[Intestinal occlusion due to traumatic hernia of the right diaphragm. A case report].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to C Romagnoli.
Explore the source record for details and available documents.
Fifty-two patients, 17 acute and 35 chronic, underwent US of the shoulder. The first class of patients had clinical history of blunt trauma occurred 2 to 30 days before examination. The second class of patients included 15 patients with history of trauma occurred 3 months (or more) before examination and 20 patients affected with impingement syndrome. As to the US signs of rotator cuff tear reported in the literature, the results of the study, supported by arthrographic (21 cases), MR (2 cases) and surgical (24 cases) findings, indicate that their presence and significance differ in the acute and in the chronic patient and that: 1) Focal discontinuity, appearing as a hypoechoic area, is demonstrable only in the acute patient. The sign is due to a tear filled with blood and/or bursal liquid and holds high diagnostic accuracy. It is rare that an acute lesion appears as a hyperechoic linear density--which has doubtful diagnostic accuracy. 2) Non-visualization of the cuff is observable in both the acute and the chronic patient and indicates rupture in both of them. This sign has high diagnostic accuracy. 3) Thinning of the cuff is also observable both in the acute and in the chronic patient. Nevertheless, while in the former the sign can be regarded with confidence as indicating a tear in almost all cases, in the latter it may be due either to a tear or to degeneration. Arthrography or MR Imaging are therefore advisable in this group of patients, especially if surgical treatment is considered.
The aim of the present work is to observe non-neurological morbidity in low-birth-weight-neonates during the first year of life, to define their predominance and to establish whether any correlation between the observed pathologies, gestational age and/or birth weight is evident. Respiratory infectious diseases were the most frequent cause of morbidity starting during the first months life. Anemia and osteopenia were significantly related to gestational age, both occurring with high frequency in babies born before 31 weeks of gestational age. In this gestational age group of neonates birth weight did not influence the incidence of the pathologies studied. On the contrary, morbidity was inversely related to birth weight when neonates of greater gestational age were considered. Candidiasis was significantly more frequent in newborn babies weighing at birth less than 2000 grams. Follow-up programs of low-birth-weight neonates give the opportunity to establish nutritional schedules fit for infants born prematurely and to provide precocious diagnosis and therapy apt to minimize infectious respiratory diseases, so often occurring in these babies.
The pharmacokinetic profile of caffeine was studied in 15 premature infants. Five infants received a single intravenous dose of 10 mg/kg of caffeine citrate 100% at birth and on the 15th day of life. Ten neonates were studied during daily therapy with caffeine for prophylaxis of idiopathic apnea. The time course of plasma and urinary concentrations of caffeine and theophylline shows that caffeine is transformed to theophylline at birth, while total urinary xanthines decrease significantly (p less than 0.001) 72 h after the loading dose given on the 15th day of life. During the whole period of treatment, the decrease in total urinary xanthines and the constant urinary percentage elimination of theophylline are due to further metabolism of theophylline. We confirm that the intravenous loading dose of 10 mg/kg can rapidly obtain therapeutic blood levels of caffeine. We also confirm that the maintenance therapy can be carried out with a single daily dose.
Explore the source record for details and available documents.
In this paper the Authors report their personal experience of the use of exchange transfusion, secondary to classic indication, in the treatment of neonatal hyperbilirubinemia, in order to: 1) determine the trend over the past wears in the number of exchange transfused neonates, both from a global point of view and in relation to indications; 2) critically assess the risks, in terms of complications and mortality, correlated to exchange transfusion. Four hundred and eighty-eight neonates, who were subjected to 693 exchange transfusions in the Pediatric Clinic and Neonatal Division of the Policlinico Gemelli in Roma, were studied over a period of 15 years (1972-1986), according to the following indications: 214 cases of neonatal hyperbilirubinemia with MEN-Rh, 106 cases of neonatal hyperbilirubinemia with MEN-ABO and 168 cases of idiopathic hyperbilirubinemia. The total number of exchange transfused neonates decreased drastically from 304 in the period 1972-76 to 65 in the period 1982-86. The frequency of exchange transfused neonates because of idiopathic hyperbilirubinemia decreased significantly (p greater than 0.001), booth in comparison to the number of live births and in comparison to the number of exchange transfused neonates, probably due to the gradual introduction of phototherapy. The frequency of exchange transfused neonates with iso-Rh and iso-ABO decreased or remained stationary on account of the confirmed relative lesser efficacy of phototherapy on hemolytic jaundice. With regard to mortality and morbidity, 27 out of 488 neonates died during the neonatal period, but only 4 within six hours of exchange transfusion; the majority of those who died had a reduced gestational age and low birthweight, and were affected by a severe associated pathology.
During the first week of life, 400 IU per day of 25(OH)D3 were given to 126 preterm and 112 full-term, small for date newborn infants, while 1000 UI per day of Vitamin D2 were given to 18 preterm and 27 full-term, small for date newborn infants, in order to compare their effectiveness for the prevention of neonatal hypocalcemia. 67 preterm and 67 full-term newborns were included in the control group. The incidence of late hypocalcemia was reduced from 16.4% to 0 in full-term babies and from 6% to 2.4% in preterm babies by the 25(OH)D3 but not by Vit. D2 administration. The incidence of early hypocalcemia was not modified at all. The Authors suggest 25(OH)D3 administration to prevent the late hypocalcemia and, together with calcium support, to treat the early hypocalcemia in the low birth weight newborn.
The serum concentration of phenobarbital used as an anticonvulsant was monitored in 30 preterm babies. The therapeutic serum concentration was achieved with a loading dose of 20 mg/kg i.v., 10 min after administration. Thirty-six hours after loading, it was possible to maintain therapeutic serum levels with a daily intramuscular dose of 5 mg/kg, avoiding toxicity. A comparison of CSF and serum concentrations indicated that the drug passage to CSF is rapid and depends on a brain lesion. Serum monitoring of phenobarbital is important in preterm neonates under 30 weeks gestation and/or with severe pathological complications.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In a randomized prospective study, we investigated the effect of antenatal phenobarbital on neonatal intraventricular hemorrhage in 39 women destined to deliver babies of less than 32 weeks of gestation. The treatment group received an intravenous loading dose of 700 mg of phenobarbital, followed by a daily maintenance dose until delivery. The newborns were treated with phenobarbital for the first 96 h. Ultrasound examinations of the infants' heads were performed. Intraventricular hemorrhage was significantly less frequent in the treated group: 2 of 21 (9.5%) versus 9 of 18 (50%; p less than 0.006). Moreover no severe hemorrhage (grade 3-4) occurred in the treated babies: 0 of 21 versus 5 of 18 (27.7%; p less than 0.01).
The authors report their experience with ultrasound in the examination of the knee in 60 hemophiliacs over a 2-year period. The results prove US to be extremely useful in the demonstration of the hemarthrosis, as well as the synovial involvement, and the articular cartilage of femoral condyles.
Seven patients suffering from renal amyloidosis (2 primitive and 5 secondary) underwent US examination. The results show a strict correlation between US findings and the pathologic changes produced by this condition. US proves to be especially useful in the early stages of the disease: its results, together with the clinical data, may in fact be highly suggestive of the correct diagnosis. On the contrary, in the late stages of renal amyloidosis, when pathologic changes lead to progressive nephrosclerosis, US findings appear aspecific, since they are undistinguishable from the patterns observed in other renal medical disorders.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
During the first week of life serum calcium, phosphorus, magnesium, immunoreactive thyrocalcitonin hormone, and parathyroid hormone concentrations were determined daily in 36 preterm and 29 small for gestational age, full term, healthy infants. Preterm babies with early neonatal hypocalcaemia had significantly higher concentrations of serum thyrocalcitonin hormone in the first four days of life than normocalcaemic preterm babies. Parathyroid hormone concentrations were similar in hypocalcaemic and normocalcaemic infants. In contrast, in the full term group no significant differences were detected in thyrocalcitonin hormone and parathyroid hormone patterns between hypocalcaemic and normocalcaemic subjects. This suggests two different pathogeneses for early hypocalcaemia in low birthweight infants. Hyperthyrocalcitoninaemia seems to be the main determining factor in preterm infants, while a non-hormonal pathogenesis should be considered in full term infants who are small for gestational age.
Echotomographic examinations were performed in 64 patients suffering from thoracic wall, pleural, pulmonary and mediastinal diseases, after preliminary examinations using standard radiographic techniques. The value of echography in the detection and evaluation of the location and extent of the lesion is assessed. Particular stress is placed on the physical difficulties involved in the detection and correct evaluation of the relationship with the adjacent organs. The importance of echography in detecting the type of the lesion is under-lined and the semeiological criteria for its correct location are given.
The incidence of skeletal changes in preterm low-birth-weight infants is rising. This is probably related to today's higher survival rate of these babies. The late positivity of biochemical data and the lack of clinical prognostic signs justify the role of radiology in such pathology. Radiology, however, although useful in detecting rachitic changes, seems to be less sensitive to minimal osteoporotic modifications, for which densitometric studies should be preferred. The authors report their personal experience in 8 cases of skeletal pathology in preterm infants and suggest a radiological follow-up of the skeleton from the 5th to the 12th week of life, whenever a densitometric method is not available.