Biomedical subjects

A Vanzulli

Publications and source records attributed to A Vanzulli.

At least 37 records · Page 2Linked to original sources

PubMed1997

Renal artery stenosis: evaluation with breath-hold, three-dimensional, dynamic, gadolinium-enhanced versus three-dimensional, phase-contrast MR angiography.

PURPOSE: To compare breath-hold, three-dimensional, gadolinium-enhanced magnetic resonance (MR) angiography with three-dimensional, phase-contrast MR angiography in the evaluation of renal artery stenosis. MATERIALS AND METHODS: Fifty-five consecutive adult patients with clinical suspicion of renovascular disease were prospectively examined with three-dimensional, phase-contrast MR angiography and breath-hold, three-dimensional MR angiography with injection of a standard dose of gadopentetate dimeglumine to evaluate the number of renal arteries and the presence and degree of stenosis. The standard of reference was intraarterial digital subtraction angiography. RESULTS: Gadolinium-enhanced MR angiography depicted all 105 main renal arteries, whereas phase-contrast MR angiography depicted 104. The number of accessory renal arteries depicted was significantly higher with gadolinium-enhanced (17 of 18) than with phase-contrast (11 of 18) studies (P = .04). Both techniques depicted 27 of the 29 stenoses (sensitivity, 93%; P > .05). Sensitivities, specificities, and accuracies in the diagnosis of hemodynamically significant stenosis (> 50% narrowing) were, respectively, 94%, 96%, and 96% for phase-contrast and 100%, 97%, and 98% for gadolinium-enhanced MR angiography (P > .05). CONCLUSION: Gadolinium-enhanced MR angiography is superior to phase-contrast MR angiography in accessory renal artery depiction. No statistically significant difference in the assessment of stenosis has been found between the two techniques.

Aged↗

PubMed1997

Color Doppler imaging in the assessment of vascular involvement by pancreatic carcinoma.

OBJECTIVE: The aim of our study was to assess the accuracy of color Doppler imaging in diagnosing the involvement of peripancreatic vessels by pancreatic carcinoma. SUBJECTS AND METHODS: We prospectively evaluated the color Doppler images of 61 patients with pancreatic carcinoma. Our evaluations occurred before surgery and focused on vascular involvement. Absence of contact or a short contiguity (< or = 2 cm) between tumors and peripancreatic vessels was considered to be a sign of resectability on color Doppler imaging; a long contiguity (> 2 cm), compression, encasement, or thrombosis was considered to be a sign of unresectability. In all patients, the sonographic diagnosis was compared with the surgical results. RESULTS: With color Doppler imaging, we detected signs of vascular involvement in 26 of 33 patients in whom vascular involvement was found at surgery. We detected no vascular involvement in 25 of 28 patients in whom no vascular involvement was found at surgery. No false-positive diagnoses occurred when vascular encasement was revealed by color Doppler imaging. For diagnosis of vascular involvement, the sensitivity, specificity, and overall accuracy of color Doppler imaging were 79%, 89%, and 84%, respectively; positive and negative predictive values were 89% and 79%, respectively. CONCLUSION: Color Doppler imaging is a sensitive and highly specific technique in assessing vascular involvement by pancreatic cancer when absence of contact or vascular encasement is seen. When vascular encasement is detected by color Doppler imaging, a definitive diagnosis of unresectability can be made, and further diagnostic procedures can be avoided. When sonography is used in the initial evaluation of pancreatic cancer, color Doppler imaging can improve the selection of patients for further diagnostic examinations or surgical exploration.

Aged↗

PubMed1996

Renal artery stenosis: value of screening with three-dimensional phase-contrast MR angiography with a phased-array multicoil.

PURPOSE: To evaluate screening with three-dimensional (3D) phase-contrast magnetic resonance (MR) angiography with a phased-array multicoil to detect renal artery stenosis. MATERIALS AND METHODS: Fifty consecutive patients suspected of having renovascular disease were prospectively examined with 3D phase-contrast MR imaging with a phased-array multicoil. Findings were correlated with those at intra-arterial digital subtraction angiography (DSA) as the standard of reference for grade of stenosis. RESULTS: MR angiography depicted 101 of 103 renal arteries depicted at intraarterial DSA; the two missed arteries were an accessory artery outside the imaging volume and an artery with a stent. At intraarterial DSA, a stenosis was found in 31 of 101 arteries. On the basis of findings at 3D phase-contrast MR angiography, the presence of any degree of stenosis was correctly depicted in 29 of 31 cases and the absence of stenosis was correctly depicted in 66 of 70 cases (accuracy, 94%; sensitivity, 94%; negative predictive value, 97%). Overall accuracy was 97% for correct depiction of severe renal artery stenosis (> 50%). CONCLUSION: 3D phase-contrast MR angiography with a phased-array multicoil was an accurate noninvasive screening technique in patients with suspected renal artery stenosis.

Adolescent↗

PubMed1996

Dynamic gadolinium-enhanced magnetic resonance imaging in staging of superficial bladder cancer.

PURPOSE: We evaluated the usefulness of dynamic enhanced magnetic resonance imaging (MRI) in the staging of superficial tumors following a bolus administration of gadopentetate dimeglumine. MATERIALS AND METHODS: In 48 patients with proved bladder tummors the results of preoperative plain spin echo T1 (repetition time/echo time 500/20 msec.) and T2 (repetition time/echo time 2,000/40 to 100 msec.)-weighted MRI, dynamic gadolinium-enhanced MRI (repetition time/echo time 200/15 msec.) and late gadolinium-enhanced MRI (repetition time/echo time 500/20 msec.) were compared and correlated with the histopathological findings. RESULTS: Unenhanced spin echo T1 and T2-weighted MRI sequences were able to stage correctly 14 (56%) and 17 (68%) of 25 superficial bladder cancers, respectively. Muscular infiltration (stages pT2 and pT3a) was correctly depicted in 3 (27%) and 6 (54%) of 11 cases respectively, with over staging being the most frequent error. On the basis of the dynamic gadolinium-enhanced T1-weighted MRI appearance, superficial involvement of the bladder wall was correctly assessed in 21 of 25 cases (84%) and muscular infiltration (stages pT2 to pT3a) in 7 of 11 (63%). Delayed enhanced T1-weighted sequences showed a low accuracy rate in staging superficial tumors (44%). The overall accuracy of T1 and T2-weighted, dynamic T1-weighted and delayed T1-weighted MRI in staging bladder cancer was 58, 71, 81 and 56% respectively. CONCLUSIONS: The use of gadolinium improved the accuracy of dynamic enhanced MRI in staging superficial bladder cancer. On the contrary, delayed enhanced MRI was not useful for staging superficial bladder cancer. The degree of bladder distension was a determinant factor in staging superficial tumors.

Adult↗

PubMed1995

Mural thrombi in abdominal aortic aneurysms: MR imaging characterization--useful before endovascular treatment?

PURPOSE: To evaluate magnetic resonance (MR) imaging accuracy in the characterization of mural thrombi in abdominal aortic aneurysms (AAAs). MATERIALS AND METHODS: Forty-five patients (37 men, eight women; mean age, 68 years) with an AAA with mural thrombus thicker than 1 cm at sonography underwent T1- and T2-weighted spin-echo MR imaging. The thrombi were prospectively classified as one of three signal intensity (SI) categories: category 1 corresponds to low SI on both T1- and T2-weighted images; category 2, high SI on T1-and T2-weighted images; and category 3, inhomogeneous SI with hyperintense areas on both T1- and T2-weighted images. During surgery, thrombi were classified as organized, unorganized, and partially organized. MR imaging and surgical findings were compared. RESULTS: SI category 1 corresponded to organized thrombi in 24 of 24 patients. Category 2 corresponded to unorganized thrombi in 11 of 11 patients. In category 3, focal hyperintense areas corresponded (both for presence and location) to unorganized portions of partially organized thrombi in 10 of 10 patients. CONCLUSION: MR imaging is accurate in AAA thrombus characterization.

Aged↗

PubMed1995

Imaging of renal cell carcinoma with gadolinium-enhanced magnetic resonance: radiological and pathological study.

The use of gadolinium-DTPA enhanced MR imaging (Gd-MR) in detecting and staging of large and small renal neoplasm was investigated in 61 patients with 66 renal cell carcinoma confirmed at surgery. The purpose of the study was also to evaluate the signal intensity of the lesions and to correlate the contrast-enhanced pattern to the pathological components and architecture of the surgical specimens. Forty-four tumors were larger than 3 cm and 22 lesions were smaller than 3 cm. Unenhanced MRI detected all large lesions (44/44) and 63% (14/22) of small lesions, while Gd-MRI detected all large and small neoplasms (100%). The overall staging accuracy was 79 and 87% for plain MRI and Gd-MRI, respectively, but both modalities led to an overstaging of the disease. Enhanced MRI was an excellent staging modality for the evaluation of tumor vascular extension and tumor spread to adjacent structures. The most frequent Gd-MRI pattern of small RCC was hyperintensity, while large lesions were mostly hypointense. The presence of fibrohyaline components seemed responsible for the hyperintense pattern. No specific contrast-enhanced MRI pattern was observed according to the tumor architecture (alveolar, tubular or papillar) of noncystic lesions. On the contrary, cystic lesion appeared as an area of low signal intensity and the use of contrast media improved detection and characterization. The inhomogeneous signal intensity increased the detectability of the lesion.

Adult↗

PubMed1995

[The use of high resolution computerized tomography (HRCT) for the diagnosis of rejection and for monitoring air-way anastomosis in patients who have undergone lung transplantation. Preliminary study].

March, 1991, to June, 1992, five lung transplantations for end-stage lung disease were successfully performed at the Ospedale Maggiore Policlinico in Milan. All patients underwent high-resolution CT (HRCT) of the lung in a complex follow-up program to identify specific abnormalities of acute and chronic rejection (bronchiolitis obliterans) and to monitor the resolution of the bronchial anastomosis. Twenty-two HRCT exams were performed. In patients with acute rejection HRCT failed to identify specific abnormalities of lung parenchyma. In contrast, in one patient with pathological evidence of early bronchiolitis obliterans HRCT showed decreased peripheral vascularization. In the study of the bronchial anastomosis, HRCT showed optimal anastomosis resolution in 4 patients, whereas in one patient with a granuloma demonstrated by fibrobronchoscopy it confirmed the lesion showing also a small pneumomediastinum. Even though the HRCT finding of decreased peripheral vascularization does not appear to be specific for bronchiolitis obliterans, it may be of value in suggesting the diagnosis of early bronchiolitis obliterans in lung transplant. HRCT should be used in all patients with bronchoscopic diagnosis of bronchial complication to study the lesion and its mediastinal spread.

Adult↗

PubMed1995

[Use of CT-guided metal wires in pre-thoracoscopic localization of peripheral pulmonary nodules].

The recent developments in thoracic surgery have broadened the application spectrum of thoracoscopy. Video-assisted thoracoscopic lung resection is now available both to diagnose and to treat peripheral pulmonary nodules. A major factor limiting the success of thoracoscopic lung resection is the difficult localization of the pulmonary nodule. When lesions are very small and deep inside the lung, their preoperative detection may be difficult. This study was aimed at investigating the effectiveness of hookwires for CT-guided localization of peripheral pulmonary lesions requiring thoracoscopic resection. In 12 patients 12 nodules, previously detected with chest radiography, were localized with hookwires under CT guidance. Ten of 12 patients underwent thoracoscopic resection for diagnostic purposes, while the extant two patients underwent therapeutic wedge resection. In all patients prethoracoscopic hookwire positioning was successful. In 11 of 12 patients the lesion was accurately localized, while in the extant patient the wire tip was inserted deeper than the nodule. In 3 patients the wire was dislodged before surgery: in all of them a small hemorrhage developed on the visceral pleura and wedge resection was likewise possible. Four patients had a small pneumothorax which was not treated before surgery. In conclusion, percutaneous hookwire localization of peripheral lung lesions is an easy and efficacious technique and promotes thoracoscopy as a less invasive alternative to thoracotomy.

Adenocarcinoma↗

PubMed1995

[Nuclear Magnetic Resonance Imaging in the staging of adenocarcinoma of the uterine cervix].

Clinical staging is often inaccurate in the evaluation of local extension of cervical carcinoma. In the present study the sensivity of MR imaging in predicting extracervical tumor invasion on the basis of the detection of a thinning of the univolved cervical stromal ring (3 mm or less) was compared to the sensivity achieved by direct visualization of a complete stomal interruption. Fifteen consecutive patients with adenocarcinoma of the uterine cervix (FIGO stage Ib-IIa), were examined with axial and sagittal weighed MR sequences. Pathologic proof after hysterectomy was obtained in all subjects. The sensitivity in predicting extracervical involvement on the basis of the MR Imaging visualization of a thinned stroma was 83%, whereas the sensitivity obtained by detection of a complete stromal interruption was 50%. Among women with a spared cervical stroma of more than 3 mm at MR Imaging, only one had at pathologic examination microscopic metastasis in a parametrial lymphnode, accounting for a negative predictivity value of 87%. The results of our study points out a high concordance between MR Imaging findings and pathologic results, and indicate that the detection of a intact cervical stromal ring exceeding 3 mm at MR imaging is related to a very low risk of extracervical seeding of tumor. On the other side, the detection of a thinned stromal ring is related to a high incidence of parametrial invasion. The information obtained by this imaging technique may therefore be extremely useful in the accurate tailoring of treatment for these patients.

Adenocarcinoma↗

PubMed1995

[Computerized tomography versus nuclear magnetic resonance in acute pancreatitis].

The aim of the study was to compare Computed Tomography (CT) and Nuclear Magnetic Resonance (MR) scan's diagnostic reliability in acute pancreatitis (AP). During a 44-month period 21 patients with a clinical and laboratory diagnosis of AP were submitted to CT and MR study. The scans were evaluated according to pancreatitis degree and presence and rate of necrosis. Pancreatitis degree was assessed using Balthazar's grading for CT scans; a similar classification was used for MR scans. Thirteen patients had oedematous pancreatitis and 8 necrotic pancreatitis. Necrosis was diagnosed intraoperatively or in non operated patients with CT scan. MR staging was identical to that of the CT ones except for 2 patients who were grade E at CT and grade D at MR. MR identified necrosis in all 8 patients with necrotic AP whereas CT diagnosed only 5 patients properly since 3 scans were performed without contrast medium infusion because of renal failure. MR proved to be a valid alternative in AP diagnosis: it provide the same diagnostic and prognostic information as CT and does not need contrast infusion, which makes it preferable to CT in the follow-up of severe AP evolution.

Acute Disease↗

PubMed1994

The accuracy of magnetic resonance imaging and ultrasonography compared with surgical findings in the localization of the undescended testis.

OBJECTIVE: To determine the accuracy of ultrasonography (US) vs magnetic resonance imaging (MRI) in the detection of undescended nonpalpable testis. DESIGN AND SETTING: A clinical, radiological, and surgical study was undertaken in boys with undescended nonpalpable testes at Pavia and Milan (Italy) University Hospitals. PARTICIPANTS: Seventeen patients with undescended nonpalpable testes aged 10 months to 14.5 years who were examined between 1989 and 1993. A total of 22 nonpalpable testes were examined using US and MRI techniques. Twenty-one testes were explored surgically. RESULTS: The US located 13 (62%) of 21 testes, 12 of which were found at surgery while one (5%) proved to be false positive. Eight (38%) of 21 evaluations were negative; four (19%) were true-negative results. Of the 12 gonads correctly localized with US, two (17%) were located near the internal inguinal ring while 10 (83%) were within the inguinal canal. The MRI examination located 11 (52%) of 21 gonads, all found at surgery. Of the 10 negative results (48%), five (24%) were false negatives and five agenetic testes (24%) were not found surgically. Of the 11 testes correctly localized using MRI, four were located in the abdomen or just proximal to the internal inguinal ring and seven were in the inguinal canal. Five of the six high testes were correctly localized using US and MRI (two using US and four using MRI). CONCLUSIONS: Neither US nor MRI is currently sensitive enough to stand alone as a screening modality for a nonpalpable testis since the two techniques used separately gave a useful result in 16 (76%) of 21 testes. They appear to be complementary since their combined specificity compared with surgical findings was 95%. Since the localization of an undescended testis is important for planning surgical strategy, US should be used for screening evaluation, and if it is not successful, it should be followed (before any invasive diagnostic procedure) by MRI, which appears to be more reliable in the localization of undescended, high, and "functioning" testes.

Child↗

PubMed1993

Prenatal diagnosis of anatomical connections in conjoined twins by use of contrast magnetic resonance imaging.

Omphalopagus conjoined twins were diagnosed by ultrasonography in a pregnant woman at 21 weeks' gestation. In order to clarify the anatomical connections, magnetic resonance imaging (MRI) was performed, having achieved fetal paralysis by intravascular injection of 100 mg of pancuronium into each twin. Prior to MRI, 2 ml of a 0.0001 mmol/ml solution of gadolinium DTPA was also injected into the stomach of one twin. The contrast agent opacified the bowel loops of both twins, indicating bowel to bowel anastomosis. Following pregnancy termination, autopsy confirmed the prenatal diagnosis.

Abortion, Therapeutic↗

PubMed1993

Small hepatocellular carcinoma: MR follow-up of treatment with percutaneous ethanol injection.

To assess the potential role of magnetic resonance (MR) imaging in the follow-up evaluation of small hepatocellular carcinoma (HCC) treated with percutaneous ethanol injection (PEI), 31 patients with a single HCC lesion less than 3.0 cm in diameter underwent MR imaging at 0.5 T before and after treatment. Posttreatment follow-up included contrast material-enhanced computed tomography (CT) and fine-needle biopsy in all cases. The most important characteristic of the treated HCC lesions was hypointensity on T2-weighted MR images in cases (27 of 31) in which complete tumor necrosis was achieved with PEI. This feature corresponded to a nonenhanced, low-attenuation area on follow-up contrast-enhanced CT scans. Four HCCs were positive for malignant cells at 6-month fine-needle biopsy; in these lesions, residual tumor tissue was of high signal intensity on T2-weighted MR images and of high attenuation on contrast-enhanced CT scans. In each case, incomplete tumor necrosis was confirmed at pathologic examination of the surgical specimen.

Aged↗

PubMed1993

Estimating the depth of myometrial involvement by endometrial carcinoma: efficacy of transvaginal sonography vs MR imaging.

OBJECTIVE: In this study we compare transvaginal sonography with MR imaging for use in detecting the depth of myometrial involvement by endometrial carcinoma. SUBJECTS AND METHODS: Forty-two consecutive patients with stage I endometrial carcinoma had transvaginal sonography and MR imaging at 0.5 T. All the patients had a hysterectomy within 1-10 days after the imaging studies. The results of histologic examination of the surgical specimen were considered the gold standard of the study. We compared transvaginal sonography and MR imaging for use in assessing myometrial invasion by endometrial carcinoma by means of the staging classification of the International Federation of Gynecology and Obstetrics: stage Ia (tumor limited to endometrium), stage Ib (invasion of less than half the myometrium), stage Ic (invasion of more than half the myometrium). The overdiagnoses and the underdiagnoses for both techniques were calculated. We also evaluated the sensitivity and specificity of the two techniques for assessing the presence of myometrial invasion (stage Ib + stage Ic) and the presence of deep myometrial invasion (stage Ic). The diagnostic indexes evaluated and the differences between them were analyzed by using McNemar's test and 95% confidence intervals. The staging diagnoses based on MR imaging and sonographic findings were compared with staging diagnoses based on histologic examination, and a score was assigned to each diagnosis: these scores were then evaluated with Wilcoxon's signed rank test for paired data. RESULTS: Histologic examination showed that six of the 42 patients had tumor confined to the endometrium (stage Ia), 14 had involvement of the inner half of the myometrium (stage Ib), and 22 had involvement of the outer half of the myometrium (stage Ic). The staging was concordant between the two imaging techniques in 32 cases (concordance, 76%). Among the 10 discordant cases, diagnosis was correct in six cases for MR and four cases for sonography. Overall staging based on sonography was correct with respect to histologic staging in 29 cases (69%; 95% confidence interval, 52-81%). Five tumors (12%) were underdiagnosed and eight (19%) were overdiagnosed. Staging based on MR findings was correct with respect to histologic staging in 31 cases (74%; 95% confidence interval, 58-85%). Five tumors (12%) were underdiagnosed, and six (14%) were overdiagnosed. CONCLUSION: In our experience, there is no difference in the staging diagnoses of transvaginal sonography and MR imaging. Also, concordance with histologic staging diagnoses and sensitivity and specificity indexes did not show statistical differences between the two techniques, although these last results have to be considered with caution because of the low power of the statistical tests.

Adult↗

PubMed1993

[Renal angiomyolipoma and oncocytoma: sensitivity, diagnosis, and controversy regarding CT and MR].

We have studied the accuracy of CT and MR in 9 oncocytoma and 6 angiomyolipoma, observed in our department from 1985 to 1991. The radiographic patterns of angiomyolipoma are due to the presence of fat in the tumors: on the CT angiomyolipoma appeared as low-density lesions (negative Hounsfield units) with an area of intermixed tissue density which represented myomatous and angiomyomatous elements. The infusion of contrast medium increased the difference between neoplasm and parenchyma because of the scarce enhancement of the angiomyolipoma. MR imaging of angiomyolipoma exhibited areas of high intensity signals on both T1 and T2 weighted images. The infusion of Gadolinium (1 mmol/kg) decreased the difference of signal intensity between angiomyolipoma and parenchyma so that the lesions appeared less clear. As far as oncocytoma diagnosis is concerned, neither CT nor MR appeared less clear. As far as oncocytoma diagnosis is concerned, neither CT nor MR appeared accurate and no specific pattern was identified. The "central stellate scar" was shown on CT in only 1 oncocytoma 7 cm large.

Adenoma, Oxyphilic↗

PubMed1993

[Role of gadolinium (Gd-DTPA) in the staging of renal carcinoma using magnetic resonance. Comparative evaluation with computerized tomography and magnetic resonance without contrast media].

The correct staging of renal neoplasms is critical for both prognosis and subsequent treatment planning. This study was aimed at evaluating the accuracy of contrast-enhanced CT, of plain MR and of contrast-enhanced MR in the staging of renal cell carcinomas (RCC). Forty-four consecutive patients with renal masses were evaluated. All of them underwent plain and enhanced CT and 0.5 T plain and Gadolinium-enhanced MR. T1, T2 and Gd-DTPA T1-weighted MR sequences were acquired (500/20; 2000/100). The diagnostic studies were prospectively and separately interpreted by three radiologists. Imaging findings were then correlated with pathologic findings in all cases. The Robson Staging System was used for pathologic classification. The anatomical staging was correctly performed by CT and MR in 36/44 patients (82%) and by Gd-MR in 39/44 (89%). Seven stage-I and 1 stage-IIIC patients were overstaged by enhanced CT and by plain MR (3 patients to stage II and 5 to stage IV A); 5 stage-I patients were over-staged by Gd-MR (4 patients to stage II and 1 to stage IV A). In four cases, in which CT and MR misdiagnosed stage IV A, Gd-MR correctly identified the lack of adjacent organ infiltration. Perinephric spread, venous invasion, metastatic lymphadenopathy and distant metastases were correctly evaluated by the three imaging modalities. Our results suggest that Gd-DTPA could be useful in identifying direct tumor spread to adjacent organs, because of the different enhancement between the cancer and the other tissues.

Adult↗

PubMed1992

Testicular masses in association with adrenogenital syndrome: US findings.

Adrenogenital syndrome (AGS) is the result of inborn enzymatic defects in the synthesis of steroid hormones. The production of cortisol is deficient and that of adrenocorticotropic hormone is increased. Sometimes male patients have clinically detectable testicular lesions, known as testicular tumors of AGS (TTAGS). From 1985 to 1991, scrotal ultrasonography (US) was performed in 30 consecutive pubertal and postpubertal patients with AGS to investigate the prevalence and US characteristics of TTAGS. Eight of 30 patients had a testicular lesion (27%); six of the eight lesions were clinically undetected. The mean diameter of the lesions was 16.44 mm (range, 2-28 mm). The lesions were hypoechoic in all cases, with well-defined margins in six cases. The nodules were multifocal in all patients and bilateral in six (75%). If testicular lesions are present in a patient with AGS, TTAGS are likely, and frequent US monitoring is adequate for diagnostic evaluation.

Adolescent↗

PubMed1992

[Clinical study for the evaluation of the tolerability of O-(beta-hydroxy-ethyl)-rutoside in the treatment of hemorrhoids during the 3d trimester of pregnancy and in the postpartum period].

Hemorrhoidal disease is particularly frequent in the last trimester of pregnancy and immediately after birth. The aim of the present study was to evaluate the efficacy and tolerability of high doses of O-(beta-hydroxyethyl)-rutoside in patients affected by this pathology. Forty-two women with hemorrhoid varices of varying severity which had appeared during the last trimester of pregnancy or immediately post-partum were treated by administering 3 g/day of the substance in question for 14 consecutive days. At the start and end of treatment a series of clinical and objective parameters were measured and at the end of treatment efficacy and tolerability were assessed. The latter was found to be excellent; in fact, it was not necessary to suspend treatment in any of the subjects treated. Clinical efficacy, assessed by the researcher, was judged to be positive in 95% of cases treated. Clinical improvements in the parameters examined were statistically significant (p < 0.01). The results obtained confirm the value of oral therapy using O-(beta-hydroxyethyl)-rutoside in pregnant or puerperal patients since the preparation was found to be efficacious and easily managed, above all significantly reducing pain, subjectively the most urgent symptom to be treated.

Adult↗