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Biomedical subjects

A Cremona

Publications and source records attributed to A Cremona.

14 recordsLinked to original sources

Comparison of ultrasound transmission velocity with computed metacarpal radiogrammetry and dual-photon absorptiometry.

The aim of our study was to evaluate the validity of a quantitative US technique for measuring the bone density of the proximal phalanges of the nondominant hand compared with computed metacarpal radiogrammetry and dual-photon absorptiometry (DPA) of the lumbar spine. Mean US bone velocity (UBV) correlated with mean metacarpal cortical index (MCI), with mean metacarpal bone density (MBD) and with bone mineral density (BMD) of the lumbar spine, whereas it was correlated negatively with age and menopause duration. The average UBV was significantly higher in premenopausal women than in postmenopausal women, and higher in normal lumbar DPA patients than in reduced lumbar DPA patients. We conclude that the US evaluation of the nondominant hand proximal phalanges may be a new alternative way for measuring bone mass in screening of osteoporosis.

Absorptiometry, Photon

[The role of magnetic resonance imaging with a low-intensity field (0.2 T) in assessing expansive lesions of the hand and wrist].

The diagnostic capabilities of a small-size low-field (0.2-T) MR unit with a dedicated coil were investigated in the study of expansive lesions of the hand and wrist. Twenty-five patients suffering from the following diseases were examined: synovial cyst (6 patients), ganglion cyst (4), acute suppurative tenosynovitis (3), stenosing tenosynovitis (2), arteriovenous fistula (1), lipoma (1), fibrolipoma (2), chondroma (1), glomus tumor (1), fibromatosis palmaris (3), villonodular synovitis (1). Spin Echo (SE) and Gradient Echo (GE) scans were performed on all patients. The MR findings were compared with US, surgical and pathologic results. In synovial and ganglion cysts, acute suppurative and stenosing tenosynovitis, fibromatosis palmaris, fibrolipoma and lipoma, MRI showed typical patterns. In arteriovenous fistula, chondroma, glomus tumor and villonodular tenosynovitis, an accurate diagnosis could not be made: in these cases US failed to yield unquestionable results and the lesions could be diagnosed only at pathology. MRI yielded very accurate information as to lesion site and relationship with the surrounding structures; this kind of information, which is extremely important for the surgical approach, is not always provided by US. Low-field MRI can be considered a valuable diagnostic tool in the study of some expansive lesions of the hand and wrist. In other lesions this method can play a major role for both their characterization and the surgical approach.

Adolescent

Interleukin 1 beta, hand and foot bone mineral content and the development of joint erosions in rheumatoid arthritis.

OBJECTIVE: To assess the relationship between plasma levels of the cytokine interleukin-1 beta (IL-1 beta) and the progression of rheumatoid arthritis (RA). METHODS: Two subgroups of patients, one with persistently raised ESR (>/= 50 mm/hour, n = 16, group A) and one with persistently low ESR (</= 28 mm/hour), n = 18, group I) were chosen to represent stable extremes of inflammatory activity from a prospective study of 106 patients with active RA studied over one year in a single centre. The change from baseline in hand, foot and calcaneal bone mineral content measured by single photon absorptiometry and radiographic score of joint damage was measured over 12 months, together with plasma IL-1 beta and erythrocyte sedimentation rate. RESULTS: Significant progression of joint damage occurred in both subgroups over one year (p < 0.0001, paired t test) though progression was significantly less in the subgroup with low ESR (p < 0.05, ANOVA). Hand and foot bone mineral content decreased by almost 10% in the subgroup with raised ESR (p < 0.005, paired t test). Stepwise linear regression analysis revealed significant independent relationships between radiographic progression over one year and plasma IL-1 beta and ESR (multiple R 0.674, F = 11.64, p < 0.0002). No such relationships were observed for changes in bone mineral content parameters. CONCLUSIONS: Plasma IL-1 beta levels correlate weakly with progression of joint damage though not with loss of peripheral bone density in RA. A significant reduction in peripheral bone mineral content occurs over one year in patients with active RA with persistently raised ESR.

Adult

The risk of alcohol.

We have reviewed 156 papers which provided sufficient information to relate individual alcohol consumption to risk for a variety of physical damage. Overall, there was evidence for a dose-response relationship between level of alcohol consumption and risk of harm for liver cirrhosis, cancers of the oropharynx, larynx, oesophagus, rectum (beer only), liver and breast, and blood pressure and stroke. An increased risk of cardiac arrhythmias, cardiomyopathy and sudden coronary death was associated with heavy drinking. There was evidence for a protective effect of alcohol consumption against risk of coronary heart disease, which could be achieved at consumption levels of less than 10 g alcohol a day. The mortality of non-drinkers was higher than that of moderate drinkers in some studies. Level of alcohol consumption and total mortality were dose-related when non-drinkers were excluded. The finding of a dose-relationship between alcohol and harm suggested causality. It was not possible to define individual risk for all harms at a given level of alcohol consumption because of variations in methodology, but some idea of the order of magnitude of the increased risk can be obtained from calculating trends of pooled log-odds ratios. At levels of alcohol consumption of more than 20-30 g a day, all individuals are likely to accumulate risk of harm. Current guidelines on upper limits of lower risk drinking in different countries (168-280 g of alcohol a week for men and 84-140 g a week for women) reflect levels at which the risk of total mortality is not greatly increased above one.

Alcohol Drinking

Alcohol and death certification: influencing current practice and attitudes.

Forty housemen were sent a letter informing them of changes to the coroner's rules and emphasizing the importance of recording alcohol abuse. All relevant death certificates signed by the housemen over the next 3 months were selected for case note review to check details of the alcohol history taken and the consequent accuracy of the death certificate. A questionnaire was also sent to the housemen covering reasons for not recording alcohol abuse and knowledge of the coroner's rules. Comparison of the results with those from an earlier group of housemen who received no informatory letter suggest that minimal educational intervention can effect housemens' attitudes and practice.

Alcoholism

Mad drivers: psychiatric illness and driving performance.

Road traffic accidents are a leading cause of mortality and morbidity. It has been estimated that over 25% of drivers involved in accidents had impaired driving due to alcohol, drugs, illness or emotional distress. This paper reviews the association between road traffic accidents and psychiatric illness including the effects of alcohol, drugs and psychotropic medication.

Accidents, Traffic

Safe limits of drinking: general practitioners' views.

A survey was carried out by questionnaire of general practitioners' views on what the safe upper limits of alcohol consumption are for health education for men and women. The results showed lower limits than those suggested by "alcohol experts" in a previous survey.

Alcohol Drinking