PubMed Health⌕ Search

Biomedical subjects

F Girardi

Publications and source records attributed to F Girardi.

At least 19 recordsLinked to original sources
PubMed2006

Rehabilitation of limb apraxia improves daily life activities in patients with stroke.

We randomly assigned 33 patients with left hemisphere stroke, limb apraxia, and aphasia to an apraxia or a control (aphasia) treatment group. Before and after each treatment, patients underwent a comprehensive neuropsychological testing battery and a caregiver evaluation of patient's activities of daily life (ADL) independence. Apraxia severity was related with ADL independence. Control (aphasia) treatment improved patients' language and intelligence performance. Apraxia treatment specifically improved praxic function and ADL.

Activities of Daily Living↗
PubMed2003

[Benchmarking in pathological anatomy].

Data from five different Institution of Pathological Anatomy Hospital Services are presented in order to show one (the benchmark) of the multiple existing ways to approach the budget problem and the macroeconomic management of our Services. The aim of this work is not to show the "best" way to work in terms of cost-efficacy but only a methods to compare our results with others. Nevertheless from this study is possible also to make some considerations about medical and technical workload in different services with different habits.

Autopsy↗
PubMed2000

The rehabilitation of limb apraxia: a study in left-brain-damaged patients.

OBJECTIVE: To assess the effectiveness of a rehabilitative training program for patients with limb apraxia. DESIGN: Randomized, controlled trial. SETTING: Neurologic rehabilitation unit of a university hospital. PATIENTS: Thirteen patients with acquired brain injury and limb apraxia (lasting more than 2 months) as a result of lesions involving the left cerebral hemisphere. Patients were assigned to a study group or to a control group following a randomization scheme. The study group underwent an experimental training for limb apraxia. The control group received conventional treatment for aphasia. INTERVENTION: A behavioral training program consisting of gesture-production exercises. The rehabilitative program was made up of 3 sections dedicated to the treatment of gestures with or without symbolic value and related or nonrelated to the use of objects. Thirty-five experimental sessions, each lasting 50 minutes, were given. MAIN OUTCOME MEASURES: Neuropsychologic tests for assessment of aphasia, verbal comprehension, "general intelligence," oral apraxia, constructional apraxia, and 3 tests concerning limb praxic function (ideational apraxia, ideomotor apraxia, gesture recognition). Scores related to each test were used to measure the outcome. Video recordings of ideational and ideomotor apraxia tests allowed us to register type and number of praxic errors. All outcome measures, except the aphasia test, were recorded before and after the experimental (or control) treatment time interval. RESULTS: The patients in the study group achieved a significant improvement of performance in both ideational (p = .039) and ideomotor (p = .043) apraxia tests. They also showed a significant reduction of errors in ideational (p = .001) and ideomotor (p < .001) apraxia tests. A trend toward improvement was found in the gesture comprehension test (p = .058), while other outcome measures did not show any significant amelioration. Control patients did not show any significant change in performance. CONCLUSIONS: The results show the possible effectiveness of a specific training program for the treatment of limb apraxia.

Aged↗
PubMed1996

Neurolinguistic and follow-up study of an unusual pattern of recovery from bilingual subcortical aphasia.

We report on the neuropsychological and neurolinguistic features of a bilingual patient, E.M., who presented with an uncommon pattern of aphasic deficit consequent to subcortical lesions mainly involving the left basal ganglia. Not only are reports of bilingual subcortical aphasia rare, but E.M.'s deficit is particularly uncommon for it concerns the most used mother tongue (Venetian) much more than a less practiced second language (standard Italian). In this patient, the linguistic deficit in mother tongue production has been observed in spontaneous speech and in cross language translation tasks, where an asymmetrical paradoxical performance has been revealed. Indeed, unlike neurologically intact subjects, E.M. has more difficulties when translating into her mother tongue than into her second language. Although E.M.'s mother tongue is prevalently an oral language, the asymmetrical translation pattern is similar in written and oral translation tasks, thus ruling out the possibility that the deficit simply reflects differences between written and oral language codes. Finally, another remarkable feature of E.M.'s impairment is its stability over almost 5 years from the stroke. We propose that this unusual type of recovery in E.M. is related to the higher degree of automatization of the first language with respect to the second one. This proposal fits with the role of basal ganglia in automatized motor and cognitive performance.

Aged↗
PubMed1995

Human papillomavirus DNA in genital cancers, metastases, and lymph nodes.

To evaluate the utility of human papillomavirus (HPV) DNA as molecular marker for diagnostic screening of lymph nodes for cancer metastases, we examined 16 involved and 124 histologically cancer-free nodes of 34 patients with cervical, vulval, or vaginal carcinomas associated with HPV 6, 16, 18, 31, 33, 45, or X. All metastases of HPV-positive tumors contained viral DNA of the same type as the primary cancer but in one case the copy number of viral genomes was dramatically reduced. In a varying proportion of histologically normal nodes of 7 of 23 patients with HPV 16-positive cancers HPV 16 DNA was revealed by Southern blot hybridization and/or PCR. Histologic reevaluation showed a metastasis in one case. Three examples of tumor heterogeneity regarding physical state or copy number of viral DNA are presented. Tumor heterogeneity is discussed as possible explanation for apparently inconsistent results such as HPV-negative metastases of HPV-positive tumors.

Base Sequence↗
PubMed1994

Cold-knife conization versus loop excision: histopathologic and clinical results of a randomized trial.

Ninety patients with cervical intraepithelial neoplasia (CIN) were randomly assigned to loop excision (n = 38) or cold-knife conization (n = 52). All specimens were well evaluable at histology. The average width of the lesions at histology was 10.2 and 9.7 mm, respectively (ns). The average weight of the specimens was 2.6 and 5.6 g (P < 0.01) and the average depth was 9.2 and 15.8 mm (P < 0.01), respectively. The distance between the cervical resection margin and CIN was 14 mm after loop excision and 24 mm after cold-knife conization (P < 0.06). The margins of the specimen were not clear of disease in 8 patients after loop excision and in 12 patients after conization (ns). Two patients after loop excision and in three patients after cold-knife conization had postoperative bleeding. The results suggest that, compared with cold-knife conization, loop excision removes less healthy tissue without reducing the chances for cure.

Adult↗
PubMed1994

Small FIGO stage IB cervical cancer.

The International Federation of Gynecology and Obstetrics (FIGO) currently defines stage IA cervical cancer as lesions invading up to 5 mm into the stroma and with no more than 7 mm width; vascular invasion does not affect the stage assignment. The Society of Gynecologic Oncology (SGO) definition of stage IA is more restrictive with regard to depth of invasion but ignores width. We reviewed 69 patients with lesions exceeding the FIGO definition of stage IA treated between 1958 and 1991; 46 patients also exceeded the SGO criteria for stage IA. The frequency of vascular invasion showed no correlation with the depth of invasion but was correlated with the width of the lesion. Treatment consisted of conization or simple hysterectomy only (n = 27), radical abdominal hysterectomy with lymphadenectomy (n = 25), radical vaginal hysterectomy (n = 13), and conization followed by radiotherapy (n = 4). No patient developed a recurrence during a follow-up of 2-35 years. Two of the 25 patients with lymphadenectomy had one positive lymph node each. The first patient had a primary lesion with 3 mm invasion and 17 mm width, no vascular invasion, and one node metastasis 2 mm in diameter; the second had a lesion with 4 mm invasion and 10 mm width, vascular invasion, and a tumor-cell embolus in the marginal sinus of a node. These results indicate that the problems involved in treating microinvasive carcinoma of the cervix also apply to cases of small stage IB disease. It will not be possible to devise a staging system that simultaneously serves as a guideline for treatment. The current FIGO classification of stage IA2 should be expanded rather than restricted.

Adult↗
PubMed1994

[Psychological status of patients with implantable cardioverter-defibrillators].

BACKGROUND: We assessed the psychological status of 20 patients (19 male, 1 female; mean age 61 +/- 9.3) with implantable cardioverter-defibrillator (ICD). Each patient underwent the Cognitive Behavioral Assessment adapted for Hospital use (CBA-H), and completed an ad hoc 20 item questionnaire designed to measure patients' perceptions of their health. METHODS: Psychological variables were treated as dependent variables and cardiac variables were considered independent variables in the one-way analysis of variance; when psychological and cardiac variables were discrete variables, Chi-square was used; correlations were performed by rank Spearman test. RESULTS: Indicated maladaptive behaviours in on 35% of the sample. Patients with pre-ICD Ventricular Fibrillation (VF) or Sustained Ventricular Tachycardia (SVT) and VF were the most psycho-physically distressed (p < .02). These were also the patients who reported feeling most stressed in the last three months (p < .03). I-E causal attribution is a psychological dimension related to the way of codify an event; I = internal means that subject attributes to itself the cause of what happens; E = external means that subject attributes to others, fate and environment what happens. The treatment received and the I-E causal attribution were found to correlate: Internal in patients who underwent both pacing and shock treatment (who were also those with the highest number of recurrent VT/VF episodes), External in patients who underwent one treatment or none (F3, 16 = 3.28; p < .04; I-E mean = 1 +/- .63 in pacing/shock treatment group; I-E mean = 2.5 +/- .57 in shock treatment group; I-E mean = 1.8 +/- .5 in pacing treatment group; I-E mean = 2 +/- .1 in no treatment group. The time since implantation (5-9, 10-18, 19-32 months) seemed to have an important effect, even if it reached statistical significance in only two areas, namely: family relationships which were better in patients who had the ICD for > 9 months, and adjustment to the physical condition, which was better in patients who had the ICD for 10-18 months. CONCLUSION: In the present study most of the patients with ICD proved to be fairly well-adjusted to their physical condition. The preimplantation cardiac condition, the treatment received, the number of recurrent VT/VF episodes, and the length of follow-up turned out to be the variables which most influenced the psychological status of patients with ICD.

Adult↗
PubMed1993

Pelvic lymphadenectomy in the surgical treatment of endometrial cancer.

Between 1982 and 1991, 76 of 322 (24%) patients with primary endometrial adenocarcinoma and morphologic risk factors underwent surgery including systematic pelvic lymphadenectomy (LA). A mean number of 37 lymph nodes per patient was removed. The number of removed nodes did not differ with respect to mode of LA, FIGO stage, depth of myometrial invasion, and histologic subtype or grade. Twenty-seven of 76 (36%) patients had lymph node metastases; 37% of lymph node metastases were < or = 2 mm in diameter. The incidence of lymph node metastases correlated significantly with the depth of myometrial invasion but not with histologic subtype and grade. Twenty-four patients with positive nodes who had stage I disease according to the clinical classification (FIGO 1971) were upstaged to stage IIIc according to the surgical staging system (FIGO 1988). This study underlines the need for complete, systematic LA and the need for thorough histologic processing with step-serial sections for correct staging of patients with endometrial cancer.

Adult↗
PubMed1993

Pelvic and parametrial lymph nodes in the quality control of the surgical treatment of cervical cancer.

Between 1971 and 1989 a total of 420 patients underwent radical abdominal hysterectomy with pelvic lymphadenectomy at our hospital for stage Ib, IIa, or IIb cervical cancer. The entire lymph node material was processed in serial sections and stained with hematoxylin and eosin. Lymph nodes were counted and the sizes of metastases measured. The entire surgical specimen was fixed as a whole with the parametria spread out. The size of the tumor was measured by morphometry. Cases treated between 1971 and 1979 were compared with those treated between 1980 and 1989. The median number of pelvic lymph nodes removed per patient was 24 between 1971 and 1979 and 35 between 1980 and 1989 (P = 0.0001). Significantly more nodes were removed at each node group (P = 0.01). Between 1971 and 1979 no common iliac nodes were obtained in 56 patients and no left common iliac nodes in 74 patients, compared to only 1 and 6 patients, respectively, between 1980 and 1989. The rate of patients with positive lymph nodes was 33% (63/195) between 1971 and 1979 and 55% (101/225) between 1981 and 1989 (P = 0.008). In the first study period the median number of parametrial lymph nodes was 2 compared to 3 in the second period. The rate of patients with positive parametrial lymph nodes increased from 15 to 24% (P = 0.027). The results of this review indicate that exacting morphologic processing of the entire lymphatic tissue obtained at surgery permits accurate postoperative staging and assessment of risk factors for decisions on adjuvant treatment. Histologic evaluation objectifies the radicality of the procedure and is useful in the quality control of the surgical treatment of cervical cancer.

Female↗
PubMed1993

Specific rearrangements of human papillomavirus DNA provide molecular evidence for genetic heterogeneity of primary cervical cancers, recurrencies, and lymph node metastases in two patients.

Two different characteristic patterns of human papilloma virus (HPV) type 16 DNA were found by Southern blot hybridization in four pelvic and paraaortic lymph node metastases in a patient with FIGO stage IIIb cervical cancer. Both patterns added up to give the HPV 16 DNA pattern of the primary tumor. This strongly suggests that the tumor was composed of two distinct compartments, each spawning its own lymph node metastases. A second patient presented with a vaginal tumor 4 years after stage IIb cervical cancer had been treated with hysterectomy only. The vaginal tumor was removed and pelvic lymphadenectomy performed. Integrated HPV 16 DNA was found in the vaginal tumor whereas one involved and one free lymph node contained episomal HPV 16 DNA with a characteristic deletion. The apparent heterogeneity of the cancer cell population may indicate that the metastasis is not related to the vaginal tumor but that it is a late sequel of the cervical cancer. Alternatively the metastasis could have originated from an unsampled portion of the vaginal tumor.

Adult↗
PubMed1993

[Clinical experiences with the Medusa Cu 240 Ag intrauterine device].

The contraceptive safety and complication rate of the Medusa Cu 240 Ag intrauterine device (IUD) were assessed in 215 women over a 3-year period after insertion. The size of the IUD was chosen according to uterine size as measured by ultrasonography before insertion, and the IUD was inserted under sterile conditions. Patients underwent pelvic examination, speculum inspection, ultrasonography and questioning as to their acceptance of the IUD at 6-months intervals. Insertion was not possible because of scarring of the external os in 4 patients with a history of cervical conization. The incidence of complications not requiring removal of the device varied from 9% to 29% at follow up. The IUD had to be removed earlier than planned in 13% of the patients. The Pearl index was 0.5. Excellent acceptance was reported at follow up by 79% to 88% of the patients. There were no cases of spontaneous expulsion or uterine perforation.

Adult↗
PubMed1992

Prognostic importance of human papillomavirus type 16 DNA in cervical cancer.

Human papillomavirus (HPV) type 16 DNA is frequent in invasive cervical cancers. Among 43 patients with invasive cervical cancer, HPV-16-positive tumors spread to the parametrial and pelvic lymph nodes significantly more often than did HPV-16-negative tumors (P less than 0.05). Demonstration of HPV-16 DNA in invasive cervical cancers may be an additional prognostic factor for this disease.

Adult↗