Biomedical subjects

T Rossi

Publications and source records attributed to T Rossi.

At least 109 records · Page 6Linked to original sources

PubMedDate not supplied

Copper intraocular foreign body: diagnosis and treatment.

Copper intraocular foreign bodies (IOFB) are relatively common after penetrating eye injuries. Ocular signs and symptoms vary greatly in relation to the copper content, ranging from chronic uveitis and severe visual loss for IOFB containing more than 85% copper, to local copper deposits with no severe ocular damage for less toxic alloys. Reported here is the case of a ten-year-old boy who suffered from recurrent chronic uveitis five months after a perforating eye injury due to copper wire. Diagnostic ultrasound and computerized tomography revealed an IOFB within the lens and X-ray spectrometry (DXS) indicated the nature of the IOFB as copper, and accurately measured the dissolution of the metal. The patient underwent cataract extraction and standard three-port pars plana vitrectomy with gas-fluid exchange. Twelve months after surgery the retina was flat and visual acuity had risen to 20/60. Undiluted vitreous samples obtained in the course of the intervention, studied by immunohistochemical techniques, showed an inflammatory reaction with a prevalence of PMN-N and CD3 T-lymphocytes. DXS thus appears to be a new and reliable diagnostic tool for the early detection and management of copper and other toxic metal IOFB.

Child↗

PubMedDate not supplied

Automatic speech recognition in vitreo-retinal surgery. A project for a prototypal computer-based voice-controlled vitrectomy machine.

In the past half decade automatic speech recognition techniques, software and hardware technology have matured enough to support sophisticated medical applications. The project described aimed at introducing a computer-based, voice-controlled prototype system in a simulated vitreo-retinal surgery scenario. The aim was to provide the surgeon with a tool that could significantly improve the quality and ease of work and shorten the duration of intervention. The speech recognition system allows voice entry of simple commands to simulate surgical instrument control, including the infusion pump, vitreous cutter and diathermy. The project relies on a Markov-based, speaker-dependent, commercial isolated-word recognizer, and consists of a specific recognition vocabulary and application software, created and developed by the authors. Results have been encouraging. The system performed well under the test conditions, proving robust, simple to use and accurate (over 97% average word recognition rate). On the basis of their experience, the authors believe that automatic speech recognition technology, though suffering from some limitations such as the need for training, speaker dependence and a relatively small vocabulary, and requiring extensive testing under operating conditions, merits further development and opens new perspectives for a possible new generation of surgical instruments.

Artificial Intelligence↗

PubMedDate not supplied

Repair of scleral rupture and total retinal detachment in a self-injuring psychotic patient under local anesthesia: a case report.

PURPOSE: Ocular self-injury by psychotic patients is an uncommon cause of ocular morbidity that poses peculiar problems. This report describes a schizophrenic self-injuring patient with scleral rupture and retinal detachment (RD), treated under loco-regional anesthesia. CASE REPORT: A 65-year-old man presented with scleral rupture, hyphema, traumatic lens luxation, vitreous prolapse, vitreous hemorrhage and total RD after deliberately hitting his head. The fellow eye had been successfully operated with scleral buckle surgery for the same reason two years earlier. The patient underwent a two-step surgical procedure under local anesthesia, with repositioning and resection of the uveal prolapse and scleral rupture repair and, separately, lens removal pars plana vitrectomy (PPV), membrane peeling, retinotomy, laser treatment and SiO tamponade. RESULTS: Twelve months after PPV, the cornea was clear, IOP was 16 mmHg, the retina was attached and VA was 20/200. The fellow eye maintained 20/30 VA. CONCLUSIONS: In psychotic patients the intrinsic difficulty of a traumatic RD is combined with systemic illness, no compliance and the risk of recurrence. Although ocular traumas usually require general anesthesia, this patient underwent both interventions under local anesthesia with sedation, because of his psychotic condition and chronic liver failure. Local anesthesia and sedation proved effective in controlling pain and intra-operative compliance even in such a difficult patient. Although it is reasonable to question operating on such patients, we nonetheless believe that every attempt should always be made at gaining useful vision in both eyes since these patients are at a high risk of recurrent ocular trauma.

Aged↗

PubMedDate not supplied

Nanophthalmic uveal effusion syndrome after prophylactic laser treatment.

PURPOSE: We report a case of nanophthalmic uveal effusion syndrome (NUES) with total exudative retinal detachment (RD) after prophylactic argon laser (AL) treatment. The RD subsided and eventually resolved with i.v. steroid therapy. METHODS: A 45-year-old woman was referred to us with NUES and total exudative RD after prophylactic AL treatment for retinoschisis performed elsewhere. The patient had been scheduled for surgical intervention and was given i.v. prednisolone. RESULTS: Two days after starting i.v. prednisolone, the subretinal fluid partially resolved. Intervention had therefore been postponed. After 15 days the RD almost disappeared and vision improved to 20/400. Ten days later the macula was flat and vision was 20/200. At the six-month follow-up visit vision was 20/40. CONCLUSIONS: To our knowledge this is the first report of NUES and total exudative RD following AL treatment that resolved with i.v. steroid therapy alone. Since the AL treatment clearly seemed to play a role in the pathogenesis of the NUES and associated RD we strongly advise careful assessment of the risk/benefit ratio of prophylactic laser treatment in nanophthalmic patients. Although sclerectomy and vortex vein decompression are well-established techniques, we believe steroid therapy might be tried before proceeding to surgery.

Female↗

PubMedDate not supplied

Endomysial antibodies in the diagnosis of celiac disease and the effect of gluten on antibody titers.

Celiac disease, a common chronic gastrointestinal disorder, is gluten induced and is controlled with a gluten-free diet. While the management of CD with a gluten-free diet is quite effective, the diagnosis is rather difficult. The ESPGAN criteria for the diagnosis of CD seems to be tedious and time-consuming. Serological tests for IgA class endomysial antibodies, as detected by indirect immunofluorescence, on human and primate smooth muscles are specific and sensitive markers of celiac disease. Of all the specimens examined, endomysial antibodies were present in patients with gluten-sensitive enteropathy. These antibodies occurred in all active cases of celiac disease, in 90 percent suspected celiac patients where all the ESPGAN criteria has not been fulfilled. This contrasts to the presence of endomysial antibodies in 46 percent of confirmed and 17 percent of suspected celiac patients maintained on a gluten-free diet for various time intervals. Endomysial antibodies also occurred in all cases with chronic diarrhea and gut histology consistent with CD and 8% of asymptomatic family members of CD patients. None of the patients with other gastrointestinal and liver diseases had endomysial antibodies. These studies thus emphasize the specificity and sensitivity of endomysial antibodies for celiac disease.

Animals↗

PubMedDate not supplied

Spermiophages in human semen in normal subjects and in patients with selected diseases.

In order to screen for spermiophages in human semen, a Neutral Red Test was carried out in: a) normal subjects (NORMAL); b) male partners of infertile couples (INFERT); c) subjects with selected diseases. Spermiophages were observed only in 7.5% of the normospermic subjects, while the test was positive in 26.5% of INFERT. Positivity was higher in the selected pathological groups, even compared to the INFERT group. This observed increase in spermiophage activity could be an important pathogenetic factor in some cases of male infertility.

Adult↗

PubMedDate not supplied

[Extrauterine endometriosis: three new cases].

Extragonadal endometriosis is rarely diagnosed preoperatively due the variety of its localizations. Presentation to general surgeons may be atypical and pose diagnostic difficulties. The Authors report three cases surgically treated between 2000-2003. The Authors stress the peculiarity of one of these cases with endometrial tissue involvement of the intestinal mucosa. They also discuss about various aetiological hypothesis, symptomatology, differential diagnosis and need for multidisciplinary treatment.

Abdominal Pain↗

PubMedDate not supplied

Patient satisfaction and vision improvement after multiple surgery for recurrent retinal detachment.

PURPOSE: To assess patient satisfaction and functional status improvement after multiple surgery for recurrent retinal detachment (RRD) with proliferative vitreoretinopathy (PVR) grade C. Main outcome measures included visual acuity (VA), anatomic outcome, and patients' answers to a standardized multiple-choice questionnaire. METHODS: The authors retrospectively reviewed records of patients undergoing pars plana vitrectomy (PPV) for RRD with PVR grade C operated between 1997 and 1999. All included patients underwent a standardized telephone interview aimed at assessing the patients' visual performance and satisfaction. Statistical analysis used Wilcoxon signed-rank test, Mann-Whitney rank sum test, and Spearman rank correlation coefficient. p Values less than 0.05 were considered statistically significant. RESULTS: The population study included 62 patients with an average 19+/-4.1 months follow-up. The average number of operations was 2.9+/-0.7 with 1.45+/-0.50 recurrences. At the end of the study, 40/62 eyes had better than 5/400 vision and 14/62 better than 20/200; 2 patients had no light perception and 5 eyes still had RRD. Questionnaire answers yielded the following results: 61% believed their VA was better than before surgery, 13% the same, and 26% worse. Fifty-two percent noticed an improvement in binocular vision versus 35% stable and 13% worse: 84% thought their result had been worth the operation, 15% did not, and 2% did not know. Ninety percent believed the information they received before surgery was accurate. Results exceeded expectations in 35% of cases and matched them in 26%. Increase in binocular visual performance after intervention was significant for clothing, bathing, and home deambulation, climbing steps, watching TV, and reading, but not for car driving. The difference in VA improvement in satisfied and unsatisfied patients was significant. There was no significant correlation between patients' satisfaction and fellow-eye vision. CONCLUSIONS: The sample population showed a high rate of satisfaction and significant subjective improvement on four out of five tested activities, despite multiple surgeries and overall poor outcome, even in patients with a good VA in fellow eye. Many other factors such as visual field and contrast sensitivity improvement, not investigated by the authors, can play an important role in the visual functional status. Correct and extensive patient information remains critical in such settings.

Female↗

PubMedDate not supplied

Neurobehavioral and neurochemical abnormalities of pre- and postnatally lead-exposed rats: zinc, copper and calcium status.

Although diverging opinions have been expressed, there is a body of evidence of a cause-effect relationship between chronic exposure to lead and altered behavior in children. There are several problems in the interpretation of the behavioral and biochemical anomalies described in experimental models of lead intoxication due mainly to the different experimental conditions used. One of the major criticisms is linked with the claim that in several studies too high levels of exposure were used, hence inducing the suspicion that the effects specifically attributed to lead intoxication could be related to unspecific actions. Here we report that, using an experimental model of pre- and postnatal intoxication of rats exposed to a very low amount of lead (1 mg/kg/day), in parallel with behavioral anomalies, there are slight changes in cerebral dopaminergic and GABAergic receptors. A new finding was the discovery that in this condition there is a markedly increased number of opiate receptors in the hypothalamus (and other brain areas) in parallel with a decrease of beta-endorphin and an increase of Met-enkephalin. Therefore, low levels of lead intoxication which could be pertinent to the human situation, seem to induce neurotoxic effects which may be responsible for the behavioral anomalies in rats and, maybe, in children.

Animals↗

PubMedDate not supplied