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Operto FF, Orsini A, Sica G, Scuoppo C, Padovano C, Vivenzio V, de Simone V, Rinaldi R, Belfiore G, Mazza R, Aiello S, Vetri L, Donadio S, Labate A, Pastorino GMG. Perampanel and childhood absence epilepsy: A real life experience. Front Neurol 2022; 13:952900. [PMID: 36034267 PMCID: PMC9404324 DOI: 10.3389/fneur.2022.952900] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of our study was to evaluate the effectiveness and tolerability of perampanel (PER) as first add-on and as second line monotherapy in subjects with childhood absence epilepsy. Methods Our sample consisted of 20 patients with childhood absence epilepsy, aged between 8 and 10, already in therapy with a first antiseizure medication with incomplete seizure control. PER was added as first add-on in a dose ranging from 3 to 8 mg/die with 1- 2 mg/week increments. The patients that were seizure-free were shifted to a PER monotherapy. All patients underwent a standardized neuropsychological evaluation in order to assess non-verbal intelligence and executive functions before adding PER and after 6 months of drug therapy. All parents completed two questionnaires, in order to assess the emotional-behavioral problems and parental stress. Results 15/20 patients responded to add-on PER and were seizure-free, in 3/20 patients we observed a reduction of seizure frequency <50%, and in the 2 remaining patients the add-on therapy with PER did not lead to a reduction in seizures frequency from baseline. The patients who were seizure-free were switched to PER monotherapy. 9/15 patients remained seizure-free in monotherapy with PER. In the first month of therapy with PER 2/20 patients (10%) reported mild, transient side effects of irritability, headache and dizziness, which did not lead to discontinuation of therapy. Adjunctive treatment with PER did not negatively affect non-verbal intelligence, executive functions, emotional/behavioral symptoms of children and parental stress levels. Significance Our clinical experience in real life showed that PER appears to be effective in the control of absence seizures in childhood absence epilepsy, with a favorable tolerability profile. PER would seem effective on absence seizures even in monotherapy. Further studies with larger samples, longer follow-up and controlled vs. placebo (or other first choice antiseizure medications) are needed to confirm our data.
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Affiliation(s)
- Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
- *Correspondence: Francesca Felicia Operto
| | - Alessandro Orsini
- Pediatric Neurology, Pediatric Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Chiara Scuoppo
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Chiara Padovano
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valentina Vivenzio
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valeria de Simone
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Rosetta Rinaldi
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Gilda Belfiore
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Roberta Mazza
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Salvatore Aiello
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Luigi Vetri
- OASI Research Institute- IRCCS, Troina, Italy
| | - Serena Donadio
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, Palermo, Italy
| | - Angelo Labate
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Pavone P, Gulizia C, D'Amico S, Grassi P, La Rosa G, Leotta R, Basile A, Palmucci S, Foti PV, Belfiore G, Marino L, Pellicanò GF, Pulvirenti G. Splenic abscesses in childhood brucellosis: a case-based review. Eur Rev Med Pharmacol Sci 2022; 26:4863-4871. [PMID: 35856378 DOI: 10.26355/eurrev_202207_29211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Human brucellosis is a zoonosis with an extremely wide spectrum of clinical manifestations. Focal splenic involvement is very uncommon, particularly in the pediatric age group, during the illness' acute phase. CASE REPORT A 4-year-old boy, already receiving third-generation cephalosporin treatment, was transferred from a local hospital to the University Pediatric Department for fever, anemia, increased inflammation index, and multiple, hyper-echogenic splenic lesions on abdominal ultrasound. Initial diagnostic laboratory investigations for Brucella infection, including the Widal-Wright test, were found to be negative. However, further diagnostic laboratory analysis using the chemiluminescent immunoassay was positive for Brucella IgM antibodies. Treatment with rifampicin at a dose of 150 mg/Kg/twice daily and co-trimethoprim at a dose of 80 mg/Kg/twice daily was started and continued for 7 weeks. IgM antibodies were undetectable after 2 weeks of treatment, and after 6 weeks of treatment, abdominal ultrasound documented a reduction of the diameter of the major splenic infiltrate from 1 to 0.5 cm. At 3 and 5 months of follow-up, re-evaluation of the abdominal lesions displayed complete resolution of the splenic lesions and a complete clinical recovery. CONCLUSIONS The present case and a literature review are presented in this study since a standard diagnostic laboratory evaluation for brucellosis may miss the diagnosis, and in suspected cases, the laboratory analysis should be extended. Splenic abscesses are known to be rare in brucellosis, but the diagnosis should be considered in children with severe focal lesions, as specific antibiotic treatment may result in complete clinical recovery.
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Affiliation(s)
- P Pavone
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University Hospital AOU "Policlinico-Vittorio Emanuele", Catania, Italy.
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Operto FF, Coppola G, Vivenzio V, Scuoppo C, Padovano C, de Simone V, Rinaldi R, Belfiore G, Sica G, Morcaldi L, D’Onofrio F, Olivieri M, Donadio S, Roccella M, Carotenuto M, Viggiano A, Pastorino GMG. Impact of COVID-19 Pandemic on Children and Adolescents with Neuropsychiatric Disorders: Emotional/Behavioral Symptoms and Parental Stress. Int J Environ Res Public Health 2022; 19:ijerph19073795. [PMID: 35409479 PMCID: PMC8997638 DOI: 10.3390/ijerph19073795] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/11/2022]
Abstract
The objective of our study was to evaluate the impact of the COVID-19 pandemic on the emotional and behavioral symptoms in minors with neuropsychiatric disorders and on parental stress through a standardized neuropsychological assessment, comparing the data collected before the pandemic with those collected during the lock-down. Another goal of our study was to analyze the relationship between parental stress and behavioral/emotional symptoms in children. Our study was conducted on 383 families of patients who had already been referred at the Child Neuropsychiatry Unit of the University Hospital of Salerno for different neuropsychiatric conditions. All the parents completed two neuropsychological standardized questionnaires for the assessment of parental stress (PSI—Parenting Stress Index-Short Form) and the emotional/behavioral problems of their children (Child Behaviour CheckList). The data collected during the pandemic were compared with those collected from questionnaires administered during the six months preceding the pandemic, as is our usual clinical practice. The comparison between the mean scores of PSI and CBCL before and after the pandemic showed a statistically significant increase in all subscales analyzed in the total sample. The correlation analysis showed significant positive relationship between the subscale Total Stress of PSI and the subscales Total Problems and Internalizing Problems of CBCL. Our study suggested that the COVID-19 pandemic and the corresponding measures adopted led to an increase in internalizing and externalizing symptoms in children and adolescents with neuropsychiatric disorder. Similarly, parental stress increased during COVID-19 and ahigher level of stress in parents can be related to the internalizing symptoms of their children.
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Affiliation(s)
- Francesca Felicia Operto
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
- Correspondence:
| | - Giangennaro Coppola
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Valentina Vivenzio
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Chiara Scuoppo
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Chiara Padovano
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Valeria de Simone
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Rosetta Rinaldi
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Gilda Belfiore
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Gianpiero Sica
- Azienda Sanitaria Locale Salerno, Via Nizza 146, 84124 Salerno, Italy;
| | - Lucia Morcaldi
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Floriana D’Onofrio
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Miriam Olivieri
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Serena Donadio
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (S.D.); (M.R.)
| | - Michele Roccella
- Department of Psychology, Educational and Science and Human Movement, University of Palermo, 90128 Palermo, Italy; (S.D.); (M.R.)
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy;
| | - Andrea Viggiano
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
| | - Grazia Maria Giovanna Pastorino
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (G.C.); (V.V.); (C.S.); (C.P.); (V.d.S.); (R.R.); (G.B.); luciaa-@hotmail.it (L.M.); (F.D.); (M.O.); (A.V.); (G.M.G.P.)
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Operto FF, Scuoppo C, Padovano C, Vivenzio V, Belfiore G, de Simone V, Pistola I, Rinaldi R, Diaspro G, Mazza R, Pastorino GMG. Migraine and epilepsy: Social cognition skills in pediatric population. Eur J Paediatr Neurol 2022; 37:68-74. [PMID: 35134658 DOI: 10.1016/j.ejpn.2022.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/30/2021] [Accepted: 01/18/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The goal of the present study was to comparatively analyze Social Cognition skills in a pediatric population diagnosed with Migraine or Epilepsy, compared to Typically Developing children (TD). The secondary aim was to relate Social Cognition skills with other migraine- or epilepsy-related variables and with executive and cognitive functions. MATERIALS AND METHODS In our cross-sectional observational study 119 children and adolescents (aged 6-16) with Migraine or Focal Epilepsy and 61 TD peers were recruited. Both the clinical groups and TD peers performed a neuropsychological evaluation through standardized test to assess Theory of Mind (TM), Emotion Recognition through facial expression (ER), executive function and non-verbal cognitive abilities. RESULTS Children and adolescents with Migraine or Focal Epilepsy showed comparable scores between each other, however their scores were significantly lower than their TD peers, in both ER and TM. Social Cognition skills were significantly related to executive functions. CONCLUSION Our study suggests that some chronic neurological conditions in childhood, such as Migraine and Epilepsy, may be associated with difficulties in Social Cognition skills, and that these difficulties may be related to a deficit in executive functions. The relationship between these two higher cognitive abilities should be further explored in future studies. Our results also suggest the importance of monitoring cognitive abilities in pediatric patients with Migraine or Epilepsy, in order to detect early impairment and ensure the necessary support.
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Affiliation(s)
- Francesca Felicia Operto
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.
| | - Chiara Scuoppo
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Chiara Padovano
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valentina Vivenzio
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Gilda Belfiore
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valeria de Simone
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Ilaria Pistola
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Rosetta Rinaldi
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Giuseppe Diaspro
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Roberta Mazza
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
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Operto FF, Pastorino GMG, Scuoppo C, Padovano C, Vivenzio V, Pistola I, Belfiore G, Rinaldi R, de Simone V, Coppola G. Adaptive Behavior, Emotional/Behavioral Problems and Parental Stress in Children With Autism Spectrum Disorder. Front Neurosci 2021; 15:751465. [PMID: 34899160 PMCID: PMC8660640 DOI: 10.3389/fnins.2021.751465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The aim of our study was to compare adaptive skills, emotional/behavioral problems, and parental stress among children with different severity levels of Autism Spectrum Disorder (ASD) symptoms. Methods: This study included a sample of 88 subjects with ASD (mean age = 6.00 ± 2.70). All subjects underwent standardized neuropsychological tests for the assessment of symptoms of the autism spectrum (Autism Diagnostic Observation Schedule-Second Edition), adaptive level (The Vineland Adaptive Behavior Scales, Survey Interview, 2nd edition), behavioral and emotional problems (Child Behavior CheckList CBCL), and parental stress (Parental Stress Index Short Form-PSI-SF). Non-parametric statistical methods (Kruskal-Wallis test and Mann-Whitney U-test for post hoc analysis) and linear regression analysis were used in this study. Results: Children who had higher severity levels of ASD symptoms had less adaptive functioning; younger children showed more severe symptoms of ASD; older children had better communication skills. The presence of greater adaptive difficulties was related to a greater presence of internalizing problems. An increase in parental stress levels was related to an higher severity of ASD symptoms, fewer adaptive skills, and a greater presence of internalizing and externalizing problems. Conclusion: This study suggests that the adaptive behavior should be considered in order to planning a habilitation intervention in children with autism. It is also important to monitor emotional/behavioral problems and parental stress levels in order to provide parenting support and improve the family quality of life.
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Affiliation(s)
- Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Chiara Scuoppo
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Chiara Padovano
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valentina Vivenzio
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Ilaria Pistola
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Gilda Belfiore
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Rosetta Rinaldi
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valeria de Simone
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Giangennaro Coppola
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Sinopoli MT, Fusillo C, Belfiore G, Galliano E, Quagliariello F, Matera C, Quintavalle G. The vaccination registry of the local health company (ASL) Roma 4. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Issue
The regional vaccination of Lazio (AVR) and the ASL vaccination registries(AVA) that feed it, have had to adapt to the directions of national vaccination registry. The ASL Roma 4 added other implementations.
Description of the Problem
L'AVA must, first of all, allow easy search of subjects, defaulters and vaccination coverage for various filters but it can also facilitate the recording and analysis activity.
Results
The provision of barcodes allows the prompt search of subjects, the check of tax code and AIC codes of vaccines. The digital signature of the privacy and consent forms and anamnesis, taken from the “Guide to contraindications to vaccinations” directly available, allows the elimination of the paper. The possibility to go directly to AVR allows the registration of vaccinations made in other ASL. In addition, the AVA allows the compilation of the adverse event reporting form and vaccine management. The link with the portal on the ASL website allows users to download the vaccination certificate. Important is the possibility to send SMS before vaccination deadlines or appointments. The SMART-SMS allows sending videos or photos and manage a short link (http://tiny.cc/XXX) to an information page on ASL website, as well as user response SMS, that can also directly change appointments.
Lessons
The dematerialization of the forms leds to a greater compliance with the procedures, a more accurate anamnesis and the streamling of the vaccination session, the SMS bring greater compliance of users and an increase in vaccination coverage. The use of mobile analytics tools allows monitoring of vaccination campaigns.
Key messages
The dematerialization of the forms in the vaccination registry leds to a greater compliance with the procedures, a more accurate anamnesis and the streamling of the vaccination session. The ability to send SMS through the vaccination registry brings greater compliance of users and an increase in vaccination coverage.
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Ruggieri M, Praticò AD, Serra A, Maiolino L, Cocuzza S, Di Mauro P, Licciardello L, Milone P, Privitera G, Belfiore G, Di Pietro M, Di Raimondo F, Romano A, Chiarenza A, Muglia M, Polizzi A, Evans DG. Childhood neurofibromatosis type 2 (NF2) and related disorders: from bench to bedside and biologically targeted therapies. Acta Otorhinolaryngol Ital 2017; 36:345-367. [PMID: 27958595 PMCID: PMC5225790 DOI: 10.14639/0392-100x-1093] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/29/2016] [Indexed: 12/22/2022]
Abstract
Neurofibromatosis type 2 [NF2; MIM # 101000] is an autosomal dominant disorder characterised by the occurrence of vestibular schwannomas (VSs), schwannomas of other cranial, spinal and cutaneous nerves, cranial and spinal meningiomas and/or other central nervous system (CNS) tumours (e.g., ependymomas, astrocytomas). Additional features include early onset cataracts, optic nerve sheath meningiomas, retinal hamartomas, dermal schwannomas (i.e., NF2-plaques), and (few) café-au-lait spots. Clinically, NF2 children fall into two main groups: (1) congenital NF2 - with bilateral VSs detected as early as the first days to months of life, which can be stable/asymptomatic for one-two decades and suddenly progress; and (2) severe pre-pubertal (Wishart type) NF2- with multiple (and rapidly progressive) CNS tumours other-than-VS, which usually present first, years before VSs [vs. the classical adult (Gardner type) NF2, with bilateral VSs presenting in young adulthood, sometimes as the only disease feature]. Some individuals can develop unilateral VS associated with ipsilateral meningiomas or multiple schwannomas localised to one part of the peripheral nervous system [i.e., mosaic NF2] or multiple non-VS, non-intradermal cranial, spinal and peripheral schwannomas (histologically proven) [schwannomatosis]. NF2 is caused by mutations in the NF2 gene at chromosome 22q12.1, which encodes for a protein called merlin or schwannomin, most similar to the exrin-readixin-moesin (ERM) proteins; mosaicNF2 is due to mosaic phenomena for the NF2 gene, whilst schwannomatosis is caused by coupled germ-line and mosaic mutations either in the SMARCB1 gene [SWNTS1; MIM # 162091] or the LZTR1 gene [SWNTS2; MIM # 615670] both falling within the 22q region and the NF2 gene. Data driven from in vitro and animal studies on the merlin pathway [e.g., post-translational and upstream/downstream regulation] allowed biologically targeted treatment strategies [e.g., Lapatinib, Erlotinib, Bevacizumab] aimed to multiple tumour shrinkage and/or regression and tumour arrest of progression with functional improvement.
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Affiliation(s)
- M Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Italy
| | - A D Praticò
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Italy
| | - A Serra
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - L Maiolino
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - S Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - P Di Mauro
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - L Licciardello
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - P Milone
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Radiology, University of Catania, Italy
| | - G Privitera
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Radiology, University of Catania, Italy
| | - G Belfiore
- Unit of Paediatric Radiology, AOU "Policlinico-Vittorio Emanuele", Catania, Italy
| | - M Di Pietro
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Ophthalmology, University of Catania, Italy
| | - F Di Raimondo
- Division of Hematology, AOU "Policlinico-Vittorio Emanuele", University of Catania, Italy
| | - A Romano
- Division of Hematology, AOU "Policlinico-Vittorio Emanuele", University of Catania, Italy
| | - A Chiarenza
- Division of Hematology, AOU "Policlinico-Vittorio Emanuele", University of Catania, Italy
| | - M Muglia
- Unit of Genetics, Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Italy
| | - A Polizzi
- National Centre for Rare Disease, Istituto Superiore di Sanità, Rome, Italy.,Institute of Neurological Sciences, National Research Council, Catania, Italy
| | - D G Evans
- Genomic Medicine, University of Manchester, Manchester Academic Health Science Centre, Institute of Human Development, Central Manchester NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK
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8
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Macchi M, Belfiore MP, Floridi C, Serra N, Belfiore G, Carmignani L, Grasso RF, Mazza E, Pusceddu C, Brunese L, Carrafiello G. Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial. Med Oncol 2017; 34:96. [PMID: 28417355 DOI: 10.1007/s12032-017-0946-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 04/04/2017] [Indexed: 12/24/2022]
Abstract
The LUMIRA trial evaluated the effectiveness of radiofrequency (RFA) and microwave ablation (MWA) in lung tumours ablation and defining more precisely their fields of application. It is a controlled prospective multi-centre random trial with 1:1 randomization. Fifty-two patients in stage IV disease (15 females and 37 males, mean age 69 y.o., range 40-87) were included. We randomized the patients in two different subgroups: MWA group and RFA group. For each group, we evaluated the technical and clinical success, the overall survival and complication rate. Inter-group difference was compared using Chi-square test or Fisher's exact test for categorical variables and one-way ANOVA test for continuous variables. For RFA group, there was a significant reduction in tumour size only between 6 and 12 months (p value = 0.0014). For MWA group, there was a significant reduction in tumour size between 6 and 12 months (p value = 0.0003) and between pre-therapy and 12 months (p value = 0.0215). There were not significant differences between the two groups in terms of survival time (p value = 0.883), while the pain level in MWA group was significantly less than in RFA group (1.79 < 3.25, p value = 0.0043). In conclusion, our trial confirms RFA and MWA are both excellent choices in terms of efficacy and safety in lung tumour treatments. However, when compared to RFA therapy, MWA produced a less intraprocedural pain and a significant reduction in tumour mass.
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Affiliation(s)
- M Macchi
- Department of Radiology, Circolo e Fondazione Macchi Hospital, Insubria University, Varese, Italy
| | - M P Belfiore
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - C Floridi
- Radiology Department, Fatebenefratelli Hospital, Milan, Italy.
| | - N Serra
- Department of Radiology and Radiotherapy, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Belfiore
- Department of Radiology, Sant'Anna e San Sebastiano Hospital, Caserta, Italy
| | - L Carmignani
- Interventional Radiology Unit, San Jacopo Hospital, Pistoia, Italy
| | - R F Grasso
- Department of Diagnostic and Interventional Radiology, Campus Bio-Medico University, Rome, Italy
| | - E Mazza
- Interventional Radiology Unit, Careggi Hospital, Florence, Italy
| | - C Pusceddu
- Division of Interventional Radiology, Department of Oncological Radiology, Oncological Hospital "A. Businco", Cagliari, Italy
| | - L Brunese
- Department of Radiology, University of Molise, Campobasso, Italy
| | - G Carrafiello
- Department of Radiology, San Paolo Hospital, University of Milan, Milan, Italy
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9
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Camera L, Di Giacomo A, Lambiase C, Fratta L, Belfiore G, Salvatore M. Acute myocardial infarction in a patient with unstable angina: A case report. Acta Radiol 2016. [DOI: 10.1258/rsmacta.43.5.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A 58-year-old-man with unstable angina developed a violent retrosternal and interscapular pain during coronary angiography with no associated ECG abnormalities. The patient was immediately submitted to transesophageal echocardiography, which revealed an echo-free space behind the ascending aorta thought to be consistent with an aortic dissection. To confirm this finding the patient underwent contrast-enhanced helical CT, which ruled out a dissection but revealed a small hypoattenuating, ill-defined area within the lateral wall of the left ventricle, consistent with an acute myocardial infarction. The finding was first confirmed by bedside echocardiography and later validated by laboratory tests. Review of the left coronary angiogram showed the culprit lesion at the origin of a major acute marginal branch of the circumflex artery.
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Affiliation(s)
- L. Camera
- Department of Radiology, University “Federico II”, Naples, Italy
- Department of Radiology, National Research Council (Institute of Bio-Images and Bio-Structures), Naples, Italy
| | - A. Di Giacomo
- Department of Radiology, University “Federico II”, Naples, Italy
| | - C. Lambiase
- Department of Radiology, University “Federico II”, Naples, Italy
| | - L. Fratta
- Department of Radiology, Internal Medicine, University “Federico II”, Naples, Italy
| | - G. Belfiore
- Department of Radiology, University “Federico II”, Naples, Italy
| | - M. Salvatore
- Department of Radiology, University “Federico II”, Naples, Italy
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10
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Magagnini MC, Spina LL, Gioé D, Campo GD, Belfiore G, Smilari P, Greco F. A case of postvaricella cerebral angiopathy with a good outcome in a child. J Pediatr Neurosci 2015; 10:156-8. [PMID: 26167223 PMCID: PMC4489063 DOI: 10.4103/1817-1745.159193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Cerebral vasculopathy is a serious but uncommon complication of varicella-zoster-virus (VZV) infection. Diagnosis is based on a recent history of VZV infection, signs and symptoms of transient ischemic attack or stroke, and vascular anomalies on neuroimaging. We report a case of postvaricella cerebral angiopathy in a 5-year-old child, who was admitted after three episodes of transient right hemiplegia, each one lasting a few minutes. He had contracted chicken pox, the month prior to admission. Brain magnetic resonance imaging showed hyperintense signals in the left lenticular and caudate nuclei, which can be considered to be a result of vasculopathy.
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Affiliation(s)
- Maria Cristina Magagnini
- Department of Medical and Pediatric Sciences, Unit of Clinical Pediatrics, University of Catania, Italy
| | - Luisa La Spina
- Department of Medical and Pediatric Sciences, Unit of Clinical Pediatrics, University of Catania, Italy
| | - Daniela Gioé
- Department of Medical and Pediatric Sciences, Unit of Clinical Pediatrics, University of Catania, Italy
| | - G Del Campo
- Department of Medical and Pediatric Sciences, Unit of Clinical Pediatrics, University of Catania, Italy
| | - G Belfiore
- Department of Radiology, Unit of Pediatrics Radiology, University of Catania, 95123 Catania, Italy
| | - P Smilari
- Department of Medical and Pediatric Sciences, Unit of Clinical Pediatrics, University of Catania, Italy
| | - Filippo Greco
- Department of Medical and Pediatric Sciences, Unit of Clinical Pediatrics, University of Catania, Italy
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11
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Trigilia C, Timpanaro T, Caff G, Belfiore G, Pavone V, Barone P, Garozzo R. Intra-articular corticosteroid therapy in oligoarticular juvenile arthritis: our clinical experience. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194559 DOI: 10.1186/1546-0096-9-s1-p200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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12
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Vecchio GM, Miano AE, Belfiore G, Giurato E, Amico P, Magro G. Fibrous hamartoma of infancy of the labium majus: a typical lesion in an unusual site. Pathologica 2010; 102:71-74. [PMID: 23596761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Fibrous hamartoma of infancy is a soft tissue subdermal fibromatous tumour that characteristically occurs in the first years of life. It is histologically composed of three different components that are intimately admixed: well-defined bundles of fibro-myofibroblastic spindle-shaped cells, nodular proliferations of immature-looking mesenchymal cells set in a myxoid stroma, and mature adipose tissue. A wide intralesional and interlesional cellular composition is commonly observed. Fibrous hamartoma of infancy usually arises from subcutaneous tissue of the trunk, axilla, upper extremities and inguinal region. Only rarely has fibrous hamartoma of infancy been reported in genital organs, with only one case described in the labium majus. We report a rare case of fibrous hamartoma of infancy in the labium majus of a 1-year old female child. Ultrasonography revealed the presence of a mass-like lesion involving subcutaneous tissue, with ill-defined margins. We emphasize that fibrous hamartoma of infancy should be included in the differential diagnosis of soft tissue tumour-like and tumour lesions of the vulva in children. Awareness that fibrous hamartoma of infancy occurs at this site with irregular margins is important to avoid confusion with other lesions exhibiting a more aggressive behaviour.
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Affiliation(s)
- G M Vecchio
- U.O.C. Anatomia Patologica, Azienda Ospedaliero-Universitaria Policlinico "Vittorio Emanuele", Catania.
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13
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Messina M, Meli G, Viglianesi A, Scavone G, Belfiore G, Di Bella D. Transient Bilateral Basal Ganglia Lesions in Rotavirus Encephalopathy. Neuroradiol J 2010; 23:42-7. [DOI: 10.1177/197140091002300107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Accepted: 10/20/2009] [Indexed: 11/17/2022] Open
Abstract
Rotavirus gastroenteritis may be associated with the onset of an acute reversible encephalitis. We describe a case of transient bilateral basal ganglia lesions after a prodromal gastroenteritis which completely resolved four months later. Diffusion weighted images were determinant to depict the basal ganglia abnormalities and were helpful to evaluate the prognosis. A review of the literature indicates that many diseases may be accompanied by signal abnormalities within the basal ganglia and that differential diagnosis is possible only through the simultaneous evaluation of imaging, clinical and laboratory findings.
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Affiliation(s)
- M. Messina
- Department of Radiology, Catania University Hospital; Catania, Italy
| | - G.A. Meli
- Department of Radiology, “San Giovanni di Dio e Sant' Isidoro” Hospital of Giarre; Catania, Italy
| | - A. Viglianesi
- Department of Radiology, Catania University Hospital; Catania, Italy
| | - G. Scavone
- Department of Radiology, Catania University Hospital; Catania, Italy
| | - G. Belfiore
- Department of Paediatric Radiology, Catania University Hospital; Catania, Italy
| | - D. Di Bella
- Department of Paediatric Radiology, Catania University Hospital; Catania, Italy
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14
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Tedeschi E, Iaccarino C, Covelli EM, Rapanà A, Barretta ML, Piscitelli V, Belfiore G. MR-Cisternography with T2-Weighted Single-Shot Fast Spin Echo Sequence in the Diagnosis of a Spontaneous CSF Fistula of the Sphenoid Sinus Causing Massive Pneumocephalus. Neuroradiol J 2009; 21:795-9. [PMID: 24257047 DOI: 10.1177/197140090802100607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Accepted: 09/07/2008] [Indexed: 11/17/2022] Open
Abstract
A spontaneous CSF fistula of the sphenoid sinus was preoperatively diagnosed in a young woman presenting with massive pneumocephalus and rhinorrhea. Diagnosis was established by MR cisternography using a heavily T2-weighted 3D single-shot FSE sequence with half-Fourier analysis (3D-EXPRESS(®)), originally developed for imaging the inner ear. While unenhanced CT failed to detect the site of the fistula, MR permitted complete evaluation of the sellar/sphenoid region and tracked the CSF signal down to the nasal cavity.
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Affiliation(s)
- E Tedeschi
- Radiology and Neuroradiology Service, "S. Anna e S. Sebastiano Hospital"; Caserta, Italy -
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15
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Belfiore G, Tedeschi E, Ronza FM, Belfiore MP, Della Volpe T, Zeppetella G, Rotondo A. Radiofrequency ablation of bone metastases induces long-lasting palliation in patients with untreatable cancer. Singapore Med J 2008; 49:565-570. [PMID: 18695866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION In oncological patients, life quality can be greatly impaired by the presence of painful bone metastases, as standard forms of treatment often achieve inadequate palliation. The aim of our study was to evaluate the clinical efficacy of radiofrequency ablation (RFA) with respect to pain relief in patients with refractory bone metastases or who are ineligible to conventional treatments. METHODS 12 patients with 13 painful osteolytic skeletal metastases, and who were unresponsive to analgesic drug therapy, underwent one (seven lesions) or two (five lesions) RFA sessions under computed tomography (CT) guidance. The RFA procedure was completed in all patients without complications. One patient also received cementoplasty after the RFA procedure. To obtain semiquantitative pain scores, the brief pain inventory (BPI) was administered before treatment and during follow-up. The local effects of RFA were monitored for at least one year in eight of 12 patients with CT and/or magnetic resonance imaging. RESULTS Immediate pain relief after treatment was experienced by nine of 12 patients, but in two cases, pain recurred within the first week. Long-lasting palliation was obtained in seven of 12 patients. BPI mean scores for worst and average daily pain decreased from 7.7 and 5.0, respectively, at baseline, to 3.1 and 1.8, respectively, at one year. Imaging follow-up showed large areas of necrosis in nine of 12 lesions. CONCLUSION In our preliminary experience, RFA showed good and long-lasting efficacy for pain control in bone metastases. A possible role of RFA as a coadjuvant palliative treatment in these cases is suggested.
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Affiliation(s)
- G Belfiore
- Department of Diagnostic Imaging, S Anna-S Sebastiano Hospital, Via F Palasciano 81100, Caserta, Italy.
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16
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La Tessa G, Tedeschi E, Covelli E, Pasqualetto L, Cirillo M, Belfiore G. Acute Encephalitis of Unknown Etiology: Early Diagnosis and Follow-up of Disease Evolution. MRI. Neuroradiol J 2006; 19:313-21. [DOI: 10.1177/197140090601900307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2006] [Accepted: 05/11/2006] [Indexed: 11/17/2022] Open
Abstract
Two women with viral encephalitis of unknown etiology were studied with serial MR studies at 1.5 Tesla using: Spin-Echo (SE) T1-weighted (T1w) sequences before and after i.v. administration of paramagnetic contrast agent, with/without magnetization transfer (MT), Fast SE and Fluid-attenuated Inversion Recovery (FLAIR) T2-weighted sequences, Echo-Planar Single-Shot sequences for the assessment of water diffusivity (Diffusion Weighted, DW, and Apparent Diffusion Coefficient maps, ADC). The DW and T1w sequences with MT after contrast were most useful to detect the initial pathologic alterations, thereby reinforcing the clinical diagnostic hypothesis and prompting appropriate drug treatment, even if the laboratory data were not conclusive for viral etiology. In a later phase, both cases showed MR evidence of lacunar foci in the grey matter, and cortical laminar necrosis, probably indicating a concomitant hypoxic/ischemic mechanism.
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Affiliation(s)
| | - E. Tedeschi
- Dipartimento di Diagnostica per Immagini, AORN S. Sebastiano, Caserta
| | - E.M. Covelli
- Dipartimento di Diagnostica per Immagini, AORN S. Sebastiano, Caserta
| | | | - M. Cirillo
- Cattedra di Neuroradiologia, II Università degli Studi di Napoli; Italy
| | - G. Belfiore
- Dipartimento di Diagnostica per Immagini, AORN S. Sebastiano, Caserta
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17
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Farina R, Pennisi F, Midiri M, Belfiore G, La Rosa M, Pennisi M, Arena C, Ettorre GC. The Color Doppler with contrast agent US in the study of post Cholecistectomy Syndrome. Radiol Med 2005; 109:532-9. [PMID: 15973227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE The aim of this study was to evaluate the study of intra- and extra-biliary ducts by contrast-enhanced colour-Doppler in patients who have undergone laparoscopic cholecystectomy. MATERIALS AND METHODS Contrast-enhanced colour-Doppler US was performed in 15 patients who had undegone laparoscopic cholecystectomy. The US contrast agent was introducted into the Kehr or Pedinelli tube to allow visualisation of the bile ducts and duodenum. RESULTS The colour-Doppler study enabled visualisation of the contrat agent in the intra- and extra-hepatic bile ducts and in the duodenum in all patients, thereby permitting the accurate study of the post-operative course. The data obtained were confirmed by conventional radiology. CONCLUSIONS The advantages of this US ultrasound technique are the complete absence of ionising radiation and no intolerance to the US contrast agent. This technique could therefore be used in selected patients as an alternative to trans-Kehr and trans-Pedinelli cholangyography.
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Affiliation(s)
- R Farina
- Dipartimento di Ostetricia, Ginecologia e Scienze Radiologiche, Università degli Studi di Catania, Catania, Italy
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18
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Camera L, Di Giacomo A, Lambiase C, Fratta L, Belfiore G, Salvatore M. Acute myocardial infarction in a patient with unstable angina. Acta Radiol 2002; 43:461-3. [PMID: 12423455 DOI: 10.1034/j.1600-0455.2002.430504.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 58-year-old-man with unstable angina developed a violent retrosternal and interscapular pain during coronary angiography with no associated ECG abnormalities. The patient was immediately submitted to transesophageal echocardiography, which revealed an echo-free space behind the ascending aorta thought to be consistent with an aortic dissection. To confirm this finding the patient underwent contrast-enhanced helical CT, which ruled out a dissection but revealed a small hypoattenuating, ill-defined area within the lateral wall of the left ventricle, consistent with an acute myocardial infarction. The finding was first confirmed by bedside echocardiography and later validated by laboratory tests. Review of the left coronary angiogram showed the culprit lesion at the origin of a major acute marginal branch of the circumflex artery.
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Affiliation(s)
- L Camera
- Department of Radiology, University Federico II and National Research Council(Institute of Bio-Images and Bio-Structures), Naples, Italy
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19
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D'Arienzo A, Scaglione G, Bennato R, Manguso F, Vicinanza G, Belfiore G, D'Armiento FP, Mazzacca G. The prognostic value, in active ulcerative colitis, of an increased intensity of colonic perivisceral fat signal on magnetic resonance imaging with ferumoxil. Am J Gastroenterol 2001; 96:481-6. [PMID: 11232694 DOI: 10.1111/j.1572-0241.2001.03531.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE In active ulcerative colitis (UC), magnetic resonance imaging (MRI) with ferumoxil, a superparamagnetic oral contrast agent, accurately evaluates, in our experience, the increased wall thickness and frequently shows a stronger perivisceral fat signal intensity (PFSI). The aim of our study was to evaluate the clinical significance of these MRI findings in active UC. METHODS Twenty-four consecutive patients affected by moderate pancolitis were enrolled. At entry, each patient underwent MRI with ferumoxil to evaluate wall thickness and PFSI. Two groups of patients were individuated: group A (increased PFSI) and group B (normal PFSI). After obtaining remission, the number of relapses and, at each flare-up, the clinical activity index (CAI) were evaluated in all patients in a 2-yr follow-up period. The mean CAI was calculated at the end of the follow-up in each patient. Where there was colectomy, a complete histological examination of the colon was performed. RESULTS PFSI was increased in 16 patients (group A) and was normal in the remainder (group B). There was a significant difference of wall thickness, number of relapses/yr, and mean CAI between the two groups of patients. No difference was observed with regard the duration of disease. Six patients of group A and no patient of group B underwent colectomy. The histological evaluation showed an increased thickness of the entire colonic wall with significant changes of the perivisceral fat structures. CONCLUSIONS An increased
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Affiliation(s)
- A D'Arienzo
- Department of Clinical and Experimental Medicine, Faculty of Medicine, Federico II University, Naples, Italy
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20
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Abstract
Primitive reflexes (PRs) are present in newborns; they disappear as the brain matures and increase in frequency in healthy elderly individuals. Primitive reflexes are more frequent in some neurological disorders than in age-matched controls. The aim of this study was to investigate the effect of diabetes on some PRs. We examined three PRs (glabellar tap, snout and palmomental reflexes) in 376 subjects: 111 normal age-matched controls, 60 patients with cerebrovascular disease (CVD) and 205 patients with type 2 diabetes mellitus. The latter patients were divided into three groups: (1) diabetics without neurological complications (D); (2) diabetics with cerebrovascular disease (D-CVD); and (3) diabetics with polyneuropathy (D-PN). The frequency of PRs was increased in CVD, unchanged in D-CVD (except palmomental) and greatly reduced in D and D-PN. It is possible that the vascular lesions in perforating arteries of the pons in diabetic subjects, previously studied in some pathological reports, can account for the reduced occurrence of primitive reflex responses.
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Affiliation(s)
- G Volpe
- Department of Neurological Sciences, University Federico II, Naples, Italy
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21
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D'Arienzo A, Scaglione G, Vicinanza G, Manguso F, Bennato R, Belfiore G, Imbriaco M, Mazzacca G. Magnetic resonance imaging with ferumoxil, a negative superparamagnetic oral contrast agent, in the evaluation of ulcerative colitis. Am J Gastroenterol 2000; 95:720-4. [PMID: 10710064 DOI: 10.1111/j.1572-0241.2000.01841.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The introduction of new oral contrast agents that enhance image quality has increased the importance of magnetic resonance imaging (MRI) in the management of ulcerative colitis. The aim of our study was to investigate the usefulness of a new negative superparamagnetic oral contrast (ferumoxil) alone or in association with gadolinium i.v. in the assessment of the disease. METHODS Twenty-eight patients with clinically active ulcerative colitis and 10 control subjects entered the study. In each patient a clinical, endoscopic, histological, and MRI evaluation was performed. In particular, in 14 patients affected by ulcerative colitis (group A) and in five controls, magnetic resonance images were acquired 1 h after the oral administration of 900 ml of ferumoxil, while the remaining 14 patients (group B) and five controls were submitted to double-contrast MRI (ferumoxil and gadolinium). In both groups, wall thickness, length of affected bowel segments, and, in group B, also percent contrast enhancement were calculated. RESULTS The comparison of endoscopic and MRI extent of disease was statistically significant. Wall thickness and, in group B, also percent contrast enhancement were significantly correlated with clinical and endoscopic activities. In each group wall thickness was significantly different in the activity phases of the disease. CONCLUSIONS MRI with negative superparamagnetic oral contrast is comparable to endoscopy in the assessment of ulcerative colitis. The double-contrast imaging does not provide more information than single oral contrast, so we concluded that the latter is preferable in the follow-up of the disease and in patients unable or with a poor compliance to undergo endoscopy.
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Affiliation(s)
- A D'Arienzo
- Department of Clinical and Experimental Medicine, Faculty of Medicine, Federico II University, Naples, Italy
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22
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Abstract
We report a preliminary pilot study on the clinical efficacy of flunarizine (FNZ), a calcium-entry blocker that causes extrapyramidal side-effects, in 10 patients with Huntington's disease (HD). FNZ (20 mg) administered by the sublingual route resulted in a decrease in choreic movements and improved dexterity in performing several tests. These effects lasted for at least 7 days after a single dose. Therefore, FNZ seems to exert the same effect as a long-acting neuroleptic agent in our HD patients.Copyright Lippincott-Raven Publishers
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Affiliation(s)
- G Belfiore
- Department of Neurology, Ospedale Civile Vito Fazzi, Lecce, Italy
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23
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Belfiore G, Lombardo P, Savarese F, Vosa C, Sodano A. [Hypoplastic left ventricular syndrome: report of a case studied with magnetic resonance in the preoperative period]. Radiol Med 1998; 95:245-7. [PMID: 9638175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- G Belfiore
- Dipartimento di Scienze Biomorfologiche e Funzionali, Università Federico II, Napoli
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24
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Affiliation(s)
- A Franzese
- Department of Pediatrics, University Federico II, Naples, Italy
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25
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Belfiore G, Vetrani A, Chef GM, Moggio G. [Role of fine needle biopsy guided with computerized tomography in peripheral lung nodules with a diameter lower than 2 centimeters]. Radiol Med 1997; 93:726-31. [PMID: 9411521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We investigated the role of CT in guiding fine-needle biopsy (FNB) in small (< 2 cm phi) lung lesions, reviewing 2109 CT-guided biopsies of peripheral lung nodules performed 1983 to 1993. "Peripheral" refers to non intrabronchial lesions, independent of the nodule position in the chest. Two hundred lesions < 2 cm phi were selected, 52 of them with complete clinical and surgical follow-up. This group was compared with 195 lung lesions > 2 cm phi for CT-guided FNB sensitivity, specificity and diagnostic accuracy. Cytologic specimens were positive for malignancy in 40/52 cases (76.9%) and negative in 12 (23.1%). Clinical-surgical follow-up confirmed all the positive cytologic findings (40 cases), while 2 of the extant 12 cases were false negatives (95.20% sensitivity, 100% specificity and 96.15% diagnostic accuracy). 158 of 195 nodules > 2 cm phi and with clinical-surgical follow-up (81.3%) were positive for malignancy and 34 were negative (17.43%) (98.75% sensitivity, 97.14% specificity and 98.46% diagnostic accuracy). Pneumothorax occurred in 33 patients (16.5%) with nodules < 2 cm phi as a complication of biopsy. Hemoptysis occurred in 15 patients (7.5%). In the whole group of lung lesions, the complications were pneumothorax in 80 patients (4.1%), hemoptysis in 199 (10.4%) and hypotensive vagal crises in 92 patients (4.8%). We conclude that CT is the best guidance for FNB also in small lung nodules, providing high sensitivity and specificity and low complication rates. Finally, the result of this procedure depends on the operator's skills.
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Affiliation(s)
- G Belfiore
- Istituto di Scienze Radiologiche, Centro CNR per la Medicina Nucleare, Università degli Studi, Federico II, Napoli
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Amato S, Gaeta G, Brancaccio V, Belfiore G. [Primary antiphospholipid antibody syndrome with left atrial intracardiac thombosis]. G Ital Cardiol 1997; 27:380-6. [PMID: 9244743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The present report describes a case of right atrial thrombus in an active 49-year-old man with a primary antiphospholipid syndrome. In 1984, the patient was admitted for autoimmune hemolytic anemia; during the hospitalization it was diagnosed a chronic hepatitis B. In July 1991, the patient had fever, mild jaundice, splenomegaly and pancytopenia; a diagnosis of hairy cell leukemia was made but it was not subsequently confirmed. Interferon therapy was started and the patient's clinical course mildly improved. However, over the same year, he experienced again a clinical deterioration. Lumbar ischemic ulcers occurred. The patient underwent elective splenectomy. Bone marrow biopsy revealed mielodisplastic syndrome. Necrotizing vasculitis with granulomatosis was diagnosed. The patient's condition improved after splenectomy. Repeated laboratory tests showed positivity for antiphospholipid antibodies. Transthoracic and transesophageal echocardiography demonstrated the presence of a right atrial thrombus, confirmed by nuclear magnetic resonance. The patient was started on long-term anticoagulant therapy, that resulted effective in reducing thrombus size.
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Affiliation(s)
- S Amato
- Divisione di Cardiologia, Azienda Ospedaliera A. Cardarelli, Napoli
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28
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Belfiore G, Camera L, Moggio G, Vetrani A, Fraioli G, Salvatore M. Middle mediastinum lesions: preliminary experience with CT-guided fine-needle aspiration biopsy with a suprasternal approach. Radiology 1997; 202:870-3. [PMID: 9051049 DOI: 10.1148/radiology.202.3.9051049] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The technical feasibility and safety of a suprasternal approach in the computed tomography (CT)-guided biopsy of lesions in the middle mediastinum was studied in 30 patients. Patients were positioned on their back with their head hyperextended. Biopsies were performed with local anesthesia and 22-gauge needles. Adequate biopsy material for diagnosis was obtained in 25 (83%) of 30 patients. A single biopsy specimen was sufficient in 14 patients, but as many as three biopsy specimens were necessary in 16 patients. Nineteen (63%) patients had various histotypes of lung cancer. In 24 (89%) of 27 adequate specimens, findings at fine-needle aspiration biopsy were consistent with findings at pathologic examination. No major complications were observed. CT-guided biopsy of middle mediastinum lesions was safe and successful with a suprasternal approach.
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Affiliation(s)
- G Belfiore
- Department of Radiology, University Federico II, Naples, Italy
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29
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Belfiore G, Savarese F, Moggio G, Discepolo A, de Rosa I, Errico ME, Salvatore M. [Peculiar features identified with computerized tomography and magnetic resonance of recurrent urothelioma of the kidney pelvis]. Radiol Med 1997; 93:142-4. [PMID: 9380855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- G Belfiore
- Istituto di Scienze Radiologiche, Università degli Studi Federico II, Medicina e Chirurgia, Napoli
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30
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Belfiore G, Cioffi A, Marano I, Della Noce M. [Report of a case of hydatid cyst of the thigh treated with hypertonic saline solution and reaspiration]. Radiol Med 1996; 92:792-3. [PMID: 9122475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- G Belfiore
- Istituto di Scienze Radiologiche, Università Federico II, Napoli
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31
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Tedeschi E, Camera L, Bartolomeo De Iuri A, Palescandolo P, Belfiore G, Cerillo A, Maiuri F, Sodano A. [Spinal cord compression in systemic hydatidosis: study of a case with magnetic resonance and computerized tomography]. Radiol Med 1996; 92:315-7. [PMID: 8975325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- E Tedeschi
- Istituto di Scienze Radiologiche, Università degli Studi Federico II, Napoli
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32
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Magro G, Giannone G, Carrubba G, Belfiore G, Grasso S. S-100 protein expression in a case of elastofibroma dorsi. Pathologica 1995; 87:528-30. [PMID: 8868181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Elastofibroma is a rare tumorlike process that manifests as slowly growing, solid mass in the subscapular region of elderly persons. Histologically, it is characterized by the presence of fibrous connective tissue in which eosinophilic fibers and globular masses, stained by the elastic tissue stains, are interspersed. We report the immunohistochemical study of the cellular component in a case of subscapular elastofibroma in a 41-year-old man. An unexpected immunoreactivity for S-100 protein was detected in most fibroblast-like cells. S-100 protein expression may be related to a chondroid metaplasia of fibroblast-like cells in response to the continuous traumatic process occuring during the friction between the scapula and the underlying chest wall.
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Affiliation(s)
- G Magro
- Istituto di Anatomia Patologica, Università di Catania
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33
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Marano I, Belfiore G, Cioffi A, Chef GM, Dore R. [The use of computed tomography guided needle biopsy in thoracic lesions in childhood]. Radiol Med 1995; 90:80-3. [PMID: 7569102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Percutaneous fine-needle aspiration biopsy (FNAB) is widely used in adult but not in pediatric patients, probably because young patients cooperate little. Twenty-six CT-guided FNABs were performed in children aged 40 days to 15 years (mean: 11.6 years) from January through December, 1993. The lesions were found in anterior mediastinum (17 cases), posterior mediastinum (5 cases) and lung (4 cases). Some specimens were fixed for cytology and some were cultured. Twenty-five of 26 biopsies (96.1%) provided adequate material for the cytologic assay, while in one case the result was poor because of much necrotic material. Cytologic findings were compared with postoperative biopsy results in 9 cases and confirmed by follow-up in 17 non-surgical lesions.
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Affiliation(s)
- I Marano
- Istituto di Scienze Radiologiche, Università Federico II, Napoli
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34
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Marano I, Della Noce M, Stagni V, Belfiore G, Sodano A, Belli G, Santangelo M. [Magnetic resonance in surgical planning in hepatocarcinomas]. Radiol Med 1995; 89:94-9. [PMID: 7716319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The diagnostic accuracy of Magnetic Resonance Imaging (MRI) in the preoperative staging of unifocal hepatocellular carcinoma (HCC) was investigated and compared with that of ultrasonography (US) and Computed Tomography (CT). Eighteen patients with focal HCCs underwent MRI, CT and US scans before surgery. In all cases the histopathologic diagnosis was made with CT-guided fine-needle aspiration biopsy (FNAB). The diagnostic accuracy of each imaging modality was investigated with the assessment of three parameters thought to be of the utmost importance for surgical planning, i.e., lesion unifocality, the presence of a capsule and finally vascular involvement. MRI proved to be more sensitive than CT in demonstrating both lesion unifocality (100% vs. 94.4%) and the presence of a capsule (100% vs. 71.4%). In 2 of 18 patients some blood vessels were involved, which was clearly demonstrated only by MRI, CT missing it. Both MRI and CT had 100% specificity in the detection of a perilesional capsule and of vascular involvement. To conclude, MRI exhibited higher diagnostic accuracy than US and CT, thus confirming its major role in the preoperative staging of unifocal HCCs.
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Affiliation(s)
- I Marano
- Istituto di Scienze Radiologiche, Università Federico II, Napoli
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35
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Belfiore G, Campanella G. A clinical sign of Parkinson's disease: the absence of lateral foot drop. Acta Neurol (Napoli) 1994; 16:291-2. [PMID: 7709801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
CT is the most accurate method for guiding fine needle biopsies in deep and/or small sized lung and mediastinic lesions. The authors have performed 2109 CT-guided lung biopsies (FNAB). The results are given in terms of sensitivity, specificity and rate of complications. In ever examination, Westcott or Chiba needles (22 or 21 gauge) were used. From 2109 lung examinations performed, 1413 (66.99%) were positive, 538 (25.5%) negative, 15 (0.7%) suspicious and 143 (6.78%) inadequate for diagnosis, 267 patients underwent surgical or clinical follow-up and, in all cases, the cytological diagnosis was confirmed. Other considerations were made on lesion topography, histological type, dimensions, complication rate, sensitivity, specificity and diagnostic accuracy. CT, of course, is the best method for guiding fine needle biopsy of the lung for its high spatial resolution and excellent anatomical definition, so that samples with smaller than 2 cm lesions, even in continuity with large vessels or other critical organs, are performed. Nevertheless, the result quality depends on the ability of the operator.
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Affiliation(s)
- G Belfiore
- Istituto di Scienze Radiologiche, II Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, Italy
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Filippone A, Basilico R, Guidotti A, Boni R, Belfiore G, Bonomo L. [Color Doppler ultrasonography in the identification and characterization of secondary focal lesions of the liver]. Radiol Med 1994; 87:283-8. [PMID: 8146366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This study was aimed at assessing the potentials of color Doppler US in the detection of hepatic metastases by measuring changes in hepatic perfusion. Color-Doppler US was performed on 40 patients with multiple metastatic lesions (mean theta: 3 cm). In each patient both smaller and bigger lesions were studied--80 lesions on the whole. Differences in flow distribution (peritumoral or intratumoral) and the highest systolic peak flow velocity were investigated on color Doppler US scans. Hepatic arterial and portal venous blood flow measured in 40 patients with hepatic metastases were compared with those in 40 healthy controls. The two groups were homogeneous relative to age, sex, height and weight. The ratio of hepatic arterial to total liver blood flow (Doppler perfusion index, DPI) and the ratio of hepatic arterial to portal venous blood flow (Doppler flow ratio, DFR) were calculated. Color flow US scans were obtained in 56 of 80 metastatic lesions. We observed peritumoral flow in 76% of the lesions, intratumoral flow in 6% and mixed peritumoral and intratumoral flow in 18% of cases. The DPI and DFR values were significantly higher in the patients with liver metastases than in the control group. The changes in DPI and DFR resulted from an increase in hepatic arterial flow; no changes in portal venous blood flow were observed. These results suggest that Doppler measurements of hemodynamic hepatic changes may be of great value for the earlier detection of hepatic metastases.
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Affiliation(s)
- A Filippone
- Istituto di Scienze Radiologiche e Formazione dell' Immagine, Università G. D'Annunzio, Chieti
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Marano I, Brunetti A, Covello M, Belfiore G, Giovine S, Salvatore M. [Magnetic resonance in the diagnosis and follow-up of soft-tissue sarcomas]. Radiol Med 1992; 84:15-21. [PMID: 1509133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The authors analyze the advantages of MR imaging in the detection, staging and follow-up of malignant soft-tissue sarcomas. The role of MR imaging is retrospectively evaluated in 34 patients (16 men and 18 women) ranging in age from 3 to 82 years (mean: 38); 19 of them had a primary neoplasm, while the extant 15 patients were examined after surgery, and residual or recurrent tumors were present. Ten examinations were performed on an 0.5 T imager (CGR Magniscan 5000), and 27 were obtained with a 1.5 T system (Magnetom 42 SP Siemens). In all cases T1 and T2 sequences were acquired; in 3 patients T1-weighted sequences were performed after Gd-DTPA administration. In the 19 patients with primary tumors pathologic specimens were obtained. The value of MR imaging in the evaluation and characterization of soft-tissue sarcomas and its capabilities in detecting neurovascular encasement and bone involvement are discussed. Post-Gd-DTPA scans may help in the differentiation of necrotic areas from active tumors. MR diagnostic criteria of malignancy, including tissue heterogeneity and irregular margins, were not fulfilled in 3 of the studied cases.
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Affiliation(s)
- I Marano
- Università degli Studi Federico II, II Facoltà di Medicina e Chirurgia, Napoli
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Brunetti A, Tedeschi E, Belfiore G, Salvatore M. [Neuroblastoma metastasis to the falx cerebri. A case report]. Radiol Med 1992; 83:467-70. [PMID: 1604008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- A Brunetti
- Istituto di Scienze Radiologiche, II Facoltà di Medicina e Chirurgia, Università Federico II, Napoli
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40
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Tamburrini O, Belfiore G, Marano I, Cirillo LC, Porta E. [Current role of MR in the morphological imaging of congenital heart diseases. Proposal of methodology of analysis]. Radiol Med 1990; 79:701-9. [PMID: 2382040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- O Tamburrini
- Istituto di Scienze Radiologiche (I Cattedra), II Facoltà di Medicina e Chirurgia, Università di Napoli
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41
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Lalla E, Rosa D, Grillo G, Belfiore G. [Instrumental diagnosis in shoulder instability]. Chir Organi Mov 1989; 74:109-13. [PMID: 2699730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The authors call attention to the pathology caused by glenohumeral instability and, in particular, to painful shoulders in athletes which so often cause problems in diagnosis. An instrumental protocol for diagnosis is suggested, based on several specific radiographic views, Ct scan and arthro-Ct scan, with double contrast medium, the latter having the task of determining lesion which would not otherwise be able to be studied.
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Porta E, Belfiore G, Marano I. [Use of magnetic resonance in the diagnosis of congenital and acquired cardiopathies. Preliminary note]. Radiol Med 1988; 75:425-32. [PMID: 3375487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The authors describe their personal experience using Magnetic Resonance Imaging (MRI) in the evaluation of cardio-vascular diseases. MRI made it possible to obtain multiplanar anatomical images of the cardio-vascular system without X-rays and conventional contrast medium. MRI supplied with indirect flow evaluation, too. MRI was particularly useful in the assessment of congenital heart diseases, since it shows the heart chambers and the great vessels at the same time and in the different phases of cardiac revolution. MRI was also useful in the evaluation of many acquired heart diseases, such as myocardium diseases, valve diseases, myocardial ischemias, pericardium diseases. Moreover, MRI correctly showed aortic aneurysms. In all the 55 patients examined, it was possible to obtain a good definition of the cardiac structures, especially when "cardiac gating" was employed. In the 3 ventricular and in the 5 atrial defects, the dimensions of the defect and the dilatation of the involved cardiac chambers were precisely assessed. In the 6 aortic coarctations, MRI evaluated the level and the grade of the stenosis, with consequent definition of the anatomic type. Moreover, collateral circulation and dilatation before and/or after the stenosis were evident. In all the 7 complex cardiopathies examined (3 Fallot tetralogies, 1 Fallot pentalogy, 1 aortic cervical arch, and 2 Ebstein diseases) MRI demonstrated each single anomaly of the malformations, at both cardiac and vascular levels. In 2 patients with atrial fibrillation, MRI visualized endoatrial thrombi. In the 7 patients with previous myocardial infarction, the site of ischemia was depicted as a thinning of the wall, while the remaining myocardium appeared hypertrophic. MRI correctly demonstrated all thoracic aorta aneurysms, even in a case where both CT and angiography were negative, due to the aneurysm being thrombosed. Mural thrombi were evident with both MRI and CT, but not always visible with angiography. In the 5 dissected aneurysms, MRI--like CT--assessed the origin of the dissection, and the dimensions of the true and false lumen; moreover, it indirectly evaluated the slow and turbulent blood flow within the true lumen, and the presence of thrombi in the false lumen.
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Affiliation(s)
- E Porta
- II Facoltà di Medicina e Chirurgia, Istituto di Scienze Radiologiche, Università degli Studi, Napoli
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Muto R, Muto M, Cirillo LC, Bozzi V, Fondacaro R, Muto M, Belfiore G, Muto P, Porta E. A bilateral mixed laryngocele: CT findings. Rays 1986; 11:69-71. [PMID: 3602453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Belfiore G, Marano I, Mazzacca A, Tamburro F, Manganiello C. [Role of computerized tomography in thoraco-pulmonary needle aspiration]. Arch Monaldi 1985; 40:247-54. [PMID: 3843174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Jannelli G, Golino A, Di Lello F, Belfiore G, Chello M, De Amicis V, Iaccarino V. [Isolated traumatic rupture of the ascending aorta. Clinical case and review of the literature]. G Ital Cardiol 1985; 15:649-51. [PMID: 4065485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Rupture of the descending aorta after severe blunt chest trauma is a well recognised injury. Instead, isolated traumatic rupture of the ascending aorta is rarely diagnosed, with only five cases reported in the literature. A case of isolated traumatic rupture of the ascending aorta is here reported and the role of medical treatment is described.
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Giampaglia F, Formicola V, Belfiore G, Vetrano A, Bellezza E, Russo S, Elia S. [Role of percutaneous thin-needle biopsy in the diagnosis of neoplasms of the lung]. Arch Monaldi 1985; 40:35-40. [PMID: 3836612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Iaccarino V, Sodano A, Belfiore G, Matacena G, Porta E. [Angioplasty of renal arteries in the treatment of renovascular hypertension. Our experience in 63 cases]. Radiol Med 1984; 70:983-6. [PMID: 6242512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Percutaneous transluminal angioplasty for treatment of renovascular hypertension was performed on 63 patients during a 5 years period. No compliance related to this procedure set in. At follow-up, the clinical results were shown to be positive in 85.7% of the cases.
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Peretti G, Belfiore G, Nuzzo A, Morera E, Basilico L. [Palliative radiotherapy of bone metastases. Comparison between 2 fractionations]. Radiol Med 1984; 70:393-5. [PMID: 6085411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
One hundred and twenty two symptomatic osseous metastases in 74 patients were treated with palliative irradiation, using two dose/time treatment plans. Pain relief was obtained in 92% of valuable cases (complete response in 68% and improvement in 24%). The complete responses were obtained in 4 weeks in 64% of responsive patients. The median duration of response was 166 days. In advanced cancer patients the short course radiotherapy achieved the same quality and duration of pain relief as conventional treatment.
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Ferulano GP, Vanni L, Abate S, Fresini A, Iaccarino V, Dilillo S, Danzi M, Belfiore G. [Biliary endoprosthesis in inoperable neoplasms of the extra-hepatic bile ducts]. MINERVA CHIR 1983; 38:1755-8. [PMID: 6669278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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50
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Iaccarino V, Sodano A, Tamburrini O, Belfiore G, Matacena G, Porta E. [Clinico-radiologic evaluation of glomus tumors for permanent embolization]. Radiol Med 1983; 69:859-62. [PMID: 6677958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The utility of the preoperative embolization of glomus tumors observed in 7 cases is reported. Two patient have been embolized with non reabsorbable materials and haven't been operated. The possibility of a definitive embolizing therapy as alternative to a surgical treatment is therefore supposed.
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