Search PubMed⌕ Search

Biomedical subjects

P Facchin

Publications and source records attributed to P Facchin.

At least 19 recordsLinked to original sources

Diurnal variations in tonic pain reactions in mice.

Diurnal changes in the behavioural reactions to subcutaneous formalin injection (20 microl, 1%) into the dorsum of an hindpaw were examined in female CBA/J mice aged 70-75 days, maintained in a 12/12 dark/ light cycle (light on at 07.00 h; light off at 19.00 h). Mice showed higher pain scores, as expressed by the amount of time spent licking the injected paw and by the number of flinching episodes, when tested under red light at the beginning of the dark phase (19.00-22.00: Dark group) than when tested either under white or red light at the beginning of the light phase of the diurnal cycle (7.00-10.00). The increases in pain reactions at night were found both during the first (0-10 min) and the second (11-55 min) phase of the behavioural response to formalin injection. They were not due to aspecific increases in motor behaviour, since self-grooming actually decreased in the Dark group during the second phase of the response, and the amount of locomotor activity after the injection was similar to, or lower than, that found in mice tested in the morning under white or red light, respectively. In another group of female CBA/J mice tested in the hotplate apparatus (at a temperature of 52 degrees), paw-lick latencies were significantly higher in mice tested at dark during the night, whereas jump (escape) latencies were higher in the morning. These results demonstrate different diurnal variations in the reactions to brief or prolonged noxious stimulation in mice, with greater responses to tonic pain at the onset of the dark phase.

Animals↗

Child abuse: current problems and key public health challenges.

Child abuse has recently been recognized by the World Health Organization as a major worldwide health problem impairing the health and welfare of children and adolescents. This paper attempts to look at child abuse from a public health perspective taking into account the vast cultural diversity in which children and adolescents live focusing on the issue of abuse and violence in a broad public health perspective, and trying to highlight the need for greater attention to be given to possible country-specific interventions.

Adolescent↗

Developmental sequence of postural control in prone position in children with spastic diplegia.

The aim of this study was to assess the development of postural control in the prone position in children with spastic diplegia and triplegia, and determine the influence of clinical characteristics, visual acuity and cognitive performance on that development. We also analysed the relation between these early motor achievements in the prone position and the subsequent acquisition of motor competence in the sitting position. We followed 24 diplegic and triplegic children from before age 2 years (mean age 12 months) to mean age 41 months, videorecording motor behaviour every six months and abstracting acquisitions in alignment and balance using a standardised procedure. We confirm a developmental sequence of all the acquired movements in the prone position. 83.3% of the children completed the uprighting sequence in the sagittal plane, acquired good balance, and ability to rotate the head and trunk. 70.8% of the children (all but one of the diplegic children and none among triplegic children) acquired symmetric posture in the frontal plane and 83.3% reduced leg hyperextension. Development was not uniform, and at 12-18 months two groups began to emerge: diplegic children who rapidly achieved all or most of the steps in the sequence and had a favourable prognosis for subsequent motor development; and triplegic children who achieved these steps at a much slower rate or in some cases not at all and had a less favourable prognosis for future development. Diplegic children with normal visual acuity, and general quotient GQ>70 did better than triplegic children with compromised visual acuity and GQ<70. Acquisition of the full uprighting sequence in the prone position before the age of two related to the later acquisition of autonomous sitting.

Cerebral Palsy↗

Predictors of independent walking in children with spastic diplegia.

A prospective study was carried out to identify predictors of independent walking in 31 children with either spastic diplegia or triplegia, observed from the age of 9 to 18 months (mean, 11 months) and followed for a mean period of 30 months (range, 24 to 36 months). Mean age at most recent examination was 41 months (range, 36 to 54 months). We used an 18-item scheme to chart the acquisition, from the prone position, of prelocomotor, sitting, and locomotor skills. Examinations were conducted every 6 months and videotaped according to a standardized procedure. At latest assessment 18 (58%) of the 31 children had achieved walking, 7 (23%) independently and 11 (35%) with assistance; 13 (42%) did not achieve walking. Ambulatory status was related to developmental quotient and visual acuity: all the children who became independent walkers had normal visual acuity and in 86% of cases a normal general development quotient. Moreover, we found a significant correlation between the number of gross motor skills achieved and the rate of achievement before 2 years of age and ambulatory status at 3 to 5 years of age. Ability to put weight on the hands while prone and to roll from supine to prone position by 18 months of age were significantly related to independent walking, while ability to sit without support was predictive only at around 24 months of age.

Cerebral Palsy↗

Civilian gunshot wounds to the head with brain stem localization. A case report.

The authors present a case of a patient wounded to the head and back by civilian firearm projectiles. The case peculiarity is that only one bullet reached the brain stem level causing significant neurological deficits. The final clinical picture is comparable to the "caudal pontine tegmentum syndrome". The authors describe both the bullet path and the intracranial localization taking into account ballistic details. The problems associated with prognosis, diagnosis, and treatment for gunshot wounds are discussed. In addition, the authors explain the main intracranial lesions and their mechanisms, the role of investigation, and the protocol of medical and surgical treatment. Lastly, a systematic approach for treating these types of gunshot wounds is outlined.

Anti-Bacterial Agents↗

Locomotion patterns in cerebral palsy syndromes.

Locomotion patterns were studied in 160 children with cerebral palsy. Ten patterns were distinguished, which were typical of the type of impairment: (1) crawling--mildly impaired children who will achieve independent walking; (2) creeping and crawling--diplegic children with moderate motor impairment; (3) creeping, never leading to independent walking--children with severe diplegia or tetraplegia; (4) bottom shuffling--children with hemiplegia and ataxia and minimal or mild motor impairment; (5) bunny-hopping--dyskinetic children with marked motor impairment but generally not mentally retarded; (6) rolling--severely diplegic and dyskinetic children; (7) other forms of locomotion, such as bridging or grub-type creeping, rare and typical of children with ataxic elements; (8) just walk--children with hemiplegia, diplegia, ataxic diplegia or ataxia, generally in cases of mild motor impairment but mental retardation; (9) just walk with aids--children with severe diplegia; and (10) no mobility. The locomotion pattern, age at onset and even manner of execution all influenced prognosis for walking. Severe deformity affected the choice of locomotion pattern. Though physiotherapy probably would not greatly influence the adoption of a particular locomotion pattern, early intervention might help prevent deformities.

Adolescent↗

Childhood obesity treatment: double blinded trial on dietary fibres (glucomannan) versus placebo.

Dietary fibres are frequently used for the treatment of paediatric obesity. The aim of this clinical trial is to evaluate the efficacy of glucomannan in the child obesity management. This experimental design was double blinded with a block randomisation, alpha = 0.05, beta = 0.2 and delta = 50%. The study involved 60 children under 15 years of age (mean age 11.2 years, mean overweight 46%), 30 of them under glucomannan treatment (1 g twice a day for two months) and 30 under placebo and the same schedule. The drug and the placebo were indistinguishable both for the family and the physician. During the two months study period the children followed a normocaloric diet evaluated every two weeks by a dietetic record book. At the beginning of the study the drug and the placebo groups were comparable in regards to anthropometric data. At the end, the mean overweight of the drug group was decreased from 49.5% to 41% and that of the placebo group from 43.9% to 41.7%. Both decreases were significant (p < 0.01), but no significant difference was observed between the drug and the placebo groups. The only significant difference concerned the lipid metabolism. The children under glucomannan treatment manifested a significant decrease of alpha-lipoprotein and an increase of pre-beta-lipoprotein and triglycerides; the children under placebo manifested only a decrease of triglycerides and apo beta-lipoprotein. We suggest that this metabolic alteration may derive from a primary decrease of alpha-lipoprotein, most likely because of an inadequate water intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Diagnostic factors in pediatric primary headache.

Primary headaches are frequent in children. They are difficult to diagnose because there is much disagreement about the interpretation of the historical data and the use of signs and/or symptoms in diagnosis. It would be useful, therefore, to standardize this procedure. We used linear discriminant analysis to determine a classification rule capable of diagnosing new cases of chronic and recurrent primary headache in children. We considered 23 symptoms in 118 patients. Through discriminant analysis we chose five variables: frequency of the attacks, type of pain, neurologic deficits, nausea, and vomiting. With this classification rule, we obtained a total correct classification of 84.7% for migraine, psychogenic headache, and non-defined headache in respect to the diagnoses formulated by a pediatrician and a child neuropsychiatrist after 3 months of follow-up. Our method for diagnosing migraine has a sensitivity of 95% and a specificity of 100%. The algorithm, validated on another 105 pediatric patients, produced a total correct result of 82.9%.

Adolescent↗

Plasma infusion for hemolytic-uremic syndrome in children: results of a multicenter controlled trial.

The results of a controlled trial to ascertain the usefulness of plasma infusion for the treatment of hemolytic-uremic syndrome (HUS) are reported. Criteria for admission were (1) observation within 8 days from first symptoms, (2) dialysis treatment required, and (3) no special treatments and no more than 25 ml blood/kg previously received. Children were subdivided according to age (less than or more than 3 years) and then randomly assigned to treatment with plasma or symptomatic therapy. Thirty-two children ranging in age from 4 months to 6 years entered this study; 17 received plasma (P+ group) and 15 only symptomatic therapy (P- group). The mean follow-up period was 16 months in both groups. Surgical renal biopsy was performed 29 to 49 days after onset in 11 P+ and 11 P- children, and 33 histologic findings were semiquantitatively evaluated. No death occurred in either group. No differences were found in blood pressure, proteinuria, or hematuria at the end of the follow-up period; in no case were severe arteriolar lesions found. There were no significant differences for the scores of the individual histologic measurements; on electron microscopy, no vascular changes were observed in seven children of the P+ group, whereas in five of seven of the P- group, thickening of the lamina rara interna and arteriolar damage were present. The ability of plasma to stimulate prostacyclin (PGI2) production, measured as its stable derivative 6-keto-PGF1 alpha, was within the normal range for all patients. In our patients with predominant glomerular involvement who were treated in a very early phase of HUS, infusions of plasma did not significantly influence the short- and medium-term clinical outcome and were not effective in severe HUS when given later in the course of the disease. A longer follow-up is needed to ascertain whether the presence of endothelial damage, demonstrated by electron microscopy in children who were not given plasma, is of clinical relevance.

Biopsy↗

Use of liquid culture and cell cycle analysis to compare drug damage following in vitro treatment of normal human bone marrow cells with adriamycin, arabinosyl-cytosine, and etoposide.

The effects of adriamycin (ADM), arabinosyl-cytosine (ARA-C), and etoposide (VP16) were studied on human bone marrow mononucleated cells using colony formation in agar, a modified liquid culture system, and flow cytometry analysis of the cell cycle. Drug concentrations tested during a 1-h incubation ranged from 0.1 to 4 micrograms/ml for ADM, from 0.3 to 30 micrograms/ml for VP16, and from 10(-7) to 10(-3) M for ARA-C. Regression analysis of the dose-response curves was used to assess the drug concentration that inhibited 90% +/- 5% (LD90) of colony growth. LD90s were 0.4 microgram/ml for ADM, 20 micrograms/ml for VP16, and 10(-4) M for ARA-C. LD90-surviving cells were cultured in liquid medium for 3 weeks. Surviving cells over this time were 13% of the control for ADM, 22% for VP16, and 95.7% for ARA-C. Although cells decreased drastically in ADM- and VP16-treated samples, granulocyte-macrophage colony-forming units (CFU-GM) per 10(5) surviving cells rose to twice the control for ADM, to 60% for VP16, and to 150% for ARA-C. Flow cytometry analysis of the cell cycle was performed at day 0 and at day 4 after treatment with the LD90 dose. It showed a rapid and reversible effect of ARA-C on cells in the S-phase, whereas the action of VP16 concerned all cells, regardless of their cycle phase. We conclude that the direct effects of the three drugs on CFU-GM in agar are poorly predictive of hematopoietic reconstitution capacity, except for VP16. Liquid culture gives a much more accurate appraisal of the long-term damage and recovery due to anticancer drugs.

Bone Marrow Cells↗

Computer diagnosis of primary headaches in children.

In the area of primary headaches in children several diagnostic classes (migraine, psychogenic) and other nondefined headaches are recognized. Their clinical diagnosis is complex and still not standardized. We present a Personal Computer program for diagnosing types of primary headaches in children. The program calls for the input of each patient's score on five clinical variables chosen by means of discriminant analysis, and the output gives a clinical diagnosis along with its posterior probability. The program was used on an initial group of 223 pediatric patients and was cross-validated at a first level on a second group of 90 patients and at a second level on a third group of 70 patients. The total correct classification figures were 85.2, 90, and 87.1%, respectively.

Child↗

Further definition of lipid-lipoprotein abnormalities in children with various degrees of chronic renal insufficiency.

We characterized the lipid-lipoprotein abnormalities encountered in a series of 45 nonnephrotic uremic children with various degrees of chronic renal insufficiency. A mild hypertriglyceridemia associated with decreased serum high-density lipoprotein cholesterol levels was confirmed. The correlation between high-density lipoprotein cholesterol and creatinine clearance showed a power behavior with a marked decrease in high-density lipoprotein cholesterol below a creatinine clearance value of 40 ml/min/1.73 m2. A number of uremic children accumulate an abnormal population of very low-density lipoprotein particles in their plasma. On agarose gel electrophoresis these particles migrate as a slow moving pre-beta band and are clearly distinguished from the regular fast moving pre-beta very low-density lipoprotein band. This electrophoretic phenomenon has been called double pre-beta lipoproteinemia. The prevalence of double pre-beta lipoproteinemia increased significantly with the degree of impairment of renal function, reaching highest figures in patients on hemodialysis. Accordingly, the very low-density lipoprotein cholesterol/triglyceride ratio also was significantly increased. The double pre-beta lipoproteinemia phenomenon was not detected in any of the control, nonuremic subjects. The clinical importance of double pre-beta lipoproteinemia in uremic plasma is related to its possible atherogenic role.

Adolescent↗

Antimetastatic action of a new analog of dacarbazine in mice bearing Lewis lung carcinoma.

We report the selective antimetastatic properties of 3-(3,3-dimethyl-1-triazenyl)-5-methyl-4,5-dihydroisoxazole in the murine transplantable tumor model Lewis lung carcinoma. The compound verifies a previous study on the correlation of antimetastatic, antitumor and cytotoxic properties of aryl- and heteroaryltriazenes with their Electron Ionization Mass Spectrometry (EI-MS) behavior. The new analog of dacarbazine exhibits a selective antimetastatic activity accompanied by limited thymus toxicity. The mechanism of action is unclear nevertheless any antiproliferative or cytotoxic effect is excluded.

Animals↗

On the neurological complications of internal and external shunt in patients with non-neoplastic stenosis of the aqueduct.

In our Department 35 patients have been operated for non-neoplastic stenosis of the aqueduct. In the first years, ventriculocisternal shunt according to Torkildsen was performed, obtaining 6 recoveries and 1 death. Later, ventriculosternostomy acc. to Stookey and Scarf, was carried out in 3 cases, obtaining 2 recoveries and 1 death; by using right ventriculo-atrial shunt we had 4 successes and 1 failure. More recently, since 1973, ventriculoperitoneal shunt has been carried out without deaths out of 21 operated patients. With this technique we have had many complications requiring repeated drainage system revisions in 9 cases, and evacuation of a chronic subdural haematoma in 3 cases. 2 patients, operated by drainage system revision and 1 for evacuation of subdural haematoma, had a dramatic postoperative course, characterised by apallic syndrome. Considering the results of the various techniques, we could conclude that the elective operation must be internal shunt (posterior or anterior ventriculocisternostomy) if, of course, the patency and the functionality of the cisterns have been ascertained.

Adolescent↗