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Biomedical subjects

E Salvati

Publications and source records attributed to E Salvati.

At least 37 records · Page 2Linked to original sources

[Circadian rhythms and depression].

The degree to which nature's cycles influence our body is now obvious, owing to the recent progress of chronobiology. It seems thus that the harmonious internal organization of our circadian rhythms depends on the dual influence of the internal clocks as well as the external temporal informations. These endogenous pacemakers, able to spontaneously generate a rhythmicity the period of which is close to 24 hours, could be triggered by environmental informations, such as light/dark or sleep/Wake cycles, on a 24 hours schedule. The disruption of this entrainment could be involved in major affective disorders. This internal or external desynchronisation seems thus to be the central concept of different models for depression. The internal coincidence model suggests that a phase advance of the strong oscillator in reference to the weak oscillator causes depression. An external coincidence model suggests that depression is caused when light/dark cycle or photoperiod provide too little illumination during a critical photosensitive interval which could be located in the second half of the night. At last, a model comparing the biological rhythms of depressed patients and of healthy volunteers during temporal isolation, suggests that the internal clocks of depressed subjects could be temporarily "blind" to environmental time cues involving internal desynchronisation. These emerging findings should open a new therapeutic approach for depression.

Antidepressive Agents, Tricyclic↗

Guidelines for use of the flexible fiberoptic sigmoidoscope in the management of the surgical patient.

Based on data from many clinical studies and programs, guidelines are presented for application of the flexible fiberoptic sigmoidoscope in the management of the surgical patient. The flexible fiberoptic sigmoidoscope has proved to be an instrument of extraordinary capability in detecting colorectal neoplasms with yields being two or three times greater than those of the rigid sigmoidoscope in the symptom-resolution, polyp and cancer surveillance patient categories. In addition, the practical advantages of the narrow diameter, flexibility, and length of the fiberoptic sigmoidoscope are readily appreciated when the surgeon finds that he can satisfactorily examine patients with rectal or sigmoid strictures, marked angulations, or contracted lumens in whom a rigid scope would be unsuitable. Data from the authors' comparative study of more than 3000 patients have permitted the development of not only guidelines for the application of the flexible fiberoptic sigmoidoscope but an appreciation of the modified role of the rigid sigmoidoscope and the proper relationship between the flexible fiberoptic sigmoidoscope and the flexible fiberoptic colonoscope. A most important consideration is based on data regarding the site distribution of 400 benign premalignant neoplasms detected in the comparative study. The even distribution of these lesions throughout the terminal 50 cm of colorectum underscores the need to examine as much of the colorectum as possible.

Colonic Diseases↗

The postero-lateral approach for total hip prosthesis.

The surgical technique of the postero-lateral approach for total hip prostheses is described. The advantages over the transtrochanteric approach are a smaller blood loss, a shorter operating time and a shorter period of hospitalization. There are no differences in the clinical and radiographic results. The transtrochanteric approach facilitates better biomechanical "reconstruction" of the hip in cases in which the anatomy is abnormal, and is therefore justified in selected cases.

Acetabulum↗

A comparison of cellular immunity in patients undergoing electrocoagulation and resection for adenocarcinoma of the rectum.

Leukocyte migration inhibition assays in patients with carcinoma of the colon and rectum were evaluated in patients treated by electrocoagulation, abdominoperineal resection or low anterior resection and those with Duke's A and B lesions. Assays were performed before treatment, immediately after treatment and two to four months later. No statistically significant differences in cell mediated immunity, measured by leukocyte migration inhibition, were noted between those in the electrocoagulated group and those undergoing resection. However, electrocoagulation does appear to cure some carcinomas of the rectum and does afford a superior quality of survival. It is, however, associated with a higher recurrence rate than resection. Therefore, the decision to use electrocoagulation should not be based upon its effect on immune parameters. Rather, the choice between electrocoagulation, local resection and abdominoperineal resectin is based upon clinical judgment in which the risk of recurrence or metastases must be weighed against a superior quality of survival.

Adenocarcinoma↗

Sigmoidoscopic examinations with rigid and flexible fiberoptic sigmoidoscopes in the surgeon's office: a comparative prospective study of effectiveness in 1,012 cases.

The results obtained from 1,012 examinations in an on-going, cooperative study indicate that the overall yield provided by use of the flexible fiberoptic sigmoidoscope is 3.2 times greater than that of examinations with the rigid sigmoidoscope. More than twice (2.4 times) the number of polyps and more than three times the number of cancers were detected with the flexible fiberoptic sigmoidoscope. Experienced endoscopists can perform an examination with the flexible fiberoptic sigmoidoscope expeditiously in the office with minimal patient preparation, a high level of patient and physician acceptance, and relative safety when the usual mandatory colonoscopic precautions and guidelines are obeyed. The extraordinary advantages demonstrated by this study warrant wide clinical application of the flexible fiberoptic sigmoidoscope. We strongly recommend provision be made for appropriate training of physicians in the use of the instrument.

Colon, Sigmoid↗

Slipped capital femoral epiphyses complicating renal osteodystrophy: a report of three cases.

Three adolescents with bilateral slipped capital femoral epiphyses complicating renal disease are presented. In one case, the severity of the deformities necessitated total hip replacement. Pathological specimens were available for evaluation. In all 3 cases, epiphysiolysis was accompanied by severe subperiosteal reabsorption along the medial aspect of the femoral neck, widening of the cartilaginous growth plate, and coxa vara. The radiographic diagnosis of a minimally displaced femoral epiphysis may precede the clinical symptoms. Early recognition of this complication is important, since the treatment of choice is prophylactic surgical stabilization before disabling deformities occur.

Adolescent↗

Seasonality of suicides: environmental, sociological and biological covariations.

The monthly rates of completed suicides in France from 1978 until 1982 were analyzed. The seasonal variations of environmental (daylight and sunlight durations, mean temperature, geomagnetism), sociological (unemployment, deaths of all causes, birth and conception rates), and biological (melatonin, cortisol and serotonin circannual rhythms) factors were compared to the seasonal patterns of suicides. A clear seasonal variation (with peaks in May and September) in suicidal behavior was detected. These patterns tended to differ as a function of age (bimodal in young, unimodal in old people). The component analysis clearly pointed out that seasonal patterns of suicides may be considered as the sum of two components, unimodal and bimodal. Almost similar covariations were found between the main seasonal (unimodal) component of suicides and environmental (daylight duration and mean monthly temperature) or sociological factors whereas the secondary component was more correlated to variations in environmental factors and, to some extent, to biological parameters.

Adult↗

Antidepressant effects of the sleep/wake cycle phase advance. Preliminary report.

Five patients with endogenous depression were asked to participate in a phase-advance procedure consisting in advancing by 5 h the time schedule of the major external synchronizers such as light/dark, sleep/wake, meal time and social activity cycles. Clinical and biological parameters were observed throughout this 2-week process which followed one night of partial sleep deprivation. All patients improved with partial sleep deprivation and four of the five showed continuing remission during the phase-advance process. The antidepressant effects of the phase-advance process are discussed in light of different chronobiological models for depression.

Adult↗