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Purpose To determine the prevalence of mitral annular disjunction (MAD) in patients undergoing cardiac MRI for various clinical indications and to assess the association of MAD with arrhythmia, mitral valve prolapse (MVP), and myocardial alteration. Materials and Methods This study analyzed data from a retrospective observational registry of consecutive patients undergoing cardiac MRI for different clinical indications. Cardiac MRI examinations were performed from January 2019 to June 2019 at 13 Italian hospitals. Images underwent double reading by expert cardiac radiologists from the enrolling center and the core laboratory to assess the presence of MAD. Presence and maximum length of MAD and its association to MVP pattern, functional and structural myocardial alteration, and arrhythmia were evaluated using nonparametric and parametric tests. Logistic regression models were used to identify predictors of arrhythmia. Results Cardiac MRI studies from 2611 consecutive patients (1730, 66% male; median age, 53 years; IQR, 39-65 years) were evaluated. Prevalence of MAD was 5.44% (142 of 2611). MAD was an incidental finding in 74.6% (106 of 142) of patients. Patients with MAD had a higher prevalence of arrhythmias compared with patients without MAD (40% [57 of 142] vs 18% [444 of 2469]; P < .001). Patients with MAD and bileaflet MVP showed a longer MAD compared with patients with single-leaflet or absent MVP (median, 7 mm [IQR, 3-9.5 mm] vs 4 mm [IQR, 3-5 mm]; P < .001), a higher prevalence of systolic curling (75% [21 of 28] vs 30.7% [35 of 114]; P < .001), higher extracellular volume values (30% [IQR, 28%-32%] vs 27% [IQR, 25%-30%]; P = .04), and a higher prevalence of arrhythmia (64.2% [18 of 28] vs 34.2% [39 of 114]; P = .006). MAD length of at least 5 mm was an independent predictor of arrhythmia (odds ratio 3.96; 95% CI: 1.93, 8.15; P < .001). Conclusion MAD was a frequent incidental finding on cardiac MRI scans from a multicenter registry. MAD length of at least 5 mm and coexisting bileaflet MVP showed a higher risk of arrhythmia. Keywords: MR Imaging, Cardiac, Mitral Annular Disjunction Supplemental material is available for this article. ©RSNA, 2024.

Aim: To assess the prognostic relevance of baseline and post-treatment skeletal muscle index (SMI) and skeletal muscle radiation attenuation (SMRA) at the level of third lumbar vertebra in patients with ovarian cancer who underwent primary surgery and platinum-based chemotherapy., Patients and Methods: This retrospective investigation analyzed 134 patients who underwent staging computed tomography, surgery, chemotherapy and post-treatment computed tomography., Results: At univariate analysis, stage (p<0.0001), histotype (p=0.01), residual disease (p<0.0001) and treatment response (p<0.0001) correlated with progression-free survival (PFS), whereas age (p=0.004), stage (p=0.006), residual disease (p<0.0001) and treatment response (p<0.0001) were associated with overall survival (OS). Neither baseline nor post-treatment SMI and SMRA had prognostic relevance. At multivariate analysis, residual disease and treatment response correlated with PFS (p<0.0001 and p<0.0001) and OS (p=0.007 and p<0.0001), whilst age was an independent prognostic variable for OS (p=0.02)., Conclusion: Baseline and post-treatment SMI and SMRA did not correlate with patient outcome in this clinical setting., (Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Behavioral Inhibition (BI) is a temperamental trait characterized by fear and wariness in reaction to new and unfamiliar stimuli, both social and non-social. BI has been recognized as possible forerunner of anxiety disorders, especially social anxiety and phobia; therefore, its assessment is clinically relevant. The present study aimed to examine the psychometric properties of the Italian adaptation of the Behavioral Inhibition Questionnaire (BIQ), which measures BI in preschool children. The BIQ was completed by 417 Italian parents (230 mothers, 187 fathers) of 270 preschoolers aged 3-5. Confirmatory factor analysis showed a good internal validity: the factorial structure was corresponding to the original six-factor version. Results showed excellent internal consistency, significant item-total correlations, good inter-rater reliability, convergent validity (by correlating the BIQ with the Italian Questionnaires of Temperament-QUIT, the Anxiety-Shy Conner's Scale and the Laboratory Temperament Assessment Battery) and discriminant validity (i.e., no correlation with Conners' ADHD scale). Significant correlations emerged between BI indexes and total BIQ scores of parents and maternal (but not paternal) versions of the questionnaire. Altogether, the results are promising and consistent with previous validation studies, suggesting the BIQ as a reliable and valid measure for evaluating parents' perception of BI in Italian preschoolers.

Purpose: To report the results of a nationwide online survey on artificial intelligence (AI) among radiologist members of the Italian Society of Medical and Interventional Radiology (SIRM)., Methods and Materials: All members were invited to the survey as an initiative by the Imaging Informatics Chapter of SIRM. The survey consisted of 13 questions about the participants' demographic information, perceived advantages and issues related to AI implementation in radiological practice, and their overall opinion about AI., Results: In total, 1032 radiologists (equaling 9.5% of active SIRM members for the year 2019) joined the survey. Perceived AI advantages included a lower diagnostic error rate (750/1027, 73.0%) and optimization of radiologists' work (697/1027, 67.9%). The risk of a poorer professional reputation of radiologists compared with non-radiologists (617/1024, 60.3%), and increased costs and workload due to AI system maintenance and data analysis (399/1024, 39.0%) were seen as potential issues. Most radiologists stated that specific policies should regulate the use of AI (933/1032, 90.4%) and were not afraid of losing their job due to it (917/1032, 88.9%). Overall, 77.0% of respondents (794/1032) were favorable to the adoption of AI, whereas 18.0% (186/1032) were uncertain and 5.0% (52/1032) were unfavorable., Conclusions: Radiologists had a mostly positive attitude toward the implementation of AI in their working practice. They were not concerned that AI will replace them, but rather that it might diminish their professional reputation.

Objectives: During the course of the Novel Coronavirus (SARS-CoV-2) pandemic, Italy has reported one of the highest number of infections. Nearly ten percent of reported coronavirus infections in Italy occurred in healthcare workers. This study aimed to understand physicians' access to personal protective equipment (PPE) and to information about their use, risk perception and strategies adopted to prevent contracting the infection., Methods: We undertook a cross-sectional, online self-reported survey implemented between March 31 and April 5 2020 of Italian physicians., Results: Responses were received from 516 physicians, only 13% of which reported to have access to PPE every time they need them. Approximately half of the physicians reported that the information received about the use of PPE was either clear (47%) or complete (54%). Risk perception about contracting the infection was influenced by receiving adequate information on the use of PPE. Access to adequate information on the use of PPE was associated with better ability to perform donning and doffing procedures [OR = 2.2 95% C.I. 1.7-2.8] and reduced perception of risk [OR = 0.5, 95% C.I. 0.4-0.6]., Conclusions: Results from this rapid survey indicate that while ramping up supplies on PPE for healthcare workers is certainly of mandatory importance, adequate training and clear instructions are just as important., Competing Interests: The authors have declared that no competing interests exist.

The COVID-19 pandemic started in Italy in February 2020 with an exponential growth that has exceeded the number of cases reported in China. Italian radiology departments found themselves at the forefront in the management of suspected and positive COVID cases, both in diagnosis, in estimating the severity of the disease and in follow-up. In this context SIRM recommends chest X-ray as first-line imaging tool, CT as additional tool that shows typical features of COVID pneumonia, and ultrasound of the lungs as monitoring tool. SIRM recommends, as high priority, to ensure appropriate sanitation procedures on the scan equipment after detecting any suspected or positive COVID-19 patients. In this emergency situation, several expectations have been raised by the scientific community about the role that artificial intelligence can have in improving the diagnosis and treatment of coronavirus infection, and SIRM wishes to deliver clear statements to the radiological community, on the usefulness of artificial intelligence as a radiological decision support system in COVID-19 positive patients. (1) SIRM supports the research on the use of artificial intelligence as a predictive and prognostic decision support system, especially in hospitalized patients and those admitted to intensive care, and welcomes single center of multicenter studies for a clinical validation of the test. (2) SIRM does not support the use of CT with artificial intelligence for screening or as first-line test to diagnose COVID-19. (3) Chest CT with artificial intelligence cannot replace molecular diagnosis tests with nose-pharyngeal swab (rRT-PCR) in suspected for COVID-19 patients.

Background: Pediatric head trauma management varies between emergency departments globally. Here we aim to compare the pediatric minor head trauma management between a US and Italian hospital., Methods: We conducted a retrospective chart review of children 0-18 years old presenting after minor head trauma (Glasgow Coma Scale 14-15) from two emergency departments, in Boston, Massachusetts, United States and Trieste, Italy, between January and December 2013. Frequencies of demographic, clinical, and management characteristic were calculated. We compared rate ratios for characteristics of patients receiving cranial computed tomography (CT) scans between the two populations., Results: There were 1783 patients in Boston, Massachusetts and 183 patients in Trieste, Italy. Patients in Boston had more reported neurologic symptoms (61.2%) than in Trieste (6%) (p < 0.001). More CT scans were ordered on the patients in Boston (17.3% vs. 6.6%) (p < 0.001), while more children were hospitalized in Trieste (55.7% vs. 8.6%) (p < 0.001). Patients with neurological symptoms more commonly had a CT scan in Trieste (45.5%) than in Boston (23.5%) (RR 0.52, 95% CI 0.27, 1.00), while more patients without neurological symptoms had CTs in Boston (7.5%) than in Trieste (4.1%) (RR 1.85, 95% CI 0.86, 4.00). Assignment of triage levels and definitions of head injury severity varied considerably between the two hospitals, resulting in dissimilar populations presenting to the two hospitals, and thus, differences in the management of these children., Conclusion: The population of head trauma patients and the management of pediatric minor head trauma differs between Boston and Trieste, with a preference for CT scans in Boston and a preference for hospitalization in Trieste. Clinical guidelines used at each institution likely lead to this variation in care influenced by the different patient populations and institutional resources.

The aim of this study was to analyze the usage and the data recorded by a RIS-PACS-connected contrast medium (CM) monitoring system (Certegra(®), Bayer Healthcare, Leverkusen, Germany) over 19 months of CT activity. The system used was connected to two dual syringe power injectors (each associated with a 16-row and a high definition 64-row multidetector CT scanner, respectively), allowing to manage contrast medium injection parameters and to send and retrieve CT study-related information via RIS/PACS for any scheduled contrast-enhanced CT examination. The system can handle up to 64 variables and can be accessed via touchscreen by CT operators as well as via a web interface by registered users with three different hierarchy levels. Data related to CM injection parameters (i.e. iodine concentration, volume and flow rate of CM, iodine delivery rate and iodine dose, CM injection pressure, and volume and flow rate of saline), patient weight and height, and type of CT study over a testing period spanning from 1 June 2013 to 10 January 2015 were retrieved from the system. Technical alerts occurred for each injection event (such as system disarm due to technical failure, disarm due to operator's stop, incomplete filling of patient data fields, or excessively high injection pressure), as well as interoperability issues related to data sending and receiving to/from the RIS/PACS were also recorded. During the testing period, the CM monitoring system generated a total of 8609 reports, of which 7629 relative to successful injection events (88.6%). 331 alerts were generated, of which 40 resulted in injection interruption and 291 in CM flow rate limitation due to excessively high injection pressure (>325 psi). Average CM volume and flow rate were 93.73 ± 17.58 mL and 3.53 ± 0.89 mL/s, and contrast injection pressure ranged between 5 and 167 psi. A statistically significant correlation was found between iodine concentration and peak IDR (rs=0.2744, p<0.0001), as well as between iodine concentration and iodine dose (rs=0.3862, p<0.0001) for all CT studies. Automated contrast management systems can provide a full report of contrast use with the possibility to systematically compare different contrast injection protocols, minimize errors, and optimize organ-specific contrast enhancement for any given patient and clinical application. This can be useful to improve and harmonize the quality and consistency of contrast CT procedures within the same radiological department and across the hospital, as well as to monitor potential adverse events and overall costs., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This study aimed to identify different kinds of stressful life events and social support associated with antenatal depressive symptoms in a sample of pregnant Italian women. We conducted the study at a primary health-care centre in an urban area (northeast Italy). Mainly recruited at antenatal classes, 404 eligible pregnant women completed a socio-demographic questionnaire that included questions about the present pregnancy, the Edinburgh Depression Scale (EDS) to estimate the prevalence of depressive symptoms, the Multidimensional Scale of Perceived Social Support and List of Threatening Experiences Questionnaire to investigate the quality and nature of social support and recent negative life events. Of the 404 women, 60 (14.9 %) scored 13 or higher on the EDS. This group reported significantly lower social support from various sources-family, friends, and significant others; only in primiparous women were depressive symptoms significantly related to lower support from friends. Women with EDS scores equal or higher than 13 also reported a higher occurrence of recent stressful life events-specifically, death or a serious problem with a close friend or relative, unemployment, financial problems, and moving or housing difficulties. Regression analyses showed that women with high levels of social support or with a positive experience of pregnancy were less likely to experience antenatal depressive symptoms. Our results underscore the associations among antenatal depression, specific life stressors, and low social support from various sources. Clinical attention to these psychosocial correlates is recommended toward detecting vulnerability to antenatal depressive symptoms.

Objective: Hand fractures are common in childhood, and radiography is the standard diagnostic procedure. US has been used to evaluate bone injuries, mainly in adults for long-bone trauma; there are only a few studies about hand fractures in children. The purpose of this study was to evaluate and confirm the safety and applicability of the US diagnostic procedure in comparison to X-ray diagnosis., Study Design: This cross-sectional study involved a convenience sample of young patients (between 2 and 17 years old) who were taken to the emergency department due to hand trauma. After clinical assessment, patients with a suspected hand fracture first underwent X-ray, and subsequently US examination by two different operators; a radiologist experienced in US and a trained emergency physician in "double-blind" fashion. US and radiographic findings were then compared, and sensitivity as well as specificity was calculated., Results: A total of 204 patients were enrolled in the study. Seventy-nine fractures of phalanges or metacarpals were detected by standard radiography. When US imaging was performed by an expert radiologist, 72 fractures were detected with sensitivity and a specificity of 91.1% and 97.6%, respectively. Sensitivity and specificity were found to be (respectively) 91.5% and 96.8% when US was performed by the ED physicians., Conclusions: US imaging showed excellent sensitivity and specificity results in the diagnosis of hand fractures in children. The study also showed a great agreement between the results of the US carried out by the senior radiologist and those carried out by the paediatric emergency physician, suggesting that US can be performed by an ED physician, allowing a rapid and accurate evaluation in ED and could become the first diagnostic approach whenever a hand fracture is suspected., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

To contribute to the application of the Childhood Atopic Dermatitis Impact Scale (CADIS), 135 Italian parents of children with atopic dermatitis (AD) aged birth to 6 years completed: CADIS, Infants Dermatitis Quality of Life Index (IDQOL) or Children's Dermatology Life Quality Index (CDLQI), and Dermatitis Family Impact 10-item questionnaire (DFI). A subsample of 66 caregivers completed the CADIS again, 48 hours later. Disease severity was measured with the Severity Scoring of Atopic Dermatitis (SCORAD) index. Exploratory factor analyses almost replicated the general factor structure of the original CADIS, established on a US sample. However, some differences emerged, probably due to cultural differences. A reduced version of the original CADIS was also obtained, based on the exploratory factor analyses, to facilitate use in clinical settings. The original and the shorter versions were tested for reliability: overall Cronbach's α and test-retest reliability for the child- and parent-related scales were acceptable. Regarding concurrent validity, estimates showed the CADIS to correlate adequately with SCORAD, IDQOL-CDLQI, and DFI. Multiple comparison tests for discriminant validity revealed significant differences between extreme groups based on AD severity for all five domains of CADIS. The original CADIS showed adequate validity and reliability in Italy as well, and the shorter version showed promising psychometric properties.

Background: The impact of atopic dermatitis (AD) on children's quality of life (QoL) in US and European countries is relatively well known, though rarely evaluated in the Italian population. Moreover, the association between child age and QoL has not been enough investigated, even though few studies detected a worse QoL in youngest AD children. The aim of the study was to evaluate the QoL in an Italian sample of atopic children and their families, also exploring a possible association with child age., Methods: 60 AD children aged between 1-12 years and their mothers completed specific QoL questionnaires (IDQoL/CDLQI, DFI) and a clinician completed a measure of AD severity (SCORAD)., Results: AD severity (Objective SCORAD) significantly correlated with QoL measures. Severe AD children showed higher IDQoL/CDLQI and DFI scores compared to mild and moderate AD groups (P = 0.006 and P < 0.0005, respectively), but only DFI scores differed in these last two conditions (P = 0.014). DFI scores negatively correlated with children's age (P = 0.046), but did not differ when considering child age ranges. Multiple linear regression analyses revealed a significant association between Objective SCORAD and QoL measures., Conclusions: A strong association between severe AD and poor QoL, both in children and mothers, was found in the Italian sample, in line with the international literature. Family's QoL scores were sensitively related to AD severity, more than the child's QoL, emphasising that the disease has a deep impact on the family. A significant association between age and QoL was only partially found and needs further investigation.

Purpose: The aim of this paper is to describe the Web site of the Italian Project on CT Colonography (Research Project of High National Interest, PRIN No. 2005062137) and present the prototype of the online database., Materials and Methods: The Web site was created with Microsoft Office Publisher 2003 software, which allows the realisation of multiple Web pages linked through a main menu located on the home page. The Web site contains a database of computed tomography (CT) colonography studies in the Digital Imaging and Communications in Medicine (DICOM) standard, all acquired with multidetector-row CT according to the parameters defined by the European Society of Abdominal and Gastrointestinal Radiology (ESGAR). The cases present different bowel-cleansing and tagging methods, and each case has been anonymised and classified according to the Colonography Reporting and Data System (C-RADS)., Results: The Web site is available at http address www.ctcolonography.org and is composed of eight pages. Download times for a 294-Mbyte file were 33 min from a residential ADSL (6 Mbit/s) network, 200 s from a local university network (100 Mbit/s) and 2 h and 50 min from a remote academic site in the USA. The Web site received 256 accesses in the 22 days since it went online., Conclusions: The Web site is an immediate and up-to-date tool for publicising the activity of the research project and a valuable learning resource for CT colonography.

Background: For coronary surgery we often use the radial artery (RA) instead of the saphenous vein, trying to exploit the advantages offered by this conduit. To eliminate the problems regarding alteration of upper-extremity function after RA procurement related to the standard conventional harvesting technique, we started using the less invasive harvesting technique with surprisingly good preliminary results. To compare the outcomes of open versus less invasive harvesting procedures, a prospective, nonrandomized study was developed by 2 centers., Methods: From January 2001 to March 2003, there were 87 consecutive patients in the less invasive radial artery harvesting (LIRAH) group and 90 patients in the conventional radial artery harvesting (CRAH) group. Patient characteristics and demographics were similar in the groups. Data collection was made to evaluate possible benefits of the LIRAH technique in terms of fewer forearm and hand complications, better aesthetics, and improved patient satisfaction., Results: Between January 11, 2001, and March 30, 2003, 177 patients underwent either primary or redo coronary artery revascularizations with procurement of the RA for use as a conduit with the less invasive harvesting technique. The mean follow-up was 2 months. Four patients died, and overall mortality was 2.26%. One hundred seventy-three patients were successfully examined during the first postoperative control, 85 in the LIRAH group and 88 patients in the CRAH group. Objective and subjective data were collected from the consultant. The overall average age was 60.5 years (range, 40-77 years). In the LIRAH group, the mean overall incision length (when 2 incisions were necessary, both incision lengths were measured) was 5.6 cm (range, 4-10 cm), and the mean vessel length was 16 cm (range, 10-19 cm). Eighteen patients (20.6%) necessitated double incision. Mean harvesting time (from incision to skin closure) was 43.3 min (range, 25-70 min). Fourteen patients (16.4%) presented some kind of complication during the study. There were no cases with acute ischemia, bleeding, or re-exploration. Seventy-five patients (88.2%) found the cosmetic result excellent. Ten patients (11.8%) found it good, and none considered it mediocre. In the CRAH group, the mean incision length was 20 cm (range, 18-22 cm), and the mean vessel length was 18 cm (range, 17-20 cm ). Mean harvesting time (from incision to skin closure) was 30.8 min (range, 14-45 min). Thirty-four patients (38.6%) presented some kind of complication during the study. Three patients (3.5%) found the cosmetic result excellent. Forty-three (48.8%) found it good, and 42 (47.7%) considered it mediocre., Conclusions: A potential of fewer neurological forearm postoperative complications, better aesthetics, and improved patient satisfaction can be achieved by the LIRAH technique.

Aims: To determine coeliac disease prevalence by an anti-transglutaminase antibody assay in a large paediatric population; to evaluate acceptance of the screening programme, dietary compliance, and long term health effects., Methods: Cross-sectional survey of 3188 schoolchildren (aged 6-12) and prospective follow up of diagnosed cases. Main outcome measures were: prevalence of coeliac disease defined by intestinal biopsy or positivity to both human tissue transglutaminase and anti-endomysium antibodies in HLA DQ2-8 positive subjects; percentage of children whose families accepted screening; dietary compliance as defined by negativity for anti-transglutaminase antibodies; and presence of clinical or laboratory abnormalities at 24 month follow up., Results: The families of 3188/3665 children gave their consent (87%). Thirty biopsy proven coeliacs were identified (prevalence 1:106). Three other children testing positive for both coeliac related autoantibodies and HLA DQ2-8 but refusing biopsy were considered as having coeliac disease (prevalence 1:96). Of 33 cases, 12 had coeliac related symptoms. The 30 biopsy proven coeliacs followed a gluten-free diet. Of 28 subjects completing 18-24 months follow up, 20 (71.4%) were negative for anti-transglutaminase antibodies, while eight were slightly positive; symptoms resolved in all 12 symptomatic children., Conclusions: Prevalence of coeliac disease is high in Italian schoolchildren. Two thirds of cases were asymptomatic. Acceptance of the programme was good, as was dietary compliance. Given the high prevalence and possible complications of untreated coeliac disease, the availability of a valid screening method, and evidence of willingness to comply with dietary treatment population mass screening deserves careful consideration.

Patients with celiac disease are at high risk of having autoimmune disorders. Moreover, untreated patients with celiac disease have been found to have a higher than expected prevalence of organ-specific autoantibodies. In a prospective study of 90 patients with celiac disease, we found that the prevalence of diabetes and thyroid-related serum antibodies was 11.1% and 14.4%, respectively. Like antiendomysium autoantibodies, these organ-specific antibodies seem to be gluten-dependent and tend to disappear during a gluten-free diet.

Background and Aims: In the past, the reported prevalence of coeliac disease ranged from 1:1000 to 1:4000, whereas recent studies using serological screening methods have found a significantly higher prevalence. The aim of this study was to investigate the prevalence of coeliac disease in healthy blood donors in a North-eastern region of Italy., Subjects: A total of 4000 healthy blood donors were studied from two immunotransfusion centres., Methods: Serum IgA-antiendomysium antibodies were detected by indirect immunofluorescence using human umbilical cord vein sections, and positive sera were tested also on monkey oesophagus tissue. Intestinal biopsy was performed in all antiendomysium-positive subjects., Results: Ten out of 4000 sera screened were found to be antiendomysium positive on human umbilical cord vein. All positive patients had flat mucosa on intestinal biopsy. Five subjects had coeliac disease-related clinical features (2 had a history of gastrointestinal symptoms, 1 a family history of IDDM, 1 sideropenic anaemia, and 1 IgA deficiency). One of the ten serum, antiendomysium positive on human umbilical cord vein, was found to be negative when tested on monkey oesophagus., Conclusions: These data confirm the high prevalence of undiagnosed silent coeliac disease in the healthy adult population. This is the first study where umbilical cord was used for screening coeliac disease in a large population. The human umbilical cord vein indirect immunofluorescence test is more specific for villous atrophy than conventional indirect immunofluorescence test on monkey oesophagus and is a reliable screening test for coeliac disease in an apparently healthy population.

Internet is an international computer network that uses standard communication protocols for the exchange of information. This facilitates the retrieval of multimedia data through a "web" of servers distributed in the whole world. Among Internet users, Radiologists are a potentially important segment, due to the inherent multimedia characteristics of the discipline, which requires a continuous international update of information. The Department of Radiology of the University of Pisa has an Internet access through the metropolitan area network which was installed in the framework of the CNR Telecomunicazioni Project. The Internet access allowed the implementation of a World Wide Web server made public on Internet in March, 1994, being the first European server specifically oriented to radiology. This server can be accessed at the following address: http:@www.rad.unipi.it:7080/IRMosaicHome.html . On the server, 3 hypermedia papers are present, a list of international servers containing radiological information, a questionnaire, and statistics concerning the number of users who accessed the server. In the first 18 months of public access through Internet (April 1, 1994-September 30, 1995) 16,166 users accessed the server, retrieving 127,349 documents, corresponding to 1,279.7 MByte of information. The mean amount of information retrieved in each access to the server in the considered quarters ranges from 72 to 85.8 kByte. The geographic distribution of the users who accessed the server is the following: United States, 7,158, Italy, 2,466; other European countries, 3,813; other extra-European countries, 2,729. The increasingly diffuse knowledge of Internet services had a substantial impact on the rise in number of the servers and of the users who can access them. It is likely that in the future this technology will be used with increasing interest by Radiologists, since it provides easier "navigation" through multimedia information, consisting of text and several images, without the inherent limitations of the printed paper.

The authors retrospectively analyzed the therapy results in a large group of children affected by rhabdomyosarcoma and treated from 1978 to 1988 with chemotherapy, radiotherapy and surgery. 39/58 patients (67%) achieved a complete response and 25/39 maintained the NED status. An individualized treatment was given to 13 patients who relapsed, but only 3 of them obtained a second response. Those with primary tumor in the orbit or in the genito-urinary tract had lower recurrence rate than patients with head and neck, extremities, pelvis and trunk diseases. Patients in clinical group I and II (according with I.R.S. stadiation) had a significantly better survival than those with more advanced disease (clinical groups III and IV). Relatively to the primary site of the disease, the late effects of combined treatment are mentioned.

Out of 1172 females recruited in a screening program for genital infections, 144 (12.28%) were cervical and/or urethral positive for Chlamydia trachomatis (Ct) by enzyme immunoassay (EIA). Patients positive for Ct showed no significant differences in terms of demography, sexual practices and clinical evidence as compared to a control group formed by Ct-negative females randomly selected. Historical data showed a higher frequency of previous pelvic inflammatory disease (PID) in patients as compared to controls. 11 of the 94 patients' partners tested were sperm positive for Ct. Of the 63 patients for whom therapeutic data were available, 38 were treated with josamycin, 16 with tetracycline and the others with different drugs. After treatment, EIA for Ct was negative for 92.1% of the patients treated with josamycin and for 68.7% of those treated with tetracycline. The results of this study confirm a high prevalence of asymptomatic Ct infection which may be correctly diagnosed by EIA performed on cervical and urethral samples. They also indicate that negative test results can be obtained by an appropriate antibiotic treatment.