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Purpose: To evaluate the role of US and CT in focal splenic lesions in AIDS patients in relation to etiology. MATERIAL AND METHODS; A total of 66 patients with AIDS and focal splenic lesions were examined with sonography. CT with administration of contrast medium was performed in 12 cases., Results: Of the focal splenic lesions, 67% were correlated with an infective pathology with prevalence of Mycobacteria tuberculosis (75%), 26% were neoplastic and 6% splenic infarcts. The lesions were hypoechoic in 60% of the cases, while 10% were hypoanechoic and 1% anechoic. At CT, all lesions appeared hypodense, even after i.v. administration of contrast medium., Conclusion: The combination of echographic reports and clinical and laboratory data allows for a diagnosis that can be confirmed, and making a decision for effective therapy of AIDS is possible. CT does not provide any additional information.

Introduction: Kaposi's sarcoma is an uncommon multifocal angiogenic lesion but the most frequent tumor (15%) in HIV+ patients: it is found in homosexual HIV+ men in 95% of cases and appears as cutaneous-mucous lesions in most patients; the respiratory system is involved in 20% of cases. We investigated the yield of conventional radiography, CT and HRCT in the diagnostic imaging of pulmonary Kaposi's sarcoma., Material and Methods: We retrospectively reviewed the findings of 205 patients with cutaneous Kaposi's sarcoma. Chest radiography (two projections) had been performed in all of them, chest CT in 23, HRCT in 7, and tracheobronchial endoscopy in 20., Results: The respiratory system was involved in 22% of the patients with cutaneous-mucous Kaposi's sarcoma. The pulmonary pattern was perivasculobronchial interstitial thickening with bilateral and symmetrical ilifugal involvement in 78% of cases, associated with multiple perivascular nodular opacities (< 1 cm) in 19 patients. Pleural effusion was seen in 52% of cases, while 3 patients had plaque thickening of visceral pleura; mediastinal adenopathy was found in 8.6% of cases. Endoscopy detected 14 tracheobronchial Kaposi's lesions. Kaposi's involvement of the respiratory system was confirmed histologically in 26 autopsy cases., Conclusions: In our experience, conventional radiology and clinical-history data permit to evaluate early pleuropulmonary involvement of Kaposi's sarcoma and to follow its evolution. CT and HRCT unquestionably detect the typical signs earlier than conventional radiology and yield further information on disease extent.

The authors investigated the role of ultrasonography (US) as the method of choice in diagnosing parotid lesions in HIV+ patients. Bilateral parotid gland enlargement associated with laterocervical lymph node enlargement is a sign of HIV infection. This pathologic condition is observed in 2-10% of seropositive patients. Histology demonstrates benign lymphoproliferative lesions referrable to immune system activation. Our series consisted of 37 HIV+ patients monitored with US for a year, all patients had cytologic confirmation of their disease, with needle biopsy in 9 patients and with MR studies in 4 patients. US showed focal solid lesions, with cystic and mixed appearance in the 26 adult subjects and gross parenchymal inhomogeneity in the 11 children; laterocervical lymph node enlargement was associated in 31 cases. In the only two cases with unilateral parotid involvement, an abscess and a lymphoma were diagnosed. To conclude, US findings in HIV+ patients, although aspecific, can help make the correct diagnosis, if they are integrated with the patient's history and clinical findings.

The authors reviewed retrospectively 139 splenopathies detected during 432 US examinations of the abdomen in AIDS patients to assess the role of US in correlation with anamnestic-clinical data and histologic findings in 45 cases. Splenomegaly was the main sign of abnormal splenic conditions, since it was present in all the examined patients. Twenty-one cases exhibited focal lesions. Non-Hodgkin's lymphomas were the only kind of neoplastic condition, which were detected in 15% of cases. In 57% of cases splenopathy was correlated with an infective agent, with a marked prevalence of Mycobacteria-i.e., tubercular in 26% and atypical in 22%. In the splenopathies with histologic confirmation which exhibited a focal US pattern (47%), US proved to be useful in assessing splenic involvement, however aspecific its signs, and in its monitoring, especially in the lesions with unexpected colliquative evolution, as in two cases of atypical mycobacteriosis.

Over the last decade the number of subjects with acquired immunodeficiencies has markedly increased; this phenomenon depends on both the large number of patients receiving organ transplants or antiblastic therapy and the spread of infections caused by the HIV virus. In 70-90% of these patients primary diseases include different pulmonary infections, relative to the type and degree of immune compromission. Pathogenic or, in most cases, opportunistic germs are responsible for severe pneumonia whose mortality rate can top 50%. Since prognosis depends on the promptness of treatment, the diagnosis of nature must be made quickly by integrating clinical and diagnostic findings with laboratory and instrumental results. Conventional chest radiology plays a major role as the first step in a diagnostic iter which can now include rather sensitive techniques--e.g., equalized chest films. CT and nuclear medicine often represent the necessary diagnostic complements but, in some cases, etiology can be diagnosed only with such invasive procedures as lung biopsy. The authors reviewed the current data on the diagnostic imaging findings of pulmonary infections caused by common germs, by Pneumocystis carinii mycobacteria, mycetes and viruses in immunocompromised patients, integrating their personal experience with literature data.

Respiration is a vital, complex function, fundamentally automatic that can be modulated by will. The aim of the original method submitted is the progressive rehabilitation of the patient to strain, by a gradual reduction of respiratory frequency at the progressive increase in expiration phases and the execution of a growing effort in strict relation to the execution of the method itself. The patient learns to beat out the rhythm of his respiration based upon the strokes of the metronome, calibrated at 60 strokes a minute. The most evident documentation of the efficacy of our method of voluntary regularization of the respiratory act is in the evaluation of the effort capacity of each patient, before and after the method. The data are referred to the distance covered by cyclette, in standard conditions. The examined clinical parametres comprehend: cardiac frequency, respiratory frequency, maximal pause and arterial pressure. The laboratory parametres examined include the value of the arterial astrup: pH, pCO2, HCO3-, total CO2, pO2, excess basis. The scarcity of clinical survey examined during our research does not permit the formulation of any conclusive considerations, which would lead to a critical revision of the whole field of the physiology of respiration. For this reason, it is more prudent to establish the modifications of various parametres collected, until a more certain and wider confirmation is available.