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1.
Biomed Res Int ; 2022: 2754051, 2022.
Article in English | MEDLINE | ID: mdl-35281602

ABSTRACT

Purpose: The article is aimed at improving the understanding of the sociocultural profile of adult orthodontic patients and their expectations. In particular, it addresses three main aspects: the motivation and needs that underpin the decision to start orthodontic treatment, how it influences the patients' daily life, and the different oral hygiene demands. Materials and Methods: An online survey was completed by 276 patients undergoing orthodontic treatment with different techniques. The questions asked concerned gender, age, type of appliance, any previous orthodontic treatments, type of any previous retainers, reasons for therapy, satisfaction, pain, problems in eating, daily number of teeth brushings and flossings before and during the treatment, perception of cost, sensation of visibility of the appliance, and if they would recommend orthodontic treatment. Results: A significant role within our sample is played by gender; 87.94% consisted of female patients out of which 72.57% wanted to improve their aesthetics, while only 54.84% of male patients cited the same reason. Invisible aligners were preferred by 67.70% of the patients due to them being considered the least painful, causing the fewest problems with eating, and the least visible. Metal braces were perceived as the less expensive treatment. Over a third of the patients (33.85%) had previously undergone orthodontic treatment, among them 54.05% wore a mobile retainer, 31.08% a fixed one, and 14.86% both. Daily tooth brushing and flossing increased during therapy with clear aligners by 48.94% and 126.39%, respectively. Conclusions: The greatest demand for orthodontic treatments comes from women, as they pay more attention to aesthetics, which makes the clear aligners the most common choice. The relapse after orthodontic treatment seems to cause a higher demand for retreatment, and oral hygiene habits significantly improve during orthodontic treatment, especially with the clear aligners.


Subject(s)
Motivation , Orthodontic Appliances, Fixed , Adult , Female , Humans , Male , Perception , Surveys and Questionnaires , Toothbrushing
2.
J Biol Regul Homeost Agents ; 35(3 Suppl. 1): 197-204, 2021.
Article in English | MEDLINE | ID: mdl-34289679

ABSTRACT

The study analyzes how and if temporomandibular joint symptoms are influenced by different types of orthodontic therapy. Two-hundred-and-thirty-six adult orthodontic patients treated by different clinicians, were asked to complete a survey in which factors as the age, the gender and the type of device were considered. The questions were about the typical symptoms of temporomandibular disorders, in particular headache, bruxism, clenching, pain while opening the mouth and joint's noise. It was highlighted if these symptoms changed during the therapy and if they increased or decreased. The answers to our questionnaire revealed that the only statistically significative difference was related to bruxism, because we found a higher rate in patients treated with aligners than patients treated with metal braces, so we can suggest the fixed technique in the orthodontic patient who suffers of bruxism, even if further studies are required.


Subject(s)
Bruxism , Temporomandibular Joint Disorders , Adult , Headache , Humans , Surveys and Questionnaires , Temporomandibular Joint , Temporomandibular Joint Disorders/etiology , Temporomandibular Joint Disorders/therapy
3.
J Biol Regul Homeost Agents ; 35(3 Suppl. 1): 179-184, 2021.
Article in English | MEDLINE | ID: mdl-34289677

ABSTRACT

The review of literature shows that 48,22% of the autotranspated teeth were orthodontically treated. A 13-year-old male patient presented a destructive decay in the element 3.6, which was underoccluded. To maintain the arch space and the quantity of bone necessary for a potential implant, it was decided to perform an autotransplantation of the impacted element 3.8. Tooth autotransplantation is a valid and durable alternative to the prosthetic and the implant solutions with high success rate.


Subject(s)
Molar, Third , Tooth, Impacted , Adolescent , Dental Care , Humans , Male , Molar, Third/diagnostic imaging , Molar, Third/surgery , Transplantation, Autologous
4.
Eur J Paediatr Dent ; 21(2): 157-162, 2020 06.
Article in English | MEDLINE | ID: mdl-32567949

ABSTRACT

AIM: The aim of our study was to explain how tele-orthodontics represents the only way to perform orthodontics during a period of restriction as the one subsequent to COVID-19 emergencies: To do this, we report a case study and explore the proposal of a model of tele-orthodontics, considering the advantages of this modality in the immediate post-emergency phase and in the future daily practice. MATERIALS AND METHODS: Study design: Our study involves 30 patients, who had undergone different orthodontic therapies in a traditional way, and that the clinician continued to follow by means of tele-orthodontics. Given the obvious limitations of tele-practice, a comparison with patients who did not undergo any follow-up or underwent only in-office follow-ups could not be possible. The communication tools used in our study and proposed in our model of tele-orthodontics are videocalls, dedicated applications, intraoral and extraoral photos taken by the patients and instant messaging. RESULTS: Tele-orthodontics allowed to perform some orthodontic follow-ups with less chairside time, reduced time spent by the patients in the dental office from up to 45 min, less risk of infection, fewer to no missed appointments, specific troubleshooting solutions, and more follow-ups with odontophobic patients. Overall, tele-orthodontics balanced the disadvantages of less personal contacts and in-office visits. CONCLUSIONS: The need to respect safety distance and the fears patients have about the risk of infection make tele-orthodontics a fundamental tool during a pandemic lockdown and in its immediate post-emergency phase. Tele-orthodontics demonstrated to be a viable tool to continue at least some orthodontic care in times of emergency, but it may be considered an appropriate solution and addition even in normal times to ease therapy demands for both the orthodontist and the patient, while reducing time and money spent, without an excessive decrease in orthodontic quality.


Subject(s)
Orthodontics , Betacoronavirus , COVID-19 , Coronavirus Infections , Emergencies , Humans , Pandemics , Pneumonia, Viral , SARS-CoV-2
5.
Case Rep Radiol ; 2019: 2016959, 2019.
Article in English | MEDLINE | ID: mdl-31737397

ABSTRACT

The corkscrew aorta is a variant of the normal anatomical course of the aorta. This rare condition is characterized by a marked tortuosity of the aorta. In our experience it concerns the tract of subrenal aorta, that is an unusual condition, since there are no other cases in the literature. It is characterized by the presence of at least two kinking, and a coiling interposed among them. It is diagnosed by Angio-CT and its response is incidental, being from an asymptomatic clinical point of view.

6.
Int Angiol ; 34(6 Suppl 1): 28-35, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26498889

ABSTRACT

AIM: The aim of this paper was to evaluate the efficacy, safety, and clinical outcomes of superselective embolization using ethylene-vinyl alcohol copolymer (Onyx Liquid Embolic System; ev3 Neurovascular, Irvine, CA, USA) as the primary treatment in active peripheral emergency arterial bleeding. METHODS: Between January 2014 and June 2014, all patients with active peripheral arterial bleeding who were treated by embolization were retrospectively analyzed. We selected 15 (age 37-91 year old) patients embolized with Onyx, chosen as embolic agent in an intention-to-treat fashion. Multidetector computed tomography was performed in all patients. RESULTS: Active bleeding was detected in all cases. Digital subtraction angiography confirmed CT findings in all cases. The causes of bleeding were traumatic in 8 patients, angiodysplasia in 1 patient, duodenal ulcer in 1, chronic pancreatitis in 1 and unknown in 4 patients. Nine patients were under anticoagulant or antiplatelet therapy. Embolization was possible in all patients. The technical success rate was 100%. The immediate bleeding control rate was 100%. No rebleeding at 30 days occurred (0%). There were no major complications, or deaths attributable to the treatment. No patient needed surgery or new embolization during a mean follow-up period of 5.1 months (range, 4.5-6 months). CONCLUSION: Control of massive active peripheral emergency arterial bleeding using superselective embolization with Onyx is feasible and safe.


Subject(s)
Embolization, Therapeutic/methods , Hemorrhage/therapy , Peripheral Arterial Disease/therapy , Polyvinyls/therapeutic use , Adult , Aged , Aged, 80 and over , Angiography, Digital Subtraction , Emergencies , Female , Humans , Male , Middle Aged , Multidetector Computed Tomography , Retrospective Studies , Treatment Outcome
7.
Radiol Med ; 118(5): 816-25, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23090254

ABSTRACT

PURPOSE: The aim of our study was to evaluate the safety of retrieving both short- and long-term permanent/ retrievable ALN vena cava filters (VCF). MATERIALS AND METHODS: From 2002 to 2010, 201 permanent/retrievable VCF were percutaneously placed in 201 patients (age range, 18-80 years). Sixty-seven were placed through the jugular vein, 61 through the brachial vein and 63 through the femoral vein. In 109 patients, the VCF was placed for absolute indications, in 77 for relative indications, and in 15 for temporary filtration. Follow-up was carried out with colour Doppler ultrasound (CDUS) and abdominal X-ray at 3 and 12 months, then annually. Indications for removal included: lack of contraindications to anticoagulant therapy, absence of pulmonary embolism and iliocaval venous patency. All candidates for VCF removal underwent computed tomography angiography (CTA). RESULTS: VCF placement with correct position (tilting up to 15°) was achieved in 99.01% of cases. In two (0.99%) cases, tilting >15° was present. Haematomas, which resolved spontaneously, occurred in only eight jugular access sites. A total of 26 of 201 VCF were removed, with 96.16% technical success. The removal procedure failed in one case only. In seven cases, a double approach through the right jugular and femoral veins was necessary. VCF was removed 6 months after deployment in 11 patients, 12 months in eight, 24 months in four after 36 months in three (range, 180-1,155 days.) There were no periprocedural complications. Of the 26 removed VCF, 21 were infrarenal and five suprarenal. Of the 15 VCF placed for temporary use, 12 were removed; the remaining three not removed owing to persistence of the neoplastic thrombus after nephrectomy for kidney cancer. Of the 186 VCF placed for permanent use, with absolute and relative indications, 14 were removed (4/109 and 10/77, respectively). Only one showed thrombi occluding the cranial end. CONCLUSIONS: VCF removal is certainly more difficult than placement. Technical failure of the removal procedure is directly proportional to the VCF tilt, and the VCF is as yet unable to ensure absolute removal safety, with the result that failure may occasionally occur. The morphological and structural features of permanent/retrievable VCF allow for unlimited time from placement to removal, documented to be up to 3 years after placement.


Subject(s)
Device Removal , Pulmonary Embolism/prevention & control , Vena Cava Filters/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Brachiocephalic Veins , Female , Femoral Vein , Humans , Jugular Veins , Male , Middle Aged , Patient Safety , Radiography, Abdominal , Treatment Outcome , Ultrasonography, Doppler, Color
8.
Radiol Med ; 117(8): 1320-32, 2012 Dec.
Article in English, Italian | MEDLINE | ID: mdl-22744353

ABSTRACT

PURPOSE: This study was done to review recurrence patterns in patients with lung cancer (primary or secondary) treated with percutaneous image-guided radiofrequency (RF) ablation. MATERIALS AND METHODS: From January 2003 to August 2010, 32 patients (24 with primary non-small-cell lung cancer and eight with metastases) with single lung cancer were treated with RF ablation. Post-treatment imaging results were available for each patient. Follow-up was performed using computed tomography (CT) scans at 1, 3, 6, 12, 18 and 24 months after the procedure and annually thereafter. Patterns of recurrence were classified as local, intrapulmonary, nodal, mixed and distant. We evaluated overall survival after RF ablation and the factors associated with recurrence. RESULTS: Seventeen (53.1%) patients showed no evidence of recurrence at follow-up imaging (range 12-72 months; mean, 32.5 months). Recurrence was seen in 15 (46.9 %) patients (range 6-36 months; mean 14.8 months). Local recurrence (40%) after RF ablation was the most frequent. Median disease-free survival was 20 months. Sex, tumour location, tumour size and tumour stage were not associated with a risk of recurrence. Patient age was related to the risk of recurrence (p<0.05). CONCLUSIONS: Local recurrence is the most common pattern in our series. A more aggressive initial RF ablation might offer improvement in outcomes, but this hypothesis needs to be confirmed by larger studies involving a larger number of patients.


Subject(s)
Carcinoma, Non-Small-Cell Lung/surgery , Catheter Ablation , Lung Neoplasms/surgery , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/secondary , Contrast Media , Disease-Free Survival , Female , Fluoroscopy , Humans , Lung Neoplasms/diagnostic imaging , Male , Middle Aged , Multidetector Computed Tomography , Neoplasm Recurrence, Local , Radiography, Interventional , Tomography, X-Ray Computed , Triiodobenzoic Acids
9.
Radiol Med ; 117(3): 410-25, 2012 Apr.
Article in English | MEDLINE | ID: mdl-21892717

ABSTRACT

PURPOSE: This study evaluated the safety and technical and clinical success rates of positioning endovascular endografts (EG) in ruptured abdominal aneurysms. MATERIALS AND METHODS: Patients with a ruptured abdominal aortic aneurysm confirmed by contrast-enhanced computed tomography angiography (CTA) were eligible for the analysis. Of 67 patients, 42 (62.7%) were treated with EG. Thirteen patients (30.9%) received an aorto-uni-iliac EG (group A) and 29 a bifurcated EG (group B). Patients were divided for comparative analysis according to the configuration of the EG implanted. RESULTS: The primary technical success rate was 100%; the primary clinical success rate was 95% (40/42). There were two intraoperative deaths (4.7%) related to intractable shock. No patient required conversion to open repair. Overall, 12 patients (28.5%) died within 30 days. The in-hospital death rate was 30.9% (13/42). Hospital mortality rate was statistically higher in group A; the type of EG and intensive care unit admission were the only independent predictors of hospital mortality. CONCLUSIONS: In our experience, a higher mortality rate was observed for the aorto-uni-iliac configuration; shock at admission was confirmed as the most important factor for postoperative survival.


Subject(s)
Aortic Aneurysm, Abdominal/surgery , Aortic Rupture/surgery , Endovascular Procedures/methods , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Rupture/diagnostic imaging , Endovascular Procedures/mortality , Humans , Tomography, X-Ray Computed
10.
Radiol Med ; 116(6): 932-44, 2011 Sep.
Article in English, Italian | MEDLINE | ID: mdl-21311991

ABSTRACT

PURPOSE: This study sought to assess the effectiveness of rotational thrombectomy (RT) with the Rotarex device in the treatment of thrombotic occlusions in native arteries, by-pass grafts, stents and stent-grafts. MATERIALS AND METHODS: Over the last 4 years, 22 patients (14 men and 8 women; mean age 62.6 years) affected by 5 acute (<14 days) thrombotic occlusions of the native arteries (4 plaque thromboses in the common iliac artery and one on a dissection intimal flap of the external iliac artery), 17 subacute and chronic thromboses affecting 4 femoro-popliteal by-pass grafts, 10 stents (7 in the common iliac artery and 3 in the superficial femoral artery) and 3 stents-grafts were studied. Acute thromboses of native arteries were follow-up with colour-Doppler ultrasound (US) examination at 1 and 3 months. Subacute and chronic thrombotic occlusions were follow-up with colour-Doppler US examination at 1, 3, 6 and 12 months and yearly thereafter. RESULTS: Immediate technical success was achieved without any need for additional procedures in all acute occlusions of native arteries (4/22 cases). In the subacute and chronic occlusions, the procedure was completed with percutaneous transluminal angioplasty (PTA) (8/22), cutting balloon (6/22) and stenting (5/22). The complication rate was 4.8% (1 rupture of the external iliac artery repaired with a stent-graft). CONCLUSIONS: Arterial recanalisation with RT is the treatment of choice for acute thrombosis of healthy native arteries (4-7 mm); the treatment of thrombosis complicating calcified plaques or dissection intimal flaps may cause rupture of the arterial wall. In subacute and chronic occlusions of by-pass grafts, stents and stent grafts, additional procedures are necessary to achieve complete recanalisation.


Subject(s)
Arterial Occlusive Diseases/surgery , Iliac Artery , Thrombectomy/methods , Thrombosis/surgery , Aged , Aged, 80 and over , Arterial Occlusive Diseases/diagnostic imaging , Female , Humans , Male , Middle Aged , Thrombosis/diagnostic imaging , Treatment Outcome , Ultrasonography, Doppler, Color
11.
Radiol Med ; 116(3): 444-53, 2011 Apr.
Article in English, Italian | MEDLINE | ID: mdl-21225370

ABSTRACT

PURPOSE: This study evaluated the short- and midterm patency of complete total occlusions of the superficial femoral artery (SFA) treated with direct stenting. MATERIALS AND METHODS: Fifty-two consecutive patients (36 men and 16 women; mean age 73.6 years; range 58-85) with chronic complete SFA occlusion and good distal run-off (two or three patent vessels) underwent endovascular recanalisation by direct stenting. All patients were symptomatic (severe claudication or critical ischaemia). Recanalisation was achieved by using a contralateral approach in 44 patients and an ipsilateral antegrade access in eight patients. A total of 152 nitinol stents were used: three stents in 32 cases, four stents in eight cases and two stents in 12 cases. Follow-up consisted of clinical evaluation and colour Doppler ultrasound at 6, 12, 18 and 24 months. RESULTS: The immediate technical success rate was 100%, with complete SFA recanalisation documented on postprocedural angiography. Four cases of distal embolism occurred, which were treated successfully with intra-arterial thrombolysis. During the follow-up, 12 reocclusions were observed: eight were treated with mechanical thrombectomy and in-stent angioplasty, and four were converted into femoropopliteal bypasses. The primary patency rates at 6, 12, 18 and 24 months were 92.3%, 76.9%, 69.2% and 69.2%, respectively. The secondary patency rates at 6, 12, 18 and 24 months were 100%, 100%, 92.3% and 92.3%. CONCLUSIONS: The percutaneous treatment of chronic complete SFA occlusions yielded good primary and secondary patency rates in the short and medium term, with few periprocedural complications. Reocclusions were treated using the percutaneous technique, which guarantees a good secondary patency rate.


Subject(s)
Arterial Occlusive Diseases/therapy , Femoral Artery , Peripheral Vascular Diseases/therapy , Stents , Aged , Aged, 80 and over , Angiography , Arterial Occlusive Diseases/diagnostic imaging , Female , Femoral Artery/diagnostic imaging , Follow-Up Studies , Humans , Male , Middle Aged , Peripheral Vascular Diseases/diagnostic imaging , Thrombolytic Therapy , Treatment Outcome , Ultrasonography , Vascular Patency
12.
Minerva Chir ; 65(3): 383-8, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20668424

ABSTRACT

Among malignant tumors of the heart, primary malignant lymphomas are unusual and they are typically non-Hodgkin's B-cell cancers. A 73-year-old man affected by non-Hodgkin lymphoma (NHL) treated with four cycle of chemotherapy and radiotherapy was admitted to the Emergency Department for chest pain. Echocardiography showed a mass inside the right ventricle obstructing blood outflow in the pulmonary artery. The ECG-gated angio-multidetector computed tomography (MDCT) examination confirmed a solid mass in the right ventricle encasing the proximal-middle tract of the right coronary artery (RCA); RCA stenosis was confirmed by coronary angiography. After trans-thoracic CT-guided biopsy the mass was characterized as a recurrence of NHL and the patient started a new cycle of chemotherapy. After 15 days a MDCT exam showed both mass reduction and absence of RCA significant stenosis. MDCT imaging allows an accurate assessment of tumour extension and it represents an useful guide during biopsy procedures, necessary for a precise histological characterization of neoplasms.


Subject(s)
Coronary Stenosis/etiology , Heart Neoplasms/complications , Lymphoma, Large B-Cell, Diffuse/complications , Neoplasm Recurrence, Local/complications , Aged , Humans , Male
13.
Radiol Med ; 115(6): 962-74, 2010 Sep.
Article in English, Italian | MEDLINE | ID: mdl-20352357

ABSTRACT

PURPOSE: The purpose of our study was to retrospectively evaluate the feasibility, safety and effectiveness of microwave ablation (MWA) in nine patients with unresectable lung tumour. MATERIALS AND METHODS: Ten lesions were treated in ten ablation sessions in nine patients. The treatments were performed with a microwave generator with 45 W and 915 MHz connected to a 14.5-gauge antenna for 10 min. Antenna placement was performed with computed tomography (CT) fluoroscopy guidance or XperGuide. All patients underwent CT follow-up at 1, 3 and 6 months from the procedure. RESULTS: Technical success was obtained in all cases; mortality at 30 days was 0%. CONCLUSIONS: This study shows that in selected patients, MWA is a valid alternative to other ablative techniques. Further studies are required to demonstrate the short- and long-term effects of this technique and to make a comparison with other available ablation systems, especially with radiofrequency.


Subject(s)
Catheter Ablation/methods , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Microwaves/therapeutic use , Tomography, X-Ray Computed , Aged , Aged, 80 and over , Catheter Ablation/adverse effects , Feasibility Studies , Female , Humans , Lung Neoplasms/pathology , Lung Neoplasms/secondary , Male , Microwaves/adverse effects , Neoplasm Metastasis , Retrospective Studies , Treatment Outcome
14.
Radiol Med ; 114(7): 1130-40, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19774446

ABSTRACT

PURPOSE: This study sought to assess the feasibility and effectiveness of hybrid treatment of isolated aortic arch aneurysms. MATERIALS AND METHODS: Between December 2000 and December 2006, we selected 14 patients affected by 14 isolated aortic arch aneurysms. All patients had involvement of the left subclavian artery, four of the innominate artery and four of the left carotid artery. All patients underwent intentional exclusion of the left subclavian artery and placement of a straight graft; four patients underwent supra-aortic vessel transposition and four underwent carotid-carotid bypass in one case combined with carotid-subclavian bypass. The procedures were planned with multislice computed tomography (MSCT), in some cases associated with virtual endoscopy. The follow-up was performed with MSCT angiography at 1, 3, 6 and 12 months and yearly thereafter. RESULTS: Immediate technical success was achieved in 100% of cases. There were four ischaemic attacks (three transient ischaemic attacks and one stroke). During follow-up (range 12-48, average 21 months), we observed two type-I endoleaks that were treated by endograft extension, in one case associated with supra-aortic vessel transposition, and two type-II endoleaks that were treated with embolisation. CONCLUSIONS: Hybrid treatment for aortic arch aneurysms is feasible and provides good short-term results, although it requires accurate planning. Further studies are needed to verify the long-term results.


Subject(s)
Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation/methods , Tomography, X-Ray Computed , Vascular Surgical Procedures/methods , Aged , Aged, 80 and over , Brachiocephalic Trunk/surgery , Carotid Artery, Common/surgery , Feasibility Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Radiography, Interventional , Retrospective Studies , Subclavian Artery/surgery
15.
Radiol Med ; 114(6): 837-51, 2009 Sep.
Article in English, Italian | MEDLINE | ID: mdl-19568701

ABSTRACT

PURPOSE: This study was undertaken to evaluate the usefulness of electrocardiographically (ECG)-gated multidetector-row computed tomography (MDCT) for the assessment of the coronary venous system and detection of its anatomical variants, in order to identify those suitable for lead placement in cardiac resynchronisation therapy (CRT). MATERIALS AND METHODS: We retrospectively examined the coronary MDCT studies of 89 patients (73 males, 16 females, average age 62.5 years, range 31-79) referred for suspected coronary artery disease. The cardiac venous system was assessed in all patients using three-dimensional (3D) postprocessing on a dedicated Vitrea workstation (five patients were excluded from the analysis). RESULTS: The coronary sinus, the great cardiac vein, the anterior interventricular vein and the middle cardiac vein were visualised in all cases. The lateral cardiac vein was visualised in 56/84 patients (67%) and the posterior cardiac vein in 63/84 patients (75%), never both missing. Along the postero-lateral wall of the left ventricle, only one branch was present in 44 cases, two branches in 21 cases and three or more branches in 19/84 cases (22%). Evaluation of the maximum diameter revealed that the lateral vein was dominant over the posterior vein in 20/40 cases. The small cardiac vein was visualised in 11/84 cases. CONCLUSIONS: MDCT provides good depiction of the cardiac venous system, enabling the study of the vessel course and the identification of anatomical variants. Hence, this imaging technique could be proposed for the preoperative planning of CRT in selected patients.


Subject(s)
Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Coronary Vessels/anatomy & histology , Electrocardiography , Imaging, Three-Dimensional , Radiographic Image Interpretation, Computer-Assisted/methods , Adult , Aged , Coronary Artery Disease/physiopathology , Coronary Vessel Anomalies/diagnostic imaging , Female , Humans , Male , Middle Aged , Retrospective Studies , Tomography, X-Ray Computed
16.
Minerva Stomatol ; 58(6): 307-15, 2009 Jun.
Article in English, Italian | MEDLINE | ID: mdl-19516239

ABSTRACT

The surgically aided rapid maxillary expansion (SARME) is indicated to treat the hypoplasia of the upper jaw, with a reduction of the palatal transverse diameters, even in absence of mono- or bilateral crossbite, in the adult patient. In such cases, maxillary osteotomies are made in order to reduce the sutural resistance and facilitate the expansion of the maxillary complex. A case of surgically-aided expansion of the maxilla by the use of laser Er:Yag is reported. This device is able to guarantee targeted osteotomies of the bone, without inducing iatrogenic damages of the soft tissues. The orthodontic treatment has been performed using a bonded palatal expander (type Hyrax) in association with a class III orthopedic traction (face mask). After this a fixed appliance at both the arches was bonded. The preliminary radiographic examination and the cefalometric evaluation have been repeated at the end of the maxillary protraction (60 days after surgery) and at the end of the orthodontic treatment. The entire duration of the treatment was 18 months. The use of the laser Er:Yag has showed several advantages if compared to the traditional tools (bur), as more safety, more cutting precision and less probability to determine side effects on the soft tissue. The orthodontic treatment has been performed according to the standard protocol and the results were similar to the referred in literature.


Subject(s)
Laser Therapy/methods , Lasers, Solid-State/therapeutic use , Malocclusion, Angle Class III/surgery , Osteotomy, Le Fort/methods , Adolescent , Combined Modality Therapy , Diastema/surgery , Esthetics , Extraoral Traction Appliances , Female , Humans , Intraoperative Complications/prevention & control , Osteotomy, Le Fort/instrumentation , Palatal Expansion Technique
17.
Radiol Med ; 114(4): 608-25, 2009 Jun.
Article in English, Italian | MEDLINE | ID: mdl-19444588

ABSTRACT

PURPOSE: The treatment of pain in bone metastases is currently multidisciplinary. Among the various therapies, local radiotherapy is the gold standard for pain palliation from single metastasis, even though the maximum benefit is obtained between 12 and 20 weeks from initiation. In carefully selected patients, several ablation therapies achieve this objective in 4 weeks. The purpose of this study was to assess the technical success, effectiveness and possible complications of percutaneous ablation therapies in patients with symptomatic bone metastases. MATERIALS AND METHODS: From November 2003 to May 2008, ten ablation treatments were performed in ten patients with acute pain from metastatic bone lesions. Patient selection and choice of the most appropriate ablation treatment was made based on lesion characteristics. Three patients were treated with radiofrequency, one with plasma-mediated radiofrequency, two with plasma-mediated radiofrequency and cementoplasty, three with radiofrequency and cementoplasty and one with microwave. RESULTS: Assessments were based not only on imaging but also on the visual analogue scale (VAS) score for determining pain and on changes in morphine-equivalent doses. In both cases, 3-month follow-up showed a statistically significant reduction of pain. In no case did local complications occur either during or after treatment. Only one patient treated with radiofrequency (1/9, 11%) developed low-grade fever and general malaise during the 6 days following the procedure, compatible with a post-radiofrequency syndrome, which was treated with acetaminophen (paracetamol) only and resolved on day 7. CONCLUSIONS: Percutaneous ablation therapies represent a safe and valuable alternative for treating localised pain from single bone metastasis, providing rapid (4-week) relief of symptoms and a significant reduction in morphine doses. This contributes to improving the quality of life of patients with metastatic disease.


Subject(s)
Bone Neoplasms/secondary , Bone Neoplasms/surgery , Catheter Ablation , Adult , Aged , Aged, 80 and over , Analgesics, Opioid/therapeutic use , Bone Neoplasms/complications , Bone Neoplasms/drug therapy , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Humans , Male , Middle Aged , Morphine/therapeutic use , Pain/drug therapy , Pain/etiology , Quality of Life , Retrospective Studies , Treatment Outcome
18.
Radiol Med ; 113(7): 999-1007, 2008 Oct.
Article in English, Italian | MEDLINE | ID: mdl-18795233

ABSTRACT

PURPOSE: This study was undertaken to evaluate the efficacy of image-guided percutaneous drainage in treating abdominal and pelvic abscesses. MATERIALS AND METHODS: From August 2001 to August 2006, 95 patients (49 men and 46 women; mean age 61 years, range 25-92) with 107 abscesses underwent image-guided percutaneous drainage. Thirty-one abscesses were retroperitoneal (9 peripancreatic, 17 perirenal, 5 pararenal), 37 intraperitoneal (2 in communication with the small bowel), 8 intrahepatic (2 in communication with the extrahepatic biliary system and 2 with the intrahepatic biliary system), 4 perisplenic and 27 pelvic (4 in communication with the large bowel). Seventy-one of 107 procedures were performed with ultrasonographic (US) guidance and 36/107 with computed tomography (CT) guidance. All procedures were carried out with 8-to 14-Fr pigtail drainage catheters. RESULTS: Immediate technical success was achieved in 107/107 fluid collections. No major complications occurred. In 98/107 abscesses, we obtained progressive shrinkage of the collection (>50%) with consequent clinical success. In 9/107 cases, percutaneous drainage was unable to resolve the fluid collection. There were 12 cases of catheter displacement and six of obstruction. CONCLUSIONS: Percutaneous drainage is feasible and effective in treating abdominal and pelvic abscesses. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation.


Subject(s)
Abdominal Abscess/diagnostic imaging , Abdominal Abscess/therapy , Abscess/diagnostic imaging , Abscess/therapy , Drainage/methods , Pelvis , Tomography, X-Ray Computed/methods , Ultrasonography, Interventional , Adult , Aged , Aged, 80 and over , Drainage/instrumentation , Feasibility Studies , Female , Humans , Liver Abscess/diagnostic imaging , Liver Abscess/therapy , Male , Middle Aged , Pelvis/diagnostic imaging , Treatment Outcome
19.
J Cardiovasc Surg (Torino) ; 49(5): 659-61, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18670384

ABSTRACT

First described in 1989, HIV-related aneurysms have been rarely reported. Considered atypical if compared to classic atherosclerotic diseases, they show no preferred location and frequently involve young patients with no other risk factors for atherosclerosis but with an impaired immune system. They are probably related to an auto-immune damage inside the aortic wall associated with a necrotizing perivasculitis. Visceral artery aneurysms are rare and life-threatening diseases; the superior mesenteric and gastro-duodenal and pancreatic vessels are rarely involved. The advantages related to the endovascular approach to these aneurysms seems to be even more effective in immuno-impaired patients (i.e. HIV+). We report a case of a young patient affected by a HIV-related gastroduodenal artery aneurysm which was treated with a combined percutaneous and endovascular approach.


Subject(s)
Aneurysm/therapy , Duodenum/blood supply , Embolization, Therapeutic/methods , HIV Seropositivity , Hemostatics/administration & dosage , Stomach/blood supply , Thrombin/administration & dosage , Adult , Aneurysm/diagnosis , Combined Modality Therapy , Humans , Male , Tomography, X-Ray Computed , Ultrasonography, Interventional
20.
Radiol Med ; 113(5): 707-18, 2008 Aug.
Article in English, Italian | MEDLINE | ID: mdl-18594761

ABSTRACT

PURPOSE: This study was undertaken to assess the indications and effectiveness of the Amplatzer vascular plug (AVP) system in interventional radiology. MATERIALS AND METHODS: Over the past year, we selected 12 patients (seven men and five women; mean age 65.8 years, range 45-82) for the occlusion of five internal iliac arteries (in three aortoiliac aneurysms, one internal iliac aneurysm and one isolated common iliac artery aneurysm), two common iliac arteries (in two ruptured abdominal aortic aneurysms), two subclavian arteries (in aortic arch aneurysms) and three splenic artery aneurysms. We used 15 AVPs (splenic artery aneurysms were excluded, with one AVP in the feeding vessel and one in the draining vessel). RESULTS: We achieved immediate technical success in 12/12 cases. No rupture or dissection of the treated arteries occurred. During the follow-up (mean 4.6 months, range 3-6) computed tomography (CT) angiography and/or contrast-enhanced ultrasound demonstrated complete artery occlusion and aneurysm exclusion. CONCLUSIONS: Ease and speed of use combined with precise, controlled delivery justify the growing use of the AVP in interventional radiology. No doubt, the system's versatility will extend its indications, and larger studies with longer follow-up periods will validate the results achieved so far.


Subject(s)
Aneurysm/therapy , Embolization, Therapeutic/instrumentation , Radiography, Interventional , Aged , Aged, 80 and over , Aneurysm/diagnostic imaging , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/therapy , Female , Humans , Iliac Aneurysm/diagnostic imaging , Iliac Aneurysm/therapy , Male , Middle Aged , Splenic Artery , Subclavian Artery
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