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Biomedical subjects

B Ricci

Publications and source records attributed to B Ricci.

At least 19 recordsLinked to original sources
PubMed2006

Analgesic effect of watching TV during venipuncture.

AIMS: To assess the analgesic effect of passive or active distraction during venipuncture in children. METHODS: We studied 69 children aged 7-12 years undergoing venipuncture. The children were randomly divided into three groups: a control group (C) without any distraction procedure, a group (M) in which mothers performed active distraction, and a TV group (TV) in which passive distraction (a TV cartoon) was used. Both mothers and children scored pain after the procedure. RESULTS: Main pain levels rated by the children were 23.04 (standard deviation (SD) 24.57), 17.39 (SD 21.36), and 8.91 (SD 8.65) for the C, M, and TV groups, respectively. Main pain levels rated by mothers were 21.30 (SD 19.9), 23.04 (SD 18.39), and 12.17 (SD 12.14) for the C, M, and TV groups, respectively. Scores assigned by mothers and children indicated that procedures performed during TV watching were less painful (p<0.05) than control or procedures performed during active distraction. CONCLUSION: TV watching was more effective than active distraction. This was due either to the emotional participation of the mothers in the active procedure or to the distracting power of television.

Analgesia↗
PubMed2006

[Abdominal emergency surgery in the geriatric patients. Our experience].

The ageing process of general population implies new socio-sanitary problems. Indications for surgical intervention have been modified and enhanced. As far as elective surgery is concerned, the results in elderly subjects do not seem alarming, whereas less satisfactory results have been registered in the patients who underwent an emergency surgical intervention, where nowadays morbidity and mortality still turn out to be high. The Authors have reported their experience of emergency surgery in the geriatric patient. From 1982 to 2002, 718 pts (361 males, 50.3% and 357 females, 49.7%; average age 50 yrs, range 5-92) underwent emergency surgical interventions for abdominal lesions. The pts were subdivided in two groups: group A (> 65 years; 190 pts, 87 males and 103 females; average age 72 yrs, range 66-92); control group B (<65 years; 528 pts, 274 males and 254 females; average age 43 yrs, range 5-65). The results were assessed in terms of morbidity and of the operative and post-operative mortality. Postoperative morbidity proved to be equal to 25.7% (36.3% in the group A, 21.9% in the group B), while intraoperative mortality equal to 0.27%. Postoperative mortality resulted equal to 12.1% (significantly higher in group A pts -- 16.8%- than in group B pts --10.4%). The mortality of the 190 pts belonging to group A was higher in the pts which were presenting respectively 1, 2, 3 or more concomitant diseases. The progressive percentage increase in the number of interventions on elderly pts not only can be due to the demographic increase of old people, but it can also be linked to a change in the surgeon's attitude. At the present time, while elective geriatric surgery implies an acceptable mortality rate (5-8 %), emergency geriatric surgery has not notably modified the prognosis in the last decades and mortality has turned out to be still high (20-30%). We think that it will be possible to obtain better results through geriatric surgery only by reducing emergency interventions as much as possible. In order to do so, it will be important to insist on intervening before the illness, during its natural evolution, requires actions which cannot be postponed. This would lead to positive results not only in terms of mortality and morbidity, which are still considered as the main targets, but also as far as the period of the stay in hospital and costs are concerned.

Abdomen↗
PubMed2006

[Carcinoid tumors of the appendix: when right colectomy?].

Three cases of carcinoid tumour of the appendix (about 0,3 % of all performed appendectomies) has induced the Authors to a review of the literature with the aim to underline the most important biological and pathological findings and the current clinic and therapeutic knowledges. The diagnosis before surgery is rarely made; it is formulated incidentally in most patients by the histological exam during the operation for an appendicitis or during other surgical procedures. The kind of surgical intervention, that is the entity of the surgical demolition, for the treatment of the carcinoid tumours of the appendix is still controversial: appendectomy or right colectomy? It is possible identify, also during the operation for an appendicitis or for other abdominal lesions, criteria that can orient toward a major surgery (size of the neoplasia, subserosal lymphatic invasion, infiltration of the serosa, diffusion in the meso-appendix, location in closeness of the base of the appendix, invasion of the the locoregional lymph nodes, presence of metastases, section ?margins, number of mitoses, cellular pleiomorfism).

Adult↗
PubMed2002

[Role of aortofemoral bypass in the management of unilateral iliac occlusive disease. A follow-up study of 95 patients over a 25-year period].

BACKGROUND: To evaluate the results in a series of patients submitted to aortofemoral bypass due to an unilateral iliac occlusion. METHODS: Retrospective follow-up study. A total of 95 patients underwent, between 1975 and 2000, aortofemoral bypass because of unilateral iliac occlusion. Most of them (71 patients) were claudicants, Fontaine stage II b, while 12 complained rest pain and 12 suffered ischemic ulcers. Mean follow-up was 128 months (min 2.5 - max 292). RESULTS: Immediate success was obtained in 88 cases (92.6%), 7 patients were submitted to early redo with restored patency in 6 cases. One month global patency was gained in 98.9% (94 cases). The mean Ankle-brachial index (ABI) improvement was 0.35. At a mean follow-up of 128 months the cumulative patency was 90.8%. During the follow-up, 15 graft occlusions were observed, followed by 9 successful reoperations achieving a 5-year secondary patency of 92.1%. The contralateral iliac artery evolved toward an occlusion in 10 patients (10.5%) during a long time observation (104 months average). CONCLUSIONS: The unilateral aortofemoral bypass confirmed an excellent long term outcome regarding effectiveness and graft related complications. The low contralateral occlusion rate, in our series, does not justify a more aggressive approach as first surgical option.

Adult↗
PubMed2001

Octyl 2-cyanoacrylate tissue adhesive in experimental scleral buckling.

PURPOSE: In this experimental study, a sutureless scleral buckling was performed by using a tissue adhesive glue to fixate a silicone band to the sclera. In fact, one of the major risks of traditional scleral buckling is accidental perforation of the bulb, which is more frequent when the sclera is extremely thin as it is in newborns or in eyes with high myopia or scleromalacia. METHODS: An encircling band of silicone, which is generally anchored to the sclera itself, was sutured in 36 rabbit eyes to three small silastic patches that had been glued to the sclera, at the level of the equator, using octyl 2-cyanoacrylate tissue adhesive. In this manner the anchoring sutures passed through silicone and silicone. The band was tightened to produce buckling of the sclera and its ends were glued together using the same adhesive. RESULTS: Examination of the eyes from 15 days to 6 months after surgery revealed that the buckle was stable, with no signs of slippage, in 33 eyes. In the remaining 3 (one examined after 15 days, 2 examined after 45 days), one of the three support patches had become detached but there was still no evidence of slippage. CONCLUSIONS: The stability of the buckle up to six months after surgery suggests that this new adhesive might be used for sutureless surgery in certain types of retinal detachment, such as that associated with stage 4 ROP in which the encircling band has to be removed after several months.

Animals↗
PubMed2000

Octyl 2-cyanoacrylate in sutureless surgery of extraocular muscles: an experimental study in the rabbit model.

BACKGROUND: Sutureless surgery for strabismus eliminates the risk of perforating the ocular bulb in patients with extremely thin sclerae. Thus far, however, the results obtained with tissue adhesives such as the cyanoacrylates instead of sutures have been less than satisfactory. METHODS: A new adhesive, octyl 2-cyanoacrylate, was tested in 36 rabbit eyes in which the superior rectus was recessed 5 mm. In 36 other eyes the same operation was performed using 5/0 Vicryl sutures. Animals were killed 1, 3, 5, 15, 30 and 45 days after surgery. One eye from each animal was used for histopathological examination of the reinserted muscle and sclera, while the other was used in a tensiometric test to measure how many grams of weight were needed to detach the muscle from its new insertion site. RESULTS: The tensile strength of the bond achieved with the cyanoacrylate adhesive was 94+/-12 g 1 day after surgery (vs 238+/-19 g in the suture group) and 520+/-24 g after 45 days (vs 576+/-27 g with sutures). No cases of slippage, muscle detachment, or local tissue reactions were observed in either group. There were no differences in histological findings between the eyes of the two groups. CONCLUSIONS: Although further study will be necessary before this technique can be used in humans, our findings indicate that octyl 2-cyanoacrylate is superior to the cyanoacrylate adhesives used in the past in terms of adhesion and holding power; given its favorable toxicity profile, this product may offer interesting applications in the future.

Animals↗
PubMed2000

Oxygen-induced retinopathy in the newborn rat: morphological and immunohistological findings in animals treated with topical timolol maleate.

Oxygen-induced retinopathy (OIR) similar to that seen in premature infants can be produced in newborn rats by exposure to 80% oxygen for the first 5 days of life, with subsequent recovery for 7 days in a room air environment. Previous studies have shown that the latter phase is associated with degeneration of retinal astrocytes. In the absence of astrocytes, the vascular endothelial growth factor (VEGF) is produced by the neurons of the inner retina. In this study, immunohistochemical methods were used to assess retinal expression of VEGF protein in ratlings exposed to the above protocol, with and without simultaneous treatment with topical timolol maleate. Intraocular pressure (IOP) and arterial pressure were measured. The severity of OIR was also evaluated in retinal flat mounts after India ink perfusion. The mean IOP was 8.25 +/- 0.32 mm Hg in untreated ratlings and 5.15 +/- 0.24 mm Hg in timolol-treated animals. OIR in retinas from the timolol group was less severe than that seen in untreated ratlings. VEGF protein expression was almost completely absent in the latter group. Retinas from timolol-treated animals expressed VEGF protein, though the level was inferior to that found in controls raised under room air conditions. In conclusion, these data seem to indicate that experimental OIR can be attenuated by a reduction of the IOP during and after oxygen supplementation. It is possible that these effects are due to improved ocular perfusion pressure, which would mitigate the hypoxic insult to the retina during the room air recovery period.

Administration, Topical↗
PubMed1999

Intraocular pressure in premature babies in the first month of life.

PURPOSE: The purpose of this work was to study the values of intraocular pressure (IOP) in premature babies during the first month of life. METHODS: Using a hand-held applanation tonometer, IOP was measured in 40 eyes of 20 preterm infants (gestational age ranging from 26 to 32 weeks) shortly after birth and at weekly intervals for the first month of life. RESULTS: IOP values in preterm infants ranged from 7.6 to 18.3 mm Hg. The mean IOP decreased during the study period from 13.25+/-2.86 mm Hg to 10.96+/-2.01 mm Hg (P< .001). CONCLUSIONS: Although the values of IOP found in this study are by no means within the range that is considered to be pathologic for newborns, the possible lack of the decreasing tendency of IOP observed during the first month of life could have, in a given case, some clinical implications. Because systemic blood pressure in preterm infants is already quite low, even a moderately elevated IOP during the first weeks of life might in some cases result in a significant reduction of the ocular perfusion pressure. The latter might play a contributory role in the development of retinopathy of prematurity by decreasing the blood supply to the peripheral retinal tissues.

Circadian Rhythm↗
PubMed1999

Refractive errors and ocular motility disorders in preterm babies with and without retinopathy of prematurity.

Ocular motility, refraction and visual acuity (VA) were evaluated at the age of 4 years in 136 preterm infants with gestational ages (GAs) at birth of less than 32 weeks. Group 1 (non-retinopathy of prematurity, ROP) included 87 children that had never developed ROP. Group 2 contained 19 children whose ROP had regressed spontaneously. Group 3 (cryo-ROP) was composed of 30 patients who had undergone cryotherapy for severe ROP. Strabismus was found in 13.9% of the total population. chi(2) analysis revealed that strabismus was significantly (p < 0.01) associated with prematurity (i.e. GA <29 weeks), ROP and cryotherapy. Myopia of more than 3 dpt was significantly (p < 0.001) more common in the cryo-ROP infants than in the regressed-ROP and non-ROP groups. The distribution of hypermetropia was similar in all three groups. VA was measured with the E chart. Of the 272 eyes examined, 251 (92.3%) displayed VA of more than 20/25. The majority of these eyes were from the non-ROP group (65.4%), 15.3% had regressed ROP and 21.1% belonged to the cryo-ROP group. Fifteen eyes (8 non-ROP, 3 regressed ROP and 4 cryo-ROP) presented VAs between 20/25 and 20/60. VA of less then 20/60 was found in 6 eyes (2 non-ROP, 1 regressed ROP, 3 cryo-ROP). Cryotherapy did not appear to preclude the development of good VA.

Child Development↗
PubMed1998

An MTP inhibitor that normalizes atherogenic lipoprotein levels in WHHL rabbits.

Patients with abetalipoproteinemia, a disease caused by defects in the microsomal triglyceride transfer protein (MTP), do not produce apolipoprotein B-containing lipoproteins. It was hypothesized that small molecule inhibitors of MTP would prevent the assembly and secretion of these atherogenic lipoproteins. To test this hypothesis, two compounds identified in a high-throughput screen for MTP inhibitors were used to direct the synthesis of a highly potent MTP inhibitor. This molecule (compound 9) inhibited the production of lipoprotein particles in rodent models and normalized plasma lipoprotein levels in Watanabe-heritable hyperlipidemic (WHHL) rabbits, which are a model for human homozygous familial hypercholesterolemia. These results suggest that compound 9, or derivatives thereof, has potential applications for the therapeutic lowering of atherogenic lipoprotein levels in humans.

Alanine Transaminase↗
PubMed1998

Iris vascular changes in newborns of diabetic mothers.

Routine ophthalmic examinations of 600 full-term neonates, including 54 born to mothers with insulin-dependent diabetes mellitus and 12 whose mothers had developed gestational diabetes, revealed significant tortuosity and dilatation of the iris vessels in over half of the infants born to diabetic mothers. Ninety percent of the newborns in the diabetic group presented hypoplasia of the iris stroma and pupil dynamics were altered in 85%. The vessel changes resolved spontaneously within 2 weeks after birth. These changes, which have also been observed in cocaine-intoxicated newborns, should raise the suspicion of adverse vascular effects in the fetus caused by maternal diabetes.

Adult↗
PubMed1998

An ultrasonographic study of stage-5 retinopathy of prematurity.

BACKGROUND: In preterm infants with severe retinopathy of prematurity, there is often a discrepancy between ophthalmic ultrasound findings and the ophthalmoscopic and/or intraoperative aspect of the eye. METHODS: Six preterm infants (8 eyes) with stage-5 retinopathy of prematurity were examined with standardized ophthalmic echography (A and B scans) shortly before undergoing open-sky vitrectomies. Sonographic findings were evaluated according to four A-scan and four B-scan criteria used to diagnose retinal detachment in adults and compared to intraoperative findings. RESULTS: Although the retinal detachments and vitreal proliferation found in all 8 eyes at surgery were almost identical, the sonographic aspects varied widely: 3/8 satisfied most of the criteria used in adults, 3/8 presented two criteria only and the remaining 2 were negative for all criteria used. CONCLUSION: The variability in the ultrasonographic aspects of these preterm eyes may depend on the degree of maturity of the preterm retina at the time of examination, with more mature retinas presenting greater reflectivity and therefore greater visibility in the sonographic exam.

Female↗
PubMed1998

Vulvar hemangiopericytoma. Case report.

A rare case of a hemangiopericytoma of the vulva, observed in a 55-year old woman, is presented. So far, only six cases of this uncommon disease--which continues to be a source of uncertainty from both a prognostic and therapeutic point of view--have been reported. The case is described along with a review of international literature.

Female↗
PubMed1997

[Extension and features of parks and gardens around spas in Italy: explorative census; possible therapeutic usefulness II].

There are described the results of a census about parks and gardens own to 27 italian Spas. The considerable areas of green around Spas, the correct ratio whith the number of subjects in thermal treatment and other arguments represent favourable elements for italian medical Hydrology. In our census the found plants generally are in conformity with their correct geographical placing. Moreover they are in order to cause favourable effects for environmental Psychology and Therapeutics. The species of recommended plants for the increase and for improvement of green around italian Spas are mentioned. The importance of green around Spas in thermal Medicine and in Ecology is stressed.

Balneology↗
PubMed1996

An inhibitor of the microsomal triglyceride transfer protein inhibits apoB secretion from HepG2 cells.

The microsomal triglyceride (TG) transfer protein (MTP) is a heterodimeric lipid transfer protein that catalyzes the transport of triglyceride, cholesteryl ester, and phosphatidylcholine between membranes. Previous studies showing that the proximal cause of abetalipoproteinemia is an absence of MTP indicate that MTP function is required for the assembly of the apolipoprotein B (apoB) containing plasma lipoproteins, i.e., very low density lipoproteins and chylomicrons. However, the precise role of MTP in lipoprotein assembly is not known. In this study, the role of MTP in lipoprotein assembly is investigated using an inhibitor of MTP-mediated lipid transport, 2-[1-(3, 3-diphenylpropyl)-4-piperidinyl]-2,3-dihydro-1H-isoindol-1-o ne (BMS-200150). The similarity of the IC50 for inhibition of bovine MTP-mediated TG transfer (0.6 microM) to the Kd for binding of BMS-200150 to bovine MTP (1.3 microM) strongly supports that the inhibition of TG transfer is the result of a direct effect of the compound on MTP. BMS-200150 also inhibits the transfer of phosphatidylcholine, however to a lesser extent (30% at a concentration that almost completely inhibits TG and cholesteryl ester transfer). When BMS-200150 is added to cultured HepG2 cells, a human liver-derived cell line that secretes apoB containing lipoproteins, it inhibits apoB secretion in a concentration dependent manner. These results support the hypothesis that transport of lipid, and in particular, the transport of neutral lipid by MTP, plays a critical role in the assembly of apoB containing lipoproteins.

Animals↗
PubMed1996

Scleral buckling surgery in stage 4 retinopathy of prematurity.

BACKGROUND: Technical advances in neonatal intensive care have significantly increased the number of very low birth-weight babies that survive the perinatal period. Some of these infants develop severe retinopathy of prematurity that may lead to retinal detachment. METHODS: Between November 1988 and January 1994, 28 eyes from 15 preterm babies underwent scleral buckling for stage 4 retinopathy of prematurity at a mean age of 4.2 months. Cryotherapy was performed preoperatively on 12 eyes and intraoperatively in the remaining 16 eyes. The mean follow-up period was 35 months. RESULTS: Scleral buckling produced retinal reattachment in 13 eyes (46.4%). Severe myopia (-5 D to -15 D) was found in all 13 of these eyes, 12 also presented convergent strabismus. Mean visual acuity, measured in 6 eyes from children over the age of 3 years was 20/40. In 7/28 eyes of the younger children of this group we found a fix and follow the light capability. No light perception was detected in 11/28 eyes; in the remaining 4/28 eyes there was only light perception. Scleral buckling failed to prevent the progression to stage 5 in 15 eyes (53.6%). Additional surgery was excluded for 9 of these eyes based on ultrasonography findings; the other 6 eyes underwent vitrectomy, which led to macular reattachment in 4 cases. CONCLUSIONS: Clinical experience shows that scleral buckling is not always capable of preventing progression of the disease to stage 5. Furthermore, even when the anatomic results of this procedure are good, the functional outcome is often complicated by severe visual impairment.

Birth Weight↗