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R Casadei

Publications and source records attributed to R Casadei.

At least 91 records · Page 5Linked to original sources

Ambulatory blood pressure monitoring does not interfere with the haemodynamic effects of sleep.

Automatic or semi-automatic blood pressure (BP) monitoring is a widely used method for assessing 24-h BP profile. However, the ability to achieve this goal depends on several factors that have not yet been controlled. The present study examined the possibility that cuff inflations disturb the sleep of patients and prevent the nocturnal fall in BP. This issue was investigated in 10 hospitalized subjects in whom BP was recorded intra-arterially for 48 h using the Oxford method. During the first or the second 24 h BP was also monitored non-invasively (Squibb ICR portable device), the cuff inflations being performed at 15 min intervals during the day and at 30 min intervals during the night. The computer analysis of the two different 24-h intra-arterial tracings showed that the addition of automatic BP monitoring had not caused any alteration in the day and night intra-arterial BP and heart rate profiles. Thus, disturbances of the haemodynamic effects of sleep do not characterize 24-h automatic BP recording, at least when made with the device employed in the present study. This removes an important objection against the ability of this approach to evaluate the patients' BP profiles properly.

Adult↗

Lack of alerting reactions to intermittent cuff inflations during noninvasive blood pressure monitoring.

Intermittent noninvasive blood pressure monitoring is becoming increasingly popular because of the belief that a daytime blood pressure profile can provide a better clinical evaluation of hypertension than that provided by casual blood pressure measurements. This approach has potential limitations, however, one of which is that the cuff inflations permitting blood pressure to be repeatedly measured may induce an alerting reaction and a pressor response in the patients and lead to an overestimation of their daytime blood pressure. Blood pressure in 22 subjects was invasively recorded for 24 hours by the Oxford method. During the day of the recording blood pressure was also measured by a noninvasive device (Vita-Stat 901), which had its cuff applied to the opposite arm from which the intra-arterial signal was derived. For 2 hours the device provided automatic cuff inflations at 10-minutes intervals. For another 2 hours it was programmed to provide cuff inflations only following patients' commands, also at 10-minute intervals. Analysis of the intra-arterial blood pressure trace during the periods preceding and following the automatically or semiautomatically induced cuff inflations showed that these procedures caused no increment in systolic and diastolic blood pressure. This finding applied not only to the mean data but also to each individual measurement considered separately, including the initial one. Our results indicate that automatic and semiautomatic blood pressure monitorings do not induce an alarm reaction and a blood pressure rise and thus do not overestimate daytime blood pressure values.

Adult↗

Cystic lymphangioma of the pancreas: anatomoclinical, diagnostic and therapeutic considerations regarding three personal observations and review of the literature.

Cystic lymphangioma is a very rare pathology and the pancreatic ones represent an exceptional report that must be considered in the differential diagnosis with others and more frequent cystic lesions of the pancreas. In this paper we describe three cases of cystic lymphangiomas of the pancreas observed in our Institute and we report on the literature review. Anatomopathological, clinical and therapeutics aspects of pancreatic cystic lymphangioma were analyzed for a better knowledge of this cystic lesion and to recognize some specific findings that could allow a preoperative diagnosis and, subsequently, a proper treatment.

Adult↗

Knee resection arthrodesis with allograft: a long-term follow-up study.

A consecutive series of 57 patients treated by knee resection arthrodesis for malignant or aggressive tumor around the knee was reviewed. Infection was present only after repeated surgery for other complications, delayed union or non-union occurred in 50% of the cases that could be evaluated, but were still easy to manage. Fracture incidence was higher than expected (32.6%) even occurring after 10 years; this was difficult to deal with and it often led to failure. The best possible method of fixation is still being debated, but locked nail and allograft cementation is often advised. Several satisfactory functional results were however achieved when surgery was performed in young patients; final results can be less satisfactory when there is leg length discrepancy and poor acceptance on the part of the patient. In recent years this type of surgery has been limited to younger male patients (10 to 14 years of age) in whom extra-articular knee resection was required or when most of the quadriceps muscle must be removed.

Adolescent↗

Substitution in vertebral resections.

The authors discuss the reconstructive methods used after curettage and/or vertebral resection possibly associated with removal of surrounding muscular, visceral and nervous structures.

Adolescent↗

The prognostic value of serum alkaline phosphatase in osteosarcoma of the limbs.

The values for serum alkaline phosphatase were evaluated in 340 patients affected with osteosarcoma of the limbs. The percentage of patients with high values for the enzyme at the onset of disease was significantly higher in the 69 cases who presented with metastases at the time of diagnosis, as compared to the 271 cases in which the neoplasm still appeared to be localized (81% vs 62%: p less than 0.001). In this last group of patients, treated with neoadjuvant chemotherapy, an evident relationship between values for alkaline phosphatase and prognosis was demonstrated. The percentage of patients who developed metastases was in fact 22% in the group with normal serum values for the enzyme at the onset of the disease and 40% for the patients with high values of the same (P less than 0.001). These data confirm the prognostic value for serum alkaline phosphatase in osteosarcoma, which should be taken into consideration when planning chemotherapy and in classifying patients for randomized therapeutic studies.

Adolescent↗

Systemic mastocytosis with skeletal involvement.

Systemic mastocytosis is a rare disease. The observation of one case characterized by clinical and radiographic bone involvement encouraged the authors to review the literature on the subject. The classification and most recent pathogenetic hypotheses correlated with various radiographic pictures, the different histological aspects, and most frequent differential diagnoses are reported.

Biopsy, Needle↗

Bone tumors of the foot: epidemiology and diagnosis.

The authors reviewed 260 cases of bone tumors localized in the foot and treated at the Tumor Center of the Rizzoli Orthopaedic Institute: 191 were benign and 58 malignant and 11 metastasis. There was predilection for the hindfoot (57%), followed by the forefoot (33%) (prevalently the metatarsals). Localizations in the midfoot were rare (10%). Osteoid osteoma was observed in 26% of all of the tumors of the foot and in 35% of the benign forms. Among malignant neoplasms Ewing's sarcoma (27.5%) was the most frequent. Conservative surgery, which was always carried out in benign tumors, was also performed in some of the malignant ones, having an early diagnosis and a correct preoperative study. The indications and the limits of the different imaging techniques available are reported (bone scan, arteriography, CAT, MRI), and the role of biopsy in the definitive diagnosis of these neoplasms in discussed.

Adult↗

Supracondylar process of the humerus: four cases.

Four cases of supracondylar process of the humerus are presented. Two of the patients were asymptomatic and in one of these the supracondylar process was fractured. In a third there was median nerve compression and in the last there was ulnar nerve entrapment. The anatomical features, clinical symptoms and therapy are described. Good results were obtained after resection of the supracondylar process; neurological symptoms regressed one month after surgery.

Adult↗

Quiz. Osteoma.

Explore the source record for details and available documents.

Adult↗

[Value and limits of CT in the preoperative assessment of primary malignant tumors of bone. Observations in 138 cases].

To estimate the capabilities and limitations of CT in the preoperative evaluation of malignant primary bone neoplasms, 138 patients were examined with high resolution CT and subsequently underwent surgery. In all cases a pathologic examination of the surgical specimen was performed, whose results were compared to CT findings. CT appears to yield important diagnostic contribution to preoperative staging. As a matter of fact, CT shows the tumor extension and its relationship to the adjacent anatomical structures, particularly, it shows the involvement of the muscular and vascular bundles, and that of the articular cavity and medullary canal. These data are of primary importance for planning therapy. The commonest CT limitations are: overestimation of the tumor extension, false positives and false negatives when searching "skip" metastases, and, sometimes, inaccurate definition of the relationship between tumor and vascular bundles and/or articular cavities. These limitations may be overcome by using, when necessary, other techniques--i.e. angiography, bone scan and, above all, MR imaging.

Adolescent↗