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S Nardini

Publications and source records attributed to S Nardini.

71 records · Page 4Linked to original sources
PubMed1991

[Is there a typical radiologic picture of primary pulmonary hypertension? Study of 18 cases].

The conventional chest radiographs were studied of 18 patients with primary pulmonary hypertension, waiting for, or treated with lung transplantation in the Papworth Hospital. The goal of the study was to find out whether there is a pattern characteristic of primary pulmonary hypertension. The following points were considered: a) pulmonary transparency; b) the hila; c) the left hemidiaphragm; d) the pulmonary artery; e) the right ventricle; f) the right atrium; g) the left ventricle. A score was assigned for any degree of abnormality of the points mentioned above. As a result, a radiological pattern was found that can: 1) confirm the presence of pulmonary hypertension; 2) exclude that this hypertension has a detectable cause; 3) measure the severity of the disease, particularly with regard to hypertension degree. The conclusion is that there is a radiological pattern strongly suggestive of primary pulmonary hypertension and that conventional radiology can help in detecting and monitoring this rare disease, which today can only be treated by means of transplantation.

Adult↗
PubMed1989

[An anatomo-radiological study of changed tracheal transparency in the pathology of the superior mediastinum. Correlations and integration with mediastinal lines].

Twenty cases of mediastinal pathologies were examined with conventional radiology and Computerized Tomography (CT). They all (4 lesions in the superior and 16 in the postero-inferior mediastinum) presented with no significant changes in mediastinal borders. Conventional X-ray pictures were carefully examined for changes in mediastinal shape, and aerial tracheograms for "tracheal dimness"; CT scans were used as anatomical reference material. Mediastinal lines were detectable and evaluable in less cases than tracheal dimness was. The latter proved an useful sign for the evaluation not only of the pathologic condition itself, but also of the therapeutical reduction obtained in previously-diagnosed lesions. The routine study of tracheal dimness on conventional X-ray pictures appears to be an useful addition to the well-known signs of mediastinal pathologic conditions, especially when filters and high voltage are but seldom used.

Adult↗
PubMed1989

[The radiological picture of the nonvascular surgical mediastinum].

A review was made of the chest X-ray features of 120 patients who underwent surgical treatment for mediastinal nonvascular pathologies over the past 12 years in the Mestre Hospital. A method of analysis is proposed which takes into account not only the differences between the immediate postoperative period and the follow-up, but also the anatomotopographic partition and the surgical practice. Normal and pathological patterns for both of the above periods are described. The "dimness" of the aerial tracheogram is emphasized as a useful and early sign of mediastinal recurrence.

Follow-Up Studies↗
PubMed1987

[Reduction in transparency of the airway tracheogram, a sign of upper mediastinal pathology].

Some cases of mediastinal pathology in which the only pathological pattern was a "dimness" of the tracheal transparency are described. This sign is not described in previous reports and is described as a short break in the aerial tracheogram as seen on the frontal roentgenograph. This sign is produced by an increase in the structures outside the trachea or by a decrease in the air column inside the trachea. Conventional and CT anatomic findings which account for the sign are discussed. A short review of the "normal" causes of tracheal dimness is presented. This sign may be useful especially in emergency radiology, since it provides additional information to a simple routine chest roentgenograph.

Emergencies↗
PubMedDate not supplied

Indoor particulate matter measurement as a tool in the process of the implementation of smoke-free hospitals.

AIM OF THE STUDY: There are International and National standards that requires hospitals and health premises to be smoke-free. According to recent data from Italy and other European Countries, smoking is a widespread habit in hospitals. To get smoke-free hospitals in an Italian region, we have adopted the European Code for smoke-free hospitals, which sets standards and provides instruments for its implementation. According to the Code, whenever possible, each step towards a smoke-free hospital, should be shared by all staff. As a mean for achieving this goal, in our region the certification of single units as smoke-free units has been chosen. For getting the certification, besides implementing the Code, we planned to use ETS (Environmental Tobacco Smoke) monitoring, as ETS should not be present in hospitals. As a marker of ETS we have chosen Particulate Matter (PM), as it can easily be measured in real-time with a portable instrument and, when other even outdoor--sources of combustion can be ruled out, it is an accurate detector of cigarette smoke. Here the first experience of measuring PM in hospitals for monitoring ETS and certificating smoke-free health premises, is described. MATERIALS AND METHODS: PM measurements were carried out without any previous notification in different areas of two Network hospitals of the Veneto Region, during a single working day. A real time laser-operated aerosol mass analyser was used. Several classes of PM (PM1, PM2.5, PM7, PM10, TSP Total Suspended Particles) were measured. RESULTS: Outdoor PM levels were found to be repeatedly lower than the annual official limits of 65 mcg/m3 and around the 24 hour official limits of 15 mcg/m3 [15 to 20 mcg/m3, with an overall mean (+/-SD) of 17.8 (1.9)] throughout the whole day. Very good indoor air quality was found in the operating theaters and isolation department, where PM2.5 concentrations were much lower than outdoor levels [1.6 (0.9) and 5.9 (0.6) mcg/m3, respectively]. No increase in PM pollution was found in the surveyed medical offices, halls and waiting rooms where smoking was positively forbidden [PM2.5 concentrations of 14.8 (2.2) and 12.9 (1.1) mcg/m3] except in a medical office and in two coffee rooms for staff only where high PM levels were recorded [PM2.5 58.7 (29.1), 27.0 (10.6) and 107.1 (47.8) mcg/m3] and an offence of smoking restrictions could be proved. CONCLUSIONS: The measurement of PM in hospital for monitoring ETS proved to be both feasible and sensible. PM measurements with a portable instrument can be used both for controlling the compliance with rules or chosen standards and for educating staff about smoking related hazards, thus gaining consensus for the implementation of the tobacco control policy. In our experience, PM measurement can be used as an aid inside all actions designed by the European Code for smoke-free hospitals.

Air Pollution, Indoor↗
PubMedDate not supplied

A survey on policies of smoking control in Italian hospitals.

BACKGROUND: In Italy National regulations forbidding smoking inside hospitals have existed since 1975. Current International medical standards for staff include refraining from smoking as an intervention of health education aimed at promoting healthy lifestyles as well as reinforcing smoking cessation advice, which staff should give patients. According to a National survey 33.3% of staff are active smokers and up to 80% of them admit to smoking in the workplace. This study was aimed at asking the hospital administrative authorities about the current situation of smoking control, according to their experience and about activities and policies they think could be effective in implementing smoking control. METHODS: As a part of a European survey, financed by the EC, 217 questionnaires were sent by mail to the General Managers of various hospitals in Italy, selected at random. The letter introducing the questionnaire was also signed by the unit of smoking control of the National Institute of Health (Rome). RESULTS: Out of the 217 questionnaires sent (56.8% in Northern Italy, 19.8% in Central Italy, 23.4% in Southern Italy), 85 (39.2%) were returned, 56.5% from Northern Italy, 22.3% from Central Italy, 21.2% from Southern Italy. Even if a smoking control policy is reported by the 82% of our sample, only 37.3% reported a complete ban of smoking. In 72% of hospitals there are no areas designated for smokers; only 51.3% provide help for smoking cessation and 83.2% report that no financial support is given to this policy. When asked about a point for smoking control the majority (72.9%) think of education of staff and half of the sample of reinforcing controls and repression as well as free smoking cessation treatments. Finally, when evaluation of compliance to existing rules is asked an insufficient or absent compliance is reported in 25.4% and the majority (50.7%) reported no smoking cessation clinic or service inside. Due to the low redemption rate, our sample cannot be considered as representative of the national hospital network. However, considering that only managers referring a good or sufficient smoking control have probably answered our questionnaire, we can conclude that the situation enlightened by our sample could be worse but not better in reality. CONCLUSIONS: In Italy the control of smoking in hospitals is far from reached. An implementation of smoking control needs support for cultural changes as well as a comprehensive policy towards smoking staff.

Female↗
PubMedDate not supplied

[Radiologic picture of the thorax in acute asphyxia caused by near drowning. A caseload contribution].

One hundred-fifteen drowning and near-drowning patients were hospitalized in Jesolo and Mestre over the last 10 years. A correlation between radiological patterns and clinical features was thoroughly investigated by the authors. A close relationship was found between clinical findings and the X-ray pattern of the first radiography, taken immediately after the rescue. The longer the hospitalization (or when SNC is assessed) the less significant the correlation. According to the author's experience, prognosis is good when the first radiograph does not demonstrate any lesions. On the contrary, when lesions are seen on the first radiograph the patient is to be carefully monitored in order to treat every complication promptly, including ARDS (10% of all cases). Chest radiographs are also useful to explain autopsy findings. No typical radiological pattern was found: however, four signs were observed, which were very frequently associated-i.e., bilateral parenchymal shadows, pneumothorax, pneumopericardium, and gastrectasia. These findings appear to be characteristic of near-drowning.

Acute Disease↗
PubMedDate not supplied

[Has the role of radiology changed in the fight against pulmonary tuberculosis?].

Tuberculosis is on the increase in Italy as in other industrial countries. The key to tuberculosis control is case finding and radiology plays a major role in both active and passive tuberculosis diagnosis. Have recent advances in radiologic techniques increased the value of conventional radiology? Has the role of chest radiography changed in tuberculosis screening? To answer these questions we examined a population referred to our hospital for both screening and diagnostic purposes over a 12-month period. In a population of 31,730 inhabitants, 1,461 chest radiographs were performed, 226 (15.4%) for passive and the others for active case finding. As for active case finding, high-risk patients were screened (21 immigrants and 296 aging people), together with the general population believed to be at risk according to current national recommendations (918 chest films). While screening allowed the diagnosis of only one tuberculosis case in the high-risk group, 3 cases were found in the symptomatic group with the passive protocol. In our experience, new radiologic techniques have not made the diagnosis of tuberculosis easier. Unlike in cancers, CT was not particularly useful in identifying symptomatic tuberculosis cases. In our experience, screening yielded poor results: in fact, this attempt at preventing tuberculosis caused an unreasonable waste of time and money because when screening low-risk groups many films are needed to diagnose a single case. Thus, the reason for this failure was not a technical one. It proved to be a problem of selecting the population to be screened. Our results suggest that no major change has taken place in the role of conventional radiology in passive tuberculosis case finding and that radiology must be used differently in passive case finding, that is, for screening purposes in high-risk groups only.

Adult↗
PubMedDate not supplied

[Diagnostic problems in reading chest radiographies of elderly patients at admission. Personal experience].

PURPOSE: More chest radiographs are presently performed in the elderly, especially the hospitalized ones. Reading these images is difficult because of the involutions in the thoracic cage, heart and lungs and the scars or calcifications from different abnormal causes. In the elderly, bronchogenic carcinoma may present as an occasional "coin" lesion and therefore such a finding may be an important diagnostic problem and require some expensive and dangerous examinations next. We investigated the relative frequency of questionable abnormal findings in the daily reading of the chest radiographs of elderly patients, the relative importance of the radiologist's experience and of the examination execution technique; the relative costs were also evaluated. MATERIAL AND METHODS: Four radiologists, two of them more experienced (FS, PT), read the consecutive chest radiographs of 811 elderly patients (273 men, 538 women) hospitalized May to December, 1997. Four hundred and ten of them were 65-75 years old and 401 over 75 (particularly, 28 were over 90). Five hundred and sixty-five chest radiographs were made with the AMBER technique and 246 with frontal views only. T-MAT G RA Kodak high-contrast films with Kodak Lanex green-transmitting intensifying screens were used in all cases. CT scans were made with conventional (CT Sytec 3000, GE) or spiral (X Vision, Toshiba) scanners. RESULTS: Seven hundred and fifty-seven radiographs were considered adequate (93%) and 54 inadequate (7%) for diagnosis (25 in patients 65-75 years old, 25 in patients 75-80 and 4 in patients over 90). Thirty-eight of these 54 inadequate radiographs had been made with the AMBER technique and 16 with frontal views only. The more experienced radiologists read 27 (11%) and 19 (10%) of them and the less experienced ones read 4 (2%) and 4 (3%), respectively. The next examinations were other projections and/or radioscopy (4 cases), conventional tomography (7 cases), CT (43 cases), and US (2 cases). "Coin" lesions were the major cause of questionable diagnosis, especially in posterior (10 cases) and peripheral (7 cases) regions, where the differential diagnosis was with vertebral osteophytosis and small rib crowding, respectively. CONCLUSIONS: More skilled radiologists have more doubts reading the chest radiographs of elderly patients. But the next examinations will likely balance the needless ones after an initial misdiagnosis. The chest of elderly patients remains a complex and very little known subject and the reader's experience plays an important role. The examination execution technique must be as accurate as possible in both optimal and suboptimal settings.

Aged↗