Biomedical subjects

L Tarantino

Publications and source records attributed to L Tarantino.

42 records · Page 3Linked to original sources

PubMedDate not supplied

Disseminated mycobacterial infection in AIDS patients: abdominal US features and value of fine-needle aspiration biopsy of lymph nodes and spleen.

BACKGROUND: We evaluated the efficacy of abdominal ultrasound (US) and fine-needle aspiration biopsy (FNAB) in the diagnosis of disseminated mycobacteriosis (DM) in acquired immunodeficiency syndrome (AIDS). METHODS: Twelve AIDS patients (nine male, three female; age range, 22-43 years) with DM underwent abdominal US within 2 days after admission with 3.5- to 5-MHz convex probes and a 7.5-MHz linear probe. All patients underwent FNAB of one or two enlarged abdominal lymph nodes. Eight patients underwent FNAB of the spleen. The aspirated specimens were stained with acid fast for quick examination and cultured for isolation of mycobacteria. RESULTS: Abdominal US showed enlarged, hypoechoic, round or oval, abdominal lymph nodes (diameter, 10-35 mm; mean, 18 mm) in all patients; splenomegaly (spleen diameter, 14-22 cm; mean, 16.8 mm) in all patients; numerous splenic abscesses (diameter, 3-20 mm) in nine patients; hepatomegaly (right hepatic lobe thickness, 14.5-17 cm) in all patients; small intestinal wall thickening in five patients (maximum bowel wall thickness, 7-15 mm); mild to moderate ascites in six patients; pleural effusion in four patients; bilateral enlargement of the kidneys with hyperechogenicity of the cortex in three patients; and a retroperitoneal tubercular abscess in one patient. No complication occurred after FNAB of lymph nodes and spleens. Fast-acid stain of spleen and/or lymph node FNAB specimens allowed early diagnosis of mycobacteriosis in 12 of 12 cases (100%). Cultures of lymph node aspirates grew mycobacteria in six of 12 patients (50%). Spleen aspirates grew mycobacteria in nine of nine patients (100%). Blood cultures were positive in four of 12 patients (33%). Mycobacterium tuberculosis was diagnosed in six patients and M. avium in five. CONCLUSION: Abdominal US features can suggest DM in AIDS patients. Spleen and/or lymph node FNAB indicated the specific diagnosis in 100% of patients.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Diagnosis of benign and malignant portal vein thrombosis in cirrhotic patients with hepatocellular carcinoma: color Doppler US, contrast-enhanced US, and fine-needle biopsy.

BACKGROUND: We assessed the role of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant portal vein thrombosis in patients who had cirrhosis with hepatocellular carcinoma (HCC). METHODS: Fifty-four consecutive patients who had cirrhosis, biopsy-proved HCC, and thrombosis of the main portal vein and/or left/right portal vein on US were prospectively studied with color Doppler US (CDUS) and CEUS. CEUS was performed at low mechanical index after intravenous administration of a second-generation contrast agent (SonoVue, Bracco, Milan, Italy). Presence or absence of CDUS signals or thrombus enhancement on CEUS were considered diagnostic for malignant or benign portal vein thrombosis. Twenty-eight patients also underwent percutaneous portal vein fine-needle biopsy (FNB) under US guidance. All patients were followed-up bimonthly by CDUS. Shrinkage of the thrombus and/or recanalization of the vessels on CDUS during follow-up were considered definitive evidence of the benign nature of the thrombosis, whereas enlargement of the thrombus, disruption of the vessel wall, and parenchymal infiltration over follow-up were considered consistent with malignancy. CDUS, CEUS, and FNB results were compared with those at follow-up. RESULTS: Follow-up (4 to 21 months) showed signs of malignant thrombosis in 34 of 54 patients. FNB produced a true-positive result for malignancy in 19 of 25 patients, a false-negative result in six of 25 patients, and a true-negative result in three of three patients. CDUS was positive in seven of 54 patients. CEUS showed enhancement of the thrombus in 30 of 54 patients. No false-positive result was observed at CDUS, CEUS, and FNB. Sensitivities of CDUS, CEUS, and FNB in detecting malignant thrombi were 20%, 88%, and 76% respectively. Three patients showed negative CDUS and CEUS and positive FNB results; follow-up confirmed malignant thrombosis in these patients. One patient showed negative CDUS, CEUS, and FNB findings. However, follow-up of the thrombus showed US signs of malignancy. Another FNB confirmed HCC infiltration of the portal vein. CONCLUSION: CEUS seems to be the most sensitive and specific test for diagnosing malignant portal vein thrombosis in patients with cirrhosis.

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PubMedDate not supplied

End-organ and drug-induced vestibular nystagmus.

The occurrence of spontaneous, positional and paroxysmal positional nystagmus was studied in patients with end-organ lesions, and in subjects with drug-induced central vestibular nystagmus. Repeated vestibular examination using electronystagmography for assessment of spontaneous and positional nystagmus in the standard head positions was carried out. The findings indicate that the paroxysmal positional nystagmus is the most frequently seen nystagmus prior to its disappearance in end-organ induced nystagmus and also the most frequently seen in drug-induced nystagmus. The direction changing type of nystagmus was very frequently encountered in end-organ lesions. These findings indicate that the type of horizontal vestibular nystagmus by itself is of no diagnostic value in localizing the site of the lesion and that the various types reflect different degrees of vestibular compensation that occur prior to their disappearance. The value of various classifications of positional nystagmus lies mainly in that they help describe the nystagmus clinically.

Adult↗

PubMedDate not supplied

[Interstitial laser photocoagulation in liver tumours: our experience].

Interstitial lasertherapy (ILT) is one of the percutaneous thermal procedures allowing the ablation of primary or secondary hepatic lesions. This technique can be performed without general anaesthesia, since the patient is completely painless, in spite of the high temperatures reached, because there are no sensitive fibers around the lesion. This study includes patients with small hepatocarcinomas (< 2 cm) non peripherically sited, far from the gallbladder and the hepatic hilum. Twenty patients suffering from 24 cirrhotic hepatocarcinomas (two patients showed two nodules) have been enrolled for the present study. Mean diameter of lesions was 1.8 cm (1.3-2 cm). One or more 21 G (length 20 cm) Chiba's needles were inserted under sonographic view into the lesions. The laser energy was switched on at 4 Watts for 4-6 minutes, until an amount of energy of 900-1800 Joule was reached. All the patients were discharged 48 hours after the procedure. Triphasic CT-scan with contrast were performed 7 to 14 days after ILT, in order to check its efficacy. CT-scan showed complete necrosis in all the nodules ranging from 1.5 to 3 cm. All the patients received only one IL T session, whose longest duration was 20 minutes. No major complications occurred. ILT of small hepatocarcinomas is a safe, efficient procedure, also feasible without anaesthesia. Differently from percutaneous radiofrequency, in fact, it shows the advantage of less pain, that can avoid the need for general anaesthesia.

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PubMedDate not supplied

[Interstitial laser treatment of small hepatocarcinoma on cirrhosis without anesthesia: feasibility study].

OBJECTIVE: We evaluated if interstitial laser photocoagulation (ILP) under ultrasound (US) guidance of intraparenchymal small HCC (<2 cm) in cirrhosis can be safely and effectively performed without any anesthesia. PATIENTS AND METHODS: Twelve cirrhotic patients with 14 nodules of HCC (diameter 1.2-2.0 cm; mean: 1.7) underwent ILP. All procedures were performed without local or general anesthesia. Necrosis of the nodules was evaluated with triphasic contrast-enhanced CT. RESULTS: Post-treatment CT showed complete necrosis in all cases. Pain occurred in 5 patients during the treatment was treated with iv pain-killer and only in 1 case the procedure was stopped before the scheduled time. No major complication occurred. CONCLUSIONS: ILP under US guidance is feasible without any anesthesia in patients with small intraparenchymal HCC.

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PubMedDate not supplied

Exploitation of statistical tables: conceptual interaction with epidemiologic data.

Health-care applications need flexible data and interaction models capable of dealing with data of different natures coming from different sources. These applications are usually devoted to diverse user groups, often casual or novice. The user interface must help the user to understand the database information content in his or her querying process. The authors synthetically describe FLN, a system featuring an integrated interaction with epidemiologic data. In an integrated model the statistical aspects of data (macro data) are represented, together with the intensional and extensional views of the variables involved in statistical tables.

Database Management Systems↗