[Expressed emotions (EE) as the basic prognostic indicator in schizophrenia. Review of studies].
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Emotions↗
Biomedical subjects
B Barbaro
Publications and source records attributed to B Barbaro.
[Diagnosis of the family of schizophrenic patients].
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Family↗
Radiotherapy in rectal cancer: stage of the disease and therapeutic approach.
Rectal cancer requires treatments tailored according to the stage of the disease at diagnosis. In stage I lesions exclusive surgery is the elective treatment. Radiotherapy is used in those cases where the site of the lesion would sacrifice sphincter function. When the features of neoplasm are favourable (size < 5 cm, grading 1-2, histological type adenocarcinoma) local excision and postoperative radiotherapy enable to achieve results comparable to those of radical surgery. In operable lesions (T3-T4 (vagina) N0-2, M0) at high risk for local recurrence, high dose preoperative radiotherapy in some randomized studies has shown a significant improvement in local control and survival with a low toxicity, especially in patients undergoing radical surgery. Concomitant chemotherapy in postoperative radiotherapy has significantly improved local control and survival as compared to radiotherapy alone. Continuous infusion appears to reduce the toxicity, which is otherwise high. Randomized studies of preoperative radiochemotherapy vs radiation alone or vs postoperative radiochemotherapy are in progress in various Centers. Intensification with radiotherapy alone (IORT, fractionation) is also under study. In lesions unresectable for cure (T4, N0-3, M0) radiotherapy alone or combined with surgery did not show significant results. Intensification with concomitant chemotherapy and/or with IORT has enabled over 70% local control and 50% 5-year survival.
Adenocarcinoma↗
Combined modality staging of low risk rectal cancer.
The work-up conducted in order to reach a correct diagnosis based on a combined modality staging in patients with low risk rectal cancer, is presented. The diagnostic accuracy of each imaging technique is analyzed by the comparison of the radiologic TN with the histologic TN in 13 patients directly referred to surgery based on combined modality staging. Control with histologic findings has staged as T1-T2 13 patients directly referred to surgery, while only a patient was shown to have microinfiltration of perirectal fat. As for T, diagnostic accuracy was 90% for transrectal US, 66% for MRI, 61% for CT. Accuracy of transrectal sonography in the differentiation of T1 from T2 was 70% with a trend towards overstaging. None of the procedures has suggested the presence of metastatic lymph nodes while on histology small neoplastic foci were evidenced in a normal-sized perirectal lymph node. The high diagnostic accuracy of US in the definition of T in rectal cancer is confirmed. It is underlined that no procedure enables the detection of neoplastic microinfiltration of normal lymph nodes.
Humans↗
Combined modality staging of high risk rectal cancer.
The personal experience with the radiologic staging of high risk rectal cancer undergoing preoperative treatment is reported. 61 patients shown to be affected by locally advanced (T3-T4, N+with any T) rectal tumors on combined modality staging, underwent restaging 4-5 weeks after treatment. In all patients liver US, pelvic CT and colorectal enema were performed before and after treatment. In 22 patients with low rectal cancer transrectal sonography was performed. In 19 patients pelvic MRI was performed. The 61 patients were considered operable on second staging and thus referred to surgery. Subsequent control on histology has confirmed the diagnostic accuracy of the single procedures and of their combination. US was shown to be of high accuracy in the evaluation of T (90.8%) and of high predictive value for N. CT accuracy (84%) and MRI accuracy (78.9%) was lower because both tend to overstaging in the evaluation of T of rectal tumors undergoing preoperative treatment. Low CT accuracy (64%) and MRI accuracy (58%) was observed for N. There was optimum agreement between histology and imaging in the assessment of tumor shrinkage, well visualized by rectal enema which supported combined restaging with 88% accuracy for T.
Combined Modality Therapy↗
The reasoned combined modality imaging of rectal anatomy.
An accurate analysis of the rectal anatomy and of its "setting" is carried out. The various anatomical structures are defined by the available imaging procedures to supply information on a reasoned combined modality imaging of rectal anatomy.
Diagnostic Imaging↗
Staging rectal cancer with transrectal US: methodology, signs and parameters.
A review of the literature on the staging of rectal cancer by transrectal sonography is presented. T and N accuracy is reported based on the analysis of most common sonographic signs and parameters drawn from literature and compared to the authors' experience.
Humans↗
Staging rectal cancer with magnetic resonance imaging: methodology, signs and parameters.
Magnetic Resonance Imaging is a rapidly developing procedure suitable for rectal cancer staging. Initial results are extremely encouraging in T staging while at present this is not so in N staging. MRI is useful in the differentiation between stage T2 and T3 because images can be obtained in multiple planes, tissue contrast is high and thus scans are always perpendicular to the tumor base. However there is a trend to overstaging of rectal cancer frequently due to the concomitant perirectal inflammatory reaction. In a near future, the extensive use of surface coils will certainly increase spatial resolution with consequently improved accuracy.
Humans↗
Abdominal complications and monitoring of liver transplants.
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Abdomen↗
Carcinoma of the pancreatic head area. Diagnostic imaging: ultrasound.
At present ultrasound (US) is performed as first choice exam in the diagnostic approach to the patient with suspected carcinoma of the pancreatic head area. The role of US is limited because of the difficult assessment of the infiltration of peripancreatic fat, of hollow viscera and of adjacent vascular structures. Lymph node invasion is better shown by CT than by US. A significant improvement in the diagnostic accuracy may be possible with the clinical application of the new US procedures as color-Doppler US, endoscopic US and laparoscopic US.
Humans↗
Color Doppler US of intrahepatic vascular system.
Aim of this article is an up-dating of the state of the art of color Doppler US in the assessment of intrahepatic vascularization. Recent reports are reviewed, based on already acquired certainties to better the knowledge of the physiology and pathophysiology of hepatic circulation to investigate new clinical applications of color Doppler US.
Hepatic Artery↗
Functional radiology of the liver: magnetic resonance imaging.
Magnetic Resonance (MR) images sensitive to the flowing blood are defined as images of MR angiography. Proton movement within a magnetic field modifies both the intensity and the phase of Nuclear Magnetic Resonance (NMR) signal; two techniques of MR angiography are thus distinguished: (TOF) the "time of flight" (intensity) and the "phase-contrast" (phase) technique. In the time of flight MR angiography the blood may appear as hypointense or hyperintense compared to stationary tissues. Blood hypointensity in vessels is due to the flow void phenomenon while hyperintensity is due to the phenomenon of flow-related enhancement. In phase contrast MR angiography, protons moving within a magnetic field modify their phase directly proportional to the displacement velocity and gradient intensity. Moreover, MRI allows noninvasive measurement of blood flow. Flow velocity is measured with TOF sequences or phase-contrast sequences. In TOF sequences quantitative measurement is performed with the bolus tracking procedure. In contrast-phase sequences the velocity is measured based on the extent of signal phase modification induced by the proton displacement velocity. The recent use of liver-specific contrast media supplies information on parenchymal liver function.
Blood Flow Velocity↗
New perspectives on the clinical applications of functional radiology of the liver.
Preliminary results of "new clinical applications" of functional imaging of the liver are reported. In 20 healthy volunteers portal flow measurement with Doppler US at the level of right, left portal branch and main portal trunk, showed the preferential distribution in baseline conditions of portal flow to the right liver (about 68%) as compared to the left portal branch. This influenced MRI volumetry of right liver as compared to left liver. After meal intake, flow increase was significantly higher at the level of left portal branch suggestive for a "functional reserve" in left liver. Portal flow physiology was examined in preparation of portal imaging before and after portal vein embolization, a procedure performed preoperatively before enlarged hepatectomies.
Diagnostic Imaging↗
Diagnostic imaging of abdominal tuberculosis: gastrointestinal tract, peritoneum, lymph nodes.
Abdominal tuberculosis is usually associated to pulmonary tuberculosis. The most frequent gastrointestinal form is ulcerative illeocecal tuberculosis. Esophageal, gastric and duodenal locations are rare; jejunal and proximal ileal tuberculosis are rare during tuberculous peritonitis. The most common form with liver and spleen involvement is miliary tuberculosis, the macronodular form being rare. Tuberculous peritonitis is a common manifestation of abdominal tuberculosis with various aspects according to the presence of ascitis and the predominant fibrotic reaction. Most common abdominal manifestation is represented by lymph node involvement with four patterns recognized on CT. In AIDS patients together with Mycobacterium tuberculosis infection, there may be Mycobacterium avium complex infection with often indistinguishable imaging findings. Patterns are similar to those of immunocompetent patients, except for markedly immunocompromised subjects in whom disseminated forms are observed.
AIDS-Related Opportunistic Infections↗