Factors interfering with parenthood decision-making in an Italian sample of people with multiple sclerosis: an exploratory online survey.

BACKGROUND: Little is known about the influence of multiple sclerosis (MS) diagnosis on parenthood attitude in people with MS (pwMS). OBJECTIVE: To investigate the impact of diagnosis, clinical features and external disease-related influences on parenthood decision-making in Italian pwMS. METHODS: A web-based survey was posted on SMsocialnetwork.com to investigate clinical status, parenthood desire, influences on family planning, pregnancy outcomes, abortions and adoptions of pwMS. RESULTS: 33/395 respondents never wanted to become parent because of MS ("anti-parenthood after diagnosis"). 362 declared to be in favor of parenthood. 51% pwMS having a child by the survey time had already received the MS diagnosis at first childbirth. The frequency of a second child in pwMS after diagnosis was 38% compared to 67% in people without yet MS diagnosis. 16% of pwMS were discouraged to become parent after diagnosis, mainly by medical personnel. In 71% of respondents, diagnosis did not delay the decision to become parent and only 39% were counseled by treating physician to plan pregnancy. Patients' distribution according to the clinical phenotype (exclusively relapsing vs exclusively progressive) showed a higher proportion of progressive patients in the "anti-parenthood after diagnosis" subgroup. CONCLUSION: MS diagnosis impacted dramatically on the life project of 7% of pwMS that decided not to have children because of the disease and in pro-parenthood pwMS impacted especially on having the second child. Only a minority was counseled to plan pregnancy. A worse disease course driving to a progressive phenotype at survey time might have negatively impacted on parenthood desire.

Prostate cancer diagnosis through electronic nose in the urine headspace setting: a pilot study.

BACKGROUND: To evaluate the efficacy of prostate cancer (PCa) detection by the electronic nose (EN) on human urine samples. METHODS: Urine samples were obtained from candidates of prostate biopsy (PB). Exclusion criteria were a history of urothelial carcinoma or other malignant disease, urine infection, fasting for <12 h before PB or ingestion of alcohol or foods that might alter the urine smell in the last 24 h. The initial part of the voided urine and the midstream were collected separately in two sterile containers. Both samples were analyzed by the EN immediately after the collection. All patients underwent a standard transperineal, transrectal-ultrasound-guided PB. The pathological results were compared with the outcomes of the EN. Sensitivity and specificity of EN were assessed. RESULTS: Forty-one men were included in the study. Fourteen out of the 41 patients were positive for PCa. Midstream urine did not correlate significantly neither with a positive nor with a negative PB. Instead, significantly different results on the initial part of the urine stream between positive and negative PBs were obtained. The EN correctly recognized 10 out of the 14 cases (that is, sensitivity 71.4% (confidence interval (CI) 42-92%)) of PCa while four were false negatives. Moreover, the device recognized as negative 25 out of the 27 (that is, specificity 92.6% (CI 76-99%)) samples of negative PBs, with only two false positives. CONCLUSIONS: We believe this is the first demonstration of an olfactory imprinting of the initial part of the urine stream in patients with PCa that was revealed by an EN, with high specificity.

In situ detection of lung cancer volatile fingerprints using bronchoscopic air-sampling.

Lung cancer diagnosis via breath analysis has to overcome some issues that can be summarized by two crucial points: (1) further developments for more performant breath sampling technologies; (2) discovering more differentiated volatile fingerprints to be ascribed to specific altered biological mechanisms. The present work merges these two aspects in a pilot study, where a breath volume, sampled via endoscopic probe, is analyzed by an array of non-selective gas sensors. Even if the original non-invasive methods of breath analysis has been laid in favour of the endoscopic means, the innovative technique here proposed allows the analysis of the volatile mixtures directly sampled near the tumor mass. This strategy could open the way for a better understanding of the already obtained discrimination among positive and negative cancer cases. The results obtained so far confirm the established discrimination capacity. This allows to discriminate the different subtypes of lung cancer with 75% of correct classification between adenocarcinoma and squamous cell carcinoma. This result suggests that a 'zoom-in' on the cancer settled inside the human body can increase the resolution power of key-volatiles detection, allowing the discrimination among different cancer fingerprints. We report this novel technique as a robust support for a better comprehension of the promising results obtained so far and present in literature; it is not to be intended as a replacement for non-invasive breath sampling procedure with the endoscope.

[Gastric neoplasms: their characterization, assessment of the degree of parietal infiltration and check on recurrence. The potentials and limits of CT, endoscopic US and MR]. / Neoplasie gastriche: caratterizzazione, valutazione del grado di infiltrazione parietale e accertamento di recidiva. Possibilità e limiti della TC, della US endoscopica e della RM.

In this report we reviewed the role of CT, of endoscopic ultrasonography and of MR in the study of the gastric wall, to assess the degree of parietal infiltration to characterize gastric neoplasms. Finally we assess the CT role to check gastric carcinoma recurrences.

[Radiologic evaluation of parietal infiltration of bladder cancer (integrated imaging: US, TC, RM) and comparison with transurethral resection (TUR)]. / Valutazione radiologica dell'infiltrazione parietale nel carcinoma della vescica (imaging integrato: US, TC, RM) e valutazione in confronto con la resezione transuretrale (TUR).

In this work we checked the reliability of Ultrasounds (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in the staging of parietal infiltration of bladder carcinoma. We studied 49 patients with documented bladder carcinoma. All patients underwent CT examination, 43 patients to MR examination and 40 patients to US examination. Between the patients who underwent US examination, 35 out of them had a sovra-pubic Ecography, 27 patients a trans-rectal Ecography and in 30 patients a trans-uretral Ecography was performed. After radiologic examination, all patients underwent a deep fractionated trans-uretral resection of the neoplastic mass (TUR) for the tumor staging. The results of the computed images and US examinations were then compared with the TUR staging. Among the group of patients studied with US, the agreement between imaging and TUR staging was respectively of 51% for the sovra-pubic study, 44.5% for the trans-rectal study and 56.7% for the trans-uretral study. The agreement was of 55% with the CT studies and 45.7% with the MRI. The sovra-pubic US studies showed a good correlation in the evaluation of superficial lesions (Tis-T1 stadied on TUR), if compared to the CT and MRI studies; moreover US is certainly more suitable because of its lower price and discomfort for the patient. On the contrary patients with a documented stage > T1 need a CT and MRI study for the correct staging. MRI has shown to be more sensitive in selected cases with localization of tumor on the top of the bladder roof, on its floor or in the follow-up after TUR. CT scan showed a better reliability in the staging of superficial lesions (Tis-T1 stages). On the contrary MRI has shown to be more sensitive in distinguishing superficial lesions (T1-T2 stages) from deeper lesions with muscles infiltration (T3a stage) on the basis of the loss of the parietal hypointense line on the T2 weighted images. Tumors with a grade T3b or more are well studied in both CT scan and MRI, which allow to get more useful information than US about the lynphoglandular involvement.

[Role of magnetic resonance in the identification, characterization and staging of prostatic cancer. Comparison with transrectal echotomography and computerized tomography]. / Ruolo della risonanza magnetica nella identificazione, caratterizzazione e stadiazione del carcinoma prostatico. Confronto con la ecotomografia trans-rettale e la tomografia computerizzata.

The results of MR imaging in diagnosing, and characterizing of prostatic malignant tumour, as well as its feasibility in assessing the extension are discussed in this paper. We also compared MR findings with the results obtained from trans-rectal ultrasonography and computed tomography. In particular, we emphasize the important role of MR examination with trans-rectal coil which is, at present, the most sensitive technique for the identification and characterization of prostatic tumours as well as for assessing their extension.

[Images of hepatic parasitic cysts: echotomography, computed tomography and magnetic resonance compared]. / Immagini delle cisti parassitarie epatiche: ecotomografia, tomografia computerizzata e risonanaza magnetica a confronto.

Hepatic hydatic cysts are a very common finding in the endemic areas like Australia, the Middle East, New Zealand, South Africa and in some countries bordering the Mediterranean. Immigration has increased the finding of this pathology in some European and North American areas. Our purpose is to show possibilities and limits using US, TC and RM to demonstrate the presence of parasitic hepatic localizations and their evolution after therapy.

[Comparison of magnetic resonance and other imaging methods in the diagnosis of diseases of the seminal vesicles]. / Confronto tra la risonanza magnetica e le altre tecniche ad immagini nell'accertamento della patologia delle vescicole seminali.

The aim of this work was to evaluate the usefulness of MR imaging in the diagnostic study of seminal vesicles and to emphasize the relationships between this technique, CT scan and trans-rectal ultrasonography (TR-US). We discussed pathological findings due to congenital anomalies, phlogistic or neoplastic lesions and iatrogenic changes of normal tissues. MR imaging and TR-US seem to be the most reliable techniques for typing pathological tissues and for grading the extension of neoplatic masses arising from bladder, prostate, and rectum, involving seminal vesicles.

[Ultrasonographic changes in the abdominal organs in the 10th decade of life]. / Alterazioni ultrasonografiche degli organi addominali nel decimo decennio di vita.

10 patients in perfect health, aged between 90 and 101 (mean age: 93 +/- 3), have been studied with echography in order to investigate the possible changes in volume and echo-pattern of abdominal organs, linked to the "physiological" aging. Our resulting data (reduced volume of liver and kidneys, changes in echo-pattern of pancreatic parenchyma, reduced thickness of renal cortical-medullary) seem to confirm the well known data of an atrophic change interesting the parenchyma of abdominal organs in aging: this latter, however, remains compatible with function preservation.