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Biomedical subjects

F Ceccarelli

Publications and source records attributed to F Ceccarelli.

At least 37 records · Page 2Linked to original sources

[Resistant and pseudoresistant hypertension: an analysis of 10 cases of pseudoresistance].

Hypertension resistant to pharmacological treatment may be caused by various factors. Next to the real refractory forms, there is one of false resistance known as "pseudoresistance". Pseudoresistance is a condition with a discrepancy between blood pressure values measured at the physician's office, which appear falsely high, compared to those measured at home by the patient or with the 24-hour ambulatory blood pressure monitoring which appear to be within the normal range. We have studied 10 pseudoresistant patients and valued their average pressures measured at the doctor's office (158/96 mmHg), comparing them with those measured at home by the patients or family members (135/83 mmHg) and with those measured with 24 hour PA monitoring with Takeda monitor mod. 2420 (average values of daytime pressure 129/79 mmHg). The difference between values at the physician's office and those measured with the 24 hour ambulatory blood pressure monitoring have resulted statistically significant (p < 0.0001). In all those patients with hypertension treated pharmacologically we recommend the use of 24 hour ambulatory blood pressure monitoring, so as to evaluate realistically the efficacy of the therapy itself and to identify other potential "pseudoresistant" individuals.

Aged↗

Kinematic and isokinetic evaluation of patients with flat foot.

In recent years research into joint physiology and biomechanics of movement has employed high-technology instruments to quantify the parameters which determine whether the behavior of a joint or kinematic chain is normal or pathologic. Motion analysis, featuring evaluation of both kinematics and the foot-ground reaction, enables us to measure the temporal and quantitative events of normal and pathologic gaits. The use of motion analysis in the study of flat foot has confirmed the ability to discriminate between "normal" and pathologic. Analysis of these themes has enabled us to follow the temporal evolution of the quantitative parameters both before and after treatment, which can be either surgical or conservative. Evaluation of the kinematic changes and the foot-ground reaction also provides information about the quality and effectiveness of the corrective treatment. For instance, the change in the subtalar alignment following application of an endo-orthotic implant can be targeted for validation by motion analysis. All of the joints comprised in the kinematic chain of the lower limb work together to achieve a symmetrical, rhythmic, and most of all harmonic gait.

Adolescent↗

Bioceramics in orthopaedic surgery: state of the art and preliminary results.

Ceramic materials utilized in orthopaedic surgery can be divided into bioinert, causing minimum tissue reaction, and bioactive types, capable of stimulating bone tissue growth, establishing a bond capable of supporting physiological loads. Alumina is a bioinert ceramic which shows excellent mechanical resistance and an extremely low level of wear when given appropriate structural characteristics. It is therefore used to make prosthetic hip components (head and acetabulum), to coat metal prosthetic shafts and to make prostheses for small joints. Among the bioactive ceramics, bioglass, bioglaze and hydroxylapatite are included in the study. At present, bioglass and bioglaze appear interesting, but not sufficiently so as to find a precise niche in orthopaedic surgery. Currently the bioactive ceramic with the most possibilities for use in orthopaedic surgery is hydroxylapatite. The close interfacial bond which is established with bone tissue allows it to be used as a filler for defective bones in various skeletal diseases and as a coating for metal prosthetic substrates.

Aluminum Oxide↗

Functional evaluation of patients fitted with total knee prostheses.

Degenerative or inflammatory diseases of the knee joint account for a large proportion of diseases affecting the elderly. Treatment aims to eliminate pain, correct the deformity and maintain complete joint mobility. In cases of total joint degeneration, fitting of a joint prosthesis is the technique currently favoured since elimination of pain and correction of the deformity, accompanied by recovery of joint mobility (the fundamental requirements for normal everyday life) can only be obtained if the knee joint is completely replaced. With the discovery of new materials and increasingly sophisticated knowledge about articular mechanics, the knee prosthesis, although more recent than the hip prosthesis, has become ever more widespread to the point that it now represents an irreplaceable aid in the treatment of this common disease. The clinical results obtained are already stable and particularly encouraging and prosthesis design is sophisticated and accurate. There is, however, still the suspicion that current prostheses can be considered "rudimentary" in comparison with the physiological and biomechanical behaviour of the human joint. We therefore wanted to begin an evaluation using a gait analysis system to assess patients fitted with knee prostheses. The first impressions gained in this study are the subject of this article.

Activities of Daily Living↗

Biological osteosynthesis in osteochondral lesions of the talus.

Osteochondral lesions of the dome of the talus whether medial or lateral are rare. Surgical treatment is required when there is a loose body, or when the lesion is symptomatic and resistant to nonsurgical treatment. Usually, the degenerated fragment is removed, followed by curettage and multiple perforations of the subchondral bed, but different methods may be used to reinsert the osteocartilaginous fragment. Having been satisfied with our first studies conducted both on animals and man, we began to reinsert the osteochondral fragment by using resorbable means of synthesis. The purpose of this study is to report our experiences with 3 such cases at a minimum follow-up of one year.

Adolescent↗

[Our experience in the treatment of idiopathic osteonecrosis of the femur head by évidement and filling with bone grafts].

UNLABELLED: The authors relate their experience in treating idiopathic osteonecrosis of the femoral head with bone grafting. CASES: 18 hips under control for a period varying from 8 to 3 years. Radiographic and clinical assessment before and after surgery according to Ficat, Arlet and Merle D'Aubigné. Four patients were affected with idiopathic osteonecrosis of the femoral head. Results were very good in 4 cases and quite good in 2 cases. Only one third of the results could be regarded as positive. This modest achievement is partly due to the method employed. In order to obtain better results, however, an early diagnosis is required and patients who are operated on should have quite a good bone mineralization.

Adult↗

Surgical correction of cervical hyperextension in rigid spine syndrome.

The rigid spine syndrome is a condition characterized by a mild axial and proximal myopathy in which the fibrous shortening of spinal extensor muscles causes a marked limitation in flexion of the spine. This 10-year-old boy with rigid spine syndrome showed a progressive limitation in flexion of the cervical spine with fixed hyperextension of the neck. To look forward he had to bend forward his trunk flexing hips and knees. An X-ray study demonstrated a progressive limitation in flexion but also in extension of the cervical spine. A particular radiologic aspect named "Alligator sign" was demonstrated. The hyperextension of the neck was corrected surgically by opening the interspinous spaces from C2 to C7 through a capsulotomy. The correction was stabilized with bone grafts fixed to the spinous processes. This boy with the straightened cervical spine was then able to look forward without any compensatory posture.

Cervical Vertebrae↗

Tibial osteotomy in the treatment of genu recurvatum in the adult.

The authors analyse the results of 23 cases of high tibial osteotomy for genu recurvatum in adults performed at the Rizzoli Orthopaedic Institute from 1968 to 1983. The osteotomy is at the supratuberosity level. After detaching the patella tendon an anterior bone wedge is inserted and the tendon reinserted at a higher level. This operation has produced better results than other surgical techniques. It is indicated in the osseous type of recurvatum or in the combined type in which the osseous component is predominant. In the combined type with a capsulo-ligamentous prevalence, the poor results obtained with osteotomy alone indicate the need for combining the operation with a plastic reconstruction of the posterior capsulo-ligamentous structures.

Adult↗

Modified Jones operation in the treatment of pes cavovarus.

The authors describe their technique and results in the treatment of pes cavovarus by transposition of extensor hallucis brevis to the first metatarsal (Jones operation) in association with arthrodesis of the interphalangeal joint of the hallux. In cases of structural deformity it is also combined with osteotomy of the base of the first metatarsal.

Adolescent↗

The surgical treatment of infantile flat foot. A new expanding endo-orthotic implant.

In the correction of flat foot in children, the fundamental requirement is to restore the normal relationship between the talus and calcaneus. To achieve this, the authors have devised an expanding orthotic implant which is inserted into the sinus tarsi. They discuss the indications and describe the surgical technique and the special instruments devised for fitting the device. The case material and first results after not less than 18 months follow-up are reported.

Adolescent↗

The treatment of supracondylar fractures of the humerus in children by closed reduction and fixation with percutaneous Kirschner wires.

The results are reported of 50 consecutive cases of supracondylar fracture of the humerus in children treated by closed reduction and fixation by two parallel percutaneous Kirschner wires. A classification based on clinical and radiological findings is proposed. This is orientated both to treatment and prognosis. The technique of fixation is described and the results of four years experience of this method are reported. The long term results confirm the validity of the method, which has undoubted advantages over traditional methods. Early treatment is essential in cases with neurological or vascular complications.

Bone Nails↗

Hormone relationships in breast cancer: the role of receptor-binding proteins.

The introduction of receptor protein studies as markers for hormone dependence of breast carcinomas has had a profound effect on the management of advanced disease. All breast carcinomas, regardless of stage, should have receptor binding protein studies for estrogen and progesterone by the sucrose gradient method or by the dextran-coated charcoal method as a good alternative. A simpler test is needed. In cases of primary advanced disease or in recurrent disease, receptor binding protein studies effectively identify the subgroup of hormone-dependent tumors that should be managed by surgical hormone ablation or endocrine manipulation. These tests are even more effective in identifying patients that should not receive hormone therapy and respond better to chemotherapy. In primary, potentially surgically curable disease, receptor studies may serve as a therapeutic guide to adjuvant hormone or chemotherapy. In all breast cancers, ER and PgR receptor studies should be performed and the information should be stored for possible future use. If possible, tisssue should be stored in a freezer in anticipation of future tests and for confirmation of hormone dependence in the event of recurrence.

Adult↗

Simultaneous perforation of a gastric and a duodenal ulcer.

This is a case report of simultaneous perforation of a gastric and duodenal ulcer. Perusal of the literature shows the rarity of this occurrence. Consideration is given to the difficulty of handling such a case in the presence of severe generalized peritonitis and the precarious condition of the patient.

Aged↗

Toward the rational development of peptidomimetic analogs of the C-terminal endothelin hexapeptide: development of a theoretical model.

In an early report on the structure-activity relationship of endothelin (ET) peptides, it was reported that the C-terminal hexapeptide ET(16-21), His-Leu-Asp-Ile-Ile-Trp, is the minimum ET fragment which maintains biological activity in some, but not all the tissues responding to ETs. Subsequently, other authors described a series of analogs of this peptide, in which the His 16 residue was replaced by non-natural amino acids, characterized by bulky aromatic side chains. Among them, two well-characterized non-selective ETA/ETB antagonists were PD 142893 and PD 145065; interest in these potent ET antagonists was, however, reduced by their peptidic structure which was likely to lead to undesirable properties such as poor bioavailability and short duration of action. On the basis of these premises, our previous studies led to the development of a peptidomimetic ligand of ET receptors (compound 3), based on the replacement of the His 16 residue of ET(16-21) with an (E)-N-(benzyloxy)iminoacyl moiety; compound 3 proved to possess a certain affinity for ET receptors, albeit lower than that shown by PD 142893 and PD 145065. We report here on ETA/ETB binding affinity of compounds 4-12, designed as a new series of ET(16-21) analogs. Compounds 4 and 5 were practically devoid of any affinity; derivatives 6-12 exhibited appreciable affinity indices for ETB receptors higher than that shown by 3, even if still lower than that obtained for PD 145065. This paper also describes the development of a pharmacophoric model able to explain the ET receptor binding properties of our hexapeptide analogs compared with those of PD 142893 and PD 145065 and IRL2500, recently reported as a potent ETB selective endothelin antagonist.

Amino Acid Sequence↗