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Biomedical subjects

L Vismara

Publications and source records attributed to L Vismara.

7 recordsLinked to original sources
PubMed2001

Attachment processes in eating disorders.

Anxious and insecure attachment, fear of abandonment and difficulties with autonomy differentiate young women with eating disorders from their normal peers. This paper uses the Adult Attachment Interview (AAI) as the correlation between eating disorders and state of mind regarding attachment (7 females and 6 males) with anorexia nervosa and EDNOS. There was a higher frequency of dismissing or entangled states of mind. The sample is far too small to allow statistical inferences to be drawn about differences between men and women in the style of state of mind regarding attachment. An inference is none the less made with regard to the role of psychotherapy in these results.

Adolescent↗
PubMed1998

[Percutaneous needle biopsy guided with computerized tomography of the chest. Personal experience with 1,605 cases].

INTRODUCTION: Fine-needle aspiration biopsy (FNAB) plays an important role in the diagnosis of lung diseases. We report the results of 1605 CT-guided chest biopsies performed September, 1992, to December, 1997, and introduce a new method for specimen storage and handling. MATERIALS AND METHODS: A lubricated flexible connection was placed between the needle and the syringe to cushion the improper movements transmitted on the needle by the operator during aspiration. 22-G needles were most frequently used. The pathologist's report included not only the presence/absence of tumor cells, but also the presence of suspicious/questionable cells, which latter finding led to another biopsy in 152 cases. RESULTS: 64.7% of the lesions were < or = 3 cm and 55.5% were < or = 2 cm. Pneumothorax occurred in 16.0% of cases and it required a chest tube in 5.0%. The specimens were not smeared on a slide but kept in a test tube and quickly sent to the pathologist. 84.3% of the specimens were adequate for diagnosis and special care was given to typifying microcytoma/non-microcytoma histotypes, because treatment is different. 1003 of 1313 cases (76.38%) were true positives, 192 (14.2%) true negatives, 101 (7.69%) false negatives and 17 (1.92%) false positives. Sensitivity was 90.85%, specificity 91.86% and diagnostic accuracy 91.01%. The positive and the negative predictive values were 98.3% and 65.5%, respectively. CONCLUSIONS: The use of a 60 mL syringe with a flexible connection reduces the rate of complications (eg, pneumothorax, bleeding) and also the biopsy time. It also improved the sampling accuracy, cushioning any possible inappropriate movement by the operator, and finally improved the material aspiration thanks to better vacuum than with the 20-30 mL syringes which are usually placed into biopsy guns.

Adolescent↗
PubMed1997

Unusual clinical features and early brain MRI lesions in a family with cerebral autosomal dominant arteriopathy.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a recently described inherited disorder. The pathologic gene maps on chromosome 19. The clinical spectrum of the disease consists of recurrent strokes, migraine, transient ischemic attacks, mood changes, and dementia. We report a genetically assessed CADASIL family with atypical clinical presentations of epileptic seizures. In two asymptomatic family members there were early brain abnormalities on MRI. Our report expands the clinical spectrum of CADASIL and suggests that it is possibly an undiagnosed disorder.

Adult↗
PubMed1996

Clinicopathological and genetic studies of two further Italian families with cerebral autosomal dominant arteriopathy.

We report on two Italian families with an early-adult onset autosomal dominant disorder, characterized by leukoencephalopathy, migraine, psychiatric disturbances, stroke and dementia. These findings fulfill the diagnostic criteria for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) syndrome. Moreover, to confirm the CADASIL gene location to 19p12, we performed a linkage analysis with four microsatellite markers. The results of the genetic study gave positive but not significant lod scores, indicating only weak evidence of a linkage with 19p12. In one autopsy case, we found extensive ischemic changes due to the selective involvement of the small muscular arteries of the cerebral white matter. The lesions consisted of a thickening of the media with deposition of granular eosinophilic material. Ultrastructural examination of the arterial walls showed graded damage to smooth muscle cells, mostly of the longitudinal layer, and an abnormal proliferation of basal lamina components. Immunocytochemical analysis showed strong reactivity using antibodies to collagen IV and smooth myosin proteins. The results suggest a primary involvement of the smooth muscle cells of small cerebral arteries, with a secondary alteration of basal lamina components and elastic tissue.

Adult↗