ABSTRACT
Radiologically-isolated syndrome (RIS) is a recently-defined entity, described as the incidental discovery of lesions suggestive of multiple sclerosis (MS) on brain magnetic resonance imaging (MRI) scans demonstrating dissemination in space (DIS) without symptom expression and with a normal neurological examination. Recent studies demonstrate that RIS patients present similar features of cognitive impairment as MS patients. We describe a case of a RIS patient in whom investigating cognitive functions was a useful tool for diagnostic and therapeutic decisions.
Subject(s)
Asymptomatic Diseases , Brain/pathology , Cognition Disorders/diagnosis , Incidental Findings , Multiple Sclerosis/diagnosis , Spinal Cord/pathology , Cervical Vertebrae , Cognition Disorders/psychology , Evoked Potentials, Visual , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Middle Aged , Multiple Sclerosis/psychology , Neuropsychological Tests , Oligoclonal Bands/cerebrospinal fluidABSTRACT
The process of institutional accreditation has been initiated in Italy too because it is considered to be the criterion upon which new relations within the National Health Service must be based. These relations include payment for the service as well as choice of quality assessment and revision of the activities carried out and the services provided. This paper describes the regulations in force regarding Institutional accreditation and the specific regulations of Italian regional credit laws on nephrology. The Regions examined are Lazio, Campania, Marche, Basilicata and Lombardy. A synoptic table showing the most important criteria, differentiated according to each region, is also included.
Subject(s)
Health Facilities/legislation & jurisprudence , Licensure/legislation & jurisprudence , Nephrology/legislation & jurisprudence , Health Facilities/standards , Italy , Licensure/standards , Nephrology/standardsABSTRACT
OBJECTIVE: To compare colposcopic findings to cytologic and histological diagnoses in women with colposcopic reports of ANTZ and/or HPV infection. METHODS: Among 791 hospitalized women referred for colposcopic examination, colposcopy showed ANTZ grade 0-2 and/or HPV infection in 271 patients (34.26%). Only 153 were fully investigated by colposcopy, cytology (under colposcopic observation) and histology (target punch biopsy: 109 patients; surgical specimens of hysterectomy: 42 patients; conization: 2 patients). Cytological and histological diagnoses were reported according to the Bethesda System. RESULTS: 132/153 Pap smears were estimable for sampling adequacy; 44/63 resulted as normal and were histologically positive for LSIL [1]. Five LSIL-positive Pap tests were negative on histology (false negative and false positive rate of 33.33% and 3.78%). The pap test was diagnostic for intraepithelial neoplasia in 34/65 cases (53.3%) and for invasive cancer in 6/11 cases (54.5%). In 67/132 cases (50.8%) adequate-for-sampling Pap smears could not predict the exact diagnosis. On the other hand, 108/141 patients with colposcopic evidence of ANTZ/cancer showed histological SIL or invasive neoplasm (76.59%): ANTZ 1 was associated to LSIL and HSIL in 74.1% and 2.4%; ANTZ 2 to LSIL, HSIL and invasive cancer in 41%, 30.76% and 10.3%. Colposcopic suspicion of invasive cancer in 8 patients was histologically demonstrated in 7 (87.5%); colposcopic diagnosis of HPV infection was confirmed in 10/12 (83.4%). CONCLUSION: A better correspondance was shown between colposcopy and histology than between cytology and histology in the diagnosis of SIL. We suggest a routine colposcopy investigation for all patients admitted to a gynecological clinic and we believe it is very important to take Pap smears under colposcopic observation if colposcopy and cervical smears are performed in the same sitting.
Subject(s)
Cervix Uteri/pathology , Neoplasms, Squamous Cell/diagnosis , Precancerous Conditions/diagnosis , Uterine Cervical Dysplasia/diagnosis , Adult , Aged , Biopsy , Colposcopy , Diagnosis, Differential , Female , Humans , Middle Aged , Neoplasms, Squamous Cell/pathology , Papanicolaou Test , Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Papillomavirus Infections/pathology , Precancerous Conditions/pathology , Predictive Value of Tests , Tumor Virus Infections/diagnosis , Tumor Virus Infections/pathology , Vaginal Smears , Uterine Cervical Dysplasia/pathologyABSTRACT
One hundred and twenty-seven pediatric and adolescent patients suffering from vulvo-vaginitis underwent clinical and instrumental tests. The results of bacterioscopic and cultural test were negative in 39 (31.7%) patients due to the probable intervention of local hormonal, allergic and/or irritative factors. The tests used by the authors revealed phlogosis in 88 patients (68.3%) which was aspecific in 58 cases (65.9%) and specific in 30 (34.1%). While aspecific phlogosis were basically caused by germs of intestinal origin, typical of childhood and the prepuberal period, mycetes, gardnerella vaginalis, protozoa and chlamydia trachomatis were identified as the causes, in order of importance, of specific phlogosis, the exclusive hallmarks of adolescence.
Subject(s)
Vulvovaginitis , Adolescent , Age Factors , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/complications , Bacterial Infections/drug therapy , Child , Child, Preschool , Chlamydia Infections/complications , Female , Humans , Trichomonas Infections/complications , Vaginosis, Bacterial/complications , Vaginosis, Bacterial/drug therapy , Vulvovaginitis/diagnosis , Vulvovaginitis/etiologyABSTRACT
La desnutrición, con su alta prevalencia de procesos infecciosos, origina cambios en el sistema inmune. Se realizó la evaluación del estado nutricional e inmunológica en 55 niños lactantes y preescolares que presentaron diarrea (ED) o infección respiratoria (IR) y se comparó con un grupo control. Se determinaron linfocitos T (LT) por rosetas y B (LB) por inmunoglobulina de superficie, a niveles de inmunoglobulinas A, G y M, y fracciones 3 y 4 de complemento por inmunodifusión radial. LT y LB en controles sanos fue de 52,3 ñ 7,9 y 20,1 ñ 6,4 respectivamente; en los enfermos fueron bajos IgA y C3 fue para EDy mayores y significativos en IR. La asociación patología desnutrición disminuyó los LT y LB y la fracción 3 de complemento. En los desnutridos las poblaciones de linfocitos aumentaron después e una semana de terapia específica y nutricional. Hubo relación entre severidad del daño nutricional y cambios inmunológicos
Subject(s)
Infant , Child, Preschool , Humans , Male , Female , B-Lymphocytes/immunology , Infant Nutrition Disorders , Receptors, Antigen, B-Cell , T-Lymphocytes/immunologyABSTRACT
Due to their anti-inflammatory and immunosuppressive properties, as well as their action on the hematopoietic system and the calcium phosphate turnover, corticosteroids are widely employed in the treatment of many diseases. However, the therapeutic use of these compounds is frequently associated with unwanted, mainly type A, effects that are directly dependent on the wide spectrum of their pharmacological activities. In this study these side effects are critically reviewed and classified on the basis of the organs and systems involved. Where possible, the incidence, pathogenesis, type of steroid, dose and schedule are reported, and the precautions that should prove useful in reducing the incidence and gravity of the side effects are given.
