PubMed Health⌕ Search

Biomedical subjects

G Caserta

Publications and source records attributed to G Caserta.

At least 19 recordsLinked to original sources
PubMed2006

Ligamentous reconstruction of scapholunate dislocation through a double dorsal and palmar approach.

Six patients were treated for scapholunate dissociation by reconstruction of both the palmar and dorsal parts of the scapholunate interosseous ligament through a combined palmar and dorsal approach. The mean active range of motion of the wrist at final follow-up was 44 degrees of flexion and 58 degrees of extension and the mean hand grip strengths was 88% of that of the contralateral hand. The average time to return to work was 105 days and the mean DASH score at a mean follow-up of 32 months was 18. At follow-up, radiographs showed maintenance of the anatomical reduction of the scapholunate articulation in all cases and the scapholunate angle was normal in five patients.

Adult↗
PubMed2003

The upper limb in cerebral palsy: surgical management of shoulder and elbow deformities.

The authors report a simple chart that offers a comprehensive picture of spasticity of the upper limb and provides a more objective method of recording data. Distinction is made between fixed postures and the residual active range of motion at the shoulder and elbow. The presence and function of the muscles can be identified easily on dynamic EMG studies, which are essential for understanding the degree of spasticity and dyssynergy related to a single muscle. When spasticity of the upper arm is managed with a global approach and objectives are defined clearly in advance with the patient and caregivers, treatment of shoulder and elbow deformities can achieve important results for personal hygiene or functional targets.

Activities of Daily Living↗
PubMed2002

Tetraplegia: update on assessment.

The overall assessment in the tetraplegic patient should be comprehensive and detailed. This paper discusses aspects of the medical and physical assessment that normally may go unrecognized but are extremely important in the outcome of the tetraplegic patient. A comprehensive classification also is provided as a new guideline for rehabilitation and surgery. Additionally, the power of [figure: see text] cultural, social, and personal dimensions of disability are illustrated and the importance of these dimensions as they relate to assessment is examined. Finally, the COPM is introduced as an outcome measure capable of crossing cultural [table: see text] boundaries and allowing for the comparison of interventions.

Activities of Daily Living↗
PubMed1999

Nitric oxide donors in pregnancy: fetomaternal hemodynamic effects induced in mild pre-eclampsia and threatened preterm labor.

OBJECTIVE: The present study was performed to determine whether there are significant differences in the effects of the nitric oxide donor, glyceryl trinitrate, administration in pregnancies complicated by mild pre-eclampsia compared to the effects in pregnancies which are uncomplicated by this pathology. Glyceryl trinitrate is able to release nitric oxide (NO); deficiency of NO has been hypothesized in the pathogenesis of pre-eclamptic disorders. METHODS: In this prospective study, ten patients with threatened preterm labor and ten patients with mild preeclampsia were studied at around 30 weeks of pregnancy. The maternal blood pressure, maternal heart rate, fetal heart rate and flow velocity waveforms of the placental uterine artery, umbilical artery and fetal middle cerebral artery, evaluated by means of color Doppler and pulsed Doppler, were recorded before and 10, 20 and 30 min after the sublingual administration of 0.3 mg of glyceryl trinitrate or placebo. The pulsatility index (PI) was calculated. The percentage change from the control period (delta %) was calculated for each parameter at 10, 20 and 30 min. Ten normal pregnant women at the same gestational age were used as controls and were administered a placebo. RESULTS: The maternal blood pressure recorded as systolic and diastolic values, demonstrated a significant decrease in the pre-eclampsia group after glyceryl trinitrate administration; the delta % at any time considered was significantly higher in the pre-eclampsia group than in the threatened preterm labor group. The PI of the placental uterine artery showed a significant decrease in both groups after 20 and 30 min from drug administration; the delta % at 20 and 30 min was significantly higher in the pre-eclampsia group than in the threatened preterm labor group. The PI of the umbilical artery showed a significant decrease after 30 min from the glyceryl trinitrate administration. The fetal heart rate showed no significant variations during the study in either group. The PI of the fetal middle cerebral artery showed no significant variations during the study in either group. No parameter was changed in the control group. CONCLUSION: Glyceryl trinitrate administration was followed by a greater reduction of the resistance to blood flow in the fetoplacental circulation of the pregnancies affected by mild pre-eclampsia compared to pregnancies uncomplicated by this pathology. This effect can be attributed to the NO released by the drug which offsets the decreased production of NO, postulated to contribute to the pathogenesis of pre-eclampsia.

Blood Flow Velocity↗
PubMed1998

[Endoscopic sphincterotomy in acute biliary pancreatitis. A multicenter study].

BACKGROUND: Severe acute pancreatitis are still dangerous, as can be seen from the high mortality rate (around 30%). It's commonly known that in the last years diagnostic ability, precise stadiation and control over the disease development were increased. Surgical therapy is directed mainly to achieve the control over septic evolution, and in biliary pancreatitis to resolve hypertension and infection inside the biliary tree (now widely accepted as the real cause of this disease). Recently, some authors demonstrated that the prognosis of a pancreatitis can be greatly improved by stopping the evolution toward a severe phase with necrosis and multiple organ failure without any surgical operation. They believe that's possible to achieve this result performing an early endoscopic sphincterotomy in all biliary pancreatitis (recognised by means of echography and CT scan), before the development of necrosis. METHODS: In our department, following this address, very good results have been obtained: that's why a multicentric trial has been carried out to appraise the results obtained by endoscopic sphincterotomy within 48 hours from the disease onset. Answers from 114 hospitals were received, with a total survey of more than 10,000 pancreatitis. Endoscopic sphincterotomy was performed in 55% of billiary pancreatitis, which were estimated at the onset, on second or third degree of Balthazar classification. RESULTS: In 86% of patients, endoscopic sphincterotomy was performed within 48 hours from symptoms onset. Complications related to this treatment are reported in less than 4% of patients. CONCLUSIONS: The procedure, avoiding the evolution toward necrosis and sepsis, allowed the reduction of surgical operations to 6.7%, and of the mortality amongst all cases gathered to 2.5%.

Acute Disease↗
PubMed1996

Doppler velocimetry of different sections of the fetal middle cerebral artery in relation to perinatal outcome.

To assess the standard curves of pulsatility index (PI) in different segments of middle cerebral artery (MCA): initial segment (MI) and subcortical segment (M2); to determine the variation of the flow velocity waveforms (FVW) of the M1 and M2 segments of MCA in presence of fetal distress and to establish the possible correlation between the two segments of MCA. 50 normal pregnancies from 25 weeks of gestation to term and 20 pregnancy with alteration of fetal growth rate were investigated with serial records of the FVW of the M1 and M2 segments of the MCA and of the umbilical artery (UA) with a colour Doppler system. Severe fetal distress was associated to cerebral-placental ratio below 1 (C/P < 1). The perinatal outcome was established on the basis: 1) abnormal intrapartum CTG, 2) emergency cesarean section, 3) Apgar score at 1st and 5th minute after birth and 4) birth eight centiles. In normal pregnancy P1 of M2 was always higher than that of M1: therefore M2/M2 resulted below 1, with a maximum peak near 32 weeks of gestation. In presence of moderate fetal distress only P1 of M2 was reduced (M1/M2 > 1). It exists a significant difference of PI in M1 and M2 segments of fetal MCA during gestation: thus MCA so it is important to identify the tract of fetal MCA when recording its FVW. Moreover we suppose that an initial "cerebral sparing" effect exists in order to protect the cortex by the initial hypoxic injury: this is shown by a M1/M2 > 1. The progression of fetal distress results in a greater haemodynamic modification, the so called "brain sparing" which is usually present when C/P < 1.

Apgar Score↗
PubMed1995

Differentially expressed mRNAs as a consequence of oxidative stress in intact cells.

Intracellular redox conditions influence the activity of several transcription factors leading to a modulation of the expression of the genes controlled by these factors. We examined the changes in cell transcription patterns after oxidative stress induced by diethylmaleate (DEM). Using the differential display technique we identified several differentially expressed sequence tags, four of which are identical or highly homologous to sequences contained in the human cDNAs encoding vimentin, c-fos, cytochrome oxidase IV and ribosomal protein L4; another one corresponds to a transcript of the mitochondrial genome of unknown function. The remaining five cDNAs are not recorded in any sequence data bank. One of these, named Rox3, lights up two mRNA species of approximately 3400 and 3600 bp, significantly increased after treatment with DEM or with other oxidizing agents. This increase appears precociously after exposure to DEM and it is completely prevented by pretreatment with N-acetylcysteine. The Rox3 fragment was used to screen a cDNA library; one fully sequenced clone showed 100% homology with the putative human guanine nucleotide regulatory protein nep1.

Cell Line↗
PubMed1995

Impact of the L-arginine/nitric oxide system in pregnancy.

Nitric Oxide (NO) recently becomes of clinical interest because of its relaxant effects on smooth muscle. In addition to endothelial cells, also myometrial cells contain the enzyme implicated in the NO production. This review is aimed toward those studies concerned with the production, metabolism, and effects of NO that could be relevant for the obstetricians. The potential clinical interest of such information covers the main areas of pregnancy complications, namely preterm delivery, preeclampsia, and intrauterine growth retardation. Moreover, original data are included in order to support the therapeutical implications of the manipulation of L-arginine-NO system in case of pregnancy disorders.

Arginine↗
PubMed1995

Tourniquet paralysis in microsurgery.

Tourniquet paralysis is a serious complication after surgery. The authors report 15 cases recorded in their institution from 1972 to 1992. Seven were a consequence of routine operations on the upper limb and 8 were after microsurgical procedures. In the first group, the incidence of tourniquet paralysis was 1 in 7000 and this does not differ from published reports. In the second group, the incidence of complications is higher: 1 in 4300 cases. In all 15 cases the Tinel sign was absent. Great care was taken to distinguish all the painful conditions which ranged from simple hyperalgesia to allodynia and causalgia. The distressing aspect of tourniquet paralysis is that all the main nerves of the upper limb (median, radial and ulnar), distally to the elbow, are usually affected by the paralysis. In the two groups, the three nerves were affected in 13 cases and the ulnar nerve was partially spared in 3 cases. In both groups the radial nerve was more severely affected. It took an average of 105 days for complete recovery for the first group (range, 30-210 days) and 115 days for the second group (range, 20-180 days). Only in 1 patient in the first group was functional recovery incomplete. According to the authors' experience, general safety factors should be considered before using tourniquet. The tourniquet should be prohibited in patients with congenital susceptibility to nerve compression and should be used with caution in cases of underlying coagulation disorders and neuropathies, in tiny cachetic patients and in patients with systemic lupus erythematosus. In microvascular procedures its use should be limited to the first phase of replantation.

Adolescent↗
PubMed1994

The role of telemetry in perinatal monitoring.

In the field of transmission and exchange of clinical information particularly good results are foreseen with the development of data telemetry. In perinatal medicine the telemetric technologies are being employed in several situations. It is possible to subdivide the telemetric technologies into short and long distance systems. Short distance telemetry employs devices which utilize radiowaves or laser techniques to transmit data from the original source to centralized equipment; the main application is the transmission of the cardiotocographic signal to permit ambulation of the patient during recording. It may allow fetal heart rate testing to be performed in a setting more acceptable to patients telemetric not be physically confined to a bed or a chair. The telemetric transmission of the cardiotocogram (CTG) may solve problems of organization when the ratio of parturient to midwife exceeds 1:1. Long distance telemetry consists of the telephone transmission of data obtained from distant source to a consultation center where the data can be evaluated, stored and where hospital staff may suggest appropriate decision related to clinical course. In prenatal medicine, the system can offer the monitoring of maternal blood pressure, automatic urine and glucose analyses, surveillance of fetal heart rate and uterine contractions. CTG telemetry has been used with good results for the prevention of preterm labor while blood pressure control by telemetry may be useful for the prevention and management of gestational hypertension. Knowledge by the pregnant woman that it is possible to continuously monitor by telemetric technology her health and the health of her fetus provides reassurance during a delicate period.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1992

Short-term effects of ritodrine, aminophylline and atropine on umbilical artery blood flow velocity waveform.

With the recent introduction of Doppler technology, a non-invasive methodology which enables to evaluate qualitative changes in circulatory vessels, it is possible to investigate the possible effects of various drugs on several parameters of utero-placental-fetal circulation. In the present study we evaluate the flow velocity waveform (FVW) of umbilical artery (UA) during and after administration of aminophylline, atropine and ritodrine to healthy pregnant women. In our study we did not observe any significant short-term variation of PI after the administration of these drugs. Slight variations were detected, and they may be interpreted on the basis of the mode of action of these drugs. Doppler technology may be a useful tool for monitoring some effects on the fetus of the maternal administration of therapeutic agents.

Aminophylline↗
PubMed1974

Piezoelectric theory of enzymic catalysis as inferred from the electromechanochemical principles of bioenergetics.

Starting from the electromechanochemical principles of bioenergetics formulated by Green and Ji, a theory is proposed which describes enzymic catalysis in terms of piezoelectricity in semiconductors. The choice of this particular physical effect for describing catalytic processes is founded on the following experimental observations: most of the amino-acid residues of enzymes, as well as a large number of other biologically important molecules, exhibit piezoelectric resonances; besides, enzymes can behave like semiconductors. In the proposed theory the catalysis is assumed to be accomplished by means of three fundamental processes: (a) the lowering of the substrate-product energy barrier; (b) the electron-induced selective amplification of the low-frequency vibrational waves present in thermal background in the enzyme structure; and (c) the channeling into the substrate of the energy associated with the amplified waves and utilization of this energy for generating electrical or mechanical fields inside a susceptible region of the substrate. A mathematical description of the theory is outlined, and a rough estimate of some quantities involved in the process of wave amplification is also reported.

Catalysis↗