[Teleradiology: case series and experience acquired in the military field]. / La teleradiologia: casistica ed esperienza acquisita in ambito militare.

PURPOSE: Our aim was to evaluate the peculiarities of military teleradiology on the basis of the large case series collected between January 2006 and December 2010. MATERIALS AND METHODS: We analysed all radiological teleconsultations/telediagnoses requested by theatres of operations: Kosovo, Iraq, Chad, warships Etna (Indian Ocean) and Cavour (earthquake in Haiti), for a total of 1,132 cases. As part of the case series collected in Kosovo (n=827), we evaluated the entire sample of patients transferred to the Celio Military Hospital in Rome following a teleradiological diagnosis (27 examinations analysed). RESULTS: A total of 1,132 radiological examinations were requested (704 military and 428 civilians). Comparison between teleradiology diagnoses and diagnoses made after patient transfer showed almost perfect concordance based on Cohen's Kappa (κ) statistic (92.59% identical diagnoses), with only a small minority of false positive results (two cases, 7.4%). CONCLUSIONS: The use of teleradiology by the Military Medical Corps helped attain an accurate diagnosis in almost all cases, significantly reducing diagnostic errors and limiting transfers from theatres of operation to cases genuinely necessitating transfer.

Materials, methods and results of the Norplant training program.

Norplant subdermal implants for contraception were introduced into UK clinical practice in October 1993. Use of Norplant requires providers to learn additional skills. A training program designed to give providers to opportunity to obtain these skills was designed and implemented through the co-operation of Hoechst Roussel, JHPIEGO and members of the UK medical profession. Uptake of training for Norplant provision has been widespread and Norplant has been established as a realistic contraceptive choice for women in the UK. Introduction of Norplant in the UK has raised many issues that go beyond clinical considerations.

[Echographic evaluation of the undescended testis beyond the therapeutically useful period. Echopattern and testicular volume]. / Valutazione ecografica del testicolo criptorchide oltre il periodo terapeuticamente utile. Echopattern e volume testicolare.

Echotomography and C.T. scan are the most common Imaging Techniques to study undescended testis: the echotomography for the inguinal, crural, perineal and penile localization; C.T. scan for the abdominal localization. The aim of this study was to evaluate morphological and volumetric alterations of testis in pre- and post-puberal patients with echotomography and C.T. scan. 65 patients were divided in two groups on the basis of age: group 1 (5-13 yrs; n = 46) and group 2 (> 13 yrs; n = 19). The volumetric and echo-structural alterations were more frequent in group 2 than in group 1. In group 1 a significant difference was observed between the incidence of echo-structural (35%) and volumetric (65%) alterations. A retained testis shows increased morphological alterations by aging. On the basis of these results we can conclude that in the group 1 the volumetric analysis is more reliable than the echo-structural analysis to evaluate testis "well-state".

[A case of congenital renal malformation with arteriovenous fistula]. / Su di un caso di malformazione renale congenita con fistola arterovenosa.

Renal arteriovenous fistulas caused by vascular malformation are relatively rare, with a reported prevalence of less than 0.04%. The authors discuss about a clinical case studied by Echo-color-doppler, C.T. scan and Digital angiography. Nevertheless there is a good correlation between the results from these different Imaging Techniques, Duplex-Doppler seems to be poorly specific to define by itself a diagnosis of a tumoral renal mass.

[Color Doppler echography of the cavernous bodies after F.I.C. in the study of erectile impotence of vascular origin]. / L'eco-color Doppler dei corpi cavernosi dopo "F.I.C." nello studio dell'impotenza erettile su base vascolare.

Study with the Doppler method has been associated with "cavernometrics" and "cavernography" in erection pathologies for some time. But this enquiry is burdened not only be technical inaccuracies such as the lack of knowledge of the angle of incidence of the doppler wave and the diameter of the explored vessel etc, but also by intrinsic difficulty method itself. Therefore, the authors have used a color Doppler to individuate and study the cavernous arteries, and present the results obtained from a group of 21 patients, all affected by erectile deficits, who were selected on the basis of anamnestica and clinical criteria. They individualized 21 patients in whom the vasculogenic nature of their affection appeared probable, out of the 125 who were under their observation for their sexual inadequacy. In three patients the clinical suspicion of a venous incompetency was confirmed by dynamic "cavernometrics with cavernography". The study of the four phases of erection (flaccidity, tumescence, erection, detumescence) was carried out after an intracavernous injection of 20 micrograms of PGE/1. The parameters considered were: systolic velocity of the hematic wave, diastolic speed, the index of resistance and range. In cases of vasculogenic impotence with an arterial base the systolic wave in the 2nd and 3rd phases presented a speed inferior to the norm of standard values, the resistance index altered by the lacking of physiological increment due in the erectile beyond the closing of venous "polsters", also to the rigidity of the albuginea.(ABSTRACT TRUNCATED AT 250 WORDS)

Control of deaths from diarrheal disease in rural communities: II. Motivating and monitoring the community.

In 1980 the Ministry of Health of Egypt undertook a short term investigation into means and methods to reduce the annually excessive number of preschool child deaths from Diarrheal Disease. This investigation sought to identify ways to overcome constraints related to logistics, supplies, and community participation. The unifying theme of this study was to examine the feasibility of stressing Oral Rehydration Therapy (ORT) instead of the then conventional parenteral treatment and heavy use of antibiotics. Study cells were arranged to test feasibility of placing responsibility for the intervention primarily with rural mothers, secondly with itinerant nurses. Appropriate health education programs, revised supervision and data collection systems were developed and implemented. Results limited to mortality indicators demonstrating that mothers could affect a significant decrease in the diarrhea-specific death rate were reported in an earlier paper. In this paper a more comprehensive presentation of various survey data associated with the investigation are presented. These data show that mothers were indeed able to recognize diarrheal disease and institute early and effective treatment, and that they developed remarkable skills of preparing safe oral rehydration fluids from home supplies of sugar and salt. In addition, the data show that health service staff increasingly gained confidence in ORT as demonstrated by increasing rates of utilization of the method, and as mothers indicated ORT to be the preferred method of treatment of diarrheal disease.

Nutrition intervention: an evaluation of six studies.

Six nutrition intervention studies were evaluated in the context of a predetermined methodology covering several categories of evaluative criteria. After a presentation of reasons for including each study, a summary is presented of the results of each study in light of the present investigators' evaluation and secondary analyses. Nutrition intervention programs can have a positive effect on health indices of infants and children, but much can be done in future nutrition projects to improve project design and thereby assist and facilitate more meaningful evaluations of nutrition intervention. To this end, a set of points for consideration by those designing nutrition intervention projects is provided.

Evaluation of Aedes albopictus tissue culture for use in association with arbovirus isolation.

The susceptibility and sensitivity of Aedes albopictus cell cultures to five different primary and four different low-passage arboviruses were tested. Yellow fever, West Nile, Ilesha, eastern equine encephalitis, and Flanders viruses replicated in A albopictus tissue cultures. Replication was determined by the ability of selected tissue culture fluids to infect suckling mice, and by recovery from tissue culture fluid of progressively increasing amounts of complement-fixing (CF) antigen with time. Virus persistence was demonstrated with Nodamura, western equine encephalitis, and Mayaro viruses, but multiplication was not proven; neither persistence nor multiplication was demonstrated with a Kemerovo group virus. When yellow fever and Ilesha viruses were simultaneously inoculated into A albopictus culture, CF antigen for each was consistently detected. In a more detailed comparative study of field specimens, 12 unpassaged strains of yellow fever virus were tested for infectivity in A albopictus tissue culture, Vero cells, and baby mice. Higher titers of virus were detected (0.8--2.3 log ID50 per ml) in Vero cell culture than in A albopictus tissue culture or baby mouse systems. These results suggest the feasibility of using A albopictus cells in association with the primary isolation of arboviruses.

Fate of rubella genome ribonucleic acid after immune and nonimmune virolysis in the presence of ribonuclease.

To determine whether rubella virion ribonucleic acid (RNA) becomes accessible to nuclease attack after immune lysis of the viral envelope, virions containing radioactively labeled RNA were examined in three ways with the following results. (i) Incubation of purified virus with heat-inactivated rubella convalescent human serum and guinea pig complement resulted in an increase in acid-soluble RNA. Antibody was required; the reaction was temperature dependent and was blocked by ethylenediaminetetraacetic acid. When exogenous nuclease was added prior to lysis, radioactivity in virions was reduced to 15% of that in unlysed control pellets (ii) Sucrose gradient sedimentation profiles of RNA released from lysed and unlysed virions under controlled conditions showed that the nuclease content of serum-virus mixtures was sufficient to eliminate all RNA of genome size, although degradation was not complete. (iii) Virions were also lysed by unheated human immune sera in the absence of guinea pig complement and by some, but not all, unheated antibody-negative sera.