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Biomedical subjects

L Lanzoni

Publications and source records attributed to L Lanzoni.

11 recordsLinked to original sources

How much and for how long does the neonatal myocardium suffer from mild perinatal asphyxia?

Cardiac troponins can be useful in monitoring cardiac injury following perinatal distress. We report here an increase of cardiac troponin I (cTnI) to 2.84 microg/l at 3 weeks (age-related median: 0.07 microg/l) followed by normalization in a newborn with an uneventful clinical course after resuscitation at birth. Serial echocardiographs showed normal cardiac function. Such a time course of cTnI, not previously reported, could be due to either a greater sensitivity of biochemical markers than of instrumental tools or birth asphyxia. Larger studies are needed

Asphyxia Neonatorum↗

Real-time 3-dimensional echocardiography evaluation of congenital heart disease.

We evaluated the ability of real-time 3-dimensional (RT3D) echocardiography to diagnose congenital heart defects and its potential for presenting structural abnormalities in novel views. Seventy-five patients with suspected congenital heart defects were examined with the use of RT3D echocardiography. Images were reviewed off-line as multiple slices of the raw data or as volume-rendered images by a blinded observer. Diagnoses made from blinded review of the RT3D images were compared with the clinical report of the 2D echocardiogram obtained at the same visit. Real-time 3D echocardiography identified all structural abnormalities except for small atrial septal defects in 2 patients and coronary artery anatomy in D-transposition of the great arteries. Less than 5 minutes were needed to acquire RT3D images in all cases, and sedation was never required. Unique region-oriented views obtained from the 3D data set can be acquired quickly and have the potential to enhance understanding of complex cardiac anatomy.

Adolescent↗

[Neurologic outcome in infants surgically treated for congenital cardiopathy: preliminary data].

INTRODUCTION: Both surgical techniques for correction of congenital heart diseases (CHD) and intraoperatory neurologic protection improved during the last 20 years. Nevertheless cardiac surgery is still a risk for neurologic morbidity. METHODS AND PATIENTS: Analysis of the postoperative neurologic status of infants younger than 6 months who underwent cardiac surgery from January 1998 to December 1999. We reviewed the EEG tracings, cranial ultrasound reports (CUS) and CT scans of 48 patients. Diagnoses were: ventricular septal defect = 15, Fallot (TOF) = 9, patent ductus arteriosus (PDA) = 5, coarctation of aorta = 4, atrio-ventricular septal defect = 4, transposition of great arteries (TGA) = 3, hypoplastic left heart syndrome = 2, pulmonary atresia = 2, total anomalous pulmonary veins drainage = 2, double outlet right ventricle = 1, cor triatriatum = 1. Mean age (range) at intervention was 54 days (2-150), 44 infants (91.7%) survived at follow-up: 23 EEG, 22 CUS and 2 CT were performed in the recent postoperative. Among survivors 5/44 had neurologic complications. EEG was altered in 4: two of them (1 TOF, 1 TGA) had pathologic CUS and CT as well (ischemic pattern in the former, atrophy in the latter). Finally a preterm newborn with PDA had mild abnormalities at CUS. After a mean follow-up of 16 +/- 6 months 3/5 patients had mild-to-moderate psychomotor delay and 2 recovered. CONCLUSIONS: According to our preliminary data the prevalence of neurologic complications in infants who undergo cardiac surgery seems to be low. The pathological findings of the recent postoperative seem to recover up to normalization in some cases at mid-term follow-up. As expected, permanent complications effect more often complex CHD. Further follow-up studies to school age will be mandatory to check the very final results of cardiac surgery performed during early infancy.

Electroencephalography↗

Increasing degrees of left ventricular filling impairment modulate left atrial function in humans.

We sought to investigate the changes in atrial reservoir, pump, and conduit functions that are associated with increasing degrees of left ventricular filling impairment. In 13 patients with an impaired relaxation type of filling and in 15 with restrictive patterns, the left atrial volume curve was constructed combining Doppler and 2-dimensional echocardiography. Nine normal subjects served as controls. Left atrial reservoir (defined as [maximum - minimum atrial volume] minus the amount of blood flow reversal in the pulmonary veins with atrial contraction), pump (defined by the volume of blood that enters the ventricle with atrial contraction), and conduit functions (defined as left ventricular filling volume - [left atrial reservoir plus pump volume]) were computed and each expressed as a percentage of ventricular filling volume. The atrial reservoir function was higher in the impaired relaxation group than in normal subjects (49+/-8% vs 38+/-8%, p <0.01) but markedly lower in the restrictive group (27+/-8%, p <0.05). The reverse was true for conduit function, exaggerated in restrictive group (54+/-12% vs 36+/-11% in normal subjects, p <0.01) but minimized in patients with an impaired relaxation type of filling (14+/-9%, p <0.001). The atrial pump contributed 19+/-6% of ventricular filling volume in restrictives, 26+/-3% in normals (p <0.01), and 38+/-4% (p <0.001) in the impaired relaxation group. We conclude that increased atrial response to early-stage left ventricular filling impairment is characterized by augmented reservoir and pump functions, according to a Starling mechanism, which becomes hardly effective at end-stage ventricular dysfunction when the limits of the atrial preload reserve are reached. At this stage, conduit in the atrium takes precedence.

Adult↗

[Not Available].

This paper is concerned with an important and original chapter in the history of experimental psychology in Italy, at the end of the nineteenth century. The first growth of the new science was connected with the possibility of using the methods of experimental psychology to study insanity problems. The limits of anatomical investigations were overcome by neurophysiological researches, but also by studies on reaction time. The measurement of time taken by a given mental operation showed the importance of attention in every mental act. These experiments, carried out on lunatics, showed considerable fluctuations of reaction time, an indication of the diminished power of attention. Great variations were due to different forms of mental disease, which could be better known thanks to this study. The first laboratory of experimental psychology in Italy was established in the Psychiatric Institute of Reggio Emilia, and Gabriele Buccola, a young psychiatrist, was the first to make use of lunatics to study the problems of normal psychology. An exact description of his psychometric researches, which used recent scientific instruments like Hipp's chronoscope, made it possible to verify the validity of the most important psychological laws and to go deep into the study of mental disease. In this way many problems-like the distinction between illusions and hallucinations, the existence of fixed ideas or particular maniacal forms-could be considered from a different point of view. Through the description of the Buccola's work, this paper aims to assess the relationship between experimental psychology and psychiatry: if the study of mental pathology has given rise to the growth of psychological researches, a new explanatory model has made it possible to overcome the conflicts between medico-organic and psychic approach in insanity studies.

Academies and Institutes↗

Comparative study of once-weekly azithromycin and once-daily amoxicillin treatments in prevention of recurrent acute otitis media in children.

Continuous chemoprophylaxis is effective in the prevention of new episodes of acute otitis media (AOM) in otitis-prone children, but compliance can be a problem and thus efficacy can be decreased. Intermittent chemoprophylaxis has so far shown conflicting results. Azithromycin, which has a peculiar pharmacokinetics, resulting, even after a single dose, in persistently elevated concentrations in respiratory tissues, could permit a periodic administration with higher compliance. We compared a 6-month course of once-weekly azithromycin (5 or 10 mg/kg of body weight) with that of once-daily amoxicillin (20 mg/kg) in a single-blind, randomized study of prophylaxis for recurrent AOM in 159 children aged 6 months to 5 years with at least three episodes of AOM in the preceding 6 months. In the amoxicillin group, 23 (31.1%) of 74 children developed 29 episodes of AOM, while in the 10-mg/kg azithromycin group, 11 (14.9%) of 74 children experienced 15 episodes. The 5-mg/kg/week azithromycin trial was prematurely interrupted after nine cases, due to the high occurrence rate of AOM (55.5%). During the 6-month prophylaxis period, the proportion of children with middle ear effusion declined similarly in both groups. No substantial modification of the nasopharyngeal flora was noted at the end of prophylaxis in both antimicrobial groups. In the 6-month-postprophylaxis follow-up period, about 40% of children in both groups again developed AOM. Azithromycin at 10 mg/kg once weekly can be regarded as a valid alternative to once-daily low-dose amoxicillin for the prophylaxis of AOM. Although in the present study no microbiological drawback was noted, accurate selection of children eligible for prophylaxis is mandatory to avoid the risk of emergence of resistant strains.

Amoxicillin↗

[1 year of traumatologic activity in the Emergency Orthopedic Unit of the G. Pini Institute (statistical data)].

The Authors have considered one year's traumatological activity in the G. Pini Institute's S.T.U. by drawing some statistical results. The data refer to the traumas ambulatorium-treated and to all those which required hospitalization during 1979. The total of the traumas surveyed in 1979 is 33335 of which 1812 required urgent hospitalization (5.44%). Previous statistics show 6679 patients in 1961 and 3209 in 1956. We can realize how these figures have increased in a few years (and in this abstract the different kinds of traumas are also highlighted) without any adjustment to the existing structures and equipment which are completely insufficient.

Contusions↗

[Incidence of painful pronation in pediatric traumatology].

After examining the traumatic mechanism responsible for the lesion and considering the possible pathogenetic interpretations, the Authors pass to a description of the clinical picture and the simple but effective reduction manoeuvre. The attached cases tend to emphasize the by no means negligible frequency of painful pronation among childhood traumatisms, a condition often misunderstood and a source of wrong diagnostic interpretations.

Arm Injuries↗

[Considerations on the surgical treatment of hallux valgus].

The authors, after showing a critical analysis of the most interesting operations for correction of valgus big toe in the history of orthopaedics, show the technique they followed, as well as the results obtained, in a specimen chosen among the patients treated with such method.

Adult↗