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Biomedical subjects

G Porcellini

Publications and source records attributed to G Porcellini.

At least 19 recordsLinked to original sources
PubMed2001

[Neonatal chronic kidney failure associated with cyclo-oxygenase-2 inhibitors administered during pregnancy].

Non-steroidal anti-inflammatory drugs (NSAID) are used since years as tocolytic due to their capacity to inhibit cyclo-oxygenase (COX) expressed in uterus and fetal membranes, fundamental for labour initiation and maintenance. The use of nimesulide, a COX-2 selective NSAID, has been recently proposed due to its capacity to selectively inhibit the enzyme expressed in the myometrium and endometrium. A case of neonatal irreversible end stage renal failure after maternal assumption of nimesulide as tocolytic for 6 week is reported. Cesarean section at the 32nd week due to oligohydramnios gave birth to a baby girl of 2090 g, in good general conditions, without signs of respiratory distress and of visible abnormalities. From birth she displayed oligo-anuria which required dialytic substitutive therapy from the second day of life. At US scan both kidneys had normal diameters for gestational age slightly increased echogenicity and a reduced cortico-medullary differentiation. On the 20th day of life she had a surgical renal biopsy for the persistence of oligo-anuria, showing fetal glomeruli, without lymphocytic interstitial infiltrate, and normal tubuli without evidence of necrosis. She is now 16 months old and under automated peritoneal dialysis on a home dialysis program. The occurrence of chronic renal failure in strict relationship with maternal nimesulide assumption in this case is strongly suggestive for a pharmacological damage, either direct or mediated by renin angiotensin inhibition, and possibly modulated by genetic factors, likely to account for the different outcome of similarly treated patients. A cautious use of this drug as long term tocolytic should be recommended while waiting for ad hoc experimental and clinical evidences of safeness.

Adult↗
PubMed1996

Increased plasma level of vascular endothelial glycoprotein thrombomodulin as an early indicator of endothelial damage in bone marrow transplantation.

We investigated the nature of hemostatic alterations occurring after bone marrow transplantation. In 45 patients, we evaluated the coagulation parameters, naturally occurring anticoagulants and thrombomodulin at days +15 and +22 after conditioning therapy. It was observed that endothelial cell damage is a central pathogenetic mechanism in some BMT complications. The increased plasma level of thrombomodulin after conditioning therapy is therefore discussed as a marker of endothelial cell injury. At day +15 a significant increase of fibrinogen from 276.1 mg/dI to 389.1 mg/dI was observed, while the natural anticoagulants all decreased significantly. Eleven patients with clinical complications related to endothelial damage had a significant thrombomodulin increase which, in uncomplicated patients, remained unchanged or resulted in lower than baseline values. Analysis of the data shows a strong correlation between clinical findings, reflecting endothelial cell injury and thrombomodulin increase when the increment is > or = 30%. We found a significant elevation in thrombomodulin in 70% of clinical complications related to endothelial cell damage namely: septicemia, GVHD, VOD. There were four cases (or 9%) of false positive data, and only two (or 4.5%) of false negative results. We therefore propose thrombomodulin assessment as a valid parameter to monitor chemotherapy toxicity-related complications.

Adolescent↗
PubMed1994

[Rotator cuff rupture in the shoulder impingement syndrome. Echography and arthrography: 2 diagnostic methods compared].

After briefly reviewing the shoulder impingement syndrome, the authors investigate the role of two diagnostic imaging methods, i.e., ultrasonography (US) and arthrography, in demonstrating the typical features of this condition. Over a 15 months' period, 190 patients suffering from shoulder pain were examined with arthrography; 50 of them subsequently underwent acromion plastic surgery and rotator cuff stitching. This study was aimed at comparing US and arthrographic results, applying classifiable criteria to make the most accurate diagnosis of rotator cuff tears. The lack of visibility of the rotator cuff at US was the major and clearest sign of tear (100% of cases). The association between cuff thinning and hypo/hyperechoic damaged focal areas was another major sign (in 76.19% of complete tears and in 14.28% of incomplete tears). Hyperechoic focal areas alone proved to be a false-positive finding in 5 cases, while in 11 of 19 cases normal US patterns were a false-negative finding; in 3 cases other conditions were diagnosed. To conclude, the value of US is emphasized in the screening of the painful shoulder and the use of arthrography is suggested when both clinical tests and US fail to yield enough information for a diagnosis to be made.

Aged↗
PubMed1990

The Steindler method in the treatment of paralytic elbow flexion.

Based on an average follow-up of 8.6 years, the authors analyse the functional results obtained in 16 patients submitted to Steindler flexoroplasty of the elbow between 1975 and 1986. The absence of active flexion of the elbow produces a severe deficit in the upper limb even when there is good function of the shoulder and hand. Since 1921, the year in which Steindler published a report on his surgical method, numerous surgical methods have been described for the treatment of paralytic elbow. Clark (1946), Merle d'Aubigné et al. (1956), Brook and Sendon (1959) propose transposing pectoralis major by suturing it to the tendon of the biceps muscle. Le Coeur (1953) instead isolates pectoralis minor and then transposes it on the biceps tendon. Bunnel (1951) describes two methods: the first consists in isolating the sternocleidomastoid by lengthening it with the fascia lata and inserting it into the tendon of the biceps, the second proposes anteriorly transposing the distal triceps tendon. Hovnanian (1956) and Zancolli and Mitré (1973) transpose the latissimus dorsi by inserting it distally on the distal biceps tendon, while Axer et al. (1973) transpose part of the same muscle. It is the purpose of this study to report the experience obtained using the Steindler method in 22 patients affected with paralysis of the flexor muscles of the elbow.

Adolescent↗
PubMed1989

Post-injective quadriceps contracture.

After reviewing the literature, the authors report 19 patients affected with post-injective contracture of the quadriceps muscle observed by them between 1971 and 1983. Clinical evaluation, indications for surgery and the results of surgery are discussed.

Child↗
PubMed1987

A new syndrome with ocular, skeletal and renal involvement.

A patient with retinitis pigmentosa, hypertension with interstitial nephropathy, short limb dwarfism with Madelung deformity of the forearms and an unclassified type of brachydactyly is described. Such bone dysplasia has never been reported to date either as a single entity or associated with renal and retinal diseases.

Abnormalities, Multiple↗
PubMed1981

[Renal tubular damage after rapid intravenous contrast study with iopamidol].

Reference is made to results obtained in 53 nephropathics in the study of urinary elimination of alphaglycosidase and lysozyme before and after rapid contrastography with sodium and meglumine diatrizoate and with iopamidol. A statistically significant difference in alphaglycosidase was evident with both media, whereas no change was noted for lysozyme. As far as the evaluation of alphaglycosidase was concerned, the tubular alteration induced by each medium was the same in terms of statistical comparison of the mean differences before and after urography.

Contrast Media↗
PubMed1981

[The value of the basophil degranulation test on the study of hypersensitivity reactions to iodinated contrast media].

The ability of basophils and tissue mastocytes activated by sensitised IgE antibodies to release mediators in the presence of the specific antigen underlies immediate hypersensitivity reactions. This phenomenon can be explored by the in vitro basophil degranulation test adopted not only in experimental pathology, but in human allergological pathology and in the study of post-streptococcal and lupus glomerulonephritis. The test has been carried out to analyse sensitisation to iodate contrast media in 71 patients already submitted to contrastography, 37 of whom had given evidence of allergic reactions. All patients with a previous history of sensitisation presented, in vitro, a positive reaction (56 + 15.3% degranulation) in the presence of the contrast medium. Against this, none of the patients with negative test presented an allergic reaction during contrastography. Stress is laid on the practical importance of the test prior to performance of contrastography so as to predict possible sensitisation and select the most suitable medium.

Basophils↗
PubMedDate not supplied

Hemiarthroplasty of the shoulder. Clinical experience in 18 cases treated by the Neer monoblock prosthesis.

The authors report the results of 18 hemiarthroplasties of the shoulder performed between 1990 and 1994 using the Neer II monoblock prosthesis, emphasizing the technical and surgical problems encountered. The patients treated numbered 13 for traumatic pathology (acute fractures: 7; sequelae of fracture of the proximal epiphysis of the humerus: 6), and 5 for degenerative lesions (arthrosis: 3; rheumatoid arthritis: 2). An evaluation of the results was based on the Constant method and isokinetic testing. Results based on follow-up obtained after 2 to 6 years were satisfactory in 83% of the cases.

Aged↗
PubMedDate not supplied

Comparison between arthroscopy and arthrotomy in the treatment of shoulder instability.

Anterior post-traumatic shoulder instability represents a common finding in orthopaedic surgery. The surgical treatment of this lesion is often indispensable for the normal social life of the patient and for the sports activity of the young. The Bankart procedure with capsular retensioning by arthrotomic access has for years been the gold standard. In the last 10 years arthroscopic accesses have gained more and more consent for the surgical treatment of such lesions, with results that have considerably improved in time. It is the purpose of this study to compare the results obtained in patients affected with anterior-inferior post-traumatic shoulder instability treated by Bankart surgery, arthrotomic and arthroscopic, with a minimum follow-up of 4 years.

Adolescent↗
PubMedDate not supplied

The inverse prosthesis as a revision prosthesis in failures of shoulder hemiarthroplasty.

The authors describe their series of seven cases of complications and failures of shoulder hemiarthroplasty that were submitted to revision surgery involving an inverse prosthesis. This prosthesis has for some time now been indicated in elderly patients with arthropathy caused by rupture of the cuff. In our cases this prosthesis was implanted in patients who had undergone shoulder hemiarthroplasty for fracture and for arthrosis. The Constant score was used for pre- and postoperative evaluation. Results at mid-term, from 2 to 4 years, indicate evident improvement in Constant score that rose from a mean of 23.14 preoperatively to a mean of 49.14 postoperatively. Despite the limited follow-up the authors suggest the use of the inverse prosthesis as an effective alternative solution in shoulder arthroplasty revision surgery.

Aged↗
PubMedDate not supplied

Arthroscopic neurolysis of the ulnar nerve at the elbow.

Cubital tunnel syndrome is a frequent form of neuropathy caused by entrapment of the upper limb. Conservative treatment and physical therapy are the treatment of choice for at least 6 months prior to any type of surgery. The surgical techniques proposed for treatment of this syndrome include simple decompression, transposition and neurolysis. It is the purpose of this study to demonstrate the advantages of arthroscopy for neurolysis of the ulnar nerve at the elbow in a specific cohort of patients. The patients were evaluated preoperatively and postoperatively based on subjective (VAS) and objective (Bishop and Dellon) scales. The degree of patient satisfaction on the average was more than 60%. The mean increase in Bishop score was 5 points (minimum 3, maximum 7). Results appeared to be good and stable at 6 and 12-month follow-up evaluation.

Adolescent↗
PubMedDate not supplied

The Bristow-Latarjet method in the treatment of shoulder instability that cannot be resolved by arthroscopy. A review of the literature and technical-surgical aspects.

Arthroscopy has surpassed traditional types of open surgery in the treatment of shoulder instability because of its mini-invasiveness and shorter rehabilitation time. Despite this, in some cases, such as those involving significant glenoid erosions and extensive capsular lesions, arthroscopic methods fail the objectives, and methods that were believed to have been surpassed are again used, such as the Bristow-Laterjet procedure. It is the purpose of this article to describe use of the method in light of the possibilities offered by arthroscopy.

Arthroscopy↗