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Biomedical subjects

Matteo Baldisserotto

Publications and source records attributed to Matteo Baldisserotto.

9 recordsLinked to original sources

Optimizing US examination to detect the normal and abnormal appendix in children.

BACKGROUND: US detection of a normal appendix can safely rule out appendicitis. However, there is a wide range of accuracy in detection of a normal appendix. OBJECTIVE: To optimize US examination to detect the normal and the abnormal appendix according to the potential positions of the appendix. MATERIALS AND METHODS: This prospective study included 107 children who underwent gray-scale US scanning. Noncompressive and compressive graded sonography was performed to detect normal and abnormal appendices according to their potential positions. The maximum transverse diameter of the appendices was measured. RESULTS: Of the 107 children examined, 56 had a histologic diagnosis of acute appendicitis. Sonography had a sensitivity of 100% and specificity of 98% for the diagnosis of appendicitis. A normal appendix was visualized in 44 (86.2%) of the 51 patients without acute appendicitis, and of these 44, 43 were true-negative and 1 was false-positive. Normal and abnormal appendices, respectively, were positioned as follows: 54.4% and 39.3% were mid-pelvic; 27.2% and 28.6% were retrocecal; 11.4% and 17.8% were deep pelvic; and 6.8% and 14.3% were abdominal. CONCLUSION: US scanning according to the potential positions of the appendix was useful in the detection of normal appendices in children suspected of having appendicitis.

Appendicitis↗

Omental infarction in children: color Doppler sonography correlated with surgery and pathology findings.

OBJECTIVE: The objective of our report is to describe color Doppler sonography findings of omental infarction and correlate them with surgical and pathology findings. Ten children underwent preoperative gray-scale and color Doppler sonographic examinations; omental infarction was confirmed at surgery. CONCLUSION: Color Doppler sonography findings were reviewed and correlated with surgical and pathology findings. Color Doppler sonography features of idiopathic omental infarction differ from those of infarction secondary to omental torsion.

Child↗

Color Doppler sonography of normal and torsed testicular appendages in children.

OBJECTIVE: The purpose of our study was to determine the size and appearance of normal and torsed testicular appendages on color Doppler sonography. SUBJECTS AND METHODS: Thirty-three patients with acute scrotal pain underwent gray-scale and color Doppler sonography and subsequent surgery. Twenty-two patients had torsion of the appendix testis, six had epididymitis, three had torsion of the testis, and two had torsion of the appendix epididymidis. The testicular appendages of 30 patients and the testes of three were excised and sent to the laboratory for histopathologic examination. RESULTS: A testicular appendage was identified on color Doppler sonography in 23 patients (21 patients with torsed appendages and two patients with epididymitis). The torsed appendixes testis measured from 4.1 to 16.3 mm, and the normal appendixes in the two patients with epididymitis measured 4.1 and 5.6 mm. With the visualization of an appendix larger than 5.6 mm as the sonographic diagnostic criterion for torsion of a testicular appendage, sensitivity was 68.2% (95% confidence interval (CI), 45.1-85.3%), and specificity was 100% (CI, 74.7-100%). CONCLUSION: The identification of a testicular appendage larger than 5.6 mm is suggestive of torsion. Therefore, depending on the patients' clinical conditions, these cases can be treated conservatively when an appendage larger than 5.6 mm is identified.

Acute Disease↗

Evaluation of surfactant function at birth determined by the stable microbubble test in term and near term infants with respiratory distress.

UNLABELLED: Surfactant function using the stable microbubble test (SMT) was investigated in term or near term infants with respiratory distress. Newborn infants > or = 34 weeks gestation with an initial clinical hypothesis of transient tachypnoea of the newborn (TTN) needing supplemental oxygen and controls were included. Gastric aspirates were collected immediately after birth for SMT. The first chest X-ray films were examined by three independent radiologists and according to their interpretation the babies were divided into a TTN, a respiratory distress syndrome of the newborn (RDS), or a poorly-defined X-ray group. A total of 32 infants with respiratory distress and 32 controls with similar gestational age and birth weight were studied. The median and interquartile range (IQR) of the stable microbubble (SMB) count was significantly lower (P < 0.001) for the respiratory distress group than for the control group (17; range 6-33 versus 120; range 79-275). The proportion of babies with less than 35 stable microbubbles/mm2 (SMB/mm2) was significantly different for the whole respiratory distress group (24/32-75%) and for the TTN (9/13-69%), the RDS (5/5-100%), and the poorly-defined (10/12-83%) groups as compared with the controls (2/32-6%; P < 0.05). A total of 24/26 babies (92%) who needed oxygen for > or = 24 h but only 1/6 (17%) of them who needed < 24 h had a bubble count of less than 35 SMB/mm2 (P < 0.05). CONCLUSION: the results suggest that deficiency or dysfunction of the surfactant system is involved in the majority of cases of respiratory distress in near term and possibly term babies. The stable microbubble test can enable clinicians to take an earlier decision to give surfactant to term or near term infants with more severe and progressive respiratory distress.

Case-Control Studies↗

Intraoperative ultrasonography of the liver in patients with abdominal tumors: a new approach.

OBJECTIVES: To compare liver intraoperative ultrasonography (IOU), computed tomography (CT), preoperative ultrasonography (USG), and intraoperative inspection and palpation in the detection of hepatic lesions in patients with abdominal tumors. METHODS: This was a prospective study including 60 patients with abdominal tumors evaluated by USG, CT, inspection and palpation, and hepatic IOU during exploratory laparotomy. Sensitivity, specificity, and positive and negative predictive values for all methods were calculated. Agreement of methods with histopathologic results was calculated by kappa statistics and the Spearman coefficient. RESULTS: Of the 60 patients, 49 (81.6%) had positive findings for hepatic lesions. Lesions could not be counted in 3 patients. The 46 remaining cases were diagnosed by histologic examination. Sensitivity, specificity, and positive and negative predictive values were 42.9%, 88.9%, 90%, and 40% for USG; 59.5%, 77.8%, 86.2%, and 45.2% for CT; 69.0%, 88.9%, 93.5%, and 55.2% for inspection and palpation; and 90.5%, 77.8%, 90.5%, and 77.8% for IOU, with histologic examination used as a criterion standard. Fair to moderate agreement was found for USG, CT, and inspection and palpation (kappa = 0.24, 0.31, and 0.49, respectively). Substantial agreement was found for IOU (kappa = 0.68). Changes in surgical strategy were made in 19 (41.3%) of the 46 cases with positive findings. CONCLUSIONS: High sensitivity associated with substantial agreement with histopathologic findings shows that IOU is an indispensable evaluation method for hepatic screening in patients with abdominal tumors who undergo laparotomy and should become a routine procedure wherever available.

Abdominal Neoplasms↗

Color Doppler sonographic findings of inflamed and perforated Meckel diverticulum.

OBJECTIVE: To describe color Doppler sonographic findings in 2 cases of inflamed and perforated Meckel diverticulum. METHODS: Two patients with inflamed and perforated Meckel diverticulum underwent color Doppler sonographic studies. RESULTS: Gray scale sonographic examination identified a fixed cystlike structure with a gut signature surrounded by a hyperechoic layer. Color Doppler sonography revealed hyperemia in the diverticular wall and hyperechoic layer, which was more intense in 1 patient. CONCLUSIONS: Identification of a fixed cystlike structure with a gut signature and wall hyperemia suggests the diagnosis of inflamed Meckel diverticulum; when a hyperechoic layer surrounds this structure, perforation of the diverticulum should be suspected.

Acute Disease↗

Sonographic findings of Meckel's diverticulitis in children.

OBJECTIVE: We know of only one previous study that has described the sonographic appearances of the inflamed Meckel's diverticulum in several cases (nine patients). Our study reviews sonographic, clinical, and pathologic findings in 10 patients with an inflamed Meckel's diverticulum. We also describe unique findings on color Doppler sonography for two of our patients. CONCLUSION: Sonographic findings of an inflamed Meckel's diverticulum may mimic findings for acute appendicitis or intestinal duplication. In patients with rectal bleeding due to diverticulitis, the visualization of a tubular hyperechoic structure on sonography is suggestive of Meckel's diverticulum. The inflamed Meckel's diverticulum may present as a cyst, but its mucosal layer is more irregular than that found in an intestinal duplication. We found that routine color Doppler sonography revealed anomalous vessels and signs of inflammation on the wall of the Meckel's diverticulum.

Child↗

Graded compression sonography of the colon in the diagnosis of polyps in pediatric patients.

OBJECTIVE: We report seven cases of juvenile polyps detected by graded compression gray-scale and color Doppler sonography in five children with nonspecific symptoms. CONCLUSION: Intestinal polyps can be detected by graded compression gray-scale and color Doppler sonography without colonic preparation. On gray-scale sonography, polyps appeared as spherical or ovoid hypoechoic nodules in the colon lumen. Small cysts were identified inside the nodules. Four polyps had fewer and smaller cysts, whereas three others contained many cysts. A hyperechoic layer surrounding the polyp corresponded to the submucosa. In two patients, the polyp was visualized in the transverse colon and caused a colocolic intussusception, which reduced spontaneously during sonography. Color Doppler sonography showed four hypovascularized and three hypervascularized polyps.

Age Factors↗