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Hereditary haemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber disease, is an autosomal-dominant vascular disease characterised by mucocutaneous or visceral angiodysplastic lesions. Its diagnosis is exclusively based on clinical criteria. The brain, lungs and liver, in growing order of prevalence, are the most frequently involved organs. Diagnostic imaging based on ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) has a fundamental role in detecting visceral involvement in HHT patients and is therefore crucial for the prognostic assessment and therapeutic approach. Arteriovenous shunts are the most common cerebrovascular malformations (CVMs). MRI and CT angiography are the methods of choice for diagnosing cerebral involvement, and it is debated whether MRI could be considered as a screening examination on account of its noninvasiveness. Pulmonary arteriovenous malformations, diffuse telangiectases or high-flow, low-pressure shunts between pulmonary arteries and veins can be studied with contrast-enhanced US, but multidetector CT seems to provide the most comprehensive evaluation of their angioarchitecture, whereas angiography has a predominant role in treatment. Liver involvement is frequent and characterised by the presence of intrahepatic shunts, disseminated intraparenchymal telangiectases and other vascular lesions. US is useful for detecting hepatic lesions but should be completed by more accurate imaging methods such as multidetector CT and MRI.

Objective: To verify and quantify lipidic peroxidation by means of tiobarbituric-acid reactive substance (TBARS) dosage in patients treated daily with HBO. To verify if a potentiated glutathione enzymatic system, with N-acetylcisteine (NAC) treatment, may determine higher HBO tolerance and reduced lipidic peroxidation., Design: Randomised study on patients treated with 20 HBO 2.2 ATA (90' oxygen) sessions., Setting: Hyperbaric Medical Centre., Patients: Seventeen patients divided, at random, into two groups; group A: 10 patients treated with only HBO; group B: 7 patients treated with NAC antioxidant therapy (Fluimucil, Zambon Group, Italy) 1800 mg/day in addition to HBO., Interventions: None., Measurements and Main Results: TBARS on blood sample at T0 (basal) T1 (at the end of the 1st HBO session) T2 (at the beginning of the 20th HBO session) T3 (at the end of the 20th). The group A TBARS analysis at the different study time has shown significant data (p < 0.01) as the difference between TBARS values of the two groups at T2 (p < 0.01)., Conclusions: HBO induces a lipidic peroxidation even if the therapeutical protocol cannot determine lung or cerebral oxygen toxicity symptoms. The NAC administration, during HBO treatment, determines a protection against the HBO radicalic stress.

The appearance of side effects was monitored in 70 selected patients who underwent radiculography and myelography. After the examination, a rapid return to normal activity was recommended. In accordance with literature, no greater incidence of side effects was found in patients who were allowed to get up soon after myelography or radiculography, than in patients confined to bed for some hours. These results are essentially attributable to the low toxicity of the contrast medium used in this study (Iopamidol), and to an adequate hydratation of the patients after examination.

As for the preventive measures used towards patients with a measles infection, the Authors review in particular the new methods of isolation on the basis of the latest acquisitions on the way and period of contagiousness. As for the preventive measures for healthy people, the Authors review in particular the vaccination route. After having considered the principal types of vaccine used, they demonstrate the efficiency and harmlesness of the live and attenuated virus vaccine, in general, and in particular the "hyperattenuated" vaccine, reviewing the principal causes of the failure of such a vaccine in some cases. They give an ample documentation of the period of immunity (persistance of HAI antibodies) in the vaccined. Considering the experience of other countries, the Authors suggest that it is time to procede in a large scale vaccination in Italy, underlining the fundamental points (use of live and hyperattenuated vaccine, appropriate storage and care of the vaccine, age of vaccination) to prevent failure and to make more and more efficient this type of vaccination.