Borderline breast lesions: comparison of malignancy underestimation rates with 14-gauge core needle biopsy versus 11-gauge vacuum-assisted device.

Objective: To compare malignancy underestimation rates in the case of percutaneous diagnosis of borderline breast lesions(B3) at 14-g core-needle-biopsy (CNB) and at 11-g vacuum-assisted-biopsy (VAB).

Methods: The histological results of 4764 image-guided breast biopsies were retrospectively reviewed. 300 B3, 151 benign papillomas, 88 radial sclerosing lesions, 46 lobular neoplasia, 15 atypical ductal hyperplasia diagnosed at ultrasound-guided 14-g CNB (76%) or stereotactically-guided 11-g VAB (24%) were identified.

Autoimmune thyroid disease in Libyan children and young adults with type 1 diabetes mellitus.

Unlabelled: Diabetes mellitus is a common autoimmune endocrine disorder associated with organ-specific autoantibodies which are frequently detected at the time of diagnosis. Some of these antibodies are specific to the pancreas (GAD, IA2, ICA) while others are related to different autoimmune diseases.

Aim Of The Study: To define the prevalence of thyroid autoimmune disease in Libyan patients with type 1 diabetes mellitus (T1DM) since no similar studies have been performed in Libya.

Serum levels of anti-CCP antibodies, anti-MCV antibodies and RF IgA in the follow-up of patients with rheumatoid arthritis treated with rituximab.

Rheumatoid arthritis (RA) is characterized by the presence of circulating rheumatoid factor (RF) and anticitrullinated peptide antibodies (ACPA), which are positive in about 70-80% of patients. APCA have a higher specificity and therefore a higher diagnostic power than RF, but are less informative than RF in monitoring the course of the disease in patients under treatment. Recently, it has been reported that the anticitrullinated vimentin (a-MCV) antibody test can identify a particular subgroup of APCA that may be negative for anticyclic citrullinated peptide (a-CCP) antibodies.

Endoscopic third ventriculostomy in patients with secondary triventricular hydrocephalus from a haemorrhage or ischaemia in the posterior cranial fossa.

Background: The aim of this project was to evaluate the efficacy of endoscopic third ventriculostomy (ETV) in the treatment of acute hydrocephalus caused by a haemorrhage or ischaemia in the posterior cranial fossa.

Methods: 21 patients who had acute triventricular hydrocephalus resulting from ischaemia in 8 cases, and from cerebellar haemorrhage in 13 cases were treated with endoscopic third ventriculostomy. This series was compared with a control group of 30 patients, with clinical neuroradiological characteristics comparable to the preceding group (18 acute post-haemorrhage hydrocephalus and 12 post-ischaemia in the posterior cranial fossa), treated by external ventricular drainage (EVD).

Surgical specimen ultrasound: is it able to predict the status of resection margins after breast-conserving surgery?

Purpose: To evaluate the accuracy of surgical specimen ultrasound in the assessment of the status of resection margins after breast-conserving surgery.

Methods And Materials: Sonographic examination of 46 surgical specimens of US-detectable malignant tumors was performed. Distance of the lesion from the specimen margins in four radial directions was measured and compared with distances measured on pathologic examination.

Male breast lesions: which abnormalities really need core needle biopsy?

Aims And Background: The purpose of the study was to identify clinical, mammographic or sonographic abnormalities of the male breast that require histological characterization.

Methods And Study Design: Clinical and imaging features of 31 male patients with breast lesions were retrospectively evaluated and correlated with core needle biopsy results.

Results: Seven of 31 (22.

[Intrahepatic cholestasis of pregnancy: diagnosis and obstetric management].

Aim: The aim of this study was to suggest a possible obstetric management of patients with intrahepatic cholestasis of pregnancy (ICP).

Methods: We performed a retrospective analysis enrolling 44 women with ICP deliveries at our Obstetrics and Gynaecology clinic of the University of Udine between January 2005 and July 2008. Data on patient age, body mass index, weight, gestational age, parity, symptoms, comorbidity, value of liver test, APGAR score and fetal weight were prospectively recorded in a computed database and clinical folder.

[Lack of prognostic predictive value of hepatic agobiopsy in a group of patients operated of hepatic resection for hepatocellular carcinoma].

Aim: To determine prior to surgery whether a fine needle biopsy is able to define a hepatocellular carcinoma grading, or not.

Material Of Study: Thirty patients, who all underwent liver resection for HCC. In every case a fine needle biopsy of the neoplasm was taken prior to surgery, and after the operation a complete microscopic assessment of tumor grade according to Edmondson and Steiner classification was taken.

A case-crossover study of sleep and work hours and the risk of road traffic accidents.

Study Objectives: Sleepiness, prolonged wakefulness, and extended work hours have been associated with increased risk of injuries and road accidents. The authors' objective was to study the relation between those factors and road accidents using a case-crossover design, effective in estimating the risk of acute events associated with transient, short effect exposures.

Design: Five hundred seventy-four injured drivers presenting for care after road accidents to the Emergency Room of Udine, Italy, were enrolled in the study from March 2007 to March 2008.

Use of the arachnoid membrane of the cerebellopontine angle to transpose the superior cerebellar artery in microvascular decompression for trigeminal neuralgia: technical note.

Background: Microvascular decompression is an accepted, safe, and useful surgical technique for the treatment of trigeminal neuralgia. Autologous muscle or implant materials such as shredded Teflon are used to separate the vessel from the nerve but may occasionally be inadequate, become displaced or create adhesions and recurrent pain.

Objective: The authors evaluated the use of arachnoid membrane of the cerebellopontine angle to maintain the transposition of vessels from the trigeminal nerve.

Fludarabine-based induction therapy does not overcome the negative effect of ABCG2 (BCRP) over-expression in adult acute myeloid leukemia patients.

Over-expression of multidrug resistance (MDR) proteins PGP and BCRP has a negative prognostic impact in acute myeloid leukemia (AML) patients. Inclusion of fludarabine in induction chemotherapy increases remission rate in PGP over-expressing cases. We investigated the role of BCRP in 138 adult AML patients receiving induction therapy with fludarabine.

The accuracy of discharge diagnosis coding for Amyotrophic Lateral Sclerosis in a large teaching hospital.

To evaluate the accuracy of hospital discharge data as a source of Amyotrophic Lateral Sclerosis (ALS) cases for epidemiological studies or disease registries, a validation study was performed. All records of patients discharged in 2005 and 2006 with principal or secondary International Classification of Diseases, 9th rev., Clinical Modification (ICD 9 CM) diagnosis code of ALS (335.

Bone ultrasonometry measurements during pregnancy.

Purpose: During pregnancy we can have changes of the calcium metabolism that can determine a loss of bone mass. Some studies used single-photon absorptiometry (SPA) or dual-energy X-ray absorptiometry, but these exams are inadvisable in pregnancy for the teratogenic effects on the fetus. We used quantitative ultrasonometry (QUS).

Health technology assessment in Italy.

Objectives: The aim of this study was to review the history of health technology assessment (HTA) in Italy.

Methods: Founded in 1978, the Italian National Health Service (NHS) has been strongly regionalized mainly after a constitutional reform, which started a devolution process. HTA started in the 1980s at the National Institute of Health and in a few University Hospitals, with a focus on big ticket technology: that process was driven by clinical engineers.

Correlation between urodynamic function and 3D cat scan anatomy in neobladders: does it exist?

Introduction: We compared the functional and anatomical differences among three different orthotopic neobladders, utilizing video urodynamics and 3D CT to determine what parameters, if any, correlate to function.

Materials And Methods: Thirty-four patients were able to participate in the evaluation of their neobladder by 3D CT and video urodynamics. Three different orthotopic neobladders were identified (12 ileal, 7 ileocecal, 15 sigmoid).

Lobular neoplasia: core needle breast biopsy underestimation of malignancy in relation to radiologic and pathologic features.

The purpose of this study is to assess the positive predictive value (PPV) for malignancy of core needle biopsy (CNB) demonstrating lobular neoplasia (LN). From 3920 CNBs, 35 (0.89%) LNs (14 atypical lobular hyperplasia - ALH - and 21 lobular carcinoma in situ - LCIS) were identified.

Liver transplant in patients with HIV: infection risk associated with HIV and post-transplant immunosuppression.

Before the introduction of highly active antiretroviral therapy, HIV-infected patients who underwent liver transplantation (LT) had poor survival, mainly because of a rapid progression to AIDS and its infectious complications during the post-LT immunosuppression phase. However, in the era of highly active antiretroviral therapy, under some specific and well-determined conditions, LT might be as safe and efficacious in HIV patients as it is in non-HIV-infected patients. End-stage liver failure as caused by hepatitis B virus, cirrhosis, and hepatotoxicity should be considered indications for LT in every transplant center.

Congenital quadricuspid aortic valve associated with obstructive hypertrophic cardiomyopathy.

Quadricuspid aortic valve is a rare congenital abnormality; it is usually an isolated lesion, but several concomitant congenital abnormalities have been described. We report a case of congenital quadricuspid aortic valve associated with obstructive hypertrophic cardiomyopathy. Two-dimensional (2D) transthoracic and transesophageal echocardiography and real-time three-dimensional (3D) echocardiography clarified the morphological and functional status of the aortic valve.

Expression of periostin in human breast cancer.

Background: Periostin is a secreted adhesion protein, normally expressed in mesenchime-derived cells. Aberrant expression of the periostin gene in epithelial tumours seems to play a role in angiogenesis and metastases.

Aims: To investigate periostin expression in a consecutive series of breast carcinomas and correlate it with established biological and prognostic factors.

Continuous and intermittent cardiac output measurement in hyperdynamic conditions: pulmonary artery catheter vs. lithium dilution technique.

Objective: This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (CO(Li)) and continuous cardiac output monitoring (PulseCO(Li)) using the arterial pressure waveform with intermittent thermodilution using a pulmonary artery catheter (CO(PAC)).

Design: Prospective, single-center evaluation.

Setting: University Hospital Intensive Care Unit.

American College of Cardiology/American Heart Association perioperative assessment guidelines for noncardiac surgery reduces cardiologic resource utilization preserving a favourable clinical outcome.

Objectives: The American College of Cardiology (ACC) and the American Heart Association (AHA) provided perioperative evaluation and management guidelines for assessing cardiac risk in noncardiac surgery. Even if previously validated as safe and effective in risk stratification, there is often a gap between clinical practice and the recommendations of the ACC/AHA guidelines. We evaluated the impact of strict application of ACC/AHA guidelines for cardiac risk assessment of patients undergoing elective noncardiac vascular surgery in a consultant anaesthesiologist-led preoperative clinic.

Pulmonary fat embolism: common and unusual computed tomography findings.

Fat embolism syndrome (FES) is a common complication of fractures, usually of the long bones and pelvis. Common computed tomography findings of pulmonary FES include areas of consolidation, ground-glass opacities, and small nodules of various sizes, whereas filling defects in pulmonary arteries are rarely described in nonfulminant syndromes. We present an unusual case of nonfulminant pulmonary FES in which computed tomography disclosed multiple macroscopic pulmonary fat emboli associated to diffuse ground-glass attenuation in both lungs.

Role of ultrasound and sonographically guided core biopsy in the diagnostic evaluation of ductal carcinoma in situ (DCIS) of the breast.

Purpose: The aim of this study was to evaluate the role of ultrasound (US)-guided core biopsy in the diagnosis of ductal carcinoma in situ (DCIS) and to correlate the histological results on percutaneous biopsy and surgical excision.

Materials And Methods: Out of 2,423 consecutive core biopsies performed under US guidance, we evaluated 65 lesions with a histological diagnosis of DCIS. All patients underwent mammography, high-frequency broadband US and percutaneous breast biopsy with a 14-gauge needle and a mean number of five samples (range 4-7 passes).