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Biomedical subjects

A Giovannini

Publications and source records attributed to A Giovannini.

At least 37 records · Page 2Linked to original sources
PubMed1999

Optical coherence tomography (OCT) in idiopathic polypoidal choroidal vasculopathy (IPCV).

PURPOSE: Idiopathic polypoidal choroidal vasculopathy (IPCV) is a distinct clinical entity characterized by an edematous maculopathy and typical choroidal vascular change. The purpose of this study is to evaluate the use of optical coherence tomography (OCT) for diagnosing of this disease. METHODS: 4 patients affected by IPVC (mean age 71-84 years) underwent biomicroscopy with a three mirror conctact lens, fluorescein angiography (FA), indocyanine green angiography (ICGA) and OCT (Humphrey Zeiss) scan. RESULTS: in all 4 cases OCT tomograms acquired at the location of the typical choroidal abnormalities demonstrated by ICGA, revealed a characteristic hyper-reflectivity in the choroidal layers. CONCLUSION: ICGA is essential to diagnose IPVC, but OCT may be able to identify characteristic reflectivity patterns.

Aged↗
PubMed1999

Diabetic maculopathy induced by vitreo-macular traction: evaluation by optical coherence tomography (OCT).

AIM: To evaluate the role and efficacy of optical coherence tomography (OCT) in the evaluation of diabetic maculopathy induced by vitreo-retinal traction. METHODS: 12 patients affected by diabetic maculopathy induced by vitreo-retinal traction were examined using biomicroscopy with a three-mirror contact lens, fluorescein angiography (FA) and OCT scanning in order to identify the presence of a vitreomacular traction. RESULTS: OCT revealed two patterns of maculopathy which were characterised by a thickening of the superior profile of the OCT tomogram or by the disappearance and inversion of the physiologic foveal depression respectively. CONCLUSIONS: OCT may be useful in the characterisation and monitoring of diabetic maculopathy induced by vitreo-retinal traction.

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PubMed1999

Indocyanine green angiography of retinal pigment epithelial tears.

PURPOSE: To investigate the fluorescein and indocyanine green (ICG) features before and after retinal pigment epithelial tear. METHODS: Fluorescein and ICG videoangiography were performed in 30 patients affected by age-related macular degeneration either complicated by tear of the retinal pigment epithelium (25 eyes) or by pigment epithelial detachment with pretear characteristics (5 eyes). RESULTS: At the pretear stage fluorescein angiography (FA) showed in all cases signs of occult CNV associated with delayed, slow and uneven filling of the pigment epithelium detachment. In 2 eyes the ICG filling of the retinal pigment epithelial detachment was seen. Progression to the tear stage was seen in 4 eyes where a CNV was evident on ICG angiography; in two eyes within one month after laser photocoagulation. At the tear stage FA showed an area of marked hyperfluorescence with well defined margins. Adjacent to the exposed area the torn RPE was markedly hypofluorescent during all angiographic phases. The bare choroid was always hypo or normofluorescent on ICG angiography. The torn retinal pigment epithelium showed moderate hypofluorescence. The exact seat and extension of CNVs could be visualized in 20 cases (67%; 95% C.I., 50-84%) with ICG angiography vs. 6 cases (20%; 95% C.I., 6-34%) with FA (p<0.001). CONCLUSIONS: ICG angiography did not add anything substantial to the analysis of frank tears. The most useful application of ICG angiography in this disease is the visualization of the seat and extension of the associated CNV In fact, it is well known that laser treatment of a pigment epithelial detachment at the pretear stage may facilitate the development of a tear of the RPE.

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PubMed1999

OCT imaging of choroidal neovascularisation and its role in the determination of patients' eligibility for surgery.

AIM: To evaluate the optical coherence tomographic characteristics of choroidal neovascularisation (CNV) in age related macular degeneration (AMD) and in idiopathic and inflammatory CNV. The use of this technique in the selection of patients for surgery is discussed. METHODS: Ocular coherence tomography (OCT), fluorescein, and indocyanine green angiography were performed in 23 patients affected by AMD complicated by well defined CNV and in 10 patients affected by inflammatory or idiopathic CNV. The neovascular membrane was surgically removed in five age related CNVs, two inflammatory choroidopathies, and two idiopathic CNVs. RESULTS: In inflammatory and idiopathic CNV, the OCT displayed a neovascularisation on the retinal pigment epithelium (RPE). In three cases the CNV was excised with an improvement of visual acuity equal to or greater than two Snellen lines; in a fourth case, the visual acuity after surgery was unchanged. In the cases of AMD the OCT fell into three different patterns: (A) CNV above the RPE (five cases); (B) focal, irregular thickening of the retinal pigment epithelial band (12 cases); (C) CNV above and below the RPE (six cases). The five pattern A CNV patients underwent the surgical excision of the neovascularisation. In four cases the visual acuity improved by two or more Snellen lines; in the fifth case the visual acuity remained unchanged. CONCLUSIONS: The authors suggest that the surgical removal of early age related CNV could be performed in those cases where the OCT shows a neovascular membrane on the RPE, as in idiopathic and inflammatory CNVs.

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PubMed1999

Usefulness of fluorescein angiography in predicting the size of the atrophic area after surgical excision of choroidal neovascularization.

Twenty consecutive patients affected by age-related macular degeneration (AMD) complicated by subfoveal and juxtafoveal choroidal neovascularization (CNV) underwent a surgical removal of the membrane. The patients were divided into two groups: group A = CNVs </=2 months; group B = CNVs >2 months. The surgical excision of the CNV was also performed in 10 cases of multifocal choroidopathies and idiopathic CNV. The atrophic area after surgery was larger in AMD than in multifocal choroidopathies or idiopathic CNV (p < 0.001). In AMD the atrophic area after surgical excision of the CNV was larger in group B than in group A (p < 0.05). The area of the CNV + the hyperfluorescent halo observed in the late phase of fluorescein angiography before surgery was 84.6% of the atrophic area after surgery. Our observations could be helpful to the surgeon for a more accurate evaluation of the expected size of the atrophic area after surgical removal of a CNV, thus allowing a better selection of the patients for whom surgery could be of some benefit.

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PubMed1999

Quality assurance of veterinary services at the international level: a proposed approach.

A proposal for the harmonization of quality assurance of Veterinary Services at the international level is made. This proposal is based on the hypothesis of accreditation of Veterinary Services according to the 9000 series of the International Standards Organisation (ISO) standards. An example of a way in which ISO 9000 standards can be used within the context of management of Veterinary Services is given, together with an explanation of the possible role of the Office International des Epizooties in ensuring fairness of evaluations of Veterinary Services at the international level.

Animals↗
PubMed1999

Import risk analysis: the experience of Italy.

The authors propose a contribution to the possible revision of Chapters 1.4.1. and 1.4.2. of the International Animal Health Code (Code) of the Office International des Epizooties (OIE). In particular, data are presented to illustrate some of the inadequacies of both the rationale and the results of the method for risk assessment reported in the Code. The method suggested by the Code for risk assessment is based on the calculation of the 'probability of the occurrence of at least one outbreak' of a given disease following the importation of a given quantity of either live animals or animal products (unrestricted risk estimate). This is usually undertaken when dealing with rare events. For a country such as Italy, this method may not be particularly useful as the frequency of disease outbreaks is what should be estimated, so as to provide decision makers with appropriate and relevant information. Practical use of risk information generated by the use of the OIE risk assessment method for swine vesicular disease (SVD) would have encouraged the Chief Veterinary Officer of Italy to prohibit all imports of swine from the Netherlands and Belgium for at least two years in the early 1990s, with the consequential heavy economic losses for both Italy and the exporting countries. On the contrary, the number of actual outbreaks of the disease due to direct imports of swine from Member States of the European Union (EU), which occurred in Italy in 1992, 1993 and 1994 was very low (two to five outbreaks due to direct imports of swine from the Netherlands and one to two from Belgium). An example of a method for assessing the risks associated with high volumes of trade in commodities is also described. This method is based on the Monte Carlo simulation and provides the information required to evaluate the costs of the strategies compared. The method can be used to predict the number of outbreaks which are likely to occur following importation and enables a comparison to be made of alternative safeguards. This would lead to the selection of the most cost-effective one. The comparison is conducted using risk curves and allows a quantitative evaluation and comparison to be made of various scenarios, varying from an absence of safeguards to combinations of various safeguards.

Animals↗
PubMed1998

Sensitivity and specificity of serological and bacteriological tests for contagious bovine pleuropneumonia.

In 1990 an outbreak of contagious bovine pleuropneumonia (CBPP) occurred in Italy. Subsequent surveillance for CBPP was based on random sampling in bovine herds, serological controls on all animals moved from the herd of origin and controls on slaughtered animals. Official tests employed were the complement fixation test (CFT) and bacteriological isolation and typing. A total of 33,856 serum samples collected from herds in CBPP-free regions were used to define CFT specificity, while samples from 595 animals from infected herds were employed to define the sensitivity. Ninety-nine animals from three infected herds were used to estimate the sensitivity of the isolation technique. Results showed the specificity of CFT (threshold +1:10) to be 98% and sensitivity to be 63.79%. The sensitivity of the test did not change significantly, regardless of whether the lesions were caused by acute or chronic infection. The sensitivity of the isolation technique was 54.1%.

Animals↗
PubMed1997

Indocyanine green angiography of multifocal choroiditis.

PURPOSE: The purpose of the study is to determine indocyanine green (ICG) angiographic characteristics of patients with multifocal choroiditis (MC) and to identify features that may assist in the differentiation of MC from other ocular inflammatory diseases. METHODS: After complete ophthalmologic examination, fluorescein angiography and ICG angiography were performed in a series of 14 patients with MC. The ICG findings were then correlated with the clinical and fluorescein angiographic appearance of these patients to determine specific characteristics and distinguishing features of the entity. These findings then were compared with those of angiographic patterns observed in patients with ocular histoplasmosis syndrome to determine whether differentiating features could be identified. RESULTS: Fourteen (50%) of the 28 eyes were found to have large hypofluorescent spots in the posterior pole on ICG angiography, which, in most cases, did not correspond to clinically or fluorescein angiographically detectable lesions. Seventeen (61%) had smaller hypofluorescent lesions (approximately 50 pm in size) in the posterior pole on the ICG study. In seven eyes exhibiting enlarged blind spots on visual field testing, ICG angiography showed confluent hypofluorescence surrounding the optic nerve. The ICG angiogram was found useful in evaluating the natural course in two patients with MC as well as a response to oral prednisone therapy in four others. The ICG angiographic findings differed from those seen in patients with ocular histoplasmosis. CONCLUSIONS: Indocyanine green angiography can provide information that is not detectable by clinical or fluorescein angiographic examination in patients with MC. This information may prove useful in differentiating this condition from the ocular histoplasmosis syndrome, provide a better understanding of the natural course and progression of the disease, and provide a potential adjunct in the clinical evaluation of patients undergoing therapeutic regimens for active inflammatory lesions.

Adolescent↗
PubMed1997

Choroidal findings in the course of idiopathic serous pigment epithelium detachment detected by indocyanine green videoangiography.

PURPOSE: To analyze the choroidal alterations associated with idiopathic serous pigment epithelium detachment. METHODS: Twenty-five consecutive patients affected by idiopathic serous pigment epithelium detachment underwent ophthalmoscopy, fluorescein angiography, and indocyanine green videoangiography. RESULTS: On indocyanine green videoangiography an early, complete, and homogeneous filling of the pigment epithelium detachment was always observed. In the late phases, the indocyanine green pattern depended on the size of the detachment. An idiopathic serous pigment epithelium detachment larger than the diameter of one optic disk was still hyperfluorescent in the late phases of indocyanine green videoangiography and was surrounded by a ring of brighter hyperfluorescence. An idiopathic serous pigment epithelium detachment smaller than the diameter of one optic disk usually could be visualized in the late phases as a hypofluorescent area surrounded by a hyperfluorescent ring. In 30 eyes (83.3%), choroidal hyperpermeability was observed. An irregular dilatation of the choroidal veins at the site or within an area the size of one disk diameter from the detachments could be visualized on indocyanine green videoangiography in 12 of 36 affected eyes (33.3%); in three cases an active focus of central serous chorioretinopathy with subretinal leakage developed in the follow-up period. CONCLUSION: The observation that pigment epithelium detachments frequently are associated with choroidal leakage and venous dilatation supports the hypothesis that an idiopathic serous pigment epithelium detachment is a variant of central serous chorioretinopathy. Moreover, the choroidal permeability alterations detected by indocyanine green videoangiography would support the theory of Gass that idiopathic serous pigment epithelium detachments could be caused by exudation of fluids from the choroidal vessels.

Adult↗
PubMed1997

Indocyanine green angiographic findings in multifocal choroidopathies.

With high definition videoangiography (TOPCON IMAGEnet H1024) the Authors studied 41 patients affected by multifocal choroidopathies (MC) (68 eyes with ophthalmoscopic or indocyanine green angiographic evidences): 29 females and 12 males; age 21-51 years with a follow up of 6-29 months. In the light of the evidence provided by FA and ICG the Authors present a classification of MC in three stages: Stage 1 of subclinical choroidal activity (5 eyes) characterised by the presence of hypofluorescent or hyperfluorescent spots visible only in the late phases of ICGA; stage 2 of clinically evident choroidal activity (45 eyes) in FA the spots are hypofluorescent in the early phases and hyperfluorescent with a slight diffusion in the late phases, in ICGA either hypofluorescent spots or less frequently hyperfluorescent spots and choroidal permeability alterations can be observed; stage 3 or healed stage (18 eyes) in FA the spots are hyperfluorescent without late leakage, in ICGA hypofluorescence can be observed during all angiographic phases. In 5 patients in stage 1 of subclinical activity, a systemic steroid therapy induced a regression of the hypofluorescent spots in ICGA, in 2 cases the regression of hyperfluorescent spots in ICGA was observed after systemic antibiotic therapy. The authors underline that ICGA could be a particularly useful tool for an early diagnosis and clinical monitoring of MC.

Adult↗
PubMed1996

Mortality from primary malignant brain tumors in the Province of Bologna, Italy, 1986-1988.

INTRODUCTION: We performed a study of mortality from primary malignant brain tumors (PMBT) in the province of Bologna, Italy, during the years 1986 to 1988. MATERIALS AND METHODS: The study was based on death certificates from the Cancer Registry of the province of Bologna. We verified death certificates for both false-positive and false-negative cases. RESULTS: The crude mortality rate was 6.7/100,000 population per year. The age and sex-adjusted mortality rate, standardized to the Italian population (Italy 81), was 5.34/100,000 (95% CI = 3.9 to 6.7). CONCLUSION: Our figures are higher than those previously reported in Italy, but are similar to values of incidence and mortality found in northern Europe and in North America.

Adult↗
PubMed1996

Indocyanine green angiographic findings in serpiginous choroidopathy.

AIMS: Analysis of the choroidal findings in patients affected by serpiginous choroidopathy (SC). METHODS: Thirteen patients (23 eyes; 11 males and two females; age range 50-68 years; mean age 59.1 years) affected by SC were examined with fluorescein angiography (FA) and indocyanine green angiography (ICGA). The follow up period was 7-33 months. RESULTS: Using ICGA the disease could be divided into the following stages: (1) subclinical or choroidal stage (hypofluorescent lesions without FA evidence); (2) active stage (with ICGA and FA evidence); (3) subhealing stage (slight late hyperfluorescent lesions with ICGA, with no evidence on FA); (4) inactive or healed stage (hypofluorescent areas with ICGA and hyperfluorescent areas with FA). CONCLUSIONS: Although FA showed a clear distinction between active and healed stages, ICGA allowed a greater subdivision of the disease. In particular, ICGA allowed: (1) better staging of SC, revealing choroidal alterations when there was no ophthalmoscopic or FA evidence; (2) better identification of the active lesions which appear to be larger at the choroidal level in comparison with the corresponding retinal lesions; and (3) revealed a persistence of choroidal activity even when the signs of retinal activity had disappeared. Thus, ICGA should be a particularly useful clinical and therapeutic monitoring tool of SC.

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PubMed1996

Manifestation and epidemiology of contagious bovine pleuropneumonia in Europe.

The authors describe the clinical profile and epidemiology of contagious bovine pleuropneumonia in Europe. This disease, once considered to have been eradicated several years ago, has now become endemic in southern countries of Europe. The status of contagious bovine pleuropneumonia in Portugal and Italy, and the evolution of the disease during the last ten years, are analysed in detail, in addition to the measures undertaken for control and eradication. The authors also refer to hosts and possible reservoirs of the infection.

Animals↗
PubMed1996

Indocyanine green angiographic findings in multifocal choroidopathies.

With high definition videoangiography (TOPCON IMAGEnet H1024) the Authors studied 41 patients affected by multifocal choroidopathies (MC) (68 eyes with ophthalmoscopic or indocyanine green angiographic evidences): 29 females and 12 males; age 21-51 years with a follow up of 6-29 months. In the light of the evidence provided by FA and ICG the Authors present a classification of MC in three stages: Stage 1 of subclinical choroidal activity (5 eyes): characterised by the presence of hypofluorescent or hyperfluorescent spots visible only in the late phases of ICGA; stage 2 of clinically evident choroidal activity (45 eyes): in FA the spots are hypofluorescent in the early phases and hyperfluorescent with a slight diffusion in the late phases, in ICGA either hypofluorescent spots or less frequently hyperfluorescent spots and choroidal permeability alterations can be observed; stage 3 or healed stage (18 eyes): in FA the spots are hyperfluorescent without late leakage, in ICGA hypofluorescence can be observed during all angiographic phases. In 5 patients in stage 1 of subclinical activity, a systemic steroid therapy induced the regression of the hypofluorescent sports in ICGA, in 2 cases the regression of hyperfluorescent spots in ICGA was observed after systemic antibiotic therapy. The authors underline that ICGA could be a particularly useful tool for an early diagnosis and clinical monitoring of MC.

Adult↗
PubMed1994

Choroidal filling in age-related macular degeneration: indocyanine green angiographic findings.

We studied the choroidal filling patterns in 145 patients with age-related macular degeneration (AMD), looking for a correlation with choroidal neovascularization (CNV). We found a correspondence in 71% of cases between the site of the CNV and watershed areas and in 59% of cases between the CNV and areas of 'delayed choroidal filling'. These data support the hypothesis of a relationship between areas of presumed choroidal ischemia and evolution of AMD complicated with CNV.

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