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Biomedical subjects

A Morini

Publications and source records attributed to A Morini.

At least 19 recordsLinked to original sources
PubMed2005

'Neurographic' palmaris brevis sign in type II degrees ulnar neuropathy at wrist.

OBJECTIVE: To investigate the source of an unusual and previously unreported volume conducted potential on motor nerve conduction studies. In a case of subacute ulnar neuropathy at wrist (UNW) selectively involving the deep motor branch, we recorded from the hypothenar eminence a large positive wave (2.5 ms-2 mV) preceding the negative takeoff of the delayed distal ulnar motor response. METHODS: We performed multiple channels motor and sensory ulnar nerve (UN) conduction studies; these included selective electrical stimulation and anaesthetic block of UN branches and also selective recording of motor responses by single fibre needles; data were confirmed by an intraoperative neurophysiological study and correlated with MRI and surgical findings. RESULTS: Detailed neurophysiological investigation demonstrated the generation of this waveform from the palmaris brevis (PB) muscle. MRI and surgical exploration documented a hypertrophy of this muscle. CONCLUSIONS: In type II degrees UNW, depolarization of a spared palmaris brevis muscle may be recorded as a positive wave preceding the delayed abductor digiti minimi motor response. SIGNIFICANCE: We underline the peculiar localizing value of this volume conducted 'meaningful artefact' in that particular setting. It actually represented an early neurographic analogue of what is known as the clinical 'Palmaris Brevis Sign' in long standing type II degrees UNW.

Action Potentials↗
PubMed2001

Symptoms and neurophysiological picture of carpal tunnel syndrome in pregnancy.

OBJECTIVE: To evaluate the incidence of carpal tunnel syndrome (CTS) in pregnancy through a validated and multiperspective assessment of CTS. METHODS: During 2000, the Italian CTS study group focussed on the occurrence of CTS in women during the final stages of pregnancy, enrolled in 7 Italian centers. In addition to the physician-centered and neurophysiologic traditional evaluations, we used a validated patient-oriented measurement to obtain more comprehensive and consistent data for severity of symptoms and functional impairment. RESULTS: In our study, CTS was clinically diagnosed in more than half of women (62%). Neurophysiological evaluation provided diagnosis of CTS in around half of women (43% were positive in one hand at least). Our study provides evidence, reported here for the first time, of a correlation between edema and neurophysiological picture. Similarly, our study provides a correlation between validated patient-oriented measurement and edema. Moreover, a significant correlation between a negative trend (subjectively assessed) and smoking and alcohol consumption was observed. CONCLUSIONS: Our observations confirm that the edema of the tissues in the carpal tunnel could induce a mechanical compression of the nerve. Moreover, our data suggest that smoking and alcohol consumption have a negative role in the evolution of the syndrome probably due to impairment of the microcirculation.

Adult↗
PubMed1998

Isolated hypoglossal nerve palsy due to an anomalous vertebral artery course: report of two cases.

The authors report two patients with isolated unilateral tongue atrophy. Magnetic resonance imaging (MRI) of the brain stem and angio-MRI demonstrated a dolichovertebral artery with an abnormal course compressing the medulla oblongata at the emergence of the hypoglossal rootlets. The semeiological observation of a sectorial and not uniform distribution of atrophy in the half-affected tongue is discussed in relation to the lesional site.

Aged↗
PubMed1998

Pregnancy after heart transplant: update and case report.

A literature review of 22 cases of pregnancy following cardiac transplantation up to 1995 and a case report are presented here. A 30 year old woman, gravida 3, para 1, contacted us for obstetric care at 8 weeks gestation, about 55 months after orthotopic cardiac transplantation. The transplant had been performed for a familial dilative cardiomyopathy, which had become manifest during her previous pregnancy. The course of the current gestation was uneventful. The patient's cardiovascular function was good throughout the pregnancy. Immunosuppressive therapy, the dose of which was increased during pregnancy, included cyclosporine and azathioprine. Because of an increase in the patient's plasma uric acid concentration and an initial rise in her blood pressure, despite therapy, a repeat Caesarean section was performed at 37 weeks gestation. A female baby weighing 2330 g, Apgar scores 7/9, was delivered. Mother and infant were discharged on postoperative day 15 and are doing well 14 months postpartum. Through a review of literature and our case, the issues and problems related to pregnancy after a heart transplant are discussed, in particular the maternal-fetal risks, management, therapy, delivery, neonatal problems and follow-up postpartum of mother and baby.

Adult↗
PubMed1994

[Acute puerperal uterine inversion: a report of 3 cases and an analysis of 358 cases in the literature].

Acute puerperal uterine inversion is a rare but very feared obstetrical complication. It determines an almost immediate shock and serious metrorrhagia. It is a "glove-finger" introflexion of parietes uteri which takes place during the third stage of labor or during the first hours of puerperium. It can be distinguished in inversion of I, II or III degree according to the zone concerned by the introflexion: only the fundus of the uterus, all the corpus emerging in the vagina or the entirety of the uterus coming out from the vulvar orifice. The research carried out in the archives of the Department Obstetrics and Gynaecology of the University of Rome "La Sapienza" has showed, for the 20 years 1968-1988, 3 cases of uterine inversion out of a total of 69,677 childbirths. The uterine inversion was immediately diagnosed and in all the 3 cases a method of replacement by central taxis was practiced. In 2 cases, despite the packed tamponade, there was a recidivist or persistent uterine inversion of 1 degree, and in both cases a surgical reduction by laparatomy was practiced. In 1 of the 2 cases a hysterectomy was needed because of the persisting metratonia and metrorrhagia. The III case was treated with a manual replacement, a uterus massage from outside keeping the organ, with fist inside the cavity, in forced anteflexion in order to reach a good contractile activity. In 2 of the 3 cases the placental stage was operative, manual in 1 case and with fundal pressure applied abdominally in the other. We have found and analysed, in the international literature, 358 cases described from 1939 to 1989. The homogeneous data have been grouped in 21 tables for an easier visualization. Frequency varies from 1 out of 1,200 childbirths to 1 out of 57,393 childbirths. The medium value has been 1 out of 5,903 in the period from 1939 to 1989. The most significant data emerging from the analysis of the 358 cases of uterine inversion concern the placental stage. This was spontaneous in a number of cases equivalent to 28.9%; the number of fundal pressure applied abdominally was up to 30.9%; tractions over funicle up to 22.3%; manual delivery of the placenta up to 17.9%. Eighty-nine percent of cases were diagnosed by simple inspection, whilst for the resting ones an exploration was needed. For most of the cases the treatment was immediate (77%) especially by means of manual reduction vaginally (88%). Hysterectomy was needed for 14 cases that is up to 4.24%.(ABSTRACT TRUNCATED AT 400 WORDS)

Acute Disease↗
PubMed1993

Further considerations on the changing face of pneumonia in Marche Region (central Adriatic coast of Italy).

The present paper provides a more detailed review of some themes already discussed in previous papers concerning the changing face of pneumonia in an area of the central Adriatic coast of Italy, including an ex novo examination of the correlations between radiological findings and serological groups not previously reported. The discussion concentrates particularly on some questions raised by the research, such as the apparent rarity of pneumococcus, the elevated number of seronegatives appearing as atypical pneumonia, the high percentage of "bacterial-type" cases occurring among the viral-like, and the therapeutic problem.

Bacteria↗
PubMed1993

[Directions of future research on GnGH analogs in the treatment of endometriosis and uterine fibromyoma].

A variety of new data on the biology, pathophysiology and metabolic changes occurring in leiomyomas and in the ectopic endometrium have opened new avenues for research in a neglected area, that of benign proliferations of the female reproductive tract. In addition, the availability of potent inhibitors of ovarian function which, like the super-agonist analogues of GnRH, have no hormonal activity (oestrogenic, progestogenic or androgenic) has allowed for the first time to evaluate the effect of oestrogen deprivation on endometriosis and uterine fibrosis. The results, although impressive, are only temporary: in both cases hypoestrogenism produces an important relief of symptoms, but--once treatment is discontinued--both conditions usually continue to evolve. For this reason, much remains to be done to optimize Gn-RH analogue utilization. In the case of endometriosis, there seem to be three main areas for future research: pain, infertility and the possibility of modifying its natural history. In addition, the role of combined, medico-surgical therapy remains to be established, especially in the case of severe disease. In the treatment of fibrosis, analogues can be utilized as pre-treatment before conservative or demolitive surgery, or as an alternative to hysterectomy. The role of analogues as a pre-surgical adjuvant has probably been overemphasized and it is time to carry out well controlled studies to narrow down indications. At present they include: severe anemia caused by chronic heavy uterine bleeding, and the need to minimize intraoperative blood loss. Much remains to be done before analogues can become a real alternative to surgery. To date no single sequential therapeutic regimen has been identified which is capable of prolonging the beneficial effects of agonists without their well known negative consequences. Temporary results can be obtained interrupting analogue therapy and substituting it with the administration of a progestogen. Finally, analogue administration can be prolonged by associating an oestrogen-progestogen sequential combination as in HRT. In all of these instances, what are urgently needed are well controlled randomized clinical trials.

Endometriosis↗
PubMed1990

Sequential Gn-RH superagonist and medroxyprogesterone acetate treatment of uterine leiomyomata.

A group of 48 women with symptomatic leiomyomata were treated during 6 months with the short-acting Gn-RH superagonist analog buserelin. The first (group C) was followed up for an additional six months of no medication. The second (group M) was treated for 6 additional months with medroxyprogesterone acetate (MPA) at doses decreasing from 200 to 25 mg/day. Buserelin therapy significantly decreased uterine size (P less than 0.001) in all patients, the average final volume being 48.5% of the original (from 262 +/- 147 ml to 127 +/- 85.4 ml). In group C there was a significant (P less than 0.001) re-growth during the post-treatment observation period (from 120 +/- 81.0 ml to 198 +/- 77.2 ml); a significant (P less than 0.01) re-growth was also observed in group M during MPA medication (from 132 +/- 77.2 ml to 170 +/- 96.0 ml). The agonist had also a marked effect on fibroids: on average they decreased from 75.1 +/- 74.3 ml to 24.7 +/- 23.3 ml (P less than 0.025). In group C during the post-buserelin period of observation without treatment, there was a significant re-growth from 23.7 +/- 21.6 ml to 47.7 +/- 27.5 ml (P less than 0.001), whereas in group M treatment with MPA prevented any significant re-growth (from 25.6 +/- 24.8 to 30.6 +/- 32.9 ml; P greater than 0.3).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[The new aspect of pneumonia in an area of the Middle Adriatic].

The present work reports the findings of a ten-year, research, the aim of which is to outline current views of pneumonia in a zone of the Middle Adriatic (USL 17-Regione Marche). The study confirmed, in its entirety, a lesser aggressiveness and loss of the "seasonal feature" of today's pneumonias. The high incidence of Atypical Pneumonia (AP) due to viral-like microorganisms (mycoplasma, chlamydia, coxiella, legionella) and an even higher one of unknown etiology is reported. After having analysed the most likely reasons for such a change and its various implications, the authors conclude that this type of research should be extended in order to trace a map of the more common infectious agents in single geographical zones, as an indispensable premise for a more concrete etiological diagnosis and for a more rational choice of the antibiotic.

Adolescent↗
PubMed1989

PCB and other organochlorine compounds in blood of women with or without miscarriage: a hypothesis of correlation.

Polychlorobiphenyls (PCBs) have been shown to affect reproduction in experimental animals and in human beings following intoxication. The concentrations of PCBs and other organochlorine compounds were determined in blood samples from 120 women hospitalized for miscarriages and 120 full-term pregnancy controls. The average PCB hematic level (reported as Fenclor 54) was higher in women with miscarriages than in control women. No differences were detected as far as the hematic concentrations of hexachlorobenzene and DDT compounds were concerned. The reproductive history of each woman was assessed together with confounding variables on the phenomenon of miscarriage and the factors regarding environmental exposure and food intake. Food consumption did not indicate diet as the main source of PCB intake.

Abortion, Spontaneous↗
PubMed1989

[Emergency ambulatory treatment of dysfunctional metrorrhagia in adolescents].

The authors compared the therapeutic efficacy of oestrogen-progestogen combinations with pure progestagen in the urgent treatment of adolescent metrorrhagia. Two groups of adolescents were studied whose haemorrhages were attributed exclusively to disfunction. Every medicine was evaluated as to: 1) effectiveness in completely spotting haemorrhage, 2) any persistence of bleeding, 3) side effects. The therapy was given during 2 consecutive menstrual cycles. Results following treatment with oestrogen-progestogen combinations were favourable, even though side effects were more noticeable.

Adolescent↗
PubMed1989

[Destructive cesarean section: hysterectomy for obstetric reasons and post-abortive hysterectomy. Analysis of 35 cases].

The Authors examined surgical case studies for the 20-year period from February 1968 to February 1988 concerning hysterectomies performed for obstetric reasons at the "La Sapienza" University of Rome, Obstetrics and Gynaecology Department; these numbered 35 out of 69,677 births. They also considered hysterectomies carried out during caesarean sections, during birth or the postpartum period, during the puerperium and after miscarriage. They also analyzed reasons for the action taken, the type of operation, the length of the gestation period, the mother's age, and transfusions given.

Abortion, Spontaneous↗
PubMed1989

[Medium term treatment and prophylaxis of dysfunctional metrorrhagia in adolescence].

The authors compared the therapeutic effectiveness of these different pharmacological methods of preventing dysfunctional menometrorrhagia in adolescents, which were: 1) chorionic gonadotropin, 2) cyclofenil, 3) ovariostatics. Therapy was given during 2 menstrual cycles, and effects were evaluated both during the treatment and for the succeeding 2 cycles. Parameters followed were: a) clinical recovery, b) persistence of spotting, c) effectiveness in inducing ovulation. The results were equally good both in treatment with ovariostatics and ovulation inducers. The latter proved however, more effective during follow-up. Side-effects were very rare, so much so that, in no case was it necessary to suspend treatment.

Adolescent↗
PubMed1989

[Use of low-dose danazol in adenosis of the breast].

Mammary adenosis is a very common affliction which, it has been calculated, affects between 7 and 15% of women of child-bearing age. The Authors report the results obtained during treatment of this condition with danazol in those different dosages (50, 100 and 200 mg per day). Results were evaluated at 3 and 6 months during therapy, and then 4 months after suspension of the treatment. Effects were evaluated in terms of changes in the symptomatic pain and in the actual clinical record. Side effects were also examined in terms of age and obstetric history. The therapy produced good results with all those dosages used. The lowest dosage gave the most favourable long-term effects, also in terms of the scarsity of side-effects.

Adolescent↗
PubMed1989

[Hysterectomy in obstetrics. Analysis and comparison of a group of cases from the Italian and the international literature (536 cases)].

The Authors made a comparison between the frequency of obstetric hysterectomies carried out at the "La Sapienza" University Obstetrics and Gynaecology Departments and of those reported in international publications regarding Great Britain, USA, Australia, Saudi Arabia and Libya. Data obtained covered the 462 hysterectomies effected out of the 442,174 births from 1972 to 1895. Results were compared as under: general frequency per number of births, reasons for surgery, type of operation carried out, age of the patient, gestation period, obstetrical history and complications.

Adolescent↗