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Biomedical subjects

V Testa

Publications and source records attributed to V Testa.

At least 37 records · Page 2Linked to original sources

Use of a tourniquet in the internal fixation of fractures of the distal part of the fibula. A prospective, randomized trial.

A prospective, randomized trial was undertaken to determine the rate of complications after the use of a tourniquet during open reduction and internal fixation of simple, closed fractures of the distal part of the fibula. Forty patients were operated on with use of a tourniquet (Group 1) and forty patients, without use of a tourniquet (Group 2). The average duration of the operation was significantly different between the two groups (41 +/- 9 minutes for Group 1 compared with 53 +/- 12 minutes for Group 2 [p = 0.026]). There were more complications in the patients in Group 1, two of whom had an isolated deep-vein thrombosis of the calf. The wound was possibly infected in eleven patients (seven in Group 1 and four in Group 2 [p < 0.05]) and frankly infected in three patients, all in Group 1 (p < 0.05). The plaster-of-Paris cast needed to be changed in three patients from Group 1. The patients in Group 1 returned to work an average of one week later than those in Group 2. The mean duration of follow-up was eighteen months (range, nine to thirty-two months). Given the lower prevalence of postoperative complications and the shorter time to recovery for the patients in Group 2, we believe that it is justified not to use a tourniquet in the operative treatment of simple, isolated fibular fractures.

Adult↗

Post-viral fatigue syndrome. A longitudinal assessment in varsity athletes.

Maximal oxygen uptake, anaerobic threshold (AT), isometric strength of the elbow flexor and knee extensor muscles, isometric strength endurance exhaustion time (prolonged contraction at 66% of maximal isometric strength), uphill sprinting exhaustion time were longitudinally studied in eight varsity endurance runners with post-viral fatigue syndrome (PVFS). Prolonged impairment of exercise performance is evident during the course of PVFS. Although maximal oxygen uptake (VO2max) had returned to pre-infection values 13 months after the viral illness (4.160 vs 4.0 L.min-1), AT was still significantly reduced [52 ml.kg-1.min-1, 18.6 km.hr-1, 176 bpm, and 82% of VO2max vs. 49.1 ml.kg-1.min-1 (p < 0.05), 175 bpm (NS), 17.2 km.hr-1 (p < 0.01) and 79% of VO2max (NS)]. Maximal isometric contraction strength of the upper limb remained constant (282 N vs. 274 N), while knee extensor muscles strength decreased significantly (730 N vs. 701 N, p < 0.05). Strength endurance was still significantly reduced by the end of the study (arm average pre-infection: 46.2 sec; end of study: 29.3 sec, p < 0.001; leg average pre-infection: 66.4 sec; end of study: 49.1 sec, p < 0.01). Up hill sprinting time was similarly reduced by the end of the study period (29.3 sec vs. 16.2 sec, p < 0.01). Both aerobic and anaerobic exercise variables are seriously affected by post-viral fatigue syndrome, and one year may not be sufficient to fully recover.

Adult↗

Mediopatellar synovial plica of the knee in athletes: results of arthroscopic treatment.

The long-term results (9-87 months) of the arthroscopic treatment of unilateral mediopatellar synovial plica of the knee in 102 athletes are reported. In all patients a large and/or fibrotic inflamed mediopatellar plica impinging on the femoral condyle on knee flexion was identified and trimmed. Chondromalacia patellae was detected in 38 patients. The impingement lesion was seen in 13 knees. In one patient, a minor tear of the lateral meniscus was trimmed, and one patient was found to suffer from a clinically asymptomatic partial tear of the anterior cruciate ligament. Isometric strength testing of the quadriceps revealed marked decrease at the second postoperative week, with subsequent gradual recovery. The results obtained justify arthroscopic treatment in a young, extremely active population.

Adolescent↗

Histochemistry of the triceps surae muscle in idiopathic congenital clubfoot.

The histochemical composition of the triceps surae muscle was investigated in 13 previously unoperated children (age 9-24 months) with unilateral idiopathic clubfoot. On both the normal and the affected side, the percentage of type I fibers was significantly higher than that of the other fiber types. The muscle biopsies from the clubfoot side showed an increase in their connective tissue content. The affected side showed a nonsignificant higher percentage of type I fibers, whereas the average capillary density and capillary to fiber ratio were significantly lower.

Clubfoot↗

The validity and reliability of measurements in spinal deformities: a critical appraisal.

Quantitative measurement of spinal deformity is the preliminary step in order to plan a therapeutic regimen. The most commonly used methods and, for this matter, practically any measurement methods, may have several sources of errors, namely: a. errors in taking a radiograph; b. errors intrinsic to the measurement method; c. errors due to anatomical deformity of the vertebrae; d. observer errors in measurement technique. These are discussed, and suggestions are given to minimize them.

Diagnostic Errors↗

Inter- and intratester reliability of radiographic measurements of spondylolisthesis.

Thirteen radiographic methods to measure spondylolisthesis were assessed to determine: 1. whether or not the different methods were correlated with each other; 2. their precision in detecting vertebral displacements; 3. inter- and intra-measurer reliability among six orthopedic surgeons performing radiographic measurements. Several methods were found to be correlated with each other in detecting spondylolisthesis on radiographs. However, on simulated displacements only three of them showed good correlation (r greater than or equal to 0.95, p less than 0.01). Intra- and intergroup correlations among the orthopedic surgeons were equally good (r greater than 0.90; p less than 0.01).

Humans↗

Glove perforation in hand surgery.

A survey of glove perforation in 100 consecutive hand surgery operations was undertaken. A total of 397 pairs of gloves were tested for punctures after the operation. Evidence of perforation was found in 19% of the gloves used, and only in 12 cases did the surgeons actually realize that a perforation had occurred. With a perforation rate of 43%, the surgeons were significantly more at risk of glove perforation than the other members of the operating team.

Gloves, Surgical↗

Glove perforation in foot surgery.

A total of 391 pairs of gloves were tested for punctures after 100 consecutive foot surgery operations to assess the rate, site, procedure, and maneuver during which glove puncture accidents took place. Evidence of perforation was found in 23% of the gloves used. The surgeons are significantly more at risk of glove perforation than the other members of the operating team.

Equipment Failure↗

Spinal anaesthesia for day case surgery in sportspersons and sedentary patients.

The effects of spinal anaesthesia were investigated in 67 sportspersons and in 128 sedentary patients (average age 31.8 +/- 6.2 yrs). The most frequent complaint in both groups was mild low back pain (27 cases vs. 58). Postspinal headache was severe and disabling, with an incidence of 13.4% in the sportspersons and 21.1% in the sedentary group. The sedentary group also showed a higher incidence of other postanaesthetic problems. Given the high rate of side effects, the young age of the subjects, and their desire to resume work as soon as possible after the operation, spinal anaesthesia is not the best anaesthetic procedure for this age group.

Absenteeism↗

[Osteosynthesis with an adhesive in skeletal fractures: an experimental study].

A-cyanoacrylate proves to be an advanced means of osteosynthesis. It is particularly indicated for short bone fragments in the articular and comminuted fractures, where a perfect anatomic reduction is required. It is shown to be non-toxic for bone and surrounding tissues and to be endowed with a remarkable chemical bond. It is easily applied and inexpensive. The results are very interesting and stimulate continuation of the studies. The authors think a-cyanoacrylate (or a derivative) is the future of biological osteosynthesis.

Animals↗

The Doppler stress test for the vertebral arteries.

The authors propose a new method of dépistage and thorough diagnostic examination of temporary vertigo caused by extrinsic compression of the vertebral arteries. This method is easy to execute, noninvasive, reliable, and relatively inexpensive. Its purpose is to confirm diagnosis by documenting criteria that are visible and reproducible.

Adult↗

Indices of sustained aerobic power in young middle distance runners.

Sixteen young endurance athletes underwent physiological testing to determine their maximal oxygen uptake (VO2max), lactate threshold (lacAT), ventilatory threshold, and the slope variation point (SVP) of the linear relationship between running speed (RS) and heart rate (HR) both on the treadmill and during a field test, and the onset of blood lactate accumulation point. The RS, HR, VO2, and blood lactate concentration at which the different thresholds occurred were highly correlated, with r ranging from 0.82 to 0.90. The highest correlation was shown by RS at lacAT and RS at SVP during the field test. Various indices of sustained aerobic power in athletic children examined were shown to occur at a percentage of their VO2max similar to adult endurance runners. The tests developed for older athletes can be used in this age group as well.

Adolescent↗

Chronic tuberculous rheumatism (Poncet's disease) in a gymnast.

Chronic arthritis, whether primary or reactive, is an unusual manifestation of long standing tuberculosis. We described the case of a 16-year-old gymnast with tuberculous rheumatism (Poncet's disease) secondary to Pott's disease of the dorsal spine. The possible pathogenetic mechanisms are discussed.

Adolescent↗

Rupture of the intersesamoid ligament of a soccer player's foot.

The traumatic dislocation of the lateral sesamoid of the flexor hallucis brevis tendon in a soccer player is reported. It was treated surgically by open reduction and ligamentoplasty of the ruptured intersesamoid ligament. Fourteen months after the injury, the patient is fully asymptomatic, and has returned to full activity.

Adult↗

[Infiltrations in gonarthrosis, a therapeutic turning point: the use of a proteinase inhibitor].

On the basis of evidence of the considerable damage caused by proteolytic enzymes in cases of degenerative arthritis, the authors propose the intra-articular introduction of an inhibitor of these enzymes (aprotinine). Both the immediate and long-term results of this therapy are very promising from a clinical standpoint. This drug not only acted on the symptoms of pain and stiffness, but also blocked the degeneration and consequent cell damage, restoring physiological homeostasis. Considering its high tolerability and absence of side effects, this drug represents a significant turning point in the treatment of degenerative joint disease, with results that are strikingly superior to those achieved with commonly used infiltrative drugs.

Aged↗

[Morphine in the inferior cerebellar cisterna for oncologic pain in the ORL area].

The study aimed to assess whether the infusion of microdoses of morphine in the cisterna magna, close to the sensitive nuclei of the cranial nerves (V-VII-IX-X) involved in painful syndromes of the head and neck, is able to control severe oncological pain in this region which does not respond to traditional pain killing treatment or neurolesive practices. Cisternal catheters were inserted in eight patients with cancer of the head and neck. The intensity of pain was assessed using VAS and the quality of analgesia obtained using cisternal morphine was judged to be: excellent, good, inadequate or null. Treatment lasted a mean of 121 days. Good or excellent analgesia was achieved in 7 patients using a mean daily dose of 1.5 mg morphine during the initial stage and 4.8 mg during the final stage; in one patient with a large component of "deafferent pain", good pain relief was obtained by associating cisternal morphine with chlorimipramin per os. The side-effects observed were almost always short-term and easily resolved. Morphine treatment was begun in the hospital and in all cases continued at home. This efficacious pain killing method should be given adequate attention in the global strategies used to treat oncological pain in the head and neck region.

Aged↗

Source and route of microbial colonisation of parenteral nutrition catheters.

To assess the effectiveness of tunnelling the polyurethane venous catheter for parenteral nutrition in reducing the frequency of catheter microbial colonisation, and to investigate the routes taken by microorganisms colonising the central venous catheter, 109 patients were randomised to traditional subclavian catheterisation (58, group A) or to subcutaneous catheter tunnelling (51, group B). Samples were taken from patients and their nurse attendants to identify their indigenous flora. Cultures were also done of swabs from the catheter insertion site, blood, nutrient solution, segment of the catheter, and washings of the catheter hub. Intravascular segment colonisation was commoner in group A (18/58) than in group B patients (4/51), and bacterial migration from insertion site to intravascular segment was also commoner among group A (9/58) than among group B patients (1/51). Catheter hub contamination was responsible in 10 out of 22 cases of microbial colonisation; in 6 of these 10 the bacterium isolated was present on the skin of nurses who changed the bag. Contamination of the insertion site skin and of the CVC hub were equally responsible for the microbial colonisation of the intravenous segment of the catheter.

Adult↗

Ankle taping: support given by different materials.

Three different adhesive and two non-adhesive tapes were used by three operators to assess the compressive action exerted on the ankle at the moment of strapping, during different phases of gait, and after some days of treatment in ten volunteers. Only the adhesive tapes were still able to prevent swelling after five days. They should be used if a prolonged compressive action is required.

Adhesives↗