Carolina Dellafiore

Effectiveness of a Single Education and Counseling Intervention in Reducing Anxiety in Women Undergoing Hysterosalpingography: A Randomized Controlled Trial

Hysterosalpingography (HSG) is generally considered a stressful and painful procedure; we aimed to evaluate whether a single education and counseling intervention could reduce womens distress and pain after undergoing HSG for infertility. Patients were randomized into control group (n = 108) and intervention group (n = 109). All patients filled the following questionnaires before and after HSG: Zung self-rating anxiety scale (Z-SAS), Zung self-rating depression scale (Z-SDS), and an ad hoc questionnaire designed to evaluate HSG procedure knowledge. Pain was scored using a visual analog scale. The intervention consisted in a 45-minute individualised session 48 h before HSG. We observed a reduction of anxiety and depression scores in the intervention arm compared to the control group. After controlling for potential confounding variables, intervention was an independent predictor of the difference of Z-SAS score before and after HSG. This is the first randomised controlled trial to assess the potential effectiveness of a single education and counseling intervention to lower anxiety in a diagnostic setting.

The clinical value of controlled attenuation parameter for the noninvasive assessment of liver steatosis.

Ultrasound is the imaging modality most widely utilized in the general population for diagnostic purposes. Controlled attenuation parameter is a novel noninvasive method for assessing steatosis. Our aim was to investigate whether the clinical value of controlled attenuation parameter in patients referred for abdominal ultrasound examinations is affected by liver fibrosis.

Thyroglossal duct cysts: Two cases

Thyroglossal duct cyst is the most common congenital neck mass in children and young adults. The authors present two cases affecting two patients aged 7 and 9 years, respectively, who had a palpable painless swelling in the submental region. In both patients ultrasound (US) examination showed an anechoic or hypoechoic rounded mass with well-defined margins thus confirming clinical suspicion of thyroglossal duct cyst. One patient also had a second, deep-lying, nonpalpaple cyst which communicated with the superficial cyst. These cases are typical and confirm that US is essential in suspected thyroglossal duct cyst to confirm clinical diagnosis, detect lesions which are not clinically appreciable due to their small size or deep location, to assess communication between the lesions and to detect possible complications. Thyroglossal duct cyst is the most common congenital neck mass in children and young adults. The authors present two cases affecting two patients aged 7 and 9 years, respectively, who had a palpable painless swelling in the submental region. In both patients ultrasound (US) examination showed an anechoic or hypoechoic rounded mass with well-defined margins thus confirming clinical suspicion of thyroglossal duct cyst. One patient also had a second, deep-lying, nonpalpaple cyst which communicated with the superficial cyst. These cases are typical and confirm that US is essential in suspected thyroglossal duct cyst to confirm clinical diagnosis, detect lesions which are not clinically appreciable due to their small size or deep location, to assess communication between the lesions and to detect possible complications.

Sjögren syndrome: A case report

Sjögren syndrome is a systemic autoimmune disorder that affects the exocrine glands. The authors present the case of a 50-year-old woman diagnosed with this syndrome on the basis of clinical and serological findings. Sonography of the major salivary glands revealed normal-sized glands with echo structures that were diffusely inhomogeneous due to the presence of multiple hypoechoic areas. Parenchymal vascularization was significantly increased on color Doppler imaging. These findings confirmed the diagnosis and revealed active disease manifested by glandular hypervascularization. This represents a typical case of Sjögren syndrome and illustrates the diagnostic value in these cases of salivary gland sonography, which is effective, noninvasive, and repeatable and provides accurate information on the vascularization status of the glands.

A Review of the Appropriateness of the Current Italian Guidelines for Noninvasive Imaging Assessment of Focal Liver Lesions

In 2007 the Italian National Institute of Health issued Guidelines for the use of diagnostic imaging techniques in the detection and the characterization of focal liver lesions. Since the publication of these guidelines in 2008, several studies relating to this topic have been published. Thus, we felt the need to assess whether interval research and new advancements in diagnostic imaging have yielded new evidence that should modify the recommendations that were previously issued. The literature search confirmed the appropriateness of the current guidelines. Although most modalities did not show substantial changes, interval introduction of DW-MRI is a valuable technique with a high diagnostic accuracy in the detection and characterization of FLLs, and its sensitivity is higher when combined with MRI.

Differential Diagnosis for Female Pelvic Masses

The female pelvis is an anatomic region which is quite complex, because it contains some organs and systems accomplishing different and independent functions. The uro-genital system represents the main part of the female pelvis but there are also portions of other or‐ gans and systems such as some important blood vessels, gastrointestinal tracts, lymphatics, nerves and parts of the musculoskeletal system. All these structures might house or generate pelvic masses even in para-physiologic conditions, and not necessarily because of current diseases, or congenital alterations, inflammatory illness and tumours.

Il color Doppler imaging nel glaucoma: confronto dello spettro Doppler dei vasi retrobulbari di un paziente glaucomatoso con uno sano

Si ritiene che le alterazioni della perfusione ematica dell’occhio abbiano un ruolo importante nel glaucoma primario ad angolo aperto. Per questo motivo l’esame CDI dei vasi retrobulbari viene usato a fini di ricerca per comprendere l’entita di queste alterazioni e il loro ruolo nella patogenesi della malattia. I parametri comunemente studiati sono il PSV, l’EDV e l’IR nell’arteria oftalmica, nell’arteria centrale della retina e nelle arterie ciliari posteriori brevi. Alla luce di un recente lavoro che ha trovato differenze statisticamente significative per i parametri ESA e Sm/Dm nell’arteria oftalmica, presentiamo i risultati dello studio CDI di un caso di glaucoma a pressione normale e lo confrontiamo con un controllo sano. Le misure ottenute concordano con la letteratura in quanto, fatta eccezione per il PSV dell’arteria oftalmica, notiamo velocita inferiori per tutti i parametri e in tutti i vasi, associati a un aumento dell’indice di resistivita. Inoltre, sempre concordemente alla letteratura, l’ESA risulta piu basso e l’Sm/Dm maggiore se confrontato con i valori misurati in un volontario sano. Ulteriori studi saranno necessari per comprendere l’entita delle alterazioni nel patologico e l’influenza che esse possono avere sulla progressione del danno al nervo ottico.

Riproducibilità della misura della velocità ematica nei vasi retrobulbari utilizzando il color Doppler imaging

L’evidenza che alcuni pazienti con glaucoma possono continuare a peggiorare nonostante una riduzione significativa della pressione intraoculare (PIO) suggerisce che altri fattori siano co-responsabili per l’incidenza e la progressione della neuropatia ottica glaucomatosa. Poiche si ritiene che fattori vascolari sistemici e locali siano molto importanti, abbiamo arruolato 16 volontari sani per testare la riproducibilita del color Doppler imaging (CDI) nella nella valutazione del flusso ematico dei vasi retrobulbari prima di realizzare uno studio su pazienti glaucomatosi. In questo studio quattro operatori mascherati hanno utilizzato due differenti macchine ecografiche. La concordanza intraoperatore nell’arteria oftalmica (AO) e risultata essere buona o molto buona per il peak systolic velocity (PSV), end-diastolic velocity (EDV) e indice di resistivita (IR) in entrambi le macchine. Le differenze nella concordanza fra macchine e/o operatori sono risultate maggiori per l’arteria centrale della retina e per le arterie ciliari posteriori. Abbiamo anche testato la riproducibilita interoperatore ma una scarsa concordanza e stata trovata fra le misure.