Workshop on harmonization of serving multiple needs with occupational exposure databases, session II.
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Biomedical subjects
Publications and source records attributed to D Risi.
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The Authors report their experience about fifty patients affected with renovascular hypertension, treated by percutaneous transluminal angioplasty (PTA) for stenosis of main renal artery and now studied by Duplex-Scan and Color-doppler. Results, compared with arterial pressure measurements, renography and laboratory renal function evaluation, showed a sensibility of 84%, specificity of 90% and an accuracy of 87.5%. Advantages and limits of Duplex-scan in patients treated by PTA are briefly discussed.
In the present study the A. try to assess the usefulness of ultrasound in detecting blending risk in portal hypertension. Endoscopic and sonographic findings of 35 cirrhotic patients with esophageal varices were compared to a control group of 27 hepatopathy patients without portal hypertension, observed in the same department and in the same interval. The medium caliber of portal vein was 14.64 +/- 2.59 and 11.8 +/- 1.33 mm, respectively in the study and in the control group (p less than 0.01). Statistic correlations were also found in subgroups of patients with varices of different degrees. A portal vein greater than 16 mm was found in 10 of 11 patients with large varices; this pattern provides a sensitivity of 71.4% and a specificity of 94.1%. In our experience this echographic finding should represents a clear indication for close endoscopic follow-up, even in patients without previous bleeding from esophageal varices.
From February 1986 to March 1988 113 abdominal US exams were performed in emergency situation to evaluate the accuracy of this methodology: 13 were blunt traumas, 18 postoperative complications. A real-time scanner with a linear probe of 5 MHz was employed. The results were confirmed by surgical and/or clinical and instrumental evaluation. In 81% of the examinations, ultrasonography allowed a diagnosis to be made. Gallbladder and biliary pathologies were the most common findings. The results (sensibility 96%, specificity 88%, accuracy 95%) confirm the reliability of ultrasonography in abdominal emergencies, as shown in literature.
The routine use of CT has given a great contribution both to the diagnosis and to the evaluation of the extent of pancreatic carcinomas. Forty-three patients clinically suspected of pancreatic carcinoma were examined with CT. Forty of them underwent surgical control. This study was conducted to evaluate the role of CT in the diagnosing and staging of pancreatic carcinomas. 31/43 neoplasms were identified, with a diagnostic accuracy of 90%. CT was extremely accurate in the demonstration of late metastases, while it had lower accuracy in assessing the involvement of lymph nodes and peripancreatic vessels (60-70%). CT proved to be extremely useful in diagnosing pancreatic carcinomas, for it allows the detection of masses associated with Wirsung's duct dilatation and atrophy, which are a highly pathognomonic sign of pancreatic neoplasms. Moreover, CT proved useful in the staging, by assessing the presence of lymph nodes and metastases.
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Intrarectal ultrasonography is a new imaging method used in the preoperative staging of rectal cancer. Twenty five patients with proven rectal cancer were submitted to preoperative intrarectal ultrasonography; 24 were resected. Real time scanner with a linear probe of 5 MHz was employed. Five sonographic structures corresponding to the five histological layers were evidenced. Ultrasound T staging was compared to pathology, using UICC classification. In all but two cases pathology corresponded to ultrasound T staging (accuracy 92%). Perirectal nodal involvement was also investigated. It is concluded that intrarectal ultrasonography will play a definite role in the preoperative staging as well as in programming treatment of rectal carcinoma.
A retrospective analysis is reported of 131 symptomatic patients for gastro-esophageal reflux, comparing the radiological diagnosis to endoscopic, manometric and pH-metric results. A low incidence of x-ray examination is found. The role of radiology in gastro-esophageal reflux is considered and discussed.
The authors report the results of a radiological evaluation of the foot in 18 patients affected with chronic renal insufficiency (CRI). After discussing the bone changes considered to be "typical" of renal osteodystrophy, they analyse the trabecular system, in which they distinguish three degrees of change. If these finer changes are taken into account a high incidence of bony alteration is observed in CRI (84%). The biomechanics and static stresses of the foot are discussed, based on the presupposition that the anatomofunctional features of this part of the skeletal system could influence the grade and progression of the bony alterations. However, no such association was observed, nor was there any correlation between the radiographic changes and the clinical symptomatology.
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A retrospective study of 92 solitary pulmonary nodules of patients submitted to surgery is reported. The review was carried out only on chest X-rays performed prior to surgery. The radiographic signs concerning density, contour and margin were correlated with the benign or malignant nature of the lesions. 91.06% of the malignant nodules had a lobulated-umbilicated contour and ill-defined margins; 82.60% of the benign nodules had smooth contour and well-defined margins. Radiographically visible calcifications were found in 85% (6 cases) of the benign nodules, and in 15% (1 case) of the malignant ones. It is concluded that it is impossible to make a definite diagnosis of nature of SPN, due to the different types of tumor growth.
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Five cases of osteoid osteoma and five cases of osteoblastoma of the spine are reported. All the patients underwent surgery and the radiographic diagnosis was always histologically confirmed. Conventional radiographic technique using tomography constantly permitted the diagnosis. Computed tomography was primarily useful for spatial localization of the lesion. The authors evaluate the radiographic findings of the two lesions discussing the symptoms which are suspected for these pathologic conditions. Bone scintigraphy must precede radiological examination.