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Biomedical subjects

C Martinoli

Publications and source records attributed to C Martinoli.

At least 55 records · Page 3Linked to original sources
PubMed1998

Microalbuminuria is an early marker of target organ damage in essential hypertension.

Microalbuminuria has been associated with a cluster of metabolic and nonmetabolic risk factors, suggesting that it might indicate the presence of generalized microvascular damage in patients with essential hypertension. To explore whether microalbuminuria is associated with early target organ damage, two groups of essential hypertensive patients, with (n = 17) (HtAlb+) and without (n = 16) (HtAlb-) microalbuminuria, and a control group (C) of healthy normotensive subjects (n = 20) were studied. The study groups, selected among participants of a large epidemiologic trial, were carefully matched for several potentially confounding variables such as gender, age, duration of hypertension, and body mass index. Albumin excretion rate was evaluated by radioimmunoassay in three nonconsecutive timed overnight collections after 3 weeks of pharmacologic wash-out. Left ventricular mass was assessed by M-B-mode echocardiography, carotid wall thickness by a high resolution ultrasound scan, and renal vascular impedance by Doppler scan. Office as well as 24-h ambulatory pressure monitoring (Takeda TM-2420) were also evaluated. There was no difference between the two hypertensive groups for office and 24-h blood pressure levels except for a lower daytime/nighttime systolic blood pressure ratio in the group with microalbuminuria. Microalbuminuric patients showed signs of early organ damage as compared to normoalbuminuric patients and normal subjects, namely greater left ventricular mass indices (LVMI 167+/-7 g/m2 in HtAlb+; 139+/-9 g/m2 in HtAlb-; 118+/-5 g/m2 in C, P < .001) and increased wall thickness of common carotid arteries (intima plus media thickness 12.5+/-0.2 mm in HtAlb+; 11.7+/-0.3 mm in HtAlb-; 11.2+/-0.2 mm in C, P < .001) as well as higher intrarenal vascular resistance (mean resistive index 0.62+/-0.01 in HtAlb+; 0.59+/-0.01 in HtAlb-; 0.59+/-0.01 in C, P < .05). In conclusion, microalbuminuria is an early marker of diffuse target organ damage in essential hypertension and therefore can be useful to identify patients for whom more aggressive preventive strategies or additional treatment measures are advisable.

Albuminuria↗
PubMed1998

Sonographic evaluation of tears of the gastrocnemius medial head ("tennis leg")

Rupture of the medial head of the gastrocnemius muscle, or tennis leg, is a common lesion affecting middle-aged persons. An imaging examination may be needed to rule out other diseases and assess the severity of the tear. We reviewed the sonographic images of 65 patients with clinically suspected tennis leg. Fifty-one partial and 14 complete tears were diagnosed. Twenty-five patients had follow-up examinations (15 days to 24 months; mean, 45 days). The torn muscle fibers, hematoma, and the reparative process were appreciated by ultrasonography. Ultrasonography may be a useful noninvasive, low-cost modality for diagnosis and follow-up of tennis leg.

Adult↗
PubMed1997

US imaging and color Doppler in patients undergoing inhibitory therapy with calcitriol for secondary hyperparathyroidism.

The aim of this study was to evaluate the changes in volume, structure, and flow pattern of parathyroid glands in uremic patients with secondary hyperparathyroidism treated with long-term intravenous calcitriol (CTL) therapy. Ultrasonography was used to follow-up volume changes occurring in 18 enlarged glands in 11 patients during an 18-month period; in 6 of these cases, 11 glands were followed-up also with color-Doppler to monitor variations in flow pattern. Vascularization was classified using three grades: grade 0 = no color signal; grade I = vessels covering less than 50 % of glandular cross-sectional area; grade II = vascular signals covering more than 50 % of glandular cross-sectional area. No significant changes in volume were demonstrated during the 18 months of follow-up. On the contrary, significant decrease in flow was observed with almost complete disappearance of color-Doppler signals. This finding related well with the observed decrease in parathormone blood levels. Lack of volume changes during medical therapy demonstrates the inability of US alone to monitor the effect of this treatment on the parathyroid glands. Conversely, the observed intraglandular flow reduction indicates the possibility to use color Doppler to monitor the effects of CLT in uremic hemodialyzed patients with secondary hyperparathyroidism. This imaging procedure can be proposed for follow-up of the response of the parathyroid glands to therapy.

Blood Flow Velocity↗
PubMed1997

Superior vena cava stents: Doppler US of the internal mammary veins to detect collateral flow--preliminary observations.

In 12 patients with superior vena cava syndrome secondary to malignant disease, duplex Doppler ultrasound (US) was performed in the internal mammary veins. In all patients, flow was retrograde. After stent placement, flow direction was again antegrade on one side (17%) or both sides (83%). During follow-up in the internal mammary veins, blood flow remained unchanged in 10 patients and retrograde flow recurred in two patients at 2 and 5 months, respectively. In these two patients, helical computed tomography showed stent failure. Successful treatment in one patient normalized the direction of flow in the internal mammary vein. Doppler US in the internal mammary veins allowed accurate evaluation of function of superior vena cava stents.

Collateral Circulation↗
PubMed1997

Elastofibroma dorsi: sonographic findings.

OBJECTIVE: Elastofibroma dorsi is a rare, slow-growing reactive pseudotumor of connective tissue typically located in the subscapular region. We report the sonographic characteristics of three cases of elastofibroma dorsi. CONCLUSION: The sonographic appearance of elastofibroma dorsi consists of arrays of interspersed linear or curvilinear hypoechoic stands against an echogenic background. These findings reflect the alternating pattern of fibroelastic streaks and fat that is also detected with other imaging techniques and found on pathologic specimens. In the proper clinical setting, a prospective sonographic diagnosis can obviate the need for further imaging assessment and biopsy.

Adult↗
PubMed1997

Microalbuminuria: a marker of cardiovascular risk and organ damage in essential hypertension.

Microalbuminuria (Mi) is thought to reflect diffuse vascular damage and to predict cardiovascular morbidity and mortality in essential hypertension, although its pathogenesis remains to be fully elucidated. The relationship between microalbuminuria and several cardiovascular risk factors and target organ damage was evaluated in a large cohort of untreated essential hypertensive patients. Albuminuria was measured as the albumin to creatinine ratio in three non consecutive first morning urine samples. Cardiac damage was evaluated by ECG and retinal vascular changes by direct ophtalmoscopy. In a subgroup of 23 patients with Mi and in a control group of 22 normoalbuminurics, selected from the entire cohort of patients and carefully matched for age, gender, body mass index (BMI) and duration of disease, we also measured left ventricular mass index by M-B mode echocardiography, common carotid wall thickness by high resolution US-scan, and renal vascular resistances by US-doppler of interlobar arteries. K-means cluster analysis performed on the entire cohort of patients showed that microalbuminuria is associated with the presence of an unfavorable risk profile and target organ damage. Furthermore, microalbuminuric hypertensive patients have a larger left ventricular mass index, increased intima media thickness of carotid arteries and higher intrarenal vascular resistances as compared to a well matched group of normoalbuminuric patients. We conclude that in essential hypertension increased urinary albumin excretion can be useful to identify patients for whom more aggressive preventive strategies and/or additional treatment measures are advisable.

Albuminuria↗
PubMed1997

[Computerized tomography-guided neurolytic block of the splanchnic nerve].

CT-guided neurolytic splanchnic nerve block is a technique for relieving abdominal cancer pain; the goal is the alcoholic neurolytic interruption of the sensitive structures in retroperitoneal space. CT yields accurate anatomical detailing and the course for needle placement and alcohol spread. January, 1993, to July, 1996, twenty-one bilateral splanchnic nerve blocks were performed through the posterior access. Forty-eight hours after alcoholization, 14 patients (66%) had complete pain regression; 52% of the patients needed no analgesics for 6 to 54 days and only 9 patients (42%) needed another low opioid therapy. Complications included hypotension and diarrhea in all cases. One had a cardiac arrest and died 8 days after the procedure. There were no other complications. The whole procedure usually lasted 60 min (range: 45 to 90 min). Splanchnic nerve neurolysis is a useful treatment in the patients with severe chronic abdominal pain. It is used as a second line treatment when large lesions change celiac anatomy and complicate the percutaneous block of the celiac plexus.

Abdominal Neoplasms↗
PubMed1996

Primary lymphoma of the mandible with diffuse widening of the mandibular canal: report of a case.

A case of primary non-Hodgkin's lymphoma (NHL) of the mandible with unusual radiographic presentation is reported. The panoramic radiography revealed diffuse widening of the right mandibular canal with ill-defined margins and absence of edge sclerosis. Computed tomography showed infiltration of the superior portion of the canal with involvement of the vestibular cortex of the bone and of the alveolar ridge.

Adult↗
PubMed1996

Interlobular vasculature in renal transplants: a power Doppler US study with MR correlation.

PURPOSE: To evaluate, with power Doppler (PD) ultrasound (US), the normal interlobular vasculature in patients who underwent renal transplantation and to assess if defects of the PD signal at the interlobular level correspond to cortical areas that lack blood perfusion at magnetic resonance (MR) imaging. MATERIALS AND METHODS: Thirty-two normal and 33 malfunctioning transplanted kidneys were studied with PD US (6.5 MHz). PD images of interlobular vessels were graded on a scale of normal (pattern I) and decreasing visualization. In kidneys with focal (pattern II) and diffuse (pattern III) absence of interlobular signal, correlative dynamic MR imaging was performed. RESULTS: Interlobular vessels were consistently depicted with PD US in the proximal cortex of normally functioning transplanted kidneys. Of kidneys with a pattern II appearance, five had no contrast material enhancement in the cortical sites in which the interlobular PD signal was detected and three were contrast enhanced but it was less intense than that in adjacent cortical sites with normal interlobular vasculature. All transplanted kidneys with a pattern III appearance had delayed contrast enhancement. CONCLUSIONS: Although PD US appears to depict the interlobular vasculature up to the renal capsule, care should be taken in the diagnosis of perfusion defects, since absence of detectable flow at the interlobular level does not always correspond to cortical areas that lack perfusion on MR images.

Adult↗
PubMed1996

Imaging of patients with pancreaticobiliary diversion for obesity: post-operative anatomy and findings in small bowel obstruction.

Pancreaticobiliary diversion is a surgical procedure undertaken for obesity. It consists of a distal gastrectomy with a long Roux-en-Y reconstruction, the enteroenterostomy being placed 200 cm distal to the gastroenterostomy and 50 cm proximal to the ileocaecal valve. Three intestinal limbs are recognized: (a) the alimentary loop from the gastroenterostomy to the enteroenterostomy; (b) common loop from the enteroenterostomy to the ileocaecal valve and (c) pancreaticobiliary loop from the duodenum to the enteroenterostomy. The radiological findings in 15 pancreaticobiliary diversion patients with small bowel obstruction were reviewed (15 plain abdominal radiographs, 13 ultrasound (US), 8 CT) and compared with 20 plain abdominal radiographs, 10 US, and 10 CT studies performed for other causes in patients with pancreaticobiliary diversion and 15 CT scans from non-operated patients. After pancreaticobiliary diversion the pancreaticobiliary loop was completely air-free. In the patients operated on more than 1 year previously, alimentary and common loops were significantly larger than the pancreaticobiliary loop and small bowel loops of non-operated subjects. Obstruction of the pancreaticobiliary loop arrests only the flow of pancreaticobiliary secretions with non-specific clinical findings. Plain abdominal radiographs were not diagnostic in all but two cases with radiographically detectable dilated fluid filled loops. Air-fluid levels were never apparent. US and CT showed markedly dilatated intestinal loops and duodenum. Obstruction of the alimentary and common loops presented with symptoms, clinical signs, and radiological findings more typical for bowel obstruction in intact subjects.

Adolescent↗
PubMed1996

Lipomatous tumors of the uterus: ultrasonographic findings in 11 cases.

We reviewed the ultrasonographic findings in eight patients with 11 lipomatous uterine tumors studied with transabdominal (eight cases) and transvaginal (six cases) techniques. A transvaginal color Doppler study was obtained in five patients. Two patients had more than one nodule (two and three uterine nodules, respectively). All lipomatous tumors had regular margins and were hyperechoic. Transvaginal sonography allowed the identification of one small previously undetected tumor but was not able to image the entire extent of two large lipomatous masses. In one case, it helped to establish the actual uterine origin of an eccentric pelvic mass. Color Doppler sonography showed complete absence of flow in all tumors examined. We believe that lipomatous tumors of the uterus can be diagnosed with a high degree of certainty by ultrasonography if a homogeneously hyperechoic avascular mass can be clearly identified to be of uterine origin.

Adult↗