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Biomedical subjects

A Landi

Publications and source records attributed to A Landi.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Angiologic screening of postal workers].

The authors present the results of an angiological survey conducted on 500 postal workers (374 males, 126 females, mean age 43.4 years). All subjects were interviewed about the history of cardiovascular diseases and risk factors. Clinical angiological examination, measurement of Doppler and oscillometric index, plethysmography (rest flow, peak flow, time to peak flow) were carried out. In 8.4% of the subjects (42 cases; 32 males, 10 females) peripheral arterial circulatory disturbance (PACD) was detected, seven of them (16.6%) had intermittent claudication. Frequency of smoking, hypertension and manual working proved to be significantly higher in the group of subjects with PACD than without PACD. Dorsalis pedis and/or tibialis posterior arteries were not palpable in seven (16.6%) of the patients with PACD, and in 25 (5.45%) of the subjects without PACD. The mean values of Doppler index, oscillometric index, peak flow, time to peak flow differed significantly between PACD "positive" and "negative" groups.

Adult↗
PubMed1995

Gait analysis of the donor foot in microsurgical reconstruction of the thumb.

Clinical and step evaluations by a piezoelectric system board were performed in 54 patients who underwent microsurgical reconstruction of the thumb by great or second toe transfer. Forty-four patients were male and 10 were female. In 13 cases, the thumb was reconstructed by the Morrison wrap-around technique. In 27 cases, an extended variant of the Morrison technique was used in which the whole distal phalanx was harvested with skin and nail apparatus. Four patients were treated by great toe transfer and 10 were treated by second toe transfer. Follow-up ranged from 2 to 144 months. The group of patients treated by the wrap-around technique presented hallux rigidus in 38.5% of cases. The group of patients treated by the extended variant of the Morrison technique presented a lesser tendency to hallux rigidus but a clear reduction of the pushing phase of hallux. The group of patients treated by second toe transfer presented a third and fourth metatarsal bone overload that was confirmed by a statistical Wilcoxon test: overload was linked to a plantar hyperkeratosis at the third metatarsal (20%), fourth metatarsal (10%), or fifth metatarsal bone (20%). A claw deformity of the third and fourth toes was observed in 20% of these patients. The four patients who underwent microsurgical reconstruction of the thumb by great toe transfer exhibited an overload of central and lateral metatarsal bones. Second toe transfer is not associated with the functional or cosmetic changes seen in great toe transfer and is therefore preferred.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Degloving injuries of the hand and fingers.

Wound coverage after a complete degloving injury of the hand and fingers is 1 of the most difficult problems in hand surgery. Important structures such as tendons, nerves, and bones are exposed and will necrose if not covered adequately. The goal of treatment should be coverage with a pliable, sensitive, and cosmetically similar tissue that will allow early mobilization. The authors' experience has led them to adopt the following general guidelines: replantation of the avulsed structures whenever possible; early transfer of a free composite flap from the foot for a complete and irreparable degloving injury of the thumb; and selection of the radial forearm flap for multiple finger lesions. Between 1981 and 1993, 13 patients were treated for degloving injuries of the hand and fingers. Revascularization of the avulsed structures was possible in only 4 patients. In 6 patients with degloving injuries of the thumb in whom replantation was not possible, the thumb was reconstructed using a free wraparound flap from the big toe. In 3 patients with degloving injuries of the fingers, coverage was obtained as an emergency measure using an island radial forearm flap. In conclusion, replantation should be attempted when the degloved skin is available and the vessels are not damaged; secondary reconstruction should be done as early as possible to limit the time of tendon, bone, and joint exposure.

Adolescent↗
PubMed1995

Tourniquet paralysis in microsurgery.

Tourniquet paralysis is a serious complication after surgery. The authors report 15 cases recorded in their institution from 1972 to 1992. Seven were a consequence of routine operations on the upper limb and 8 were after microsurgical procedures. In the first group, the incidence of tourniquet paralysis was 1 in 7000 and this does not differ from published reports. In the second group, the incidence of complications is higher: 1 in 4300 cases. In all 15 cases the Tinel sign was absent. Great care was taken to distinguish all the painful conditions which ranged from simple hyperalgesia to allodynia and causalgia. The distressing aspect of tourniquet paralysis is that all the main nerves of the upper limb (median, radial and ulnar), distally to the elbow, are usually affected by the paralysis. In the two groups, the three nerves were affected in 13 cases and the ulnar nerve was partially spared in 3 cases. In both groups the radial nerve was more severely affected. It took an average of 105 days for complete recovery for the first group (range, 30-210 days) and 115 days for the second group (range, 20-180 days). Only in 1 patient in the first group was functional recovery incomplete. According to the authors' experience, general safety factors should be considered before using tourniquet. The tourniquet should be prohibited in patients with congenital susceptibility to nerve compression and should be used with caution in cases of underlying coagulation disorders and neuropathies, in tiny cachetic patients and in patients with systemic lupus erythematosus. In microvascular procedures its use should be limited to the first phase of replantation.

Adolescent↗
PubMed1994

[Prognostic evaluation of patients with arteriosclerosis obliterans].

The natural course of 365 random patients with peripheral arterial obliterative disease was followed up on an average 8 years. In 36% of the patients worsening of angiological condition has been shown. The state of the other patients was unchanged (55%) or improved (9%). During the observation period 87 angiological surgeries and amputation of 41 lower limbs were performed, most of them in 1-2 years after onset of the disease. At follow up in 151 cases myocardial infarction and in 72 cases stroke occurred; the incidence of both diseases was characterized by a cluster like accumulation in 1-3 years before or after onset of the disease. The deterioration of the angiological condition of the patients was related to smoking (mainly heavy smoking), diabetes mellitus and-even more markedly--to the combinations of different risk factors including smoking. The pathological levels of haemorheological factors also showed significant connection with the severity of the disease. In the prospective 6 year period of the study 147 patients (40%) died. This mortality was twice that of the general population matched for age and sex. Information about the cause of death could be collected in 128 cases (87%), among them 51 (40%) died of vascular diseases (peripheral arterial obliterative disease, myocardial infarction, stroke).

Aged↗
PubMed1994

Serial overnight recordings of intracarpal canal pressure in carpal tunnel syndrome patients with and without wrist splinting.

In 15 carpal tunnel syndrome patients pressure was measured during the day and at 2-hourly intervals from midnight to 6 a.m., via a catheter introduced into the carpal canal, using the constant infusion technique. Intracarpal tunnel pressure of the patients always exceeded the critical pressure of 30 mmHg and the highest values were found at 6 a.m. Slightly lower pressures were found when the wrist was splinted, but the difference was not significant, nor were critical pressure levels prevented by splinting.

Adult↗
PubMed1994

Brain stem and motor evoked responses in "locked-in" syndrome.

A patient suffering for an ischemic "locked-in" syndrome following a subarachnoid hemorrhage, was evaluated with brain stem acoustic evoked potentials (BAEPs), short latency somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs). Neuroradiological findings failed to reveal any lesion in the brain stem, while a transcranial Doppler showed increased flow velocity upon the basilar artery, suggesting vascular spasm. BAEPs were normal and SEPs showed to be slightly impaired while MEPs upon magnetic cortical stimulation were heavily deranged. Neurophysiological investigations appeared remarkable for the early diagnosis of the disease, when neuro-radiological findings were still negative.

Adult↗
PubMed1994

[Respiratory function tests as a predictive indicator of postoperative course in patients undergoing pneumonectomy because of neoplasms].

Postoperative morbidity and mortality were correlated with the preoperative results of three widely used pulmonary function tests (FVC, FEV1, FEV1/FVC) in 100 consecutive patients who underwent pneumonectomy for lung carcinoma. Factor analyzed following operation included thirty-day mortality, incidence of cardiovascular and respiratory complications, number of individuals requiring prolonged mechanical ventilation. Nineteen patients had a forced vital capacity (FVC) of 70% or less of the normal value, seven had a one-second forced expiratory volume (FEV1) of 1.5 liters or less, and thirty-three had a FEV1 of less than 2 liters. Fourteen patients had a FEV1/FVC ratio of 65% or less. There were no differences in morbidity or mortality between these patients and those presenting higher test scores. As a general rule, decisions regarding operability and extent of resection cannot be made solely on the basis of the three spirometry tests reviewed.

Adult↗
PubMed1993

[Relation of angiographic changes to clinical data and risk factors in patients with arteriosclerosis obliterans].

The arteriographical changes of 66 patients with peripheral arterial obliterative disease and the relationship between the observed alterations and certain clinical and laboratory data as well as some risk factors were analysed. A score system was used to quantify the arteriosclerotic lesions. The arterial alterations of the examined 90 extremities were studied in the pelvic (common and external iliac arteries), femoral (common, superficial, deep femoral and popliteal arteries) and crural (anterior and posterior tibial arteries) regions. Pathomorphological changes in 433 of the investigated 720 arteries were shown, from among them plaque in 11.8%, stenosis in 22.3%, total occlusion in 26% were proved. Most frequently (89%) the superficial femoral artery was affected. As to the single vessels, the superficial femoral and posterior tibial arteries, while among the zones the femoral region proved to be most serious radiologically. The degree and extent of vessel lesions were related to age. The morphological severity was basically concordant with the results of clinical investigations (walking distance, ergometry, Doppler index). The separately examined risk factors (smoking, hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia) were not related consequently to the radiological changes, but in certain combinations, as heavy smoking with hypertension and heavy smoking with diabetes, the relationship proved to be statistically significant.

Adult↗
PubMed1993

[Indications and results of conservative treatment of closed trauma of the liver].

During the last years, a marked change toward a more conservative approach in the treatment of abdominal trauma especially liver blunt trauma has been noted. The rationale for a conservative management is to avoid the operation or whenever this is not possible, to perform less extensive surgical resections. This approach, initially used in handling splenic trauma, is justified by the finding of spontaneous haemostasis in about half of liver injuries at the time of laparotomy. Moreover, the finding of an haemoperitoneum without signs of circulatory instability is not an absolute indication to laparotomy. In conclusion, the importance of CT and Ultrasonography in the selection of patients suitable for nonoperative treatment as well as in follow up studies is emphasized.

Humans↗
PubMed1993

[Emergency or elective surgery in the treatment of acute cholecystitis].

The authors report their experience in the surgical management of acute cholecystitis. From 1979 to 1991, 308 patients underwent early cholecystectomy. Results obtained, accuracy of pre- and intraoperative diagnostic investigations, and surgical strategy are discussed in relation to prognostic indexes. Personal experience and literature review indicate early cholecystectomy as the treatment of choice in acute cholecystitis.

Acute Disease↗
PubMed1992

[Medical treatment of arteriosclerosis obliterans].

The author gives an overview on former and recent ways of medical therapy in peripheral arterial occlusive disease. The importance of possible elimination of the risk factors is emphasized. The author summarizes the mechanism and clinical effects of drugs affecting vasodynamic as well as thrombolytic processes. The conclusion of the review indicates that although presently there is no ideal therapy for the disease, yet in a remarkable part of cases a marked clinical improvement and inhibition of the basic pathologic processes can be produced even by the available preventive and therapeutical methods.

Arterial Occlusive Diseases↗
PubMed1992

Elastase-type enzymes and their relation to blood lipids in atherosclerotic patients.

Serum elastase-type activity, elastase inhibitory capacity and their relation to lipids were examined in 140 male patients with ischemic vascular disease (coronary, cerebral, peripheral) and in 60 control subjects. In a further 24 patients with acute myocardial infarction elastase activity, inhibitory capacity and lipids during the course of the illness have also been investigated. Serum elastase-type activity was found to be significantly lower and inhibitory capacity significantly higher in the groups of patients than in the controls. HDL- and HDL2-cholesterol as well as apo A concentration showed significant negative correlation with elastase inhibitory capacity both in atherosclerotic and in control subjects. During the course of myocardial infarction a significant elevation of serum elastase-type activity could be observed at the end of the first week; serum triglyceride levels increased, HDL- and HDL2-concentrations decreased significantly in the first 3 weeks, than gradually approached the initial values. In the patients with an elevation of serum elastase-like activity by more than 30% in the first week, there was a significantly higher elevation of serum GOT and LDH1 and a greater occurrence of transmural (Q) infarction than in those with a smaller variation of elastase-like activity.

Adult↗
PubMed1992

Compartment syndrome of the scapula. Definition on clinical, neurophysiological and magnetic resonance data.

Compartment syndromes of the scapula and pelvic girdle have received scant attention in the literature. In 1938, Comolli first described a clinical sign which he considered specific to fracture of the scapula. We report data on two patients, one presenting with prolonged pressure on the posterior surface of the scapula and the other with symptoms associated with scapular fracture. In one of these patients we were able to measure pressures around the scapula, perform neurophysiological assessment of nerve function and produce magnetic resonance images of the area. In the other case, surgical exploration revealed an established ischaemic contracture of the infraspinatus muscle within its compartment. These findings suggest that the muscles around the scapula are vulnerable to the development of compartment syndrome.

Action Potentials↗
PubMed1991

[Serum elastinolytic activity and blood lipids in various clinical forms of arteriosclerosis and in acute myocardial infarct].

Serum elastase-type activity, elastase inhibitory capacity and their relation to lipids were examined in 140 male patients with ischemic vascular disease (coronary, cerebral, peripheral) and in 60 control subjects. In further 24 patients with acute myocardial infarction dynamics of elastase activity, inhibitory capacity and of lipids during the course of the illness have also been investigated. Serum elastase-type activity was found to be significantly lower, inhibitory capacity significantly higher in the groups of patients than in the controls. HDL- and HDL2 cholesterol and apo-A concentrations showed significant negative correlations with elastase inhibitory capacity both in atherosclerotic and in control subjects. During the course of myocardial infarction a significant elevation of serum elastase-type activity could be observed at the end of the first week; serum triglyceride levels increased, HDL- and HDL2 concentrations decreased significantly in the first 3 weeks, then gradually approached the initial values. In the subgroup of patients with an elevation of serum elastase-like activity by more than 30% in the first week, there was a significantly higher elevation of serum GOT and LDH1 and a greater occurrence of transmural (Q) infarction than in those with a smaller variation of elastase-like activity.

Arteriosclerosis↗
PubMed1991

The distally based posterior interosseous island flap for the coverage of skin loss of the hand.

Eight patients with skin coverage of the hand by the distally based posterior interosseous island flap (DBPIIF) are presented. The first web was reconstructed in 6 and the volar and dorsal aspect of the hand in 2 patients. Primary closure of the donor sites has always been possible. An echo Doppler examination is indicated to verify the presence and size of the vessel and the direction of its flow. The dissection of the vascular pedicle, however, is frequently quite complex and time consuming. To better appreciate the cosmetic aspect of the DBPIIF and its donor site, a random study has been undertaken to compare this flap with the radial forearm and the groin flap and their corresponding donor sites. Females have more often preferred the groin flap, whereas doctors preferred the DBPIIF. Reliability, a good aesthetic result at the donor site, and the preservation of the main vessels of the hand are the specific merits of the DBPIIF.

Adolescent↗
PubMed1991

Trigeminal evoked potentials in patients undergoing percutaneous microcompression of gasserian ganglion.

22 patients undergoing percutaneous microcompression of Gasserian ganglion for the treatment of trigeminal neuralgia were monitored intraoperatively by means of trigeminal evoked potentials (TEPs). The second trigeminal branch was stimulated at the maxillary foramen; evoked responses were recorded using subcutaneous electrodes placed over the scalp. TEPs presented several short-latency waves (called W1, W2, W3, P4, N5, P6, N10) which are generated before and after the ganglion (W1, W2, W3), in the brain stem (P4, N5, P6) and possibly in the cortex (N10); other waves occur within 150 ms after the stimulus (late waves). During compression, W1 did not change, while W2 and W3 as well as P4, N5, P6, N10 and late waves decreased in amplitude: this pattern was noted in the patients who presented with pain relief during the follow-up period. On the contrary, the patients who suffered from pain recurrence did not show similar intraoperative TEP changes. In conclusion, intraoperative TEP derangements may be related to the effectiveness of the compression on the Gasserian ganglion.

Aged↗