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Biomedical subjects

A Bernasconi

Publications and source records attributed to A Bernasconi.

At least 19 recordsLinked to original sources
PubMed1991

[Assessment of early complications of kidney transplantation. Is duplex-Doppler useful for the diagnosis of acute rejection?].

The authors studied with duplex-Doppler US 28 renal transplant recipients in 31 clinically different episodes, during the early postoperative period. Morphological data were thus obtained, as well as hemodynamic information. According to the literature on the subject, a pulsatility index (PI) greater than 1.5 was considered as abnormal. US diagnosis was retrospectively compared with final clinical diagnosis and with response to therapy. In one case, the kidney was surgically removed. We evaluated US sensitivity and specificity in the diagnosis of acute rejection with real-time US, Doppler alone and combined with duplex. A PI greater than or equal to 1.5 corresponded to acute rejection, with 60% sensitivity and 85.7% specificity. With a PI greater than 1.8, sensitivity decreased to 50%, but specificity increased to 100%. The severest changes in Doppler waveforms had a bad prognostic significance. Besides poor specificity--which is so often emphasized in literature--our results chiefly demonstrated sensitivity limitations, partly corrigiable with real-time US signs, together with Doppler PI (sensitivity: 90%, specificity: 85.7%). Duplex-Doppler US, in spite of its well-known limitations, remains therefore a simple, rather reliable and non-invasive technique to study renal transplant complications.

Acute Disease↗
PubMed1989

[Pulmonary eosinophilic granuloma in adults. Case histories and a review of the literature].

Histiocytosis X is a disease of unknown origin which usually affects multiple organs, including the lung. The age of onset, the clinical course and the pattern of spread allow a distinction to be made between 3 varieties: Letterer-Siwe, Hand-Schüller-Christian and eosinophilic granuloma. The latter form, in adult patients, may predominantly or solely affect the lungs. The authors reviewed clinical, radiographic and CT findings of 7 adult patients with pulmonary eosinophilic granuloma, picked out of a series of 265 cases of interstitial lung pathology, diagnosed since 1973. Typical pulmonary involvement is bilateral, symmetrical and predominates in the upper areas. Honeycomb pattern was found in 1 patient at the onset of symptoms, and in 2 cases during the follow-up, without severe reduction in pulmonary volumes. Pneumothorax was observed in 3 cases and bone lesions in 2. CT added new and important informations such as presence, size and wall thickness of "cystic" lesions. New laboratory tests and bronchoalveolar lavage demonstrated minor diagnostic usefulness than radiological findings. The authors conclude by discussing such problems as prognostic factors and differential diagnosis.

Adolescent↗
PubMed1989

[Thoracic manifestations of AIDS (acquired immunodeficiency syndrome)].

AIDS (acquired immunodeficiency syndrome) seems to be related to human immunodeficiency virus (HIV) and is characterized by severe T-helpers lymphocyte dysfunction. Many of the AIDS patients (47-70%) develop pulmonary manifestations, both infectious and neoplastic, in the course of their disease. In the Department of Infectious Diseases of our Hospital are studied many patients HIV+. Every year 246 seropositive new patients have been discovered. Among them we have studied 25 subjects with respiratory disease, by chest radiographs; successively, according to clinical picture, we have performed thoracic computed tomography, Gallium scintigraphy, fiberoptic bronchoscopy with transbronchial biopsy (TBB), bronchoalveolar lavage (BAL); the majority of these patients (68%) had AIDS, only 28% had ARC and 4% had PGL. In our experience, the diagnosed diseases were mainly infections (92%), and most frequently (52%) due to Pneumocystis carinii, alone or in association with other etiologic agents. We have not found pathognomonic radiographic abnormalities, but chest X-ray evaluated with clinical and laboratory data, may often be useful to obtain diagnostic indications and in order to determine a more specific and aggressive diagnostic approach.

AIDS-Related Complex↗
PubMed1988

[Exogenous lipid pneumonia. Clinico-radiologic characteristics].

Exogenous lipid pneumonia (ELP) is caused by the aspiration of animal, vegetal or, more often, mineral oils. Even though it may also be acute, ELP is most frequently a chronic disease, affecting people with predisposing factors, such as neuromuscular disorders, structural abnormalities and so on; very often exogenous lipid pneumonia is found in tracheotomized patients. The pathology of lipid pneumonia is a chronic inflammatory process evolving in foreign-body-like reaction, and eventually in "end-stage lung" condition. Clinically, most patients are asymptomatic; few cases only present with cough, dyspnea and chest pain. Eight cases of ELP, studied over the past 3 years, are described in this paper. All the patients were examined by chest radiographs and standard tomograms; 3 patients underwent CT. X-ray features were mono/bilateral consolidation of the lower zones, with air bronchogram and variable reduction in volume. CT density was not specific for fat tissue. In all cases the diagnosis was confirmed at biopsy. In 5 patients, followed for at least one year, clinical-radiological features showed no change. Thus, complications of ELP (especially malignant evolution) could be excluded. The authors conclude that lipid pneumonia must be considered in differential diagnosis of patients with history of usage of oils and compatible X-ray findings. The usefulness of an accurate follow-up is stressed.

Adult↗
PubMed1987

[Transbronchial needle aspiration of mediastinal masses during fiber-bronchoscopy].

The authors present their own experience in the diagnosis of thoracic adenopathies and mediastinal masses by transbronchial needle aspiration (Wang needle). The diagnostic usefulness and safety of the method is stressed. Radiology plays an important role in choosing biopsy site (by CT), in monitoring the procedure by fluoroscopy and looking for complications following completion of the examination.

Aged↗
PubMed1986

[Echographic diagnosis of acute rejection of the transplanted kidney].

After a general review of the US findings in acute renal allograft rejection, the results are discussed of a retrospective sonographic-histologic study in 17 patients affected by acute rejection. The high sensitivity of sonography in detecting acute rejection is confirmed, but echographic studies were unable to differentiate between vascular and cellular sub-types of rejection and to provide a prognostic evaluation.

Adult↗
PubMed1984

[Chests x-ray in status asthmaticus. Relations between radiological abnormalities and impaired respiratory function].

The chest radiographs of 78 adult asthmatic patients admitted with severe acute asthma over a three-years period were reviewed. Radiographic findings were compared with functional data. Overinflation was demonstrated in 32% of chest X-rays. In four patients the presence of atelectasis was shown. On admission only PaO2 was significantly lower in patients with radiological abnormalities than in patients with normal chest radiographs. The usefulness of chest radiographs in patients with acute asthma is discussed.

Adolescent↗
PubMed1984

[Radiologic diagnosis in malignant pleural mesothelioma].

The authors summarize clinical findings and radiological aspects of pleural malignant mesothelioma. This tumor, previously uncommon, is now observed with increasing frequency in developed countries (pathogenetic relationship with asbestos fibers inhalation is proved). Common and uncommon findings are described and 8 new cases are presented. Differential diagnosis between malignant mesothelioma and other primary or secondary pleural tumors is difficult and always requires a confirmation by multiple biopsies and/or thoracotomy. The usefulness of CT study in the accurate staging of mesothelioma is particularly emphasized. In this field CT may completely replace the conventional tomography.

Asbestosis↗
PubMed1984

[Radiological evaluation of the state of hydration in uremic patients under periodic dialysis].

Seventy-four uremic patients in chronic hemodialysis were studied by X-ray of the thorax before and after the same dialysis. Radiological signs and variables (originally proposed by Milne) related to hemodynamics of pulmonary and systemic circulation were evaluated in relation to fluid subtraction. The study demonstrated the high sensitivity and the clinical value of thoracic radiography in the follow-up of these patients and particularly in the evaluation of fluid overload.

Adolescent↗
PubMed1982

[The echotomographic study of renal transplants].

The authors emphasize the role of renal sonography in detecting post renal-transplant complications, such as fluid collections and hydronephrosis. Ultrasonic study proved also to be useful in the diagnosis and follow-up of renal allograft rejection. A total of 32 renal allograft patients were studied. Focal areas of decreased parenchymal echogenicity were the most striking sonographic finding in renal rejection. Cortico medullary demarcation was difficult to interpret and was inconsistently related to rejection.

Abscess↗