Clinical Application of Ultra-High-Frequency Ultrasound.

Musculoskeletal ultrasound involves the study of many superficial targets, especially in the hands, wrists, and feet. Many of these areas are within the first 3 cm of the skin surface and are ideal targets for ultra-high-frequency ultrasound. The high spatial resolution and the superb image quality achievable allow foreseeing a wider use of this novel technique, which has the potential to bring innovation to diagnostic imaging.

Post-Procedural Follow-Up of the Interventional Radiology's Management of Osteoid Osteomas and Osteoblastomas.

The family of painful osteocytic tumors includes osteoblastomas and osteoid osteomas-these lesions are considered benign, but they could produce a significant painful symptomatology. Usually, people affected are between 20 s and 30 s. When symptomatic, an effective treatment is mandatory for the management of these lesions to allow for a ful quality of life. The possibilities of treatment range from chirurgical en-block resection (procedure of surgical oncology aiming to remove a tumoral mass in its entirety, completely surrounded by a continuous layer of healthy tissue) to interventional approaches that, nowadays, are considered the most affordable and sustainable in terms of effectiveness, recovery after procedure, and for bone structure sparing. The main techniques used for osteoid osteomas and osteoblastomas are radio frequency ablation (RFA) and magnetic resonance-guided focused ultrasound (MRgFUS): the most important difference between these approaches is the needleless approach of MRgFUS, which further reduces the minimal invasiveness of RFA (and the related consequences) and the absence of exposure to ionizing radiation. Despite their high efficacy, a recurrence of pathology may occur due to a failure in therapy. In light of this, describing the various possibilities of follow up protocols and the imaging aspects of recurrence or incomplete treatment is mandatory. In the scenario given in the literature, many authors have tried to asses an organized follow up protocol of these patients, but many of them did not undergo periodical magnetic resonance (MR) or computerized tomography (CT) because of the lack of symptomatology. However, even if it seems that clinical evolution is central, different papers describe the protocol useful to detect eventual relapse. The aim of our manuscript is to review the various possibilities of follow-up of these patients and to bring together the most salient aspects found during the management of these osteocytic bone lesions.

Impulsivity traits and awareness of motor intention in Parkinson's disease: a proof-of-concept study.

INTRODUCTION: In patients with Parkinson's disease (PD), impulsivity is still a matter of investigation. It has been hypothesized that impulsive personality traits may favour impulse control disorder (ICD) onset during dopaminergic therapy. In healthy subjects, a relationship between the awareness of motor intention and impulsive personality traits assessed by the Barratt impulsivity scale (BIS-11) has been reported. The aim of this study was to evaluate the relationship between the awareness of voluntary action and impulsivity traits in PD. METHODS: Twenty-eight PD patients (stages I-III on the Hoehn and Yahr scale) underwent an impulsivity trait assessment by the BIS-11 scale and a task based on the Libet's clock. Participants were requested to perform a self-initiated movement and report the time they first feel their intention to move (W-judgement) or the time of the actual movement (M-judgement). RESULTS: In patients with higher BIS-11 scores, the time lag between the W-judgement and the actual movement was significantly lower than in patients with lower BIS-11. No difference emerged in the M-judgement. CONCLUSION: Data suggest that also in PD patients, the impulsive personality trait is related to a "delayed" awareness of motor intention and therefore to a shorter interval to allow a conscious "veto" of the impending action. Characterization of the temporal profile of awareness of motor intention could prove useful in identifying PD patients at risk of developing ICDs during dopaminergic treatment.

Severe neurologic impairment and respiratory failure after fall and hip fracture in an elderly woman.

Fat embolism syndrome is a rare complication of long bone fractures and orthopedic surgery. We report a case of a 90-year-old woman who developed severe neurologic impairment and respiratory failure few hours after an accidental fall complicated by fracture of the left femur neck and left humerus.

Campania preventability assessment committee: a focus on the preventability of the contrast media adverse drug reactions.

OBJECTIVE: The current study aims to assess the preventability of the contrast media adverse drug reactions reported through the Campania spontaneous reporting system, identifying the possible limitations emerged in this type of evaluation. METHOD: All the individual case safety reports validated by the Campania Pharmacovigilance Regional Centre from July 2012 to September 2015 were screened to select those that reported contrast media as suspected drug. Campania Preventability Assessment Committee, in collaboration with clinicians specialized in Radiology, assessed the preventability according to the P-Method, through a case-by-case approach. RESULTS: From July 2012 to September 2015, 13798 cases were inserted by pharmacovigilance managers in the Italian Pharmacovigilance Network database (in the geographical contest of the Campania Region), of which 67 reported contrast media as suspected drug. Five preventable cases were found. The most reported causes for preventability were the inappropriate drug use for the case clinical conditions and the absence of the preventive measure administrated prior to the contrast media administration. Several limitations were found in the evaluation of the critical criteria for the preventability assessment. CONCLUSIONS: Educational initiatives will be organized directly to the healthcare professionals involved in the contrast media administration, to promote an appropriate use of the contrast media.

Suspected adverse reactions to contrast media in Campania Region (Italy): results from 14 years of post-marketing surveillance.

OBJECTIVE: During the last years in Italy, contrast media (CM) use increased. An increase of monitoring activities on CM-induced adverse drug reaction (ADR) is necessary, also in our regional territory. The main aim of this study was to give a preliminary evaluation of all Spontaneous Reports of ADRs (SRA) attributed to CM sent to Campania Pharmacovigilance Regional Center (CRFVC) from 01 January 2001 to 31 October 2014. RESEARCH DESIGN AND METHODS: For each SRA we evaluated: frequency and source, ADRs onset (time to event, seriousness and outcome), socio-demographic characteristics and risk factors of cases, the most reported CM (checking for pharmacodynamic and pharmacokinetic interactions). RESULTS: A total of 111 SRA were sent to CRFVC; specialist in radiology was the main source of reports. Ninety-seven SRA (87.3%) were referable to hypersensitivity reactions. Thirty-four SRA (30.6%) reported serious ADRs. The most reported CM were iopamidol, gadobenic acid and gadoteric acid. We identified two SRA induced by pharmacokinetic and/or pharmacodynamic interactions. CONCLUSIONS: During 14 years of post-marketing surveillance, only few SRA concerning CM-induced ADRs were sent to CRFVC probably due to underreporting. We aim to improve monitoring activity on CM-induced ADRs especially in hospitals. Most reported ADR and CM were in line with current body of literature.

Reliability of administrative data for the identification of Parkinson's disease cohorts.

Parkinson's disease (PD) is a major worldwide public health problem with a prevalence that is expected to increase dramatically in the coming decades. Because administrative data are useful for epidemiologic and health service studies, we aimed to define procedural algorithms to identify PD patients (on a regional basis) using these data. We built two a priori algorithms, respecting privacy laws, with increasing theoretical specificity for PD including: (1) a hospital discharge diagnosis of PD; (2) PD-specific exemption; (3) a minimum of two separate prescriptions of an antiparkinsonian drug. The two algorithms differed for drugs included. Sensitivities were tested on an opportunistic sample of 319 PD patients from the databases of 5 regional movement disorders clinics. The estimated prevalence of PD in the sample population from Tuscany was 0.49 % for algorithm 1 and 0.28 % for algorithm 2. Algorithm 1 correctly identified 291 PD patients (sensitivity 91.2 %), and algorithm 2 identified 242 PD patients (sensitivity 75.9 %). We developed two reproducible algorithms demonstrating increasing theoretical specificity with good sensitivity in identifying PD patients based on an evaluation of administrative data. This may represent a low-cost strategy to reliably follow up a large number of PD patients as a whole for evaluating the effects of therapies, disease progression and prevalence.

The painful muse: migrainous artistic archetypes from visual cortex.

Neurological diseases which constituted traditionally obstacles to artistic creation can, in the case of migraine, be transformed by the artists into a source of inspiration and artistic production. These phenomena represent a chapter of a broader embryonic neurobiology of painting.