We carried out total body computerized tomography (CT) studies and examined the retrospective clinical data of 29 adult patients with thalassemia intermedia (TI) to evaluate the incidence, features and pathogenesis of ectopic erythropoiesis (EE), located chiefly at the paravertebral gutters in the thorax, was present in 65.5% of the patients; 15% of them had severe clinical complications. We found a clear relationship between EE development and early presentation age of thalassemia, splenectomy and the presence of 100% fetal hemoglobin. The frequent occurrence of EE suggests that CT screening of patients with thalassemia intermedia should be mandatory. We also recommend radiotherapy as a preventive measure for the clinical complications of thalassemic patients with EE.

Adolescent↗

PubMedDate not supplied

[New CT and MR imaging techniques in non-traumatic neurological emergencies].

New CT and MR imaging techniques used for non-traumatic neurologic emergencies (represented mostly by ischemic stroke) fulfil the exigency to know quickly and with high accuracy the presence of abnormalities in cerebral perfusion, with the final aim to practise immediately all the treatments needed to prevent the progression of the neurologic damage, by selecting those patients to undergo fibrinolysis, which is useless and not indicated in many occasions. The diagnosis of ischemia is only the first goal reached by these new diagostic tools, while it is nowdays possible and required to stratify the risk factors for the therapy and to accurate select those patients candidates to fibrolnilysis, in order to minimize the risck related to the inadequate treatment choice.

Brain↗

PubMedDate not supplied

[Imaging of simple and complicated acute cholecystitis].

Acute Cholecystitis is a common disease and it needs to be treated in emergency. In case of complication, surgery is mandatory in 48-72 hours. Ultrasonography (US) is the first diagnostic step in that it allows to identify the signs of major complications, not always visible. Spiral CT identifies complications misdiagnosed at US and allows a correct classification. However, spiral CT is able to depict fluid collections or gas in the wall or in the lumen of the gallbladder or free air in the peritoneum, signs not always depicted by US and which also needs surgical treatment in emergency. If one or more signs of complications are present, CT is mandatory to identify complicated cholecystitis (phlegmonous or empyematous cholecystitis, abscesses, emphysematous, gangrenous, hemorragic or perforated cholecystitis) and to indicate its urgent surgery.

Cholecystitis, Acute↗

PubMedDate not supplied

[Therapy of hepatic carcinoma by the intra-arterial injection of lipiodol, antineoplastic agents and gelfoam].

Chemoembolization by selective intra-arterial injection of lipiodol--chemotherapeutic agents (mitomycin and/or adriamycin)--followed by terminal embolization with gelfoam was performed on 20 inoperable patients with hepatic tumors: 13 hepatocellular carcinomas (HCC), 6 metastases from colorectal cancer, and one adenoma. A total of 29 embolizations were performed, 17 of them followed by gelfoam embolization. Significant decrease in tumor size or no tumor increase was shown in 8 patients--6 capsulated and well-limited HCC's, and 2 multinodular HCC's. Apart from occasional episodes of post-embolization syndrome (fever, vomit, abdominal pain), no significant complications were observed. Nine patients died at intervals ranging from 2 weeks to 37 months after the first embolization; in 6 patients the cause of death was not related to the advancing of the cancer, but to the complications of the underlying cirrhosis. In cirrhotic patients, damage to the rest of liver parenchyma can be limited by using superselective catheterization. Of the 6 patients with greater than 12 months follow-up, 4 are alive and 2 have died; 2 more patients are still alive 18 months after the first embolization. Finally, lipiodol was useful as radiopaque marker to detect lesion changes during the follow-up.

Adult↗

PubMedDate not supplied

[Oculomotor and visual sensory changes in the neurologically lesioned child].

Pathological changes in the visual system are often present in children with neurological handicaps. Strabismus, refractive errors, amblyopia, optic atrophy are the more frequent findings. The ophthalmological evaluation in these children includes: eliciting of pupillary light reflex; occlusion test; cover-test; observation of symmetry of corneal light reflexes; retinoscopy and ophthalmoscopy. Strabismus is the most frequent alteration. The so-called "caotic" strabismus, with very variable angle of squint and abnormalities of the vertical movements, is peculiar in children with neurological handicaps. Sensorial adaptation to strabismus can lead to: suppression, lack of fusion power, anomalous retinal correspondence, amblyopia; these sequelae are the same as those found in strabismic patients without neurological lesions. The basic aims of therapy are an energetic treatment of sensorial anomalies of strabismus, and the development of the best possible visual acuity in each eye. Surgical treatment has mainly cosmetic purposes. It tends to be delayed in time because the results are rather impredictable, owing to the variations of the angle of squint. It is stressed that surgical and non-surgical treatment of strabismus in children with neurological handicaps has no influence on their psycho-motor performances.

Brain Damage, Chronic↗

PubMedDate not supplied