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Biomedical subjects

G Piazza

Publications and source records attributed to G Piazza.

At least 55 records · Page 3Linked to original sources

A prospective clinical and epidemiological study of head injuries in northern Italy: the Comune of Ravenna.

An analysis of all the head injuries occurring during one year within a well-defined geographical area was conducted in the region served by the Ravenna City Hospital in Northern Italy. This hospital does not have a neurosurgical service, so that patients suspected of having neurosurgical problems are transferred to the neurosurgical unit in Bologna, a distance of 65 Km (40 mi.). Of the 1468 head-injured patients seen in the emergency room, 644 (44%) were hospitalized, with an incidence of 372/10(5) pop/year) and were subjected to X-ray study of the skull (83%), EEG (64%), and CT scan (7.5%). 9 patients were transferred to the neurosurgical unit as emergencies on a clinical basis only, all were found to harbor cerebral lesions, and 7 were operated on. Of the patients hospitalized and subjected to CT scan in Ravenna, only one (0.17%) was found to have a lesion necessitating surgery. Mortality was 7.2% with 83% of these patients dying before admission. Three-month follow-up examination revealed the persistence of some symptoms in 20% of the 379 patients examined, but 91% had already returned to their previous occupation. Analysis of the risk factors present in the patients admitted to a non-specialized hospital seems to show that the presence of skull fracture, abnormal EEG, and alteration of the clinical condition constitute the indications for a CT scan, in order to detect the presence of intracranial lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Skull fracture as a factor of increased risk in minor head injuries. Indication for a broader use of cerebral computed tomography scanning.

Two series of patients with a minor head injury (for a total of 182 cases), differing only in the presence and absence of a linear skull fracture, were admitted to a nonspecialized hospital and prospectively examined by computed tomography scanning. The presence of a fracture line proved to be significant, inasmuch as it was accompanied by approximately 38% of intracranial abnormalities versus 6% in the nonfracture cases. Early detection of any intracranial pathology that was still asymptomatic allowed prompt transfer of patients to the neurosurgical center, where operative treatment was carried out, when indicated, without mortality or morbidity. All operations (11 cases) were performed on patients with a fracture (105 cases) whereas none of the nonfracture patients (77 cases) required surgery. It is proposed that adult patients with minor head injuries with a skull fracture be submitted to computed tomography scanning in order that intracranial lesions may be detected, and treated, before the onset of clinical deterioration.

Adult↗

Skull fracture as a risk factor of intracranial complications in minor head injuries: a prospective CT study in a series of 98 adult patients.

Ninety eight patients admitted to hospital after a minor head injury were studied by CT. Forty seven patients had a skull fracture and 51 did not. Significantly more intracranial lesions were found in those with a fracture (16) that those without (3) (p less than 0.01). Nine of the patients with a skull fracture and positive CT were transferred to a neurosurgical department, where six underwent operation. Operation was not required in patients without a skull fracture. Head injured patients with a skull fracture should undergo CT scanning to enable early detection of an intracranial haematoma.

Adolescent↗

Craniopagus twins. An unsuccessful separation and a clinical review of the entity.

Craniopagus twinning is an extremely uncommon birth defect with an estimated incidence of 4-6 every 10 million births. The most complex and challenging issue is the feasibility of surgical separation, which involves not only technical but also socioethical problems and requires strict multidisciplinary cooperation between pediatricians, neuroradiologists, anesthesiologists, and plastic and neurological surgeons. The authors report a case in which separation was followed by the death of both twins and stress the importance, from the surgical and prognostic viewpoints, of the degree of vascular connections between the major dural sinuses. We propose a classification into three types according to severity.

Cerebral Angiography↗

Some aspects of "deep lung" cellular immunity in chronic bronchitis before and after therapy with tiopronin.

Fifteen patients suffering from obstructive chronic bronchopneumonia in a clinical steady-state phase received 0.6 g of tiopronin once a day during 10 days per os. The lymphocyte subsets (OKT3, OKT4 and OKT8) have been identified in peripheral blood and in bronchoalveolar lavage liquid (BAL) before and after treatment and phagocytosis has been evaluated in pulmonary alveolar macrophages (PAM) (phagocytosis index, phagocytosis percentage, superoxide-ion production). A highly significant improvement in the phagocytosis process has been observed in the PAM, as well as an increase in the number of lymphocytes T3 and in the T4/T8 ratio (due to an increase in T4 lymphocytes) in the BAL; while in peripheral blood T3 and T4 lymphocytes and the T4/T8 ratio only showed a nonsignificant increase after treatment. The possible mechanisms on which these variations are based have been investigated.

Aged↗

Chronic expanding intracerebral hematoma.

The cases of 10 normotensive patients with chronic intracerebral hematomas are reported. The patients' median age at diagnosis was 42 years. The median duration of symptoms was 22 days. Seizures were the presenting symptom in 50% of the cases. Computerized tomography almost consistently demonstrated ring-shaped lesions with mass effect and perifocal edema. Arteriography revealed that all but one of the lesions were avascular. All patients had superficial white matter lesions, mostly in the frontoparietal region. All patients were treated surgically. Most of the hematomas were encapsulated and contained blood in various stages of organization. The thick capsule consisted of an outer layer of collagenous tissue and an inner layer of granulation tissue. Occult cerebrovascular malformations were detected in two instances. There were two deaths, both related to recurrent postoperative hemorrhage. This entity can present much like a brain malignancy and should be considered in the differential diagnosis of ring-shaped lesions whatever the clinical presentation. Strategies of treatment are discussed.

Adolescent↗

Stereotaxic biopsy and radioactive implantation for interstitial therapy of tumors of the pineal region.

Stereotaxic biopsy was performed in 10 patients with tumors of the pineal region. On the basis of intraoperative tissue diagnosis, low-energy radioactive sources (125I) were implanted in seven patients for interstitial irradiation during the same stereotaxic procedure. Results were good in five cases. This therapeutic modality appears to be indicated in cases of proven low-grade malignancy, inasmuch as the implantation of radioactive sources in a highly malignant lesion carries the risk of severe, often irreversible, damage to the surrounding brain, because of possible seed migration.

Adolescent↗

Squamous cell carcinoma of the brain with sarcoma-like stroma.

A cerebral neoplasm containing a well differentiated epidermoid cyst surrounded by islands of infiltrating squamous cell carcinoma and a pleomorphic spindle cell stroma was described. By immunoperoxidase staining all these components contained keratin. The lesion was therefore similar to malignant squamous cell lesions with sarcoma-like stroma occurring in other body sites.

Brain Neoplasms↗

Acute hypokalemic myopathy due to chronic licorice ingestion: report of a case.

A 35-year-old man, who had been ingesting one or two bags of tablets of pure licorice daily (20-40 g/day) for about two years, developed an acute myopathy with high levels of serum muscle enzymes and the typical features of mineralocorticoid excess: serious hypokalemia, hypertension, metabolic alkalosis. Both plasma renin and serum aldosterone were below the normal values. Ultrastructural study of muscle showed only minor, aspecific changes. Glycyrrhizinic acid, a steroid-like glycoside contained in natural licorice, has a well-known mineralocorticoid activity but severe potassium depletion and rhabdomyolysis due to chronic licorice ingestion have rarely been reported. This case further indicates that such a possibility is to be considered in the differential diagnosis of a patient admitted because of acute flaccid tetraparesis and hypokalemia.

Adult↗

Benign traumatic intracerebellar hematoma.

Prompt surgical intervention is thought to be necessary in patients with traumatic intracerebellar hematoma. The case reported here ran a benign course without operation. Pertinent serial computed tomographic scans are presented. It is concluded that not all traumatic hematomas of the cerebellum require operations.

Adolescent↗

Epidemiological study of pneumoconiosis in the Italian poly(vinyl chloride) industry.

Among 1216 workers employed in a poly(vinyl chloride) production factory, 20 cases of pneumoconiosis were found. None of these workers had had previous exposure to organic or inorganic dusts; 731 had been exposed to PVC dust (employed in drying, sacking and blending of polymer) and 485 had been exposed to monomer alone. Chest x-ray films were read by two independent physicians utilizing the ILO/UC Pneumoconiosis Classification, 1971. X-ray abnormalities were characterized by limited profusion, irregular type and low gravidity; in a small percentage of cases these were associated with slight restrictive respiratory function impairments. All 20 workers with PVC-induced pneumoconiosis had been exposed to high PVC dust pollution for at least five years. Mild nonspecific alterations (profusion of 0/1 class) were found both in the group exposed to PVC dust and in the group exposed to VCM alone. Such changes (observed in 388 cases, 31.9% of the whole population), are related mainly to age and smoking habits, and the role of exposure is minor.

Adult↗

Arachnoid cysts of the middle cranial fossa: a clinical and radiological study of 25 cases treated surgically.

Arachnoid cysts of the middle cranial fossa are probably not so infrequent as previously thought. Twenty-five cases are reported together with the most relevant clinical and radiological findings. The authors emphasize the importance of computerized tomography (CT) in providing pre- and postoperative anatomical and physiopathological information. The potential morbidity of these lesions is stressed and surgical indications are discussed with preference for a radical craniotomy rather than a shunt procedure.

Adolescent↗