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Biomedical subjects

C Baldi

Publications and source records attributed to C Baldi.

At least 37 records · Page 2Linked to original sources

Migration of metallic clips used during laparoscopic cholecystectomy and formation of gallstones around them: surgical implications from a prospective study.

Two groups of patients, with laparoscopic cholecystectomy (LC) were prospectively studied. All patients had serial plain abdominal X-ray examinations at various intervals after operation, to record the position of clips placed during LC. Seventy-one patients had less cystic duct (CD) dissection and > or =4 clips placed during the procedure. One hundred and fifteen patients had a larger CD dissection and only 4 clips placed (2 on the cystic artery and 2 on the CD, without additional clips on smaller vessels). In the former group, 7 patients had clip migration within 1 month and 11 within 1 year vs 1 either at 1 month or 1 year in the latter group (p = 0.01 and <0.001, respectively). During the follow-up, a 72-year-old man belonging to the former group had a recurrent common duct brown pigment stone containing a metallic clip 26 months after operation. He was treated successfully by endoscopic sphincterotomy. Factors predisposing to clip migration were short cystic stump, inadvertent clip dislodgment or incorrect placement, cystic duct ischemic necrosis, and local suppurative complications. Data from 29 patients with GS formed around suture material or phytobezoars observed during a prospective study and from the physicochemical and structural analysis of a cumulative series of 64 GS containing foreign bodies are also presented and discussed. It is suggested that metallic clips can migrate from their initial sites at various intervals within the peritoneal cavity or into the common duct and serve as a nidus for GS formation. Metallic clip migration in most cases is due to technical factors and can usually be prevented. However, it is not possible to prevent either clip migration or GS formation in every case, since even well-placed clips can migrate due to suppurative complications or local ischemic damage, and, once that penetration within the bile tract has occurred, GS are usually going to form, irrespective of the nature and the shape of the foreign body.

Adolescent↗

Isolated atrial inversion in situs inversus: a rare anatomic arrangement.

Isolated atrial inversion in situs inversus is a rare congenital cardiac malformation. Its physiology resembles transposition of great vessels, and the best option for its surgical treatment is the atrial switch operation. In this article, we present a case of isolated atrial inversion in concordance with visceral situs inversus diagnosed at birth by echocardiography and cardiac catheterization, which was successfully treated at 8 months of age by a Senning procedure.

Coronary Circulation↗

Mucosal immunity in allergic rhinitis.

Secretory IgA (SIgA) is the main agent protecting the mucosal districts against both infectious microorganisms and inert foreign macromolecules. A lack of secretory immunity has previously been described in patients with allergic rhinitis, but it is a controversial finding. The discrepant results of SIgA levels found in allergy may partially be due to methodological problems. Sixty patients with previously demonstrated allergic rhinitis, treated or not with specific desensitization therapy and free from clinical manifestation of rhinitis were studied. Normal volunteers and patients with selective 11S IgA deficit, without allergic pathology, were investigated as controls. The titration of SIgA in nasal secretions, performed by an original immunoisoelectro-focusing method, showed significantly decreased values in allergic patients. An evaluation of the IgE level in nasal secretion was performed by ELISA. Low rates of IgE were also found in the intercritic period.

Adolescent↗

[Significance of the combination of small intestine enema and ultrasonography in the follow-up of Crohn's disease. Clinical correlations].

High-resolution US yields important information for the study of Crohn's disease. A more accurate follow-up is possible by the integration of US with radiological and clinical findings. Sixty-two patients with suspected or known Crohn's disease were examined with double-contrast small bowel enema and high-resolution US. The latter allowed the demonstration of such pathologic findings as mesenteric thickness greater than 15 mm, submucosal thickness (third hyperechoic layer greater than 50% of total bowel wall thickness), lymphadenopathies, and fluid collections. The authors suggest that US grading be performed, and radiological correlations made. The combined use of the two techniques yields better results and allows a better assessment of the patients, which is very useful for both prognosis and therapy.

Adolescent↗

Tumor-associated trypsin inhibitor (TATI) in bone diseases.

The casual observation of high serum levels in (TATI) of tumor associated trypsin inhibitor in patients with osteosarcoma inspired us to evaluate the use of this peptide in the diagnosis of various bone diseases. We determined the serum concentrations of TATI in 35 patients with various bone diseases, i.e. degenerative diseases, bone metastasis and osteosarcomas. The cut off, determined as the 99th percentile of TATI serum levels in healthy volunteers was 32 micrograms/l. TATI has a better sensitivity in osteosarcomas (83%) than in metastatic bone diseases (33%). Its specificity in non-malignant bone diseases was not exceptional (82%). This is probably because TATI may also behave as on acute phase protein, the levels of which can rise in non-malignant diseases and also as a result of a tissue reaction in primary bone tumors.

Biomarkers, Tumor↗

[Ultrasonography in the study of synovial disorders and tendon lesions in rheumatoid arthritis].

Conventional radiology is the main diagnostic tool for the visualization of osteoarticular lesions in rheumatoid arthritis. Articular effusions and popliteal cysts were examined with US. This paper is aimed at proving US capabilities in yielding important information about articular and peri-articular soft tissues in the early phases of rheumatoid arthritis. Over the last 30 months, the shoulder, wrist, hand, knee, and hip of 73 rheumatoid patients were studied by means of US and conventional and microfocal radiography. The patients were divided into 2 groups according to the time of onset of the disease. In group A, US demonstrated early synovial exudative inflammation, whereas conventional and microfocal radiography mainly demonstrated soft tissue swelling. In group B (where the first onset dated back to over 1 year), US demonstrated exudative and proliferative changes, together with recurrences. The authors believe US to be able to recognize the early changes of rheumatoid arthritis: as a matter of fact, US shows articular and periarticular soft tissues abnormalities and allows a differential diagnosis to be made between exudative and proliferative forms.

Arthritis, Rheumatoid↗

Urinary thallium: critical problems, reference values and preliminary results of an investigation in workers with suspected industrial exposure.

Using a sensitive ETA ASS method, urinary thallium (Tl-U) has been measured in a group of non-exposed individuals and in two groups of workers with suspected industrial exposure. In non-exposed subjects (72 healthy males aged 41 +/- 11 years) the Tl-U mean value was 0.22 mu/l (range 0.05-0.61). Significantly higher values were found in two groups of workers (30 and 21 subjects) employed in two cement factories and two cast iron foundries (mean Tl-U value: 0.38 and 0.33 mu/l, respectively; range 0.06-1.2). Thallium has been determined in coal, raw materials and, in one factory, also in environmental samples, but no detectable levels were found. The analytical problems connected to urinary thallium determination and the preliminary results of biological monitoring in non-exposed individuals and in workers are discussed.

Environmental Exposure↗

Urinary chromium levels in subjects living in two north Italy regions.

The concentration of total urinary chromium (Cr-U) in two different groups of healthy occupationally non-exposed subjects living in the Italian regions of Lombardia and Veneto has been determined using an ETA-AAS direct method. The age, sex, residence and smoking habits were correlated with CrU excretion. The mean CrU value found in subjects living in Lombardia (n = 310, males 170 and females 140) was 0.59 + 0.26 microgram/l (range 0.08 - 2.10); in Veneto subjects (n = 238, males 187 and females 51) the mean value was 0.52 +/- 0.31 microgram/l (range 0.05 - 1.90). A significative difference between male and female values and a decrease of CrU levels with age increasing have been evidenced in both groups. Smoking habits seem to influence metal urinary levels while, on the other hand, no influence of living sites was observed. Some analytical problems of ETA-AAS Cr determination systems are discussed and "normal" CrU values measured in this study are compared with data reported in the literature.

Adult↗

Effects of silver in isolated rat hepatocytes.

Addition of silver nitrate or silver lactate to freshly isolated hepatocytes caused dose-dependent loss of cell viability, measured by trypan blue exclusion, at concentrations within 30-70 microM. Silver cytotoxicity was accompanied by a decrease in hepatic thiol concentration and an increase in lipid peroxidation. Treatment of hepatocytes with the reduced glutathione (GSH)-depleting agent diethylmaleate markedly increased their vulnerability to silver toxicity whereas protective effects were produced by the thiol-reducing agent, dithiothreitol. Both alpha-tocopherol, which protected from the onset of silver-associated lipid peroxidation, and the iron chelator agent, deferoxamine failed to prevent loss of cell viability. These data suggest that perturbation of intracellular thiol homeostasis may play a critical role in the mechanism underlying silver-induced lethal damage to isolated rat hepatocytes.

Animals↗