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Biomedical subjects

E Ferrari

Publications and source records attributed to E Ferrari.

At least 127 records · Page 7Linked to original sources
PubMed1995

Continuous wave Nd:YAG laser photocoagulation in proliferative diabetic retinopathy.

AIMS: The therapeutic efficacy of the continuous wave (CW) Nd:YAG laser (working in the free running mode) was investigated in proliferative diabetic retinopathy (PDR) comparing it with a conventional laser source such as the krypton laser. METHODS: Twenty four eyes of 12 patients affected with bilateral PDR were included and divided in two groups. The right eyes were treated with a red krypton laser and the left eyes with a CW Nd:YAG laser. RESULTS: Three months after krypton photocoagulation 10 eyes showed a reduction or a complete regression of PDR and two eyes were unchanged. In the CW Nd:YAG laser group no eyes showed any regression of new vessels, in seven eyes the angiographic features were unchanged, and in five eyes they worsened. All the eyes of the second group underwent retreatment with the krypton laser after 3 or 6 months. After a mean follow up of 13 months all eyes in the krypton group showed a reduction or complete regression of PDR; in the retreated group 10 eyes improved and two were unchanged. CONCLUSIONS: The statistical analysis showed a highly significant difference (p = 0.001) between krypton and CW Nd:YAG laser which indicated the lack of efficacy of the latter in the treatment of PDR. In the krypton laser group no significant difference (p = 0.05) after the retreatment was found confirming the efficacy of this treatment.

Adult↗
PubMed1995

Neuroendocrine correlates of the aging brain in humans.

Physiological brain aging is characterized by important biochemical and structural changes and by the unbalance among the different neurotransmitters and neuromodulators. The study of the circadian organization of neuroendocrine functions may be considered a clinically reliable tool to investigate the changes of the CNS and particularly of the limbic-hypothalamic system occurring in aged people. The circadian rhythms of plasma melatonin, ACTH and cortisol and of oral temperature were studied in 16 clinically healthy women aged 66-90 years and in 14 young controls aged 20-30. In addition, the effect of dexamethasone on the plasma cortisol circadian rhythm and the cortisol response to Synacthen pulse intravenous injection were evaluated. All subjects were studied as inpatients, with the same synchronization to the hospital life schedule. When compared with young controls, elderly subjects exhibited a reduction of the mean level and of the amplitude of the circadian rhythm of oral temperature, an increase of the mean level of ACTH and cortisol rhythms and a selective impairment of melatonin nocturnal secretion. Furthermore, elderly subjects showed a reduced sensitivity to the dexamethasone suppression test, by comparison to young controls. These changes were age-related and they may depend either on CNS modification or on alterations of the hormonal metabolic clearance.

Adrenocorticotropic Hormone↗
PubMed1995

IDDM in the province of Pavia, Italy, from a population-based registry.A descriptive study.

OBJECTIVE: To report the incidence of insulin-dependent diabetes mellitus (IDDM) in the Province of Pavia, Italy, in the 0- to 29-year-old age-group between 1988 and 1992. Urban versus rural residence, socioeconomic level, and family size of IDDM cases were also investigated. RESEARCH DESIGN AND METHODS: A prospective register was established in 1988 to collect all newly diagnosed IDDM patients with onset before 30 years of age. The primary data source was based on notification of new cases by hospitals, out-patient clinics, family doctors, and pediatricians. The secondary and independent data source consisted of the registries of prescriptions for insulin syringes in the health districts of the province. RESULTS: In 5 years (1988-1992), 66 cases of IDDM in the 0- to 29-year-old age-group were identified. The completeness of ascertainment was 100% for the combined sources. Age-adjusted (world-standardized) incidence rates per 100,000 (95% confidence interval) were 9.52 (6.42-13.61), 6.72 (4.68-9.34), and 8.27 (6.42-10.58), respectively, for the age-groups 0-14, 15-29, and 0-29. The rates were higher for residents in urban areas. The number of children in the families of IDDM patients was significantly higher than in the reference population. CONCLUSIONS: Our data indicate the concordance of IDDM incidence rates with the North-Italian rates and a possible association of the disease with environmental factors. These factors might enhance the susceptibility to IDDM in genetically predisposed individuals.

Adolescent↗
PubMed1995

[Refractory sinus tachycardia: late complication of radiotherapy].

The authors describe a case of sinus tachycardia, an unusual cardiac complication of mediastinal radiotherapy; occurring in two patients by the first days of treatment and persisting for several years. No other cause for this tachycardia could be detected in either case. Electrophysiological investigation of one of the two patients was normal. Despite the risk of a high-degree conduction disorder, "symptomatic" beta-blocker treatment was prescribed, but only induced a limited effect.

Adult↗
PubMed1995

[Pulmonary hypertension caused by talcoma in a couple of drug addicts].

The authors report a case of severe pulmonary hypertension (PHT) in a couple of HIV seropositive heroin addicts. The parallel clinical course in these two patients with only mild immunodeficiency and the fact that they both had the same supplier were in favour of PHT secondary to talcoma. In the light of these cases, one wonders whether, as suggested by certain epidemiological studies currently underway, drug addiction should be considered to be a cause of PHT in its own right. According to the authors, this approach would underestimate the incidence of this disease in this particular population and would therefore bias the epidemiological data.

Adult↗
PubMed1995

[Duration of antivitamin K therapy in venous thromboembolic disease].

The necessity for anticoagulant treatment after pulmonary embolism or deep vein thrombosis has been demonstrated. The modalities of this treatment have been established, especially the value of initial heparin relayed by oral antivitamin K therapy with a target INR value between 2 and 3. The last question remaining in this protocol is that of the duration of anticoagulant treatment. The choice of duration of anticoagulation should take into consideration two potential complications: haemorrhage due to over-anticoagulation and excessive duration of therapy, and recurrent thromboembolism which could result from an inadequate duration of therapy. Several trials have addressed this question and have led to a consensus of opinion: therefore, secondary venous thrombo-embolic disease, occurring under known, special circumstances, the cause of which has been treated, should be given 4 to 6 weeks anticoagulant therapy. In the other cases, so-called idiopathic venous thromboembolism (the proportion of which is on the increase), recent studies are inadequate to reach a consensus. These "idiopathic" forms are characterised by a higher incidence of recurrent thromboembolism of "secondary" cancer and coagulation abnormalities. The search for the optimal duration of anticoagulant therapy in these forms requires prospective trials taking their features into account and should lead to further therapeutic options. The evaluation of longer treatment protocols with less intensive degrees of anticoagulation and of alternatives to oral vitamin K antagonists is justified.

Anticoagulants↗
PubMed1995

Changes in the amplitude of the N30 frontal component of SEPs during apomorphine test in parkinsonian patients.

Somatosensory evoked potentials (SEPs) to median nerve stimulation have been performed before and after apomorphine-test in 10 parkinsonian patients. Latency and amplitude of the P14-N20 parietal complex and of the P20-N30 frontal complex were evaluated. The N30 amplitude was significantly reduced before apomorphine administration (p < 0.001) with a consequent increase of the N20/N30 amplitude ratio (p < 0.001). Eight patients clinically improved after Apomorphine. Following Apomorphine there was no change in the amplitude of the parietal complex P14-N20. On the other hand the frontal complex P20-N30 showed a significant amplitude potentiation (p < 0.005), with a reduction of the N20/ N30 amplitude ratio (ns). This finding was almost constant among the 8 responder patients. These results suggest the utility of combining clinical and neurophysiological data to assess the responsiveness to dopaminergic treatment.

Adult↗
PubMed1995

[Epidemiology of pulmonary embolism].

There are few conditions in medicine as difficult to diagnose as pulmonary embolism. This is certainly not due to the rarity of the disease which is probably as common as myocardial infarction in France. The circumstances surrounding pulmonary embolism and the risk factors of deep venous thrombosis have been well identified. The risk of thromboembolic venous disease has been assessed for each type of surgery. The methods of treatment and prevention have progressed over a number of years. However, in practice, these advances have not "transformed" the frequency of the disease or reduced its mortality. Further progress could come from improved identification of patients at risk, especially by biological tests and new abnormalities of blood coagulation.

Adult↗
PubMed1994

[Transesophageal echocardiography in the etiological evaluation of ischemic cerebral vascular accidents. Value in young subjects].

OBJECTIVES: We conducted this study to evaluate the role of transoesophageal echocardiography in the aetiologic diagnosis of ischaemic cerebral vascular events in young subjects. METHODS: Over a 16-month period, 70 consecutive patients under 55 (mean age 49 years; range 32-55; 34 females, 36 males) underwent transoesophageal echocardiography as part of a complete work-up after a recent (< 1 month) cerebral event considered to be ischaemic in nature. Exclusion criteria were age over 55, vascular stenosis or ulcerated plaque, embologenic heart disease and valve prosthesis. 24-h Holter recordings were also obtained in all patients. RESULTS: The cerebral event was temporary in 11 subjects and permanent in the other 59. The ischaemic nature of the event was confirmed in all patients with computed tomography or magnetic resonance imagery. All patients were in sinus rhythm at examination and supraventricular paroxysmal arrhythmia was observed in 7 during the Holter recordings. The transoesophageal echocardiography was normal in 37 patients (52%) and pathologic in 33 (48%). The source of the embolus was identified in 4 cases (6%) and the probable cause of the cerebral event was found in 29 (42%). Among the abnormal structures observed were permeable oval foramens, inter-atrial septum aneurysms and plaques on the ascending aorta. CONCLUSIONS: In our selected population of patients under 55 years of age, transoesophageal echocardiography detected the certain or probable source of the ischaemic cerebral event in 48% of the cases, a diagnostic yield better than most other methods. Nevertheless, there is no known therapeutic response to several of the potential sources of embolus observed.

Adult↗
PubMed1994

Proton magnetic resonance spectroscopy in patients with ischemic stroke.

Proton magnetic resonance spectroscopy (1H-MRS) is a non-invasive technique which has proved to be useful for monitoring various brain metabolites (N-acetyl-aspartate, choline, creatine-phosphocreatine, lactate). A total of 18 patients underwent a combined magnetic resonance imaging (MRI)/1H-MRS protocol in order to evaluate the distribution of the metabolites in the various stages of cerebral ischemia. Our results show a marked decrease of N-acetyl-aspartate and a large content of Lactate during the early phases, and a decrease in N-acetyl-aspartate, choline and creatine-phosphocreatine (Cr-PCr) during the chronic phase.

Adult↗
PubMed1994

The value of aspiration needle biopsy in evaluating thyroid nodules.

From 1980 to 1990 4,229 consecutive euthyroid patients with thyroid nodule (73% with single and 27% with multiple nodules) were examined by FNA cytology for preoperative selection. One thousand four hundred and eight of these patients (33%) had nodules also suitable for evaluation by large needle biopsy histology (Aspiration Needle Biopsy, ANB). No significant complications occurred following ANB. The proportion of inadequate specimens was 25% for ANB and 15% for FNA, however a definite diagnosis was obtained with ANB in 62 patients with inadequate FNA finding. Diagnostic sensitivity was higher (93%) for FNA than for ANB whereas specificity was better (82%) for ANB diagnoses. Nonetheless ANB contributed to the increase of overall sensitivity as four of all the malignant nodules diagnosed as benign by FNA were correctly identified by ANB. Analysis of the postoperative results of 102 nodules with FNA and ANB finding of benign nodule or of suspected cancer showed that the addition to the same FNA finding (benign nodule or suspected cancer) of a different ANB diagnosis (suspected cancer or benign nodule) greatly changed the probability of finding a malignant nodule at postoperative histology. ANB was also useful in showing a macrofollicular component in 52% of 150 nodules diagnosed by FNA as pure microfollicular nodules.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗