MRI findings of intraductal papillary mucinous neoplasms (IPMNs).

Cystic lesions of the pancreas are relatively frequent imaging findings due to the improvement of imaging technologies. They may be secondary to both benign and malignant disease processes and their prevalence increases with age. In most cases, these lesions are detected incidentally by computed tomography and magnetic resonance imaging (MRI) performed for other reasons.

Use of DWI in identification of small solid pancreatic focalities (≤ 2 cm).

Incidental finding of pancreatic focalities has increased thanks to a larger use of radiological examinations (Ultrasound, CT). The differential diagnosis between focal inflammatory and heteroplastic disease is frequently complicated by the wide spectrum of lesions and by the aspecificity of clinical and medical history, as well as of imaging findings. MRI is the second level choice of examination thanks to its higher intrinsic contrast resolution and parametric capability (1); furthermore, the use of Diffusion Weighted Imaging (DWI) sequences provides additional diagnostic informations.

MRI in acute ligamentous injuries of the ankle.

Ankle sprains are the most common lower limb injuries and affect more frequently young athletes; imaging is needed for an accurate diagnosis of such traumatic injuries. The purpose of this review is to analyse the magnetic resonance (MR) findings of both normal and pathological ankle's ligaments; indeed, MRI is the gold standard for the diagnosis of acute traumatic injuries and is useful for differentiation of the causes of ankle instability as well as for pre-operative planning.

Imaging of osteonecrosis of the femoral head.

Osteonecrosis of the femoral head is a common disease affecting both children and adults causing acute hip pain and functional impairment. Among the various techniques allowing a correct diagnosis, MRI represents the gold standard for an early detection, the latter being useful for a positive outcome. The purpose of this review is to describe the imaging findings of the osteonecrosis of the femoral head.

Impact of oral P2Y12 inhibitors on residual thrombus burden and reperfusion indexes in patients with ST-segment elevation myocardial infarction.

Aims: We sought to assess the impact of different oral P2Y12 receptor inhibitors on residual thrombus and reperfusion indexes in ST-segment elevation myocardial infarction patients enrolled in the COCTAIL II trial, which included 128 primary percutaneous coronary interventions randomized to intracoronary vs. intralesion abciximab bolus with or without thrombectomy.

Methods: Patients were divided into three groups: clopidogrel (n = 44), prasugrel (n = 45) and ticagrelor (n = 39).

The Association Between Low Back Pain and Composition of IgG Glycome.

Low back pain (LBP) is a common debilitating condition which aetiology and pathogenesis are poorly understood. We carried out a first so far analysis of associations between LBP and plasma IgG N-glycome in a sample of 4511 twins from TwinsUK database assessed for LBP, lumbar disc degeneration (LDD) as its possible cause, and IgG-glycan levels. Using weighted correlation network analysis, we established a correlation between LBP and glycan modules featured by glycans that either promote or block antibody-dependent cell-mediated cytotoxicity (ADCC).

Comparison between off- and on-pump coronary artery bypass grafting: long-term results of a real-world registry.

Objectives: The aim of this study was to compare 5-year rates of overall death, cardiac-related death, myocardial infarction, repeat revascularization, stroke and new occurrence of postoperative renal failure in a large cohort of patients with coronary disease, treated with on- or off-pump coronary artery bypass grafting (CABG).

Methods: Two propensity score-matched cohorts, each of 560 patients, undergoing isolated surgical coronary revascularization at the regional public and private centres of Emilia-Romagna region (Italy) over the period 1 January 2003 - 31 December 2013, were used to compare long-term outcomes of on-pump CABG (6711 patients) and off-pump CABG (597 patients).

Results: The matched on-pump group received significantly more bypass grafts than the matched off-pump group (2.

Trapeziectomy With Ligament Reconstruction and Tendon Interposition Arthroplasty With the Entire Width of the Flexor Carpi Radialis Tendon.

The original Burton-Pellegrini technique used to treat trapeziometacarpal joint osteoarthritis suggests the use of half of the flexor carpi radialis (FCR) width to reconstruct the ligament and perform the tendon interposition arthroplasty. In our study, unlike the original technique, we used the full thickness of the FCR and evaluated a sample of 100 thumbs (95 patients) preoperatively and postoperatively, with a mean follow-up of 36 months. According to the Eaton classification, 1 thumb was grade II, 81 were grade III, and 18 were grade IV.

A pharmacological treatment algorithm for localized neuropathic pain.

Neuropathic pain is caused by a lesion or disease affecting the somatosensory system and is difficult to manage, often proving refractory to existing treatments. In more than half of cases, it is localized and affects a specific, clearly circumscribed area of the body (localized neuropathic pain, or LNP). A recently developed screening tool enables patients with probable neuropathic pain/LNP to be identified quickly and easily.

Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings.

Advances in the technology and improved access to imaging modalities such as Computed Tomography and laparoscopy have changed the contemporary diagnostic and management of acute appendicitis. Complicated appendicitis (phlegmon, abscess and/ or diffuse peritonitis), is now reliably distinguished from uncomplicated cases. Therefore, a new comprehensive grading system for acute appendicitis is necessary.

Duration of Antimicrobial Therapy in Treating Complicated Intra-Abdominal Infections: A Comprehensive Review.

Background: Surgeons managing intra-abdominal infections should always respect the basic principles of antibiotic treatment. An adequate duration of antimicrobial therapy is important to optimize empiric therapy and minimize selective pressures favoring antimicrobial resistance.

Methods: The optimal duration of antibiotic therapy for intra-abdominal infections (IAIs) has been debated in the last years.

Foregut caustic injuries: results of the world society of emergency surgery consensus conference.

Introduction: Lesions of the upper digestive tract due to ingestion of caustic agents still represent a major medical and surgical emergency worldwide. The work-up of these patients is poorly defined and no clear therapeutic guidelines are available.

Purpose Of The Study: The aim of this study was to provide an evidence-based international consensus on primary and secondary prevention, diagnosis, staging, and treatment of this life-threatening and potentially disabling condition.

WSES guidelines for management of Clostridium difficile infection in surgical patients.

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent.

The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper.

The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is appropriately resuscitated and hemodynamically stable and thus better able to heal.

Comparison between intermediate and severe coronary stenoses and clinical outcomes of an OCT-guided PCI strategy.

Aims: We compared optical coherence tomography (OCT) features of intermediate and severe coronary stenoses in patients with stable angina and acute coronary syndrome (ACS), and tested the clinical impact of an OCT-based strategy for treating intermediate stenoses.

Methods: The study enrolled 135 consecutive patients with either ACS or stable angina and a single de-novo coronary stenosis. Patients were divided into two groups: intermediate stenosis defined as quantitative coronary angiography percentage narrowing less than 70%, or presence of angiographic vessel haziness and severe stenosis with percentage narrowing more than 70%.

Inter-observer agreement of CT measurement of the glenoid bone surface by the CT Pico method: Comparison with laser in a cadaveric model.

Objective: The aim of this study was to test reproducibility of the CT Pico method in a cadaveric model and to compare CT Pico measurements with a high-precision laser probe for optical scanning.

Materials And Methods: The glenoid surface of ten dried cadaveric scapulae (with intact surface) was measured by and high-precision laser probe for optical scanning, the latter being assumed as a reference standard. Measurements were done according to the Pico technique, using a circle-shaped region of interest (ROI) that was placed on the inferior glenoid rim.

Diagnostic value of contrast-enhanced cardiac magnetic resonance in patients with acute coronary syndrome with normal coronary arteries.

Purpose: To evaluate retrospectively the diagnostic value of cardiac magnetic resonance (CMR) in patients with acute coronary syndromes (ACS) with normal coronary arteries, without pre-existing comorbidities.

Materials And Methods: We retrospectively reviewed the contrast-enhanced (CE) CMR images of 143 patients (70 males and 73 females, mean age 63 years, age range 37-87), within a server of 1590 patients, between January 2012 and January 2014. Only patients with ACS (anginal episode lasting at least 30 min) with normal coronary arteries were included, as well as patients with serologic assay of positive troponin I (TnI) and possible changes in ECG, particularly ST elevation.

Curved Needles in CT-Guided Fine Needle Biopsies of Abdominal and Retroperitoneal Small Lesions.

Purpose: To demonstrate the advantages of using curved needles in fine needle aspiration (FNA) with CT-guided, for analyzing abdominal and/or retroperitoneal small lesions which are impossible to reach with conventional non-surgical biopsy techniques, particularly in cases in which the cytology sample was not possible to obtain by means of US or CT guide with axial images.

Materials And Methods: An authorization for CT-guided FNA in patients with neoplasms is not required by the institutional review board of our Institute. From April 2012 to November 2014, the study included retrospectively 25 patients (16 M, 9 F) who underwent CT-guided FNA of abdominal and/or retroperitoneal small lesions (<30 mm), in which the ultrasound and axial CT scans were not reliable guides for the biopsy procedure because of the interposition of anatomical obstacles.

Semiautomatic Analysis on Computed Tomography in Locally Advanced or Metastatic Non-Small Cell Lung Cancer: Reproducibility and Prognostic Significance of Unidimensional and 3-dimensional Measurements.

Purpose: The aim of the study was to compare both reproducibility and prognostic value of lesion size measurements obtained manually and semiautomatically on computed tomography in advanced non-small cell lung cancer (NSCLC).

Materials And Methods: Manual axial longest diameter, semiautomatic axial longest diameter, and volume of NSCLC lesions were independently analyzed by 4 readers at baseline and after at least 1 cycle of platinum-based chemotherapy. The prognostic value of the proportional change in lesion size between baseline and follow-up CT was evaluated using either RECIST or experimental thresholds derived from the quartiles of the changes as assessed manually or semiautomatically.

Systematic cell-based phenotyping of missense alleles empowers rare variant association studies: a case for LDLR and myocardial infarction.

A fundamental challenge to contemporary genetics is to distinguish rare missense alleles that disrupt protein functions from the majority of alleles neutral on protein activities. High-throughput experimental tools to securely discriminate between disruptive and non-disruptive missense alleles are currently missing. Here we establish a scalable cell-based strategy to profile the biological effects and likely disease relevance of rare missense variants in vitro.