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The effects of surface geology on ground motion provide an important tool in seismic hazard studies. It is well known that the presence of soft sediments can cause amplification of the ground motion at the surface, particularly when there is a sharp impedance contrast at shallow depth. The town of Avellino is located in an area characterised by high seismicity in Italy, about 30 km from the epicentre of the 23 November 1980, Irpinia earthquake ( M = 6.9). No earthquake recordings are available in the area. The local geology is characterised by strong heterogeneity, with impedance contrasts at depth. We present the results from seismic noise measurements carried out in the urban area of Avellino to evaluate the effects of local geology on the seismic ground motion. We computed the horizontal-to-vertical (H/V) noise spectral ratios at 16 selected sites in this urban area for which drilling data are available within the first 40 m of depth. A Rayleigh wave inversion technique using the peak frequencies of the noise H/V spectral ratios is then presented for estimating Vs models, assuming that the thicknesses of the shallow soil layers are known. The results show a good correspondence between experimental and theoretical peak frequencies, which are interpreted in terms of sediment resonance. For one site, which is characterised by a broad peak in the horizontal-to-vertical spectral-ratio curve, simple one-dimensional modelling is not representative of the resonance effects. Consistent variations in peak amplitudes are seen among the sites. A site classification based on shear-wave velocity characteristics, in terms of Vs30, cannot explain these data. The differences observed are better correlated to the impedance contrast between the sediments and basement. A more detailed investigation of the physical parameters of the subsoil structure, together with earthquake data, are desirable for future research, to confirm these data in terms of site response. [ABSTRACT FROM AUTHOR]

Study design:Between-groups design with repeated measures.Objective:To quantify spastic hypertonia in spinal cord-injured (SCI) individuals.Setting:Rehabilitative Center, Italy.Subjects:29 individuals with a motor complete SCI (American Spinal Injury Association impairment scale grade A or B) and 22 controls.Methods:According to the modified Ashworth scale (MAS), patients were subgrouped as SCI-1 (MAS=1, 1+) and SCI-2 (MAS=2, 3). Passive flexo-extensions of the knee were applied using an isokinetic device (LIDO Active) at 30°, 60°, 90° and 120° s−1. We measured the peak torque, mean torque (MT) and work. Simultaneous electromyography (EMG) was recorded from leg muscles.Results:At the speed of 120° s−1 all SCI-2 patients presented EMG reflex activities in the hamstring muscle. All biomechanical parameter values increased significantly according to speed, but analysis of variance revealed a significant interaction between the angular velocity and group (F(d.f. 6, 138)=8.89, P<0.0001); post hoc analysis showed significantly greater torque parameter values in the SCI-2 group compared with the SCI-1 group and the control group at 90° and 120° s−1. Receiver operating characteristic curves showed that using peak torque values the probability of correctly classifying a patient into SCI-1 and SCI-2 was 95%, compared with 70% for MT and 68% for work.Conclusions:The isokinetic device is useful for distinguishing individuals with a high level of spastic hypertonus. Examination of EMG activity may help ascertain whether increased muscle tone is caused by reflex hyper excitability and to determine whether muscle spasm is present. Peak torque and simultaneous EMG assessment should be considered for the evaluation of individuals with SCI in the rehabilitative context, that is, in measuring therapeutic interventions. [ABSTRACT FROM AUTHOR]

Background and Aims: Dynamic contrast enhanced magnetic resonance improves prostate cancer detection. The aims of this paper are to verify whether wash-in-rate parameter (speed of contrast uptake in dynamic contrast enhanced magnetic resonance) can help to differentiate prostate cancer from non-neoplastic T2-weighted hypointense lesions within prostate gland and to assess a cut-off for prostate cancer diagnosis., Methods: Prospective, monocentric, multi-departmental study. Thirty consecutive patients underwent T2-weighted and dynamic contrast enhanced magnetic resonance, and re-biopsy. T2-weighted hypointense lesions, >5mm in size, were noted. Lesions were assessed as cancerous (showing mass effect, or no defined margin within transitional zone) and non cancerous (no mass effect) and were compared with histopathology by 2×2 tables. Wash-in-rate of each lesion was calculated and was correlated with histopathology. Student's t-test was adopted to assess significant differences. Receiver operating characteristic (ROC) analysis was employed to identify the best cut-off for wash-in-rate in detecting prostate cancer., Results: At re-biopsy, cancer was proven in 43% of patients. On T2-weighted MRI, 111 hypointense lesions ≥5 mm in size were found. Sensitivity, specificity and accuracy of T2-weighted MRI were 80% (±12.4 CI 95%), 74.6% (±10.1 CI 95%), and 76.5% (±7.9 CI 95%), respectively. Mean WR was 5.8±1.9/s for PCa zones and 2.96±1.44/s for non-PCa zones (p<0.00000001). At ROC analysis, the best area under curve (AUC) for wash-in-rate parameter was associated to 4.2/s threshold with 82.5% sensitivity (CI±7.07), 97.2% specificity (CI±4.99) and 91.2% accuracy (CI±5.27). Eighteen false positive lesions on T2-weighted MRI showed low wash-in-rate values suggesting non-cancer lesions, while in 5/8 false negative cases high wash-in-rate values correctly suggested prostate cancer. Nine lesions with surgically proven cancer were not included in the saturation biopsy scheme, in 2/9 cases the only site of cancer., Conclusions: Wash-in-rate parameter allows to differentiate prostate cancer from non-neoplastic lesions, helping cancer detection in areas not included in the biopsy scheme., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Radiologists receive little formal training regarding the structure of the radiology report and its importance as a medicolegal document; failure to communicate, in fact, represents one of the main problems facing the modern radiologists' activity. Duty to the patient does not end anymore with the written report; the paradox is that we are so advanced in imaging technology, but not in communicating imaging findings. Communication must be timely, appropriate, and fully documented. There is an increasing trend to communicate results directly to the patients; radiologists have the greatest problem when communicating unexpected findings. To improve patient care and reduce the risk of being sued, radiologists should follow shared report guidelines and be more familiar with their professional responsibilities., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: To investigate the differential impact of lower urinary tract symptoms (LUTS) on female sexual function (FSF)., Methods: In a cross-sectional study in Agostino Gemelli Hospital, Rome, Italy, 188 sexually active patients with LUTS, as assessed by self-reported questionnaires, underwent comprehensive urologic and urodynamic examination between January 2008 and December 2010. Patients with urinary incontinence, voiding-phase LUTS, overactive bladder (OAB), and bladder pain syndrome (BPS) were included. FSF was assessed by PISQ-12 questionnaire, and scores (0-100; higher scores indicate worse FSF) were compared between the patients and a group of age-matched women without LUTS. PISQ-12 scores of different clinical and urodynamic patient subgroups were also compared by multivariate analysis., Results: The global PISQ-12 mean score was significantly higher among patients with LUTS (32.7) than among controls (18.4; P<0.0001). Women with BPS reported the highest global PISQ-12 score (46.1), followed by those with urodynamic detrusor overactivity (45.0), clinical urgency (41.4), mixed (37.7) and stress urinary incontinence (28.1), dry OAB (22.2) and voiding-phase LUTS (19.6). Age, urinary incontinence, BPS, and detrusor overactivity were independent predictors of FSF., Conclusion: BPS was associated with the greatest impairment of FSF among women with LUTS. Clinical and urodynamic urgency-type urinary incontinence affected FSF more markedly than other types., (Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Objectives: To evaluate the costs of bladder bladder cancer treatment and follow-up., Materials and Methods: A purely economic analysis was carried out evaluating in our Institution a) the cost of an hospital stay of patients submitted to transurethral resection of superficial bladder cancer and to radical cystectomy for invasive bladder cancer, b) the cost of endovesical immuno-chemotherapy performed as day hospital regimen, c) the cost of the first year of follow-up according to European Association of Urology's Guidelines as outpatient regimen., Results: The total cost related to a superficial tumour of the bladder treated with an endoscopic resection amounts to Euro 2,242.20, while in case of invasive bladder cancer treated with a radical cystectomy it comes to Euro 6,860. For chemo-immunotherapy the costs in a day hospital regimen related to a 8-weekly session of mitomicin, 6-weekly session of epirubicin and BCG are Euro 1,420, Euro 1,037 and Euro 975, respectively. The first year of follow-up for a patient with low risk of superficial bladder cancer without recurrence costs Euro 265.15. In case of high risk superficial bladder cancer the cost reaches Euro 321.75. In case of a patient with invasive bladder cancer in the first year, when follow-up is more strict, expenses amount to Euro 548.90., Conclusions: Cancer bladder is a high-cost illness due, in particular, to its heterogeneity in presentation and high rate of recurrences which makes any evaluation underestimated. The possibility of containing costs is essentially related to optimization of the follow-up and to the development of optimal therapeutic procedures which could lead to a reduction in the number of recurrences.

Objective: To evaluate the clinical impact of different definitions of hereditary prostate cancer (PCa), the relative risk (RR) of relatives of PCa cases and differences in clinical-pathological features and outcome as function of a family history in a surgical series exposed to Mediterranean diet., Methods: We classified as Sporadic (SPC), Familial (FPC) or Hereditary (HPC) 606 consecutive PCa cases, 65 years old or less at diagnosis, underwent radical retropubic prostatectomy between January 1, 1987 and December 31, 2002 (mean follow-up: 6.4 years). The disease-free, overall and PCa-specific survival were also compared between SPC and non-SPC (NSPC) cases., Results: Overall 12.5% of cases had a positive family history. We found 14 (2.3%) HPC cases versus 16 (2.6%) taking account of X-linked transmission. Relatives of early-onset PCa cases had a higher RR to PCa (4.3) compared to late-onset PCa cases. NSPC cases had a lower frequency of positive margins status (p=0.011), perineural infiltration (p=0.028) and positive lymph nodes (p=0.005) than SPC cases, but no differences were found in major prognostic factors (preoperative PSA, Gleason sum, pathological stage) and outcome endpoints as function of a family history., Conclusions: A positive family history is an important risk factor to PCa. HPC frequency is probably underestimated because of exclusion of X-linked transmission. We support the similarity between SPC and NSPC with respect to biological aggressiveness.