Conoscenza e consapevolezza sugli effetti biologici degli ultrasuoni nella pratica clinica in Italia: risultati di una inchiesta con questionario tra ecografisti della socetà italiana di ultrasonologia in medicina e biologia (S.I.U.M.B.)

Background New potential hazards in the use of ultrasound (US) are implied in new diagnostic applications of US, such as contrast enhanced US. Aim To assess the level of awareness and knowledge on safety issues of clinical use of US among physicians who are members of the Italian National Society for Ultrasound (SIUMB) Materials and methods A questionnaire including 11 multiple choice quiz was sent by e-mail to members of SIUMB, who preliminarly agreed to participate in this initiative. The answers were received anonimously and statistically analyzed. Results The number of returned valid questionnaires was 97 (8 were considered not valid for less than 10 answers filled). Mean age of the responders was 44 years old, and the average time the physician has been performing ultrasound examinations was 13 years. The principal workplace (70%) was a public Hospital. Physicians seemed to know the general definitions of principal safety-parameters, but few of them knew the definition of specific indexes. There was a general knowledge about the safe use of ultrasound in obstetrics, but there was a poor knowledge of biological effects of US: only about 37% answered correctly to questions about damage of vasculature of lung by high Mechanical Index US investigation and about the increase of temperature under the probe, according to the thermal indexes. Conclusion In conclusion the present findings indicate that greater efforts of National Ultrasound Societies are warranted in disseminating knowledge about the bio-effects of diagnostic ultrasound modalities among their members to prevent possible hazards.

Metodi biochimici e biomolecolari applicati alla medicina clinica: rendimento della real-time TaqMan PCR per la valutazione della resistenza alla claritromicina in H.pylori e tests fecali nella diagnorstica del carcinoma colo-rettale: M2PK, calprotectina e FOBT

1) Background: The most common methods to evaluate clarithromycin resistance is the E-Test, but is time consuming. Resistance of Hp to clarithromycin is due to point mutations in the 23S rRNA. Eight different point mutations have been related to CH resistance, but the large majority of the clarithromycin resistance depends on three point mutations (A2142C, A2142G and A2143G). A novel PCR-based clarithromycin resistance assays, even on paraffin-embedded biopsy specimens, have been proposed. Aims: to assess clarithromycin resistance detecting these point mutation (E-Test as a reference method);secondly, to investigate relation with MIC values. Methods: Paraffin-embedded biopsies of patients Hp-positive were retrieved. The A2142C, A2142G and A2143G point mutations were detected by molecular analysis after DNA extraction by using a TaqMan real-time PCR. Results: The study enrolled 86 patients: 46 resistant and 40 sensible to CH. The Hp status was evaluated at endoscopy, by rapid urease test (RUT), histology and hp culture. According to real-time PCR, 37 specimens were susceptible to clarithromycin (wild type dna) whilst the remaining 49 specimens (57%) were resistant. A2143G is the most frequent mutation. A2142C always express a resistant phenotype and A2142G leads to a resitant phenotype only if homozigous. 2) Background: Colonoscopy work-load for endoscopy services is increasing due to colorectal cancer prevention. We tested a combination of faecal tests to improve accuracy and prioritize the access to colonoscopy. Methods: we tested a combination of fecal tests (FOBT, M2-PK and calprotectin) in a group of 280 patients requiring colonoscopy. Results: 47 patients had CRC and 85 had advanced adenoma/s at colonoscopy/histology. In case of single test, for CRC detection FOBT was the test with the highest specificity and PPV, M2-PK had the highest sensitivity and higher NPV. Combination was more interesting in term of PPV. And the best combination of tests was i-FOBT + M2-PK.