[Hyperbaric oxygenation in medicine and surgery].
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Biomedical subjects
Publications and source records attributed to A Borromei.
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The AA. describe two cases of serious juvenile myasthenia arisen after jennerian vaccination, antidiphteric and antitetanic vaccination in the first patient and after antitetanic vaccination in the second one. They put forward the hypothesis that in the two patients juvenile serious myasthenia is a complication due to vaccination for the following reasons: 1) the chronological relation between vaccination and the arising of myasthenic sumptomatology is very close; 2) the vaccine produces in the body a reaction of immunity type and myasthenia is nowadays generally considered as an immunity disease. Although the ways in which the vaccine inoculation can give rise to the disease are unknown, it can be supposed that in the occurrence at the same time of a genetic factor or of an susceptible area, the vaccine can act as a factor provoking the immunity answer of myasthenic type.
The authors review reports in the literature on the fitness and ability to drive of neurosurgical patients and subjects afflicted by neurological disorders, before focusing on their own series of 204 idiopathic Parkinson's disease (PD) patients. The study sample comprised 173 men and 31 women (average age 70.6 and 74.2 years, respectively) of whom 51, for various reasons, still drove (albeit only short distances). Different variables were examined (Hoehn & Yahr scale values (of the total group and of the subgroup of active drivers), scores for various clinical diseases, and so on) looking for an association between these variables and the number of accidents incurred by PD patients as compared with the healthy population and with a control group of healthy age-matched subjects (ISTAT data). The need for adequate legislation on driving in PD emerges clearly and recommendations are given on which such legislation might be based.
On average 0.04% of the population is affected by craniostenosis. It is believed there are anatomo-clinical forms at moderate risk and others at high risk. The neurosurgical indications are very different according to various Authors. The forms at high risk which are caused by an isolated synostosis of the coronal system with brachicephalia are either associated to other synostosis (oxicephalia) or to facial synostosis should always be operated, with various techniques, within the first 6 months of life. Basing on the experience of 3 cases of craniostenosis, deliberately not operated on, followed and controlled for over 20 years from the decision of not to operate, all in excellent general condition both neurological and psychiatric, the Authors consider and discuss the criteria of surgical indications with particular regard to clinical objectivity (implicity disregarding a precise value of the craniometric data).
The Authors report the results obtained by long-term clinical and radiological evaluation of patients who had undergone cervical multiple bilateral laminectomy to relieve the compression exerted on the cord by different diseases (spondylarthrosis, syringohydromyelia, intramedullary and extramedullary tumours, leptomeningeal cysts and extradural tumours). 98 patients were reviewed, the follow-up ranging from 8 to 24 years (mean 14 years). The results demonstrate that the most severe post-laminectomy changes are recorded in patients with intramedullary lesions and when middle-low cervical spine levels (C4-C7) are affected. The significance of spinal deformities such as kyphosis, spondylolisthesis and swan-neck is also discussed.
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