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Biomedical subjects

G Villa

Publications and source records attributed to G Villa.

At least 145 records · Page 8Linked to original sources
PubMed1981

Influence of age, sex, literacy and pathologic lesion on incidence, severity and type of aphasia.

The influence of sex, age, educational level and pathologic lesion on incidence, severity and clinical form of aphasia was investigated in 390 right-handed, left brain-damaged patients. Sex and educational level were not related to any parameter. Etiology of lesion and age were related to both incidence and type of aphasia. Incidence of aphasia increased with age and was higher in patients with cerebrovascular accidents than in subjects with other types of brain lesions. Non-fluent forms of aphasia were more frequent in young patients suffering from acute cerebrovascular accidents, whereas anomia prevailed in neoplastic subjects and Wernicke's aphasia increased regularly in frequency with age. Some tentative explanations of these findings are discussed.

Adult↗
PubMed1981

Comparative study of oxdralazine and dihydralazine in essential hypertension.

Thirty-one patients with moderate and severe essential hypertension completed a comparative study of oxdralazine and dihydralazine. Treatments were administered for a 6-month period. The therapeutic regimen also included diuretic and a beta-blocking agent given at a constant daily dose. After a 4-week run-in period on diuretic plus beta blocker, which caused a mean blood pressure reduction of 17/7 mmHg, the administration of the vasodilators produced a further, more marked decrease of pressure values. After 1-month treatment mean blood pressure reductions were 26/18 mmHg on oxdralazine and 16/11 mmHg on dihydralazine. After 6 months, 10/15 patients on oxdralazine and 7/16 patients on dihydralazine had achieved a stabile diastolic pressure below 95 mmHg. These results were confirmed by an additional phase of the study, in which 21 patients had the vasodilator cross-over and were observed for a second 6-mont period. Oxdralazine and dihydralazine therapy were well tolerated: only a few patients complained of side effects that were of mild intensity and never required any change in treatment. At the first visit after the cross-over, those patients changing from oxdralazine to dihydralazine complained of side effects with a higher frequency than the patients changing from dihydralazine to oxdralazine. In one patient from the former group it was necessary to stop dihydralazine treatment.

Adult↗
PubMed1980

[Prevention of pulmonary embolism in surgery: analysis of 2 clinical cases].

After some short notices on the physiopathology of thrombosis, the AA. consider clinic, symptomatology and surgical therapy for prevention of pulmonary embolism. They outline that only a precocious operation and an exact diagnosis can help the patient who had had an embolism; in the end they report two cases, describing the operation and its indications.

Adult↗
PubMed1980

[Etiopathogenesis and classification or recurrent varices].

The AA examine the most frequent causes of relapsing varices: they remember that the exact anatomic knowledge of sapheno-femoral and and sapheno-popliteal crosses in essential for the execution of an exact operation; rapidly they inspect the casuistry of S. Giuseppe Hospital, classifying the relapses on the base of a topographic standard and seeing that the technical mistake is essential for the relapses.

Femoral Vein↗
PubMed1980

[Surgical treatment of recurrent varices].

The AA describe the different kinds of operation, on the base of the different kinds of relapsing varices. They outline the importance of a through isolation of internal saphena vein at sapheno-femoral "cross" and of external saphena at sapheno popliteal "cross" for avoiding "high" relapses. They they insist on the subfascial ligature of incontinent perforating veins and on the closing of open muscular breach though a "zed" stitch.

Femoral Vein↗
PubMed1979

Long-term study of oxdralazine in hypertensive patients.

56 moderate and severe hypertensive patients entered an open long-term trial aimed at evaluating the efficacy and tolerability of a combined treatment consisting of 3-hydrazino-6-[N,N-bis-(2-hydroxyethyl)amino]pyridazine (oxdralazine, L 6150), propranolol and chlorthalidone. The mean basal blood pressure was 186.9/111.8 mmHg: after one month of treatment, the mean value was 149.7/95.5 mmHg (p less than 0.01). The heart rate was practically unaffected by treatment, the mean value changing from 75.4 b.p.m. (basal) to 73.3 b.p.m. (one month). The significant reduction in the blood pressure observed at the end of the first month remained unchanged in the following months of therapy, and only minor variations occurred. The combined treatment was well tolerated. Five patients were withdrawn from the trial during the first month; three of them because of side-effects and two of them for personal reasons.

Antihypertensive Agents↗
PubMed1976

Structure-activity relationship of some steroidal compounds in ocular inflammation.

The structure-activity relationship of some topically applied 21-desoxy-substituted steroids as anti-inflammatory agents was investigated; the anti-inflammatory activity remained unaltered or increased on introducing a methyl group in position 6alpha and a hydroxyl group in position 11beta, even after eliminating the hydroxyl group in position 21. The activity of the molecule was further increased by the introduction of a hydroxyl group in position 17alpha and a fluorine atom in position 9alpha.

Animals↗
PubMedDate not supplied

Is there an association between ACE and CKMM polymorphisms and cycling performance status during 3-week races?

In this paper, we examine the association between polymorphisms of the angiotensin-converting enzyme (ACE) and muscle-specific creatine kinase (CKMM) genes, and the actual performance status observed in professional cyclists capable of completing a classic tour stage race such as the Giro d'Italia, Tour de France, or Vuelta a España. To accomplish this, we compared the frequencies of the ACE and CKMM genotypes/alleles in 50 top-level Spanish professional cyclists that have completed at least one of these events to 119 sedentary controls, and 27 elite (Olympic-class) Spanish runners. The genetic polymorphism at the CK-MM locus was detected with the NcoI restriction endonuclease. The results of our study showed that the proportion of the DD genotype was higher in cyclists (50.0 %) than in the other two groups (p<0.05), the proportion of the ID genotype was higher in controls (46.2 %) than in the other two groups (p<0.05), and the proportion of the II genotype was higher in runners (40.7 %) than in the other two groups (p<0.05). The proportion of the D allele was higher in both cyclists (65.0 %) and controls (57.6 %) than in runners (46.3 %) (p<0.001), whereas the proportion of the I allele was higher in runners than in the other two groups (p<0.001). No statistical differences were found for CKK-MM- NcoI. We conclude that in top-level professional cyclists capable of completing a classic 3-wk tour race, the frequency distribution of the D allele and the DD genotype seems to be higher than in other endurance athletes such as elite runners (in whom the I allele is especially frequent).

Adult↗
PubMedDate not supplied

Localization of the sentinel lymph node in breast cancer by combined lymphoscintigraphy, blue dye and intraoperative gamma probe.

Axillary lymph node status represents the most important prognostic factor in patients with operable breast cancer. A severe limitation of this technique is the relatively high rate of false negative sentinel lymph nodes (>5%). We studied 284 patients suffering from breast cancer; 264 had T1 tumors (16 T1a, 37 T1b and 211 T1c), while 20 had T2 tumors. All patients underwent lymphoscintigraphy 18-h before surgery. At surgery, 0.5 mL of patent blue violet was injected subdermally, and the sentinel lymph node (SN) was searched by gamma probe and by the dye method. The surgically isolated SN was processed for intraoperative and delayed examinations. The SN was successfully identified by the combined radioisotopic procedure and patent blue dye technique in 278/284 cases (97.9%). Analysis of the predictive value of the SN in relation to the status of the axillary lymph nodes was limited to 191 patients undergoing standard axillary dissection irrespective of the SN status. Overall, 63/191 (33%) identified SNs were metastatic, the SN alone being involved in 37/63 (58.7%) patients; a positive axillary status with negative SN was found in 10/73 (13.7%) patients with metastatic involvement. In T1a-T1b patients the SN turned out to be metastatic in 9/53 patients (17.0%). In 7/9 patients the SN was the only site of metastasis, while in 2/9 patients other axillary lymph nodes were found to be metastatic in addition to the SN. None of the 44 patients in whom the SN proved to be non-metastatic showed any metastatic involvement of other axillary lymph nodes. Our results demonstrate a good predictive value of SN biopsy in patients with breast cancer; the predictive value was excellent in those subjects with nodules smaller than 1 cm.

Adult↗
PubMedDate not supplied

Different sites and modes of tracer injection for mapping the sentinel lymph node in patients with breast cancer.

Several studies have been published describing the techniques of identification of the "sentinel lymph node" (SN). There are marked differences in the techniques used by different investigators. Although agreement exists about the tracer particle size and the volume of injection, it is unknown what is the best site where to inject the tracer or the vital dye. The aim of the present study was to define the influence of different sites of injection on imaging of the lymphatic ducts and their SNs. We performed a pilot study in 30 consecutive patients with breast cancer who underwent SN biopsy by means of radioguided surgery and vital blue dye mapping. The patients were divided into six groups of five patients each; each patient was given a subdermal (ID) or peritumoral (IP) injection of radiotracer (300 microCi in 150 mL of 99mTc-HSA microcolloids; Albures, Amersham Sorin) above the tumor site in order to localize the SN. After the identification of the SN, a second injection of radiotracer was performed, which was different in each patient subset. In some cases more than one lymph node appeared on the lymphoscintigraphic scans after the second injection of radiotracer. When the peritumoral route was used it took longer to visualize the lymphatic pathways. For the ID route, injection at the exact skin projection over the tumor is optimal. Internal mammary lymph nodes were identified by both IP (2) and ID (1) injection, irrespective of the quadrant in which the tracer was injected. Our findings support the hypothesis of a precise topographic correspondence between the primary tumor and its specific SN. The subdermal route is more accurate than the intraparenchymal route, as it allows faster identification of the lymphatic vessels and SN. We believe these observations should be taken into account for the proper selection of the injection site of either vital dye or radiopharmaceuticals.

Adult↗
PubMedDate not supplied

Mapping the sentinel lymph node in malignant melanoma by blue dye, lymphoscintigraphy and intraoperative gamma probe.

Eighty-eight consecutive patients (48 men and 40 women; mean age, 58.9 years; range, 16-84 years) with clinically localized cutaneous melanoma involving the trunk, extremities or head and neck underwent lymphatic mapping at our institution. The primary melanoma had a mean thickness of 2.74 mm (range, 0.95 to 9 mm). Patients were divided into two groups: group A (39 patients) underwent only vital blue dye (VBD) mapping, while group B (49 patients) underwent lymphatic mapping with VBD and radio-guided surgery (RGS) combined. In all patients 1-1.5 mL of VBD was injected subdermally around the biopsy scar 10-20 min before surgery. In group B 37 MBq in 150 microL of 99mTc-HSA nanocolloid was additionally injected intradermally 18 h before surgery (3-6 aliquots injected perilesionally). In all lymphatic basins where drainage was noted the sentinel lymph nodes (SNs) were identified and marked with a cutaneous marker. Final identification of the SN was then performed externally by a hand-held gamma probe. After the induction of anesthesia 0.5-1-0 mL of patent blue V dye was injected intradermally with a 25-gauge needle around the site of the primary melanoma. SNs were examined by routine hematoxylin and eosin (H&E) staining and immunohistochemistry. Patients with histologically positive SN(s) underwent standard lymph node dissection (SLND) in the involved lymph node basin. The SN was identified in 37/39 patients (94.9%) of group A and in 48/49 patients (98.0%) of group B. Blue dye mapping failed to identify the SN in 5 of the 88 patients (5.8%), while the radioisotope method failed in only 1 of 49 patients (2.0%). Similar results were obtained with the combined use of the two probes. The average number of SNs harvested was 1.9 per basin sampled, which does not differ significantly from the numbers reported by other authors. The SN was histologically positive in 18 patients (20.5%). None of the 12 patients with a Breslow thickness less than 1.5 mm had positive SNs, whereas 18 of the 77 patients (23.4%) with a Breslow index exceeding 1.5 mm showed metastatic SNs with H&E or immunohistochemistry. The latter all underwent SLND of the affected basin. In 10 patients (55.6%) the SN was the only site of tumor invasion; eight patients (44.4%) with positive SNs had one or more metastatic lymph nodes in the draining basin.

Adolescent↗
PubMedDate not supplied

Repair of scleral rupture and total retinal detachment in a self-injuring psychotic patient under local anesthesia: a case report.

PURPOSE: Ocular self-injury by psychotic patients is an uncommon cause of ocular morbidity that poses peculiar problems. This report describes a schizophrenic self-injuring patient with scleral rupture and retinal detachment (RD), treated under loco-regional anesthesia. CASE REPORT: A 65-year-old man presented with scleral rupture, hyphema, traumatic lens luxation, vitreous prolapse, vitreous hemorrhage and total RD after deliberately hitting his head. The fellow eye had been successfully operated with scleral buckle surgery for the same reason two years earlier. The patient underwent a two-step surgical procedure under local anesthesia, with repositioning and resection of the uveal prolapse and scleral rupture repair and, separately, lens removal pars plana vitrectomy (PPV), membrane peeling, retinotomy, laser treatment and SiO tamponade. RESULTS: Twelve months after PPV, the cornea was clear, IOP was 16 mmHg, the retina was attached and VA was 20/200. The fellow eye maintained 20/30 VA. CONCLUSIONS: In psychotic patients the intrinsic difficulty of a traumatic RD is combined with systemic illness, no compliance and the risk of recurrence. Although ocular traumas usually require general anesthesia, this patient underwent both interventions under local anesthesia with sedation, because of his psychotic condition and chronic liver failure. Local anesthesia and sedation proved effective in controlling pain and intra-operative compliance even in such a difficult patient. Although it is reasonable to question operating on such patients, we nonetheless believe that every attempt should always be made at gaining useful vision in both eyes since these patients are at a high risk of recurrent ocular trauma.

Aged↗
PubMedDate not supplied

Evaluation of separate renal function by means of 99mTc-aprotinin uptake test.

The possibility that relative kidney uptake of technetium-99m aprotinin (TcA) might be indicative of separate renal function was investigated in 89 patients who underwent both effective renal plasma flow (ERPFs) and glomerular filtration rate (GFR) determination. A reference group consisted of 27 healthy volunteers, studied only with TcA. The correlation with ERPFs (r = .73) was similar to that previously reported and confirmed. The correlation with GFR (r = .68) was better if a subgroup of renal units with TcA uptake lower than 16% (lower normal limit) was considered. Most likely, glomerular filtration is a limiting factor of the tubular uptake of TcA, and when GFR is reduced, both parameters decrease in the same manner, while if GFR is normal the two parameters are relatively independent. The correlation between TcA and GFR in 32 children was very similar to that found in adults. TcA uptake test seems to be a useful indicator of separate renal function, providing morphological information at, the same time.

Adolescent↗
PubMedDate not supplied

Octreoscan perspectives in sarcoidosis and idiopathic interstitial pneumonia.

STUDY OBJECTIVES: Clinical, radiological, and serological tests have been proven to be unsatisfactory as markers of activity in sarcoidosis and idiopathic interstitial pneumonia (IIP). We investigated 111In-Octreotide (Octreoscan) scintigraphy as a tool for classifying and assessing disease activity in sarcoidosis and IIP, in comparison of the radiological imaging and dyspnea symptom scores. PATIENTS: Thirty-three patients (pts) of which 16 with sarcoidosis (mean age 43.6, range 30-58 years) and 17 with histologically diagnosed IIP (mean age 62.2, range 35-79 years), were enrolled in the study. Clinical history was taken as well as, physical examination, chest X-ray and pulmonary function tests were assessed. A high-resolution computed tomography scan (HRCT) was carried out in-patients affected by sarcoidosis, who had a normal chest X-ray, and in IIP patients. Both groups were evaluated with the Octreoscan uptake index (U.I.; normal value: < or = 10). RESULTS: In patients affected with sarcoidosis, the Octreoscan U.I. was significantly higher than in patients with IIP (16.35 +/- 3.1 and 10.06 +/- 0.8, respectively; p < 0.01) and was correlated with the radiographic staging (p < 0.01) and with the degree of dyspnea (p < 0.01). In-patients with IIP the Octreoscan uptake index was slightly above the normal limit (range 10.3-11.7) in non-specific interstitial pneumonia (NSIP) and desquamative interstitial pneumonia (DIP), whereas in usual interstitial pneumonia (UIP) Octreoscan uptake index was always within normal limit (< or = 10 U.I.). A negative correlation was observed with histological findings (p < 0.01) and with HRCT appearance (p < 0.01). CONCLUSIONS: Octreoscan U.I. is correlated with the degree of dyspnea in patients affected by sarcoidosis and can quantify more accurately the degree of pulmonary involvement, as compared to radiological assessment. Further studies are necessary to evaluate Octreoscan as an early test for predicting disease progression. Octreoscan U.I. could be helpful in monitoring IIP in specific histological subsets (NSIP and DIP) and substitute HRCT in the assessment of UIP for its excellent accuracy.

Adult↗
PubMedDate not supplied

[Italian study on the treatment of anaemia in chronic dialysis patients switched over to less frequent doses of darbepoetin from human recombinant erythropoietin (rHuEPO)].

BACKGROUND: Darbepoetin alpha is a novel erythropoiesis stimulating protein with unique properties as compared to recombinant human erythropoietin (rHuEPO), including a three-fold longer elimination half-life that allows for less frequent dosing. This study was aimed at testing the efficacy and safety of darbepoetin alpha in a large number of chronic dialysis patients switched from rHuEPO. METHODS: Nine hundred and fifty dialysis patients in stable treatment with rHuEPO were switched to darbepoetin alpha. Patients receiving rHuEPO 2 or 3 times weekly were switched to once weekly darbepoetin alpha and those receiving rHuEPO once weekly were switched to once every other week darbepoetin alpha. Patients received darbepoetin alpha by the same route of administration (SC or IV) as the one used for rHuEPO. The unit doses of darbepoetin alpha (10-150 microg) were titrated to maintain haemoglobin concentration within -1.0 and +1.5 g/dL of the individual mean baseline haemoglobin levels and between 10 and 13 g/dL for 24 weeks. RESULTS: The mean change in haemoglobin from baseline to the evaluation period (weeks 21-24) was statistically but not clinically significant [-0.10 g/dL (95% CI: -0.18, -0.02]. In general, the geometric mean weekly dose of study drug from screening/baseline to evaluation period remained substantially unmodified [(from 26.10 micro g/wk to 25.90 microg/wk; percentage change -0.40% (95% CI: -3.78, 3.10)]. Overall, darbepoetin alpha was well tolerated. CONCLUSIONS: The treatment of anaemia of a large dialysis patient population with unit dosing of darbepoetin alpha is effective and safe in maintaining target haemoglobin concentration at reduced dose frequency.

Anemia↗
PubMedDate not supplied

[Diffusive and convective treatments in the clinical practice: observation study of the Pavia district nephrology group].

UNLABELLED: PURPOSE. Although convective treatments are widely used, there is no evidence that they can improve patient survival or hospitalizations nor clinical criteria indicating which patients could benefit from them. This study was carried out to evaluate the dialysis modality distribution and the clinical criteria used in choosing the dialysis therapy by the four dialysis Centers in the district of Pavia, a district characterized by a quite homogeneous population. METHODS: We evaluated age, gender, body mass index (BMI), time on dialysis, number of sessions per week, dialysis duration, dialysis modality, criteria used in choosing dialysis therapy, vascular access (VA), Kt/V, and the number of hypotensive episodes. RESULTS: Two hundred and seventy-two patients were enrolled in the study. Mean age was 67.3 +/- 12 yrs, BMI was 26.3 +/- 6.1, dialytic age was 5.49 +/- 5.5 yrs, Kt/V was 1.4 +/- 0.3, mean session time was 238 min. Fifty-two patients (19.2%) were on a convective treatment. Age, BMI, time on dialysis, dialysis duration and number of sessions per week were no different between convective treatment patients and diffusive treatment patients. Kt/V was significantly different between convective and diffusive methods (1.55 +/- 0.37 vs 1.4 +/- 0.28, p<0.05). Convective treatments were prescribed for cardiovascular (CV) instability by the nephrologists from the Pavia district in the majority of patients (90.9%). There was no difference in hypotensive episodes between convective and diffusive methods. CONCLUSIONS: Our study demonstrated that lacking clinical evidence indicating an improvement in the long-term outcome with convective techniques, nephrologists in the Pavia district choose this type of dialysis treatment to ameliorate CV stability in uremic patients.

Aged↗
PubMedDate not supplied

[Why not try to move on ankylosed tooth orthodontically?].

Due to presence of rigid inorganic matrix, mechanical perturbations cannot affect the bone blood supply or deform osteocytes. Because convincing evidence that bone can directly perceive mechanical forces in lacking, we hypothesize that mechanical perturbations can only elicit remodeling by acting through a soft tissue envelope. These soft tissue envelopes are the periodontal ligament, periosteum, fibrous tissues that can form around implants, sutures and the like. Fibroblast, preosteoblast, and mesenchymal cells are composing the envelopes. It is possible that these cells are indeed responsible for bone remodeling subsequent to forces application.

Alveolar Process↗