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Objective To update quality standards for CT colonography based on consensus among opinion leaders within the European Society of Gastrointestinal and Abdominal Radiology (ESGAR). Material and methods A multinational European panel of nine members of the ESGAR CT colonography Working Group (representing six EU countries) used a modified Delphi process to rate their level of agreement on a variety of statements pertaining to the acquisition, interpretation and implementation of CT colonography. Four Delphi rounds were conducted, each at 2 months interval. Results The panel elaborated 86 statements. In the final round the panelists achieved complete consensus in 71 of 86 statements (82 %). Categories including the highest proportion of statements with excellent Cronbach's internal reliability were colon distension, scan parameters, use of intravenous contrast agents, general guidelines on patient preparation, role of CAD and lesion measurement. Lower internal reliability was achieved for the use of a rectal tube, spasmolytics, decubitus positioning and number of CT data acquisitions, faecal tagging, 2D vs. 3D reading, and reporting. Conclusion The recommendations of the consensus should be useful for both the radiologist who is starting a CTC service and for those who have already implemented the technique but whose practice may need updating. Key Points • Computed tomographic colonography is the optimal radiological method of assessing the colon • This article reviews ESGAR quality standards for CT colonography • This article is aimed to provide CT-colonography guidelines for practising radiologists • The recommendations should help radiologists who are starting/updating their CTC services

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To assess the effect of computer-aided detection (CAD) as a second reader on the sensitivity and specificity of computed tomographic (CT) colonography in detecting 6-9-mm colorectal cancer (CRC) lesions.Individuals with clinical indications for colonoscopy--either for symptoms or as part of participating in a surveillance program or CRC screening--were prospectively enrolled at one of 10 academic centers between July 2007 and May 2009. Institutional review board approval was obtained at each clinical site, and all participants provided written informed consent. All participants underwent CT colonography and colonoscopy on the same day. Experienced readers interpreted the CT colonography images unassisted and then reviewed all colorectal lesion-like structures pinpointed by the CAD algorithm. Segmental unblinding of CT colonoscopy findings at colonoscopy was utilized. The sensitivity and specificity of unassisted and CAD-assisted reading in identifying individuals with 6-9-mm lesions were calculated and compared by means of pairwise analysis.A total of 618 participants (mean age, 57.9 years; 54.5% male) were included in the final analysis. Of these participants, 464 (75.1%) had no lesions 6 mm or larger, and 52 (8.4%) had 6-9-mm lesions. The sensitivity of CT colonography with unassisted reading and that with CAD-assisted reading in identifying individuals with 6-9-mm lesions was 65.4% (95% confidence interval [CI]: 50.9%, 78.0%) and 76.9% (95% CI: 63.2%, 87.5%; P = .016), respectively. No significant change in specificity was observed: The specificity of CT colonography with unassisted and that with CAD-assisted reading was 91.8% (95% CI: 88.9%, 94.1%) and 90.9% (95% CI: 88.0%, 93.4%; P = .063), respectively. Evaluation of CAD candidates required an additional 1.6 minutes (25th-75th percentile: 1.0 minute to 3.4 minutes).The addition of CAD to reading performed by experienced readers resulted in a significant benefit in the detection of 6-9-mm polyps at CT colonography in this cohort.http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120376/-/DC1.

The European project p-medicine creates an information technology infrastructure that facilitates the development from current medical practice to personalised medicine. The main access point to this infrastructure is the p-medicine portal that provides clinicians, patients, and researchers a platform to collaborate, share data and expertise, and use tools and services to improve personalised treatments of patients. In this document, we describe the community-based structure of the p-medicine portal and provide information about the p-medicine security framework implemented in the portal. Finally, we show the user interface and describe the p-medicine tools and services integrated in the portal.

Particularly in tertiary care centres, there is an increased need for diagnostic procedures, such as CT scans, magnetic resonance, endoscopies, lumbar punctures, biopsies, etc., which require different degrees of anesthesia and/or sedation of the child to ensure safety and performance and to avoid unnecessary pain and discomfort. The limited availability of anestesiologists often represents a problem, leading to unnecessary waiting time. For this reason paediatricians and nurses with specific training in intensive care are increasingly involved in providing sedation for diagnostic procedures. Safety concerns have been voiced and discussed about the use of a variety of drugs and procedures. The Authors report their one-year experience in a tertiary care paediatric hospital regarding in-ward sedation for non invasive (such as diagnostic imaging) or moderately invasive (such as endoscopies and biopsies) procedures. Propofol was used for moderately invasive procedures. A small task force (2 paediatrician and 2 nurses) was established to ensure continuity and good performance. The experience has been satisfactory in terms of efficacy, safety and cost and has been positively evaluated by both patients and health professionals.

BACKGROUND: The availability of a common computerized program for echocardiographic study archiving and reporting at national and/or international level could make it possible to standardize the echo reports of different echocardiographic laboratories, and to use the wealth of data thus obtainable with echocardiography, and to exploit its capillary territorial distribution, with the aim of collecting echocardiographic data in a standard format for epidemiological, scientific and administrative purposes. METHODS: To develop such a software, an ad hoc joint National Association of Hospital Cardiologists and Italian Society of Echocardiography task force worked in conjunction with the Italian Branch of Agilent Technologies to standardize the phraseology of accepted echocardiographic terms and of the quantitative parameters derived from transthoracic and transesophageal echocardiographic examination at rest as well as during exercise and pharmacological stress, and to develop an ad hoc software. This echocardiographic study archiving and reporting program is part of the whole G8-Cardio ANMCO software developed to computerize the whole cardiological chart. The software has been developed by Agilent Technologies to provide a fast, easy-access and easy to use report generator for the non-computer specialist using DBMS Oracle 7.3 database and Power Builder 5.0 to develop a user-friendly interface. RESULTS: The number of qualitative and quantitative variables contained in the program is 733 for echocardiography at rest, while it depends on the stressor and on the length of the examination for the stress echo (dipyridamole 214-384, dobutamine 236-406, exercise 198-392). The program was tested and refined in our laboratory between November 1999 and May 2000. During this time period, 291 resting and 56 stress echocardiographic studies were reported and recorded in a database. On average, each resting echocardiographic study lasting 10 +/- 4 (range 5-17) min was recorded using 50 +/- 11 (range 33-67) variables and 41,566 bytes of hard-disk memory space. Stress echocardiographic studies, each lasting 7 +/- 5 (range 5-21) min, were recorded using 143 +/- 74 (range 38-194) variables and 38,531 bytes of hard-disk memory space. CONCLUSIONS: To our knowledge this software represents the first experience of a common computerized program for echo archiving and reporting carried out at national level.

Chicken pox is still a common disease, usually with a favourable course. Complications are rare (2-3/100.000) in immunocompetent patients. The Authors review the published experience regarding treatment with acyclovir and conclude that the advantage is marginall (25% reduction of the duration of symptoms), while there is no reduction in the rate of complications. Acyclovir should be used in immunocompromised patients including primary immune deficiencies, patients treated with steroids or long-term salycilates, patients affected by chronic lung diseases, eczema, diabetes and heart diseases.

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, I a family history of IDDM, 1 sideropenic anaemia, and I IgA deficiency). One of the ten serum, antiendomysium positive on human umbilical cord vein, was found to de 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.

The effects of mGlu1 and mGlu5 receptor activation on the depolarization-evoked release of [3H]d-aspartate ([3H]D-ASP) from mouse cortical synaptosomes were investigated. The mGlu1/5 receptor agonist 3,5-DHPG (0.1-100microM) potentiated the K+(12mM)-evoked [3H]D-ASP overflow. The potentiation occurred in a concentration-dependent manner showing a biphasic pattern. The agonist potentiated [3H]D-ASP exocytosis when applied at 0.3microM; the efficacy of 3,5-DHPG then rapidly declined and reappeared at 30-100microM. The fall of efficacy of agonist at intermediate concentration may be consistent with 3,5-DHPG-induced receptor desensitization. Facilitation of [3H]D-ASP exocytosis caused by 0.3microM 3,5-DHPG was prevented by the selective mGlu5 receptor antagonist MPEP, but was insensitive to the selective mGlu1 receptor antagonist CPCCOEt. In contrast, CPCCOEt prevented the potentiation by 50microM 3,5-DHPG, while MPEP had minimal effect. Unexpectedly, LY 367385 antagonized both the 3,5-DHPG-induced effects. A total of 0.3microM 3,5-DHPG failed to facilitate the K+-evoked [3H]D-ASP overflow from mGlu5 receptor knockout (mGlu5-/-) cortical synaptosomes, but not from nerve terminals prepared from the cortex of animals lacking the mGlu1 receptors, the crv4/crv4 mice. On the contrary, 50microM 3,5-DHPG failed to affect the [3H]D-ASP exocytosis from cortical synaptosomes obtained from crv4/crv4 and mGlu5-/-mice. Western blot analyses in subsynaptic fractions support the existence of both mGlu1 and mGlu5 autoreceptors located presynaptically, while immunocytochemistry revealed their presence at glutamatergic terminals. We propose that mGlu1 and mGlu5 autoreceptors exist on mouse glutamatergic cortical terminals; mGlu5 receptors may represent the "high affinity" binding sites for 3,5-DHPG, while mGlu1 autoreceptors represent the "low affinity" binding sites.