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In order to optimize the use of ultrasound in the characterization of cystic or nodular lesions, the incidence of simple cysts in the general population, their growth and evolution is discussed considering some follow-up studies. After studying the typical sonographic criteria of simple cyst, we describe the sonographic features of cancer and the incidence of various types of tumors. In such cases radiological evaluations are required and the Bosniak classification is useful in the clinical choice of waiting, more detailed diagnosis or excision of the lesion. The use of the radiological means will decrease when EcocolorDoppler with contrast is widely available. Nevertheless, this technique has already found its way into peculiar fields and in certain cases, it has a higher sensitivity compared to TAC with contrast medium.

OBJECTIVE The prevalence of neuropathy, a common complication of diabetes, was determined in diabetic patients recruited from 109 outpatient diabetes clinics in Italy. RESEARCH DESIGN AND METHODS Neuropathy was diagnosed using the Diabetic Neuropathy Index (DNI), a standardized examination developed for use in the outpatient setting. A total of 8,757 diabetic patients were studied, 51.2% men and 48.8% women, with average and median ages of 56 and 58 years, respectively. RESULTS Of the 8,757 patients, 32.3% had neuropathy, defined as a positive score of > 2 points on the DNI. A total of 2,033 (49.6% men and 50.4% women) were administered the Diabetic Neuropathy Score (DNS), the second component of the screening program, by a neurologist. This component consists of a quantitative neurological examination and nerve conduction studies that together provide a summated score. A total of 335 patients (16.5%) were not neuropathic, and 395 (19.4%) had borderline, 453 (22.3%) mild, 592 (29.1%) moderate, and 258 (12.7%) severe neuropathy. The concordance between a positive score on the DNI and a DNS indicating neuropathy was 83.5%. The severity of neuropathy increased with both age and disease duration. Of patients with neuropathy, 64.1% had an average age between 58 and 59 years with a disease duration between 12.4 ± 8.4 years (mild neuropathy) and 15.6 ± 9.7 years (severe neuropathy). CONCLUSIONS Neuropathy is a common complication of diabetes and, in this study, was present in 32.3% of all patients. An increased awareness of the high prevalence of neuropathy can lead to early therapeutic intervention and possible prevention of later neuropathic complications, such as infection and foot ulcers.

Molecules in the solid phase have been detected in the line of sight of quiescent molecular clouds and star forming regions as icy mantles on dust grains. Water (H_2O), carbon monoxide (CO), carbon dioxide (CO_2), methanol (CH_3OH), carbonyl sulfide (OCS), methane (CH_4), ammonia (NH_3) and sulfur dioxide (SO_2) are the most abundant observed species (e.g. Gibb et al. 2004). It is generally accepted that some of these species (such as CO) freeze out from the gas phase while others (such as water and methanol) are formed on grains after surface reactions (Ioppolo et al. 2008). CO_2 and OCS are not expected to freeze out from the gas phase and grain surface models do not account for their observed abundance (Ruffle & Herbst 2001; Garrod et al. 2007). It has been suggested that these molecules are formed after energetic processing (i.e. cosmic ion and UV irradiation) of icy grain mantles (d'Hendecourt et al. 1986; Moore et al. 1991; Palumbo & Strazzulla 1993; Ioppolo et al. 2009; Garozzo et al. 2010 ). Here we will present the results of laboratory experiments which show the formation of CO_2 and OCS after ion irradiation of relevant ice mixture at low temperature (10-20 K). We will also present the comparison between the profile of bands in laboratory spectra with those observed in space. We will show that laboratory spectra well reproduce the interstellar features and that the amount of carbon dioxide and carbonyl sulfide formed after ion irradiation can account for the observed amount towards molecular clouds.

To investigate the relationship between carotid atherosclerosis and some major cardiovascular risk factors in uremic patients on chronic dialysis.A cross-sectional study was carried out in 119 unselected dialysis patients (89 on hemodialysis and 30 on chronic ambulatory peritoneal dialysis, CAPD). Fasting blood sampling for serum lipids, albumin, hemoglobin, and echo-colour-Doppler evaluation of common carotid arteries were performed in all patients (during the non-dialysis day in hemodialysis patients). In hemodialysis patients BP was measured before and after dialysis; in CAPD patients home BP values were recorded during the month before the study day.Ninety-five patients had at least one plaque and 57 had at least four plaques. Thirty-eight had mild and eleven severe carotid stenosis. In multiple regression models, the mean internal diameter of carotid arteries was explained (R=0.52, P=0.0001) by systolic pressure (r=0.39), serum cholesterol (r=-0.28), age (r=0.27) and smoking (r=0.24) while the degree of carotid stenosis was predicted (R=0.39, P=0.0001) by age (r=0.36) and smoking (r=0.25). The number of atherosclerotic plaques was explained (R=0.51, P=0.0001) by age (r=0.36), smoking (r=0.25) and pulse pressure (r=0.20), serum albumin just failing to reach statistical significance (P = 0.06). However, serum albumin was a significant and independent predictor of the number of atherosclerotic plaques (r=-0.26) in hemodialysis patients (n=89). Sex, diabetes, Kt/V, duration of dialysis treatment, hemoglobin, serum calcium and phosphate did not add any predictive power to the models.In dialysis patients arterial pressure and smoking are associated with carotid atherosclerosis. Serum albumin appears to serve as an independent predictor of carotid atherosclerosis.

Introduction: Freehand renal biopsy represents a valid alternative to the most widespread ultrasonography-guided technique, although some concerns can derive from the possible increased complication rate and lower adequacy rate. Objectives: In the present audit study, efficacy of freehand method have been established through the analysis of 328 consecutive renal biopsies in 322 patients, instead the safety of the procedure was assessed in 196 patients. Patients and Methods: We retrospectively reviewed hospital databases of all patients who underwent a percutaneous renal biopsy over an 18 years’ period at Santa Marta and Santa Venera hospital in Acireale. Results: The procedure led to a definitive diagnosis in the majority of cases (98.48%), being uninformative only in 5 out of 328 cases (1.52%). Comparing these results against a Proforma, resulting from analysis of best literature reports for the items studied, adverse event rates were similar. Conclusion: Freehand renal biopsy resulted a good option to obtain renal tissue, without serious side effects. We argue about safety and we prefer to reserve this invasive procedure to selected cases, avoiding renal biopsy if biochemical and instrumental data allow a definitive diagnosis as well as in high risk patients. Our policy protects patients from the adverse effects that can result from kidney biopsy.

ObjectiveAge is considered a negative prognostic factor for High Grade Gliomas (HGGs) and many neurosurgeons remain skeptical about the benefits of aggressive treatment. New surgical and technological improvements may allow extended safe resection, with lower level of post-operative complications. This opportunity opens the unsolved question about the most appropriate HGG treatment in elderly patients. The aim of this study is to analyze if HGG maximal safe resection guided by an intraoperative multimodal imaging protocol coupled with neuromonitoring is associated with differences in outcome in elderly patients versus younger ones.MethodsWe reviewed 100 patients, 53 (53%) males and 47 (47%) females, with median (IQR) age of 64 (57; 72) years. Eight patients were diagnosed with Anaplastic Astrocytoma (AA), 92 with Glioblastoma (GBM). Surgery was aimed to achieve safe maximal resection. An intraoperative multimodal imaging protocol, including neuronavigation, neurophysiological monitoring, 5-ALA fluorescence, 11C MET-PET, navigated i-US system and i-CT, was used, and its impact on EOTR and clinical outcome in elderly patients was analyzed. We divided patients in two groups according to their age: 65 years, and surgical and clinical results (EOTR, post-operative KPS, OS and PFS) were compared. Yet, to better understand age-related differences, the same patient cohort was also divided into 70 years and all the above data reanalyzed.ResultsIn the first cohort division, we did not found KPS difference over time and survival analysis did not show significant difference between the two groups (p = 0.36 for OS and p = 0.49 for PFS). Same results were obtained increasing the age cut-off for age up to 70 years (p = 0.52 for OS and p = 0.92 for PFS).ConclusionsOur data demonstrate that there is not statistically significant difference in post-operative EOTR, KPS, OS, and PFS between younger and elderly patients treated with extensive tumor resection aided by a intraoperative multimodal protocol.

The assessment of the road roughness conditions plays an important role to ensure the required performances related to road safety and ride comfort, furthermore providing a tool for pavement maintenance and rehabilitation planning. In this work, the authors compared the roughness index (International Roughness Index, IRI) derived from high speed inertial profilometer with two other roughness indices, one dynamic and one geometric computed on a digital elevation model (DEM) built by using mobile laser scanner (MLS) data. The MLS data were acquired on an extra-urban road section and interpolated on the nodes of a DEM with a curvilinear abscissa, coinciding with the global navigation satellite system (GNSS) track of the profilometer. To estimate the grid cell elevation, we applied two interpolation methods, ordinary kriging (OK) and inverse distance weighting (IDW), over the same data. The roughness values computed on the surface of the DEM showed a similar trend and a high correlation with those acquired by the profilometer, higher for the dynamic index than for the geometric index. The differences between the IRI values by profilometer and those computed on the DEM were small enough not to significantly affect the judgments on the analyzed sections. Moreover, the road sub-sections derived from profilometer measure that were classified as critical coincided with those derived from light detection and ranging (LiDAR) surveys. The proposed method can be used to perform a network-level analysis. In addition, to evaluate the effects of vibrations on human comfort, we input the DEMs into a dynamic simulation software in order to compute the vertical accelerations, as specified in the UNI ISO 2631 standard. The values obtained were in line and correlated with those inferred from the standard methodology for profilometer measures.

Purpose Membranous nephropathy (MN) is the most frequent cause of nephrotic syndrome in adults and the disease course is characterized by the "rule of third", with one-third of patients experiencing complete remission and the remaining experiencing relapses or progression of the disease. Additionally, the therapeutic approach is not standardized, leading to further heterogeneity in terms of response and outcome. Experimental design In this pilot study, MALDI-MSI analysis is performed on renal biopsies (n = 13) obtained from two homogeneous groups of patients, which differentially responded to the immunosuppressive treatments (Ponticelli regimen). Results A signal at m/z 1303 displays the greatest discriminatory power when comparing the two groups and is observed to be of higher intensity in the glomeruli of the non-responding patients. The corresponding tryptic peptide is identified as macrophage migration inhibitory factor (MIF). Conclusions and clinical relevance Despite much effort being made in recent years to understand the pathogenesis of MN, a biomarker able to predict the outcome of these patients following therapeutic treatment is still lacking. Here, a protein (MIF), verified by immunohistochemistry, that can differentiate between these MN patients and could be a valuable starting point for a further study focused on verifying its predictive role in therapy response is highlighted.

The monitoring of pavement distress takes a key role with respect to the functionality of a road structure, which is necessary to schedule maintenance works, optimizing the available resources. The identification, classification and quantification of different typology of distress involve complex practical activities and data processing that are sometimes inefficient and risky since interfere with road traffic. Our work focuses on the three-dimensional reconstruction of the paved surface making use of innovative technologies of surveying and data computation for the purpose of vehicle dynamics simulation. With the evolving LiDAR (Light Detection and Ranging) technologies, including static and mobile laser scanners, it is possible to obtain very dense point clouds. The experimentation concerns a road segment whose surface has been surveyed by means of a static Terrestrial Laser Scanner (TLS) and a Mobile Laser System (MLS) to analyze their performances and compare the results in a test case. These data were used to generate a few 3D geometrical models of the road surface. The IRI (International roughness Index) was computed on both the TLS and MLS surface, this latter measured at different acquisition speed. In order to evaluate road safety and comfort, the DEM (Digital Elevation Model) was imported in a vehicle dynamics simulation software that predicts the performance of vehicles in response to driver’s controls.