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Biomedical subjects

G Paludetti

Publications and source records attributed to G Paludetti.

At least 91 records · Page 5Linked to original sources

40-Hz auditory event-related potential in normal adults.

40-Hz event-related potentials (AERP) in response to 0.5-, 1-, 2- and 4-kHz tone pips were studied in 45 subjects (18 males and 27 females) in order to assess their reliability and threshold in normal adults and to study the effects of stimulus frequency and intensity on their latency and amplitude. In all subjects well-formed and reproducible 40-Hz AERP were detected, thus showing a good reliability of 40-Hz AERP to tone pips. The response was always detectable within 15 dB nHL intensity level and showed a sequence of positive (P1, P2 and P3) and negative (N1, N2 and N3) waves. It has also been observed that the latency of the first component following the acoustic stimulus decreased at increasing stimulus frequency and intensity, while the amplitude of the whole response increased upon increasing stimulus intensity. It can be suggested that the 40-Hz AERP to tone pips may represent a useful tool in assessing auditory threshold in the low-frequency range.

Adolescent↗

Effects of sex on auditory brainstem responses in infancy and early childhood.

The effects of sex on I-III, III-V and I-V interwave intervals and I, III, V ABR waves latency values have been studied in 171 normal children born at term, 94 males and 77 females, aged between 2 and 720 days. The obtained data confirm that latency values decrease progressively with age, and show that there is a statistically significant difference in wave III and V latency values and in III-V and I-V intervals between males and females. Moreover, these differences seem to increase with age. The authors also discuss the possible underlying mechanisms and claim that even in infancy, sex-related variability should be taken into account.

Brain Stem↗

Radioisotopic method for nasal mucociliary function evaluation.

In 13 healthy young adults, nasal mucociliary transport velocity was measured by means of albumine microsphere labeled with Tc99m as a tracer. M + ISD of clearance velocity values and of the half time radioactivity (T1/2) resulted to be respectively 1.02 + 0.22 cm/min and 1.07 + 0.24 min. A significant correlation (P less than 0.05) between half time clearance (T1/2) values of the radioactive particles and the mucociliary velocity ones could be detected, making T1/2 a reliable and rapidly obtainable parameter for determining nasal mucociliary function. Advantages and disadvantages of the different techniques are discussed.

Adult↗

Influences of birthweight upon brainstem maturation as reflected by auditory brainstem response (ABR) evaluation.

The authors have studied auditory brainstem responses (ABR) in 49 preterm (Group A) and in 54 fullterm (Group B) newborns, classified according to the birthweight related to conceptional age, in order to verify the influences of this latter parameter upon ABR. In Group A newborns, 4 recording sessions were performed, while only 3 in Group B, to evaluate data obtained at the same extra-uterine age. The obtained data show that birthweight related to conceptional age seems to play a major role on the development of ABR, since no significant differences were detected between preterm and fullterm newborns, provided the birthweight was appropriate for conceptional age (ACA). On the contrary, small for conceptional age (SCA) newborns showed an abnormal ABR pattern at birth, which tended to normalize at the following recording sessions. The authors conclude that birthweight related to conceptional age represents an important factor in the development of auditory brainstem responses and that the audiological diagnosis has to be very cautious in SCA newborns, regardless if they are pre- or fullterm.

Birth Weight↗

Auditory brainstem and middle-latency responses in Bell's palsy.

Patients with acute peripheral facial palsy (Bell's palsy) were examined by auditory brainstem response (ABR) and middle-latency response (MLR) for signs of brainstem involvement. ABR data on 30 patients indicated that wave V latencies were abnormal by greater than 3 SD in only 2 patients, 1 of whom showed abnormality contralateral to the affected side. When the criterion for abnormality was reduced to 2 SD, wave V abnormality was found in only 3 of the 30 patients. All 14 patients tested by MLR showed normal responses. These findings suggest that on the basis of evoked potential measures, brainstem involvement may not be pathognomonic of Bell's palsy.

Adolescent↗

Auditory brain-stem (ABRs) and middle latency auditory responses (MLRs) in the prognosis of severely head-injured patients.

Auditory brain-stem responses (ABRs) were studied in 66 subjects with severe head trauma. Middle latency responses (MLRs) were also recorded in 22 of them. Patients were carefully selected to avoid conditions such as pre-existing or acute deafness, hypothermia or ethanol intoxication. In order to evaluate the usefulness of potentials in predicting recovery, patients were classified according to the Glasgow Coma Scale (GCS). ABR tracings were classified into 5 groups and MLR into 2 groups. The recovery was good in the presence of a type 1 ABR, poor in the presence of types 3, 4 and 5. Concerning type 2 ABR, the outcome is related to the MLR type, and to the presence of an electrophysiological improvement within the first 3 months following trauma. The reliability of ABR and MLR in predicting the outcome of severe head injury appears to be greater than other usually considered clinical and instrumental data (age, GCS, CT scan, EEG).

Adolescent↗

Mucociliary function and nasal resistance evaluation before and after adenoidectomy.

Thirty-four children with clinically and radiologically confirmed adenoid hypertrophy underwent otoscopy, impedance tests, active anterior rhinomanometry and nasal mucociliary clearance evaluation before and 6 months after adenoidectomy. Mucociliary clearance velocity increased significantly while binasal resistances decreased after surgery. The authors conclude that mucociliary evaluation and objective measurements of nasal resistances should be added to impedance tests as indicators to adenoidectomy.

Adenoidectomy↗

Microbial flora of nose and paranasal sinuses in chronic maxillary sinusitis.

Nasal secretions, maxillary sinus aspirates and specimens of the maxillary sinus mucosa were collected in 44 patients aged between 25 and 60 affected by mono- or bilateral chronic maxillary sinusitis, in order to establish the best sampling technique for microbiological purposes, the most frequently involved bacteria and the physiopathological mechanism underlying chronic maxillary disease. The sinusal mucosa resulted to be the most reliable sample as it reduces contamination and microbial variability. Anaerobic bacteria were isolated in nasal swab (15.6%), in maxillary sinus aspirates (30.4%) and in maxillary sinus mucosa (36.4%) of maxillary sinusitis patients. In controls anaerobic bacteria were isolated only in one nasal swab (2.3%), while they could not be isolated in maxillary sinus aspirates and in maxillary sinus mucosa. The presence of anaerobic bacteria in chronic maxillary sinusitis patients and their absence in controls seem to confirm that anaerobic microorganisms represent the main pathogenetic agents of chronic maxillary sinusitis. The possible physiopathological mechanisms underlying chronic maxillary sinus disease are finally discussed.

Adolescent↗

Auditory brainstem responses in the full-term newborn: changes in the first 58 hours of life.

The authors have studied auditory brainstem responses (ABR) in 33 full-term newborns at 0-9, 10-30, 31-58 h, in order to evaluate changes in the first hours after birth, particularly in relation to different repetition rates and recording procedures. The data obtained show that the characteristic newborn 3-peak tracing is observed in almost all the cases at the third recording session while, at the first, wave I is absent in two-thirds of the cases. The most reliable waves at birth are waves III, V and N II, which is often present even when other vertex-positive peaks are absent. Latency values of the considered peaks tend to decrease in a statistically significant way and this decrease is almost complete at the second recording session (30 h), while V-I interval values decrease, especially when the 9 stimuli/s repetition is employed. Stimulus repetition rate affects ABR replicability and synchronization, but it hardly influences latency values. Contralaterally recorded potentials are often absent at birth and become evident 58 h later. The authors conclude that the maturational processes probably affect both peripheral and central auditory structures in the first hours after birth. In this period, increasing repetition rates seem to have a greater effect on wave replicability than on latency values.

Brain Stem↗

Human bone cell cultures: a new model for studying the mechanism of action of calcitonin.

An investigation on cell cultures obtained from temporal human bone fragments showed that they provide a suitable model for studying the mechanism involved in calcitonin action on bone cells. Furthermore they demonstrated: a transitory increase in 45Ca uptake that returned to control values ten minutes after the hormone was added; a relation between 45Ca uptake and increased cAMP concentrations when these were measured at the same time intervals; a reproduction of the salmon calcitonin (sCT) effect after incubation of the cultures with either db-cAMP or db-cGMP and inhibition of 45Ca uptake and parallel decrease in cAMP levels with propanol. These results suggest that in human bone cell cultures, sCT acts as a temporary promoter of 45Ca uptake, probably by activating an adenylate-cyclase system through a beta-receptor.

Bone and Bones↗

Epstein-Barr virus serology in nasopharyngeal carcinomas and other head and neck neoplasms in Italy.

This paper reports the results of the EBV-specific antibody response in 17 Italian nasopharyngeal carcinoma (NPC) patients, 15 other head and neck tumor patients and 15 normal controls. Nucleic acid hybridization has been performed on the biopsy tissue from 4 of the NPC patients, and EBV-DNA was present in two undifferentiated (WHO 3) tumors, and absent in two samples of the keratinizing (WHO 1) type. EBV serology appears to be specifically related to NPC, more evidently for VCA-IgA and EA-IgG antibodies, and useful as an aid in diagnosis of NPC. However, in order to assess a prognostic value of the above markers, a greater number of patients followed for a longer period of time (at least 5 years) is needed, and is currently being pursued.

Adult↗

Audiological findings in Down's children.

The authors have investigated the auditory function in 35 Down's subjects, aged between 1 month and 16 years. Clinical examination revealed the occurrence of impaired nasal breathing in 18 subjects (51.4%), while otoscopy results were bilaterally normal in 12 cases (34.3%). Behavioural pure-tone audiometry yielded reliable results in 10 children (28.6%), impedance tests in 28 (80.0%), and brainstem audiometry in 29 (82.9%). A clinical and audiological follow-up has been performed in 11 cases (31.4%). Pure-tone audiometry, which may be employed in all cases only beyond 8 years of age, revealed a conductive hearing loss in 7 cases (20.0%). Impedance tests, whose usefulness is limited by the high occurrence of external ear canal stenosis, showed bilateral type A tympanograms only in 8 cases (28.6%). Stapedial reflex data were often missing, even in presence of a type A tympanogram, due to the weakness of tubaric muscles and to the presence of ossicles abnormalities. ABR has been performed in 29 cases (82.9%) and resulted to be as effective as in the normal population. It revealed a normal configuration concerning threshold and morphology in 16 cases (55.1%). The authors conclude that middle ear pathology in the Down's population is more frequent than expected on clinical basis and that objective tests are mandatory in order to obtain a reliable evaluation. While impedance tests are very sensible in detecting mild middle ear pathologies, but are not effective in threshold definition, brainstem audiometry is the choice tool in the uncooperative child, even if it cannot allow a differential diagnosis between normality and mild low-frequency conductive hearing losses.

Acoustic Impedance Tests↗

Choanal atresia: a surface and ultrastructural study of the nasal mucous membranes.

Biopsies taken from the anterior two-thirds of the inferior turbinate of 3 female patients affected by unilateral complete choanal atresia were studied at the light, transmission and scanning electron microscope. Several changes, such as the uneveness of the mucosal surface, the thickening of the basal membrane, and the presence of ciliary abnormalities in the respiratory mucosa of the affected cavity, were observed. Ciliary abnormalities consisted of the presence of several 'adhesive' and 'bulging' compound cilia, of cilia with excessive cytoplasm and cytoplasmatic processes, and of ciliary structures with loss of the peripheral membrane. At SEM, cilia of the affected cavity appeared bundled, irregularly oriented, flattened and covered by an increased and/or accumulated secretion. Choanal atresia represents, according to the authors, a chronic suffering condition of the nasal mucous membranes. It is characterized by peculiar aspects which are probably related, on one hand, to the increased and/or accumulated mucous secretions and, on the other, to the congenital and long-standing airflow deprivation.

Adolescent↗

Pseudo aneurysm of the external carotid artery: report of a case.

The authors report a case of left otorrhagia in a 1-year-old male infant in the presence of a mass involving the parotideal and upper cervical regions, which had appeared after an infection of the upper airways. Non-invasive techniques, such as echography and CT scan, provided useful but contradicting information. Surgery allowed us to define the diagnosis of mycotic aneurysm of the external carotid artery. The authors, after pointing out the extreme rarity of such a pathology, discuss the ethiopathogenetic theories, the clinical features, the diagnosis and the surgical and medical treatment of the disease. Concerning surgery ligation of the external carotid artery is the treatment of choice, since distally the blood flow is provided by a conspicuous collateral circle and because a possible postoperative septic dissemination is avoided.

Carotid Artery, External↗

Contribution to the differentiation of peripheral versus central tinnitus via auditory brain stem response evaluation.

Auditory brain stem response (ABR) parameters were evaluated in 54 subjects with unilateral idiopathic subjective tinnitus in order to verify the possibility of detecting its site of origin. All the subjects had normal hearing or a symmetrical bilateral sensorineural hearing loss. All the cases in whom middle or inner ear disease had been diagnosed, were excluded. Subjects, classified on the basis of their mean auditory threshold and masking curves according to Feldmann, underwent a residual inhibition (RI) test and ipsilateral narrow-band noise masking before a second ABR test was performed. Patients with positive RI made up the A+ group, while those with negative RI made up the A- group. The main characteristics observed were an increase of the mean latency values of wave I in the tinnitus ear in the A+ group while, after masking, the values of the affected and unaffected ears almost overlapped. An increase in the latency values of wave V, unaffected by the masking procedure, could be observed in A- patients. The occurrence of waves I and III was often affected in the tinnitus ears in both groups, but it increased, after masking, only in the A- patients. Based on the obtained data, the authors conclude that there may be a substantial difference concerning ABR parameters between the patients in whom residual tinnitus masking is demonstrable compared with those in whom it is not.

Adult↗

Auditory brainstem responses (ABR) in multiple sclerosis.

Thirty-two multiple sclerosis (MS) patients, 10 males and 22 females, aged between 21 and 55, underwent pure-tone audiometry and testing of auditory brainstem response (ABR). Thirteen were classified as 'definite', 12 as 'probable' and 7 as 'possible', according to the McAlpine criteria. Each ear of each patient was tested monoaurally. The most common alterations were seen in the parameters of the cross-correlation between the normal template and the template of the individual MS patient. The second most altered parameters were those concerning the V wave which was absent in most cases but, when present, rarely showed latency-amplitude values falling outside the 90% confidence limit ellipses. Test-retest replicability and stimulations with increasing numbers of stimuli per second were useful in detecting intra-individual variability of waveform characteristics. When considering all the tests performed, 88% of the 'definite', 71% of 'probable' and 64% of 'possible' MS patients' ears showed ABR abnormalities. We stress the importance of a separate evaluation of the two ears due to the frequent unilateral alterations, and of an accurate evaluation of the ABR characteristics. We conclude that brainstem audiometry is a more reliable test for detecting demyelinating processes than is usually described in the literature.

Adult↗

Functional evaluation of velar insufficiency by means of the rhinomanometric method.

25 subjects aged between 5 and 17 years, 15 females and 10 males, underwent anterior rhinomanometry. 10 of them were normal and 15 affected by velar insufficiency following adenotonsillectomy in 11 case and palatosynthesis in 4. The rhinomanometric tracing was obtained while the patient repeatedly pronounced oral vowels such as a, e, i, c, u and CVs such as ka, ga. In normal subjects intranasal pressure modifications were represented by a series of dyphasic waves with a positive-negative polarity. In the subjects with velar insufficiency the waves were almost monophasic with positive polarity. During and after the phoniatric rehabilitation, waves returned to be dyphasic together with a progressive reduction of hypernasality. While morphology of the rhinomanometric tracing can be considered a reliable index of velar function, wave's amplitude is influenced by the anatomical conditions of the nasal cavity and by the intensity with which the subject pronounces the vowels and the CVs. Rhinomanometry represents therefore an atraumatic, rapid and reliable technique, easy to perform, in order to evaluate velopharyngeal function and to monitor the increase of velar function during and after treatment.

Adolescent↗