MR-diffusion imaging in assessing chronic liver diseases: does a clinical role exist?

PURPOSE: This study was done to evaluate whether and which of the magnetic resonance diffusion-weighted imaging (MR-DWI) parameters - apparent diffusion coefficient (ADC), diffusion (D) or perfusion fraction (f) - correlates with the degree of chronic liver disease progression. MATERIALS AND METHODS: Twenty-eight patients were evaluated with abdominal MR-DWI from March to November 2010: seven healthy volunteers, seven patients with chronic liver disease F0-F2 (METAVIR score), seven F3-F4 Child-Pugh A, and seven F4 Child-Pugh BC, classified as groups 1-4, respectively. DWI acquisitions were performed during breath-holding (b = 0-150 s/mm(2) and 1,000) and free breathing (multi-b = 0-200-400-600-800-1,000 s/mm(2)). Using a double-blind control procedure, two observers estimated ADC, D, and f by applying a region of interest (ROI) in 4/12 sections in the middle-lower portion of the right hepatic lobe. Statistical analysis was done with analysis of variance (ANOVA). RESULTS: A reduction in the mean value of f, ADC(150) and, to a lesser extent, ADC(1,000) is shown to progress from healthy volunteers (group 1) to cirrhosis patients (group 4), with wide overlap among groups. There were no statistically significant changes of D. CONCLUSIONS: Our results indicate that stratifying patients with chronic liver disease for clinical purposes cannot be done with DWI. However, there is a tendency among groups for reduced perfusion-related parameters as chronic liver disease progresses.

The effects of patellar taping on patellofemoral incongruence. A computed tomography study.

Patellar taping for the purpose of patellar medialization is a nonoperative rehabilitation technique used in the treatment of patellofemoral pain. Despite early reports of excellent success rates, the indications for this treatment and its efficacy on patellofemoral pain are unclear. The present computed tomography study was undertaken to evaluate the effect of patellar taping on patellofemoral incongruence. Sixteen female patients (age range, 16 to 25 years) with anterior knee pain related to patellofemoral incongruence underwent computed tomography examination with their quadriceps muscles relaxed and contracted both before and after patellar taping. Patellar lateralization was measured as lateral patellar displacement, and patellar tilt was measured as lateral patellar angle. Patellar taping did not significantly affect patellofemoral lateralization or tilt. The results of this study do not support the use of this method for passive correction of patellofemoral incongruence. Although patellar taping may well be effective in controlling anterior knee pain during physical therapy, it does not do so by medializing the patella.

Autotransfusion with intra- and postoperative blood recovery in prosthetic hip surgery. A study conducted on 1368 cementless prostheses.

With regard to increasing reservations as to homologous transfusions and the objective risks that they involve, since 1984 we have been using an autotransfusion technique in total hip arthroplasty constituting blood predeposit for hemodilution, and intra- and postoperative blood recovery. When this method was used postoperative complications were not very significant even when patients were high-risk (cardiopathic); furthermore, the use of homologous transfusions was required in 2.2% of the patients in 1994 as compared to 90% in 1985. The use of our orthopaedic protocol allows for rapid recovery of movement in the patient thus reducing time bed-ridden and related risks (DVT and/or PTE); the transfusion protocol allows for a return to normal of hemodynamic conditions a few days after surgery. Finally, the reduced incidence of complications caused by homologous transfusions (hepatitis, AIDS...) constitutes a financial saving for the government.

[Emergency examinations: results of a survey conducted by the Tuscan Section of the Italian Society of Clinical Biochemistry]. / Gli esami urgenti: risultati di un'indagine conoscitiva promossa dalla sezione toscana della Società Italiana di Biochimica Clinica (S.I.Bio.C.).

The hospital laboratories in Tuscany were asked about the emergency tests organization. Such a survey showed that each laboratory solved the problem after an individual manner, probably in relation to the available instrumentation and staff, and to the physician requests. The authors think that emergency test problems must be solved by stating, in agreement with the physicians, which tests can be regarded as emergency. The laboratories should then be supplied with the instruments allowing a rapid carrying out of such tests.

[Results of 2 quality control programs performed in Tuscany in the year 1973 and 1974]. / Risultati di due programmi di controllo di qualità effettuati in Toscana nel 1973 e nel 1974

Here after are reported all the results obtained from an interlaboratory quality control program performed in Tuscany in 1973 and in 1974. In 1973, 35 hospital laboratories partecipated to the program, while in 1974 the partecipating laboratories were 79: hospital's, private's and of public bodies. The results obtained in the program performed in 1974 were less satisfactory of those obtained in 1973 and showed the need of repeating such programs in order to improve the operating efficiency of laboratories.