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Biomedical subjects

M Innocenti

Publications and source records attributed to M Innocenti.

At least 37 records · Page 2Linked to original sources
PubMed1998

Stereomicroscopic and scanning electron microscopic study of roots obturated with vertically condensed gutta-percha, epoxy resin cement, and dentin bonding agent.

Root canal fillings performed with dentin bonding agent, gutta-percha, and epoxy resin sealer were observed by stereomicroscope. Fourteen palatal roots of extracted maxillary molars were used. Seven roots (group 1) were filled with gutta-percha, epoxy resin sealer, and dentin bonding agent. Seven (group 2) were filled with gutta-percha and epoxy resin sealer alone. The presence of these materials (gutta-percha, adhesive, cement, and a combination of these materials) and the number of voids present were evaluated in the apical, middle, and coronal thirds of the canals. In group 1, a combination of the three materials used was found to be the statistically most frequent case only in the apical third. No statistically significant difference was found between the overall number of voids present in the two groups. The resin-dentin-gutta-percha interface of roots from group 1 was observed by scanning electron microscopy: no statistically significant difference was found between apical and coronal sections regarding the presence of hybrid layer, penetration of resin into the dentinal tubules, or the presence of gaps in either the dentin-resin interface or the resin-gutta-percha interface.

Bismuth↗
PubMed1998

Free vascularized growth-plate transfer after bone tumor resection in children.

Limb-salvage surgery is the standard care for most malignant tumors affecting the extremities, and a vascularized fibula transfer is probably the most popular microsurgical option to reconstruct long-bone defects. Skeletal reconstruction after bone-tumor resection involving the metepiphysis of a growing child can be successfully achieved with a vascularized fibula graft incorporating the proximal physis and active growth plate. Such a procedure has been utilized in 12 children under the age of 10 years who had malignant bone tumors located in the upper limb (3 in the distal radius, 9 in the proximal humerus). The follow-up ranged between 4 years and 3 months. Ten grafts were supplied by the anterior tibial artery, and two by the peroneal artery. The average growth rate of the grafts based on the former artery has been more than 1 cm per year, ranging between 0.75 and 1.33 cm. The authors describe a modified operative technique and discuss the clinical results of the procedure which offers a satisfactory skeletal reconstruction and prevents future limb-size discrepancy.

Bone Neoplasms↗
PubMed1997

Modeling arterial hypotension during hemodialysis.

A mathematical model of the hemodynamic response to hemodialysis is presented. This model includes the dynamics of sodium, urea, and potassium in the intracellular and extracellular pools; fluid balance equations for the intracellular, interstitial, and plasma volumes; systemic and pulmonary hemodynamics; and the action of several short-term arterial pressure control mechanisms. The control mechanisms are triggered by information coming from both arterial and cardiopulmonary pressoreceptors, and they work on systemic arterial resistance, heart rate, and systemic venous unstressed volume. Moreover, the model hypothesizes that decreasing left atrial pressure below a given threshold causes a paradoxical withdrawal of the sympathetic drive and a consequent vasodepressor syncope. The model is used to simulate the pattern of the main hemodynamic quantities (systemic arterial pressure, heart rate, total systemic resistance, and cardiac output) during hemodialysis in several groups of patients (both hypotension resistant and hypotension prone) whose data were drawn from the clinical literature. The simulation results point out that the model is able to reproduce a variety of different conditions, including no hypotension, moderate hypotension, and severe hypotension with ultimate vasodepressor syncope, by adjusting a few parameters with clear physiological meanings. Hypotension is principally imputed to a loss of the sympathetic mechanisms working on systemic resistance and to an impairment of vascular refilling at the capillary wall. The results suggest that hypotension during hemodialysis is a complex phenomenon that depends on the superimposition of several concomitant factors working together that can lead to a variety of distinct individual patterns.

Baroreflex↗
PubMed1997

Mathematical investigation of some physiological factors involved in hemodialysis hypotension.

A previously developed mathematical model is used to investigate the role of some hemodynamic, regulatory, and osmotic factors in the development of symptomatic hypotension during hemodialysis. Sensitivity analysis of the model parameters suggests that a decrease in atrial pressure, with a consequent fall in cardiac output (Frank-Starling mechanism), is the primary hemodynamic perturbation induced by ultrafiltration. Also, during the first hours of a hemodialysis session, the sympathetic mechanism working on systemic resistance is the main factor responsible for arterial pressure maintenance, and the physiological response is probably characterized by a prevalence of the cardiopulmonary over the arterial baroreflex control. During this period, a decrease in plasma osmolarity, caused mainly by urea removal, may contribute to the reduction of vascular refilling. During the last hours of the session, the arterial pressure level is also significantly affected by other factors that influence vascular refilling and mean circulatory filling pressure (systemic compliance; action of feedback mechanisms working on venous unstressed volume; plasma oncotic pressure; and, especially, capillary wall permeability and interstitial space elastance). Simulation of hemodialysis with different modalities emphasizes the importance of avoiding high ultrafiltration rates and of maintaining the sodium concentration in the dialysate close to the sodium concentration of the extracellular fluid to limit the risk of symptomatic hypotension. Higher values of sodium in the dialysate are, however, associated with poor sodium removal from the extracellular pool with risks of interdialytic morbidity. In the future, the model may be used to optimize the ultrafiltration rate and sodium profile in the dialysate according to individual patient prescriptions.

Baroreflex↗
PubMed1997

Predictors of renal outcome in diffuse proliferative glomerulonephritis in systemic lupus erythematosus.

The occurrence of nephritis is considered to be the most important factor influencing the prognosis in systemic lupus erythematosus (SLE). Despite the apparent histological similarity of the lesions, however, patients with diffuse proliferative glomerulonephritis (DPGN) may exhibit different outcomes. A retrospective study was carried out on 81 SLE patients with DPGN to evaluate the prognostic significance of different clinical, serological and histological variables; in particular, 95 renal biopsies were re-evaluated and the activity and chronicity indices for the patients were determined. A positive correlation was observed between the presence of chronic lesions on renal biopsy and a poor renal outcome (< 0.001). Moreover, in the repeat biopsies the patients with a poor outcome showed a higher degree of chronic lesions. Active lesions and other clinical and serological parameters did not correlate with the outcome.

Adolescent↗
PubMed1996

Iloprost in the treatment of thrombotic microangiopathy: report of thirteen cases.

Defective prostacyclin bioavailability seems to play a role in the pathogenesis of thrombotic microangiopathy, including thrombotic thrombocytopenic purpura and hemolytic uremic syndrome. Eight consecutive patients with a proven diagnosis of thrombotic microangiopathy were treated by Iloprost, a recently developed stable prostacyclin analogue; during follow-up, three of them relapsed and received further treatment. To our knowledge, this is the first report on a wide series of patients who received Iloprost for thrombotic microangiopathy. Soon after diagnosis, Iloprost was given by continuous intravenous infusion at a rate of 1.5-2 ng/kg/minute over 16-18 h/day for several days (mean 12 days; range 6-24) until the platelet count steadily increased. In addition, plasma exchange with fresh frozen plasma (average volume exchange 20-40 mL/kg for each session) was performed in 11 out of the 13 cases. No other antiplatelet agent was given. In all 13 cases, Iloprost administration coincided with achievement of remission. At present, all the patients are still maintaining remission. Our results indicate a useful role for Iloprost in the management of thrombotic microangiopathy.

Adolescent↗
PubMed1995

[Reconstruction with free vascularized or island flaps of soft tissue loss in the upper limb after tumor resection. 16 cases].

We have reviewed 16 cases of soft tissue sarcomas of the upper limb treated with wide excision of the tumour and immediate soft tissue reconstruction by means of a microvascular flap. 9 patients were males, 7 females; age ranged from 12 to 74 years. All the patients had been referred to us after previous failed or inadequate excisions. All the tumours were high-grade malignancies in an extracompartmental location (stade IIB according to Enneking). Histopathologic diagnosis was: synovial-sarcoma in 11 cases; fibrosarcoma in 2 cases; malignant fibrous histiocytoma in 1 case, soft tissue osteosarcoma in 1 case, epitheloid sarcoma in 1 case. The site of the tumour was the hand in 2 cases, the wrist in 6 cases, the forearm in 5 cases and the elbow in 3 cases. The free flaps used for soft tissue reconstructions were the latissimus dorsi in 6 cases, the dorsalis pedis in 2 cases, the lateral arm flap in 2 cases, the serratus in 1 case, the gracilis in 1 case. The island flaps were the radial forearm flap in 1 case, the posterior interosseous flap in 1 case, the cubital flap in 1 case. 14 cases required immediate associated reconstructive procedures such as tendon transfers or grafts (5 cases), vascularized or non vascularized bone grafts (4 cases), articular allografts (1 case), ligament reconstruction (1 case), nerve grafts (2 cases). Brachytherapy was associated to microsurgical reconstruction in the last 6 cases of this group. The catheters were charged with the radioisotope 5 days after surgery. No complications were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[1000 osteoarthrosis patients in treatment with GGGs: an assessment of joint pain].

The analgesic activity of a chondroprotective agent--galactosamineglucuronoglycan sulphate (Condral) was evaluated in the course of an open investigation in a large number of outpatients attending the Istituto Emilio Bruzzone of Genoa or related Centres. Out of 1720 outpatients seen, 1000 were treated for 2 years with 800-1200 mg daily of GGG in one single administration (2-3 sachets or capsules of 400 mg) By the results obtained GGG was shown to have analgesic activity in a large number of cases. Tolerance of the treatment was good and no significant clinical side effects were ever observed.

Analgesics, Non-Narcotic↗
PubMed1992

Effect of parenteral administration of GM1 on cytokines and anti-ganglioside antibody patterns. Preliminary report in normal human individuals.

To assess the effects of monosialoganglioside GM1 on some immunological parameters, 12 healthy men were treated with 100 mg GM1 i.m. daily for 15 days. Before and after treatment, the following were studied: (1) serum levels of antibodies against GM1, asialo-GM1 (aGM1), GM2 and GD1b; (2) serum levels of interleukin (IL)-1 beta, IL-2, soluble IL-2 receptor (sIL-2R), tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma); (3) IL-1 beta and TNF-alpha production by peripheral blood monocytes (PBMO). Anti-ganglioside antibody and cytokine serum levels were not affected by exogenous GM1 administration with the exception of a transient increase in anti-GM1 antibody titer observed in one subject. In addition, no inhibition of IL-1 beta and TNF-alpha production by PBMO was observed. These preliminary data do not support a potential immunogenic or immunomodulatory function for in vivo administered GM1.

Adolescent↗
PubMed1992

Comparison of anti-hepatitis C virus detection with ELISA assay and RIBA 4 in dialysis patients: our experience.

Hepatitis C virus (HCV) has been demonstrated to be the main cause of non-A, non-B hepatitis and the emergent infectious illness in dialysis units. At present, the anti-HCV 100 ELISA and an immunoblot assay in which 2 new antigens are included, are available. We have tested 110 patients on chronic dialysis with anti-C100 ELISA. Twenty-seven of them were anti-HCV positive. We tested the 27 anti-HCV-positive and 7 anti-HCV-negative patients with the RIBA 4 assay. The results were similar with both test.

Enzyme-Linked Immunosorbent Assay↗
PubMed1992

Retrospective study on the prevalence of B and non-A, non-B hepatitis in a dialysis unit: 17-year follow-up.

To evaluate the prevalence of HBV, non-A, non-B hepatitis (NANBH) and HCV, their evolution and the route of transmission, we performed a retrospective study (17 years) on 65 hemodialyzed patients (mean dialytical age 5 years, range 1-16) who developed acute viral hepatitis. Twenty-six percent of them were affected by HBV; 5 of them (29%) became chronic. Fourty-eight of 65 patients were affected by NANBH; in 1990, 42 of them were tested for antibody to HCV with the C-100 Elisa assay: 27 patients (64%) were positive. Seven of 27 patients demonstrated normal values of ALT. The evaluation of intrafamiliar transmission of HBV showed 8 sexual partners infected. In the family, no one was anti-HCV positive. In agreement with the current literature, we have observed: (1) a decrement in HBV infection; (2) that HCV is the major cause of NANBH; its rate of chronicity is over 50%; (3) that the prevalent mode of HCV transmission is the parenteral route while the sexual route seems to be negligible.

Adult↗
PubMed1991

Laser treatment of pharyngeal pouch.

The symptoms of pharyngeal pouch become more troublesome, eventually requiring surgical treatment. Excision of the pouch and cricopharyngeal myotomy through a neck incision was the operation of choice until Dohlman described endoscopic diathermy operative treatment 30 years ago. The diathermy technique has been largely superseded by endoscopic microsurgical division of the cricopharyngeus muscle in the party wall using carbon dioxide laser. This operation is now established as a precise, accurate and safe procedure providing reliable relief of symptoms with minimal risk to the patient. Fifteen patients treated by the microsurgical laser procedure in the past 5 years are reported.

Aged↗
PubMed1991

[Ultrasonography in the diagnosis of acute obstructive renal insufficiency: a cautionary note].

Ultrasonography (US) has recently been considered in nephrology as the imaging method of choice in the differential diagnosis of acute renal failure (ARF). A dilated renal collecting system is the hallmark of obstructive nephropathy (ON). We report 4 cases of ARF due to ON in which US detected no dilatation of collecting system. Similar data were obtained by computer tomography (TC). The normal size and structure of the kidneys and the clinical suspicion prompted us to perform retrograde pyelography which revealed ON. Ureteral catheterization determined a marked improvement of renal function in all the patients (pts). 2 pts were one kidney, 3 pts had renal stones, in 2 pts dehydration and sepsis were present. We conclude that ON has not ever been excluded on the criterion of absence of dilated urinary tract from US and TC.

Abdominal Neoplasms↗
PubMed1991

[The surgical treatment of cervical disk pathology. A review of cases. The long-term clinical and radiographic results].

The experience of the Clinica Ortopedica dell'Università di Firenze in the surgical treatment of cervical disk disease has changed over time due to both the ongoing improvement of surgical techniques and the availability of ever more effective and less invasive diagnostic tests. Although our first experience was indirect and we were not able to review all patients due to the long follow-up period, we believe that our current setup provides valid data, as is demonstrated by the thorough clinical and radiographic evaluation we performed on patients reviewed after a minimum of 5 years. We believe that the anterior-approach procedure, which can currently be recommended thanks to non-invasive diagnostic tests, is effective not only in cases of spinal cord impingement but also in cases of cervicobrachialgia. In the latter, aside from the relief of nerve root impingement, we noticed that intersomatic spinal fusion helped relieve pain at the site of the lesion even after a considerable period of time, whereas cervical pain often remained after laminectomy and frequently increased over time.

Brachial Plexus Neuritis↗
PubMed1990

Recurrent digital fibromatosis of childhood.

Recurrent digital fibromatosis is a rare, benign fibrous growth of childhood. The condition, which features rapid growth and local recurrences, may be mistaken for a malignant tumor. A case report is presented.

Fibroma↗