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Biomedical subjects

M Nobili

Publications and source records attributed to M Nobili.

34 records · Page 2Linked to original sources
PubMedDate not supplied

Catatonia with high CSF lactate in a case of diabetes with associated conditions.

A case of reversible catatonia in a well controlled insulin-dependent diabetic is described. The course of catatonia was characterized by very high CSF lactate values (serial semiautomatic determinations) during more than one month, beyond the clinical recovery. The CSF lactate elevations seem to reflect cerebral hypoxia. The uncommon coincidence of diabetes with cerebral atrophy, mental weakness, and perceptive deafness migh suggest the classification of this case of diabetes in the group 'associated with certain conditions and syndromes'.

Adult↗
PubMedDate not supplied

[Esophageal atresia and tracheoesophageal fistula: personal contribution].

From January 1988 to December 1999, 21 new born babies, 13 boys and 8 girls, with esophageal atresia (EA) and tracheosophageal fistula (TEF) were treated at Division of Pediatric Surgery in Foggia (Italy). At birth their weight ranged from 1.600 to 3.000 g, the gestional age ranged from 36 to 41 weeks. Five (23%) of them were premature, seven (58%) SGA, seventeen (80%) associated congenital anomalies. Complete surgical correction was performed in all patients. In three AE cases with wide-gap an azygos vein flap was used to strengthen the anastomosis under excessive tension. The pathogenetic factors involved in these complications such as leak, stricture (stenosis), recurrent TEF and gastro-esophageal reflux are (are taken into account) and analysed. No baby died owing to anastomatic complication. Survival rate was 100% in Montreal I and 83% in Montreal II. A new born baby died but his death was due to major associated conenital anomalies and not to surgical complications. The Authors believe that the azygos vein flap is a useful technique in the treatment of esophageal atresia wide-gap.

Esophageal Atresia↗
PubMedDate not supplied

[Uncommon etiology of acute abdomen in pediatric age: the torsion of spleen].

The torsion of spleen on its vascular shank represents an uncommon problem, responsible of acute and chronic pain. The mobile spleen is fixed only through hilus vessels the gastrosplenic ligament. The incidence is unknow, greater in the male with an M:F ratio 6.1 in the first ten years of life, even if an episode of intrauterine torsion has been reported. The diagnosis can be performed with ultrasonography, angiography, scintigraphy and CT scan. There are reported two cases: male of 2.5 years female of 14 years who presented with recurrent pain to the left side, vomit diarrhoea and fever. Objectively a palpable mass was present. Ultrasonography and angio-CT scan of abdomen revealed splenomegaly, ptosis of the spleen and malrotation with signs of obstruction of the vessels. The treatment in both cases was splenectomy. The spleen appeared rotated on its shank and increased of volume, deprived of anatomical structures of fixation. The histological report confirmed the haemorrhagic infarction. The excessive mobility of the spleen, from insufficiency or absence of the ligamentous attachments is case of abdominal pain or acute abdomen, that can complicate with the infarction of the spleen. Angio-CT scan, in the cases here reported, has shown to greater sensibility in comparison to the ultrasonography. The Authors believe that the video-laparoscopic splenopexy, when the diagnosis is made of "wandering spleen" with painful repeated episodes, can be finalized, to the preservation of organ.

Abdomen, Acute↗
PubMedDate not supplied

[Changes induced by carbamazepine in the action of ADH (antidiuretic hormone) in neurologic patients].

We report the result of a study performed in 27 patients taking carbamazepine because of epilepsy or neuralgia, in order to point out subclinical water abnormal retention. We tested serum sodium and potassium levels, plasma and urine osmolarity, free water clearance. The carbamazepine serum level is also reported. We didn't find abnormal values. So in our experience there is not any complication concerning water retention during oral carbamazepine treatment.

Body Water↗
PubMedDate not supplied

[Dyskinetic-athetosic syndrome in a patient with prior radiculo-myelo-encephalopathy of probable viral origin. Therapeutic guidelines with levodopa and preliminary results].

The regulation of skeletal muscle tone and of the automatic and half-automatic movements by the extrapyramidal system in briefly discussed. The essential importance to keep separated the akinetic-hypertonic syndromes from the hypotonic-hyperkinetic ones is further confirmed. In fact two different chemical mediating agents work separately in these two cases: the Dopamine for the Nigro-Striatal system and the Ach for other tracts whose anatomy is still not well known, but which surely belong to the extrapyramidal system. Further more a clinical case of dyskinetic-athetosic post-infective syndrome, successfully treated with L.D., is discussed. The effectiveness of neuroleptic drugs in these hypotonic-hyperkinetic syndrome is stressed while they cause and worsen extra-pyramidal symptoms such as hypertonia and akynesia (hypertonic akinetic s.).

Athetosis↗
PubMedDate not supplied

[Computerized electroencephalography in acute cerebral ischaemia (author's transl)].

Physiopathological, clinical and therapeutical problems of acute cerebral ischaemia and brain infarction are briefly discussed. In the opinion of the Authors, a first valuable approach to the diagnosis and treatment of these conditions is afforded by the computerized electroencephalography (Berg Fourier Analysis). This investigations proved to be a safe, easy and reliable tool for testing and monitoring the effectiveness of individually selected drugs in early phases of cerebral ischaemia.

Acute Disease↗
PubMedDate not supplied

[Peduncular hallucinosis in a young woman with vertebrobasilar insufficiency based on severe hypoplasia of a vertebral artery, demonstrated angiographically].

A clinical case of peduncular hallucinosis due to circulatory insufficiency of the cerebral trunk is reported. Angiography revealed marked hypoplasia of a vertebral artery. The patient presented changes to sleep-arousal rhythms and neurological signs with focus involving the cerebral trunk. The patient took an emotional part in her visual hallucinations even though she was aware that they were only hallucinations. A review of the literature on the subject follows.

Adult↗
PubMedDate not supplied

[Vertebrobasilar insufficiency sustaining grave hypoplasia of the vertebral artery. Report of a clinical case resembling disseminated sclerosis].

The case of a young woman affected by at first paroxysmal and then stabilized disturbances of the pyramidal system and of certain cranial nerves is reported. The case had been diagnosed on several previous occasions as ascribable to demyelinizing disease. Careful study of the vertebrobasilar circulation and of the origin of the large trunks of the aortic arch, highlighted hypoplasia of a vertebral artery. The need to study further the arterial circulation (aortic arch and vertebrobasilar district) in those young patients whose symptoms too obviously point to disseminated sclerosis is pointed out.

Adult↗
PubMedDate not supplied

[Long-term levodopa syndrome. Report of a clinical case].

Since it is was first described by James Parkinson in 1817 much has been learnt about Parkinson's disease. The complete picture is not clear, however, and a new impulse has been given to the study of the physiopathology of the basal ganglia by the therapeutic employment of L-Dopa with a peripheral inhibitor of the decarboxylase. This treatment is the best available particularly for akinetic-hypertonic forms. In certain cases, however, patients developed a dyskinetic long-term L-Dopa syndrome, depending on the amount of L-Dopa given and individual sensitivity. The syndrome occurs in Parkinsonism only and can be prevented by thalamolysis. It would appear to be a specific expression of the effect of L-Dopa on the striatonigral system rather than of generic hypersensitivity due to denervation. A personal case is presented.

Basal Ganglia↗