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Biomedical subjects

J Barsotti

Publications and source records attributed to J Barsotti.

At least 19 recordsLinked to original sources
PubMed1991

[Radio-anatomical study of the calcaneus. Accuracy of Böhler's angle measurement].

The authors have studied variations of Böhler's angle by various radiographic incidences. They have defined anatomic references of this angle on the correspondent dry bone. With the same radiographic incidences, Böhler's angle was 32 degrees. This value remained constant when X-ray incidences were modified with 15 degrees in all the directions from the external profile. Anatomic variations of the 3 references on dry bone which define this angle, were very small. Böhler's angle is therefore a good morphologic reference for evolutive study of each patient. It's variation in population needs comparative radiographic control of the opposite side.

Calcaneus↗
PubMed1990

Comparative double-blind study of two dosage regimens of low-molecular weight heparin in elderly patients with a fracture of the neck of the femur.

A randomized double-blind study comparing the efficacy and safety of two different dosage regimens of a low-MW heparin, Enoxaparin (Lovenox) 20 mg twice (group A) or 40 mg once (group B), was carried out in 103 elderly patients with a fracture of the neck of the femur. Distal and proximal thrombosis occurred in 18.3% of patients in group A and in 10.4% in group B. No major hemorrhagic complication was observed, except for two hematomas in each group. This trial suggests that a total daily dose of 40 mg of Enoxaparin can be effective in the prevention of deep vein thrombosis in elderly surgically treated patients and does not involve a major risk of bleeding.

Aged↗
PubMed1990

[The current role of lymphoscintigraphy in the study of lymphedema of the limbs].

After a brief review of the classical methodology and results of lymphoscintigraphy, the technique is considered in terms of an original kinetic study approach. Immediately after distal subcutaneous injection of a technetium colloid (rhenium sulfocolloid), 40 1-min serial images of the limbs are recorded followed 4 h after injection by recording of static images. The main abnormalities detected by scintigraphy concern the lymphatic vessels, nodes and interstitium. They reveal the presence of lymphedema and provide information about its mechanism, indicating, particularly in the case of primary lymphedema, whether there is predominant hyperplasia or hypoplasia in vessels or nodes. Synoptic study of the initial dynamic recording based on simple examination of serial images is difficult. Complementary data provided by activity curves determined from manually selected regions of interest (ROI'S) are of limited value since the ROI'S correspond to superimposed spatial structures. Two data-processing techniques--the condensed image (CI) and factorial analysis (FA)--were therefore applied to dynamic scintigraphic recordings in order to study lymphatic progress of the radiotracer in the legs. A complete dynamic series is described in two IC, one for each leg. The CI, obtained by mounting the 40 serial images in vertical strips 1 pixel in width, describes the spatial distribution of radioactivity along the leg during recording. Factorial analysis provides automatic extraction of pure kinetic components or factors from the dynamic series despite their spatial superposition. The factors are described by factorial curves and factorial images representing the spatial identity of the factor. Three-factor FA was applied successively to each leg.(ABSTRACT TRUNCATED AT 250 WORDS)

Arm↗
PubMed1990

[Surgical treatment of lymphedema].

In our experience, indications for surgical management of lymphedema do not amount to more than 10% of cases. Surgery is significantly complemented by expert pre and postoperative physiotherapy. Excisional procedures are presently seldom carried out, although they may be helpful when carried out as simple "orange-slice"-type resection, or as the Thompson operation. Liposuction is an attractive alternative, but its effectiveness needs be confirmed yet. Actually, the most effective types of surgical treatment are microsurgical lymphovenous or lymphoveno-lymphatic bypass. Secondary lymphedema of the lower extremities (more rarely of the upper limbs) are primary indications. The Campisi-Casaccia team from Genoa has acquired interesting experience with congenital lymphedema. Results relating to surgical treatment of lymphedema can be assessed only after a follow-up of 3-5 years. About one third of cases, on average, do very well and another third do well. Elastic support of the leg must practically always be maintained.

Adolescent↗
PubMed1990

[A survey of the French-speaking Association of Lymphology on the use of pressotherapy in France during the treatment of lymphedema].

116 physicians out of the 1000 who were questioned use pressure-therapy in the treatment of lymphedema of the extremities. Another 170 are interested in the technique and await this report before possibly adopting it. Overall, the devices utilized are compartmented and use discontinued pressure that is asynchronous in relations to heart beat; each session lasts 30 minutes, on average, with compression and resting phases lasting 45 seconds and 15 seconds, respectively. The usual schedule is one session daily, three days per week, in two series clustered within a single year. Although manual drainage of lymphatics is combined with pressure-therapy in 71.55% of the times, only 43.47% of physicians use elastic support following the treatment. Results are good or very good in 64.4% of cases, and the incidence of post-therapeutic events is rather low (polyuria, pain recrudescence of lymphangitis, etc.). Aside from lymphedema, venous insufficiency, hypodermitis and leg ulcers may also benefit from pressure-therapy.

Clinical Protocols↗
PubMed1990

The potential usefulness of condensed image processing of sequential lymphoscintigrams in patients with lymphedema.

Condensed image processing (CIP), a computerized technique of scintiscans that generates a vertical distribution of activity as a function of time in a single image, was applied to isotopic lymphoscintigrams of four patients with leg lymphedema. By "condensing" information gained from multiple images into a single image, CIP better evaluates ascending progression of radiolabeled colloid in peripheral lymph and better localizes stagnant areas. In "high lymph flow failure," CIP also depicts radioactive "bursts" suggestive of increased lymphatic truncal contractility. This data processing method improves interpretation of dynamic scintiscan recordings and seems ideally suited for evaluation of peripheral lymph kinetics.

Adolescent↗
PubMed1989

Factorial analysis of dynamic lymphoscintigraphy in lower limb lymphoedema.

The purpose of this work is to assess the contribution of factor analysis to the interpretation of dynamic lymphoscintigraphy. Twenty six adult patients with a lower limb lymphoedema and five control patients were studied. The technique involved a 3 mCi lymphovectoscint* 99Tcm-labelled ammonium sulphur colloid, bilateral pedal subcutaneous injection. Recording consisted of 40 consecutive 1-min frames of both legs followed by static pictures of each leg and pelvis at 40 min and 4 h after injection. The analysis of static pictures allowed a classification of patients into three groups: enhanced pattern, hypoplasia and dermic reflux. To evaluate better the different kinetic components of the sequential pictures, a factorial analysis (FA) software package was used. FA processing enabled the extraction from the dynamic series of different dynamic components, factorial curves and their associated factorial images which represent the anatomic structures with the same temporal behaviour. In each pattern the results of dynamic recording and of three FA factors were compared. FA provides an analytical temporal and spatial description of the dynamic sequence by extracting the different kinetic components; it yields a better differentiation of vessel and interstitium activity. It also provides some clues towards the understanding of oedema physiopathology and is of potential interest for the management of lymphoedema.

Adolescent↗
PubMed1989

Factorial analysis in radionuclide lymphography: assessment of the effects of sequential pneumatic compression.

The effects of intermittent pneumatic compression (IPC) in 12 patients with lower or upper limb lymphedema were studied using a computer-based technique (factorial analysis) of dynamic lymphoscintigraphy. After subcutaneous injection of radiocolloid into the first interdigital web space of the arm or leg, scintigraphic recordings consisted of 40 consecutive one-minute frames of both lower extremities or an edematous upper extremity. Pneumatic compression by Euroduc (6 patients) or by Lymphapress (6 patients) was applied during the final 20 minutes of the recording. A three factors factorial analysis (FA) was performed successively for each extremity. FA allowed "uncontaminated" curves to be displayed distinct from neighboring structures and corresponded to dynamic tracer activity in the interstitium, at the injection site, and within lymphatic vessels. Based on the results of lymphatic vascular factorial analysis, a beneficial effect of IPC was detected in 18 of 22 limbs examined. FA processing suggested that IPC facilitated radiocolloid transport in the proximal portion of the limb and also propelled tracer from the injection site toward the lymphatics. The effect of IPC was evident as soon as external compression therapy began and was similar with either mechanical unit. Residual tracer activity in peripheral lymphatics 20 minutes after application of IPC was higher in the edematous as compared with the normal limbs. FA processing is a new and potentially valuable method to evaluate the effects of external pneumatic compression in the management of peripheral lymphedema.

Arm↗
PubMed1987

Visualization of the thoracic duct by lymphoscintigraphy.

Imaging of the thoracic duct is usually performed by radiological lymphography. However, this procedure, which uses an oil based dye injected directly into the lymph channels, has some adverse effects. In this paper we note that lymphoscintigraphy, a physiological and non invasive method, may visualize thoracic duct abnormalities, and might be particularly useful when radiological lymphography is contraindicated.

Chylothorax↗
PubMed1987

[Comparative study of 2 dosages of low molecular weight heparin, PK 10169, in the prevention of thromboembolic incidents during treatment of 103 femur neck fractures].

Results of this study in the elderly with fractures of femoral neck, in whom their exists an enhanced thrombogenic risk, showed that the dose of 40 mg per 24 hours as one or two divided injections of enoxaparine was as effective as adapted subcutaneous doses of calcium heparinate. It was also less iatrogenic and easier to manage (biological assays were of little use apart from platelet counts). Clinical evidence of pulmonary embolism, or mortality, were not observed in this series of 103 patients.

Aged↗
PubMed1987

Use of lymphscintigraphy in traumatic chylous ascites.

This report describes the use of lymphscintigraphy in a patient with traumatic chylous ascites. Radioactivity "leakage" near the origin of the thoracic duct and accumulation into the peritoneal cavity were delineated.

Adult↗
PubMed1986

[Antibiotic sensitivity of bacteria isolated from pathological specimens and utilization of beta-lactams in an orthopedic surgery service].

From 1980 to 1984, computerized data on the sensitivity to the main antibiotics of 1991 strains isolated from clinical specimens were evaluated in relation to beta-lactam use and hospital activity in a unit of orthopedic surgery. No major variations were found in distribution of species throughout the study period, whereas sensitivity to antimicrobial agents changed. From 1980 to 1982, patients had postoperative prophylactic treatment with cephalosporin (cefazolin) for two days; during the same period, 59% of 557 Gram negative organisms were resistant to cefazolin and 31% of Staphylococci were resistant to methicillin (and to other antibiotics). In 1983 and 1984, cefazolin was replaced by intraoperative flash therapy with a penicillin-M (cloxacillin); concomitantly, sensitivity to cefazolin increased among Gram negative organisms (38% of 485 isolates were cefazolin-resistant; p less than 0.001) and Staphylococci (16% of 342 isolates were methicillin-resistant; p less than 0.001). Phage typing of S. aureus failed to disclose any epidemic outbreak. Since hospital activity remained the same throughout the period under study, it seems justified to correlate the increase in bacterial sensitivity observed to the decrease in use of cephalosporin, although other factors (microepidemic, isolation techniques) may be involved.

Anti-Bacterial Agents↗