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Biomedical subjects

L Quaranta

Publications and source records attributed to L Quaranta.

At least 19 recordsLinked to original sources
PubMed1999

Ab-interno goniotrabeculotomy versus mitomycin C trabeculectomy for adult open-angle glaucoma: a 2-year randomized clinical trial.

OBJECTIVE: To evaluate the effect of ab-interno goniotrabeculotomy (AIGT) on the intraocular pressure (IOP) in adult patients with primary open-angle glaucoma (POAG), compared with the effects of mitomycin C trabeculectomy (MT). DESIGN: Prospective, randomized, clinical trial. PARTICIPANTS: Thirty-two eyes of 32 patients with medically uncontrolled POAG. INTERVENTION: Standard limbus-based trabeculectomy with adjunct mitomycin C (0.3 mg/mL for 3 minutes) in 16 eyes of 16 patients; AIGT was performed in 16 eyes of 16 patients. The groups were matched for age, preoperative IOP, duration of preoperative antiglaucoma treatment, use of preoperative beta-blockers and parasympathomimetics, and use of beta-blockers in the fellow eye. The IOP (average of the two highest values measured in the diurnal curve, from 8 AM to 6 PM, every 2 hours) and complications were recorded 1, 3, 6, 12, 18, and 24 months after surgery. MAIN OUTCOME MEASURES: Identification of complications and IOP. RESULTS: All patients were followed up for 24 months. More postoperative complications occurred in the MT group during the 2-year follow-up. One month after surgery, IOP was 10 +/- 1.46 mmHg (range, 8-13) in the MT group and 12.12 +/- 1.63 mmHg (range, 8-14) in the AIGT group (Student's t test, P = 0.001). Three months after surgery, IOP was 11.5 +/- 1.59 mmHg (range, 8-14) and 12.75 +/- 1.57 mmHg (range, 10-16) in the MT and AIGT groups, respectively (Student's t test, P = 0.033). From the 6th to the 24th postoperative month, no statistically significant difference in IOP was found between the two groups. At the end of follow-up, 14 of 16 eyes (87.5%) of the AIGT group and 13 of the 16 eyes (81.25%) of the MT group showed an IOP < or = 14 mmHg. CONCLUSION: Ab-interno goniotrabeculotomy appears to be a viable and safe surgical treatment for adult POAG. More extended follow-up, however, and a larger series of patients are needed to ascertain the actual effectiveness of this procedure in adult POAG.

Anterior Chamber↗
PubMed1998

Congenital glaucoma associated with Rubinstein-Taybi syndrome.

PURPOSE/METHODS: Rubinstein-Taybi syndrome is a constellation of clinical findings characterized by mental and motor retardation, broad thumbs and broad first toes, marked growth retardation, microcrania, typical facies, high-arched palate, and cryptorchidism in males. Ocular and adnexal abnormalities are quite common and include antimongoloid slant of the palpebral fissures, epicanthal folds, congenital obstruction of the lacrimal excretory system, ptosis, strabismus, and severe ametropia. Macrocornea, microophthalmos, colobomas of the iris and of the optic nerve head, congenital cataract, and optic nerve atrophy have also been described. Congenital glaucoma is a rare complication. We examined a patient with Rubinstein-Taybi syndrome with bilateral congenital glaucoma. RESULTS/CONCLUSIONS: Examination of this patient revealed bilateral antimongoloid slants of the palpebral fissures, and bilateral congenital glaucoma. Gonioscopic examination revealed the iris to be inserted flatly into the trabecular meshwork. This case emphasizes the importance of detailed, complete ocular examinations in patients with Rubinstein-Taybi syndrome, and also highlights the occurrence of ocular abnormalities rarely associated with this disease.

Female↗
PubMed1997

Color Doppler imaging of ophthalmic artery blood flow velocity: a study of repeatability and agreement.

PURPOSE: Color Doppler imaging (CDI) is a relatively new technique that allows quantification of blood flow velocity in orbital and ocular vasculature. Despite the numerous clinical studies that have used CDI, repeatability of this technique and agreement between observers have not been documented. METHODS: The authors performed a prospective investigation of the repeatability and agreement between observers on ophthalmic artery blood flow velocity measurements in 35 patients (35 eyes). RESULTS: Results on the estimated error of measurement (variability between repeated readings on the same subject) indicate good repeatability of the measurements; in fact, the measurement variances were only 5.6% for the peak systolic velocity, 11.4% for the end diastolic velocity, and 6.2% for the mean envelope velocity. The statistical analysis of repeatability showed a very narrow 95% confidence interval for both observers. The measurement of agreement between the two observers demonstrated the existence of a good concordance of the measurements taken by each observer on each subject. CONCLUSIONS: Results suggest that CDI is a reliable tool for quantitative assessment of ophthalmic artery blood flow velocity.

Aged↗
PubMed1996

[Laparoscopy: access with open versus closed technique].

Pneumoperitoneum in diagnostic or therapeutic laparoscopy can be achieved by an open or a closed technique. The authors, on the basis of their experience, compare both techniques, concluding that open method is safer, because of the lack of major complications observed in the closed method and with only few minor complications.

Cholecystectomy, Laparoscopic↗
PubMed1995

Power Doppler sonography enhances visualization of orbital vessels.

Our study was intended to determine whether power Doppler sonography can be considered superior to color Doppler technique in depiction of normal orbital vasculature. Ten healthy volunteers (20 eyes) were examined with a 10 MHz linear probe; each orbital vessel was recorded with both color and power Doppler methods; the images were reviewed independently by all the observers, who agreed that power Doppler clearly is superior to color Doppler technique for evaluation of the anatomy of orbital arteries and veins.

Adult↗
PubMed1995

[Perforated endometriosis of the sigmoid. Report of a case].

The term endometriosis means the presence in an ectopic site of normal functioning endometrial tissue, the ectopic endometrial tissue, as the normal uterine mucosa, undergo hormonal stimulation and follow the proliferative and functional changes along the menstrual course; this evolution, characterize the clinical story of patients affected by endometriosis. Endometriosis is considered to be one of the most common gynecologic disorders, occurring in about 10% of women in fertile age. An involvement of adjacent organs such as the pelvic colon and rectum by endometriosis is not uncommon and may cause symptoms difficult to distinguish from malignant or inflammatory disease located in the pelvic region. The purpose of the following case report is to elucidate certain diagnostic and therapeutic problems of a disease concerning both the surgeon and gynecologists. Our case concerns a 44 year old patient with two children and a negative previous clinical gynecological history; the patients reports the occurrence in the last two years of alterations of colic evacuation consisting in a period of constipation lasting 5-7 days. The patient reached us in emergency with a sub-occlusive state that has lasted for 5 days, in the last 12 hours the appearance of a violent trafictive pain referred to the lower abdomen configure the clinical picture of a acute abdomen. The patient underwent surgery and the laparotomy demonstrated the presence of a perforated tumours located at the recto-sigmoid junction. We proceed to perform an Hartman's resection and a right ovariectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Severe corneoconjunctival xerosis after biliopancreatic bypass for obesity (Scopinaro's operation).

PURPOSE/METHODS: A 35-year-old woman, who had undergone an uncomplicated Scopinaro-type biliopancreatic bypass for obesity nine years previously, was examined because of severe bilateral corneoconjunctival xerosis and markedly decreased vision. One month earlier she had had a bout of nonspecific enteritis. She was treated with intramuscular vitamin A. RESULTS/DISCUSSION: After one month of therapy, the ocular xerosis had cleared completely and her vision had returned to normal. This case suggests that this kind of operation can cause instability of vitamin A absorption.

Adult↗
PubMed1994

The effect of increased intraocular pressure on pulsatile ocular blood flow in low tension glaucoma.

In the present study the relationship between intraocular pressure (IOP) and pulsatile ocular blood flow (POBF) in low tension glaucoma (LTG) has been investigated. The POBF was measured using the Ocular Blood Flow system of Langham in undisturbed eyes and repeated at IOP increments of about 5 and 10 mmHg in 20 patients affected with bilateral LTG and in 25 healthy subjects matched for age, IOP, refractive error, arterial blood pressure and heart rate. The POBFs were 740.1 (SD 58.83) and 667 (SD 108) microliters/minute (microliter/min) in the control and LTG groups, respectively and statistically significantly different. The POBFs at an IOP increased by 5 mmHg were 658.1 (SD 60.2) and 457.3 (SD 74.8) microliter/min in the control and LTG groups, respectively; in the control group the mean POBF at an IOP increment of 10 mmHg was 552.1 microliters/min (SD 66.9), and in the LTG group was 317.7 microliters/min (SD 85.2). Statistical analysis of the data showed a significant difference of POBFs in the two groups either at an IOP increment of 5 or 10 mmHg (p < 0.0001). The substantial decrease of POBF with increased IOP in LTG eyes compared with normals shows an altered response of the vascular system in LTG. These findings are probably consistent with a lack of the myogenic autoregulation in reply to IOP-induced modifications of the perfusion pressure.

Analysis of Variance↗
PubMed1994

Surgical avulsion of the iris to treat selected cases of neovascular glaucoma.

Surgical avulsion of the iris was performed in 11 eyes of 11 patients affected with diabetic retinopathy, rubeosis of the iris and neovascular glaucoma that had been unsuccessfully treated otherwise. Nine eyes had extensive iris neovascularization, complicated cataract and vitreous haemorrhage, whereas the other two eyes were aphakic and had previously undergone vitrectomy, lensectomy and extensive laser photocoagulation. Prior to surgical avulsion of the iris, all eyes received topical and entheric hypotensive therapy. The intraocular pressure (IOP) ranged from 24 to 52 mmHg. Iris avulsion lowered the IOP in 9 of the 11 eyes treated (IOP range, 6-19 mmHg).

Adult↗
PubMed1994

[Hemorrhagic necrotic acute pancreatitis: analysis of our case series in the light of the most recent diagnostic and therapeutic criteria].

During the period between 1-1-1979 and 30-9-1992, 43 cases of hemorrhagic necrotic acute pancreatitis were referred to the authors' attention. Six patients were not operated, 12 underwent emergency surgery and laparotomy was postponed in 25 cases. The introduction of sophisticated diagnostic methods, such as Eco, CT, ERCP, intensive medical therapy and postoperative NPT have allowed a more rational surgical approach in terms of timing and extent to be adopted, operating on patients who are metabolically more stable. NPT is a useful tool in the latter postoperative stage. In the series of patients undergoing emergency laparotomy there was a mortality rate of 66%. The mortality rate fell to 16% in those patients in whom surgery was postponed.

Acute Disease↗
PubMed1994

[Color Doppler echography of the orbit. Its normal aspects and pathological conditions with vascular involvement].

This study was aimed at investigating the role of color-Doppler US in the assessment of orbital vasculature under normal conditions; the results were then applied to the flowmetric analysis of some vascular diseases of the orbit, i.e., retinitis pigmentosa, simple chronic glaucoma, low-tension glaucoma and carotid-cavernous fistulas. The study consisted of two phases: first, a group of 20 healthy volunteers was examined and then 39 patients were divided into 4 subgroups. The patients (18 men and 21 women, age range: 52-68 years) were further divided into 4 subgroups: 12 of them had retinitis pigmentosa, 15 simple chronic glaucoma, 8 low-tension glaucoma and 4 carotid-cavernous fistulas. Color-Doppler yielded useful pieces of information on the position of orbital vessels and flow direction, while pulsed Doppler allowed the measurement of several variables, i.e., time average velocity, protosystolic velocity, peak systolic velocity, mesodiastolic velocity, end diastolic velocity, resistive index and pulsatility index. The study of the 20 healthy volunteers yielded valuable information on the anatomy and flow patterns of some vessels, such as the ophthalmic artery, the central retinal artery, the lacrimal artery and the posterior ciliary arteries, all of them visible in 90-100% of patients; the central retinal vein, the superior ophthalmic vein and venae varicosae were demonstrated in about 10-30% of them. In the group of patients, the mean flow velocities of the examined arteries were significantly lower than those in the normal volunteers; in the patients with carotid-cavernous fistulas an ectasic superior ophthalmic vein was demonstrated, with its typical flow "arterialization" pattern. The results suggest that color-Doppler could play a mayor role in the study of ocular hemodynamics.

Aged↗
PubMed1993

Color Doppler assessment of normal ocular blood flow.

The purpose of this study was to determine the role of CDI in the assessment of normal ocular vasculature. Color and pulsed Doppler examinations were performed in 20 healthy subjects. The principal orbital vessels were detected: ophthalmic, central retinal, lacrimal, and posterior ciliary arteries and, in a small percentage, superior ophthalmic, central retinal, and vortex veins; blood flow of arterial vessels was studied by measuring TAV, St, PS, MD, ED, PI, and RI; the morphology of the spectral waveform also was investigated. Our results suggest that duplex color Doppler may be of value in ocular vasculature examination.

Blood Flow Velocity↗