOI: 10.1016/j.rec.2016.01.002] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 01/08/2016] [Indexed: 10/22/2022]
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57
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Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M. 2015 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension. Eur Respir J 2017; 34:1219-63. [PMID: 19749199 DOI: 10.1183/09031936.00139009] [Citation(s) in RCA: 857] [Impact Index Per Article: 122.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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58
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Rasciti E, Sverzellati N, Silva M, Casadei A, Attinà D, Palazzini M, Galiè N, Zompatori M. Bronchial artery embolization for the treatment of haemoptysis in pulmonary hypertension. Radiol Med 2016; 122:257-264. [PMID: 28025781 DOI: 10.1007/s11547-016-0714-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/27/2016] [Indexed: 01/10/2023]
Abstract
PURPOSE To test the efficacy of bronchial artery embolization (BAE) to treat haemoptysis in pulmonary hypertension (PH). METHODS 33 patients were treated by BAE for haemoptysis associated with PH (PH group = 21) or non-associated with PH (control group = 12). The details of procedure, outcome, and rate of relapse were compared between the two groups. Within the PH group, the comparison was operated between subjects with congenital heart disease-associated pulmonary artery hypertension (CHD-APAH subgroup = 12) and non-CHD (non-CHD-APAH subgroup = 9). RESULTS The rate of relapse at 30 and 90-days was similar between the PH group and control group. BAE in the PH group was more challenging (median 2 arteries embolized per procedure) compared to the control group (median 1 artery embolized per procedure; p = 0.001). Bleeding arteries were more heterogeneous in the PH group, while a single right bronchial artery was the only clinical finding in 66.7% of controls (p = 0.001). Within the PH group, the CHD subgroup showed higher survival rate compared to the non-CHD-APAH group (p = 0.007). CONCLUSION BAE is effective and safe for the treatment of haemoptysis in PH, yet more challenging than other conditions. In PH-associated haemoptysis, BAE provides higher survival rate for subjects with PH associated with CHD.
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Vizioli L, Ciccarese F, Forti P, Chiesa AM, Giovagnoli M, Mughetti M, Zompatori M, Zoli M. Integrated Use of Lung Ultrasound and Chest X-Ray in the Detection of Interstitial Lung Disease. Respiration 2016; 93:15-22. [DOI: 10.1159/000452225] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/30/2016] [Indexed: 11/19/2022] Open
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60
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Ciccarese F, Garzillo G, Chiesa AM, Poerio A, Baroncini S, Bacchi Reggiano ML, Sverzellati N, Zompatori M. Incidental finding of bronchial diverticula in a non-smoker population: evaluation on thin-section CT. Monaldi Arch Chest Dis 2016; 81:743. [PMID: 27374216 DOI: 10.4081/monaldi.2015.743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 11/23/2022] Open
Abstract
Bronchial diverticula have been described as a common radiological finding in smoker patients with COPD, but the specificity of this sign should be further investigated. Thus, the aim of our study was to evaluate the prevalence of diverticula in a cohort of non-smoker subjects. Between February and July 2012, 2438 patients were admitted to our Radiology Unit to undergo a chest CT. Among them, we enrolled 121 non-smoking patients (78/121-64.5% females, 43/121-35.5% males), of different age (57.0±20.7 years-range: 12-88), without any respiratory symptoms, submitted to chest CT for several reasons (oncologic evaluation: 59/121-48.8%; follow up of lung nodules: 27/121-22.3%; screening in connectivitis: 12/121-9.9%; others: 23/121-19.0%). We considered thin-section CT scan on axial, coronal and sagittal plans to evaluate prevalence, numbers and level of bronchial diverticula. Diverticula were found in 41/121-33.9% patients, with a slight major prevalence in males (p=0.048), but no significant difference on age. In 31/41-75.6% the number was <3, whereof 17/31-54.8% with just one diverticulum assessed. Regarding the level, in 30/41-73.2% they were subcarinal, but they were also detected in mainstem (2/41-4.9%) and lobar bronchi (with the right upper lobe bronchus most frequently involved- 12/41-29.3%). Bronchial diverticula can be observed in non-smokers, as well as in smoker patients with COPD. However, their prevalence seems to be lower than in smokers and they tend to be isolated and subcarinal. The age of patients does not influence their finding. More studies should be proposed to better define a cut-off between smokers and healthy subjects.
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Deodato F, Cilla S, Morganti A, Annese C, Macchia G, Ianiro A, Picardi V, Digesù C, Ferro M, Labropoulos F, Torre G, Nuzzo M, Dinapoli N, Valentini V, Veraldi A, Zanirato A, Romani F, Zompatori M, Cammelli S, Ardizzoni A, Frezza G. EP-1206: Adequacy of dose/volume constraints in stereotactic radiotherapy and radiosurgery of thoracic area. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32456-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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62
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Frakulli R, Salvi F, Balestrini D, Palombarini M, Cammelli S, Macchia G, Zompatori M, Morganti A, Frezza G. EP-1216: Differential diagnosis between toxicity and recurrence after SBRT in early stage inoperable NSCLC. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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63
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Ciccarese F, Attinà D, Zompatori M. Combined pulmonary fibrosis and emphysema (CPFE): what radiologist should know. Radiol Med 2016; 121:564-72. [PMID: 26892068 DOI: 10.1007/s11547-016-0627-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 01/27/2016] [Indexed: 12/11/2022]
Abstract
Combined pulmonary fibrosis and emphysema is a relatively newly defined entity, which has been deeply studied in the recent years. Despite the wide numbers of papers on this topic, there are still several open questions about pathogenesis, epidemiology, natural history and prognosis. The diagnosis could be assessed only after HRCT scan as functional tests often result in an underestimation of this syndrome. What radiologists need to know about this syndrome consists in the heterogeneity of appearances: emphysema is mainly paraseptal and fibrotic pattern could be variable, including the variant of airspace enlargement with fibrosis which needs to be differentiated from honeycombing. A special attention must be paid on complications which could worsen the prognosis, such as pulmonary hypertension and lung cancer. Further studies are needed to address if the type of fibrotic pattern as well as fibrosis CT index could be considered as prognostic factors. Thus, the role of radiologists in the management of these patients is crucial as it involves diagnosis, detection of complications and could possible concerns the identification of patients at higher risk.
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Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Noordegraaf AV, Beghetti M, Ghofrani A, Sánchez MÁG, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M, Aboyans V, Carneiro AV, Achenbach S, Agewall S, Allanore Y, Asteggiano R, Badano LP, Barberà JA, Bouvaist H, Bueno H, Byrne RA, Carerj S, Castro G, Erol Ç, Falk V, Funck-Brentano C, Gorenflo M, Grantonc J, Iung B, Kiely DG, Kirchhof P, Kjellstrom B, Landmesser U, Lekakis J, Lionis C, Lip GY, Orfanos SE, Park MH, Piepoli MF, Ponikowski P, Revel MP, Rigau D, Rosenkranz S, Völler H, Zamorano JL. Guía ESC/ERS 2015 sobre diagnóstico y tratamiento de la hipertensión pulmonar. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.01.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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65
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Giannotta M, Leone MB, Greco L, Baldazzi M, Zompatori M. Intralobar pulmonary sequestration with bronchial atresia and a systemic artery feeding a normal contralateral lung. BJR Case Rep 2016; 2:20150176. [PMID: 30364365 PMCID: PMC6195924 DOI: 10.1259/bjrcr.20150176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 10/13/2015] [Accepted: 10/28/2015] [Indexed: 12/01/2022] Open
Abstract
We report a case of an intralobar pulmonary sequestration in the left lower lobe presenting with aspects of bronchial atresia associated with an anomalous systemic artery supplying the basal segments of the right lower lobe, which showed no bronchial or parenchymal anomalies. This is an extremely rare occurrence and has been reported only twice in the literature so far.
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Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 2016. [PMID: 26320113 DOI: 10.1093/eurheartj/ehv317)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
MESH Headings
- Adult
- Algorithms
- Antihypertensive Agents/therapeutic use
- Arrhythmias, Cardiac/etiology
- Balloon Embolectomy/methods
- Biomarkers/metabolism
- Cardiac Catheterization/methods
- Child
- Combined Modality Therapy/methods
- Connective Tissue Diseases/complications
- Connective Tissue Diseases/diagnosis
- Connective Tissue Diseases/therapy
- Cross Infection/prevention & control
- Drug Interactions
- Echocardiography/methods
- Elective Surgical Procedures/methods
- Electrocardiography
- Exercise Test/methods
- Exercise Therapy/methods
- Female
- Genetic Counseling
- Genetic Testing/methods
- HIV Infections/complications
- HIV Infections/diagnosis
- HIV Infections/therapy
- Health Status
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/therapy
- Hemangioma/complications
- Hemangioma/diagnosis
- Hemangioma/therapy
- Hemoptysis/etiology
- Humans
- Hypertension, Portal/complications
- Hypertension, Portal/diagnosis
- Hypertension, Portal/therapy
- Hypertension, Pulmonary/diagnosis
- Hypertension, Pulmonary/etiology
- Hypertension, Pulmonary/therapy
- Lung Transplantation/methods
- Magnetic Resonance Angiography/methods
- Multimodal Imaging/methods
- Patient Compliance
- Pregnancy
- Pregnancy Complications, Cardiovascular/therapy
- Referral and Consultation
- Respiratory Function Tests/methods
- Risk Assessment/methods
- Risk Factors
- Social Support
- Terminal Care/methods
- Therapies, Investigational/methods
- Thromboembolism/complications
- Thromboembolism/diagnosis
- Thromboembolism/therapy
- Tomography, X-Ray Computed/methods
- Travel Medicine/methods
- Treatment Outcome
- Ventricular Dysfunction, Right/complications
- Ventricular Dysfunction, Right/therapy
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Nanni S, Lovato L, Vagnarelli F, Ghetti G, Ferlito M, Pasquale F, Russo V, Zompatori M, Bacchi Reggiani L, Semprini F, Taglieri N, Melandri G, Rapezzi C. Inferior Q waves in apparently healthy subjects: Should we take a deep breath? An electrocardiographic, echocardiographic and cardiac magnetic resonance study. J Electrocardiol 2016; 49:46-54. [DOI: 10.1016/j.jelectrocard.2015.08.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Indexed: 11/26/2022]
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68
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Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Noordegraaf AV, Beghetti M, Ghofrani A, Sanchez MAG, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Kardiol Pol 2015; 73:1127-206. [DOI: 10.5603/kp.2015.0242] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Indexed: 11/25/2022]
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69
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Ciccarese F, Bazzocchi A, Ciminari R, Righi A, Rocca M, Rimondi E, Picci P, Bacchi Reggiani ML, Albisinni U, Zompatori M, Vanel D. The many faces of pulmonary metastases of osteosarcoma: Retrospective study on 283 lesions submitted to surgery. Eur J Radiol 2015; 84:2679-85. [DOI: 10.1016/j.ejrad.2015.09.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/15/2015] [Accepted: 09/27/2015] [Indexed: 01/15/2023]
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70
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Attinà D, Ciccarese F, Mughetti M, Rocca A, Contini P, Zompatori M. When the chest is clueless, look downstairs. Monaldi Arch Chest Dis 2015; 79:49-50. [DOI: 10.4081/monaldi.2013.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Not available
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71
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Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 2015; 46:903-75. [DOI: 10.1183/13993003.01032-2015] [Citation(s) in RCA: 1929] [Impact Index Per Article: 214.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.
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Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2015; 37:67-119. [DOI: 10.1093/eurheartj/ehv317] [Citation(s) in RCA: 3916] [Impact Index Per Article: 435.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, Gibbs J, Huisman MV, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindler TH, Svitil P, Vonk Noordegraaf A, Zamorano JL, Zompatori M. Corrigendum to: 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2015. [PMID: 26224077 DOI: 10.1093/eurheartj/ehu479] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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74
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Pezzuto G, Claroni G, Puxeddu E, Fusco A, Cavalli F, Altobelli S, Portalone S, Zompatori M, Simonetti G, Saltini C, Sergiacomi G. Structured multidisciplinary discussion of HRCT scans for IPF/UIP diagnosis may result in indefinite outcomes. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2015; 32:32-36. [PMID: 26237353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 01/19/2015] [Indexed: 06/04/2023]
Abstract
Recent ATS/ERS/JRS/ALAT guidelines for the diagnosis and management of Idiopathic Pulmonary Fibrosis (IPF) have defined key features and specific high-resolution computerized tomography (HRCT) patterns for the diagnosis of UIP. The aim is the sorting of patients with suspected IPF into three subgroups, confident, possible or inconsistent with UIP patterns, after a multidisciplinary discussion (MDD). Specialists in respiratory diseases, radiologists and pathologists should reach IPF diagnosis based on either patients' clinical, radiological and laboratory data, either submitting patients to surgical biopsy. After ATS/ERS/JRS/ALAT recommendations have been applied, it has been identified a subgroup of patients showing uniform apical-basal distribution of honeycombing and reticular abnormalities that could not be categorized as confident, or possible nor inconsistent with UIP. These patients were subsequently diagnosed with IPF after MDD and lung biopsy. Inclusion of this pattern in the recommendation for IPF diagnosis would be worth considering.
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Ciccarese F, Chiesa AM, Feletti F, Vizioli L, Pasquali M, Forti P, Zoli M, Zompatori M. The Senile Lung as a Possible Source of Pitfalls on Chest Ultrasonography and Computed Tomography. Respiration 2015; 90:56-62. [PMID: 26044398 DOI: 10.1159/000430994] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 04/16/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Age-associated changes in the pulmonary system could be detected with imaging techniques. Widespread use of lung ultrasonography (US) requires characterization of a normal pattern. OBJECTIVES To compare US and computed tomography (CT) findings in healthy subjects undergoing both techniques (with CT as the gold standard). METHODS We prospectively selected 59 subjects undergoing chest CT and US on the same day, without a history of smoking, respiratory symptoms, or known pulmonary pathologies. There were 44 patients in group 1 (age ≥60 years - elderly) and 15 patients in group 2 (age ≤50 years - young). Lung US was performed with a convex and a linear probe, and 10 chest areas per patient were analyzed. Convex and linear probe agreement was evaluated by means of the Cohen κ statistic; Fisher's exact test was used to compare categorical variables between groups. RESULTS Isolated B-lines were frequent in both group 1 (54.5%) and group 2 (40.0%); the number of chest areas positive for B-lines increased with age (16.1% in group 1 vs. 5.3% in group 2, p = 0.0028). In group 2, we found that 37.5% of subjects with B-lines had at least 1 chest area with multiple B-lines, but only 2 subjects had 2 or more. Moreover, in group 1 the chest CT documented a reticular pattern (2.3%), areas of increased density (9.1%), ground glass (6.8%), cysts (2.3%), bronchiectasis (22.7%), and bronchial thickening (6.8%); in group 2, only cysts (6.7%) and bronchiectasis (6.7%) were found. CONCLUSIONS The senile lung is characterized by mild changes on CT and US. Chest areas positive for B-lines increase with age, and focal multiple B-lines can be found. However, diffuse patterns, especially in symptomatic subjects, suggest a different diagnosis.
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