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Biomedical subjects

G Canepa

Publications and source records attributed to G Canepa.

At least 19 recordsLinked to original sources

Social adjustment in children with Down mental retardation (MRD) and Fragile-X mental retardation (MRX).

BACKGROUND: Since adjustment abilities became important in mental retardation (MR) diagnosis, it seemed interesting to study social adjustment in persons with MR Down (RMD) and MR Fragile-X (RMX). These two syndromes are the most common causes of MR of chromosomal origin. To evaluate the influence of temperament insofar as behavior and temperament are concerned in social adjustment, we studied temperamental dimensions (emotionality, activity, sociability and shyness) and social functioning (attention problems and withdrawal). METHODS: Our study group was composed of 35 children with MR; 23 with RMD (F=14) age range 4 to 21, and 12 (F=1) with RMX age ranged from 5 to 19. #Social adjustment was evaluated by two scales: EAS and CBCL. RESULTS: The six evaluated dimensions of adjustment functioning (emotionality, activity, sociability, shyness, attention problems and withdrawal) differ in the two MRD and MRX groups. MRX scores are all higher except for sociability; shyness, attention problems and emotionality show a significant difference. CONCLUSIONS: The RMX group is that one may have more difficulty in social adjustment. This is because they are characterized by hyperactivity, withdrawal, low attention, low social function and high emotionality that are all negative symptoms for a social adjustment. In our study group MRD have higher values in the sociability area and they don't show relevant behavioral disorders and they have got more adaptive abilities. We may hypothesize that this attitude is a part of their genetic structure, and also that the best social adjustment of Down persons may be linked to a better interaction with the environment.

Adolescent↗

Horseshoe-shaped marlex mesh for the treatment of pelvic floor prolapse.

OBJECTIVE: Pelvic prolapse results from weakness or damage to the normal pelvic-support systems. The main support for the pelvic viscera is provided by the pelvic fascia, which is naturally reinforced by urethra-pelvic ligaments, cardinal ligaments and uterosacral ligaments. A polypropylene mesh (Marlex-Bard) was used as a genitourinary and rectal support in order to substitute the damaged pelvic fascia. METHODS: Sixteen consecutive females suffering from severe genitourinary prolapse entered the study. Using the HWS (Baden-Walker) classification 10 patients presented a grade-IV and 6 patients a grade-III cystocele, 7 patients a grade-III and 1 a grade-IV rectocele. Hysterocele of grade IV was present in 2 patients and in 5 patients grade III. No enterocele was present at the pre-operative visit. Twelve patients suffered from stress incontinence; one had obstructive urinary symptoms with postvoiding residual urine of >200 ml. All patients underwent urodynamic tests and pre-operative cystography. The primary aim was prolapse reduction and continence. The operation, under general anesthesia, consisted of insertion and fixation of a horseshoe-shaped Marlex mesh between pubis and sacrum to close the area between the pelvic viscera and inferior pelvic hiatus. Three patients underwent hysterectomy. RESULTS AND CONCLUSIONS: The follow-up ranged between 12 and 29 months. In 15 patients the prolapse was completely resolved and 13 were dry at follow-up. One patient presented a complete recurrence at the 3-month follow-up. Nine cases of pre-operative constipation were recovered after surgery. This technique seems to give promising results in the repair of genitourinary prolapse and stress incontinence.

Aged↗

Neuropsychological follow-up in early-treated congenital hypothyroidism: a problem-oriented approach.

Screening programs for congenital hypothyroidism (CH) dramatically improved the neuropsychological prognosis in affected children. However, mild impairments in cognitive performances, poorer motor skills, defective language abilities, and learning problems have been reported in some studies of early-treated CH children. The occurrence of these defects makes neuropsychological follow-up mandatory. The aim of the present study was to identify those neuropsychological functions that are more frequently affected in early-treated CH children and that might require prompt rehabilitation treatment to prevent permanent defects. The study group involved 24 CH children. Levothyroxine (LT4) treatment (initial dose 8-10 microg/kg per day) was started at mean age of 28 days (range 15-45) and was then adjusted with the goal to keep thyrotropin (TSH) and free thyroid hormone levels in the normal range. Cognitive evaluation was performed at 3, 5, and 7 years of age and did not significantly differ from that of controls. Mean neurological scores were lower in children 5 years of age than in controls. Children with severe neonatal hypothyroidism (serum thyroxine [T4] < 2 microg/dL) had significantly lower neurological scores compared to less affected CH children and normal controls. The most affected functions were balance, extremity coordination, fine motricity, quality of movements, associated movements, and head movements. Language disorders were observed in half of CH children at 3 and 5 years of age, but moderately severe defects were restricted to those with severe neonatal hypothyroidism. In conclusion, a problem-oriented, simplified neuropsychological follow-up of early-treated children with CH should not systematically include the frequent repetition of time-consuming and expensive psychometric tests because individual IQ scores are in the normal range of tests in almost all CH children and can be differentiated from those of normal controls only on a population-statistic basis. Selected tests of motor proficiency are indicated at 3 and 5 years of age to detect those defects in motor skills that appear to be more specifically affected in CH children. Language performances are at particular risk in CH children, and should be always checked at 3 and 5 years of age. Children with even mild language disorders or delayed language achievements should be regularly reevaluated at 6-month intervals and, if no spontaneous improvement is observed, they should receive specific rehabilitation treatment. No further motor and language evaluation is warranted in CH children with normal tests at age 5 years.

Child↗

Post-operative analgesia with tramadol: a controlled study compared with an analgesic combination.

The analgesic action of tramadol in the post-operative period was compared with that of an analgesic combination (Nisidin) in a sample of 60 patients (31 male, 29 female) aged between 20 and 70 years undergoing surgical operations on the abdomen involving opening of the peritoneum. The study was carried out according to a controlled and randomized experimental design. Tramadol in 100 mg/2 ml vials and Nisidin in 2 ml vials were administered parenterally at a dosage of three vials a day during the first three days of the post-operative period. The analgesic action of tramadol was shown to be more effective than that of Nisidin both after the first dose and during the three days of observation (p < 0.01). Local and general safety were good in both groups, and respiratory and heart rates did not undergo clinically significant modifications. In conclusion, tramadol proves to be particularly indicated in the treatment of post-operative pain, given that it has analgesic action combined with good local and general safety.

Adult↗

[A retrospective study on the efficacy of the treatment of functional dyspepsia. An evaluation of 166 cases].

A retrospective study is reported carried out on a group of 166 patients affected by dyspeptic syndrome who presented at least 3 of the 9 symptoms which characterise this pathology. One hundred and twenty-eight patients underwent prokinetic drug therapy and 38 received placebo. Clinical parameters were evaluated following one month of therapy all patients in order to compare them to basal values. The results obtained confirm a satisfactory efficacy of the prokinetic treatment in improving dyspeptic symptoms. Although administered to a smaller number of patients, placebo was also found to play an important role in the multifactorial etiopathogenesis of the dyspeptic syndrome on a functional basis.

Adult↗

[Verification of indications and validity of consent to surgical treatment by transsexuals].

The authors analyze some medico-legal aspects concerning the surgical therapy of transsexualism, as it is regulated by the Law N. 442/1982. At first they examine the problems related to the verification of the indications for the surgical treatment, with particular reference to nosography, differential diagnosis and clinical criterions suitable to evaluate the usefulness of this intervention. Afterward they analyze the problem of the validity of the consent, considering the particular kind of treatment and the psychological connotations of these patients.

Humans↗

[Prosthesis replacement of the inferior vena cava].

The development of reconstructive venous surgery has been hampered by the lack of suitable graft materials. Fourteen carbon fibre grafts (phi: 8 mm), 30 glutaraldehyde treated ovine collagen grafts and 29 polytetrafluoroethylene (PTFE) grafts were used to replace a 35 mm segment of infrarenal inferior vena cava in pigs. Prostheses were removed 1 hour and 7, 14, 28, 56 and 112 days after implantation. All specimens were examined by light and scanning electron microscopy. The 112 day patency rate was 67% for ovine collagen grafts, while all carbon and PTFE grafts thrombosed. The difference was statistically significant (p less than 0.01). During the first hour after implantation, a thick (800-900 microns) thrombotic layer deposited on the inner surface of carbon grafts. This layer possibly caused the subsequent complete occlusion of the tubular segments. A thin neointima (less than 200 microns) developed on the flow surface of ovine collagen prostheses. This favoured complete endothelialization of the graft inner surface as soon as four weeks after surgery. In conclusion, glutaraldehyde treated ovine collagen would represent the first sound material to be used as venous substitute.

Animals↗

Different effects of atropine and cimetropium bromide on gastric emptying of liquids and antroduodenal motor activity in man.

Atropine (1 mg intravenously) and a new antimuscarinic compound, cimetropium bromide (5 mg intravenously), as well as placebo (physiological saline) were tested for their effects on gastric emptying and antroduodenal motility in healthy humans. In a first single-blind cross-over study, the emptying rate was assessed in 12 subjects by measuring paracetamol absorption. In a second single-blind parallel-group study, antroduodenal motor activity was measured in 20 subjects through four perfused open tip catheters with orifices positioned in the antroduodenal region. Atropine, unlike cimetropium bromide, significantly delayed gastric emptying. Antral and duodenal motility index was reduced significantly by atropine, but not by cimetropium bromide. Heart rate significantly increased only after atropine. Three subjects taking atropine complained of dry mouth and one of blurred vision. In conclusion, the results of these studies show that atropine, unlike cimetropium bromide, strongly inhibits gastric emptying of liquids and reduces antroduodenal motor activity in man.

Adult↗

Use of the polytetrafluoroethylene surgical membrane for control of intra-abdominal adhesions.

The new polytetrafluoroethylene (PTFE) surgical membrane is specifically designed to prevent adhesion formation. The present study was planned in order to evaluate the effectiveness of the PTFE surgical membrane as a parietal peritoneal substitute. Furthermore, the effects of the suture material used to implant the membrane under different operating conditions (clean or contaminated surgery) were also evaluated. One hundred-eighty rats were divided into 9 groups and underwent the following surgical procedures: Group 1: removal of a parietal peritoneum patch, which was left unrepaired; Group 2: a similar peritoneal defect was covered with the PTFE membrane by 8 polypropylene sutures; Group 3 (control group): only the 8 polypropylene suture were placed on the margin of the standard peritoneal defect; Group 4: the same procedure as in Group 2, using as sewing material PTFE sutures; Group 5 (control group): only the 8 PTFE sutures were placed on the margin of the standard peritoneal defect; Group 6, 7, 8 and 9: the same procedures as in Group 2, 3, 4 and 5 respectively, adding division and subsequent reanastomosis of the caecum. Animals of each group underwent a second laparotomy 10 days or 3 months after surgery for evaluation of the extent and density of adhesions, and of the intraperitoneal organ involvement. Histological examination of adhesions which formed was then carried out. No adhesions developed in rats of group 1, while they were always present in all the other groups. Under clean surgery, the adhesions were limited to the margin of the peritoneal defect, while under contaminated surgery they formed also on its central portion. The PTFE surgical membrane itself caused variations neither of the extent and density of adhesions which developed nor of the magnitude of intraperitoneal organ involvement. The type of suture material used to implant the membrane had no effect on adhesion formation.

Abdomen↗

Monthly fluctuations of active duodenal ulcers.

In an attempt to verify whether the periodicity of ulcer-related symptoms would be confirmed by a spring and fall exacerbation of peptic ulcers, we have analyzed the monthly variation of active duodenal ulcers found at endoscopy of the upper gastrointestinal tract in the years 1979-1981. Control diagnoses were active gastric ulcers, gastric and rectal adenocarcinomas, and rheumatoid arthritis. Data were also available on hospital admission for perforated ulcers. The calendar fluctuation of active duodenal ulcer is characterized by a significant fall in August which is associated with July and fall peaks. This pattern of variation for duodenal ulcer was evident in both sexes and across the different decades of age. Duodenal ulcer diagnosis and hospitalization for perforated ulcer fluctuated in a similar way. The shape of monthly variation for active duodenal ulcer was not paralleled by similar changes in gastric ulcers and in the control diagnoses, gastric and rectal carcinomas, and rheumatoid arthritis.

Adult↗

Candida overgrowth in gastric juice of peptic ulcer subjects on short- and long-term treatment with H2-receptor antagonists.

Candida overgrowth in gastric juice of peptic ulcer subjects under therapy with H2-receptor (H2-R) antagonists has been detected in 21.4 and 53.8% of cases after short- and long-term treatment respectively, and in 8% of controls. Both types of H2-R antagonists, ranitidine and cimetidine, were equally associated with production of yeasts. The location of ulcers, whether gastric or duodenal, seems to have no influence on fungal growth. Females were more susceptible than males to develop Candida in gastric juice. In the short-term course with H2-R blockers fungal colonization of gastric juice was associated with delay of the rate of ulcer healing. Fungal detection in gastric juice was not associated with mucosal invasion by Candida since in none of the patients who had a biopsy for gastric ulcer was Candida detected by histology.

Adult↗