Treatment of a transorbital penetrating injury: a particular endovascular approach.

The management of craniocerebral penetrating injury currently represents a challenge for neurosurgeons and neuroradiologists and requires innovative planning. This report describes the case of a worker admitted to hospital with an intracranial piece of concrete-cutting saw stuck through the right eye. At the time of admission the patient was conscious and this fact influenced the choice of a particular approach. This patient escaped without neurological deficit or complications, except for the inevitable removal of an eye.

Effective dose delivered by conventional radiology to Aosta Valley population between 2002 and 2009.

OBJECTIVE: Medical diagnostic procedures can be considered the main man-made source of ionising radiation exposure for the population. Conventional radiography still represents the largest contribution to examination frequency. The present work evaluates procedure frequency and effective dose from the majority of conventional radiology examinations performed at the Radiological Department of Aosta Hospital from 2002 to 2009. METHOD: Effective dose to the patient was evaluated by means of the software PCXMC. Data provided by the radiological information system allowed us to obtain collective effective and per caput dose. RESULTS: The biggest contributors to per caput effective dose from conventional radiology are vertebral column, abdomen, chest, pelvis and (limited to females) breast. Vertebral column, pelvis and breast procedures show a significant dose increment in the period of the study. The mean effective dose per inhabitant from conventional radiology increased from 0.131 mSv in 2002 to 0.156 mSv in 2009. Combining these figures with those from our study of effective dose from CT (0.55 mSv in 2002 to 1.03 mSv in 2009), the total mean effective dose per inhabitant increased from 0.68 mSv to 1.19 mSv. The contribution of CT increased from 81% to 87% of the total. In contrast, conventional radiology accounts for 85% of the total number of procedures, but only 13% of the effective dose. CONCLUSION: The study has demonstrated that conventional radiography still represents the biggest contributor to examination frequency in Aosta Valley in 2009. However, the frequency of the main procedures did not change significantly between 2002 and 2009.

A large outbreak of Opisthorchis felineus in Italy suggests that opisthorchiasis develops as a febrile eosinophilic syndrome with cholestasis rather than a hepatitis-like syndrome.

We describe the greatest Italian human acute opisthorchiasis outbreak acquired from eating raw tenches. Out of 52 people with suspected opisthorchiasis, 45 resulted in being infected. The most frequent symptoms and laboratory findings were fever, abdominal pain and eosinophilia. Seven tri-phasic computed tomography (CT) scans were done, showing multiple hypodense nodules with hyper-enhancement in the arterial phase. All patients took one day of praziquantel 25 mg/kg TID without failures. Reported symptoms suggested a febrile eosinophilic syndrome with cholestasis rather than a hepatitis-like syndrome. It seems common to find hepatic imaging alterations during acute opisthorchiasis: CT scan could be the most suitable imaging examination. Even if stool test remains the diagnostic gold standard, we found earlier positivity with the serum antibody test. Without previous freezing, the consumption of raw freshwater fish should be avoided.