Ophthalmology
The following are available: eye examination, visual field, perimetry, orthoptic assessment, OCT (ocular computed tomography), instrumental diagnostics, which are also paid for by the National Health System.
An interview with dr. Roberto Spolaore
Dietetics
Allergology
What is allergy?
Allergy is an exaggerated response of an individual towards allergens (foreign substances) that are present in the environment where we live, such as: pollens, molds, insects, or towards substances that we introduce with food (food allergens).
The symptoms of allergy are various: sneezing, burning eyes, nose itchiness…. There are various types of allergic diseases:
- allergenic asthma
- food allergies
- hives
- drug allergic reactions
- insect allergic reactions
Allergy is typical of our times; it is increasing in frequency and affects at least eight million Italians. Treatment may be administered by:
- using anti-histamine and antiallergic drugs: nasal sprays, tablets…
- using vaccines. The aim is to induce tolerance towards the allergen. Oral, epi-cutaneous and injection vaccines are available.
Psychiatry
Psychiatry is the specialistic branch of medicine dealing with the prevention, treatment and rehabilitation of mental disorders from a theoretic and practical point of view. Psychiatry may be defined as a “discipline of synthesis”, since pursuing and maintaining mental health, which is the main aim of psychiatry, is obtained by taking into consideration various fields: medical-pharmacological, neurological, psychological, sociological, juridical, and political.
In particular, compared to psychology, psychiatry is often more inclined to identify a mental or psychological disorder as deriving from an anomalous physiological functioning of the central nervous system.
Psychology
Psychology is the science studying psychic and mental processes, in their conscious and subconscious components, by means of a scientific method and/or based on an intrapersonal subjective perspective. Said study, therefore, deals with a patient’s intrapsychic processes, with individual and group human behavior, and with the relationships between the patient and his/her environment.
Psychology differentiates from psychiatry: the latter is a medical discipline, focused on the treatment of psychopathological disorders, even though both share clinical psychology and psychotherapeutic treatments.
Pneumology
Diabetology
Diabetology deals with the diagnosis and management of diabetes.
Diabetes mellitus is a condition characterized by a chronically high level of blood glucose (hyperglycemia), caused by a deficit in secretion or activity of insulin, or more often of both. Furthermore, diabetes is an insidious and poorly symptomatic disease, which often becomes manifest only late. In order to reduce complications, an early and aggressive diagnostic and therapeutic approach is essential.
The most common diseases related to diabetology are:
- Type 1 diabetes mellitus (insulin-dependent) in patients over 18
- Type 2 diabetes mellitus (in patients over 18)
- Impaired fasting glucose (IFG)
- Impaired glucose tolerance (IGT)
Senology
Senology is the branch of medicine dealing with diseases of the breast. In the past senology was established as a mainly female specialty and was linked to Gynecology. Nowadays, owing to sensitization and screening programs aimed at the early diagnosis of tumors, it involves more and more specialistic branches, from endocrinology to radiology, oncology and pathological anatomy.
It is not a “specialty” acknowledged by a specific school, but in the last 20 years various educational initiatives have been undertaken to perfection and officialize this specialistic branch, especially in the oncological field.
Cytological analyses
This test examines a sample of any biological liquid or tissue, to verify whether it contains abnormal cells.
Cytological analyses comprise: swabs, PAP test, histological samples, HPV test, etc.…
Mapping of moles
Mapping of moles consists in acquiring on a computer both macroscopic and dermoscopic images of moles. Dermoscopic images are acquired with an appropriate camera equipped with a lens that is applied on each nevus to collect images that are not visible to the naked eye.
Mapping of moles is aimed at evaluating changes in the appearance of nevi over time. In this case nevi may become dangerous and must be removed so as to prevent their degenerating into a melanoma.
Electromyography
Electromyography (also called EMG) is a diagnostic test useful in diagnosing nerve diseases (e.g. neuropathies) and muscle diseases (e.g. myopathies). By the term “electromyography” in general we intend both “nerve conduction speed” or “electroneurography” (ENG) and the true and proper electromyography (“needle” EMG).
For the diagnosis of which diseases is electromyography useful?
- Carpal tunnel syndrome (or median nerve trapping in the carpal tunnel – wrist)
- Ulnar sulcus syndrome (or ulnar nerve trapping in the elbow)
- Guyon’s syndrome (or ulnar nerve trapping in Guyon’s canal – wrist)
- Tarsal tunnel syndrome
- Radiculopathies
- Polyneuropathies (e.g. diabetic neuropathy)
- Plexus pathologies
- Amyotrophic lateral sclerosis
- Muscle diseases (e.g. myopathies and myositis)
- Diseases of the neuro-muscular junction (e.g. myasthenia gravis)
- and other diseases…
Gastroenterology
Esthetic Medicine
OCT
Optical computed tomography (OCT) or optical coherence tomography, is a non-invasive diagnostic exam which allows obtaining scansions of the cornea and retina for the diagnosis and follow-up of numerous corneal and retinoic diseases, and for the preoperative diagnosis and postoperative follow-up of most eye diseases needing surgery.
What is optical computed tomography (OCT)?
It is a non-invasive imaging technique, based on white light or low coherency interferometry, a Laser bundle with no harmful radiations, which is used to analyze ocular structures, especially retinoic and corneal, by means of high resolution sections.
What is optical computed tomography (OCT) used for?
OCT allows obtaining very precise corneal and retinoic scansions and subsequently a detailed analysis of corneal strata, the central region of the retina called the macula, and the optic nerve. This “imaging” method allows a doctor to diagnose and monitor numerous corneal and retinoic diseases, such as, for example, senile macular degeneration, diabetic retinopathy and glaucoma. It is particularly useful in cases of macular edema of various origin. OCT is an indispensable exam in the preoperatory diagnosis and postoperative follow-up of most eye diseases needing surgery. Since it is a digitalized exam, it allows comparing different tests thus providing differential maps of the patient’s eyes. It is a fundamental exam in the early diagnosis of some diseases: for example, in patients affected by glaucoma, OCT is able to measure the thickness of the nervous fibers surrounding the optic nerve, showing, in some cases, an early alteration of said fibers in the presence of a normal visual field, and this allows initiating promptly a treatment in order to slow down the progression of the disease.
Who can undergo optical computed tomography (OCT)?
All patients in whom a corneal, retinoic or optic nerve disease is suspected, except for those presenting with a remarkable opacity of the crystalline lens, important modifications of the lacrimal film and absence of eye fixation.
Is optical computed tomography (OCT) painful or dangerous?
It is a reliable, non-invasive, harmless exam, not involving any contact.
How does optical computed tomography (OCT) work?
Performing an OCT is simple and fast, and lasts about 10-15 minutes. The patient is seated in front of the device and is invited by the operator to fix a luminous point with his/her eye: scansion begins immediately when the eye structure to be analyzed is focused. With last generation OCTs, the exam may be performed even without dilating the pupil, after the operator has evaluated the features of the eye and the type of disease to be investigated.
Prenatal tests
An innovation in prenatal screening: starting from the 10th week of pregnancy, with a normal blood sample taken from the mother for analyzing fetal DNA, it is possible to diagnose Trisomy 21, 18, 13 and chromosome aneuploidy.
The information that the Prenatal test can provide concerns the risk of Trisomy 21, 18, 13 by measuring the quantity of fetal DNA, specific for the related chromosomes, which circulates free in maternal blood, but this does not rule out all fetal anomalies. Therefore, since it is not a diagnostic test, the doctor may decide to integrate the information provided by the test with other clinical and echography data.
The test may be requested by sector professionals for pregnant women starting from the 10th week of gestation. Based on a simple blood sample taken from the mother, it can be performed even in single or twin pregnancies (maximum 2 fetuses) after in vitro fecundation.
The very high reliability of the test significantly reduces the
risk of useless invasive diagnostic procedures (amniocentesis, villocentesis).
The scientific studies published confirm the high sensitivity of the test, in as much as it is the only prenatal screening used at London’s Fetal Medicine Center where the international organization (Fetal Medicine Foundation), dealing with verifying the reliability of the tests used in this delicate sector, has its premises.
The results of the test are available within two weeks from the date of sampling and, in a very clear and understandable way, they specify the specific risk for each trisomy. At the pregnant woman’s discretion, the sex of the unborn child may be indicated, too, and the X and Y chromosomes investigated for the presence of any correlated aneuploidy.
Neurology
Urology
The Urology outpatient clinic deals with the diagnosis and treatment of male and female disorders of the urinary system (kidneys, ureters, bladder), and with disorders of the male reproductive system.
It is also possible to perform the following types of surgery:
- Circumcision
- Frenectomy/Frenuloplasty
- Removal of genital warts
Polysomnography
Most people, although they have experienced, temporarily or for long, how difficult it is to have good sleep, are too often unaware of the importance of nocturnal sleep and ignore the existence and consequences of the most important sleep disorders: INSOMNIA, NARCOLEPSY, SNORING, OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS), RESTLESS LEGS SYNDROME, CIRCADIAN RHYTHM DISORDERS, JET LAG, BRUXISM, SOMNAMBULISM.
Among all sleep disorders, the least known is paradoxically also the most dangerous: Obstructive Sleep Apnea Syndrome (OSAS).
By Obstructive Sleep Apnea Syndrome we mean a condition characterized by repeated episodes of occlusion of the upper respiratory tract (anatomic/functional), complete (apnea) or partial (hypopnea), during sleep; which cause:
- respiratory stress
- the reduction of oxygen in the blood
- sleep fragmentation
OSAS is a PATHOLOGICAL INTERRUPTION OF NOCTURNAL BREATHING, associated with STRONG SNORING, and it may cause:
- morning headaches
- lack of concentration
- diurnal sleepiness
- falling asleep while driving
- mood depression
- work injuries
- hypertension
- arrythmias and cardiovascular mortality (stroke).
Obstructive Sleep Apnea Syndrome is a serious and growing medical, social and economic problem, and the lack of diagnosis and the non-treatment of this syndrome are decisive over time.
All this today is easily diagnosable and treatable with Polysomnography: this is an exam during which sleep can be monitored and organic disorders studied, especially in patients who have been struggling with sleep for a long time.
Polysomnography enables sleep to be studied objectively by recording all the physiological variables involved in disorders of the various phases of sleep: REM and non-REM.
On the basis of an accurate diagnosis and evaluation of the results of the test, the specialist in Sleep Medicine can diagnose the nature of the disorder and, keeping in mind the needs of the patient, choose the most appropriate treatment.
As already said, polysomnography is aimed at monitoring and recording cardio-respiratory activity and in certain cases, nocturnal neurological activity by means of:
- a chest band detecting chest expansion movements
- an abdominal band detecting abdominal muscle movements
- a pulse oximeter which is positioned on a finger of the hand to detect peripheral oxyhemoglobin saturation and the heart rate
- a nasal cannula to detect respiratory flow through changes in pressure
- a sensor for snoring
- a position sensor enabling the position of the body while sleeping (supine, lateral or prone) to be detected
- electrodes positioned on the scalp enabling brain activity to be detected (a parameter possible only in case of neurological nocturnal polysomnography)
This is a painless test, during which important physiological parameters, normally guaranteeing refreshing sleep, are monitored and recorded.
Electrocardiogram
A painless test that allows analyzing heart frequency by reading electric impulses.
A basic electrocardiogram (ECG) is done while the patient is lying on a medical bed, a stress ECG needs physical activity to be done (either on a treadmill or on specific medical steps).
This test is necessary not only for routine follow-ups but also for obtaining competitive or non-competitive sports fitness certificates (a single ECG is sufficient in case of certificate renewals).
Electroencephalogram
An ELECTROENCEPHALOGRAM (EEG) is a diagnostic test which, by means of electrodes positioned on the scalp, measures brain electrical activity and reproduces it on a monitor, in the shape of a series of waves with various frequencies.
An electroencephalogram is a painless test, with no side effects, which can be done at any age.
Besides its central role in epileptic disorders, it is a valid tool in evaluating all those diseases capable of modifying brain electrical activity, such as: tumoral or vascular brain lesions, degenerative diseases, metabolic abnormalities, infective diseases, comas, therapeutic response to medicines that are active on the central nervous system, certain types of headaches, outcomes of cranial traumas, sleep disorders.
Physiatrics
Physiatrics deals with the recovery or treatment of the outcomes of various types of diseases: traumatological, orthopedic, rheumatological, neurological, ENT, respiratory, urological, cardiological, dermatological, angiological.
Echo color doppler
An echo color doppler (or ECD) is a non-invasive diagnostic procedure, which, through Ultrasound, enables a doctor to visualize the main blood vessels of the body and study the blood flow within them. This technique is capable of providing very precise information on the blood flow within blood vessels.
The technique has revolutionized the diagnostics of vascular and heart diseases, with the possibility of detecting and monitoring over time: arterial stenosis, aneurysms, superficial and deep venous thrombosis, venous insufficiency.
Diagnostic tests done:
- Complete abdomen ECD
- abdominal aorta and
- large abdominal vessels ECD
- arterial ECD of upper vessels
- arterial ECD of lower vessels (paid for by the NHS)
- arterial and venous ECD of the arms and SAT (supraortic trunks)
- arterial and venous ECD of the legs (paid for by the NHS)
- cardiological ECD (paid for by the NHS)
- liver and spleen ECD
- penis ECD at rest and after pharmacological stimulation
- kidney ECD
- ECD of a single organ
- testicle ECD
- ECD of supraortic trunks (SAT) (paid for by the NHS)
SAT ECD with angiological evaluation
Bone densitometry
Bone densitometry is a technique used to diagnose osteoporosis. This exam enables a doctor to measure the exact content of calcium in the bones.
The exam is done using a DEXA method, with which it is possible to evaluate the degree of mineralization of the bones of the lumbar spine, the femur, the wrist, the hip or of the whole skeleton (”total body” bone densitometry).
Bone densitometry is very precise, and shows early alterations of bone tissue when mineral loss (osteopenia) is still in an initial stage. This exam does not need any preparation, does not take much time and, once finished, the patient can immediately return to his/her normal life.
The exam is painless and without risks. Thanks to this test it is possible to:
- evaluate your fracture risk;
- decide if and which therapeutic measures are necessary;
- monitor therapeutic measures;
- verify therapeutic effectiveness.
Bone density values are then compared in a reference curve with those of a person of the same age and sex.
The results of a densitometry may be:
- in the norm (the suspect of osteoporosis is not confirmed);
- osteopenia (bone density is only slightly reduced);
- osteoporosis (reduction of bone density is evident or remarkable).
Radiology / Imaging diagnostics
An interview with dr. Francesconi
Reconstructive plastic surgery
Breast esthetic surgery
Additive mastoplasty
Breast lift
Reductive mastoplasty
Nipple correction
Prosthesis replacement

Endocrinology
Endocrinology is the branch of medicine dealing with the study of glands of internal secretion and of hormones in relation to their nature, production and action. Glands of internal secretion are those that release their secretive product (typically but not necessarily a hormone) into circulating fluids: thyroid, parathyroid, hypophysis, epiphysis, thyme, adrenal glands, endocrine pancreas, testicle interstitial gland, ovary interstitial gland.
An endocrinologist deals with the diagnosis and treatment of disorders affecting the glands of internal secretion present in the human body and the various diseases that these glands may cause.
Which are the diseases more often treated by an endocrinologist?
- Diabetes
- Metabolic disorders
- Infertility
- Thyroid diseases
- Menopause
- High blood pressure (hypertension)
- Cholesterol problems
- Puberty related problems (early and delayed)
- Excessive or insufficient production of hormones
- Osteoporosis and bone fragility
- Endocrinal gland tumors
Geriatrics
Andrology
Andrology is typically a multidisciplinary science, involving urological, endocrinological and dermatological fields, and not only does it deal with sexual dysfunctions and infertility, but it is also a valid help in the field of prevention, by improving the patient’s lifestyle and correcting behavioral errors that may compromise sexual health.
An andrological evaluation is aimed at the diagnosis of the main andrological disorders such as: erectile dysfunctions, premature ejaculation, varicoceles, phimosis, a short frenulum, or monitoring the evolution of an already diagnosed disorder.
Oxygen Ozone Therapy
Ozone therapy uses a mixture of oxygen and ozone for therapeutic purposes. The aim of the treatment consists essentially in increasing the available amount of oxygen or of its radicals, by introducing ozone into the body through a needle and a specific device.
One of the most widespread applications of ozone therapy concerns the treatment of lumbar and cervical herniated (slipped) discs. The treatment is based on the injection of a gas mixture of oxygen and ozone in the surrounding area of the back, in order to stimulate a healing process. The treatment requires indicatively ten sessions, each session lasting a few minutes.
After a few weeks, ozone and oxygen induce tissue dehydration, thus eliminating compression on nerve roots and ensuring relief from pain, especially in case of an acute slipped disc.
Ozone therapy has other fields of application in lower back pain, neck pain, hip and knee arthrosis, tendinitis and shoulder periarthritis, epicondylitis.
At Blue Medical Center, the painful component of oxygen-ozone therapy injections is minimized thanks to preventive pain management.
The treatment is administered by specialist doctors.
Mesotherapy
Mesotherapy consists of intradermic injections of medications, including homeopathic ones, in certain districts of the body. With very thin needles small quantities of a medication are injected into the derma corresponding to the skin projection of an organ, or part of an organ, which is affected by a pathological process.
Since absorption of a medication at dermic level is rather slow, a small deposit will form, which will run out in more than 12 hours. This prolonged action by the medication will mainly involve the receptors of the district where the disease to be treated is present; only a minimal part of the therapeutic molecules will enter the bloodstream.
Infiltrations
In the medical field, in particular orthopedic, infiltrations are defined as injections of medications (such as, for example, hyaluronic acid, local anesthetics, cortisone, etc.) or biological solutions (such as, for example, platelet growth factors or staminal cells).
In the orthopedic field, we can distinguish the following types of infiltrations:
- articular (joint) injections
- peri-articular injections.
In the first case, the medical solution is injected internally inside the joint, whereas in the second case the medicament is injected into an area adjacent to the joint.
The main indications for infiltrations are joint diseases (for example arthrosis or non-infective arthritis, cartilage disorders etc.) and diseases involving periarticular structures and soft tissues (bursitis, capsulitis, enthesopathies, fasciitis, fibrositis, peri-tendinitis, radicular syndromes, tendinitis, tenosynovitis, etc.)
For these purposes, the most performed injections are injections of hyaluronic acid and injections of cortisone. The widespread use of this medical practice is due both to its proved effectiveness and to the fact that positive results can be attained in a short time without practically any risks.
Orthopedics and traumatology
Disorders treated:
- shoulder problems: subacromial impingement syndrome, rotator cuff lesions, shoulder instability, shoulder dislocation, arthrosis
- knee problems: arthrosis, meniscus lesions, cartilage lesions, anterior cruciate ligament problems, patellar femoral syndrome
- hip problems: arthrosis
- hand problems: carpal tunnel syndrome
- foot problems: hallux valgus (bunion)
- fractures
Otorhinolaryngology or Ear-Nose-Throat (ENT)
An ENT evaluation is a medical examination which has the aim of detecting diseases of the ear, nose and throat and other organs of the head and neck district.
A physical examination evaluates the state of health of these complex organs which, although well distinct one from the other, are often functionally correlated and may present with associated disorders, such as inflammation, infections and tumors.
The tests which may be performed after physical examination and aimed at evaluating, for example, possible surgery are:
- an accurate inspection of the mouth and oropharynx. The hypopharynx and larynx are accurately evaluated by means of rigid or flexible optic fibers, i.e. a “laryngoscopy”, which enables visualizing on a monitor the anatomical, clinical and functional situation, highlighting any anomalies and lesions;
- otoscopy, using an instrument called an otoscope, which enables the doctor to evaluate, inside the ear, the tympanic membrane and the outer ear canal;
- rhinoscopy, an exam which is performed with a thin optic fiber endoscope enabling the doctor to explore the inside of the nose, communications with the paranasal cavities, rhino-pharynx and openings of the Eustachian tubes;
- tonal and impedance audiometric test: these enable the doctor to study in an exhaustive way a patient’s auditive functionality, giving information on the auditive threshold and the vibrating ability of the eardrum.
Dermatology
A dermatological evaluation is a specialistic evaluation which allows checking – in a non-invasive and painless manner – your skin’s state of health, diagnosing any diseases or monitoring previously diagnosed disorders for which the patient is being treated.
All skin disorders can be examined with a dermatological evaluation, and namely nevus anomalies, skin eruptions, the presence of hives, vesicles, angioedema; you can also consult a dermatologist if you have symptoms such as itchiness, red skin, changes in your skin appearance.
Some of the most common skin disorders are dermatitis, acne, psoriasis, eczema, hives.
A dermatology outpatient clinic also treats pediatric skin disorders, skin ageing, skin neoplasms, and skin allergies.
A dermatological evaluation is also indicated for the diagnosis and treatment of hair and scalp disorders.
Following skin examination, further diagnostic procedures may be necessary, such as for example nevus mapping by means of dermoscopy.
An interview with dr. Erika Briscik.
Angiology
Vascular problems (distension and narrowing) affect arteries and veins of the whole body. These issues, when concerning the arteries, are known as arteriopathies and can develop progressively but without any particular symptoms. Therefore, the issue will be detected only when it is already in an advanced stage.
Specialistic evaluation and aimed tests allow diagnosing the problem and modifying the natural history of the disease, which, if neglected, can cause serious complications such as: strokes, ischemia, or hemorrhages due to the rupture of an aneurysm.
Angiology specialistic evaluation concerns the study of the two sectors of blood circulation: arterial and venous. The purpose is to treat an already evident disorder, but also to prevent potentially fatal complications of vascular diseases that have not yet become evident.
Mammography
Mammography is an X-ray in which the breast is squeezed between two plates, in order to detect the presence of potentially tumoral formations. It is therefore performed when on breast palpation a nodule is present, or when there are other signs requiring an in-depth diagnostic procedure. Mammography is furthermore performed as a screening test to try and discover a breast disease before it becomes manifest.
Breast echography (Ultrasound)
Breast echography is a simple and safe investigation based on the emission of high-intensity and low-frequency Ultrasounds which do not cause any harm to the body. The probe is in contact with the breasts, which are covered with a thin film of watery gel giving better quality images. The ultrasounds emitted by the probe are reflected in different ways according to the type of tissue. This allows detecting any neoplasms within the breast and distinguishing between those with a liquid or with a solid content.
In most cases a breast echography is performed together with a mammography and the two exams are complementary. In younger women, in whom the glandular tissue is denser, echography gives more information than mammography.
Holter
Often associated with a cardiological evaluation, this exam allows evaluating the heart rate over a certain period of time, usually 24 hours, but sometimes monitoring for 48 or 72 hours is required.
The test is performed by positioning electrodes on a patient, which are connected to a device where data are recorded in continuum. The test is completely painless, and includes application and removal of electrodes and data recording. A document will be given to the patient with the recorded data together with a report signed by the cardiologist.
Echocardiogram
An echocardiogram is an exam done by means of Ultrasounds transmitted by a probe positioned on the chest. On a special monitor it is possible to visualize the heart chambers and measure them, evaluate the heart pump function and the state of the heart valves. It is a diagnostic instrument used to identify the principal heart diseases.
For a complete first evaluation, heart examination can be accompanied by a heart echocardiogram and a basic electrocardiogram (ECG). These procedures guarantee an initial level of cardiological screening.
Cardiological checkup
This procedure is addressed to everyone, both to those suffering from heart diseases, and to those wishing to monitor their heart functionality. Within a single appointment the following are performed:
- cardiological examination
- electrocardiogram
- heart echo color doppler cardiography at rest.
Gynecology and obstetrics
Gynecology and Obstetrics are the two clinical specialties dealing with: a woman’s health (Gynecology), a woman’s health and that of her baby until childbirth (Obstetrics).
In our facility the following diagnostic and preventive procedures are performed:
- an obstetrical evaluation
- a gynecological evaluation
Besides the following instrumental/diagnostic tests:
- Obstetrical echography
- Morphological echography
- Biometrical echography
Cardiology
The heart is the most important organ of our body. Thanks to the heart, oxygen is transmitted throughout our body and enables us to breath and in one word: to live. Cardiology deals with this tireless muscle, which in a lifespan beats an average of 3 billion times, by means of prevention, diagnosis and, when necessary, therapy.
A cardiological examination is the first contact or the continuation of a diagnostic or therapeutic procedure and represents the essential basis for the diagnosis and treatment of a cardiological issue. The doctor listens to the patient and then examines him. A cardiological evaluation is usually completed by performing an electrocardiogram.
A cardiological examination is fundamental for the diagnosis and treatment of the main heart diseases among which: hypertension, ischemic cardiopathy, heart failure, cardiomyopathies, heart valve diseases or patients with valve prostheses. Furthermore, patients who do not have known diseases are referred to outpatient heart clinics, because they need the cardiologist’s opinion for symptoms such as: chest pain, exertion or at rest breathlessness (dyspnea), fainting (syncope) or dizziness, palpitations or asthenia.
SARS-Cov-2 serological test
Blue Medical Center performs a qualitative serological test, certified CE-IVD, for the search of IgG and IgM immunoglobulins, useful in identifying the presence of SARS-CoV-2 antibodies (Covid 19). With a sample of venous blood it is possible to verify whether a patient has come into contact with the virus. In case of positivity, it is appropriate to contact your doctor.
Thoraco-pulmonary echography (Ultrasound scan)
BREATH CLINIC- THORACO-PULMONARY ECHOGRAPHY
A thoraco-pulmonary echography is one of the diagnostic tests included in the procedure concerning “the study of breath”.
This diagnostic test is scheduled together with other tests and always after a lung or ENT evaluation, in cases of dyspnea that may be caused by:
- chronic diseases
- pneumonia follow-ups (slowly resolving pneumonia)
- follow-ups after a COVID 19 infection
- obesity
- heart problems
A thoraco-pulmonary echography is today an important tool in the diagnosis of pulmonary diseases, and has interesting applications in evaluating a patient with respiratory symptoms and in particular with dyspnea, and in differentiating between cardiogenic and respiratory dyspnea. In these cases a pulmonary echography should be considered an extension of a heart echography, in a comprehensive ultrasound evaluation of the chest.
One must remember that a pulmonary echography can provide determinant information in clinical pictures that are not easy to interpret. In particular, in recent emergency times, it has been used for monitoring the state of:
- pleura exudation
- pneumothorax
- pneumonia
A chest echography is in any case surely indicated in those situations where it is preferable to avoid exposure to ionizing radiations, as in pregnancy and in the pediatric age. (The data obtainable with a thoraco-pulmonary echography can avoid a patient’s exposure to ionizing radiations. Irradiation with a thoracic CT scan corresponds to that of about 400 chest X-rays, but even a simple chest X-ray may, in carriers of a vulnerable genotype as the mutation BRCA1-BRCA2, double the risk of breast cancer).
The doctor performing this diagnostic test has received specific training.
Stress urinary incontinence
The kidneys filter the blood and produce urine: the latter is conducted by the ureters into the bladder and from here, through the urethra, to the outside with micturition. The bladder works as a reservoir that collects and keeps urine. If the bladder didn’t exist, urine would flow outside continuously since its production is continuous (even if flow varies according to the different hours of the day).
The bladder, therefore, allows the urine to be collected and eliminated when an individual decides to urinate. The mechanism which makes the bladder a reservoir, and, when necessary, allows it to empty itself, is called a sphincter.
In practical terms, the sphincter behaves like a tap which is mostly closed and opens only when we wish to empty the bladder/reservoir. Actually, the sphincter is a complex formation of both voluntary and involuntary muscular strata, which synergically keep the passage between the bladder and urethra closed. Thetightness of the sphincter is not absolute, but is relative to physiological pressure: a high pressure of urine may force its tightness. When the sphincter does not work properly, we have incontinence (leakage of urine), i.e. partial or total emptying of the bladder, without the participation and/or will of the individual.
In order to understand the causes and types of incontinence, we must remember how the bladder works. The bladder is a reservoir that adapts to its content as urine flows into it.
This reservoir is made up of involuntary smooth musculature and fills up as an elastic system (similar, for example, to a balloon), and, when it is full, it would contract and empty itself automatically if there were no control.
Physiologically, instead, when the bladder fills up with a certain amount of urine, the liquid increases its internal pressure. Since the bladder is inside the abdomen, it also receives external pressure due to muscular tension and the distention of the intestine.
Pressure receptors (indicators) positioned on the bladder wall, sensing the sum of the two pressures (internal and external), send the brain, through the nervous fibers of the spinal medulla, a message that the bladder is becoming full. The brain becomes aware that the bladder is full (sensation of fullness, the need to urinate) and, if it is impossible to urinate, the brain inhibits bladder contraction. Vice versa, when you reach the toilet, the brain removes inhibition, the bladder contracts, by reflex the sphincters open, and you can urinate. Any problem, disease or trauma interfering with this simple mechanism may cause malfunctioning and thus a leakage of urine.
We generally distinguish two types of incontinence: urge and stress incontinence, which sometimes may be associated.
Urge incontinence occurs when the bladder contracts before the brain inhibits contraction: this fact, by increasing urine pressure above the tightness of the sphincter, makes you lose your urine. The most common causes are inflammatory (cystitis) due both to bacterial or viral infections or physical damage, and neurological diseases that modify or interrupt the nervous connections between the bladder and the brain.
Stress incontinence occurs when the sphincter diminishes or loses the strengthwith which it closes the urethra: therefore, at physiological bladder filling, when the brain is not informed of the state of fullness, the increase in pressure on the bladder causes it to empty itself partially or totally.
This happens with coughing, sneezing, weight lifting, or with changes in body position: all these facts increase abdominal pressure causing a greater pressure on the bladder. If the pressure threshold to which the sphincter responds is lower than the pressure stimulating it, the sphincter does not resist and urine spills out: hence the leakage of urine.
In case of urine leakage, it is necessary to understand which type of incontinence has caused the loss of urine. Therefore, a urological evaluation is necessary, which, through an accurate reconstruction of the episodes of incontinence and the concomitant circumstances, will enable the doctor to identify the type of incontinence and find a remedy for it.
The basic tests necessary to frame the problem, besides the patient’s history and urological evaluation, are:
- some blood tests;
- urinalysis;
- urine culture;
- abdominal echography with an evaluation of residual urine in the bladder after micturition.
These tests confirm/rule out urinary tract infections, anatomical abnormalities of the urinary tract and of male and female genitalia (for example prolapses), and concomitant systemic diseases.
It is necessary to keep in mind whether the patient is in pharmacological treatment for any concomitant disorders; previous physical treatments (radiotherapy) and habits such as intestine malfunctioning must also be considered.
Sometimes, besides these basic tests, other diagnostic procedures are necessary, such as a diary of micturition and urine leakages, or a uroflowmetry. Only in particular cases and on exclusive judgement of a urologist, is it necessary to undergo a urodynamic investigation or evaluations by other specialists such as a neurologist.
Joint Magnetic Resonance
The new department of Diagnostic Radiology at Blue Medical Center has been active since the 1st of December 2020.
The new device ESAOTE O-Scan allows performing the exam in a fast and accurate way, similarly to high field resonance, and above all with patient’s comfort thanks to its open ergonomics.
Esaote dynamic Magnetic Resonance is capable of revealing hidden interferences that are difficult or often impossible to visualize with traditional static magnetic resonance.
Functional evaluation provides an added tool in improving assistance to patients, in particular in the field of professional sports medicine.
Traditional Diagnostic Radiology
The new department of Diagnostic Radiology at Blue Medical Center has been open since the 1st of January 2020.
The new apparatus Esaote DR M40-1A is very light, easy to work and of limited overall size.
It offers quality imaging thanks to its high nominal power independently from the volume of the body being examined.
It optimizes the high productivity dosage of the system thanks to the possibility of using Anatomically Programmed Radiography (APR).
It allows performing most of the traditional radiology X-rays.
Ortottico