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Biomedical subjects

C Giusti

Publications and source records attributed to C Giusti.

178 records · Page 10Linked to original sources
PubMedDate not supplied

[Diabetic retinopathy: medical-legal implications and statistical assessment of 341 type 1 and 2 diabetic patients].

As a result of its asymptomatic nature and its aetiopathogenesis, still unclear in its multifactorial complexity, DR-related blindness has a growing socioeconomic impact in industrialized countries. In this study, the authors performed a statistical analysis on a group of 341 type 1 and type 2 diabetic patients with special consideration to the medico-legal implications of this serious ocular disease.

Adult↗
PubMedDate not supplied

[Central serous chorioretinopathy: a new extragastric manifestation of Helicobacter pylori?: Analysis of a clinical case].

Central serous chorioretinopathy is classically characterized by a shallow, round, serous detachment of the macular retina. It preferentially affects men between 20 and 45 years of age and recurrences have been documented in most cases. Although the aetiopathogenesis of the disease is still unknown, it has been thought to be due to a focal leakage from one or more defects in the retinal pigment epithelium, which allow serous fluid from the choriocapillaris to diffuse into the subretinal space. Moreover, it is theorized that damage of the active fluid transport mechanisms through the retinal pigment epithelium may also play a contributing role. Finally, the reported correlation with psychophysical stress provides support for the concept of the disease being "adrenergically conditioned". Recently, an interesting association has been observed between this chorioretinal pathology and the Helicobacter pylori infection and, consequently, a new etiological hypothesis has been proposed. Here we report a retrospective analysis of a clinical case of central serous chorioretinopathy with Helicobacter pylori positivity.

Adult↗
PubMedDate not supplied

Novel diagnostic and therapeutic approaches to the diabetic retinopathy.

Diabetic retinopathy is a common cause of vision loss in industrialized countries and it is now evident that adequate screening protocols can identify the disease at an earlier, more treatable stage. Novel imaging techniques and therapeutic strategies, developed during the past few years and critically reviewed in this paper, may not only increase the standard quality of actual eye care but may also improve access to ophthalmological examinations and compliance with the eye care guidelines for all diabetic patients.

Diabetes Mellitus↗
PubMedDate not supplied

[The vitreous and vitreoretinal interface: natural history and associated retinal diseases].

Such significant correlations have been found between vitreal changes and retinal breaks that retinal detachment is now considered as a vitreoretinal disease. Concerning this issue, not only the posterior vitreous detachment seems to play an important role in the occurrence of rhegmatogenous retinal detachment but also the vitreoretinal interactions themself seem to be important in the pathogenesis of cystoid and diabetic macular edema, proliferative diabetic retinopathy, age-related macular degeneration, macular pucker, idiopathic macular hole and macular disease associated with optic disk pit. It seemed therefore useful to the author an updated review on alterations of the vitreoretinal interface and associated ocular diseases.

Humans↗
PubMedDate not supplied

Deflazacort treatment of cystoid macular edema in patients affected by Retinitis Pigmentosa: a pilot study.

BACKGROUND: To investigate the efficacy of a long-term treatment with Deflazacort (DFZ), a third generation synthetic glucocorticoid, in patients affected by Retinitis Pigmentosa (RP) complicated by Cystoid Macular Edema (CME). METHODS: A randomized group of 10 RP subjects were selected for this pilot study and treated with DFZ for one year according to a standard protocol. Far and near Best Corrected Visual Acuity (BCVA), fluorescein angiography (Heidelberg Retina Angiograph) and computerized perimetry (Humphrey Visual Field Analyzer) were statistically assessed. RESULTS: Near visual acuities, fluorescein angiographic findings and perimetric data improved significantly (p < 0.01) while far BCVA varied only slightly (p < 0.05). No ocular or systemic side effects were recorded. CONCLUSIONS: Further case-control studies, also involving a larger number of patients, are required to confirm these preliminary results. However, the present investigation seem to suggest that DFZ could be effective in reducing fluorescein angiographic findings and improving perimetric data and near visual acuities in RP patients, even though the pathogenesis of CME remains poorly understood.

Adult↗
PubMedDate not supplied

[Retinal complications of posterior vitreous detachment: retrospective analysis of 3 clinical cases].

Posterior vitreous detachment is an irreversible consequence of vitreal aging and will be encountered even more frequently as the population grows older. Because vitreous detachments are not always complete and clean, associated retinal complications may develop. Patients should be carefully examined at initial symptoms in order to diagnose and treat possible retinal injuries as soon as possible. Here we report a retrospective analysis of three different retinal complications of posterior vitreous detachment.

Aged↗
PubMedDate not supplied

Clinical pathogenesis of macular holes in patients affected by retinitis pigmentosa.

BACKGROUND: To define the main clinical mechanisms involved in the pathogenesis of macular holes (MH) in patients affected by Retinitis Pigmentosa (RP). METHODS: 236 RP subjects were enrolled in this study and ophthalmologically examined according to a standard FIARP (Italian Federation of the RP Associations) protocol. The prevalence of posterior vitreous detachment (PVD) as well as all types of RP-related macular abnormalities--especially vitreoretinal interface alterations (VRIA), cystoid macular edema (CME), "bull's eye maculopathy" (BEM) and MH--was reported; statistical analyses and correlations were assessed by means of Student t test and Pearson chi2. RESULTS: VRIA and CME were observed in 26.15% and 9.45% of the cases respectively and resulted significantly associated with MH, since they were constantly present in 22 of the 25 eyes affected by MH (88%) (chi2 = 50.4; p < 0.01). In particular, in 9 of these cases (40.9%) MH was correlated to both CME and VRIA, while in 11 (50%) and 2 (9.1%) eyes CME or VRIA were present separately. A normal biomicroscopic macular appearance, PVD and BEM were found in 26.81%, 6.6% and 21.54% of the cases respectively. CONCLUSIONS: Further studies involving a larger number of patients are required to complete these preliminary results. However, the present investigation seem to confirm the data already reported in the literature, i.e. that pathogenesis of MH in RP is strictly correlated to the presence of VRIA, cellophane maculopathy and cystic foveal degeneration with CME.

Adult↗
PubMedDate not supplied

Potential implications for pathophysiology in a type 1 diabetic patient affected by Stargardt disease.

PURPOSE/METHOD: To present a 35-year-old woman affected by type 1 diabetes mellitus, Stargardt maculopathy and fundus flavimaculatus. To our knowledge, this association is unusual and not yet described in the ophthalmic literature. RESULTS/CONCLUSIONS: Visual acuity was reduced to < 20/200 in both eyes, color vision was absent and computerized perimetry showed an absolute central scotoma. Pattern visual evoked potentials and electroretinogram (ERG) (scotopic, photopic and flicker) were considerably reduced in amplitudes. Full-field ERG was within normal limits whereas oscillatory potentials were reduced in number and amplitude. Fluorescein angiography confirmed the diagnosis of Stargardt maculopathy and fundus flavimaculatus but no diabetic retinopathy was clinically evident. Potential interactions between the diabetic microangiopathy and the retinal degenerative disorder are hypothesized and discussed.

ATP-Binding Cassette Transporters↗
PubMedDate not supplied

The abortive form of Bourneville-Pringle syndrome.

BACKGROUND/METHODS: To present a 26-year-old woman affected by the abortive form of Bourneville-Pringle syndrome. To our knowledge, this disease is unusual since only very few cases have been reported in the scientific literature at this time. RESULTS/CONCLUSIONS: Visual acuity was 20/20 in both eyes. No relevant ocular abnormalities were observed excepting two retinal hamartomas, a smaller one in the nasal midperiphery of the right eye and a larger one located along the super-temporal retinal vessels of the left eye. Classical signs of Bourneville-Pringle disease, such as mental retardation and epilepsy, were absent whereas a slight facial adenoma sebaceum and renal cysts represented the solely systemic manifestations of the disease. This case report confirms that retinal phakomata are a typical manifestation of Tuberous Sclerosis, even in the absence of a detected involvement of the brain.

Adult↗
PubMedDate not supplied

[Effects of physical activity on the cardiovascular autonomic function in the aged].

The objective of this trial was to evaluate whether cardiovascular vagal-sympathetic relationship, which is expected to be decreased in the elderly, can be modified by physical activity performed in advanced age. Cardiovascular autonomic function, as assessed by heart rate and arterial blood pressure during lying to standing, deep breathing, handgrip isometric stress test and Valsalva manoeuver, was estimated through Ewing's test in 10 sedentary healthy elderly subjects (mean age 68 +/- 3.1) compared to 10 long-distance runners of the same age (mean age 69 +/- 4.6). The endurance athletes, suitable for competition, had been practicing sport activity for a long time. Moreover in order to evaluate the influence of physical activity on cardiovascular response to exertion in the elderly all subjects were submitted to maximal electrocardiographic exercise test on a cycloergometer (multistage program with 30 watt x 3 min. steps). Heart rate, arterial systolic and diastolic blood pressure were recorded; double product was calculated at baseline; furthermore, total and maximal watts were recorded. For each of the parameters, Student's "t" test for independent observations was used in order to evaluate statistical differences among the two groups. Our data exhibited better results in cardiovascular reflex response due to parasympathetic (Valsalva and deep breathing test) neurovegetative modulation in the trained subjects with respect to the sedentary controls: Valsalva ratio (VR) = 2.04 +/- 0.44 vs 1.40 +/- 0.18 p < 0.001); deep breathing test (FC) = 23.6 +/- 6.2 vs 15.1 +/- 2.5 p < 0.01.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[The pancreas in diabetes mellitus. The echographic aspects].

Forty patients with diabetes mellitus (25 with insulin-dependent and 15 with non-insulin dependent diabetes) were studied by means of US in order to evaluate possible volumetric alterations in the pancreas and their eventual progression over time. Thirty healthy subjects were also studied as a control group. The following variables were recorded: thickness of the head, body and tail of the pancreas and area of its head. The patients were also divided into 5 groups according to the age of diabetes (< 1, > 1, > 7, > 14, > 21 years). The results showed 25 IDDM patients to exhibit significant reduction in these variables relative to controls (p < = 0.01), especially in the body (average reduction -40%) and tail (average reduction -20%) of the pancreas. NIDDM patients exhibited non-significant reductions in pancreatic size. The study of the 5 groups of IDDM patients, divided according to the duration of diabetes, revealed all pancreatic variables to reduce more than in controls within a year since diagnosis, to exhibit relative increase during the next 7 years and finally to reduce again in the following years. These results show that anatomic damage to the pancreas occurs within the first year of diabetes. Moreover, IDDM was seen to alter the normal proportions among the single anatomic structures forming the pancreas, especially relative to two anatomic ratios--i.e., head/body and tail/body pancreatic thickness. The relative values in IDDM patients were markedly higher than those in controls (p < 0.001). The patients were again divided into 5 groups according to the age of diabetes: the values of the above ratios in the course of diabetes greatly differed from those observed in controls--i.e., they increased within the first year of diabetes, were steady during the next 7 years, and returned to normal values after 21 years of diabetes, which meant the return to the normal anatomic ratios among the three parts of the pancreas.

Adolescent↗