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Biomedical subjects

A Morandi

Publications and source records attributed to A Morandi.

26 records · Page 2Linked to original sources

[Contrast echocardiography in the diagnosis of tricuspid insufficiency. Evaluation before and after cardiosurgical intervention in 24 patients].

26 patients (pts) (8 males and 18 females), mean age 50 +/- 9 years, with rheumatic valve (MV) disease, candidates to MV replacement, were examined by contrast echocardiography (CE) before and after surgery. This was done in order to assess pre and postoperatively the presence of associated tricuspid regurgitation (TR) and to evaluate the short and long-term results of the operation on the TR itself. For assessing TR, the systolic presence, intensity and persistence of the microbubbles of the contrast medium injected into an antecubital vein, were observed within the inferior vena cava (IVC). We used synchronous time motion (TM) and two dimensional (2D) echocardiography from subcostal view. TR was classified as follows: severe (massive systolic opacification and persistence of the microbubbles in the IVC for at least 20 seconds); moderate (moderate systolic opacification lasting less than 20 seconds); mild (slight systolic opacification lasting less than 10 seconds); insignificant TR (sporadic appearance of the contrast medium into the IVC). On the average, the examination was carried out 48 hours before surgery, 15 days after and, in pts undergoing De Vega tricuspid valvuloplasty, 14 months after the operation. At pre-operative examination, massive TR was found in 16 pts, only 6 of whom showed clinical signs of TR. The findings were confirmed at surgery in 15 pts who underwent not only MV replacement but also tricuspid repair. In the other pts, agreement was found between CE and surgery as far as moderate TR was concerned, meanwhile mild CE TR was not confirmed at surgery. Sensitivity (SN) was 100%, specificity (SP) 38%, positive predictive value (PPV) 78%, negative predictive value (NPV) 100%. Excluding CE mild TR, SP and PPV raised to 75% and 95% respectively, meanwhile SN and NPV remained 100%. Short term post-operative follow-up CE performed on 13 out of the 15 pts with tricuspid repair showed no signs of TR in 7 and slight signs in 6. Furthermore, in those pts undergoing simple MV replacement, CE showed a marked reduction of the contrast echographic effect. Long term post-operative follow-up CE performed in the 13 pts with tricuspid repair showed no signs of TR in 9, slight signs in 3. Moreover in two pts massive TR due to late mitral prosthesis detachment was diagnosed by means of CE and confirmed at cardiac catheterization and surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Our experience in treating femoral neck fractures. Comments on cases treated from 1972 to 1984. A clinico-statistical study].

The Authors report the clinico-statistic results concerning 550 cases of femur neck fractures, representing the casuistry of 12 years' activity developed by the Ortopedico-Traumatological Department of the Hospital Institutes of the Association of the Bergamo Lowland Communes, USSL nr. 32 (from 1972 up to 1984). After considering the main etiologic factors of this injury, the Authors study the surgical techniques adopted, discuss the indications, state the results obtained, and do some remarks about the patients' functional and social recovery. The Authors emphasize the importance of an early and valid osteosynthesis allowing a quicker functional recovery, a reduction in the times of stay in bed and an extension in the average survival of such patients.

Age Factors↗

[Synthetic salmon calcitonin. Treatment of choice in Sudeck's disease].

56 cases of primary and post-traumatic Sudeck's disease, treated with Sandoz synthetic salmon calcitonine are reported. The results obtained suggest that this drug should be considered of choice in this type of pathology provided it is administered with the right, highish doses. 2 completely cured cases of stemming of bone cyst using the same product are also reported.

Calcitonin↗

[Ventricular septal defect associated with aortic insufficiency: observations on 40 patients surgically treated].

Since 1970, forty patients with ventricular septal defect (VSD) and aortic insufficiency (AI) have undergone surgical treatment in our institution. In the majority of the patients (60%) the VSD was subcristal. In sixteen cases the aortic valve was replaced, whereas in 9 patients the valve was repaired and in 15 subjects simple closure of the VSD was deemed to be sufficient to correct the AI. There have been 2 hospital and 4 late deaths. The A.I. seems to be due to two different pathogenetic mechanisms in supra- and subcristal V.S.D., with the faster progression in the supracristal ones. With simple patch closure of the V.S.D. we had the best late results, good results were obtained with the plasty of the aortic leaflets while the worst late results were found in the group which had undergone aortic valve replacement. For this reason the Authors recommend surgical intervention as soon as AI shows up.

Adolescent↗

[Evaluation of ambulatory medical care in Milan].

Ambulatory procedures are an essential component of health care both for their number and for their cost. We aim therefore to identify and to quantify the volume of ambulatory procedures performed in Milan during 2003. The data come from the Outpatient Care Information Report that collect much information by characteristics of patient, health care institution and procedure categories. The analyses in this report are based on absolute measures, utilization rates and concentration index. During the year 2003 nearly 20 millions of ambulatory procedures were performed in the public and private outpatient facilities of Milan for the resident population. The average annual rate was 15 procedures per person. Utilization varied according to patient age and sex, higher in women and in the elderly group, statistically significant variability is observed (p<0.001). Outpatient care accounts for high density supply (124 specialty points for 100,000 inhabitants). Utilization rate was not homogenous both for the medical specialties and for the geographical district distribution, all that, it seems depending on the activity concentration differences and complexity supply of services than on a different distribution of health needs. This analysis may be useful as methodological starting point for further investigating current outpatient care data and for identifying those sectors in need of corrective actions.

Adolescent↗

[The assessment of skeletal age in hypothyroidism during the first year of life. The features of a new method].

Determining skeletal maturity in the first year of age with usual methods is often quite difficult. Some years ago, we investigated a new method based on the time of appearance of appreciable ossification centres in the upper limbs with the following succession: humerus head, capitate, coracoid process, hamate, humerus capitulum, greater tuberosity and radius distal epiphysis; in the first month of age it must be associated to knee and foot study. We studied with our method the skeletal maturity of 16 hypothyroid patients before and after 6 and 12 months of therapy; in the first month of age we associated the study of left knee and foot and study of left hand and wrist using Greulich and Pyle's method at 12 months of age. We compared data of hypothyroid patients to data of 399 infants hospitalized in Pediatric Clinic of Florence for infectious diseases or for neonatal hyperbilirubinemia. Our study has showed that skeletal maturity, retarded before therapy, rejoined normal values over a period of time of 12 months of substitutive treatment; it was accelerated in some patients.

Age Determination by Skeleton↗