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Biomedical subjects

F Malara

Publications and source records attributed to F Malara.

7 recordsLinked to original sources
PubMed2006

Use of the one-legged hyperextension test and magnetic resonance imaging in the diagnosis of active spondylolysis.

BACKGROUND: Active spondylolysis is an acquired lesion in the pars interarticularis and is a common cause of low back pain in the young athlete. OBJECTIVES: To evaluate whether the one-legged hyperextension test can assist in the clinical detection of active spondylolysis and to determine whether magnetic resonance imaging (MRI) is equivalent to the clinical gold standard of bone scintigraphy and computed tomography in the radiological diagnosis of this condition. METHODS: A prospective cohort design was used. Young active subjects with low back pain were recruited. Outcome measures included clinical assessment (one-legged hyperextension test) and radiological investigations including bone scintigraphy (with single photon emission computed tomography (SPECT)) and MRI. Computed tomography was performed if bone scintigraphy was positive. RESULTS: Seventy one subjects were recruited. Fifty pars interarticulares in 39 subjects (55%) had evidence of active spondylolysis as defined by bone scintigraphy (with SPECT). Of these, 19 pars interarticulares in 14 subjects showed a fracture on computed tomography. The one-legged hyperextension test was neither sensitive nor specific for the detection of active spondylolysis. MRI revealed bone stress in 40 of the 50 pars interarticulares in which it was detected by bone scintigraphy (with SPECT), indicating reduced sensitivity in detecting bone stress compared with bone scintigraphy (p = 0.001). Conversely, MRI revealed 18 of the 19 pars interarticularis fractures detected by computed tomography, indicating concordance between imaging modalities (p = 0.345). There was a significant difference between MRI and the combination of bone scintigraphy (with SPECT)/computed tomography in the radiological visualisation of active spondylolysis (p = 0.002). CONCLUSIONS: These results suggest that there is a high rate of active spondylolysis in active athletes with low back pain. The one-legged hyperextension test is not useful in detecting active spondylolysis and should not be relied on to exclude the diagnosis. MRI is inferior to bone scintigraphy (with SPECT)/computed tomography. Bone scintigraphy (with SPECT) should remain the first-line investigation of active athletes with low back pain followed by limited computed tomography if bone scintigraphy is positive.

Adolescent↗
PubMed1999

Effects of entropy inhomogeneity on density-temperature correlation in solar wind.

Compressive fluctuations in solar wind slow speed streams are studied by means of a magnetohydrodynamics (MHD) model, which represents the plasma in the vicinity of the heliospheric current sheet. The model contains a current sheet, as well as density and temperature variations, corresponding to a large scale modulation of the specific entropy. Alfvénic fluctuations are initially superimposed on the background equilibrium and compressive fluctuations are consequently generated during the time evolution. The resulting correlation between density and temperature fluctuations at various spatial scales is interpreted in terms of both generation of magnetosonic fluctuations and of an "entropy cascade." The latter phenomenon arises as a consequence of the interaction between the MHD turbulence and the underlying large scale entropy structure. In particular, it is responsible for anticorrelated density and temperature fluctuations detected at various scales. The results of the model are compared with the proton density-temperature correlation calculated during several crossings of solar wind slow speed streams by the Helios spacecraft. The model reproduces to a good extent the main observed features, in particular the dependence of the correlation coefficient on location (close to or far from the current sheet) and on the fluctuation scale. The results show that large scale inhomogeneities, in particular, that of specific entropy, are important ingredients in the dynamics of the MHD turbulence in slow speed streams.

Journal Article↗
PubMed1995

[Ambulatory angiologic diagnosis using the Doppler c.w. (continuous wave) method].

A one year clinical activity of instrumental angiological diagnostics (doppler c.w. examinations) was evaluated and analysed. 970 outpatient continuous wave doppler have been performed: 37% examinations of epiaortic vessels (TSA), 31% examinations of lower limb veins, 28% examinations of lower limbs arteries. The question has been inappropriate (normal exam) in 81% of TSA, in 67% of AIA and in 52% of AIV. The authors think that the reasons for these results are a large misinformation from the physicians postulant and a consequent abuse of the instrumental method. It's therefore necessary to put a clinical filter to regulate the access to the instrumental (high technological) examinations, too often unnecessary.

Ambulatory Care↗
PubMed1992

[Cardiovascular adjustments in hypertensive patients. An echocardiographic study].

Echocardiography was used to asses parameters of cardiovascular function in order to identify the main cardiac adjustment mechanisms to arterial hypertension. In addition to morphological parameters of septal and parietal thickness and diameter, telesystolic (Ses) and telediastolic (Spk) stress, EF, Vcfm, the index of left ventricular mass (ILVM), hypertrophy ratio (h/r), contractility index (Do), peripheral resistances (RPT) and Tarazi's index (SAC) were evaluated. In comparison to control subjects, higher levels of PwTs, h/r, SAC, RPT and ILVM (at the limit of significance) were found in hypertensive patients, which were reflected by higher Spk and Do values. From the further analysis of data to identify patients with signs of left ventricular hypertrophy (h/r greater than 0.40 and/or ILVM greater than 140) it was concluded that the hypertrophy ratio (h/r) is the functional parameter which most closely reveals the type of myocardial adjustment. Irrespective of absolute values of ILVM, the adequacy of myocardial hypertrophy to the dimensions of the cavity is accompanied by the normalisation of stress and the return of Do values close to normal levels. Hearts with low h/r those with the highest stress levels, as well as preesting the lowest EF and the highest Do values.

Adult↗
PubMed1986

[Endoscopic excision of a pin implanted in the 3d portion of the duodenum].

The Authors, while presenting a case of endoscopic extraction of a foreign body fixed in the duodenum, underline the value of operative endoscopy, which, going beyond the limits of a exclusively diagnostic technique, is intended as a first choice therapeutic procedure to be always carried out, leaving to surgery the treatment of the most complicated cases and those where the endoscopic attempt fails.

Adult↗