Rosacea: a potential complication of expanded flaps.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
Giovanni Nicoletti
Publications and source records attributed to Giovanni Nicoletti.
The congenital deficit of protein S as a new prognostic factor in microsurgery.
Explore the source record for details and available documents.
Anastomosis, Surgical↗
Trends in HIV prevalence among drug-users attending public drug-treatment centres in Italy: 1990-2000.
The occurrence of HIV infection among drug-users in Italy between 1990 and 2000 is described; the data concern drug-users attending a nation-wide network consisting of 510 public drug-treatment centres. We included only individuals with written documentation of an HIV-test result. Of the 1,299,972 attendees, 54.5% had a documented HIV-test result. The overall HIV prevalence among those with a test result was 19.8%. The annual prevalence decreased from 30.8% in 1990 to 15.8% in 2000 (chi-square for linear trend P < 0.0001); the decrease was more evident between 1990 and 1996, whereas the prevalence apparently levelled-off after 1996. The annual prevalence was significantly higher among females compared to males throughout the study period. The annual prevalence was consistently three to four times higher for prior attendees, compared to new entrants. Although information on whether or not the attendees injected drugs was not available for the entire study period, the proportion of attendees with a documented HIV-test result can be considered as an approximation of the proportion who inject drugs. Although HIV infection was widespread among injecting drug-users in Italy beginning in the mid-1980s, since the early 1990s it has been somewhat contained. However, the levelling-off of the prevalence after 1996 may conceal an increase in the number of new infections and should be more thoroughly investigated. Aggregated national-level data, despite their limitations, represent a reliable tool for monitoring the temporal trend of HIV prevalence among injecting drug-users in Italy.
Adult↗
Embryonal rhabdomyosarcoma of the tongue in old age.
Rhabdomyosarcoma represents the most common soft tissue sarcoma of patients under 15 years of age, but it is definitely rare in subjects older than 45. A very rare case of embryonal type rhabdomyosarcoma of the tongue in a 65-year-old man is reported. The adult patient was treated with surgery and post-operative adjuvant radiotherapy and is disease-free at 48 months of follow-up. TUNEL analysis showed that apoptosis was present in 10% of the cells, thus suggesting that an high number of apoptotic cells may represent an indicator of good prognosis for this malignancy.
Aged↗
Blink reflex abnormalities in Tourette syndrome.
OBJECTIVE: Tourette syndrome (TS) is a not uncommon disorder which represents the most complex manifestation of the spectrum of tic disorders, with onset during childhood or early adolescence. There are no definitive tests for diagnosis of TS. The objective of this study has been to demonstrate whether neurophysiological abnormalities of the blink reflex can be observed in patients affected with TS and correlate with the severity of TS. METHODS: We enrolled 17 patients with Tourette syndrome, diagnosed according to DSM IV Diagnostic Criteria, and 10 healthy volunteers. Tic severity was assessed using a self rating scale (Tourette Syndrome Symptom List, TSSL) and examiner ratings (Yale Global Tic Severity Scale (YGTSS), and Tourette-Syndrome Global Scale (TSGS)). The blink reflex was elicited by stimulating the supraorbital nerve in order to measure the early response (R1), homolateral and contralateral R2 (late) responses, amplitude of R1 and duration of R2. RESULTS: We observed a mean duration of R2 significantly longer in the patient group than in the control group (P<0.01, Student t test), without any statistically significant differences of R1 and R2 latencies and of R1 amplitude between the patient group and the control group. Correlations between changes in clinical rating scores and R2 duration were tested by simple linear regression analysis, which has not demonstrated a significant correlation between TSSL scores, clinical rating scores (measured by TSGS and YGTSS) and duration of R2. CONCLUSIONS: A pattern as to excitability of the blink reflex can be a frequent abnormality in TS patients, not correlated with its severity.
Adult↗
Objective assessment of speech after surgical treatment for oral cancer: experience from 196 selected cases.
In 1992, a personal computer-based workstation for speech-digitized analysis was developed in conjunction with Canniesburn Hospital and Edinburgh University to measure all dispersion in speech after surgery for oral cancer. The voices of 196 patients with tumor of the oral cavity were recorded preoperatively and postoperatively. Surgical resection was carefully mapped out on standard diagrams of the oral cavity. Patients' recordings were assessed for conversational understandability by two referees. Patients also self-scored their speech using the Functional Intraoral Glasgow Scale self-questionnaire. Many patients had similar if not identical resections; therefore, 12 homogeneous groups were identified. Functional outcome for speech was correlated with the site and size of resected tissue and with the reconstruction modalities. The original association of an objective, computer-based tool and two subjective assessment tools proved to be the most suitable investigation method for speech. The general pattern was for consistently better speech quality with smaller excisions. The reconstruction modalities did not seem to influence the overall speech quality, as it was related mainly to the extent of surgical demolition. The authors present a detailed correlation between site and size of excision and functional outcome using color multiple-view diagrams for immediate appreciation. Positive and negative prognostic factors were identified in surgery for oral cancer.
Adult↗
Chewing and swallowing after surgical treatment for oral cancer: functional evaluation in 196 selected cases.
One hundred ninety-six patients treated for oral cancer between 1992 and 1999 self-scored their speech, chewing, and swallowing using a new self-questionnaire (Functional Intraoral Glasgow Scale) developed at Canniesburn Hospital, Glasgow, to assess the functional efficiency of patients treated for intraoral cancer. The patients were distributed into 12 homogeneous groups, according to the site and size of surgical resection, carefully mapped out on standard diagrams of the oral cavity. The functional outcome for chewing and swallowing was correlated to the site and size of resected tissue, to the reconstruction modality, and to radiotherapy and compared with the speech quality. The general trend is very similar for both chewing and swallowing; the smaller the resections, the better the functional outcome. Chewing was mostly affected by resections of the floor of the mouth, whereas swallowing was mostly affected by demolition of the base of the tongue and of the retromolar trigone. Speech showed a better postoperative recovery than chewing and swallowing. The reconstruction modality did not influence the eventual outcome for either function. Radiotherapy in combination with surgery is a negative functional prognostic factor. A correlation between site and size of excision and functional outcome is presented using color multiple-view diagrams for immediate appreciation to identify positive and negative prognostic factors.
Adult↗
Prediction of the response to citalopram and reboxetine in post-stroke depressed patients.
RATIONALE AND OBJECTIVE: Depression is a significant complication of stroke. The effectiveness of antidepressant drugs in the management of post-stroke depression (PSD) has been widely investigated. However, the choice of antidepressant drug is critically influenced by its safety and tolerability and by its effect on concurrent pathologies. Here we investigate the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI), citalopram, and a noradrenaline reuptake inhibitor (NARI), reboxetine, in post-stroke patients affected by anxious depression or retarded depression. METHODS: This was a randomized double-blind study. Seventy-four post-stroke depressed patients were diagnosed as affected by anxious or retarded depression by using a synoptic table. Randomisation was planned so that 50% of the patients in each subgroup were assigned for 16 weeks to treatment with citalopram and the remaining 50% were assigned to treatment with reboxetine. The Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale (HDRS) and a synoptic table were used to score depressive symptoms. RESULTS: Both citalopram and reboxetine showed good safety and tolerability. Citalopram exhibited greater efficacy in anxious depressed patients, while reboxetine was more effective in retarded depressed patients. CONCLUSIONS: Citalopram or other SSRIs and reboxetine may be of first choice treatment in PSD because of their good efficacy and lack of severe side effects. In addition, PSD patients should be classified according to their clinical profile (similarly to patients affected by primary depression) for the selection of SSRIs or reboxetine as drugs of choice in particular subgroups of patients.
Adrenergic Uptake Inhibitors↗