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Biomedical subjects

A Rossi

Publications and source records attributed to A Rossi.

At least 307 records · Page 17Linked to original sources
PubMed1998

Possible risk factors for primary adult onset dystonia: a case-control investigation by the Italian Movement Disorders Study Group.

OBJECTIVES: Little is known about the aetiology of idiopathic adult onset dystonia. The Italian Movement Disorders Study Group promoted a case-control study on some hypothetical risk factors including past medical events, life events, life habits, occupational hazards, and family history of dystonia, parkinsonism, and tremor. METHODS: Cases affected by idiopathic adult onset dystonia (age at symptom onset >20 years, duration of disease >one year and <five years) were selected among consecutive outpatients attending 14 Italian centres. Control outpatients matched for age (+/-5 years), sex, and referral centre were identified among diagnostic categories thought to be unassociated with study exposures. Information was obtained by a standardised questionnaire administered by medical interviewers. Conditional logistic univariate and multivariate regression analyses were performed by a standard statistical package. RESULTS: Multivariate analysis on 202 cases and 202 age and sex matched control outpatients indicated that head or facial trauma with loss of consciousness, family history of dystonia, and family history of postural tremor independently increased the risk of developing adult onset dystonia, whereas hypertension and cigarette smoking exerted a protective effect. The findings also suggested a positive association between local body injury-for example, previous ocular diseases and neck or trunk trauma-and dystonia of the same body part. CONCLUSIONS: The results support the idea that environmental and genetic factors may both be important in the aetiology of adult onset dystonia, and suggest aetiological clues worthy of further analytical investigation.

Adult↗
PubMed1998

Gender-related seasonality of human platelet phenolsulfotransferase activity.

This study focused on the investigation of the possible effect of gender and season on the activity of the thermolabile and thermostable forms of platelet phenolsulfotransferase (PST) in a group of 23 healthy, drug-free volunteers of both sexes. The results showed a different seasonal profile of PST activity in men and women: in men, PST seasonal rhythms revealed a shallow profile with higher values in both the spring and summer than in the autumn. Conversely, in women, the PST seasonality showed a profile consisting overall of a main peak in the summer. Also, significant gender-dependent correlations were found between the photoperiod length and PST values. Our findings should stimulate further investigation into gender-dependent molecular mechanisms underlying the regulation of the metabolism of endogenous and xenobiotic agents, such as monoamines and phenols, which are the substrates of PST.

Adult↗
PubMed1998

Rapidly growing choroidal metastasis: case report.

A rapidly growing choroidal metastasis from an occult carcinoma is described. The patient was first seen with a loss of visual acuity. The fundus examination showed a non-pigmented solid mass located at the posterior pole. Clinical history, echographic characteristics and tumour growth kinetics are described in detail.

Adenocarcinoma↗
PubMed1998

Orbital metastases: echographic findings our experience.

In this paper the authors examine the echographic findings in 20 patients with metastatic and secondary tumors of the orbit observed at the University Eye Clinic of Ferrara (Italy) between January 1985 and August 1995. The aim of this study is to identify some typical echographic characteristics in these forms and to underline the diagnostic role of orbital echography.

Adult↗
PubMed1998

Posterior scleritis: ultrasound findings in two cases.

Two cases of posterior inflammatory scleritis are described. The authors show the echographic findings, pointing out the helpfulness of diagnostic ultrasound and the crucial role in monitoring these diseases with A scan examinations to obtain clear results of therapy, even if subjective symptoms disappear.

Aged↗
PubMed1998

Immersion technique in anterior-segment examination.

Ultrabiomicroscopy, using equipment with high-frequency transducers, is a very simple method for the study of superficial ocular structures. Nevertheless, these equipment are very expensive and not commonly used. The most widespread and used instrumentations are still provided with lower-frequency probes. These are sufficient to show the anterior segment of the eye. In this work we underline the diagnostic importance of this method and, in some cases, the therapeutic role.

Anterior Eye Segment↗
PubMed1998

Static intrinsic PEEP in COPD patients during spontaneous breathing.

Intrinsic positive end-expiratory pressure (PEEPi) is routinely determined under static conditions by occluding the airway at end-expiration (PEEPi,st). This procedure may be difficult in patients with chronic obstructive pulmonary disease (COPD) during spontaneous breathing, as both expiratory muscle activity and increased respiratory frequency often occur. To overcome these problems, we tested the hypothesis that the difference between maximum airway opening (MIP) and maximum esophageal (Ppl max) pressures, obtained with a Mueller maneuver from the end-expiratory lung volume (EELV), can accurately measure PEEPi,st. Using this method, we found that, in eight ventilator-dependent tracheostomized COPD patients (age 71+/-7 yr), PEEPi,st averaged 13.0+/-2.9 cm H2O. That measurement was validated by comparison with a reference static PEEPi (PEEPi,st-Ref) taken at the same EELV adopted by patients during spontaneous breathing, and measured on the passive quasi-static pressure-volume (P/V) curve of the respiratory system, obtained during mechanical ventilation. PEEPi,st-Ref averaged 13.1+/-3.0 cm H2O, i.e., a value essentially equal to PEEPi,st measured by means of our technique. We conclude that PEEPi,st can be accurately assessed in spontaneous breathing COPD patients by the difference between MIP and Ppl max during the Mueller maneuver.

Aged↗
PubMed1998

Effects of proportional assist ventilation on exercise tolerance in COPD patients with chronic hypercapnia.

This study investigates the impact of proportional assist ventilation (PAV), a new mode of partial ventilatory support, on exercise tolerance and breathlessness in severe hypercapnic chronic obstructive pulmonary disease (COPD) patients. We also examined the effects of continuous positive airway pressure (CPAP) and pressure support ventilation (PSV). On two consecutive days, 15 stable hypercapnic COPD patients underwent four endurance tests on a cycle ergometer at 80% of their maximal workrate, receiving, via a nasal mask in random order, either: 1) sham ventilation (CPAP: 1 cmH2O); 2) CPAP (6 cmH2O); 3) PSV (inspiratory pressure support: 12-16 cmH2O; expiratory positive airway pressure (EPAP): 1 cmH2O); or 4) PAV (8.6+/-3.6 cmH2O x L(-1) and 3+/-1.3 cmH2O x L(-1)x s(-1) of volume and flow assistance, respectively plus EPAP: 1 cmH2O). Oxygen supply was standardized to maintain an arterial oxygen saturation (Sa,O2) of 92-93%. Breathing pattern and minute ventilation (by respiratory inductive plethysmography), pulse oximetry, end tidal partial pressure of CO2, cardiac frequency and sensations of dyspnoea and leg discomfort (by Borg scale) were monitored. In comparison to sham ventilation, PAV, PSV and CPAP were able to increase the endurance time (from 7.2+/-4.4 to 12+/-5.6, 10+/-5.2 and 9.6+/-4.6 min, respectively) and to reduce dyspnoea and oxygen flow to the nasal mask. However, the greatest improvement was observed with PAV. We conclude that PAV delivered by nasal mask can im-prove exercise tolerance and dyspnoea in stable hypercapnic COPD patients and hence this mode of ventilatory support may be useful in respiratory rehabilitation programmes.

Aged↗
PubMed1998

Carboplatin plus vinorelbine, a new well-tolerated and active regimen for the treatment of extensive-stage small-cell lung cancer: a phase II study. Gruppo Oncologico Centro-Sud-Isole.

PURPOSE: To evaluate the activity and toxicity of the combination carboplatin plus vinorelbine in extensive small-cell lung cancer (SCLC). PATIENTS AND METHODS: A two-stage optimal Simon design was applied. To proceed after the first stage, responses from 8 of 11 treated patients were needed. Overall, 31 responses of 43 treated patients were required to comply with the design parameters. Inclusion criteria were cytohistologically proven SCLC; extensive disease; age of 70 years or less; Eastern Cooperative Oncology group performance status (ps ECOG) of 2 or less; normal cardiac, hepatic, renal, and bone marrow functions; and no previous chemotherapy. Patients were staged by physical examination; biochemistry; chest radiograph; brain, thoracic; and abdominal computed tomographic (CT) scans, and bone scan. All patients received carboplatin 300 mg/m2 intravenously (i.v.) day 1 and vinorelbine 25 mg/m2 i.v. on days 1 and 8 every 4 weeks up to six cycles. Of 43 enrolled patients, 36 were men and 7 women, with a median age of 63 years (range, 46 to 70 years). RESULTS: All patients were assessable for response and toxicity. We observed 32 (74%) objective responses, with 23% complete responses. Median time to progression was 25 weeks, and median survival was 37 weeks. The treatment was well tolerated. The reported main toxicities were leukopenia grade 3 in 21% of patients and grade 4 in 5% of patients, anemia grade 2 in 11% of patients and grade 3 in 2% of patients, and thrombocytopenia grade 3 in 7% of patients. CONCLUSION: These data show that carboplatin plus vinorelbine is an active and well-tolerated regimen in extensive SCLC. In view of the activity, low toxicity, and ease of administration, it may be a reasonable alternative to more toxic cisplatin-containing regimens.

Aged↗
PubMed1998

Extracorporeal lithotripsy of intrahepatic stones with associated strictures of intrahepatic biliary ducts.

BACKGROUND AND AIMS: Intrahepatic stones are a frequent disease in the Eastern world but rare in Western countries. Treatment is complex and often requires surgical intervention. Extracorporeal shock wave lithotripsy is a relatively recent technique, widely used in the treatment of stones in the gallbladder and common bile duct. It can also be used in the treatment of intrahepatic stones. The present study analyses the efficacy of extracorporeal shock wave lithotripsy in intrahepatic stones. PATIENTS AND METHODS: In our study, we used extracorporeal lithotripsy in six cases of intrahepatic stones (mean age 53 years). In five of these cases deformities of the intrahepatic bile ducts were also present: stenoses and angulated strictures. The stones were in the right lobe of the liver in 5 patients, and in both lobes in 1 patient. Four patients had multiple stones and 2 a single stone, all varying in diameter from 6 to 25 mm. The stones were localized radiologically with contrast medium through a drainage tube. The technique does not require anaesthesia. An average of three lithotripsy sessions were necessary, with a mean total of 8050 shock waves per patient. RESULTS: Successful fragmentation was obtained in 5 out of 6 patients, while the remaining subsequently underwent surgery. No complications were observed. CONCLUSIONS: Extracorporeal shock wave lithotripsy proved to be effective, easy to perform and safe for the treatment of intrahepatic stones.

Adult↗
PubMed1998

[Radiation protection in the use of tracers in radioguided breast surgery].

PURPOSE: Recent techniques in nuclear medicine have permitted to implement new procedures useful in surgery. Among these, the procedures for locating sentinel lymph nodes and nonpalpable breast lesions are of great interest. The protocols for the location of the sentinel lymph node and for the radioguided location of occult lesions developed at the European Institute of Oncology (IEO, Milan) are based on the administration of radiopharmaceuticals labelled with Technetium-99m (99mTc). We evaluated the dosimetric data relative to patients and hospital personnel to assess whether specific radiation protection procedures are needed. MATERIAL AND METHODS: Fifty patients with nonpalpable breast lesions and 50 patients with suspected lymph node involvement were enrolled in this study. All the patients underwent surgery the day after in-loco administration of the radiopharmaceutical (11 MBq of 99mTc). The absorbed dose to the hospital personnel was estimated from the air kerma rate measured by ionization chamber at different distances from the patients at 0 and 16 hours after the radiopharmaceutical administration. In order to evaluate radiation protection for patients, absorbed doses were measured positioning thermoluminescent dosimeters on the patient's skin for about 16 hours. In the operating room, activity was measured on some excised tissues (lymph nodes and tumors) and on surgical instruments. RESULTS: Absorbed doses were very low for the clinical staff also in case of prolonged patient assistance. After 100 cases, the surgeon mean absorbed dose to the hands and mean effective dose were .45 mGy and .09 mGy, respectively. These values correspond to 1% of the annual dose limit to the hands and to 10% of the annual equivalent effective dose recommended for the population (ICRP 60 and law by decree 230/95). The absorbed dose to healthy tissues of the patients were lower than 1 mGy (mean values: contralateral breast: .9 mGy; abdomen .45 mGy). The mean activity detected in the excised tissues was 9 kBq and 900 kBq in the sentinel lymph nodes and in the tumor lesions (injection site), respectively. The activity detected on the surgical instruments, higher on gauzes (< 100 kBq), was negligible. CONCLUSIONS: From the radiation protection point of view, the data support the validity of our protocols. Absorbed doses to the hospital personnel are low and require neither a radiation protection control nor a classification of exposed workers as classes A or B. Special containers for radioactive wastes are necessary in the administration room but not in the operating room, where the levels of possible contamination are negligible.

Breast Neoplasms↗
PubMed1998

Endoscopic treatment of a case of obstructive jaundice secondary to portal cavernoma.

Biliary changes secondary to portal hypertension are uncommon. These patients do not usually present clinical or biochemical evidence of cholestasis. This report describes one case of obstructive jaundice due to portal cavernoma. The obstructive jaundice appeared in adulthood in a patient who had developed the portal cavernoma during childhood. Endoscopic retrograde cholangiography allowed both the diagnosis and the palliative treatment of the stenosis of the common bile duct, avoiding risky surgical treatment.

Adult↗
PubMed1998

Early ischemia-induced alterations of the outer mitochondrial membrane and the intermembrane space: a potential cause for altered energy transfer in cardiac muscle?

Our aim was to carefully analyse the time-dependent changes that affect the mitochondrial function of myocardial cells during and after an ischemic episode. To this end, variables characterizing mitochondrial function have been evaluated on myocardial samples from isolated rat hearts subjected to different conditions of ischemia. The technique of permeabilized fibers was used in order to evaluate the mitochondrial function whilst retaining intracellular structure. The earliest alteration that could be detected was a decrease in the stimulatory effect of creatine on mitochondrial respiration. This alteration became more pronounced as the severity (or duration) of the ischemia increased. Afterwards, a significant decrease in the apparent Km of mitochondrial respiration for ADP also appeared, followed by a diminution of the maximal respiration rate which was partly restored by adding cytochrome c. Finally, for the most severe conditions of ischemia, the basal respiratory rate also increased. These observations are indicative of a sequence of alterations affecting first the intermembrane space, then the outer mitochondrial membrane, and finally the inner membrane. The discussion is focused on the very early alterations, that could not be detected using the conventional techniques of isolated mitochondria. We postulate that these alterations to the intermembrane space and outer mitochondrial membrane can induce disturbances both in the channelling of energy from the mitochondria, and on the signalling towards the mitochondria. The potential consequences on the regulation of the production of energy (ATP, PC) by the mitochondria are evoked.

Adenosine Diphosphate↗
PubMed1998

Monomanual pupil stretcher.

The monomanual pupil stretcher is a new instrument that allows the authors to easily, quickly, and safely stretch the pupil. The specific features of the hooks allow pupil stretching to be performed in a single maneuver and in a more effective manner.

Equipment Design↗
PubMed1998

[Subarachnoid hemorrhage and pregnancy].

Intracranial haemorrhage from ruptured aneurysm or bleeding in arteriovenous malformation is rare, but may result in significant maternal and fetal mortality and serious neurological morbidity in survivors. Surgical intervention creates risks for the mother and her fetus, but is the best form of management. The anaesthetic procedure can present many clinical dilemmas, one of which is the role of induced hypotension. This review will focus on the diagnosis and management of this dramatic event.

Female↗