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Biomedical subjects

C Castelli

Publications and source records attributed to C Castelli.

90 records · Page 5Linked to original sources
PubMed1982

[The natural development of arteriosclerotic coronary disease. Coronarographic study in time intervals].

In 96 patients with coronary artery disease a coronary arteriography was performed twice at least with some months' interval, in order to establish the rate of progression of coronary atherosclerosis and the factors which could affect this progression. It was possible to select patients with progression of the coronary arteria lesions from patients with no increase of coronary stenosis. From the angiographic point of view, the progression of angina and the appearance of myocardial infarction are connected with a general progression of arterial lesions on all main coronary branches. As to the electrocardiographic aspects, the ECG at rest give no informations about the evolution of the coronary disease. Among the risk factors the smoking only has some importance in order to predict the progression of the coronary atherosclerosis.

Adult↗
PubMed1981

[Aortic valve disease and coronary atherosclerosis. Clinical and coronarographic study (author's transl)].

77 patients with aortic valve disease have undergone heart catheterization in prevision of valve replacement: in this group the incidence of angina pectoris and the incidence of coronary artery disease associated with the valvular disease have been evaluated. The most important data resulting from out study are: 1) High frequency of angina pectoris both aortic stenosis and in aortic regurgitation: respectively about 60% and 50%. 2) The frequency of coronary atherosclerosis associated with aortic valve disease is much higher in aortic stenosis than in aortic regurgitation: respectively 35% versus 15%. 3) Coronary atherosclerosis associated with aortic stenosis frequently occurs (about 30%) also in young-aged patients (under 40 years). On the contrary in case of aortic regurgitation it occurs much more frequently in elderly patients. 4) The absence of angina both in aortic stenosis and in aortic regurgitation virtually excludes the presence of associated coronary atherosclerosis. 5) The presence of angina in aortic stenosis indicated either severe valvular stenosis or associated coronary artery disease (in this case the valvular stenosis is mild or moderate). The presence of angina in aortic regurgitation indicates either severe impairment of left ventricular performance or associated coronary atherosclerosis.

Adult↗
PubMed1980

Distribution and anomalies of coronary arteries in tetralogy of fallot.

The surgical management of tetralogy of Fallot (TF) may be complicated by anomalies in the course and distribution of coronary arteries. Selective coronary angiography was performed in 119 cases of TF in order to prevent injury of aberrant vessels. In 11 patients, anomalies in the origin of coronary branches were revealed (five patients with a single coronary ostium, five with the anterior descending coronary artery arising from the right coronary artery or right sinus of Valsalva, and one with the circumflex artery arising from the right coronary artery). Other findings include anastomoses between coronary and bronchial arteries, small fistulas between coronary arteries and the pulmonary artery or right atrium, and hypoplasia of the coronary tree. The onset of left anterior hemiblock after total correction of TF could possibly be explained, in cases with a dominant left pattern, by injury to the coronary system after closure of the interventricular septal defect, rather than by injury to the conduction system.

Adolescent↗
PubMed1980

[Left ventricular kinetics in bundle-branch block. Analysis by different methods in patients without coronary artery diseases (author's transl)].

Radiological ventriculographic findings of twenty-three patients with left bundle branch block (LBBB) without valvular heart disease and without evident coronarographic lesions are studied by means of six differents methods for quantitative evaluation of wall motion analysis. The patients are subdivided into two subgroups on the basis of hemodynamic criteria, but the results of wall motion studies are similar in both, if the values obtained are normalized for election fraction (EF). End-diastolic images of left ventricle are similar in both subgroups too, but very different from those of normals because apical region is characterized by rounded contour of images. The modes of contractility in LBBB patients evidence, after normalization by the same EF, hypercinetic motility of anterior wall. The patterns of contractility, shaped by progressive simulated EF, show that low EF are obtained through contraction of anterior wall. Greater EF are obtained by further uniform contraction of all the explored regions. The apical zone in LBBB patients is affected by persistent hypokinesis.

Adult↗
PubMed1979

[Distribution and anomalies of coronary arteries in tetralogy of Fallot (author's transl)].

Anomalies in the course and distribution of coronary arteries may complicate the surgical correction of tetralogy of Fallot (TF). With the aim of preventing possible serious, and even lethal, cardiac events caused by the injury of aberrant vessels, 119 patients with TF were subjected to selective coronary angiography. Apart from demonstrating anastomoses between the coronary and bronchial arteries in 31 cases, small fistulas between the coronary arteries and pulmonary artery (in 14 cases) and hypoplasia of the entire coronary tree in 1 case, this investigation revealed anomalies in the origin of coronary branches in 11 cases. In some cases the first septal branch was absent and the diagonal branches were poorly developed. An injury to the coronary system, following the closure of the interventricular septal defect, may possibly explain the onset of a "left anterior hemiblock" after total correction of TF. Selective coronary angiography in small children presents no riskes provided it is correctly performed. In our cases no complications arose.

Adolescent↗
PubMed1978

[Myocardial infarction in young people. A coronary angiographic study in 21 patients under the age of 30 (author's transl)].

The Authors have taken into account 21 patients who complained of myocardial infarction before they were 30 years old. We performed coronary angiography, left ventriculography and left cardiac catheterization in all the patients. In 20 cases we found atherosclerotic alterations (50 or greater obstruction) at least in one of the three main braches of coronary tree. The coronary angiography in one patient showed a picture of dissection of right coronary. The alterations are localized more frequently on the anterior descending branch than on the right coronary. On the contrary we found very seldom atherosclerotic lesions on the circumflex artery. Monovascular alterations were more frequent than plurivascular alterations (more than 40% of the total). Left ventricular function was out of order in almost all cases. In summary the important differences between young patients with myocardial infarction and older patients are the following: 1) from the clinical point of view the sudden onset of myocardial infarction without previous symptoms of angina pectoris; 2) from the angiography point of view high incidence of monovascular alterations and low incidence of collateral circulations.

Adult↗
PubMedDate not supplied

[Cost of psychiatric patients by disability type].

OBJECTIVE: The study of the relation between treatment costs and disability of psychiatric patient groups. DESIGN: Perspective assessment of costs and disability of 1371 adult psychiatric patients in charge at two Operative Psychiatric Units (OPU), followed during an average period of 9 months. Data are related to all OPU's psychiatric services, including ambulatory, full or half-residential and psychiatric departments of acute hospital services. SETTING: OPUs of Magenta (MI) and Desio (MI). METHOD: The disability level has been measured by Health of the Nation Outcome Scales (HoNOS) filled in at the inclusion of the patient in the study and every three-months on average thereafter. Besides other HoNOSs have been filled in both at admission and discharge from psychiatric departments of acute hospitals, Residential Centres of psychiatric Therapies and Rehabilitation and Guarded Communities. All patients have been grouped using the main psychiatric diagnosis (first digit ICD-10) and the maximum disability level shown in the whole period of the study. Direct costs of publicly financed psychiatric services have only been considered. Their attribution to each patient has been made applying standard costs or tariffs (diagnostic procedures) to the data perspectively collected by the regional Register and a purposely designed protocol. RESULTS: Total cost of 1371 patients has been 9771.1 million lire with a cost per patient of 7,127,000 lire (sd 19,499,000) and a cost per "day in charge" of 27,172 lire (sd 68,358). The cost per day has been found unrelated with the length of observed time frame. At the inclusion the mean level of disability has been 4.26 points (sd 3.73) and 3.19 points (sd 3.26) at the end of the study. Its value, measured at maximum level shown by each problem in the whole period of study, has been 6.00 points (sd 4.64). Disability and treatment cost of each patient did result directly related (r = 0.626, p = 0.0001). All patients have been grouped in 12 classes with a significant (p = 0.0001) overall difference on both their disability level and treatment cost. CONCLUSIONS: All adult psychiatric patients could be grouped in disability related classes which sometimes have also a different treatment cost. A study on a greater number of patients is needed to confirm these results. It may also provide a more reliable basis for a new financing system of psychiatric services.

Adult↗
PubMedDate not supplied

Two autologous melanoma-specific and MHC-restricted human T cell clones with identical intra-tumour reactivity do not share the same TCR V alpha and V beta gene families.

Among tumour infiltrating lymphocytes (TIL) of a melanoma patient, A CD8+, WT31+ CTL clone (8B3) had been previously isolated which exhibited specific and MHC-restricted lytic activity against the autologous tumour. To molecularly characterize T cell receptor (TCR) alpha and beta transcripts of clone 8B3, sequence analysis of several cDNA isolates was carried out. Such analysis indicated that the functional alpha and beta chain of 8B3 are composed of V alpha 2.1/J alpha/C alpha and V beta 8.2/D beta/J beta 1.2/C beta 1 gene segments. Eleven additional melanoma-reactive T cell clones from the same patient (one MHC-restricted and 10 MHC-unrestricted) were analysed for usage of the 8B3 V alpha 2 and V beta 8 gene segments by Northern blot hybridization. Neither the V alpha 2 nor the V beta 8 segments were used by 8D9, the second MHC-restricted melanoma-specific TIL clone that displayed intra-tumour reactivity identical to that of 8B3 recognizing only 4 out of 25 melanoma clones isolated from the same metastases. No V beta 8 expression was found among the MHC-unrestricted T cell clones and all but two (found in duplicate as 4C4 and 4A6) were also negative for V alpha 2 expression. Southern blot analysis revealed different TCR beta chain rearrangements in most MHC-unrestricted T cell clones providing evidence of their independent derivation. Taken together these findings show that TCR of clone 8B3 is unique in composition and not shared by MHC-unrestricted melanoma-reactive T cell clones. The different set of V alpha and V beta families used by clone 8D9 further indicates that the TCR usage in the specific and MHC-restricted response to melanoma can be polyclonal.

Amino Acid Sequence↗
PubMedDate not supplied

Prevalence and clinical significance of antiphospholipid antibodies to noncardiolipin antigens in systemic lupus erythematosus.

The specificity and immunoglobulin isotype distribution of antiphospholipid (aPL) antibodies have been evaluated in 68 patients with systemic lupus erythematosus (SLE) by ELISA which employed a panel of 7 different PL antigens. A total of 49 patients (72%) were positive for aPL antibodies of different isotypes and directed to one or more PL epitopes. Prevalence of IgG anticardiolipin (aCL, 37%) was similar to that of the other negatively charged PLs phosphatidylserine (PS, 35%), phosphatidylinositol (PI, 35%), phosphatidylglycerol (PG, 35%) and phosphatidic acid (PA, 40%); prevalence reduced to 9-12% and 7-16% respectively for IgM and IgA isotypes to the same antigens. aPL antibodies to the zwitterionic PLs phosphatidylcholine (PC) and phosphatidylethanolamine (PE) were also observed, though their prevalence was lower than that demonstrated for negatively charged PLs. Of the 36 SLE patients who were aCL negative (53%), 17 (25% of all patients and 47% of aCL-negative patients) were positive for aPL antibodies of different isotypes to one or more non-CL epitopes. During a mean follow-up period of 30 months, 10 patients had deep vein thrombosis (DVT) with a total of 21 events. By chi 2 test, a significant correlation was found between DVT and IgG aCL (p = 0.03) and between this event and the presence of lupus anticoagulant (LA) antibody (p = 0.04). However, stronger correlations were demonstrated between DVT and IgA aCL (p = 0.007), IgG anti-PS (p = 0.02), and IgA anti-PC, -PI and -PG (p = 0.02, 0.003 and 0.02, respectively), whereas no correlation was found between thrombotic events and aPL antibodies with PE and PA specificities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Characteristics of nursing students attending the University Courses for Nursing Diploma at Trento: reasons for their choices in the first trimester].

Motivations and reasons for the choice of the nursing course were explored in the students applying for the university nursing courses from 1995 to 1998. Aim of the study was to trace a picture of students' characteristics but also to have elements to promote campaigns for increasing the number of applicants. Overall, 183 first year students (70 in 1995; 60 in 1996 and 53 in 1997) were administered a questionnaire with questions related to socioanagraphic data, reasons for the choice of the University Diploma in Nursing Sciences (DUSI) and aspects of the nursing profession considered positive and negative. The 87% of the students had previous work experiences, more than 20% in the health field and a larger number in the social field. The main reasons for choosing the DUSI are the strong connections between theory and practice and the opportunity of working soon after the course. Fifty per cent of the students make definitely up their mind on the final choice of becoming a nurse during the course: in fact only 55% of the students are moderately-strongly convinced of practising the nursing profession when they enter the curriculum. The data are commented on with special attention to the implications for the contents and strategies of a campaign or ad hoc initiatives aimed at increasing the number of students that apply to the nursing courses.

Adult↗
PubMedDate not supplied

[Postural tenosynovitis caused by misuse of a computer input device (mouse)].

Several reports of postural problems among video display unit workers are available, most frequently involving the back, neck and shoulder. The case described is an example of tenosynovitis of the right wrist at the point where the wrist rests on the work surface while operating the mouse in a computer workstation (2-3 hours/day 6 days/week). The alteration was caused by a combination of friction and pressure on the wrist joint tendon due to the faulty positioning of the hand and wrist. This is the normal resting position for the wrist (inclined towards the ulnar side), and is thus the most natural position to adopt. The reported alteration, which responded to a short period of rest and treatment with non-steroid anti-inflammatory drugs for 2-3 days, is described as an example of common injury caused by an unusual faulty posture of the hand. The preventive measures suggested to avoid the occurrence of this type of injury include: (i) instead of resting the weight of the hand on the ulnar side of the wrist it should be distributed between the two pads of fatty tissue which form the base of the palm, (ii) the mouse button could be clicked with the third finger instead of the index finger in order to avoid the tendency of hand to roll into the faulty rest position.

Computer Terminals↗
PubMedDate not supplied

[The approach to Achilles tendinopathies in athletes. Echographic aspects].

The recent great diffusion of sports has significantly increased the traumatic pathology of Achilles tendon. Owing to the importance of a correct diagnosis and prognosis and of an adequate therapy (especially for professionals), a clinical and radiological study has been performed. Echotomography has been associated with xeroradiography in 185 athletes with painful symptoms; among these 79 were normal while 106 showed various types of tendinopathies. The main results can be summarized; peritendinitis: non uniform thickening; hyperechogenicity of Kager's triangle; insertional tendinopathies: thickening; calcifications; tendinosis: thickening; degeneration nodules; tendinous ruptures: rough contours of the rupture; degeneration nodules. The good echotomographic results allowed a correct diagnosis in about 85% of the 39 surgically treated patients.

Achilles Tendon↗
PubMedDate not supplied

[Professional and working conditions of newly licensed nurses in the province of Trento].

Aim of the survey was to gather information on the occupational situation of recently trained registered nurses of the Trento Province. 484 questionnaires were mailed to all the nurses that obtained their diploma from 1993 to 1995; 379 questionnaires (78%) were returned. Among the 70 subjects not working as nurses, 19 are unemployed, 12 study full time, 26 work full time in other professions, 11 are in the army, all the others work occasionally, but not as nurses. 46% are unsatisfied or partially satisfied with their job; 87.3% would choose again the nursing profession. 20% of the nurses would prefer to work on a part time basis.

Career Choice↗
PubMedDate not supplied

The surgical treatment of trauma of the cervical spine. C3-C7 lesions.

The surgical treatment of trauma in the C3-C7 region must obtain three goals: preservation of life, preservation or restitution of good neurological function, and achievement of stabilization that allows for early rehabilitation. In our experience we have come to believe that the goals set out to be achieved may be obtained if a correct anatomical-pathological classification of the lesion and the mechanism that caused trauma are kept clear: these premises are necessary for the choice of treatment and, consequently, the most suitable route of access.

Bone Plates↗
PubMedDate not supplied

Complications of prosthetic surgery in the dysplastic hip.

The complications of prosthetic surgery in the dysplastic hip have specific features that are related to the conditions that make the realization of an implant technically complex; the altered primary acetabular and femoral morphology, the sequelae of previous non-substitutive surgery, and the consequent possible upsetting of joint biomechanics. It is possible to distinguish between complications relative to the skeleton, joint biomechanics, and soft tissues. Prosthetization of the acetabular skeletal aspect may encounter frequent errors in reconstruction (incongruous reaming-too much or too little-the improper use of bone grafts), errors in orientation of the acetabular component (excessive verticalization and anteversion) that are considered early complications. The same technical errors may cause late complications in the implant, or its migration. At the femoral level the particular shape of the medullary canal and of the femoral neck may lead to defects in orientation in anteversion and fracture of the diaphysis. Possible complications of a biomechanical nature are essentially to be related to changes in the center of rotation in both a craniocaudal and a mediolateral sense and or to the heterometry of the limbs. In the soft tissues, muscle tension may become too much or too little, in relation to recovery of joint biomechanics; in cases with significant lengthening neurologic deficit may occur. Accurate preoperative planning (traditional x-rays and CT scan), the choice of the most suitable surgical route of access, and the different prosthetic models that adapt best to the different morphological situations, the expertise of the surgeon, are all essential elements in monitoring complications.

Arthroplasty, Replacement, Hip↗