Purpose
To assess the use of the new Focal-One
®
HIFU platform in salvage setting to evaluate the occurrence of postoperative complications.
Methods
Patients who underwent salvage HIFU (sHIFU) with ...Focal-One
®
platform were enrolled prospectively (Candiolo cancer institute—FPO IRCCS; registry number: 258/2018). Perioperative and postoperative outcomes (in terms of oncological and functional ones) were recorded during the first year of follow-up. In particular postoperative complications were classified according to Clavien–Dindo system.
Results
20 patients were enrolled. No grade 3 complications were recorded. Referring to grade 2 complications, eight patients reported urgency after 3 months of follow-up, and in 4 cases, a low urinary tract infection occurred. Evaluating the impact of sHIFU on patients’ sexual potency, micturition and quality of life, no significant deterioration was recorded during the follow-up as proven using the ANOVA analysis for repeated measurements. Only two patient had a biochemical failure after 12 months of follow-up.
Conclusions
The real-time intraoperative guidance with Focal-One
®
platform, allows a continuous monitoring and tailoring of the treatment, with a minimization of the adverse events even in a salvage setting.
68Ga-PSMA Uptake in Fibrous Dysplasia Reale, Maria Lucia; Buttigliero, Consuelo; Tucci, Marcello ...
Clinical nuclear medicine
44, Številka:
6
Journal Article
Recenzirano
Prostate cancer is one of the most common malignancies. Imaging tools play an important role throughout the entire process of the disease. The scenario, however, is going to change. Thanks to a ...higher sensitivity and specificity, the use of the prostate-specific membrane antigen (PSMA) PET is of increasing importance, particularly at the time of diagnosis and in case of biochemical recurrence. Nevertheless, previous reports have described false-positive findings, as tracer-avid physiological findings or benign processes, potential pitfalls for interpretation of Ga-PSMA PET/CT. Here we report a case of PSMA uptake in a histologically proven fibrous dysplasia.
Purpose
To assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography ...(CT) (
18
FFDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus.
Methods
This is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January–February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET.
Results
Overall,
18
FFDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the COVID period (7.1%) compared with that found in the pre-COVID (5.35%) and control periods (5.15%) (
p
< 0.001). Instead, no significant difference among pre-COVID and control periods was present. The prevalence of interstitial pneumonia detected at PET/CT was directly associated with geographic virus diffusion, with the higher rate in Northern Italy. Among 284 interstitial pneumonia detected during COVID period, 169 (59%) were FDG-avid (average SUVmax of 4.1).
Conclusions
A significant increase of interstitial pneumonia incidentally detected with
18
FFDG PET/CT has been demonstrated during the COVID-19 pandemic. A majority of interstitial pneumonia were FDG-avid. Our results underlined the importance of paying attention to incidental CT findings of pneumonia detected at PET/CT, and these reports might help to recognize early COVID-19 cases guiding the subsequent management.
Background
To date, bone metastases remain the main cause of morbidity and mortality in patients with metastatic castration-resistant prostate cancer (mCRPC). Therefore, the combination of accurate ...early detection of bony disease and effective treatment of these lesions is crucial in the management of mCRPC patients, but clinical trials specifically designed to test novel approaches are currently lacking.
Case Description
This report describes the case of a 74-year-old male with bone mCRPC and symptomatic and biochemical progression, who underwent radium-223 therapy, following previous treatment failure. 18F-choline positron emission tomography (PET)/computed tomography (CT) was used to assess changes in skeletal tumor activity before and after radium-223. Changes in prostate-specific antigen and alkaline phosphatase were also determined. 18F-choline PET/CT showed that treatment with radium-223 was able to effectively reduce bone metastatic disease, and this was accompanied by an excellent metabolic response.
Conclusions
In clinical practice, metabolic assessment of lesions by 18F-choline PET/CT following radium-223 seems a valid approach to monitor treatment response. Until results from clinical trials become available, reporting of single cases relating to data on the use of this technique remains paramount.
To assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) (
...FFDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus.
This is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January-February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET.
Overall,
FFDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the COVID period (7.1%) compared with that found in the pre-COVID (5.35%) and control periods (5.15%) (p < 0.001). Instead, no significant difference among pre-COVID and control periods was present. The prevalence of interstitial pneumonia detected at PET/CT was directly associated with geographic virus diffusion, with the higher rate in Northern Italy. Among 284 interstitial pneumonia detected during COVID period, 169 (59%) were FDG-avid (average SUVmax of 4.1).
A significant increase of interstitial pneumonia incidentally detected with
FFDG PET/CT has been demonstrated during the COVID-19 pandemic. A majority of interstitial pneumonia were FDG-avid. Our results underlined the importance of paying attention to incidental CT findings of pneumonia detected at PET/CT, and these reports might help to recognize early COVID-19 cases guiding the subsequent management.
Patients with diabetes mellitus (DM) are at high risk for fractures. However, the relationship between diabetes and osteoporosis is not yet completely understood. Many factors such as type of ...diabetes, type of population and co-morbidities may influence the type and severity of bone abnormalities in these patients. The aim of this study was to evaluate which factors may explain the risk of fractures in a homogeneous population of postmenopausal women with type 2 DM. Twenty-one consecutive postmenopausal women with type 2 DM were enrolled. Serum and urinary markers of bone metabolism as well as the biochemical markers of glucose homeostasis and diabetes severity were evaluated. Bone mineral density and prevalence of vertebral fractures were evaluated by using MOC DXA and spine radiography, respectively. The measurement of 25-hydroxyvitamin D serum levels revealed a condition of deficiency in 67% and insufficiency in 28% of patients. Vertebral and femoral neck T-scores were -1.1±1.1 and -0.8±1.0, respectively, while Z-scores were 0.1±1.1 and 0.1±0.9, respectively. Twenty-four % of patients showed ≥1 vertebral fractures. There was a direct correlation between occurrence of fractures and PTH levels (p<0.05), and an inverse correlation between fractures and deficiency of 25-hydroxyvitamin D (p<0.05). In conclusion, although bone mineral density is comparable with that of age-matched normal subjects, patients with type 2 DM have an increased risk of fracture which appears to be associated with vitamin D deficiency and secondary increase of PTH.
Multiple factors may affect the metabolic fate of carbohydrates. Today, well-standardised and accepted methods may allow for the definitions of the changes in the glucose and insulin curves following ...the ingestion of either carbohydrate-based and other foods. More debate is still raised on the clinical meaning of these classifications when used at a population level, while emphasis is raised on the approach to carbohydrate metabolism on an individual basis. Within these ranges of applications, other compounds, such as plant polyphenols, may favourably add synergic effects through the modulation of carbohydrate digestion and glucose metabolic steps, resulting in lowering postprandial glucose and insulin levels. Finally, a growing knowledge suggests that the balance of dietary fructose and individual physical activity represent the key point to address the compound towards either positive, energy sparing effects, or a degenerative metabolic burden. The carbohydrate quality within a whole dietary and lifestyle pattern may therefore challenge the individual balance towards health or disease.
The use of illicit substances represents one of the most difficult problems to confront in the health system. Drug use is a global problem but is not uniform throughout the world, within the same ...country and changes over time. Therefore, knowing the illicit substances that are used in a territory is essential to better organize health services in that specific geographical area. To this aim, we analysed 4200 samples confiscated from individuals who held them for personal use by police forces in the Italian provinces of Modena and Reggio Emilia from 2008 to 2017.
The suspected samples were screened by gas-chromatography-mass spectrometry (GC-MS) and by liquid chromatography-tandem mass spectrometry (LC-MS/MS); all samples were subsequently analysed by gas chromatography-flame ionization detector (GC-FID) for quantitative analyses.
Cannabis was the most seized illicit substance (70.7%). Over the study period, the number of seizures of herb with a high content of Δ
-THC increased. The number of cocaine seizures remained stable (total 16.1%), but the median purity of seized cocaine increased to 75% in 2017. Heroin seizures decreased over time, but the median purity of seized heroin reached 16.8% in 2017. In almost all the years, heroin samples with a purity exceeding the 97.5 percentile were found. Especially from 2014, the range of seized substances increased and started to include synthetic cathinones, phenylethylamines, UR-144, LSD, psilocybe, prescription opioid and hypnotics. In two cases, tramadol together with tropicamide was seized. Most of the seizures involved male subjects and 82% of the seizures were from individuals younger than 35 years of age.
The persistence of old illicit drugs and the rapid emergence of new psychoactive substances represented a serious challenge for public health in the studied Italian area. Some useful interventions might be: informing mainly young people about the possible complications of cannabis use; implementing standardized procedures to diagnose and treat cocaine-related emergencies in hospitals; increasing the distribution of naloxone to antagonize possible heroin overdoses; equipping laboratories to be able to identify the new psychoactive substances.
•Evidences about the effectiveness of prevention programmes are still scarce.•Occupational health and safety training can improve worksite protection.•A training programme targeted to employers ...showed no effect on injuries incidence.•The reduction was comparable with the one estimated in the areas outside ours.•Studies in the field of occupational safety must be conducted using a controlled design.
Interest in work-related injury prevention is increasing, but evaluating workplace safety interventions poses a critical challenge on methodological approaches. The hypothesis has been made that safety training programmes targeting management executives could improve worksite safety. This study aimed to investigate the correlation between a training programme for employers and the rate of occupational injuries in a sample of wood processing industries.
One hundred forty worksites were randomly assigned to the intervention or the control arms of the study. The intervention consisted in a 6h training course for employers focusing on the benefits, feasibility, and cost-saving connected to safety in the workplace. The primary outcome was the rate of injuries assessed by means of the incidence rate difference (point estimates and 95% confidence interval) in the two arms of the study at the end of the follow-up period.
The rate of work-related injuries decreased in both groups, with an incidence rate after intervention of 3.35 and 3.91 (×10,000 working hours), respectively, in the study and control arms, for a difference of −0.56 (95% CI −1.56–0.45). The reduction in injuries from baseline to the end of the follow-up was comparable to that noted in other geographical areas.
The intervention programme did not appear to have any effect on the decrease in the rate of work-related injuries. We can hypothesize that the training course did not modify employers’ behavior to affect the incidence of occupational injuries.
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