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Biomedical subjects

A Bortolani

Publications and source records attributed to A Bortolani.

9 recordsLinked to original sources
PubMed2004

Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women.

OBJECTIVES: The aim of the present study was to test the association between muscular strength, functional limitations, body composition measurements and indexes of sarcopenia in a sample of community-dwelling, elderly women at the high end of the functional spectrum. DESIGN: Cross-sectional. SUBJECTS: In all, 167 women aged 67-78 y were selected from the general population in central Verona. A group of 120 premenopausal healthy women aged 20-50 y represented the young reference group. MEASUREMENTS: Body weight, height, body mass index (BMI) and the presence of acute and chronic conditions were evaluated in each subject. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Physical functioning was assessed using a modified version of the Activities of Daily Living Scale. Dominant leg isometric strength was measured with a Spark Handheld Dynamometer. RESULTS: Elderly women with BMI higher than 30 kg/m(2) and in the highest quintile of body fat percent showed a significantly higher prevalence of functional limitation. In our population study, about 40% of sarcopenic elderly women and 50% of elderly women with high body fat and normal muscle mass were functionally limited. The prevalence of functional limitation significantly increased in subjects with class II sarcopenia, defined according to the skeletal muscle mass index (SMI=skeletal muscle mass/body mass x 100). In logistic regression models, after adjusting for age and different chronic health conditions, subjects with BMI higher than 30 kg/m(2), in the highest quintile of body fat, or with high body fat and normal muscle mass or class II sarcopenia according to SMI, had a 3-4 times increased risk of functional limitations. Finally, isometric leg strength was significantly lower in subjects in the lowest quintile of relative muscle mass and in sarcopenic and sarcopenic obese women. CONCLUSIONS: High body fat and high BMI values were associated with a greater probability of functional limitation in a population of elderly women at the high end of the functional spectrum. Among the different indexes of sarcopenia used in this study, only SMI predicted functional impairment and disability. Isometric leg strength was significantly lower in subjects with sarcopenia and sarcopenic obesity.

Absorptiometry, Photon↗
PubMed1996

Fluid replacement in burned patients.

Burn injury involves a large amount of water, electrolytes and proteins loss trough the burn wound. For this reason, to avoid shock, a wide infusion of fluid is necessary in the first hours after trauma. Many reanimation formulas were proposed in the past years, with different composition: saline, colloids, plasma. The authors have studied 40 burned patients admitted in Verona Burn Center within 4 hours after burn, with burns over 30% of the body surface area. Twenty of them were treated with Baxter reanimation formula (ringer lactated saline, RLS) while the others with Monafo hypertonic lactated saline (HLS), modified by Milan Burn Center. The two randomized groups were assessed and compared. In RLS group total fluid volume infused was higher while sodium requirements was lower than in HLS patients, with statistically significative difference (p < 0.01). On the contrary, in HLS group, potassium administered was perhaps twice if compared with the other. Haematocrit, urine output and urine osmolarity were adequate in both the groups, and did not showed statistical differences, such as serum proteins concentration, that was low in all patients, while a significative difference was noted in urine osmolarity (p < 0.01). A metabolic alkalosis was present in HLS patients, while, on the other hand, serum nitrogen was significantly higher (p < 0.05), in the first 48 hours after burn, in RLS group. Patients were assessed for pre-existing diseases too, and data showed that complications were lower in HLS than in RLS group. HLS resuscitation formula guarantees a good electrolytes balance with lower fluid load, reducing tissue oedema and complication rate. Mortality rate was higher in HLS, may be for an higher Roy index in this group.

Acid-Base Equilibrium↗
PubMed1994

Benign "metastatic" cellular blue nevus.

This report illustrates the case of a patient with a pigmented lesion on the dorsal skin of his left foot associated with a bulky homolateral inguinal mass. A metastatic melanoma was clinically suspected; therefore, the pigmented foot lesion was excised and grafted, and the groin mass was dissected. The histological examination of the foot lesion revealed a well-preserved epidermal layer, beneath which spindle cells endowed with regular nuclei yet without any atypia or mitotic figures, were present. Melanin-rich histiocytes surrounded the nerve fibers and the vessels that intermingled with such spindle cells. Under light microscopy, the sections of the inguinal lymph nodes revealed clusters of pigmented cells that looked very much like those found in the foot skin lesion. These spindle-shaped cells infiltrated the nodes' capsule and peripheral sinuses and left the inner parenchyma unaltered. The inguinal mass revealed a thick, fibrous capsule surrounding a heavily pigmented tissue rich with blue nevus cells with islands of melanophages. In the case presented here, the differential diagnosis between cellular blue nevus and nodular melanoma was mandatory. In this case report, we provide the differential diagnosis and review the criteria used for it. Further support for the diagnosis was obtained from immunohistochemical findings that were positive for S-100 protein and not for HMB-45. Wide but conservative surgery appears to be the treatment of choice for cellular blue nevus. In fact, the patient described here is still alive 5 years postoperatively. Hence, the clinical evolution of the patient's lesions can be considered benign.

Diagnosis, Differential↗
PubMed1994

[Intra-oral cancer: immediate reconstruction using a free radial forearm flap].

The radial forearm flaps is ideal for intra-oral reconstruction. In that it offers thin, pliable, hairless skin to replace oral mucosa removed during wide resection in surgical treatment of cancer. The vascularity of the area allows considerable variation in design and size of the flap and offers the possibility of covering structures on different levels and, when bone is included, of carrying out immediate reconstruction of the mandible. The Authors used this flap in 24 patients for intra-oral reconstruction. The ages of the subjects ranged from 30 to 70 years. The arteries and the veins of the flap used for microsurgical anastomosis were radial arteries and superficial veins of the elbow. Neck vessels were superior arteries of the thyroid and jugularis externa vein. Operating time was slightly prolonged when compared to repair employing a myocutaneous island flap. This reconstruction method was completely successful in all 24 patients; in one patient a DIC partially compromised the vascularity of the flap on day 8. Morbidity was observed, resouled, however, with minor surgical procedures. Our results support the choice of this method for intraoral reconstruction.

Adult↗
PubMed1992

Merkel-cell carcinoma of the skin.

Three cases of Merkel-cell carcinoma of the skin have been presented. The need for a correct clinical and histologic diagnosis has been highlighted. Rapid widespread growth of the tumor occurs when surgical treatment is delayed. Immunohistochemistry is essential for accurate differential diagnosis.

Aged↗
PubMed1991

Monitoring of elastase in plasma of burned patients in relation to other inflammation parameters.

Twenty burned patients divided in three groups according to the severity of the lesions were investigated at 1- or 2-day intervals for up to 5 weeks after injury. Plasma elastase levels were elevated during the first day after injury and were correlated with the area of the burns. However, plasma elastase was rapidly bound and inactivated by protease inhibitors. Leucocyte counts, fever and the concentration of alpha-1-proteinase inhibitor were not correlated with the extent of the burn. The rise of plasma elastase was not accompanied by consumption of the elastase inhibitory capacity (EIC) of plasma, which increased to a plateau around day 5. The EIC values were in accord with the rise of alpha-1-proteinase inhibitor, the major anti-elastase agent in plasma. Studies of blister fluid in eight patients showed that the elastase content was higher than that of corresponding plasma, while the concentration of alpha 1-proteinase inhibitor and the EIC were comparable with those of plasma. Measurements of the levels of tumour necrosis factor released by stimulated macrophages in five patients with major burns showed no significant increase compared with controls.

Blister↗
PubMed1984

[Changes in the concentration of urinary homovanillic acid as a prognostic factor in patients treated for malignant melanoma].

In 34 patients with malignant melanoma in three different stages HVA concentrations were determined. Some patients in stage 1 presented a considerable discrepancy between concentration values and values reported in other works. This group had been controlled for three years to observe the development of disease. We found three subgroups: the first with values within 4,3-6.0 mg/24 hr haven't had any recurrence; the second with values within 6.8-11.75 mg/24 hr presented lymphonodal metastasis in the lapse of six months - 1 year; in the third with values within 10-20 mg/24 hr patients died in two years for disseminated metastasis. The Authors according to the results achieved, conclude that variation of HVA concentration will be further prognostic factor.

Female↗
PubMed1983

[Reconstruction of the breast after radical mastectomy].

The Authors review the indications for mammary reconstruction following mastectomy, and add a new series of procedures after considering the oldest ones. They point out the possible post operative complications and evaluate the result of a reconstruction which can prove useful both cosmetically and psychologically.

Breast↗