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Biomedical subjects

F Cozzi

Publications and source records attributed to F Cozzi.

At least 55 records · Page 3Linked to original sources
PubMed1991

Esophageal atresia, choanal atresia, and dysautonomia.

Patients with esophageal atresia (EA) or choanal atresia (CA) manifest similar clinical and pathophysiological features. To determine the significance of this observation, the clinical records of 80 patients with EA and 57 with CA were reviewed. This survey showed that similarities between the two conditions included inspiratory and expiratory dyspnea, episodes of reflex apnea and/or bradycardia, oropharyngeal dysphagia, vomiting, convulsions, hyperhydrosis, hyperthermia, sialorrhea, and sudden death. After the second year of life most symptoms disappeared spontaneously. In both conditions, respiratory effort resulted in partial or complete obstruction affecting both the inspiratory and expiratory phases of the respiratory cycle. Support for this finding was obtained by studying the breathing pattern of 3 patients with EA and 3 with CA, before and during postural respiratory loading. The data suggest that patients with EA are similar to those with CA, having upper airway instability that may result in obstructive hypopnea or apnea associated with expiratory grunting. It is possible that this upper airway instability is a manifestation of more general maturational dysautonomia previously not recognised in patients with EA.

Apnea↗
PubMed1991

McKusick-Kaufman syndrome: report of the 66th case complicated by a staphyloma of the left eye.

Sixty-five cases of the Kaufman-McKusick syndrome, an autosomal recessive disorder, have been thus far reported in the literature. In the female, hydrometrocolpos and postaxial polydactyly are the prominent features of the disorder, and together with congenital heart disease form the distinctive triad of symptoms characterizing this entity. Since the initial reports, multiple other anomalies have been reported in the affected patients. Hydrometrocolpos, especially if unrecognized, may be a life-threatening condition in the newborn girl. We present a child with the features of the syndrome, and a staphyloma of the left eye, which necessitated its enucleation.

Abnormalities, Multiple↗
PubMed1990

[Stress hormones liberated by fangotherapy. ACTH and beta-endorphin levels under heat stress].

In 6 healthy subjects submitted to fango therapy in the Euganean thermal baths (Italy), the plasma concentrations of beta-endorphin and ACTH increased transitorily but significantly. These results correlate with the release of these peptides by the pituitary in response to thermal stressing. The analgesic and hypothermic action responsible for good toleration of thermal stress induced by fango therapy, can be explained by this increase in plasma beta-endorphin. The repeated brief increases in plasma beta-endorphin during thermal treatment result in progressive improvement in articular and muscular symptomatology. The results of our study on plasma levels of ACTH confirm that the thermal stress associated with fango therapy activates the pituitary gland. Immunomodulatory effects are discussed.

Adrenocorticotropic Hormone↗
PubMed1990

Intestinal obstruction at the onset of acute lymphoblastic leukemia in a child.

Surgical complications need not be fatal in acute leukemia. If these are promptly diagnosed and properly treated, the prognosis will improve. This report deals with a case of acute lymphoblastic leukemia presenting with an acute abdomen following surgery for choledochal cyst. A peripheral blood smear and examination of the bone marrow revealed acute lymphoblastic leukemia. The child received transfusions of blood and platelets. Pretreatment with prednisolone was started as therapy for leukemia, and 2 days later, the patient underwent surgery. Therapy was continued until the general condition allowed a more aggressive form of treatment. Complete remission was achieved, and the patient is still in good health 48 months after diagnosis and 15 months after discontinuation of treatment. The favorable outcome in this child shows that prompt surgery is sometimes an essential step in the treatment of childhood leukemia.

Abdomen, Acute↗
PubMed1990

[Electrocardiographic disorders in diverse clinical variations of scleroderma].

The electrocardiograms of 130 patients affected by scleroderma, 117 with systemic sclerosis (67 with diffuse and 50 with limited form) and 13 with localized scleroderma were analyzed. ECG was normal in 44.6% of cases, respectively in 39.3% with systemic sclerosis and in 92.3% with localized scleroderma. The more frequent electrocardiographic abnormalities were supraventricular and ventricular premature beats, right bundle branch block, left anterior hemiblock, low QRS voltages, ST-T wave abnormalities and Q or QS aspects. All the abnormalities above resulted to be more frequent in the patients with diffuse systemic sclerosis in comparison to the patients with limited systemic sclerosis. Our results confirm that the cardiac involvement appears to be much more serious in the diffuse systemic sclerosis.

Adolescent↗
PubMed1989

Erythrocyte membrane lipid peroxidation before and after vitamin E supplementation in children with cholestasis.

In 10 children with chronic cholestasis and without neurologic signs, we evaluated lipid peroxidation and vitamin E levels in serum and in the erythrocytes before and after a therapeutic trial with alpha-tocopherol. We also studied the effects of vitamin E administration on hematocrit and hemoglobin values and on reticulocyte and erythrocyte counts. Plasma and erythrocyte malonyldialdehyde (MDA) values were significantly higher compared with normal control values, whereas plasma and erythrocyte tocopherol measurements were lower. Oral administration of high doses of vitamin E (300 mg/day for 15 days) resulted in lower serum MDA levels, whereas serum vitamin levels did not change significantly. In erythrocytes, the MDA decreased but not to control levels, and vitamin E increased but to lower values than normal. Hematologic values also improved. We conclude that longer treatment might be necessary to completely reverse the oxidative damage associated with vitamin E deficiency in children with cholestasis.

Biliary Atresia↗
PubMed1988

Clinical manifestations of choanal atresia in infancy.

The clinical features of 41 infants with various types of nasal obstruction were reviewed to study the correlation between the degree of nasal obstruction and clinical manifestations. Twenty-one subjects had bilateral choanal atresia/stenosis; 12 had unilateral choanal atresia/stenosis, and eight who were referred with suspected choanal atresia had a simple inflammatory nasal obstruction. Patients with bilateral choanal obstruction and patients with unilateral choanal obstruction or rhinitis showed no differences in clinical picture or in referral age. Many infants with either unilateral or bilateral choanal obstruction had one or more symptoms not fully relieved after surgical repair, although the choanae were widely patent. At long-term follow-up the surviving patients showed spontaneous recovery and good nasal respiration. Overall, five patients died. Since the common syndrome appeared to be related to a dysfunction of the autonomic nervous system, we conclude that any type of nasal obstruction may exacerbate or precipitate an underlying maturational autonomic disturbance.

Aging↗
PubMed1988

Induction of supraventricular tachyarrhythmia at rest and during exercise with transoesophageal atrial pacing in the electrophysiological evaluation of asymptomatic athletes with Wolff-Parkinson-White syndrome.

Even today there is controversy as regards the best approach to asymptomatic or slightly symptomatic athletes with the WPW syndrome as regards fitness for sports activity, especially in some countries where the doctor is responsible for certifying sports fitness. This study concerns 84 asymptomatic or slightly symptomatic athletes (66 males, 18 females, mean age 21.7 years, range 12-44 years) who underwent a stimulation protocol the end-point of which was the induction of atrial fibrillation (or, if not possible, atrial tachyarrhythmia) in the basal state and during bicycle stress test with transesophageal atrial pacing. The 81 athletes in whom the end-point was reached were divided into two groups: Group I includes the 32 athletes with the shortest R-R interval between pre-excited beats less than or equal to 240 ms in the basal state and/or less than or equal to 210 ms during bicycle ergometer test, Group II includes the other 49 patients. The evaluation during exercise was not carried out in four athletes because of serious haemodynamic compromise due to the arrhythmia induced in the basal state. Only 21/32 athletes would have been included in Group I if only evaluated in the basal state. In 30/81 athletes (37%), there was discrepancy between the result of stimulation and the result of the usual non-invasive evaluation (Holter monitoring, ergometric stress test, ajmaline test). On average, 40 min are required for the performance of the study protocol except when the induced arrhythmia lasts more than 5 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Does fetal gut obstruction cause hydramnios and growth retardation?

In order to study the effects of impaired fetal intestinal absorption of amniotic fluid, two series of neonates (551 from Liverpool and 172 from Rome) with different types of congenital gut obstruction were divided into two groups and compared. Group A consisted of patients with complete obstruction at or above the proximal jejunum (within 15 cm of the ligament of Treitz). Patients of group B had either incomplete obstruction at group A level or either incomplete or complete obstruction at a lower level. Maternal hydramnios and fetal growth retardation rates were found to be significantly higher in group A than in group B. Maternal hydramnios was associated with an increased prematurity rate (P less than .001). Fetal growth retardation was not related to the presence of additional anomalies. In group A growth retardation was more frequent in babies born after 37 weeks of gestation (P less than .05). No differences were found between the Liverpool and Rome series of patients. These findings suggest that fetal gut function not only contributes to the control of amniotic fluid volume but also, in the final stages of pregnancy, to normal fetal growth. Maternal hydramnios may be the cause of premature delivery of fetuses with upper gut obstructions.

Birth Weight↗
PubMed1986

[Electrophysiologic evaluation of athletes with Wolff-Parkinson-White syndrome: induction of supraventricular arrhythmia at rest and under exertion with transesophageal atrial electrostimulation].

The most suitable approach to the athletes with WPW is controversial. Therefore 66 symptom-free athletes with WPW and without heart disease (53 M, 13 F, mean age 21.98 yrs, min 12--max 44) underwent a study protocol whose end-point was the induction of supraventricular tachyarrhythmia, i.e. atrial fibrillation or, if not possible, atrial flutter or atrial tachycardia at rest and during ergometric stress test. The athletes with shortest R-R interval between preexcited beats less than or equal to 240 ms at rest and/or less than or equal to 210 ms during exercise were judged as being at risk i.e. no fit for sport activity. The end-point was reached in 64/66 athletes (in 62 atrial fibrillation). In 4 athletes with life threatening arrhythmia induced at rest the evaluation during exercise was not performed. According to the evaluation at rest we were able to identify only 18 athletes (28.1%) as being at risk, while according to the complete study protocol 26 athletes (40.6%) were judged as such. In 23/64 athletes (36%) this judgement was discordant with the usual non invasive evaluation (i.e. Holter monitoring, ergometric stress test, ajmaline test). During induced atrial fibrillation no significant difference, was found between the percentage of preexcited beats at rest and during exercise. On the average, 40 min. are required for performance of this study protocol (if the induced arrhythmia lasts less than 5 min.). According to our results we conclude: a) the non invasive assessment of the WPW athletes is unsatisfactory; b) the induction of atrial fibrillation during exercise gives a remarkable increase of the diagnostic power with respect to the assessment only at rest; c) since it is simple to perform and not expensive (in time, staff and cost) and because of its high diagnostic yield, we regard this protocol as fundamental for the electrophysiological evaluation of WPW athletes and also suitable for systematic study of WPW patients.

Adolescent↗
PubMed1985

Glossoptosis-apnea syndrome in infancy.

The clinical and physiologic features of 28 infants with Pierre Robin syndrome and those of 20 infants with various types of nasal obstruction were reviewed to determine whether different causes of upper airway obstructure may lead to a common syndrome. The patients had no significant differences in distribution of main clinical manifestations. Their features included cyanosis with respiratory distress, apneic spells, oropharyngeal dysphagia, vomiting, failure to thrive, cor pulmonale, brain damage, and sudden death during sleep. The common physiologic manifestation appeared to be an oropharyngeal obstruction caused by glossoptosis, which occurred mainly during wakefulness. Upper airway obstruction led to hypoxemia, which, in many instances, was not associated with hypercapnia and was not relieved by oxygen administration. It is concluded that regardless of a specific cause, any airway obstruction that results in a decreased inspiratory pressure overcoming the airway maintaining genioglossus action causes a glossoptosis-apnea syndrome.

Age Factors↗