PubMed Health⌕ Search

Biomedical subjects

L Barozzi

Publications and source records attributed to L Barozzi.

At least 37 records · Page 2Linked to original sources
PubMed1998

Prostatic abscess: diagnosis and treatment.

OBJECTIVE: Prostatic abscesses are uncommon in clinical practice because early antibiotic therapy has reduced complications of prostatitis. Prostatic abscess mainly affects diabetic and immunosuppressed patients. The organisms most frequently involved are Escherichia coli and Staphylococcus, whereas gonococcus is rarely encountered. The results in eight men with prostatic abscess, five of whom were treated with sonographically guided percutaneous drainage, are reported. The diagnosis, clinically suspected in only three patients, was confirmed by transrectal sonography. All patients experienced complete abscess resolution. CONCLUSION: Transrectal sonography is the most reliable imaging method to diagnose prostatic abscess. Percutaneous transperineal or transrectal drainage is the first choice for therapy because of the lower risk of complication compared with surgery.

Abscess↗
PubMed1998

[Potential of ultrasonography and ultrasonography-guided biopsy in the diagnosis of local recurrence following radical prostatectomy].

INTRODUCTION: [corrected] We investigated the diagnostic role of combined transrectal US (TRUS) and biopsy to detect recurrent cancer after radical prostatectomy, in patients with negative bone scintigraphy and elevated prostate specific antigen (PSA) levels. MATERIALS AND METHODS: From March, 1997, to May, 1998, we examined 12 patients with persistently detectable serum PSA levels and negative bone scintigraphy. At the time of diagnosis, an average 36 months had elapsed since prostatectomy. Digital rectal examination (DRE) and disease stage at the time of surgery were also considered. Patients age ranged 47 to 83 years (mean: 65). All patients underwent TRUS with a 7.5 MHz biplane probe; biopsy was performed with a 16 G cutting needle. TRUS findings were considered suspicious if the scan showed any unusual hypoechoic tissue adjacent to the bladder neck, in retrotrigone or peri-retroanastomotic site. In these cases a transperineal US-guided biopsy was performed. RESULTS: The biopsy proved cancer in 10/12 cases (in 12 cases after two biopsies), showing a better diagnostic accuracy than DRE, which poorly distinguished postoperative changes from recurrent or residual cancer. CONCLUSIONS: The early detection of recurrences after radical prostatectomy in patients with negative bone scintigraphy is feasible when the above examinations are performed in the same order as described: PSA levels, if altered, indicate the patients to be submitted to TRUS. The latter may be falsely negative in some cases because small recurrences may exhibit no findings at US, and therefore US-guided biopsy of peri-retro-anastomotic regions should be always performed too. The recurrence must be confirmed at histology because histologic findings help choose adjuvant treatment and/or radical irradiation.

Aged↗
PubMed1998

[Multiple bilateral biopsy of the prostate].

INTRODUCTION: Transrectal guided biopsy is the method of choice to detect carcinoma of the prostate. Systematic bilateral biopsies have been recently introduced in clinical practice because they provide valuable information about the local staging of the cancer and better representation of the actual Gleason grade of the whole tumor. The purpose of this study is to assess the frequency of neoplastic lesions in prostatic areas with normal structure at US and rectal examination and to identify, if possible, some criteria to be used in the selection of patients for random biopsies. MATERIAL AND METHOD: Systematic bilateral prostatic biopsies were performed in 155 patients with elevated prostate specific antigen (PSA) values, not exceeding 40 ng/mL and with suspected neoplastic unilateral lesion at rectal examination or US. All patients with bilateral or diffuse nodules were not included in this analysis. Three random biopsies for every side of the gland were performed using a 16-18 gauge tru-cut needle. A direct biopsy of the hypoechoic nodule or area was always performed. All specimens results were correlated with PSA and PSA density values obtained before biopsy. RESULTS: Systematic biopsy identified cancers in 53/155 patients (34.19%). Of 53 cases, 35 (66%) had unilateral prostatic carcinoma and 18 (34%) had bilateral cancer. The final diagnosis was benign prostatic lesion in the remaining 102 patients (benign prostatic hyperplasia, nonspecific granulomatous prostatitis, chronic prostatitis). Dividing all the patients into main groups on the basis of pathologic findings (benign, unilateral and bilateral carcinoma) there was a statistically significant difference of PSA values between the 3 groups. CONCLUSIONS: Our observations confirm the utility of systematic US-guided biopsies in the detection of tumors in normal appearing areas at US and transrectal examination, but the clinical utility of this approach needs further confirmation. Additional data on cancer volume, Gleason grade, capsular infiltration, lymph node metastasis and long term survival must be evaluated with large number of patients. In our experience PSA values can be used as a criterion to select the patients to submit to this technique to provide useful, preoperative information suspected prostatic malignancy.

Aged↗
PubMed1998

Retrocalcaneal bursitis in spondyloarthropathy: assessment by ultrasonography and magnetic resonance imaging.

OBJECTIVE: To establish by magnetic resonance imaging (MRI) and ultrasonography (US) the frequency of retrocalcaneal bursa involvement in Achilles enthesitis of spondyloarthropathy (SpA) and to compare the results of the 2 examinations. METHODS: Nineteen Achilles tendons with severe enthesitis and 9 normal tendons of 14 patients meeting the Amor criteria for SpA were examined by MRI and US. RESULTS: Both MRI and US showed a significant increase in the mean Achilles tendon thickness in the pathologic legs compared to the normal legs both at the superior calcaneal surface and 3 cm above. MRI showed retrocalcaneal bursitis in 14 (73.7%) of 19 pathologic legs and superficial bursitis in 2 (10.5%). US showed fluid collection only in 7 of 14 retrocalcaneal bursae positive on MRI, and failed to show fluid in the 2 superficial bursae involved. Using MRI as the gold standard, US showed 50% sensitivity and 100% specificity for retrocalcaneal bursa involvement and lacked sensitivity for superficial bursitis. CONCLUSION: Achilles tendon involvement in SpA is not only a disease of the enthesis but also of the adjacent bursae.

Achilles Tendon↗
PubMed1997

Proximal bursitis in active polymyalgia rheumatica.

BACKGROUND: The cause of musculoskeletal symptoms in the proximal extremities of patients who have polymyalgia rheumatica is not completely understood. The diffuse and severe discomfort can only be partially explained by the mild joint synovitis that is observed in these patients. OBJECTIVE: To determine the involvement of the synovial structures of the shoulder girdle of patients who have active symptoms of polymyalgia rheumatica. DESIGN: Case-control study. SETTING: 2 secondary referral centers of rheumatology. PATIENTS: 13 case-patients who had active symptoms of polymyalgia rheumatica seen during a 6-month period, 9 control-patients who had early symptoms of elderly-onset rheumatoid arthritis, and 10 age-matched healthy controls. MEASUREMENTS: Magnetic resonance imaging of the shoulder was done on the 13 case-patients, 9 control-patients, and 10 healthy controls. RESULTS: The frequency of subacromial and subdeltoid bursitis was significantly higher in the case-patients (who had polymyalgia rheumatica) than in the control-patients (who had elderly-onset rheumatoid arthritis). The frequencies of synovitis of the joints and tenosynovitis of the biceps did not significantly differ between the 13 case-patients and the 9 control-patients. None of the healthy controls showed evidence of fluid accumulation in the joints, bursae, or sheaths of the long head of the biceps. CONCLUSIONS: Inflammation of subacromial and subdeltoid bursae in association with synovitis of the glenohumeral joints and tenosynovitis of the biceps may contribute to the diffuse discomfort in the shoulder girdle observed in patients with polymyalgia rheumatica.

Aged↗
PubMed1997

Iliolumbar ligament ossification in undifferentiated seronegative spondyloarthropathy.

The case of a man suffering from undifferentiated seronegative spondyloarthropathy (uSpA) without spine involvement and with iliolumbar ligament ossification is reported. Unlike a similar previously published case showing ossification only of the middle part of the left ligament, our patient had ossification of the whole course of both ligaments.

Foot↗
PubMed1997

Toe dactylitis in patients with spondyloarthropathy: assessment by magnetic resonance imaging.

OBJECTIVE: To investigate using magnetic resonance imaging (MRI) the part played by flexor and extensor tenosynovitis and synovitis of the metatarsophalangeal (MTP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints in producing the "sausage-like" aspect of spondyloarthropathy (SpA) toe dactylitis. METHODS: Twelve sausage-like toes and corresponding contralateral toes of 7 consecutive patients meeting Amor criteria for SpA were studied by MRI. RESULTS: All dactylitic toes showed fluid collections in the flexor synovial sheaths on MRI. Due to the sheath distension the plantar bone to skin distance was significantly increased (p < 0.05) in the dactylitic toes compared to normal contralateral toes. Peritendinous soft tissues were not involved since these were significantly thicker (p < 0.05) in normal toes. Extensor synovial sheaths were involved in only 4 dactylitic toes. Of the 36 joints of the 12 dactylitic toes only 2 MTP joints showed capsule distension. Considering MRI as the "gold standard", examination showed 100% sensitivity and specificity for flexor sheath involvement but lacked sensitivity for extensor synovial sheaths and showed a low specificity for joint capsule distension. CONCLUSION: Like finger dactylitis, toe dactylitis may also be due to flexor tenosynovitis and synovitis of MTP, PIP, and DIP joints may not be a required condition for sausage-shaped appearance. Extensor tenosynovitis may be present in addition to flexor tenosynovitis. Physical examination is a sufficient method for diagnosing toe dactylitis.

Adult↗
PubMed1996

Dactylitis in patients with seronegative spondylarthropathy. Assessment by ultrasonography and magnetic resonance imaging.

OBJECTIVE: To establish by means of ultrasound and magnetic resonance imaging (MRI) the role of tenosynovitis and arthritis in determining the "sausage-like" aspect of finger dactylitis and to compare the results of the 2 examinations. METHODS: Twelve dactylitic fingers and their corresponding normal contralateral fingers belonging to 10 patients who met the Amor criteria for the diagnosis of seronegative spondylarthropathy (SpA) were studied by ultrasonography and MRI. RESULTS: MRI revealed a significant increase in the volar bone-to-skin distance in dactylitic fingers with respect to that of the normal contralateral fingers (P < 0.001). This increase was due to distension of the flexor synovial sheaths (P < 0.00001) by fluid collection. Peritendinous soft tissues were not involved, since these were found to be significantly thicker in the normal fingers (P < 0.05). Of the 36 joints of the 12 dactylitic fingers, only 1 showed capsule distension. Using MRI as the "gold standard," ultrasonography showed a 100% sensitivity and specificity for flexor tenosynovitis, but lacked sensitivity for joint involvement because it failed to reveal joint capsule distension in the only joint involved. Similarly, physical examination showed a 100% sensitivity and specificity for flexor sheath involvement. CONCLUSION: Dactylitis is due to flexor tenosynovitis. Enlargement of the finger joint capsule is not an indispensable condition for the "sausage-like" feature. Physical examination is a sufficient method for the diagnosis of dactylitis.

Fingers↗
PubMed1994

[Color-Doppler of the renal arteries at their origin. Technical-methodologic problems].

Steno-obstructive diseases of the renal arteries affect mainly the ostium and the proximal vessels. The Doppler US study of the renal arteries can be troublesome on account of their depth, reduced caliber and considerable anatomical variability in their origin, course and number. Recent color-Doppler techniques have helped partially overcome these limitations relative to the identification of both vessels and stenoses. The technique for the visualization of the renal arteries requires supine transverse epigastric, coronal and transcaval scans to obtain a good beam angle. The stenosis can be recognized by the phenomena of turbulence and blood flow acceleration that elicit a typical yellow-green or white color variance, according to the different units. Spectral analysis allows monitoring of spectral broadening, velocity/frequency increase in systolic peak and increase in aortic-renal ratio. Stenoses can be quantified by calculating the stenosis index. The major limitation to the clinical use of color-Doppler US to study steno-obstructive diseases of the renal arteries is the high incidence of supplemental vessels (25-30% of the patients) and early bifurcations of the main branch. Thus, a correct and accurate imaging technique designed to search supplemental vessels plays a major role in decreasing the number of false negatives. Captopril renal scintigraphy is more sensitive than color-Doppler US in the identification of renin-dependent hypertension, but Doppler US is definitely better at detecting stenoses < 60% which may lead to chronic renal insufficiency.

Humans↗
PubMed1994

[Echography and magnetic resonance of the penis. I. Its anatomy].

The use of such new diagnostic imaging methods as ultrasonography (US) and Magnetic Resonance Imaging (MRI) has given radiology an increasingly important role in the study of penis abnormalities. The normal anatomy of the penis was investigated with US with real-time units, high-frequency linear probes, and with an 0.5-T MR unit. The two methods are definitely better than conventional radiologic techniques because they allow the direct and detailed demonstration of all anatomical structures. Both the normal and the abnormal anatomy are better depicted when the exam is performed after pharmacologically induced erection. The normal US and MR features of the different anatomical structures must be known to diagnose penis conditions. US exhibited better spatial resolution than MRI and demonstrated very small structures which may be missed at MRI because of gap interslices. On the other hand, MRI exhibited better contrast resolution, especially on T2-weighted sequences. Thus, the two imaging methods must be considered as complementary, even though US is suggested as the method of choice because of its cost-effectiveness and widespread availability.

Evaluation Studies as Topic↗
PubMed1994

[Tubular ectasia of the rete testis. The echographic aspects].

Tubular ectasia of the seminiferous tubules of the rete testis is an uncommon benign condition which was only recently described. Its US pattern is typical and allows the disease to be distinguished from cystic tumors of the testicle. The condition was evaluated with US in 10 patients; all men were over 50 years old. US was performed with a 7.5-MHz linear probe. The lesion was unilateral in 7 and bilateral in 3 patients. It was always localized in the mediastinum testis and was associated with spermatocele in 5 cases and with testicular cysts in 4. On US scans, the condition presented with several tubular or rounded anechoic structures, mimicking a hypoechoic mass. In 5 men with 4-19 months' follow-up, no change in lesion size and structure was observed. Tubular ectasia was never assessed with biopsy or histology. Tubular ectasia of the rete testis shares several US features with testicular cysts and spermatocele, which are likely to have the same underlying mechanisms. This benign condition can be distinguished from true cysts and testicular tumors on the basis of US findings and its differential diagnosis is important to avoid unnecessary surgery.

Aged↗