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Biomedical subjects

A Castriota-Scanderbeg

Publications and source records attributed to A Castriota-Scanderbeg.

32 records · Page 2Linked to original sources

Ultrasound of femoral head cartilage: a new method of assessing bone age.

This paper analyses the relationship between the thickness of the anterior femoral head cartilage (FHC), as measured by ultrasound, and some anthropometric parameters, such as height, weight, skeletal and chronological age. In addition, it provides standard norms for FHC thickness in a paediatric population. Both hips were examined in 213 consecutive subjects (99 boys and 114 girls), aged 1.9-14 years. Seventy-four subjects underwent hand and wrist X-rays for skeletal maturation: 32 of these were dropped from the study because a discrepancy as high as two standard deviations was found between their skeletal and their chronological age. The thickness of FHC correlated strongly with skeletal and chronological age, standing height and body weight. A side difference of 0.2 mm in FHC was considered to be abnormal. The study population was divided into 13 groups according to chronological and values of FHC for boys and girls are provided for each group. It is suggested that the magnitude of hyaline FHC is valuable feature in the evaluation of skeletal maturation in children.

Adolescent↗

Spontaneous regression of exostoses: two case reports.

Exostoses are a common skeletal disorder. Despite their incidence, little is yet known about their origin and biological behaviour. In particular, spontaneous regression of exostoses--an extremely rare event--is still a subject for debate. In this study, we describe two additional cases of spontaneous regression of exostosis; one was a solitary lesion while the other occurred in a patient with multiple heritable exostoses. Radiographic findings are presented along with some of the theories which aim at explaining this phenomenon.

Bone Neoplasms↗

[Diagnosis of mycoplasma pneumonia in children: which is the role of thoracic radiography?].

Despite its frequency, pneumonia is often surprisingly difficult to diagnose in children and young adults. In particular, the etiologic agent of pneumonia is difficult to recognize in an early stage, which obviously implies an empirical or delayed treatment. Chest radiography is one of the most common procedures required when pneumonia is suspected. This retrospective study was carried out to investigate the capabilities of chest radiography to identify the specific patterns of mycoplasma pneumonia in children. The chest radiographs of 76 children and adolescents (aged 4.2 to 16.4 years) with a radiographic diagnosis of pneumonia were reviewed. All patients were tested twice for serum antimycoplasma antibodies. Thirty-eight subjects (50%) with markedly increased antimycoplasma antibody levels were diagnosed as having mycoplasma infection. In the remaining 38 patients, viral (22 patients, 29%), bacterial (13 patients, 17%) and mixed (3 patients, 4%) infections were diagnosed on the grounds of clinical and laboratory data. Parahilar peribronchial infiltrates were found to be associated with both viral and mycoplasma infections, whereas segmental or lobar consolidation was associated with bacterial, viral and mycoplasma infections. Reticulonodular infiltrates were a specific pattern of mycoplasma pneumonia. The authors conclude that, in the presence of a reticulonodular infiltrate in a lobe, mycoplasma pneumonia can be confidently diagnosed.

Adolescent↗

Slipped capital femoral epiphysis: ultrasonographic findings.

Slipped capital femoral epiphysis (SCFE) is an uncommon skeletal disorder of adolescence often overlooked because of its nonspecific clinical presentation. Anteroposterior radiography may fail to demonstrate a minimal slip even when clinical examination raises suspicion of the disease. On the other hand, prompt diagnosis is essential to obtain better therapeutic results. In our patient population joint effusion, which often accompanies SCFE, was readily recognized and quantified by ultrasonography (US). US also permitted recognition of the initial SCFE and assessment of the degree of slip by measuring the height of the physeal step. As to metaphyseal remodeling, plain radiography seems to be more informative than US; however, US has a role in the follow-up of SCFE because of the risk of slippage in the contralateral hip. This work suggests that US is useful as a primary imaging tool in the evaluation of subjects with limp or hip or knee pain to rule out SCFE.

Adolescent↗

[Ultrasonography in the diagnosis and follow-up of hip pain in children].

Fifty-seven subjects aged 1.5-14 years (mean: 6.5; standard deviation: 3.3) complaining of hip pain and/or limp underwent clinical, US and radiologic examinations on admission and after variable time intervals. Twenty-eight of them were found to be affected with transient synovitis, 2 with rheumatic fever, 2 with slipped capital femoral epiphysis and 5 with Legg-Calvè-Perthes disease. The extant 20 subjects with normal US and X-ray findings were diagnosed as having irritable hip without effusion. No false-negative results were obtained from US (100% sensitivity), whereas X-ray provided false-negative results in 28 of 37 patients with hip disorders other than irritable hip without effusion (24.3% sensitivity). No significant difference in the extent of hip joint effusion was found at US between the various groups. In the transient synovitis group, joint effusion was apparent on X-ray image in 3 of 28 patients, in whom the effusion was significantly more severe than in the extant 25 patients. Capsular joint effusion resolved more rapidly in transient synovitis than in Legg-Calvè-Perthes disease. The patients with both rheumatic fever and transient synovitis exhibited the most rapid onset of symptoms. On the basis of our results, we suggest that each patient complaining of hip pain and/or limp should undergo US first and that X-rays be performed second, in selected cases only.

Adolescent↗

[Hemosiderosis in thalassemia major. Quantitative study with magnetic resonance (MR)].

Hemosiderosis, which results from transfusional therapy and from increased absorption of dietary iron, is a severe complication of thalassemia major. The complication is also very difficult to manage. An accurate determination of the total amount and of the distribution of body iron stores is essential for prognostic purposes and to evaluate the efficacy of chelation therapy. Therefore, a suitable tool for the noninvasive depiction of iron overload is to be hoped for. MR imaging has been usefully employed, of late, to this purpose. Sixteen thalassemic patients have been studied to evaluate iron depositions using a 1.5 T magnet. Signal intensities from liver, pancreas, spleen, bone marrow, and heart were considered. The signals were dramatically lower than the normal values obtained in a sex- and age-matched group; the differences were due to the iron. Iron distribution appeared inhomogeneous, with the highest overload in liver and bone marrow. Since cardiomyopathy represents the first cause of death in thalassemic patients, the relationship between cardiac function and iron overload in the heart has been thoroughly investigated. Finally, the authors conclude that MR will become a widely employed method for assessing iron overload and will contribute to improve the management of thalassemia major.

Adolescent↗

Calcified ovarian metastases from mucinous carcinoma of the colon.

The authors report a case of calcified ovarian metastases from a mucinous carcinoma of the colon observed in an 85-year-old woman. The radiological aspects observed at computed tomography (CT) are described and the possible mechanisms of tumoral calcifications are discussed.

Adenocarcinoma↗

Normal values of total reticulocytes and reticulocyte subsets in children and young adults.

This work provides the values for percentage and total reticulocyte count, as well as the values of reticulocyte fluorescence intensity ratios as determined by an automated fluorescent technique in a normal pediatric population. The peripheral reticulocyte subsets, as assessed on the basis of their degree of maturation, allow a more accurate evaluation of bone marrow activity than the percentage or total count do. This would result in a more appropriate management of erythropoietic disorders in children.

Adolescent↗

Turbo-Proton Echo Planar Spectroscopic Imaging (t-PEPSI) MR technique in the detection of diffuse axonal damage in brain injury. Comparison with Gradient-Recalled Echo (GRE) sequence.

PURPOSE: Diffuse axonal injury (DAI) is a common type of primary neuronal injury in patients with severe traumatic brain injury, and is frequently accompanied by tissue tear haemorrhage. The T2*-weighted gradient-recalled echo (GRE) sequences are more sensitive than T2-weighted spin-echo images for detection of haemorrhage. This study was undertaken to determine whether turbo-PEPSI, an extremely fast multi-echo-planar-imaging sequence, can be used as an alternative to the GRE sequence for detection of DAI. MATERIALS AND METHODS: Nineteen patients (mean age 24,5 year) with severe traumatic brain injury (TBI), occurred at least 3 months earlier, underwent a brain MRI study on a 1.5-Tesla scanner. A qualitative evaluation of the turbo-PEPSI sequences was performed by identifying the optimal echo time and in-plane resolution. The number and size of DAI lesions, as well as the signal intensity contrast ratio (SI CR), were computed for each set of GRE and turbo-PEPSI images, and divided according to their anatomic location into lobar and/or deep brain. RESULTS: There was no significant difference between GRE and turbo-PEPSI sequences in the total number of DAI lesions detected (283 vs 225 lesions, respectively). The GRE sequence identified a greater number of hypointense lesions in the temporal lobe compared to the t-PEPSI sequence (72 vs 35, p<0.003), while no significant differences were found for the other brain regions. The SI CR was significantly better (i.e. lower) for the turbo-PEPSI than for the GRE sequence (p<0.00001). CONCLUSIONS: Owing to its very short scan time and high sensitivity to the haemorrhage foci, the turbo-PEPSI sequence can be used as an alternative to the GRE to assess brain DAI in severe TBI patients, especially if uncooperative and medically unstable.

Journal Article↗

Methods for evaluating iron stores and efficacy of chelation in transfusional hemosiderosis.

An accurate determination of the total amount and distribution of body iron stores is essential for prognostic purposes and to evaluate the efficacy of chelation therapy. In the clinical setting, a rough estimate of the total body iron burden may be obtained in patients with transfusion-dependent anemias by calculating the amount of blood administered plus the amount absorbed by the gastrointestinal route, which is influenced by the level of Hb and by bone marrow activity. An increase in serum iron and a decrease in total iron binding capacity are early indicators of iron overload, but their sensitivity and specificity are not very high. In normal individuals, serum ferritin correlates well with iron stores, as measured by phlebotomy, and with directly measured liver iron. However, plasma ferritin, being an acute phase reactant, is increased in cases of chronic disease, disseminated malignancy, or inflammatory disorders. Non-transferrin bound iron, i.e. iron that circulates in plasma unbound to transferrin, is potentially toxic since it is capable of taking part in free radical-mediated reactions that result in irreversible tissue damage. This iron can be measured with a HPLC based assay. At present the most accurate way of estimating the iron burden is by direct measurement of iron concentration in tissues. The liver is the most accessible. The measurement is done by atomic absorption spectrometry on ashed or lyophilized samples obtained by needle biopsy, and correlates well with the total amount of blood transfused and with the extent of hepatic fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Chelation Therapy↗