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Le Grazie di Ancona, Italy

Valeri G.,Clinical Radiology | Mari A.,Health Physics | La Riccia L.,AOU Ospedali Riuniti
Radiologia Medica | Year: 2015

Purpose: This study was done to evaluate the appropriateness of dose indices in computed tomography (CT) by comparing the body computed tomography dose index (CTDI) and the size-specific dose estimates (SSDE) to determine which of these two parameters is more appropriate to estimate the radiation dose to both adult and paediatric patients. Materials and methods: We analysed 150 thoracic CT and 150 abdominal CT scans, half of which from adult patients and the other half from paediatric patients. We compared the values of the CTDIvol and the SSDE reporting the average, maximum and minimum percentage difference for each body region and depending on the age of the patients. Results: In the thoracic CT and abdominal CT scans, we found values of difference between the SSDE and the CTDIvol of 26.3 and 27.3 %, respectively, in adult patients and of 46.9 and 48.5 % in paediatric patients. Conclusions: The SSDE is a good tool for estimating the average radiation dose for a given patient depending on the input parameters and the dimensions of the specific person in question before a CT examination. © 2014, Italian Society of Medical Radiology. Source

Cioffi G.,Villa Bianca Hospital | Faganello G.,Cardiovascular Center | De Feo S.,Pederzolli Hospital | Berlinghieri N.,Cardiology Unit | And 5 more authors.
Experimental and Clinical Cardiology | Year: 2013

BACKGROUND/OBJECTIVE: Left ventricular (LV) circumferential or longitudinal shortening may be impaired in patients with type 2 diabetes mellitus (DM). In the present study, patients with type 2 DM without myocardial ischemia and combined impairment of circumferential and longitudinal (C+L) shortening were studied to assess the prevalence and factors associated with this condition. METHODS: Data from 386 patients with type 2 DM enrolled in the SHORTening of midWall and longitudinAl left Ventricular fibers in diabEtes study were analyzed. One hundred twenty healthy subjects were used to define C+L dysfunction. Stress-corrected midwall shortening and mitral annular peak systolic velocity were considered as indexes of C+L shortening and classified as low if <89% and <8.5 cm/s, respectively (10th percentiles of controls). RESULTS: Combined C+L dysfunction was detected in 66 patients (17%). The variables associated with this condition were lower glomerular filtration rate (OR 0.98 [95% CI 0.96 to 0.99], greater LV mass (OR 1.05 [95% CI 1.02 to 1.08]), high pulmonary artery wedge pressure (OR 1.23 [95% CI 1.04 to 1.44]) and mitral annular calcifications (OR 3.35 [95% CI 1.71 to 6.55]). Considering the entire population, the relationship between stress-corrected midwall shortening and peak systolic velocity was poor (r=0.20), and the model was linear. The relationship was considerably closer and nonlinear in patients with combined C+L dysfunction (r=0.61; P<0.001), having the best fit by cubic function. CONCLUSIONS: Combined C+L dysfunction was present in one-sixth of patients with type 2 DM without myocardial ischemia. This condition was associated with reduced renal function, worse hemodynamic status and structural LV abnormalities, and may be considered a preclinical risk factor for heart failure. ©2013 Pulsus Group Inc. All rights reserved. Source

Morabito F.,Unita Operativa Complessa di Ematologia | Gentile M.,Unita Operativa Complessa di Ematologia | Mazzone C.,Unita Operativa Complessa di Ematologia | Rossi D.,University of Piemonte Orientale | And 21 more authors.
Blood | Year: 2011

We assessed efficacy, safety, and reversal of renal impairment (RI) in untreated patients with multiple myeloma given bortezomib-melphalan-prednisone- thalidomide followed by bortezomib-thalidomide (VMPT-VT) maintenance or bortezomib-melphalan- prednisone (VMP). Exclusion criteria included serum creatinine ≥ 2.5 mg/dL. In the VMPT-VT/VMP arms, severe RI (estimated glomerular filtration rate [eGFR] ≤ 30 mL/min), moderate RI (eGFR 31-50 mL/ min), and normal renal function (eGFR > 50 mL/min), were 6%/7.9%, 24.1%/24.9%, and 69.8%/67.2%, respectively. Statistically significant improvements in overall response rates and progression-free survival were observed in VMPT-VT versus VMP arms across renal cohorts, except in severe RI patients. In the VMPT group, severe RI reduced overall survival (OS). RI was reversed in 16/63 (25.4%) patients receiving VMPT-VT versus 31/77 (40.3%) receiving VMP. Multivariate analysis showed male sex (P ∇ .022) and moderate RI (P ∇ .003) significantly predicted RI recovery. VMP patients achieving renal response showed longer OS. In both arms, greater rates of severe hematologic adverse events were associated with RI (eGFR < 50 mL/min), however, therapy discontinuation rates were unaffected. VMPT-VT was superior to VMP for cases with normal renal function and moderate RI, whereas VMPT-VT failed to outperform VMP in patients with severe RI, although the relatively low number of cases analyzed preclude drawing definitive conclusions. VMPT-VT had no advantage in terms of RI reversal over VMP. This study is registered at http://www. clinicaltrials.gov as NCT01063179. © 2011 by The American Society of Hematology. Source

Scartozzi M.,Marche Polytechnic University | Bianconi M.,Marche Polytechnic University | Faloppi L.,Marche Polytechnic University | Loretelli C.,Marche Polytechnic University | And 10 more authors.
British Journal of Cancer | Year: 2013

Background: Currently, sunitinib represents one of the therapeutic strongholds for renal cell carcinoma, but the criteria for treatment selection are lacking. We assessed the role of vascular endothelial growth factor (VEGF) and VEGF receptor (VEGFR) polymorphisms in the prediction of the clinical outcome in metastatic renal cell carcinoma (mRCC) patients.Methods:A total of 84 tumour samples from mRCC patients receiving first-line sunitinib were tested for VEGF and VEGFR single-nucleotide polymorphisms (SNPs). The SNP results were correlated with progression-free survival (PFS) and overall survival (OS).Results:Median PFS was 8.22 months, although whereas median OS was 32.13 months. The VEGF A rs833061 resulted significant in PFS (17 vs 4 months; P<0.0001) and OS (38 vs 10 months; P<0.0001). The VEGF A rs699947 was significant for PFS (18 vs 4 months; P=0.0001) and OS (37 vs 16 months; P<0.0001). The VEGF A rs2010963 was significant in PFS (18 vs 8 vs 2 months; P=0.0001) and OS (31 vs 36 vs 9 months; P=0.0045). The VEGR3 rs6877011 was significant in PFS (12 vs 4 months; P=0.0075) and OS (36 vs 17 months; P=0.0001). At multivariate analysis, rs833061, rs2010963 and rs68877011 were significant in PFS, and rs833061 and rs68877011 were independent factors in OS.Conclusions:In our analysis, patients with TT polymorphism of rs833061, CC polymorphism of rs699947, CC polymorphism of rs2010963 and CG polymorphism of rs6877011 seem to have a worse PFS and OS when receiving first-line sunitinib. © 2013 Cancer Research UK. All rights reserved. Source

Valeri G.,Clinical Radiology | Mazza F.A.,Radiology Postgraduate School | Maggi S.,Health Physics | Aramini D.,AOU Ospedali Riuniti | And 3 more authors.
Radiologia Medica | Year: 2015

Materials and methods: We selected 23 programs for Windows and 20 programs for Mac from 150 possible OSS programs including DICOM viewers and various tools (converters, DICOM header editors, etc.). The programs selected all meet the basic requirements such as free availability, stand-alone application, presence of graphical user interface, ease of installation and advanced features beyond simple display monitor. Capabilities of data import, data export, metadata, 2D viewer, 3D viewer, support platform and usability of each selected program were evaluated on a scale ranging from 1 to 10 points.Purpose: The purpose of this paper is to evaluate the use of open source software (OSS) to process DICOM images.Results: Twelve programs received a score higher than or equal to eight. Among them, five obtained a score of 9: 3D Slicer, MedINRIA, MITK 3M3, VolView, VR Render; while OsiriX received 10.Conclusions: OsiriX appears to be the only program able to perform all the operations taken into consideration, similar to a workstation equipped with proprietary software, allowing the analysis and interpretation of images in a simple and intuitive way. OsiriX is a DICOM PACS workstation for medical imaging and software for image processing for medical research, functional imaging, 3D imaging, confocal microscopy and molecular imaging. This application is also a good tool for teaching activities because it facilitates the attainment of learning objectives among students and other specialists. © 2014, Italian Society of Medical Radiology. Source

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