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Biomedical subjects

R Manfrini

Publications and source records attributed to R Manfrini.

10 recordsLinked to original sources

Kinematic study of a reconstructed hip in paediatric oncology.

In 1997, a large portion of the femur of a four-year-old child affected by a Ewing's sarcoma was reconstructed with an innovative technique that used a massive bone allograft, in conjunction with a vascularised fibula autograft that was directly articulated within the acetabulum. The aim of the present study was to assess the kinematic behaviour of the reconstructed hip during flexion, once the acute remodelling process observed after the operation had ceased. A few additional CT slices of the hip joint region, in a flexed position, were taken at month 33 of the follow-up. The helical axes relative to the neutral-flexion motor action were estimated: their relative positions, with respect to the anatomical femoral heads, were compared, and the translation of the anatomical head centres was estimated. The angles spanned by the two femurs were almost equal, as were the translations along the respective helical axis. The main difference between the two femurs was the distance between the estimated femoral head centres and the relative helical axes. This resulted in a non-negligible translation of 2.9 mm of the fibula head inside the acetabulum during flexion, significantly higher than the 0.5 mm found for the intact contralateral femur. The results showed that, although the transplanted fibula grew and remodelled during the follow up, the action of the reconstructed hip joint still cannot be described as a ball-and-socket.

Biomechanical Phenomena↗

Modulation of clinical expression of plaque-induced gingivitis: effect of incisor crown form.

Evidence indicates that incisor crown form correlates with clinical periodontal features. It was hypothesized that incisor crown form may explain subject differences in gingivitis expression. The present experimental gingivitis study aimed to assess the effect of incisor crown form on plaque accumulation and gingival inflammation, and on individual susceptibility to plaque-induced gingivitis. Eighty-five periodontally healthy subjects were evaluated. A negative correlation was found between incisor crown width/crown length ratio and bleeding score (p = 0.045). From the 85 subjects, two groups of subjects with either 'long-narrow' or 'short-wide' incisor form were identified. The 'long-narrow' group had a significantly higher bleeding score than the 'short-wide' group (p = 0.014). No significant differences were found in the incisor crown width/crown length ratio between previously identified 'high responder' and 'low responder' subjects (Trombelli et al., 2004a). In conclusion, incisor crown form appears to affect the bleeding response of inflamed gingival tissues, while it exerts no influence on explaining differences in individuals' susceptibility to plaque-induced gingivitis.

Adult↗

High prevalence of nodular thyroid disease in patients with Cushing's disease.

OBJECTIVES: In the recent past, we have noted a frequent occurrence of thyroid nodules in our patients with Cushing's disease. We therefore elected to evaluate thyroid structure and function in these patients and also in patients with Cushing's syndrome of primary adrenal origin. PATIENTS AND METHODS: In 33 of the 37 patients (30 women and 3 men aged 19-66 years) with endogenous hypercortisolism referred to our Institution during the last five years, measurement of T4, T3, FT4, FT3, TSH serum levels and thyroid ultrasonography were performed, at first admission in 15 cases and subsequently in the course of follow-up in 18 cases. At the time of the study, 16 of the 33 patients had active Cushing's disease while 9 were in remission after successful surgery, 6 patients had an adrenal tumour and 2 patients had previously undergone unilateral adrenalectomy for an adrenal adenoma. Thyroid function and ultrasonography were also evaluated in 55 normal subjects, 40 women and 15 men aged 20-73 years. RESULTS: In 25 patients with Cushing's disease, we found a significantly higher prevalence of thyroid nodular disease than that recorded in 55 control subjects (60.0 vs 20.0%, chi 2 = 10.779, P < 0.005) and comparable to that in patients with active disease (56.2%) and those in remission (66.6%). Multiple nodules were present in 8 Cushing's patients and in 4 normal subjects while a single nodule was detected in 7 patients and in 7 controls. A markedly lower occurrence of thyroid abnormality was found in the 8 patients with adrenal tumours (25.0%, NS vs controls). In 9/17 (52.9%) patients with ultrasonographic evidence of thyroid nodules, these were palpable. As expected, serum thyroid hormone and TSH levels were reduced in patients with active Cushing's syndrome compared to normal controls. CONCLUSIONS: We found a significantly higher prevalence of nodular thyroid disease in patients with Cushing's disease with respect to a group of controls in whom the prevalence of thyroid nodules was comparable to that reported for the general population in Europe. The possibility that glucocorticoid excess is responsible for the development of thyroid changes does not seem likely since in our small series of patients with adrenal tumours the prevalence was only slightly higher than that observed in control subjects. Other factors related to hyperactivity of the corticotrophic cell, or a growth factor stimulating both corticotroph and thyrocyte proliferation might be involved. Evaluation of a larger series of patients with adrenal tumours may help to distinguish between these possibilities.

Adult↗

[Nephropexy using the Aglietti procedure. Case reports].

The paper reports two cases of 3rd degree nephroptosis which were treated surgically using the technique described by Prof. Aglietti. Both cases were women suffering from associated pathologies. The need to distinguish between symptoms related to renal ptosis and those caused by different disorders required an accurate clinical and instrumental study to be performed in both patients. Only after the concomitant pathologies had been treated could the patients undergo nephropexy. The paper gives a brief description of the technique. The authors discuss the indications for surgery and analyse the results.

Abdominal Pain↗

[Our subcostal retractor].

A new self-restraining table-fixed abdominal retractor, thought up and built by Dr. Bonini, is described. This retractor is easy to construct and use and is recommended whenever very good exposure of the diaphragmatic vault and the supramesocolic area is required.

Abdomen↗

[Carcinoma of the gallbladder. Clinico-statistical considerations].

The Authors shortly describe some essential aspects of the gall-bladder primitive cancer, and state their experience about 19 cases of malignant neoplasms observed out of 2280 operations on biliary duct. They confirm the extremely severe prognosis of such disease due to diagnostic delay. As a conclusion, they affirm the simple cholecystectomy is the choice operation in the precocious forms, and suggest the preventive cholecystectomy in the risk patients for such pathology.

Adenocarcinoma↗

Treatment of erosive reflux oesophagitis: a double-blind multicentre trial with nizatidine 300 mg b.i.d. versus placebo.

Histamine H2-receptor antagonists at conventional doses have proved only partly efficacious in the treatment of reflux oesophagitis. The aim of this study, therefore, was to compare the efficacy of high doses of nizatidine (300 mg b.i.d.) versus placebo in 117 patients with grade I and II oesophagitis. After 6 weeks' treatment, 70.6% of nizatidine-treated patients showed complete endoscopic healing against 25.4% of placebo-treated subjects (p less than 0.001). After 12 weeks, the respective healing rates were 77.5% and 47.4% (p less than 0.01). Nizatidine also proved significantly more effective than placebo in improving overall symptoms (p less than 0.05). Antacid intake was significantly greater in the placebo group (p less than 0.001). Both treatments were well tolerated. In conclusion, this study demonstrates that nizatidine at the dose of 300 mg b.i.d. for 6-12 weeks constitutes an effective treatment for patients with reflux oesophagitis.

Adult↗

[Submucosal polyps of the large intestine. Observations on 2 cases and review of the literature].

Lipoma of the large bowel is an infrequent pathology. The Authors, on the basis of a review of the literature and of their own experience of two cases reported analyze the clinical features, macroscopic appearance, endoscopic signs which may serve as a guide to diagnose the disease. They stress the importance of colonoscopy for a correct diagnostic and therapeutic approach.

Adult↗