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Biomedical subjects

G De Bastiani

Publications and source records attributed to G De Bastiani.

At least 19 recordsLinked to original sources

High calcitonin levels in unconscious polytrauma patients.

We measured levels of calcitonin and other markers of calcium and phosphorus metabolism in both unconscious and conscious patients after multiple trauma. We found dramatic increases in calcitonin levels in unconscious patients, and smaller increases in conscious patients. In two cases, very high levels, more than 100 x normal, appeared to be related to more rapid healing of bone. Calcitonin levels were highest immediately after admission and decreased over the ensuing two weeks. The possible relationship between unconsciousness and the increased rate of healing of fractures is discussed.

Adolescent

Limb lengthening by distraction of the epiphyseal plate. A comparison of two techniques in the rabbit.

We have compared, in rabbits, two techniques of limb lengthening by distraction of the epiphyseal plate using a unilateral external fixation frame. In all cases, 14 mm of symmetrical lengthening without deviation was achieved. With rapid distraction at rates of 1 mm per day (distractional epiphyseolysis) separation of the epiphysis from the metaphysis occurred by day 7, and by day 70 almost complete ossification of the cartilage and the elongated segment was evident. In contrast, slow distraction at 0.25 mm every 12 hours (chondrodiatasis) produced hyperplasia of growth cartilage without any evidence of detachment at 28 days, the end of the distraction period. By day 70 the epiphyseal plate had returned to normal thickness with normal cellular morphology, while the lengthened segment was occupied by ossified tissue. The significance of these findings is discussed.

Animals

Chondrodiatasis-controlled symmetrical distraction of the epiphyseal plate. Limb lengthening in children.

We describe a technique for slow, progressive, symmetrical distraction of the growth plate using a lightweight dynamic axial fixation system. Results are given for the elongation of 40 bony segments in children with limb-length discrepancies and 60 segments in children with achondroplasia or hypochondroplasia. Increases in limb length of up to 36% were obtained in non-achondroplastic and up to 64.5% in achondroplastic patients. There were no nerve or vascular lesions or bony infections and no case required a bone graft. Pin-track complications occurred in only 1.5%.

Achondroplasia

Use of ceftazidime in the treatment of osteomyelitis and osteoarthritis.

The authors report the results obtained with the use of ceftazidime, administered by various methods, in 18 cases of orthopedic infections (osteomyelitis, arthritis). The results, which are regarded as good, are stable over time. The antibiotic therapy proves particularly efficacious in those cases subjected to appropriate surgical treatment.

Adolescent

Dynamic axial fixation. A rational alternative for the external fixation of fractures.

Conventional external fixation systems neither inhibit motion at the fracture site sufficiently to permit primary bone healing, nor do they allow sufficient motion to encourage adequate external callus formation. Healing with such systems is therefore prolonged. These methods are usually reserved for the most severe fractures when internal fixation may be contraindicated. A unilateral, dynamic axial fixation system (Orthofix - registered trademark) is described which allows for simple conversion from a rigid to a dynamic mode, and so can be readily adapted to the changing physiological patterns of fracture repair. In 288 fresh fractures a success rate of 94% was achieved, with an average time to healing of 4.4 months. The incidence of pin-track infection was only 0.6%. The contribution which the mechanical and design features of the apparatus make to the results obtained is discussed. It is suggested that the system is capable of extending the range of indications for an externally mounted system to include many cases which would formerly have been treated by internal fixation, plaster cast or traction.

Adult

[Treatment of algodystrophic syndromes with calcitonin].

A general account of algodystrophic syndromes is followed by the presentation of results obtained with 160 MRC U/day extracted pig or 100 MRC U/day synthetic salmon calcitonin in 95 patients with the most common form (Sudeck's syndrome). Clinical, biohumoral and radiographic data are reported. There was no difference in the response to the two products. Excellent results were noted, first clinically and then radiographically. Some radiographs are presented.

Calcitonin

Syndesmomyolysis in early osteoarthrosis of the knee.

The authors present a new operative procedure for the early stages of osteoarthrosis of the knee associated with varus or valgus axial deviations. This is based on biomechanical considerations related to the articular equilibrium of the knee, and on pathogenetic interpretations of arthrotic disease in this particular joint. After reviewing the capsular, muscular and ligamentous systems of the medial and lateral compartments of the knee, they consider the active forces capable of opposing the eccentric thrusts of load and gravity in disequilibrium due to axial deviation. Clinical investigations have been carried out which reveal that under these pathological conditions, cicatricial retraction occurs on the concave side and stretching on the convex side of the axial deviation. For the former they have devised the operation of "syndesmomyolysis", which must be preceded by preoperative muscular reinforcement on the convex side. The objective of this procedure is to restore the equilibrium of the forces acting on the articular axis.

Aged

Pig calcitonin in the treatment of localised osteoporosis.

On the basis of positive results obtained in the treatment of Sudeck's atrophy with calcitonin, the authors extended their investigation to other forms of localised osteoporosis. Six patients were examined affected by osteoporosis secondary to immobilisation, three patients with osteoporosis of the lower limbs from paralysis of the sciatic nerve and six patients with migrant osteoporosis. Treatment was as follows: pig calcitonin (Calcitar) in doses of 160 u MRC/daily + calcium gluconate in doses of 3 gr/daily. The duration of treatment averaged forty five days. In osteoporosis from immobilisation and nerve lesions the calcitonin treatment did not influence the condition and there was no change in radiographic appearances nor was there any analgesic action. On the other hand, the results were clearly positive in migrant osteoporosis: in all the patients treated there was complete regression of pain, cutaneous trophic changes, and functional loss. At a later stage, normal radiographic appearances were restored.

Animals

Effect of calcitonin on carrageenan foot oedema.

The effect of salmon calcitonin (SCT) on acute inflammation was tested in carrageenan induced foot oedema of the rat. A considerable inhibition of the oedema was obtained with 20 MRC U/kg of SCT. The injection of SCT is followed by decrease of calcemia. A hypothesis of possible inhibition of prostaglandin (PG) synthesis and/or release, caused by decrease of calcemia, is advanced.

Animals

Osteoporosis.

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Adult

Limb lengthening by callus distraction (callotasis).

Callotasis is a new technique of limb lengthening involving slow distraction of the callus formed in response to a proximal submetaphyseal corticotomy. Using a dynamic axial fixator with telescoping capabilities, distraction begins after 2 weeks. When the required length is attained, the fixator is held in the rigid mode until radiographic evidence of callus is observed. The locking screw is then released, and dynamic axial loading is instituted to promote corticalization. One hundred bony segments have been lengthened; 50 patients had limb length inequality, and 23 had achondroplasia. The mean lengthening achieved was 22% (maximum, 58%). There were 14 complications (14%).

Achondroplasia