Search PubMed⌕ Search

Biomedical subjects

A Gigante

Publications and source records attributed to A Gigante.

At least 37 records · Page 2Linked to original sources
PubMed1993

Clinical and pathological aspects of solitary spinal neurofibroma.

Four cases are described of solitary spinal neurofibroma, a rare tumour of the spinal cord or nerve roots. Computerised tomography provided an accurate topographical definition of the tumour. Magnetic resonance imaging showed an increased T2-weighted signal and multiple areas of decreased T1- and T2-weighted signals centrally. The MR signals matched the histological examination which showed hyperplastic interfascicular connective tissue, pleomorphic cells, and tightly packed nerve fibres compressed by the surrounding loose connective tissue. Electron microscopy showed three types of cell: Schwann cells, fibroblast-like cells, and mast cells. The histological findings suggests that solitary spinal neurofibroma is a distinct pathological entity which could be diagnosed preoperatively from the MR images.

Adult↗
PubMed1993

The role of instrumental diagnostic methods in the staging of Sudeck's disease.

Forty patients with Sudeck's atrophy were assessed in order to evaluate the diagnostic accuracy of x-ray, scintigraphy and telethermography in staging the 3 phases of the disease. The dynamic and early static phases of scintigraphy were the most sensitive and specific instrumental tests for detecting the early stage, whereas telethermography was fairly sensitive but not very specific. Radiographic examination was not sensitive in detecting slight changes in bone density, but it was the most reliable index for recognizing the transition to stage II of the disease. Moreover, it was possible to confirm that the late static phase of scintigraphy is the index which is best related to bone metabolism.

Adult↗
PubMed1993

Critical analysis of intramedullary nailing by the Ender method in the treatment of intertrochanteric fractures.

A retrospective study was carried out to evaluate the results of intramedullary fixation by Ender nailing in the treatment of intertrochanteric fractures. During the period 1980-1989, 85 patients were treated with this method at the Orthopedic Department of the Università Cattolica in Rome. Evaluation of the cases took into account the patient's characteristics (age, sex, weight, height, obesity, previous or concomitant illness, level of autonomy, mental condition, type of fracture, time elapsed before operation and laboratory tests), details of the operation (length, accuracy of reduction and mechanical fixation stability, post-operative hospitalization period and general and local complications) and follow-up evaluation (X-ray examination, functional examination and evaluation of the results). Analysis of the observations showed that, although it induced less surgical trauma, internal fixation by the Ender method did not ensure a stable reduction, particularly with highly comminuted and basicervical fractures. As a result, the elective indication for this method should be restricted to stable intertrochanteric fractures, particularly in patients with a generally poor condition.

Aged↗
PubMed1991

Fibrin-antibiotic mixtures: an in vitro study assessing the possibility of using a biologic carrier for local drug delivery.

An in vitro study assessing the kinetics of drug release from antibiotic-fibrin seal compounds and the antibacterial efficacy of the delivered drug has been performed. Antibiotic sensitivity and the amount of drug released was measured by means of agar diffusion test. Standard and experimental curves were established for each antibiotic and each bacterial test in order to evaluate the quantities of the drug released during each 24 h period. The reconstitution of lyophilized human fibrin with an aqueous solution containing an antibiotic resulted in only minor modification of the clotting process, with the exception of those solutions containing cefotaxim and mezlocillin which failed to clot altogether and were excluded from further study. The evaluation of the kinetics of elution of the antibiotics from the fibrin clots showed that all of the antibiotics had been almost completely released by 96 h. The delivered amount of each drug was enough to maintain the Minimal Inhibitory Concentration (MIC) until the 4th day of culture for the most of antibiotics, resulting in a prolonged release of the drug.

Anti-Bacterial Agents↗
PubMed1991

Effects of chronic alcohol intake on carbohydrate and lipid metabolism in subjects with type II (non-insulin-dependent) diabetes.

PURPOSE: To study the effects of chronic alcohol intake on carbohydrate and lipid metabolism in subjects with non-insulin-dependent (type II) diabetes (NIDDM). To also evaluate the effect of alcohol withdrawal on metabolic control. PATIENTS AND METHODS: The study group consisted of 46 alcohol-consuming patients with NIDDM (NIDDM-B group), 35 non-alcohol-consuming patients with NIDDM (NIDDM group), and 40 normal control subjects. All patients were admitted to the hospital. Carbohydrate and lipid metabolism was assessed in these individuals immediately on admission to the hospital and during the following days. RESULTS: In the NIDDM-B group, blood alcohol (ethyl alcohol) concentration was very low. However, chronic alcohol intake was associated with higher fasting and postprandial glucose concentrations and higher hemoglobin A1c. No significant differences were found in C-peptide levels. Moreover, higher concentrations of 3-hydroxybutyrate and free fatty acids were observed in the NIDDM-B group than in the NIDDM group. No differences were found in triglyceride concentrations, acid-base patterns, or electrolyte levels. The metabolic effects of alcohol completely waned after 3 days of complete withdrawal. CONCLUSION: Chronic alcohol intake causes deterioration in metabolic control of persons with NIDDM. The effects induced by alcohol are completely reversed after a few days of withdrawal. Strict metabolic assessment is necessary when alcohol is an important constituent of the diet.

3-Hydroxybutyric Acid↗
PubMed1991

Insulin secretion, glycosylated haemoglobin and islet cell antibodies in cystic fibrosis children and adolescents with different degrees of glucose tolerance.

In comparison with 12 weight-matched controls, 39 children and adolescents with cystic fibrosis (CF) showed higher fasting glycaemic levels and both delayed and enhanced blood glucose responses to OGTT. Glycaemic response was normal in 30/39 patients (76.9%), impaired in other 7 cases (18%) and diabetic in the remnant two (5.1%). Fasting insulin levels and total insulin output during OGTT did not differ in patients and controls, but insulin peak in CF group was delayed and sustained. In the whole CF series mean HbA1c was higher than in controls but no difference was found between patients with normal and those with impaired glucose tolerance. Islet cell antibodies were absent in the entire CF group. In conclusion, our results confirm the raised prevalence in CF of glucose tolerance abnormalities, which do not seem to depend on auto-immune factor involvement. Delayed insulin response to OGTT can be considered a very early expression of beta cell impairment in the course of CF. In our experience HbA1c assay did not constitute a sensitive and specific screening test for detection of the C patients with glucose intolerance.

Adolescent↗
PubMed1991

[Surgical treatment of diaphyseal fractures of the forearm during pre-adolescent age].

The results of treatment of 10 both-bone unstable diaphyseal fractures of the forearm in children by open-reduction and intramedullary fixation with Kirschner wiring of the radius are presented. All fractured healed in perfect alignment. No complications occurred. In a 3 year and 2 month follow-up all the patients had excellent results with full range of movement. The advantages of this method are: a) it is easy to carry out; b) it maintains anatomical reduction; c) a second operation to remove the internal fixation device is not required; d) fixation of the ulna is not necessary, because in all patients a realignment of the ulnar fragments occurred after radius reduction.

Bone Wires↗
PubMedDate not supplied

Regnauld procedure in the surgical treatment of metatarsalgia: interpretation of follow-up X-ray imaging.

In lesser ray metatarsalgia (rays 2 through 5) due to an altered Lelievre's metatarsal formula (depending on the respective lengths of the metatarsals), the resection of metatarsal heads aims at restoring a correct metatarsal support. This being a destructive procedure, metatarsal head resection is best indicated in the treatment of severe forefoot deformities such as those resulting from rheumatoid arthritis. In all metatarsalgias that recognize biomechanical origin, the enclavement procedure, according to Regnauld's original report, should be preferred. The aim of this study is analysis of the radiographic evolution of the metatarsal epiphysis following the Regnauld procedure on the basis of anatomic and pathological events occurring during the attachment process. The procedure was performed on 31 feet and the patients were followed-up for 24 months postoperatively. The enclavement process evolved favorably in all cases. It consists of four anatomic/pathologic phases corresponding to typical radiographic features. While graft consolidation is achieved in 3 to 4 months postoperatively, complete recovery of the metatarsal bony architecture and functional adaptation requires 18 to 24 months.

Aged↗
PubMedDate not supplied

Prevalence of interstitial lung involvement in patients with connective tissue diseases assessed with high-resolution computed tomography.

OBJECTIVES: To assess the prevalence of interstitial lung disease (ILD) in patients with different forms of connective tissue disease (CTD) using non-invasive procedures including high-resolution computed tomography (HRCT) and to evaluate the relationship between the imaging and functional status of the patients. METHODS: Eighty-one subjects with CTD (47 inpatients and 34 outpatients) were evaluated with pulmonary function tests (PFT) and radiological investigations. The extent and severity of lung disease was quantified with an HRCT scoring system previously used in patients with systemic sclerosis (SSc). Interstitial lung involvement was defined as predominantly fibrotic or inflammatory based on HRCT abnormalities. RESULTS: HRCT abnormalities suggestive of ILD were observed in 69 patients (85.1%), whereas PFT and plain radiograph alterations occurred less frequently (40.7%). The most frequent HRCT abnormalities were septal/subpleural lines and ground-glass appearance whereas lesions consistent with advanced fibrosis were observed in a minority of patients. The HRCT score was higher in patients with abnormal PFT (p<0.001). Thirty-five patients had predominant fibrosis and 34 patients predominantly inflammatory abnormalities. A score of 10 points represented the best compromise between sensitivity and specificity in predicting functional impairment. CONCLUSIONS: A high prevalence of ILD was found based on HRCT abnormalities. However, HRCT scans characterized by minor abnormalities have poor specificity for clinically significant disease and functional findings should also be considered. The large number of patients with predominantly inflammatory HRCT abnormalities suggests that many cases of ILD may be diagnosed in a relatively early stage of the disease.

Adult↗
PubMedDate not supplied

The effects of patellar taping on patellofemoral incongruence. A computed tomography study.

Patellar taping for the purpose of patellar medialization is a nonoperative rehabilitation technique used in the treatment of patellofemoral pain. Despite early reports of excellent success rates, the indications for this treatment and its efficacy on patellofemoral pain are unclear. The present computed tomography study was undertaken to evaluate the effect of patellar taping on patellofemoral incongruence. Sixteen female patients (age range, 16 to 25 years) with anterior knee pain related to patellofemoral incongruence underwent computed tomography examination with their quadriceps muscles relaxed and contracted both before and after patellar taping. Patellar lateralization was measured as lateral patellar displacement, and patellar tilt was measured as lateral patellar angle. Patellar taping did not significantly affect patellofemoral lateralization or tilt. The results of this study do not support the use of this method for passive correction of patellofemoral incongruence. Although patellar taping may well be effective in controlling anterior knee pain during physical therapy, it does not do so by medializing the patella.

Adolescent↗
PubMedDate not supplied

Patellofemoral malalignment in adolescents. Computerized tomographic assessment with or without quadriceps contraction.

Twenty-seven adolescents with anterior knee pain with or without patellar instability were studied by computerized tomography to detect patellofemoral malalignment. The examination was performed with and without quadriceps contraction with the knee flexed to 15 degrees. Congruence angle, patellar tilt angle, sulcus angle, and trochlear depth were measured. This investigation showed the well-known types of patellofemoral malalignment with quadriceps relaxed (tilted, lateralized, lateralized, and titled patella) and, in 52% of cases, revealed changes in type and severity with quadriceps contraction (in 41%, lateralization and tilting were markedly more evident; in 11%, the type of malalignment changed). The results demonstrate that, in addition to assessment with quadriceps relaxed, computerized tomography with quadriceps contraction is a useful adjunct to diagnose and define the type of malalignment in particularly difficult circumstances.

Adolescent↗
PubMedDate not supplied

First-phase insulin response to intravenous glucose in cystic fibrosis patients with different degrees of glucose tolerance.

The aim of our study was to determine whether first-phase insulin response to intravenous (i.v.) glucose could be used as a simple and rapid test to identify cystic fibrosis (CF) patients at risk to develop diabetes mellitus. Forty consecutive CF patients with normal fasting blood glucose values but with different degrees of glucose tolerance on the standard oral glucose tolerance test (22 with normal glucose tolerance, 16 with impaired glucose tolerance, 2 with diabetes mellitus) and 12 normal subjects, matched for age and body mass index, underwent an i.v. glucose bolus to evaluate early phase insulin release. When compared to the normal subjects, CF patients had significantly reduced basal (76 +/- 50 vs 108 +/- 30 pM/l, 2 p < 0.02) and glucose stimulated insulin levels (1 + 3 min insulin = 456 +/- 275 vs 951 +/- 170 pM/l, 2 p < 0.01). Early phase insulin release, however, did not differentiate between CF patients with normal and impaired glucose tolerance; also in the two diabetic patients insulin levels did not clearly differ from those observed in the other groups of CF subjects. In conclusion, first-phase insulin response may identify an impairment of B-cell function in CF subjects; however, it does not discriminate between different degrees of glucose tolerance, as determined by the oral glucose tolerance test and, therefore, it does not reliably identify those patients who will eventually develop overt diabetes mellitus.

Adolescent↗
PubMedDate not supplied

Changes of elastic fibers in musculoskeletal tissues of Marfan syndrome: a possible mechanism of joint laxity and skeletal overgrowth.

The aim of the study was to analyze by histochemical, ultrastructural, and morphometric methods the musculoskeletal tissues in three humans affected with Marfan syndrome. Histochemical and morphometric data demonstrated that the content of elastic fibers in the perichondrium, periosteum, and knee capsule of the individuals with Marfan syndrome was dramatically reduced in comparison with control tissues. Ultrastructurally the elastic fibers appeared fragmented and indented, because of the presence of discontinuous aggregates of elastin among randomly dispersed filaments. These abnormalities of the articular capsule argue that these fibers could be functionally incompetent to resist normal stress, predisposing to joint laxity. Moreover, alterations in both perichondrium and periosteum seems to support our previous hypotheses about the control of long-bone growth exerted by elastic fibers.

Adolescent↗
PubMedDate not supplied

Safety of conventional drugs and biologic agents for Rheumatoid Arthritis.

While initial researches documented that Rheumatoid Arthritis (RA) patients who took biologic agents had decreased symptoms with those receiving traditional treatment, safety of the drugs remains a concern. The authors in this paper review the safety of the RA new therapeutic approach utilizing biological agents and compare it with the safety of conventional disease-modifying anti-rheumatic drugs (DMARDs).

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Systemic lupus erythematosus and renal involvement: which role of citokines expression?

The role of cytokines in systemic lupus erythematosus (SLE) glomerulonephritis is extremely complex. Proinflammatory molecules, such as TNF, IL-6, IL-1 and IL-18 are upregulated, as are both Thl and Th2 cytokines, with different implications: the local effects may be different from the systemic immunoregulatory ones. Excessive T helper cell function is a hallmark of SLE and abnormalities of Th citokine profiles have been implicated in loss of immune tolerance, increased antogenic load, defective B cell suppression and a variety of clinical manifestations. For some cytokines, TNF and IL-18 in particular, the local proinflammatory ones may be more relevant to the disease.

Cytokines↗
PubMedDate not supplied

[Oral hygiene motivation in orthodontic patients].

The task of the present study has been to verify experimentally if prolonged motivation may produce better oral hygienic conditions in orthodontic patients. Applying oral hygienic index modified, gingival index and saliva lactobacilli's concentration count, the A.A. obtained encouraging data evaluating the motivated subjects situation versus control group.

Adolescent↗