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M Lamacchia

Publications and source records attributed to M Lamacchia.

6 recordsLinked to original sources
PubMed2002

Detection of common bile duct stones before laparoscopic cholecystectomy. Evaluation with MR cholangiography.

PURPOSE: To assess the diagnostic value of MR cholangiography (MRC) for detecting common bile duct (CBD) stones in candidates for laparoscopic cholecystectomy (LC). MATERIAL AND METHODS: A series of 95 selected patients with gallstones and suspected CBD lithiasis (abnormal serum liver tests and/or CBD size > or = 6.5 mm at US) were referred to our institution for MRC, before LC. MRC was performed on a 0.5 T magnet through a non-breath-hold, respiratory-triggered, fat-suppressed, thin-slab, heavily T2-weighted fast spin-echo sequence and through a breath-hold, thick-slab, single-shot T2-weighted sequence in the coronal plane. Axial T1- and T2-weighted sequences were first obtained. Two observers in conference reviewed source images and maximum intensity projections to determine the presence or absence of choledocholithiasis. MR findings were compared with endoscopic retrograde cholangiography and intraoperative cholangiography (IOC); IOC was always performed during LC. RESULTS: CBD calculi (single or multiple) were identified in 41 out of 95 patients (43%). Two false-positive and 4 false-negative cases were found on MRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MRC for choledocholithiasis were 90%, 96%, 94%, 95%, and 93%, respectively. CONCLUSION: MRC is a highly effective diagnostic modality for evaluation of patients with risk factors for CBD stones prior to LC.

Adult↗
PubMed2000

Bone marrow aspirate on the 14th day of induction treatment as a prognostic tool in de novo adult acute myeloid leukemia.

BACKGROUND AND OBJECTIVES: In adult acute myeloid leukemia (AML), a variety of clinical and biological parameters have been examined for their potential value in predicting treatment response. Early response to induction therapy could be an important prognostic factor in this disease. DESIGN AND METHODS: We studied the relationship between reduced blasts in bone marrow aspirate on the 14th day (BMA14th) of induction chemotherapy and treatment outcome in 198 adult AML patients of whom 124 were < 60 years old (group A) and 74 > or = 60 years old (group B). Receiver operating characteristic curve analysis was used to assess the prognostic performance of BMA14th. Using the percentages of blasts of < or = 22% and < or = 15% as criteria for predicting treatment outcome gave the highest accuracy in terms of sensitivity and specificity in groups A and B, respectively. RESULTS: In group A, of 97 patients with a BMA14th < or = 22%, 77 (79%) achieved complete remission (CR), whereas of 27 patients with a BMA14th > 22%, 22 (81%) were non-responders (NR) (p < 0.0001). The test sensitivity and specificity were 93.9% and 71.4%, respectively. In group B, of 27 patients with a BMA14th < or = 15%, 18 (67%) achieved CR, whereas of 47 patients with a BMA14th >15%, 38 (81%) were NR (p = 0.0001). The test sensitivity and specificity were 66.7% and 80.9%, respectively. INTERPRETATION AND CONCLUSIONS: Our data suggest that BMA14th may be a predictive test for CR, helping to identify NR patients early in their disease. Further studies are needed to establish the practical implications of the results of our study.

Acute Disease↗
PubMedDate not supplied

Ultrasound versus plain film in the detection of pneumoperitoneum.

To evaluate ultrasound (US) versus conventional plain film radiography (CPF) in the detection of pneumoperitoneum, 30 patients with postsurgical pneumoperitoneum and a control group of 22 patients were studied using US and CPF. Sonograms and radiograms were obtained while patients were supine and in left lateral decubitus. The two orthogonal plain films of the abdomen were acquired with a horizontal X-ray beam. The epigastric region and right hypochondrium were investigated with ultrasonography. Four experienced, blinded radiologists examined 160 sonograms and 104 radiograms. Statistical analysis yielded a sensitivity of 75.7% for radiography versus 86% for ultrasonography, a specificity of 89.2% versus 83.5%, an accuracy of 81.5% versus 85%, a positive predictive value of 90.2% versus 87%, and a negative predictive value of 76.2% versus 83.5%, respectively. US could therefore be considered a reliable alternative imaging technique in the detection of pneumoperitoneum.

Adult↗