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Biomedical subjects

S Redaelli

Publications and source records attributed to S Redaelli.

At least 19 recordsLinked to original sources

The distribution of occlusal contacts in the intercuspal position and temporomandibular disorder.

The aim of this study was to describe the distribution of occlusal contacts in subjects with signs or symptoms of temporomandibular disorder (TMD), and to assess whether any difference exists with healthy subjects. Twenty-five university dental students with complete natural dentition who exhibited TMD (13 females and 12 males, age from 19 to 30 years) and 25 age- and sex-matched controls entered the study. Occlusal contacts were evaluated in the intercuspal position and wax registrations were made in all subjects. Occlusal contacts were classified according to location and intensity. No differences were found between TMD and control groups for the overall number and distribution of contacts or for any side and intensity of contact. An intra-subject analysis showed that TMD subjects had significantly greater bilateral asymmetry in the number of contacts than controls. Median absolute difference of the number of contacts on right and left sides was 3 (95% CI, 2-4) in TMD subjects and 2 (95% CI, 1-2) in controls. In TMD subjects with mono-lateral TMD there was a significant concordance (88.9%) between the side of disorder and the side of higher number of contacts. These findings, while confirming that a significant relationship exists between distribution of occlusal contacts and TMD, further suggest that in young adults it may be primarily expressed by asymmetries in occlusal contact patterns. Existence and aetiology of any association of TMD with occlusal contacts should be further investigated.

Adult↗

Transcatheter closure of atrial septal defects with the STARFlex device: early results and follow-up.

BACKGROUND: The STARFlex (SF) device is a CardioSEAL (CS) double-umbrella device that has been modified by the addition of a self-centering mechanism comprised of nitinol springs connected between the two umbrellas and a flexible core wire with a pin-pivoting connection. This paper compares the results of atrial septal defect (ASD) closure with CardioSEAL and STARFlex devices. PATIENTS AND METHODS: Between December 1996 and March 2000, 117 patients underwent ASD closure with CardioSEAL (n = 79) and STARFlex (n = 38). The mean age (17 years), weight (49 kg), and ASD size (15 mm) were similar in the two groups. The procedures were performed under general anesthesia with both fluoroscopic and transesophageal echocardiographic monitoring. IMMEDIATE RESULTS: The devices were successfully implanted in all patients. Ten patients had multiple ASDs. A single device was used in four patients (CardioSEAL in three, STARFlex in one), while a simultaneous placement of two CardioSEAL (one patient) or two STARFlex (five patients) were performed in six patients. The results are summarized as follows: [table: see text] Follow-Up Results: On follow-up clinical exam, electrocardiograms, chest X-rays, and echocardiograms were obtained at 1, 6, and 12 months. [table: see text] During follow-up there were no deaths, endocarditis, rhythm disturbances, or other complications. Arm fractures were observed almost exclusively with large CardioSEAL devices (40 mm, less frequently with 33 mm), and only in one 33-mm STARFlex device. There were no clinical complications related to fractures. CONCLUSIONS: The STARFlex device seems to offer better results than the CardioSEAL, with significantly lower rates of residual shunts and arm fractures.

Adolescent↗

Familial occurrence of isolated right ventricular hypoplasia.

Isolated right ventricular hypoplasia is a rare congenital anomaly. This condition is usually associated with a communication between the atria in the form of a patent foramen ovale or secondum atrial septal defect. We describe a familial occurrence of this rare disease. A 1-day-old male child and his 34-year-old father were found to have isolated right ventricular hypoplasia with atrial septal defect. An autosomal dominant mode of inheritance is likely for this rare congenital anomaly.

Adult↗

Estimation of the entropy of the solar wind flow

We analyze a time series of velocities of the low-speed stream measured by the Helios spacecraft in the inner heliosphere, which is the region of space dominated by the solar wind flow. We use a nonlinear filter to give a faithful representation of the solar wind nonlinear behavior. We have demonstrated that the influence of noise in the data can be much more efficiently reduced by a nonlinear filter than with the conventional (linear) filters, and this allows a more realistic calculation of the solar wind entropy. The resulting Kolmogorov entropy is positive, and possibly the largest Lyapunov exponent is also positive locally, which would exhibit exponential sensitivity to initial conditions. Thus, these results show that the solar wind in the inner heliosphere is most likely a deterministic chaotic system.

Journal Article↗

Mechanical valves in the pulmonary position: a reappraisal.

OBJECTIVES: To evaluate midterm results of mechanical valves in pulmonary position in patients with pulmonary regurgitation and right ventricular dysfunction as an alternative to bioprostheses. PATIENTS: Mechanical valves (six tilting disc valves and two bileaflet valves) were implanted in eight patients previously operated on for tetralogy of Fallot (n = 7) and truncus arteriosus (n = 1), with severe right ventricular dysfunction caused by massive pulmonary regurgitation. RESULTS: All patients survived prosthesis implantation and are currently well. At follow-up (3 months to 9 years), they do not show signs of valve failure, and right ventricular function has dramatically improved in all but one, who still shows moderate ventricular hypokinesia. CONCLUSION: After operative correction of congenital heart defects in selected patients who show severe dysfunction of the right ventricle caused by pulmonary regurgitation/stenosis, mechanical valves may represent an alternative to bioprosthetic valves. The selection of the valve type is still a matter of debate. However, according to literature data, complications seem to have occurred only in patients with bileaflet mechanical valves in the pulmonary position, whereas no thromboembolic episodes or valve failure is reported in subjects with tilting disc valves in the right ventricular outflow. Tilting disc valves might perform better in the right ventricular outflow than bileaflet valves.

Adolescent↗

Balloon aortic valvuloplasty in the first year of life.

Between February 1988 and September 1993 balloon aortic valvuloplasty was attempted in 33 consecutive patients in the first year of life: 20 patients (61%) were younger than 1 month. Major associated anomalies such as mitral stenosis, coarctation, and hypoplastic left ventricle were found in 11 cases (33%). The balloon dilation of the aortic valve was accomplished through the right carotid cut-down approach in neonates and patients with body weight < 5 kg, through a percutaneous femoral approach in the others; the procedure was completed in all. The peak systolic gradient across the aortic valve measured at catheterization fell from 80 +/- 33 mmHg (range 25-165) before the dilation to 27 +/- 17 mmHg (range 0-65), afterwards (p < 0.0001). The left ventricular ejection fraction increased from 44% +/- 26% to 61% +/- 17%, 24-48 hours after the procedure (p < 0.0001). Aortic insufficiency developed in 17 cases, being moderate in 2, mild in 6, and trivial in 9. Seven patients (21%), all in the first month of life, died within 30 days from the valvuloplasty; major associated anomalies were present in six; the death was due to a procedure related complication in one. No mortality was observed among the patients undergoing valvuloplasty beyond the first month of life. On follow-up (6 months to 6 years) aortic restenosis occurred in 3 cases; 1 was treated by surgical valvotomy, 2 by repeat balloon valvatomy; in another 2 cases, a subvalvular aortic obstruction developed and was relieved by surgical resection. There was no late mortality. Thus, balloon valvuloplasty appears to be an effective palliation for critical aortic stenosis in infancy. Early mortality is mainly related to associated anomalies.

Aortic Valve Stenosis↗

[Pulmonary valvuloplasty].

The aim of this study was to present the experience of 2 Institutions (Department of Cardiology in Bergamo and Department of Pediatric Cardiology, Apuano Pediatric Hospital in Massa) in performing the balloon dilatation of the pulmonary valve. From January 1985 to August 1993 the balloon pulmonary valvuloplasty was performed in 220 patients, age ranging from 1 day to 60 years (mean age 5 years), 55 (25%) in the first year of life, 17 (8%) in the first week of life. The systolic gradient across the pulmonary valve fell from 78 +/- 31 mmHg (range 40-160) to 20 +/- 16 mmHg (range 0-70) immediately after the procedure (p < 0.001). In-hospital mortality happened in 3 cases (1.3%); 2 of them were neonates with critical pulmonary stenosis. In 7 cases (3%) the balloon valvuloplasty was repeated afterwards, because of inadequate relief of the gradient after the first dilatation. During the mean follow-up period of 4 years the other 210 patients (95%) did not need any further treatment and remain in stable clinical conditions. The balloon valvuloplasty gives excellent early and intermediate term results and should be considered the first choice procedure in the treatment of pulmonary stenosis at all ages.

Adolescent↗

[Permanent pacemaker implantation in children after open heart cardiac surgery (author's transl)].

Between 1972 and 1977, a permanent pacemaker has been implanted in 9 children for complete heart block, after repair of a congenital heart disease. Children's age ranged between 2 1/2 years and 13 years (mean age 8 years). The block had been caused by the operation in 8 children and was pre-existent in the last one. A permanent pacemaker was not implanted in another four children with postoperative complete heart block. In seven cases the pacemaker was implanted in the subclavear zone and connected to a transvenous electrode; in the remaining two cases the pacemaker was positioned subcutaneously in the abdomen and connected to an epicardial electrode. VVI-type pacemaker have always been used. Three children died after implantation because of chronic cardiac failure complicated, in one case, by surrhenalic insufficiency. In two cases the pacemaker was replaced because of battery exhaustion, as suggested by routine controls; in five cases, wire breakage occurred and it was replaced together with the pacemaker. In another case transvenous electrode displacement occurred; skin infection at pacemaker site occurred only once. No skin breakdown at pacemaker site has ever occurred, or any problem due to excessive pacemaker dimensions. Reappearance of normal synus rhythm was noted in one patient. No complication has been reported so far for the cases with postoperative complete heart block not treated with cardiac pacing.

Cardiac Surgical Procedures↗

Synthesis of derivatives of 3-amino-2,3-dideoxy-L-hexoses related to daunosamine (3-amino-2,3,6-trideoxy-L-lyxo-hexose).

The synthesis is described of 3-amino-2,3-dideoxy-L-arabino-hexose (10), methyl 2,3-dideoxy-alpha-L-lyxo-hexopyranoside(17), methyl 3-amino-2,3-dideoxy-alpha-L-ribo-hexopyranoside (21), methyl 2,3-dideoxy-3-trifluoroacetamido-alpha-L-xylo-hexopyranoside (26), and certain derivatives from methyl 4,6-O-benzylidene-2-deoxy-alpha-L-arabino-hexopyranoside (3). Conversion of 2-deoxy-L-arabino-hexose into 3 by modified, standard procedures, and on a large scale, gave a 75% yield.

Daunorubicin↗

Synthesis and antitumor properties of new glycosides of daunomycinone and adriamycinone.

The synthesis of 4'-epi-daunorubicin and of 4'-epi-adriamycin was performed by condensation of 2,3,6-trideoxy-3-trifluoroacetamido-4-O-trifluoroacetyl-alpha-L-arabino-hexopyranosyl chloride with daunomycinone or the protected adriamycinone derivative 17, respectively. Both the alpha and beta anomers were obtained and characterized. All new compounds are biologically active in cultured cells and the alpha anomers display noticeable activity in experimental tumors in mice. Interestingly, 4'-epi-adriamycin (4) appears nontoxic to cultured heart cells up to a concentration of 5 mug/ml.

Aminoglycosides↗

Angiocardiography with small-size rapid cassette changer films.

The disadvantages of small-size 10 X 10 cm. films in angiocardiography do not preclude correct diagnosis in a well equipped cardiac laboratory. On the contrary, the advantages are such as to recommend a more extensive use. In our department the method has been limited to pediatric patients, mainly because of excessive scattered radiation at high kVp. It is hopeful that improvement in recording and combination with image intensification will make the system available in the future for adult use.

Angiocardiography↗