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Biomedical subjects

N Martelli

Publications and source records attributed to N Martelli.

29 records · Page 2Linked to original sources
PubMed1985

Ultrasonographic evaluation of infantile hydrocephalus before and after shunting. A study in 20 children.

The authors present the results of a prospective study of 20 children with congenital or acquired hydrocephalus of nontumoral etiology and submitted to ventriculo- (or cyst-) peritoneal shunting with valve. The diagnosis was established by B-mode or real-time brain sonography, in association with another neuroradiological procedure (computed tomography, ventriculography with air or Dimer-X, cerebral angiography). Among the proposed measurements (cortical thickness, lateral ventricle height, III ventricle width and ventricular ratio) for pre- and postoperative comparison, the cortical thickness and the lateral ventricle height were the ones that changed significantly when analyzed by sonography. The routine use of brain sonography allowed the visualization of the ventricular catheter position and the diagnosis of complications, such as subdural collection, progressive enlargement of cysts, isolated IV ventricle, etc, even before symptoms arise. The authors conclude that sonography is easily performed, inexpensive and innocuous, and should be used routinely during the follow-up of children with hydrocephalus.

Cerebral Cortex↗
PubMed1984

[Computerized tomography in patients with neurocysticercosis with intracranial hypertension due to obstructive hydrocephalus: comparison with Dimer-X ventriculography].

The authors reviewed the alterations observed on computerized tomography (CT) examinations of 16 patients with increased intracranial pressure and obstructive hydrocephalus due to cerebral cysticercosis. Plain radiograms of the skull were available in all cases and Dimer-X ventriculography in 12 cases. In 7 cases there were radiologic signs of increased intracranial pressure. CT scan showed normal cerebral parenchyma in 9 cases and low density areas, with various size, with or without surround contrast enhancement, and/or small calcifications in the parenchyma. Hydrocephalus was the only alteration observed in the ventricular system in the case that the examination was done before ventricular drainage. Ventriculography was analyzed in other paper and permitted to situate the obstruction, determine its morphological characteristics and identify occuping space lesions within the ventricles. Comparison between ventriculography and CT scan made in the same period evidence that the former gives best information about the ventricular system and that tomography gives additional information about the cerebral parenchyma. In conclusion, CT scan and ventriculography are investigations that complete each the other for evaluation and diagnosis of cerebral cysticercosis.

Brain Diseases↗
PubMed1984

[Tumor form of neurocysticercosis: surgical removal of a cysticercus measuring 70X77 mm and treatment with praziquantel].

The authors report a case of a female patient, age 22, who presented episodes of focal seizures, right hemiparesis and dysphasia of five months duration. The neurologic exam revealed bilateral papilledema and computarized tomography of the head showed a cystic lesion (70X77 mm) in the left fronto-temporo-parietal area, midline shift and similar lesions scattered in the brain parenchyma. She was submitted to a left craniotomy with the diagnosis of cerebral cysticercosis and the major cyst (Cysticercus racemosus) and a small cortical cyst (10X10 mm) were removed to aliviate the increased intracraneal pressure and for histopathological examination. Thirteen days after surgery she was discharged without neurological deficits, except mild papilledema. One month later she was treated with praziquantel (50 mg/kg/day) during 21 days. The CSF examination was normal before the treatment started and showed a transient eosinophilic cellular reaction with positivation of the complement fixation test for cysticercosis while on treatment. The CT-Scan performed before the medical treatment revealed ventricular dilatation and several low density areas (10 to 40 mm) scattered in the cerebral parenchyma, including the operative site. CT-Scan performed three months later showed small low density areas only in the left cerebral hemisphere, including the operative site, calcification in the parenchyma, and slight dilatation of the left lateral ventricle. The clinical evolution was uneventful and the neurologic examination was normal three months later.

Adult↗
PubMed1982

[Cerebral ultrasonography in children during the 1st year of life. A method for diagnosis and follow-up of ventricular dilatation].

The ultrasonography (Mode B--Real Time) experience was analyzed to evaluate neurological diseases in children during their first year of life. Forty-two examination were accomplished in twenty-eight children with the following diagnosis: hydrocephalus (22), normal (15), subdural hygroma (3), intracranial cyst and hydrocephalus (1), giant encephalocele (1). The technique consists of positioning the transducer in the coronal, sagital and axial direction and selecting dynamically the images to be photographed. In the coronal position, the height of the lateral ventricle and the width of the third ventricule were obtained. In the axial position, the ventricular ratio-lateral ventricle width cerebral hemisphere width was obtained. Although it was a small group of patients, those indexes can objectify the ventricular size variation in children with well or poor functioning shunts. The importance of this method was the possibility to follow the development of hydrocephalus in cases of myelomeningocele and to analyze the etiology and features of hydrocephalus with or without shunts. In conclusion, this test is very usefull, mainly because it is very brief (about 20 minutes), the patient does not need sedation, it is innocuous, very precise even when compared with computerized tomography and for its low cost.

Brain Diseases↗
PubMed1981

[Surgical treatment of hydrocephalus in children. I. Clinical development and mortality].

The authors analized the clinical evolution and the mortality of fifty seven children with hydrocephalus due to congenital malformation (41.1%), meningitis (36.8%) and tumors (21.1%), that were submitted to surgical treatment for hydrocephalus, from 1970 to 1980. Insertions of ventriculostomy reservoir and of external ventricular drainage were satisfactory used to control the expanding hydrocephalus in children with meningitis, that wait insertion of the valve. The use of hypothalamic ventriculostomy with catheter has showed satisfactory results in the treatment of children with hydrocephalus due to non inflammatory origin. Ventriculoatrial shunts were utilized in few cases but were useful in the treatment of hydrocephalus in children. The operative mortality rate was 25.7%. Ventriculoperitoneal shunts showed good results in the treatment of hydrocephalus in 89.4% of the cases in the immediate post-operative time and this number drop to 88.2% at the eighteen post-operative month. The overall mortality rate was 34%. At the end of the third post-operative month 27.3% of the survivors of the children with hydrocephalus due to congenital malformation and meningitis submitted to ventriculoperitoneal shunts showed normal neuromotor development and at the end of the second post-operative year this number increased to 50%. The operative mortality rate in this group was 25% and the majority of death occurred due to meningitis.

Cerebral Ventricle Neoplasms↗
PubMed1981

[Surgical treatment of hydrocephalus in children. II. Complications].

The authors analized the complications of fifty seven children with hydrocephalus due to congenital malformation (42.1%), meningitis (36.8%) and tumor (21.1%), that were submitted to surgical treatment for hydrocephalus, from 1970 to 1980. External ventricular drainage and insertion of ventriculostomy reservoir were used to control the expanding hydrocephalus in children with meningitis. Complications weren't observed in the first procedure. Cutaneous abscess, brain abscess, cerebrospinal fluid leakage, wound dehiscence, malposition of the reservoir and local tumor were observed in the use of the ventriculostomy reservoir and these complications caused a revision rate of 0.47 revisions per patient. Hypothalamic ventriculostomy with catheter showed complications (catheter obstruction and meningitis) that caused a revision rate of 0.57 revisions per patient. Ventriculoatrial shunting procedure showed several complications (malposition of the distal catheter, malfunction of the valvular system without obstruction and infection and thrombosis of the superior vena cava), that caused a revision rate of 0.57 revisions per patient. Ventriculo-peritoneal shunting procedure showed infections in 30.8%, malfunction of the valvular system in 32.2% cerebrospinal fluid leakage in 17.3%, malposition of catheter in 13.5%, catheter disconnection in 9.6%, transient abdominal distension in two cases and overdrainage phenomena, ascites and abdominal pseudocyst in one case.

Brain Abscess↗
PubMed1979

[Intraspinal syphilitic gumma causing spinal cord compression. Report of a case].

A case of an syphilitic intraspinal gumma is reported. A 48 years-old woman developed severe spastic crural paraparesis of two months duration, associated with sensory and sphincteric disturbances. Myelography revealed an intraspinal tumor at T3 level. Surgical exploration by dorsal laminectomy showed a syphilitic gumma attached to the spinal cord. Clinical observations and laboratory studies are discussed. Revision and comments on previous reports are presented.

Female↗
PubMedDate not supplied

Nutritional antioxidants as antidegenerative agents.

In this study, primary cultures of cerebellar granule neurons were prepared from eight-day-old Wistar rats, and maintained in an appropriate medium containing a high (25 mM) concentration of KCl. All experiments were performed with fully differentiated neurons (eight days). To induce apoptosis, culture medium was replaced with a serum-free medium (containing 5 mM KCl) eight days after plating. In another series of experiments, apoptosis was induced by application of glutamate (50 microM) to the cell cultures. Apoptosis was measured by flow cytometry, the TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP-fluorescein nick end-labeling) method, and by the classical method of DNA fragmentation. Since there is evidence that an increased formation of reactive oxygen species (ROS) is involved in the apoptosis induced by both low K(+) concentrations and glutamate, a series of natural antioxidants and a red wine lyophilized extract (which is rich in antioxidant compounds) were tested in our experimental model. It was found that ascorbic acid (30 microM) and a red wine lyophilized extract (5 microgram/ml) were capable of blocking the apoptotic process. Addition of the following natural antioxidants did not have any protective effect on apoptosis induced by low K(+) concentrations: trans- and cis-resveratrol (5-200 microM), alpha-tocopherol (100-200 microM), reduced glutathione (100-400 microM), 3-hydroxytirosol (25-100 microM), epicatechin (25-100 microM), or quercetin (25-50 miroM). It is concluded that only a limited number of natural antioxidants are provided with antiapoptotic activity in cultured cerebellar granule neurons. This effect is probably exerted by reducing ROS formation, and by blocking caspase-3 activity.

Animal Nutritional Physiological Phenomena↗