Spray formulation of silver and hyaluronic acid in the treatment of superficial cutaneous ulcers of different etiopathogenesis: analysis of fifty-four clinical cases.

AIM: The aim of this study was to assess a spray formulation containing colloidal silver and hyaluronic acid. METHODS: Patients included in the study were divided in two separate groups: 30 patients had chronic wounds and 24 patients had superficial traumatic wounds. Applications were performed at intervals of 3-7 days, depending upon lesions characteristics. Subsequent improvements were evaluated at various intervals after enrollment. The lesion area and the rate of re-epithelialization were calculated, considering the time span and monitoring the patients for clinical signs of wound infection. Patients satisfaction and compliance were evaluated by a questionnaire aimed at assessing pain and ease of use of the device. RESULTS: Chronic lesions were healed at week 12, with a high rate of closure observed at 6 weeks (70%). Furthermore, traumatic wounds healed at six weeks, with a substantial percentage of closure (80%) at three weeks. A good control of microbial contamination was evident in all the treated wounds; in no case other antimicrobial medications were used. Finally, patients favorably expressed compliance with regard to the spray formulation and ease of use. CONCLUSION: This type of clinical approach seems to be a rational good choice to promote re-epithelialization of superficial cutaneous ulcers of different origins as well as control of bacterial infections.

Renal volume assessment with 3D ultrasound.

PURPOSE: This study was undertaken to determine the accuracy of 3D ultrasound (US) in assessing renal volume, with multislice computed tomography (MSCT) considered as the gold standard. MATERIALS AND METHODS: Forty-nine patients (30 men, 19 women; age range 30-82 years) underwent abdominal contrast-enhanced MSCT and 3D-US performed with a 3.5-MHz 3D/4D convex-array probe. The results of the two modalities were compared with the Wilcoxon test. Variability between the two measurements was determined with the Bland-Altman method and reported in terms of bias and coefficient of repeatability (CoR). RESULTS: Mean values obtained were 210 ml with MSCT and 192 ml with 3D-US (p<0.001). Analysis of variability per patient between MSCT and 3D-US showed a bias of 19 ml, a CoR of 47 ml and an accuracy of 78%, with an average 3D-US underestimation of 19 ml (9%). Analysis of variability per kidney showed a bias of 9 ml, a CoR of 34 ml and an accuracy of 80%. CONCLUSIONS: Three-dimensional US is a valuable technique for monitoring renal volume, whereas MSCT may be reserved for assessing renal anatomy and relationships with neighbouring organs.

Low-fat angiomyolipoma of the liver studied with contrast-enhanced ultrasound and multidetector computed tomography.

We report the case of a 30-year-old woman with persistent pain at the right hypochondrium, relapsing fever, and normal serum tests. Ultrasound showed a hyperechoic inhomogeneous mass; following sulfur hexafluoride injection, uniform enhancement at 14-16 s and rapid wash-out at 26 s was found. Multidetector computed tomography showed an inhomogeneously hypodense mass, with no detectable negative density values, characterized by inhomogeneous enhancement at the arterial phase and wash-out at the portal phase. Histopathology demonstrated a hepithelioid angiomyolipoma with a poor fatty component. This diagnosis should always be considered in the presence of a very rapid wash-out after intravenous contrast injection. However, a hepatocellular carcinoma cannot be excluded and the final diagnosis of low-fat angiomyolipoma must be pathologically proved based on immunohistochemistry.

[Echography of the hip in premature infants]. / Ecografia dell'anca nel prematuro.

The authors report the data relative to 50 preterm infants with gestational age less than or equal to 34 weeks. The newborns were studied sequentially with clinical and US examination from February 28, 1989 to March 23, 1990 in order to exclude hip dysplasia or dislocation. US examination was carried out according to Graf's technique. All the newborns had another clinical examination at one year of age in order to evaluate their normal walking. Risk factors had poor significance in the studied group of infants.

[Echography of the hip in the newborn. 1507 cases]. / Ecografia dell'anca nell'epoca neonatale. 1507 casi.

The authors report the data relative to 1507 infants studied with clinical and US examination, in the neonatal period, in order to exclude hip dysplasia or dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips at birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th month of life. At about one year of age all infants could normally walk, except for one who was being treated with harness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, the authors believe US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period.

[Digital angiography of the pudendal arteries in erectile impotence]. / L'angiografia digitale delle arterie pudende nello studio della impotenza erettile.

Digital angiography of pudendal and penile arteries was performed on 32 consecutive patients with erectile failure of suspected vascular origin. Intra-arterial injection of contrast medium via selective catheterization of the hypogastric arteries was used in 6 cases. In 27 cases, one of which already submitted to arterial catheterism, the intravenous route was employed for contrast administration, using a single, large volume, high speed bolus. In one case, digital angiography was diagnostically unreliable due to patient's motion and to blurring artifacts. Among the remaining cases, 9/31 (29%) showed a normal angiographic picture, while 22/31 (71%) possessed stenotic-obstructive lesions of different severity. The pictures obtained after intravenous contrast administration were diagnostically equivalent to those obtained with arterial catheterism: in addition, intravenous route allowed the simultaneous representation of the arterial network of both sides and the overall examination resulted less invasive and quicker. In 22/32 patients (69%), functional determinations of erectile capability and of penile blood flow were performed for comparison. Nocturnal penile tumescence (12 cases diagnostically useful) was well correlated with the angiographic picture. Penile blood flow measurements with the Doppler technique (21 cases) seemed on the contrary to be less sensitive than digital angiography.

[Radiotherapy of local recurrences of surgically treated rectal and rectosigmoidal cancer]. / La radioterapia delle recidive locali dei carcinomi rettali e retto-sigmoidei operati.

Local surgical failures of rectal and rectosigmoidal cancer are often observed and represent a heavy clinical problem from the viewpoint of quality of life. After having referred bad results of radiotherapy in a group of 55 patients locally relapsed after radical surgery, the authors analyse causes of therapeutic failure, underlining that ineffectiveness of radiation treatment comes mainly from late and, frequently, not complete diagnosis. Computed tomography must be currently considered the best way for monitoring these patients in order to get an earlier detection and the most correct radiation treatment plan.