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Biomedical subjects

P Bruschini

Publications and source records attributed to P Bruschini.

34 records · Page 2Linked to original sources

Acoustic reflex characteristics in hypo- and hyperthyroid patients.

The various parameters of the stapedial reflex, evoked by acoustic stimuli and recorded using an impedance meter, were evaluated in untreated hyperthyroid and hypothyroid patients and in normal controls. In hyperthyroid patients neither the threshold nor the latency time, the rise time, the recovery time and the maximal amplitude of the reflex were different from normal subjects. On the contrary, hypothyroid patients showed a longer recovery time and a reduced maximal amplitude, suggesting, in the absence of alterations of middle ear structures, a weaker contractile activity of the stapedial muscle.

Auditory Threshold↗

Audiovestibular involvement in systemic sclerosis.

In order to evaluate the nature and association of audiovestibular disturbances and systemic sclerosis (SSC), 37 unselected SSC patients were studied with a detailed audiological and vestibular examination since November, 1987. Pure-tone audiometry, speech audiometry, impedance audiometry, brainstem response audiometry and vestibular function using electronystagmographic recording were performed. We found a rather frequent audiovestibular involvement (41%). A hearing loss was found in 14 SSC patients; hearing loss was sensorineural in 10 cases and mixed in 4 cases. The latter revealed a finding similar to tympanosclerosis. Four patients showed altered vestibular test values and only one of these had normal hearing. Sensorineural deafness was the more frequent pathological finding and in all cases the site of lesion was cochlear. SSC appears to be directly responsible for audiovestibular damage, since in 12 out of 15 patients with such involvement, no other apparent cause could be revealed. SSC may be included among the autoimmune diseases which may cause audiovestibular disturbances.

Acoustic Impedance Tests↗

[Bovine costal cartilage as material for otologic reconstruction: anatomo-functional results].

The Authors present their experience in using bovine cartilage as otological material reconstruction. Cartilage of the ribs is to collect from selected bred cattle and is first placed in an antibiotic solution for 3 days and then in a 70% ethyl alcohol in which it is stored for 20 days before being utilized. One hundred-nineteen cartilage heterografts have been implanted in the middle ear since January 1989. We report the results of 86 cases which were included in a followed study for at least 12 months. Bovine cartilage was used in 47 canal up techniques, 28 canal down techniques and 11 anatomic and functional rehabilitation of old radical cavities. The result prove most encouraging. In 74 cases we observed good anatomical results characterized by a new, intact eardrum with no sign of inflammation or a cavity lined with normal epithelium. No extrusion was found. Removal of cartilage implanted after a year enabled us observe the high tolerance of the graft and to carry out further histological examination. The histological findings indicated normal and intact cartilagineous matrix, lined with fibrous tissue and mucosa with no evidence of condrocytes. In cases in which the heterografts were utilized for ossiculoplasty, the post-operative air-bone gap was 11.1 dB and the mean hearing gain was 26.3 dB. Moreover, bovine cartilage is easily obtainable and available in pieces of sizes necessary for specific purposes in otologic surgery. Cartilage heterografts might well be a good alternative to autologous and homologous cartilage grafts.

Adolescent↗

[Histological and ultrastructural aspects of oto-mastoid cholesteatoma in children].

Cholesteatomas were intraoperatively removed from subjects under 14 years of age presenting widespread cholesteatoma with bone erosion. The samples were studied under light and transmission electron microscopy in order to consider the features of inflammation and bone erosion. The results showed that the perimatrix of cholesteatoma in children is rich in mononuclear inflammatory elements and generally presents the features of chronic, as well as acute, inflammation. The perimatrix infiltrates and erodes the surrounding bone. Next to the resorption areas many areas were observed having new bone the surface of which is lined with osteoblasts. The new bone formation activity is marked in these cases of childhood cholesteatoma and appears to be an attempt at spontaneous repair which is thwarted by the persistence of inflammation.

Adolescent↗

[Lyophilized bone homografts in reconstructive surgery of the middle ear].

The authors present their experience with stored lyophilized bone allografts utilized in middle ear reconstructive surgery. The implants were cut from the cortical substance of the long bone in subjects deceased. A demineralization in 0.6 N HCl solution was performed in order to induce osteoinductive capacity to the bone matrix. From November 1986 to December 1988 this material was utilized in 45 operations: 31 canal up techniques; 7 canal down techniques; 4 anatomical and functional rehabilitation of old radical cavities. Good anatomical results without perforation of the tympanic membrane and without signs of inflammation or retraction were obtained in 33 cases (79%). Furthermore, no extrusion was observed in cases with retraction of the graft and protrusion of the prosthesis. In cases in which the homografts were utilized for ossiculoplasty, the post-operative air-bone gap was 21 dB and the mean hearing gain was 15 dB. The histological examination of two homografts, removed 13-18 months after implantation, appeared to be coated with normal mucosa and to contain areas of active bone formation.

Adult↗

[HIV infection and nosocomial risk: experience at the ORL Clinic of Pisa].

The risk of nosocomial risk of HIV infection and the problem of preventative measures to adopt has been modifying how workers in the health field deal with patients. In fact, the increased spreading of HIV infections within our population has led to the establishment of a national protocol of preventative measures by which no patient can be considered "safe". Consequently, the likelihood that contact with any patient can lead to infection causes the health care worker to look upon the patient as a potentially dangerous enemy, thus leading to a decline in the quality of health care. On the other had, although the risk of a health care worker being infected by HIV during routine work is low, preventative measures must be taken both during examination and during surgery. Unanimous agreement exists in regard to what measures are to be taken to prevent cutaneous and mucosa exposure of workers whenever the risk of accidentally coming into contact with the blood and/or other biological fluids exists. On the other hand, the use of an anti-HIV screening for all patients in order to distinguish between infected and non infected subjects is still subject to debate. Some feel such screening is unacceptable because it would deny sero-positive patients adequate care and could give rise to both false positives and false negatives while others propose routine screening feeling it to be helpful both to those who are sero-positive and to health care workers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Audiological and neuropsychological development study in a sample of school children from a low-iodine area of the Central Apennines that is endemic for cretinism].

We have evaluated neuropsychic development in 70 normal schoolchildren in an area of severe endemic goitre and cretinism in the Central Apennines (Montefeltro). In each subject we have studied auxological, psychometric and audiometric parameters, together with tympanograms and stapedial reflexograms. Auxological data were in the normal range, as were the stapedial reflexograms and tympanograms. On the contrary, 54.8% of the sample performed below the 25th percentile in psychometric tests (Raven test PM-47), being also 22.8% below the 5th percentile. Audiometric data showed a neurological hearing impairment in 3.1% of the children tested, as compared with 0.28% in the area of Pisa. These data point out that an impairment of central nervous system function still persists in this area of severe endemic goitre.

Child↗