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Biomedical subjects

M Fontana

Publications and source records attributed to M Fontana.

At least 145 records · Page 8Linked to original sources
PubMed1976

Hydrocephalus in infancy and childhood. Our experience of CSF shunting.

A surgical series of 346 children with nontumoral hydrocephalus shunted in the period January 1957 to December 1973 is presented. The etiological factors, preoperative clinical and anatomical status of the patients, their surgical career, the reasons for revision operations and causes of death, are analyzed and discussed in relation to each of the four groups constituting the series: tetraventricular communicating hydrocephalus, triventricular hydrocephalus, obstructive hydrocephalus from ventriculocisternal block and postmeningocele or postmyelomeningocele hydrocephalus. 141 patients required 218 revision operations. 16 patients died after the first operation, 27 on revision and 38 sometime later. 41 patients were lost to follow-up. A recent clinical and instrumental review of the physical, neurological and mental status of the remaining 224 patients showed that 136 (60.7%) are well or very well, 68 (30.3%) have residual deficits likely to regress with treatment and 20 (8.9%) are severely handicapped. These long-term results and the surgical aspects of the problem are discussed in the light of the literature.

Age Factors↗
PubMedDate not supplied

Lactose malabsorption and recurrent abdominal pain in Italian children.

The role of lactose malabsorption (LM) was investigated in 32 children (mean age 8.13 +/- 2.46 years) with recurrent abdominal pain (RAP). LM was detected in 75% of them by a lactose breath hydrogen test (LBHT) after a 2-g/kg (max 50-g) load. Of the 18 malabsorbers who participated in a 3-month lactose-free diet (LFD), 14 were judged "improved" and reported lower pain frequency (p less than 0.001). The malabsorbers who improved versus the not improved had comparable past lactose ingestion but were distinguishable on the basis of their lactose absorption capacity (0.36 vs. 0.81 g/kg; p less than 0.01), as subsequently determined by multiple LBHTs with 25-, 12.5-, and 6-g loads. The ratio between past lactose ingestion and lactose absorption was 1.89 in the improved and 0.55 in the not improved groups (p less than 0.01), retrospectively indicating lactose as a possible cause of the symptoms in the improved group. The reintroduction of lactose in amounts not exceeding the absorption capacity into the diet of each malabsorber who had improved with LFD caused relapse in none of the 14 subjects monitored for 2-6 months. In conclusion, LM seems an important cause of symptoms in Italian children with RAP. Assessment of the lactose absorption threshold of each subject of LBHTs provides a basis for reintroduction of "calibrated" amounts of lactose-containing foods (e.g., milk) into the diet.

Administration, Oral↗
PubMedDate not supplied

Inhibition of secondary caries lesion progression using fluoride varnish.

The purpose of this study was to determine the efficacy of fluoride varnish (FV) in inhibiting progression of secondary caries (SC). In a first experiment, human teeth, restored either with amalgam or resin composite, were exposed for 4 days to a microbial caries model. Half of each specimen was then painted with an acid-resistant nail varnish to maintain the baseline SC lesion. Specimens were then either treated with a FV (removed after 24 h) or not treated (control groups) prior to being exposed for 4 more days to the caries model. A second experiment was conducted to compare the effect that the varnish (with and without fluoride) had on SC development around amalgam. Confocal laser scanning microscopy data from these experiments suggested that the application of a FV to early, active SC lesions significantly slowed down their progression. Furthermore, the application of a placebo varnish showed a trend towards slowing down lesion progression, suggesting that the effect of FV on SC is not only due to its fluoride release.

Bacteria↗
PubMedDate not supplied

Injury of the suprascapular nerve at the spinoglenoid notch. The natural history of infraspinatus atrophy in volleyball players.

From 1985 to 1996, we observed 38 cases of isolated atrophy of the infraspinatus muscle in athletes; all were involved in volleyball at a competitive level. There were 20 men and 18 women with a mean age of 26 years (range, 15 to 27). At the time of the first examination, 35 of these athletes had no pain and were treated with exercises to strengthen the external rotators. The remaining three patients underwent surgery because of pain at the posterior aspect of the shoulder. Sixteen of the 35 players treated nonoperatively were reviewed at a mean follow-up of 5.5 years (range, 3 to 10). Thirteen were still involved in volleyball and three had retired symptom-free at the end of their careers. On physical examination, atrophy of the infraspinatus muscle was unchanged in all cases. The patients treated surgically were reviewed at a mean follow-up of 2 years. All of them were able to play volleyball at their preinjury levels, but one had pain at the anterior aspect of the shoulder after strenuous activity. Physical examination showed a notable reduction of the atrophy in one patient. Entrapment of the suprascapular nerve at the spinoglenoid notch is a usually painless syndrome that is frequently observed in volleyball players. Surgical treatment is indicated in the rare cases of painful neuropathies after careful patient selection.

Adolescent↗
PubMedDate not supplied

[Hepatocarcinoma: epidemiologic and clinical evaluation of 90 patients].

PURPOSE: The aim of the study was to improve the knowledge of epidemiology and clinic of primitive HCC. PATIENTS AND METHODS: Ninety consecutive HCC patients, attending the Medical Therapy Dpt. of Rome University "La Sapienza" were examined: diagnosis of HCC was based on histologic data in 71; in the others the diagnosis derived from ultrasonographics, RMN, TC data. RESULTS AND CONCLUSIONS: Show M/F ratio 3.7/1; in 87% HCC is associated to liver cirrhosis (HCC/CEA); the cumulative presence of HBV and HCV is 75.6%: HCV alone 33.4%, resulting the major risk factor for HCC; patients with associated alcoholism, HBV and/or HCV show evidence of earlier appearance of HCC. Significant higher presence of HBsAg is recorded in HCC without surrounding liver cirrhosis compared to HCC/CE. The cumulative survival rate of treated patients is higher compared with non treated, irrespectively to kind of therapy. The HCC/CE+ patients have significant greater presence of elevated levels of alpha-FP and portal thrombosis compared to a randomized group of patients with liver cirrhosis only. At the end we outline that over 10% of HCC has none note risk factor for hepatic diseases.

Adult↗
PubMedDate not supplied

Detection and clinical evaluation of GBV-C/HGV in plasma from patients with chronic hepatitis of unknown etiology.

PURPOSE: The role of GBV-C/HGV virus infection in patients with chronic hepatitis of unknown etiology has been studied. Two groups of patients have been included: a) 50 consecutive patients with chronic hepatitis (mean age 47 yrs; M/F = 35/15), negative for markers of hepatitis viruses (HBV-HCV). These patients did not show evidence of metabolic, autoimmune, alcoholic or toxic liver disease; b) 50 healthy blood donors (mean age 35 yrs; M/F = 35/15). All the subjects were HIV-seronegative. PATIENTS AND METHODS: The detection of GBV-C/HGV RNA was performed by reverse transcription-polymerase chain reaction techniques and capillary zone electrophoresis analysis (CZE). RESULTS: There was no difference between the two groups of patients (14% vs 6%; p = 0.18 NS). CONCLUSIONS: The etiopathogenetic role of GBV-C/HGV in chronic hepatitis of unknown etiology is yet to be shown.

Adult↗
PubMedDate not supplied

A new fork-shaped condylar and osteotomy plate.

The authors present their experience with a new crossed condylar and osteotomy plate, which is innovative because of the features of its design, and the instrumentation used for its application, as compared to the traditional AO blade plate. The plate is called "fork-shaped" because there are 2 prongs in place of the blade with a "U" profile, and it involves the use of more accurate and less traumatic instrumentation to implant it. The results of a study conducted on a group of 20 patients, who were homogeneous for pathology and surgery, treated by a fork-shaped osteotomy plate, compared with an equal number of patients treated by a blade plate, are reported. The results were better in the group treated with a fork plate because there was a more accurate correspondence with the preoperative planning, and because there were fewer intraoperative complications, and time required for surgery was shorter.

Adult↗
PubMedDate not supplied

Lateral epicondylitis: clinical classification and proposal for treatment.

The authors report their experience in a retrospective study on a sample year (1997) of cases (77 in number) of lateral epicondylitis treated non-surgically at the Rizzoli Orthopaedic Institute. The results for the 63 patients reviewed are very disappointing (healing only in 36.5% of cases). In their opinion, this may be attributed to the lack of an accurate clinical definition of the pathology, and an inadequate treatment protocol. They conclude with the proposal to classify 3 clinical forms for epicondylitis (acute, chronic recurrent, and chronic persistent) and to follow a corresponding treatment protocol, aimed at improving results.

Adult↗
PubMedDate not supplied

Molecular characterization of common variable immunodeficiency-related lymphomas.

Common variable immunodeficiency (CVI) patients are at high relative risk of developing non-Hodgkin lymphomas (NHL), mainly represented by B-lineage diffuse large cell lymphomas. The molecular pathogenesis and histogenesis of CVI-related NHL are poorly understood. We have thus attempted to provide a detailed molecular characterization of their histogenesis and pathogenesis. A panel of 5 CVI-related NHL was subjected to detailed analysis of histogenetic markers (mutations of immunoglobulin variable heavy chain-IgVH and of BCL-6 genes) acquired by B-cells at the time of germinal center transit. Somatic hypermutation of IgVH and BCL-6 genes occurred in 5/5 cases; in all cases, mutations were stable with no evidence of ongoing mutation processes. In 3/5 cases, the pattern of IgVH mutations was consistent with selection and stimulation of the tumor clone by antigen. To further clarify the pathogenesis, samples were tested for inactivation by promoter hypermethylation of the genes 0(6)-methylguanine-DNA-methyltransferase (MGMT) and glutathione S-transferase (GST) p1, which code for detoxifying enzymes, as well as of death-associated protein (DAP)-kinase, coding for a proapoptotic molecule. Promoter hypermethylation of MGMT, GSTp1 and DAP-kinase was detected in 2/5, 3/5 and 3/5 CVI-related NHL, respectively. Overall, these data indicate that: i) similarly to other immunodeficiency-related NHL, CVI-related NHL derive from germinal center-related B-cells, namely centrocytes or post-germinal center B-cells; ii) antigen stimulation and selection are involved in the development of at least a fraction of these cases; iii) hypermethylation of the MGMT, DAP-kinase and GSTp1 genes occurs at sustained frequencies in CVI-related NHL and may provide novel prognostic markers and therapeutic targets for the clinical management of these lymphomas.

Common Variable Immunodeficiency↗