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Biomedical subjects

L Ferrante

Publications and source records attributed to L Ferrante.

At least 127 records · Page 7Linked to original sources

Cardiac involvement in Behçet's disease.

To assess the prevalence and the extent of cardiac involvement in patients with Behçet's disease and to investigate the possible causes that may predispose to this involvement, 30 patients affected by Behçet's disease and 30 normal control subjects were submitted to M-mode, two-dimensional, and Doppler echocardiographic evaluation. Moreover, antinuclear and anticardiolipin autoantibodies were determined in the sera of both patients and control subjects. Finally, HLA-B51 positivity was assessed in the patients and in a historical control group. Mitral valve prolapse was observed in 50% and proximal aorta dilatation in 30% of the patients. There was a significant difference in the rate of these abnormalities in comparison with the control group. Left ventricular function parameters were similar between the two groups. The positivity rate of antinuclear and anticardiolipin autoantibodies was very low (7%), without differences between the groups. HLA-B51 was detected in 82.7% of the patients versus 21.7% in the control group (p < 0.00001). In conclusion, this study demonstrates a high rate of cardiac abnormalities in patients with Behçet's disease.

Adult↗

Coagulation study in patients who had undergone surgery for meningioma.

Abnormal fibrinolysis and thrombotic complications have been often observed in patients who had undergone surgery for meningioma. Fourteen patients, affected by meningioma, were studied before surgery, during surgery and 24 h after surgery in order to evaluate the modifications of the fibrinolysis system and the coagulation physiological inhibitors. Before surgery, no patient showed hyperfibrinolysis and/or modifications of coagulation physiological inhibitors. During surgery, an activation of fibrinolysis with pathological levels of tissue plasminogen activator activity (mean = 6.33 U/dl, SD = 7.9, p = 0.02) and increased levels of fibrin degradation products (mean = 0.21, SD = 0.18, p = 0.002) was noted. Modifications of the fibrinolysis parameters occurred only in 9/14 patients (64%). These patients presented a more vascularized tumour, revealed before surgery by computerized tomography scan and cerebral arteriography and directly confirmed during the resection. Twenty-four hours after surgery no patient presented fibrinolysis activation. There was no evidence of disseminated intravascular coagulation in our patients. None of them presented pathological decrease of the physiological coagulation inhibitors or thrombotic complications. In conclusion, during surgery, fibrinolysis parameters show important modifications in patients with vascularized meningioma suggesting an ongoing tumour-host interaction. These variations must be taken in account, in order to plan timely a correct therapeutic approach.

Adult↗

A linear model for the pharmacokinetics of azithromycin in healthy volunteers.

The pharmacokinetic profile of azithromycin, after oral ingestion of 500 mg, was determined in 10 healthy volunteers. Statistical and biochemical reason seemed to indicate a zero-order absorption of the drug. The disposition of azithromycin was described by a two-compartment model (plasma compartment and extravascular compartment) with elimination from the plasma compartment. The absorption process ends abruptly after a time T = 2.3 +/- 0.49 h, from the administration. The transfer rate constant from the plasma compartment to the extravascular compartment (k12 = 0.12 +/- 0.04 h-1) and the mean residence time of the drug in the extravascular compartment (MRT2 = 43.53 +/- 13.80 h) indicate a rapid and extensive distribution of azithromycin from the serum into the extravascular fluids. The results confirmed the efficacy of a single daily dose of 500 mg per os for clinical use.

Administration, Oral↗

[Encephaloceles. with special reference to the diagnostic difficulties].

We have studied 15 occipital, 3 frontal and one parietal cases of encephaloceles from the point of view of the etiopathogenetic, clinic and especially diagnostic problem. The diagnosis of M.E. is based on: 1) the x-ray demonstration of the bone-gap by particular projections and by tomography; 2) in the frontal M.E. the presence of face deformity, with hipertelorism and widening of nose bridge and the finding of ectopic tissue in the nose or in the oral cavity in presence of palatoschisis. Cerebral angiography and pneumoencephalography, made by tomography, are useful to show the herniated brain, hydrocephalus and other associated anomalies. Finally we think computerized tomography (C.T.) is very important for the diagnosis, since it shows the herniation, the bone-gap and the kind of herniated tissue.

Abnormalities, Multiple↗

[Surgical treatment of spasmodic torticollis. Physiopathological considerations and follow-up of 20 cases (author's transl)].

The standard surgical procedures on either peripheral or central nervous system in the treatment of primary spasmodic torticollis are: myotomy, neurotomy, cervical rhizotomy, cortical topectomy, prefrontal lobotomy and a variety of stereotaxic nucleotomies and tractotomies (globus pallidus, thalamus, subthalamus, midbrain). These procedures are briefly reviewed. Some newly proposed operations are than discussed (Svien's labyrinthine suppression and Mazar's interruption of cortico-capsular head-turning pathways). The former surgical intervention is based on physiological and experimental evidence than an altered influence of the reticular substance of the midbrain on the "central" vestibular circuits may be relevant in the genesis of primary spasmodic torticollis. The results are reported of 20 personal cases treated with various surgical procedures with a maximum follow-up of 14.4 years (mean = 6.7 years). It is concluded that at present the most effective and reliable treatment is bilateral anterior rhizotomy of C1-C3 combined with unilateral or bilateral neurotomy (or spinal rhizotomy) of the 11th cranial nerve. The results were rated clinically as useful in 66.6% of the 15 patients treated with this procedure.

Adolescent↗

Cervico-medullary junction hemangioblastomas. Report of two cases and review of the literature.

Reporting two cases of dorsally located cervico-medullary hemangioblastomas the Authors discuss clinico-biological features, diagnosis and therapy of this vascular neoplasms, analyzing the cases reported in detail in the available literature. In this site the tumor has often an exophitic development, adhering more or less extensively to the posterior surface of medulla oblungata, where progressively creates a niche. Transient neurogenic arterial blood hypertension, by possible involvement of the dorsal nucleus of vagal nerve, together with the lack of postoperative respiratory disturbances constitute the main clinical features of differentiation with intraaxial hemangioblastomas of the brainstem. Actually MRI represents the radiological investigation of choice, even if angiography still plays an important role in the correct preoperative diagnosis of hemangioblastomas. The therapy of dorsally located cervico-medullary hemangioblastomas is the total removal of the lesion also in asymptomatic patients, being the late surgical results generally successful.

Adolescent↗

Medulloblastoma in adulthood.

Reporting 32 cases of medulloblastoma in patients aged 17 to 65 years and reviewing the major case-series in the literature, we analyze the clinicobiological and diagnostic features and treatment of this tumor in adulthood. We consider some factors that seem to have a favorable bearing on the prognosis: female sex, length of clinical history, tumor size, hemispheric site, and total removal followed by radiotherapy. We then discuss the differences in tumor behavior between adulthood and childhood that emerged from the comparative analysis.

Adolescent↗

Occasionally-occurring familial brain tumours (OFBT). Reports of cases and review of the literature.

We use the term "occasionally-occurring familial brain tumours" (OFBT) to designate cases in which more than one member of a family presents a brain tumours outside the range of the clinical syndromes in which CNS cancer heredity is well established. We report our experience of OFBT and review the published work on such cases with special reference to some clinicobiological concordances among affected families. On the evidence we present and on that of several genetic and epidemiologico-statistical studies we are inclined to think that there are genetic factors predisposing to the onset of OFBT.

Adolescent↗

Narrowing of thoraco-lumbar spinal canal in achondroplasia.

The incidence of neurological deficits in achondroplastic subject is by no means negligible. We considered the clinico-radiological and therapeutic data of 35 achondroplasic patients (5 personal cases and 30 published in the available literature) harbouring myelo-radicular deficits related to narrowing of thoraco-lumbar canal. There was no significant sex prevalence. The clinical symptoms appear most frequently in the III or IV decades of life. Actually morphological anomalies of the spinal canal are already present at birth in achondroplasic dwarfs, and signs of cervical cord involvement are not uncommon in achondroplasic children. The delayed occurrence of clinical symptoms related to narrow toracho-lumbar canal may be explained by the pathogenetic role of acquired cofactors as prolapse of intervertebral disks and for degenerative spondyloartrosis. The clinical history is usually of insidious onset. Most frequent symptoms are motor weakness of the lower limbs (82.8%) and low-back pain (77.1%). Sensory and/or sphincter disturbances appeared to be less frequent (about 40% of the examined subjects). Plain X-rays, myelography, CT, CT-myelography and MRI are the diagnostic examination of choice. Surgical treatment consists of anterior decompression with fusion, when thoraco-lumbar kyphosis is prevalent, and/or posterior decompression, when the symptoms are mainly caused by canal stenosis. From the prognostic point of view, two groups of patients are recognized, in relationship to the presence of marked dorsal kyphosis. Those with kyphosis showed almost invariably poor functional results. In the remaining ones the results were satisfactory, provided that the clinical history lasted less than 3 years and the symptomatology was not already too advanced.

Achondroplasia↗

A review of papillomas of the third ventricle. One case report.

The Authors present one case of choroid plexus papilloma localized in the third ventricle. This is in fact the only case in a series of about 4,000 patients operated on for brain tumors at the Neurosurgical Institute of the University of Rome. They consider 56 cases reported in the literature. Out of these, 43 are described and summarized in a table according to the clinical, radiological and surgical features. Twentyfive were the patients operated on, the average mortality in the cases which underwent indirect or not specified operation was 80%; that of patients submitted to a direct approach or to subtotal excision was 50%; and finally 3 patients out 13 (about 23%) who had total resection, died after surgery.

Adolescent↗

Postoperative arachnoidal diverticula of the lumbar spine.

Arachnoidal diverticula are a rare complication of spinal surgery and occur most often at lumbar level, especially after discectomy. We report a case of lumbar arachnoidal diverticulum that arose two years after an L4-L5 discectomy and presented clinically with low back pain and sciatic pain and neurological deficits. We analyze the etiopathogenesis, clinical and radiological features and treatment.

Arachnoid↗