Head CT scan in emergency room: Is it still abused? Quantification and causes analysis of overprescription in an Italian Emergency Department.

In recent years, the increasing prescription of diagnostic imaging has been noted, due to advances in imaging technology and the development of defensive medicine. Overuse of diagnostic imaging significantly impacts the quality and costs of health care. Therefore, the purpose of this study was to quantify overprescription and investigate its causes through the evaluation of head computer tomography (CT) scan prescriptions.

"Less is better"-always true?

Objective: The aim of the study is to try to explain what an overtreatment is and which ones are the possible risks related to an excess of simplification in the medical practice, through the description of an emblematic clinical case.

Methods: In the present article, we report the case of a female patient aged 57 who complained about lower back pain and crural neuralgia and had a lumbar and sacral magnetic resonance imaging performed in the Department of Neuroradiology in Bari showing suspicious repetitive bone lesions; therefore, the patient underwent several medical procedures and laboratory exams which ended with a surgical removal of a left L3-L4 foraminal disc herniation and a bone biopsy.

Results: When it was finally possible to exclude any other diseases including thyroid neoplasms, a "reassuring" osteoporosis diagnosis has been made since the lesions were likely to be degenerative and the patient underwent menopause 7 years ago.

Langerhans cell histiocytosis of the maxillae in a child treated only with chemotherapy: a case report.

Background: Langerhans cell histiocytosis is a sporadic disease caused by an uncontrolled pathogenic clonal proliferation of dendritic cells that have Langerhans cell characteristics. New treatment protocols provided by the HISTSOC-LCH-III (NCT00276757) trial show an improvement in the survival of children with langerhans cell histiocytosis.

Case Presentation: We report a case of Langerhans cell histiocytosis, which presented as an osteolytic lesion of the left pre-maxillae enclosing the deciduous incisor and canine in a 7-month-old white Italian boy.

Description of six cases of child cauda equina leptomeningitis: an emerging disease.

Child cauda equina leptomeningitis (CCEL) is a typical clinical example of aseptic meningitis with patterns of an emerging disease, and it affects children aged 2-9. Here we will describe six cases of CCEL. After the prodromes, all children underwent an acute phase with hypoasthenia of the lower limbs, hyporeflexia, staggering and ataxia with steppage.