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1.
Radiol Med ; 125(9): 894-901, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32654028

RESUMEN

Preparedness for the ongoing coronavirus disease 2019 (COVID-19) and its spread in Italy called for setting up of adequately equipped and dedicated health facilities to manage sick patients while protecting healthcare workers, uninfected patients, and the community. In our country, in a short time span, the demand for critical care beds exceeded supply. A new sequestered hospital completely dedicated to intensive care (IC) for isolated COVID-19 patients needed to be designed, constructed, and deployed. Along with this new initiative, the new concept of "Pandemic Radiology Unit" was implemented as a practical solution to the emerging crisis, born out of a critical and urgent acute need. The present article describes logistics, planning, and practical design issues for such a pandemic radiology and critical care unit (e.g., space, infection control, safety of healthcare workers, etc.) adopted in the IC Hospital Unit for the care and management of COVID-19 patients.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/prevención & control , Arquitectura y Construcción de Hospitales , Hospitales de Aislamiento/organización & administración , Pandemias/prevención & control , Neumonía Viral/prevención & control , Servicio de Radiología en Hospital/organización & administración , COVID-19 , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Humanos , Unidades de Cuidados Intensivos/organización & administración , Italia/epidemiología , Equipo de Protección Personal , Admisión y Programación de Personal/organización & administración , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Radiografía , SARS-CoV-2 , Tomografía Computarizada por Rayos X/instrumentación , Ultrasonografía
2.
Mol Genet Metab ; 104(4): 677-81, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21945273

RESUMEN

Autosomal recessive polycystic kidney disease (ARPKD), characterized by progressive cystic degeneration of the kidneys and congenital hepatic fibrosis (CHF), is the most common childhood onset ciliopathy, with an estimated frequency of 1 in 20,000 births. It is caused by mutations in PKHD1. The carrier frequency for ARPKD in the general population is estimated at 1 in 70. Given the recessive inheritance pattern, individuals who are heterozygous for PKHD1 mutations are not expected to have clinical findings. We performed ultrasound (USG) evaluations on 110 parents from 64 independent ARPKD families and identified increased medullary echogenicity in 6 (5.5%) and multiple small liver cysts in 10 parents (9%). All ARPKD parents with these abnormal imaging findings were asymptomatic; kidney and liver function tests were unremarkable. Complete sequencing of PKHD1 in the 16 ARPKD parents with abnormal imaging confirmed the mutation transmitted to the proband, but did not reveal any other pathogenic variants. Our data suggest that carrier status for ARPKD is a predisposition to polycystic liver disease and renal involvement associated with increased medullary echogenicity on USG. Whether some of these individuals become symptomatic as they age remains to be determined.


Asunto(s)
Heterocigoto , Riñón/patología , Hígado/patología , Riñón Poliquístico Autosómico Recesivo/genética , Receptores de Superficie Celular/genética , Adulto , Anciano , Quistes/diagnóstico por imagen , Análisis Mutacional de ADN , Femenino , Humanos , Riñón/diagnóstico por imagen , Hígado/diagnóstico por imagen , Hepatopatías/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Mutación Missense , Padres , Ultrasonografía
3.
Eur Urol Oncol ; 4(6): 868-876, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33582104

RESUMEN

BACKGROUND: Imaging techniques are used to identify local recurrence of prostate cancer (PCa) for salvage therapy and to exclude metastases that should be addressed with systemic therapy. For magnetic resonance imaging (MRI), a reduction in the variability of acquisition, interpretation, and reporting is required to detect local PCa recurrence in men with biochemical relapse after local treatment with curative intent. OBJECTIVE: To propose a standardised method for image acquisition and assessment of PCa local recurrence using MRI after radiation therapy (RP) and radical prostatectomy (RT). EVIDENCE ACQUISITION: Prostate Imaging for Recurrence Reporting (PI-RR) was formulated using the existing literature. An international panel of experts conducted a nonsystematic review of the literature. The PI-RR system was created via consensus through a combination of face-to-face and online discussions. EVIDENCE SYNTHESIS: Similar to with PI-RADS, based on the best available evidence and expert opinion, the minimum acceptable MRI parameters for detection of recurrence after radiation therapy and radical prostatectomy are set. Also, a simplified and standardised terminology and content of the reports that use five assessment categories to summarise the suspicion of local recurrence (PI-RR) are designed. PI-RR scores of 1 and 2 are assigned to lesions with a very low and low likelihood of recurrence, respectively. PI-RR 3 is assigned if the presence of recurrence is uncertain. PI-RR 4 and 5 are assigned for a high and very high likelihood of recurrence, respectively. PI-RR is intended to be used in routine clinical practice and to facilitate data collection and outcome monitoring for research. CONCLUSIONS: This paper provides a structured reporting system (PI-RR) for MRI evaluation of local recurrence of PCa after RT and RP. PATIENT SUMMARY: A new method called PI-RR was developed to promote standardisation and reduce variations in the acquisition, interpretation, and reporting of magnetic resonance imaging for evaluating local recurrence of prostate cancer and guiding therapy.


Asunto(s)
Imágenes de Resonancia Magnética Multiparamétrica , Neoplasias de la Próstata , Consenso , Humanos , Imagen por Resonancia Magnética , Masculino , Recurrencia Local de Neoplasia/diagnóstico por imagen , Próstata , Antígeno Prostático Específico , Prostatectomía , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/cirugía
4.
Nanomedicine (Lond) ; 10(9): 1423-37, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25392239

RESUMEN

AIMS: To demonstrate the use of gadolinium (Gd)-labeled dendrimers as lymphatic imaging agents and establish the long-term biodistribution (90-day) of this type of agent in mice. MATERIALS & METHODS: A G5-Gd-BnDOTA dendrimer was prepared and injected into mice and monkeys for MR lymphangiography, and long-term biodistribution of the conjugate was studied. RESULTS: Administration of G5-Gd-BnDOTA in mice demonstrated a rapid uptake in the deep lymphatic system while injection in monkeys showed enhanced internal iliac nodes, indicating its general utility for lymphatic tracking. Biodistribution studies to 90 days showed that gadolinium conjugate is slowly being eliminated from the liver and other organs. CONCLUSION: The use of G5-Gd-BnDOTA holds great promise for lymphatic imaging, but its slow clearance from the body might hamper its eventual clinical translation.


Asunto(s)
Medios de Contraste , Dendrímeros/química , Dendrímeros/farmacocinética , Sistema Linfático/metabolismo , Linfografía/métodos , Imagen por Resonancia Magnética/métodos , Animales , Cromatografía de Afinidad , Cromatografía Líquida de Alta Presión , Femenino , Haplorrinos , Ratones , Ratones Desnudos , Distribución Tisular
5.
Clin Nucl Med ; 39(10): 874-81, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25144214

RESUMEN

BACKGROUND: Despite its success in diagnosing and staging lymphoma, F-FDG PET/CT can be falsely positive in areas of posttreatment inflammation. 3'-F-fluoro-3'-deoxy-l-thymidine (F-FLT) is a structural analog of the DNA constituent thymidine; its uptake correlates with cellular proliferation. This pilot study evaluates the ability of F-FLT PET/CT to distinguish viable lymphoma from posttreatment inflammatory changes in F-FDG avid residual masses. METHODS: Twenty-one patients with lymphoma with at least 1 F-FDG avid residual mass after therapy underwent F-FLT PET/CT imaging. F-FDG and F-FLT uptake values were compared, including quantitative pharmacokinetic parameters extracted from the F-FLT time activity curves generated from dynamic data using graphical and nonlinear compartmental modeling. RESULTS: The true nature of the residual mass was confirmed by biopsy in 12 patients (8 positive and 4 negative for viable lymphoma and by follow-up CT and/or repeat F-FDG PET/CT imaging over 1 year); among the remaining 9 patients, 7 lesions resolved or decreased and 2 showed growth indicative of lymphoma. F-FLT PET SUVest.max was significantly higher in tumors than in benign lesions (5.5 [2.2] vs 1.7 [0.6]; P < 0.0001), whereas the difference in F-FDG SUVs was not significant (malignant, 7.8 [3.8] vs benign, 5.4 [2.4]; P = 0.11). All of the benign lesions had an F-FLT SUVest.max of less than 3.0. CONCLUSIONS: F-FLT shows improved specificity over F-FDG in distinguishing residual lymphoma from posttreatment inflammation and may be useful in the evaluation of patients with residual F-FDG-positive masses after completing therapy.


Asunto(s)
Didesoxinucleósidos , Fluorodesoxiglucosa F18 , Linfoma/diagnóstico por imagen , Radiofármacos , Adulto , Anciano , Femenino , Humanos , Linfoma/terapia , Masculino , Persona de Mediana Edad , Imagen Multimodal , Proyectos Piloto , Tomografía de Emisión de Positrones , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
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