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Biomedical subjects

L Rocchi

Publications and source records attributed to L Rocchi.

At least 19 recordsLinked to original sources
PubMed2006

Percutaneous fixation of mallet fractures by the "umbrella handle" technique.

Over a period of 8 years, 48 fingers with mallet fractures of Wehbé and Schneider Types 1 and 2, subtypes B and C, were treated in 31 men and 17 women of mean age 42 (range 17-61) years. The fractures included 5 Type 1 subtype B, 2 Type 1 subtype C, 23 Type 2 subtype B and 18 Type 2 subtype C fractures. The technique used consisted in passing a K-wire percutaneously from dorsal to volar and pinning the fracture fragment while leaving the distal interphalangeal joint free to allow immediate postoperative mobilisation. Fracture splintage was removed at 6 weeks. The results at 8 weeks, which remained unchanged at 12 months in 46 fingers, were assessed as excellent in 11, good in 35 and fair in two cases by the Crawford rating system. One case of pin track infection required early removal of the pin.

Adolescent↗
PubMed2006

[Incidence and causes of failures in wrist arthroscopic techniques].

OBJECTIVES: Arthroscopy represents a new and promising technique for the diagnosis and treatment of disorders of the wrist. Causes predis posing to clinical failure can arise during any phase of the approach to a patient who is a candidate for arthroscopic treatment. The author examine the causes of failure during pre-operative diagnostic workup, operative procedure and post-operative rehabilitation program and discus how to prevent them. MATERIALS AND METHODS: Three hundred fifty outpatients who had wrist arthroscopy were reviewed to determine type of procedure, type of anaesthetic, portals used and incidence and nature of preoperative, operative, and postoperative complications. Complications were divided in two groups: major and minor. The first group consists of isolated or combined vascular, nerve and/or tendon injuries, compartment syndrome joint infection and RSD, wrist rigidity. The second group includes transient superficial dorsal ulnar sensory neurapraxia, superficial portal sit infection, skin burns, tendonitis, instrumentation breaking inside the wrist joint, ganglion formation, haematomas. In a separate group othe causes of failure, especially those due to surgical or rehabilitation failures, are considered. RESULTS: Ten cases of surgical and post-surgical complications (2,9%) and 8 other cases of failure considered separately (2,3%) were identified, making a total of 18 cases of clinical failure (5,1%). Among these complications 4 cases were classified as "major" [sensory nerve branch lesions of ulnar nerve (3 cases) and of radial nerve (1 case)] and 6 cases were classified as "minor" [sensory neurapraxia (3 cases), instrumentation breakage (1 case), ganglion formation (1 case), a large subcutaneous haematoma (1 case)]. CONCLUSIONS: Wrist arthroscopy is a sophisticated procedure, requiring dedicated surgical training and a thorough knowledge of joint disorders in order to lower the risks of complications and surgical failures.

Adolescent↗
PubMed2006

Results and complications in dorsal and volar wrist Ganglia arthroscopic resection.

The authors present the procedure and results of five years of arthroscopic treatment of wrist radiocarpal and midcarpal ganglia. Thirty cases of dorsal ganglia and seventeen cases of volar ganglia were operated on arthroscopically. The technique was easy to perform in all the radiocarpal ganglia, not easy in midcarpal dorsal ganglia and very difficult in midcarpal volar ganglia. The results were recorded with a mean follow-up of 15 months. Twenty-seven cases of dorsal ganglia and twelve cases of volar ganglia had excellent results with active motion recovery, no complications, absence of scars and no recurrence. Two cases had a recurrence. There were four complications: a case of injury of a radial artery branch, a case of extensive haematoma, and two cases of neuropraxia. In three cases the procedure was converted into open surgery: they had a longer time of healing and a residual scar. The arthroscopic resection has been in our experience effective and safe for the treatment of all radiocarpal ganglia. Good results have been obtained also in the treatment of dorsal midcarpal ganglia. Concerning the uncommon cases of volar midcarpal (STT) ganglia, an open approach seems still indicated.

Adolescent↗
PubMed2006

Human postural response to lower leg muscle vibration of different duration.

Body lean response to bilateral vibrations of soleus muscles were investigated in order to understand the influence of proprioceptive input from lower leg in human stance control. Proprioceptive stimulation was applied to 17 healthy subjects by two vibrators placed on the soleus muscles. Frequency and amplitude of vibration were 60 Hz and 1 mm, respectively. Vibration was applied after a 30 s of baseline. The vibration duration of 10, 20, 30 s respectively was used with following 30 s rest. Subjects stood on the force platform with eyes closed. Postural responses were characterized by center of pressure (CoP) displacements in the anterior-posterior (AP) direction. The CoP-AP shifts as well as their amplitudes and velocities were analyzed before, during and after vibration. Vibration of soleus muscles gradually increased backward body tilts. There was a clear dependence of the magnitude of final CoP shift on the duration of vibration. The amplitude and velocity of body sway increased during vibration and amplitude was significantly modulated by duration of vibration as well. Comparison of amplitude and velocity of body sway before and after vibration showed significant post-effects. Presented findings showed that somatosensory stimulation has a long-term, direction-specific influence on the control of postural orientation during stance. Further, the proprioceptive input altered by soleus muscles vibration showed significant changes in postural equilibrium during period of vibration with interesting post-effects also.

Adult↗
PubMed2004

Feature selection of stabilometric parameters based on principal component analysis.

This study addresses the challenge of identifying the features of the Centre of pressure (COP) trajectory that are most sensitive to postural performance, with the aim of avoiding redundancy and allowing a straightforward interpretation of the results. Postural sway in 50 young, healthy subjects was measured by a force platform. Thirty-seven stabilometric parameters were computed from the one-dimensional and two-dimensional COP time series. After normalisation to the relevant biomechanical factors, by means of multiple regression models, a feature selection process was performed based on principal component analysis. Results suggest that COP two-dimensional time series can be primarily characterised by four parameters, describing the size of the COP path over the support surface; the principal sway direction; and the shape and bandwidth of the power spectral density plot. COP one-dimensional time series (antero-posterior (AP) and medio-lateral (ML)) can be characterised by six parameters describing COP dispersion along the AP direction; mean velocity along the ML and AP directions; the contrast between ML and AP regulatory activity; and two parameters describing the spectral characteristics of the COP along the AP direction. On the basis of the results obtained, some guidelines are suggested for the choice of stabilometric parameters to use, with the aim of promoting standardisation in quantitative posturography.

Adult↗
PubMed2003

The dorsal flap of the first web.

In the first web space region, there are communications between the dorsal arteries which arise from the dorsal branch of the radial artery and the digital arteries of the thumb and the index finger. These allow a distally based flap to be raised in the first dorsal intermetacarpal area. This flap has been used in 15 cases of soft-tissue loss from the thumb and index finger. The donor sites were closed primarily in all but two patients. There were no complications, and the results show that this flap is useful for soft-tissue defects on the tip and the palmar and dorsal surfaces of the thumb. Moreover, it may be used as a "cross-finger" flap.

Adolescent↗
PubMed2003

["Square sail" flap in median nerve lesions at the wrist. Anatomical elements and review of twenty operated cases].

INTRODUCTION: Following an anatomical study on the vascular supply of the upper limb, we propose a new adipo-fascial flap at the wrist. The fat pad of pronator quadratus lies over the muscle and is vascularised by a recurrent branch arising from the anastomotic "cross-road" of the anterior interosseous, radial and ulnar arteries, at the radio-carpal joint. The peripheral extensions of the adipose tissue have to be anchored to the palmar fascia of the muscle in order to hoist the flap as a "square sail". The flap is then distally rotated in order to cover the traumatized median nerve segment at the wrist, for 2.5-3 cm of length. METHODS: The authors present a review of the clinical applications (1995-2001) on painful neuromas of the median nerve at the wrist, where traumatic and iatrogenic injuries frequently occur. The surgical procedure consists of external neurolysis followed by coverage of the nerve using this vascularised flap. RESULTS: The results confirm the usefulness of vascularised fat flaps in creating an optimal perineural environment in terms of biological and mechanical quality. The advantage offered by this particular local flap is that it can be speedily raised. Because of its limited length the flap is only able to cover the median nerve at the level of the carpal tunnel: its indications are therefore very selective but not rare, due to the frequency of median nerve injuries at this level. DISCUSSION: Clinical results were very satisfactory: in the twenty cases reviewed, resolution of the symptoms of algodystrophy and causalgia was consistently observed, sometimes to an extraordinary degree, and associated with an improvement in the neurological deficit.

Adipose Tissue↗
PubMed2002

Effects of deep brain stimulation and levodopa on postural sway in Parkinson's disease.

OBJECTIVE: To quantify postural sway in subjects with Parkinson's disease and elderly controls, and determine the effects of Parkinson's disease, deep brain stimulation, levodopa, and their interactions on postural control during quiet stance. METHODS: Centre of foot pressure (CoP) displacement under each foot was measured during three 60 s trials of quiet stance with eyes open in 11 controls and six patients with Parkinson's disease. Subjects with Parkinson's disease were tested in four treatment conditions: off both deep brain stimulation and levodopa (off condition); on deep brain stimulation; on levodopa; and on both deep brain stimulation and levodopa. The variables extracted from CoP included: root mean square distance (rms), mean velocity, 95% power frequency (f(95%)), area of the 95% confidence ellipse (ellipse area), direction of its major axis (mdir), and postural asymmetry between the feet. RESULTS: rms and area of postural sway were larger than normal in subjects with Parkinson's disease in the off condition, increased further with levodopa, and significantly decreased with deep brain stimulation. Mean velocity and f(95%) were also larger than normal but were restored to normal by all treatments, especially by deep brain stimulation. The combined effect of deep brain stimulation and levodopa resulted in a postural sway that was an average of the effect of each treatment individually. Levodopa increased sway more in the mediolateral than in the anterior-posterior direction. Subjects with Parkinson's disease had asymmetrical mean velocity and f(95%) between the feet, and this asymmetry increased with levodopa but decreased with deep brain stimulation. The f(95%) of the CoP correlated with tremor, posture, and gait subcomponents of the unified Parkinson's disease rating scale. CONCLUSIONS: Subjects with Parkinson's disease have abnormal postural sway in stance. Treatment with levodopa increases postural sway abnormalities, whereas treatment with deep brain stimulation improves postural sway. Quantitative evaluation of static posturography may be a useful adjunct to clinical measures in patients with Parkinson's disease.

Aged↗
PubMed2001

[Antecubital flap: advantages in elbow coverage. An anatomical study and experience of five clinical cases].

The antecubital flap is a fasciocutaneous strip that has its blood supply provided by the first proximal collateral of the radial artery. This flap was described for the first time in 1983 by Lamberty and Cormack, but it has not been widely used and there have been only a few reports in the literature concerning this procedure. The aim of the present investigation was to demonstrate via an anatomical study and a report on five cases the viability of the various anatomical features of this cutaneous flap, and also its positive contribution to elbow reconstruction. The anatomical study involved eight fresh cadavers (eight upper limbs). An injection of colored prevulcanized latex was made in the humeral artery in the lower third of the arm. The aim was to determine which artery provided blood supply to the flap, its anatomical location, and also to look for possible distal anastomoses which would permit a distal pedicled flap to be removed. Contrary to the findings of other authors, in the present study it was found that the vessel providing blood to the antecubital flap always branched off from the radial artery. However, no anastomoses with distal vascularization were detected, which would have permitted a distal pedicled flap to be obtained. The use of the antecubital flap for elbow coverage was then illustrated by five clinical cases of soft tissue defects of the elbow. This method was found to be reliable, practical, and the flap could be rapidly dissected. Moreover, this particular technique is sensitive, and has an interesting rotational arc. The distal cutaneous island flap has the advantage of limiting scar tissue. A comparison between the antecubital flap and other pedicled flaps has then been made. In conclusion, it appears that this little-known procedure has definite advantages, and that it should be included in the range of surgical techniques that are available for soft tissue reconstruction in the case of elbow defects.

Adult↗
PubMed1998

Acute promyelocytic leukaemia: epidemiology and risk factors. A report of the GIMEMA Italian archive of adult acute leukaemia. GIMEMA Cooperative Group.

Acute promyelocytic leukaemia (APL) exhibits peculiar epidemiological, clinical, cytogenetic and molecular features, compared to the other acute myeloid leukaemias (AML). Data on epidemiology and occupational risk factors for APL desumed from the GIMEMA archive are reported and compared with those of the other AML. An exploratory case-case study was designed on AML patients from 56 haematology centres in Italy. Overall, 4296 patients older than 15 yr with a new diagnosis of acute leukaemia were recorded between July 1992 and July 1997. Of these, 335 were classified as APL, and 2894 as other AML. The median age of APL patients was 43 compared to 59 yr for the other AML (p < 0.00001). In order to identify peculiar risk factors for APL development, different parameters were compared in the 2 groups. After adjusting by age no significant differences were observed with regard to education, lifetime prevalence of cancer among siblings and previous diseases in the patient's history. Occupational exposure as a possible risk factor for APL showed no increased risk compared to other AML among farmers, builders and leather workers. A significant association was found in electricians (OR=4.4, 95% CI=2.0-9.7) and a weak association was found in wood workers (OR=3.2, 95% CI=0.8-10.8). The proportion of APL with respect to other AML was significantly higher in the north east of Italy compared to the rest of the country (OR=1.7, 95% CI=1.3-2.2). These data confirm the younger age of APL patients compared to the other AML. A possible role of electromagnetic fields is suggested by the higher risk of APL in electrical workers and in the more industrialized areas of the country.

Adolescent↗
PubMed1997

Buflomedil interference with the monoclonal EMIT d.a.u. amphetamine/methamphetamine immunoassay.

The interference of buflomedil with the monoclonal and polyclonal EMIT d.a.u. amphetamine immunoassays was investigated. Urine samples collected from 20 patients taking 600 mg of buflomedil daily gave false positive results with the monoclonal EMIT d.a.u. assay, as did urine specimens collected 2 hours after the first oral dose of buflomedil. Conversely, no false positive results occurred with the polyclonal EMIT d.a.u. amphetamine assay. Urine samples with buflomedil added at concentrations greater than 100 mg/l gave false positive results with the monoclonal immunoassay. Buflomedil concentrations found in the patient urines (56-400 mg/l) failed to correlate to EMIT assay responses: this result suggests that one or more buflomedil metabolites, besides the unchanged drug, probably interfere in the monoclonal EMIT d.a.u. assay.

Adult↗
PubMed1991

Telethermography and Raynaud's phenomenon.

A Raynaud's Phenomenon reported by a young female athlete in concomitance with a traumatic injury occurred during her gymnastic performance is described. Discussion is carried out taking into account the recent acquisitions about the pathophysiology of this syndrome.

Adolescent↗
PubMed1989

Telethermographic evaluation of NSAIDs in the treatment of sports injuries.

In a multicenter double-blind clinical trial, forty-five athletes, 39 males and 6 females, mean age 20.87 yr (SD 4.48), affected by sports injuries were treated with diclofenac, suprofen, or placebo, orally administered for a period of 1 wk. An objective examination like telethermography was performed with the clinical evaluations (pain on movement or at pressure, motility, and swelling) before and after the treatment period, in all patients. Moreover, at the end of the trial both investigator and patient gave their global judgement of efficacy. The statistical analysis showed a significant superiority of diclofenac sodium versus suprofen and placebo both in patients' and in investigators' global evaluations (P less than 0.05--Kruskal-Wallis tests). This superiority appeared particularly clear in the telethermographic evaluation (P less than 0.05), which is more objective than the clinical one, attesting to the usefulness of the early administration of anti-inflammatory drugs in management of sports injuries. Furthermore, a correlation analysis showed that telethermography is a good technique in controlling the recovery process.

Adult↗
PubMed1988

EMG computerized analysis of localized fatigue in Duchenne muscular dystrophy.

EMG power spectra obtained during a sustained isometric contraction were analyzed in a group of 10 children affected by Duchenne muscular dystrophy (DMD) and compared with those obtained in a control group of 5 normal children. In myopathic subjects the isometric contraction caused an increase of the total power, a progressive increase of power of the lower frequencies, a decrease of that of the higher frequencies, and a shift downward of the median frequency. In normal children an increase of the total power without a significant median frequency shift was noted. The modifications observed in DMD children were explained by a decrement of the firing rate of the more damaged fast twitch motor units. This decrease was probably induced by a relative predominance of activity of the slow twitch motor units, which are less damaged by the pathological process.

Child↗