Enhancement of professional skills to address gender differences at Ente per le Nuove Tecnologie, l'energia e l'ambiente (ENEA).
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Developed Countries↗
Biomedical subjects
A De Carli
Publications and source records attributed to A De Carli.
Effect of age, birth cohort and period of death on Italian liver cirrhosis mortality, 1972-1986.
Liver cirrhosis is one of the main causes of death in Mediterranean countries. A trend towards a global reduction in the mortality rate has been recently reported. In order to clarify better this trend and in an attempt to hypothesize the future pattern of mortality, we analysed data from 254,834 Italian subjects aged 30-79 who died from liver cirrhosis during the period 1972-1986. We used a log-linear Poisson model to examine the effects of age, calendar period of death and birth cohort. Our data confirm that both in the population as a whole and after stratification for three geographical areas (Northern, Central and Southern Italy) the mortality rate is decreasing. The age-effect analysis showed an exponentially rising effect in the Southern population, in accordance with the viral aetiology of cirrhosis, whereas an increased effect followed by a decreased effect was observed in the Northern and Central population, suggesting the alcoholic aetiology for the disease. The results from the birth-cohort effect suggested that in the Northern and Central populations mortality should continue to decrease over the next decade, possibly due to the implementation of better prevention programmes for cirrhotics and to decreased alcohol consumption in Italy. In the Southern population, however, mortality is still rising and this will probably continue for the next decade, as the generations born between 1940 and 1950 who are at high risk of carrying chronic hepatitis B virus infection, reach the age of higher risk of death from liver cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Osteoarthritis of the knee after ACL reconstruction.
One hundred and fourteen knees with deficiency of the anterior cruciate ligament (ACL) which had undergone reconstruction of the ligament using semitendinosus and gracilis were reviewed at a mean of 61 months after operation. Radiological and clinical evaluation was undertaken. A significant correlation was found between the number of meniscectomies performed in acute cases and those undertaken on the chronic knee. There was also significant correlation between meniscectomy and the Fairbank grading of degenerative changes seen on the radiographs. There was no correlation between the clinical results, residual laxity and the development of osteoarthritis. In ACL deficient knees with irreparable meniscal tears, or in which meniscectomy had been undertaken, the development of osteoarthritis seemed independent of the degree of stability, but in such knees with no meniscal tear or meniscal repair, reconstruction appeared to save the menisci and preserve the joint.
Adolescent↗
Results of reconstruction of the anterior cruciate ligament with the tendons of semitendinosus and gracilis in acute capsulo-ligamentous lesions of the knee.
This report presents the mid-term results of 55 cases of anterior cruciate ligament (ACL) lesions surgically treated in "acute phase" using intra-articular transfer of the semitendinosus and gracilis tendons, performed at the First Orthopedic Clinic of "La Sapienza" University in Rome since 1979. The follow-up is based on clinical (point system comprising subjective and objective criteria), instrumental (KT-1000 arthrometer), and radiographic (comparative AP view radiographic exam of the knees under load) data. On the basis of the results obtained, ACL reconstruction with the semitendinosus and gracilis tendons in the treatment of acute lesions can provide the patient with a good possibility of complete functional recovery of the knee.
Anterior Cruciate Ligament↗
[2 cases of arthralgia associated with infection by Clostridium difficile].
The Clostridium difficile is the etiologic agent most often isolated in patients with antibiotic-associated colitis. Rarely this symptomatology is complicated by postinfection arthritis. The following describes 2 cases of acute colitis by clostridium difficile associated with acute polyarthritis.
Adult↗
The results of reconstruction of the anterior cruciate ligament with semitendinosus and gracilis tendons in chronic laxity of the knee.
The authors report the medium term results (41 months) in 88 patients submitted to surgery for reconstruction of the anterior cruciate ligament according to the method currently in use at our Clinic which uses the semitendinosus and gracilis tendons. The results were evaluated according to a score card method and in 28 patients a KT-1000 arthrometer was also used. The method gives a probability of full success in approximately 85% of cases, with significantly better results in patients not submitted to meniscectomy. A comparison with other methods of autogenous transplant and prosthetic substitution, even on the basis of the data provided by the KT-1000, still places the semitendinosus and gracilis method at the forefront.
Consumer Behavior↗
[Colorectal carcinoma following radiotherapy of gynecological carcinoma].
To assess the risk of radiation-induced cancer of the colon we studied 196 patients with a history of radiation treatment for cancer of the female genital system. After a median follow-up of 12.4 years (range 10-15 years) corresponding to 1172 patient-years, 94 (48%) patients were still alive. 84 (89%) of these patients were evaluated for a second primary cancer to the colon. In 38 (45%) colonoscopic examination was performed. 3 patients were found to have a second primary cancer to the colon compared with 0.32 expected (relative risk 9.3) on the basis of rates from the Zürich Tumor Registry. Due to partial long-term survival, patient non-compliance and non-feasibility of colonoscopic examination, only one fourth of all patients initially treated by radiotherapy for cancers of the female genital system were suitable for colon screening. For these high risk women, colorectal tumor screening should be integrated into a gynecologic tumor follow-up.
Adult↗
[The Mantoux test using Berna and Copenhagen tuberculins in comparison with the epicutaneous Mérieux Monotest in adults].
New infection with tuberculosis is a risk for hospital patients, and it would therefore be desirable to evaluate the proportion of converters by a simple epicutaneous test. It is also known that reactions to Mantoux tests of different manufacturers may vary widely. Simultaneous tuberculin skin tests with tuberculin Berna, tuberculin Kopenhagen and Monotest Mérieux have been compared in 81 geriatric patients and 54 young volunteers. Monotest Mérieux and Mantoux test with tuberculin Berna were administered in 222 additional patients, and it was therefore possible to compare a Monotest and a tuberculin test in a total of 357 patients. There was no statistically significant difference between the two Mantoux tests. An unexpectedly high false positive rate was found with Monotest. The reasons for this are discussed. The two products used in Switzerland today are equivalent. Positive reactions to Monotest need confirmations by Mantoux test.
Adult↗
[Respiratory function tests in adolescents with beta-thalassemia major (author's transl)].
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Adolescent↗
Prognostic significance of the growth rate of breast cancer: preliminary evaluation on the follow-up of 196 breast cancers.
The doubling time (DT) of 196 consecutive breast cancers was studied by means of a double mammographic examination (average time between the 2 mammographies, 30 days) and calculated with the formula of exponential growth. On the basis of DT values the case series was divided into 3 groups of growth: fast (DT from 1 to 30 days), 31 cases (15.8%), intermediate (DT from 31 to 90 days), 84 cases (42.9%), slow (DT more than 90 days), 81 cases (41.3%). No relationship was found between growth rate and size of tumor, or menopausal status of the patient. After mastectomy fast and slow cases were equally distributed in the N- and N+ groups, whereas for the intermediate cases the N- : N+ ratio was 1 : 2. One hundred and thirty-four cases were followed for a period of 12 to 52 months. Evaluation was done on the basis of the subdivision into N- 2nd N+, and the latter group into N+ (1-3) and N+ (greater than 3). For N- tumors the course of the disease was apparently not affected by the growth rate. However, the case of fast growing tumors showed a higher proportion of recurrences with respect to N+ slow growing tumors. This difference was even more noticeable the higher the number of involved lymph nodes, but not statistically significant. The course of slow growing tumors was identical in the N- and N+ groups, but all the N+ tumors were subjected to adjuvant chemotherapy.
Adult↗
Defect of bone marrow granulocyte reserve in rheumatic diseases evaluated with etiocholanolone.
In 10 patients with rheumatoid arthritis, with normal baseline granulocyte count, the etiocholanolone test showed a decrease in the bone marrow granulocyte reserve; factors causing such a defect are discussed.
Adult↗
The frequency of Baker's cysts associated with meniscal tears.
We reviewed the films of 1760 patients who had magnetic resonance image scanning of the knee joint to assess the most common pathologic changes associated with an incidental finding of a Baker's cyst. Of the 1760 knees scanned, Baker's cysts were noted in 238. The cysts were classified as small (55%), medium (30%), or large (15%) and were primarily found on the medial side of the knee (94%). The menisci were evaluated and changes were classified as complete tears, where signal contacts the surface, or degenerative intrasubstance tears. One hundred eleven (47%) complete meniscal tears were found, and 88 (37%) degenerative tears. The majority of tears were found in the posterior horn of the medial meniscus (65 complete tears and 45 degenerative tears). Thus, 199 tears were found in 170 knees, and 106 of the 170 knees (62%) had tears of the posterior horn of the medial meniscus. Baker's cysts are frequent findings on physical examinations and on magnetic resonance imaging scans of the knee. They are thought to be due to intraarticular pathologic changes, usually posterior meniscal tears. This study documents the association between Baker's cysts and meniscal tears and notes that a complete tear is not necessary for the cyst to be present.
Adolescent↗
Open capsulorrhaphy with suture anchors for recurrent anterior dislocation of the shoulder.
Forty of 42 consecutive open capsulorrhaphies with suture anchors for treatment of traumatic recurrent anterior dislocation of the shoulder were reviewed after a minimum follow-up of 2 years. Two patients were lost to follow-up. Follow-up was conducted according to the rating systems of Rowe and the Society of American Shoulder and Elbow Surgeons. The surgical outcome was satisfactory in 38 patients (95%). Eighteen of the 22 patients who were involved in competitive overhead or collision sports before surgery returned to their preoperative sports levels. One patient, whose operation was unsuccessful, experienced recurrent dislocation. In one patient a deep infection that occurred as a complication of the surgical technique healed after suture anchor removal. Although a longer follow-up is necessary, this technique appears to have encouraging results as it avoids the risks related to the use of screws and staples.
Adolescent↗
Injury of the suprascapular nerve at the spinoglenoid notch. The natural history of infraspinatus atrophy in volleyball players.
From 1985 to 1996, we observed 38 cases of isolated atrophy of the infraspinatus muscle in athletes; all were involved in volleyball at a competitive level. There were 20 men and 18 women with a mean age of 26 years (range, 15 to 27). At the time of the first examination, 35 of these athletes had no pain and were treated with exercises to strengthen the external rotators. The remaining three patients underwent surgery because of pain at the posterior aspect of the shoulder. Sixteen of the 35 players treated nonoperatively were reviewed at a mean follow-up of 5.5 years (range, 3 to 10). Thirteen were still involved in volleyball and three had retired symptom-free at the end of their careers. On physical examination, atrophy of the infraspinatus muscle was unchanged in all cases. The patients treated surgically were reviewed at a mean follow-up of 2 years. All of them were able to play volleyball at their preinjury levels, but one had pain at the anterior aspect of the shoulder after strenuous activity. Physical examination showed a notable reduction of the atrophy in one patient. Entrapment of the suprascapular nerve at the spinoglenoid notch is a usually painless syndrome that is frequently observed in volleyball players. Surgical treatment is indicated in the rare cases of painful neuropathies after careful patient selection.
Adolescent↗
Diet or dialysis in the elderly? The DODE study: a prospective randomized multicenter trial.
There are no solid data on the real advantage of an early start of dialysis, as suggested by the DOQI guidelines. Uremic patients frequently have a poor nutritional status. However, we cannot distinguish between the detrimental effect on nutrition of too low a residual renal function or too long a period of low protein-diet, per se. However, it appears that a very-low-protein diet (VLPD) supplemented with essential amino acids and keto-analogs of amino acids, and with an adequate quantity of calories, can prevent hypoalbuminemia at the start of dialysis and can slow the progression of chronic renal failure. EDTA and USRDS data suggest that most patients starting dialysis nowadays are elderly, who also have the highest incidence of morbidity and mortality. Moreover, hospitalization rate becomes higher after the start of dialysis compared to the pre-dialysis period. Can an aminoacid-supplemented VLPD, prolonged beyond the GFR limits suggested by DOQI, offer elderly patients better survival and better quality of life than dialysis? The answer can only come from a prospective, randomized trial, in elderly patients, starting at the GFR values suggested by the NKF-DOQI for starting dialysis, comparing outcomes with a vegetarian VLPD supplemented with a mixture of keto-analogs of amino acids and essential amino acids, and with dialysis.
Age Factors↗