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Biomedical subjects

E Fazzi

Publications and source records attributed to E Fazzi.

51 records · Page 3Linked to original sources
PubMed1986

Ultrasound-clinical correlations in the assessment of the newborn at risk for brain damage.

In the Pavia Neonatal Intensive Care Unit all newborns at risk for brain damage have, since 1983, undergone transfontanellar ultrasound scanning regularly for the early diagnosis of hemorrhage and/or anoxia-ischemia. They have also been assessed clinically by a child neuropsychiatrist during the hospital stay and every two months at outpatients' for the first year of life as a check on the prognostic value of ultrasound scanning. The results relating to a sample of 56 at risk newborns, with normal and abnormal ultrasound scans, who have now reached 12 months corrected age are reported. A normal ultrasound scan presupposes normal neuropsychic development in 87% of cases, as happens in the event of uncomplicated hemorrhage. Major sequelae occur in as many as 83% of cases of complicated hemorrhage. The diagnosis of severe anoxia-ischemia likewise argues for a pathological neuropsychic development. Our results convince us that transfontanellar ultrasound scanning is an indispensable tool not only for the early diagnosis of brain damage but also as a guide to prognosis in the newborn at risk.

Atrophy↗
PubMed1984

Benign paroxysmal vertigo in childhood: a migraine equivalent.

The two main problems in defining and classifying the syndrome of benign paroxysmal vertigo (BPV) in childhood are the vestibular function pattern and the relationship between BPV and migraine. 13 children suffering from this syndrome were submitted to complete otoneurological examination, including caloric and rotational labyrinthine stimulation with ENG recording, and to headache provocation tests with nitroglycerin, histamine and fenfluramine. Vestibular responses were normal in all except 2 cases which presented signs of central vestibular impairment at the level of the vestibulocerebellar pathways. Headache provocation tests were positive in 9 out of 10 children, and in 4 cases they induced a typical vertiginous attack instead of headache. In addition, several children had a positive family history for migraine, headache was frequently associated with the crisis and other signs of a 'periodic syndrome' (motion sickness, cyclic vomiting, abdominal pain) were present, unrelated to vertiginous attacks. During the follow-up period, some children responded positively to migraine treatment. BPV, like paroxysmal torticollis in infancy and the signs of the periodic syndrome, can be considered a migraine equivalent or a migraine precursor and could be due to the same vascular and/or biochemical mechanisms responsible for the migraine. In children, for anatomical or developmental reasons, these mechanisms could selectively affect parts of the brain stem, including the vestibular nuclei and vestibulocerebellar pathways.

Child↗
PubMed1983

Cyclic vomiting and recurrent abdominal pains as migraine or epileptic equivalents.

A retrospective method was used to estimate the incidence of recurring motion-sickness, cyclic vomiting and abdominal pain considered as different manifestations of a so-called periodic syndrome in 100 migraine sufferers, 100 epileptics and 100 control subjects in the pediatric age group. Such recurrent symptoms are significantly more frequent in those suffering from migraine than in the other two groups. Examination of subgroups of patients affected by particular forms of migraine (classical and common) and of epilepsy (generalized seizures, simple partial seizures, complex partial seizures) contributed little new to our understanding of the nature of periodic syndrome. It is concluded that the above symptoms of periodic syndrome should generally be considered as manifestations of a migrainous rather than of an epileptic disorder.

Abdomen↗
PubMed1983

The periodic syndrome in pediatric migraine sufferers.

The present study takes into consideration some of the symptoms comprised in the Periodic Syndrome. These include motion-sickness, cyclic vomiting, recurrent abdominal pains and paroxysmal vertigo. Particular consideration is given to the chronological and long-term aspects of such symptoms. Among 247 migraine sufferers in the pediatric age group, 173 subjects who complained of at least one of these symptoms were chosen. Results of the data show that motion-sickness is the first to manifest itself (mean age of onset 2 years), and has a tendency to continue into the headache period; cyclic vomiting appears in the third year of life, and terminates sooner than the other symptoms. At the mean age of five years abdominal pains start, and at seven, paroxysmal vertigo. Headache is the final symptom in this group. The sequentiality of such disturbances in each subject leads to the assumption that the Periodic Syndrome is the expression of a single disorder which manifests itself polymorphously as a rather precisely timed process.

Abdomen↗
PubMed1983

Psychological aspects of migraine in childhood.

Experimental data indicate that certain unconscious emotions cause modifications of the brain stem neurotransmitters, inducing neurohumoral and vascular changes which underlie the migraine attack in biologically predisposed subjects. The present study investigates, with patient interviews, psychodiagnostic tests (Rorschach, Blacky pictures, Thematic Apperception test, drawings, Wechsler) and parental interviews in 20 pediatric migraine subjects. In 85% of the cases, a condition of repressed anger preceding the attack is seen. In 40% of the subjects, events such as a death in the family, separations, angry quarrels among parents, and scholastic problems, are seen just before onset of the disease. In conclusion, migraine may be considered a psychosomatic disorder, with the phenomenon of pain as a somatic extrinsication of psychological distress.

Adolescent↗
PubMedDate not supplied

Ring chromosome 9: an atypical case.

A new case of ring chromosome 9 in a 36-month-old child is presented. In addition to the pathognomonic features of this rare disorder (only 21 cases reported), our patient presents some peculiarities, such as corpus callosum hypoplasia and epileptic seizures (infantile periodic spasms). We also observed a reduced level of leukocyte interferon alpha whose synthesis is controlled by a gene on chromosome 9 and which could be responsible for the recurrent respiratory tract infections, typical and sometimes fatal in these patients.

Adult↗
PubMedDate not supplied

Kinematic and dynamic analysis of the ankle joint in children with cerebral palsy.

The assessment of walking in children affected by cerebral palsy (CP) is currently based principally on qualitative assessment criteria. Gait analysis, meanwhile, evaluates quantitatively kinematic and dynamic aspects of locomotion. The main aim of this study was to examine (using an optoelectronic system and a force platform) kinematic and dynamic aspects of the ankle joint in hemiplegic and in diplegic children (9 and 11 subjects respectively) and in 10 normal control subjects. Our results reveal, in spastic subjects, "equinus" placement of the foot in the initial contact phase, a lack of dorsiflexion (negative DF peak) in the stance phase and a reduction in push-off capacity (capacity to move the leg forward) in the swing phase. The results furnished by this study represent a useful contribution to the assessment of the walking ability of children affected by CP and to the evaluation of the indications and advantages of the rehabilitative intervention chosen.

Ankle Joint↗
PubMedDate not supplied

Energy consumption and gait analysis in children with myelomeningocele.

The aim of this study was to determine, in children with different levels of myelomeningocele (MMC), the gait pattern and energy cost of walking with and without ankle-foot orthoses (AFOs). We found that each MMC level was characterised by recognisable gait patterns and that the abnormalities closely reflected the muscle deficits present. Furthermore, the study also introduces new indices for evaluating the energy cost of locomotion and demonstrates that the energy required for walking is increased in children with MMC compared with non disabled children. With respect to barefoot conditions, the use of AFOs leads to an improvement in gait and reduced energy consumption.

Adolescent↗
PubMedDate not supplied

Short-term effects of "botulinum toxin a" as treatment for children with cerebral palsy: kinematic and kinetic aspects at the ankle joint.

Botulinum toxin A (BTA) therapy plays several roles in the management of paediatric cerebral palsy (CP). However, few studies contain objective documentation of gait changes. The main aim of this study was to provide objective information on the outcome of the treatment. Gait analysis data from 20 normal subjects and 23 CP children were collected before and after BTA injections into the gastrocnemius-soleus complex. The follow up was performed 1 month after the first injection. The kinematic and kinetic data revealed significant improvements in dynamic ankle dorsiflexion, both in stance and in the swing phase, an improvement of equinus foot upon initial contact and better support in stance. The results of this study are promising, but studies of other joints involved in gait, such as the knee, are also needed.

Adolescent↗
PubMedDate not supplied

[Neuropsychologic development of small for gestational age preterm infants: follow up at 12-36 months of age].

We followed 94 preterm infants (G.A. < 37 weeks) small for gestational age (SGA) born from 1980 to 1987 in Pavia and admitted to the Neonatal Intensive Care Unit of S. Matteo Hospital (Pavia). A control group matched for gestational age of 94 preterm appropriate for gestational age (AGA) was also studied. Neurological examination was carried out at 40 weeks postmenstrual age and at 3, 6, 9, 12, 24, 36 months of age with the method of Amiel-Tison and Grenier (1986). Psychomotor development was assessed using Brunet-Lezine's Scale until 1985 and after Bayley Scales of Infant Development. Intrauterine mortality was 23.40% in the SGA group and 5.32% in the AGA group (p = 0.0003); neonatal mortality was 18% in the SGA group and 6.62% in the AGA group (p < 0.01). 42 SGA (80.8%) and 58 AGA (79.5%) were completely normal (group A) at 36 months, but SGA infants showed transient neurological abnormalities (TNA) more frequently than the control group (30.7% vs 6.8% - p < 0.001). 5 SGA (9.6%) and 10 AGA (13.7%) had minor abnormalities (group B); no SGA children and only one AGA had diplegia (group C); 3 SGA (5.8%) and 4 AGA (5.5%) were considered to have severe handicap (group D) SGA children had a higher incidence of epilepsy (3.8% vs 0) than AGA (group E). These results show that in our group of SGA preterm infants the union of intrauterine growth retardation and prematurity compromise the possibility of survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMedDate not supplied

Response to pain in a group of healthy term newborns: behavioral and physiological aspects.

Various reports have documented the difficulty in assessing neonatal response to painful stimuli. The aim of our study was to evaluate previously described scales for assessing pain in a group of 18 healthy term newborns selected according to Prechtl's optimality criteria and subjected to a routine metabolic screening blood test performed on the 5th day of life. Both a modified CHEOPS scale and Grunau-Craig Scale, to assess pain behavior response before, during and after a painful stimulus, revealed definite modifications in scores. Response to pain was also evaluated by measuring variations in decreases in transcutaneous oxygen pressure in all newborns during application of the stimulus and in returns to baseline or higher values upon removal of the stimulus. Our study confirms that healthy term newborns feel pain when subjected to limited painful stimuli such as the routine blood test and suggests useful and easy methodological tools to evaluate pain in the newborn.

Blood Gas Monitoring, Transcutaneous↗