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Biomedical subjects

L Zanardi

Publications and source records attributed to L Zanardi.

12 recordsLinked to original sources

In vitro evaluation of the inflammatory activity of ultra-high molecular weight polyethylene.

To understand the inflammatory potential of oxidised ultra high molecular weight polyethylene (ox-UHMWPE) compared with the virgin one (UHMWPE), we analysed in vitro the predisposition of their interaction with plasma proteins and cells involved in the inflammatory response. The adsorption on the surface of the two materials of adhesion proteins (Fibronectin and Albumin), and pro-inflammatory proteins (IgG and IgA) have been studied. Moreover, we have evaluated the materials effect on complement activation and on macrophages and monocytes-neutrophils behaviour. The two UHMWPE chemical forms adsorbed all the proteins studied; the only difference was in complement activation. Enzyme immunoassay results evidenced higher levels of factor Bb and iC3b in plasma after the contact with the oxidised form. Physico-chemical properties of the oxidised UHMWPE affected the attachment of the cells as demonstrated by macrophages adhesion experiments. UHMWPE favoured only a limited peritoneal macrophages (PMs) spreading (round-shaped cells); the cell spreading and presence of microvilli on the cell membranes was evident in the case of the oxidised form, suggesting the activation of these cells on this chemical form. Ox-UHMWPE evidenced a statistically significative increase in chemiluminescence values respect to human unstimulated peripheral blood mononuclear cells, an index of increased cell release of reactive oxygen metabolites. In conclusion, UHMWPE oxidative degradation with its chemical modification induces monocytes-neutrophils chemiluminescence activation and PMs morphology changes correlated with macrophage activation, data consistent with the complement activation results obtained in this study; such modifications, along with changes in mechanical properties, are related to implant failure.

Adsorption↗

Enhancing vaccine safety surveillance: a capture-recapture analysis of intussusception after rotavirus vaccination.

The Vaccine Adverse Event Reporting System (VAERS) is the passive reporting system for postmarketing surveillance of vaccine safety in the United States. The proportion of cases of an adverse event after vaccination that are reported to VAERS (i.e., VAERS reporting completeness) is mostly unknown. Therefore, the risk of such an event cannot be derived from VAERS only. To study whether its reporting sensitivity and risks could be estimated, VAERS was linked to data from a case-control and a retrospective cohort study in a capture-recapture analysis of intussusception after rotavirus vaccination (RV). Cases of intussusception after RV were selected from the common time frame (December 1998 through June 1999) and the common geographic area (19 states) of the three sources. Matching occurred on birth date, gender, state, date of vaccination, and date of diagnosis. Thirty-five matches were identified among a total of 84 cases. The estimated VAERS reporting completeness was 47%. The relative risks of intussusception in the periods 3-7 and 8-14 days after RV (relative risk = 22.7 and 4.4, respectively) were comparable with those reported in the two studies. Linkage of VAERS to complimentary data sources may permit more timely postmarketing assessment of vaccine safety.

Adverse Drug Reaction Reporting Systems↗

[Clinico-instrumental assessment of swallowing in head injury rehabilitation].

During the phase of clinical and neurological stability following head injury, the recommencement of oral nutrition indicates not only the recovery of normal physiological function but is also closely correlated to the overall rehabilitation process and therefore represents a complex source of valuable stimuli in the context of a therapeutic and rehabilitation programme of the cognitive functions themselves. Before any attempt of oral feeding it is important to make a full clinical and instrumental evaluation of the swallowing process in order to diagnose any dysphagic problems and to assess the correct feeding method for the patient so as to avoid the severe sequelae caused by the penetration of food into the air paths.

Craniocerebral Trauma↗

Left atrial size in paroxysmal atrial fibrillation: echocardiographic evaluation and follow-up.

Echocardiographic measurement of left atrial size was performed in 24 patients (13 males, 11 females, median age 56 years) with idiopathic paroxysmal atrial fibrillation (IPAF). A second measurement was done, after a mean period of 20 months. Our study showed that: (1) the patients with IPAF had normal-sized atria, the dimensions of which remained unmodified over a 20-month period; and (2) no correlation was found between the frequency of recurrent arrhythmic episodes and left atrial size. Since atrial enlargement, which is the known risk factor for embolic stroke, was not observed in our patients, we conclude that patients with IPAF do not need anticoagulant therapy.

Adult↗

Early outcome prediction in severe head injury: comparison between children and adults.

The prognostic value in 49 children and 56 adults of the following parameters recorded on admission was analyzed: oculocephalic and light reflexes, posturing, Glasgow Coma Scale (GCS), the need for ventilatory support, and the presence of associated injuries. All patients had been in coma for at least 6 h. The presence of intracranial hematoma and the duration of coma were recorded and the relative risk of poor outcome calculated. There was poor outcome in 51% of the children and 61% of the adults. Oculocephalic and light reflexes, posturing, GCS, need for ventilatory support, and duration of coma were significantly related to the outcome in children. Only oculocephalic and light reflexes, and posturing were significantly related to the outcome in adults. Some parameters appeared to have different prognostic value in children and in adults: the simultaneous evaluation of oculocephalic reflex and need for ventilation was the best prognostic guide in children, the light reflex was the best prognostic indicator in adults.

Adolescent↗

Severe head injury in children: early prognosis and outcome.

The outcome is reported in 62 children with severe head injuries following a road traffic accident. All patients were comatose for at least 6 h; all patients were graded using the Glasgow Coma Score (GCS) or the Children Coma Score (CCS). Fifty-four patients were comatose immediately after injury, 8 after a lucid interval. Thirty patients had isolated head injuries and 32 had associated injuries, either long bone fractures or rupture of an abdominal organ. Additional information concerning main brainstem reflexes, posture and respiration was included in the study. The overall mortality was 32%. The goal of the study was to identify those clinical features available soon after injury which are important indicators of treatment and outcome.

Accidents, Traffic↗

Severe acute poisoning from the ingestion of a permanent wave solution of mercuric chloride.

1 A woman developed severe mercury intoxication from ingestion of about 2.5 g of mercuric chloride. 2 Antidotal treatment with a dithiol (BAL i.m.) and a monothiol (tiopronin i.v.) was started promptly. 3 Dialysis treatment thereafter markedly increased the elimination of mercury, thus hastening recovery. 4 It is suggested that chelating agents associated with dialysis are an effective treatment for mercury poisoning.

Dimercaprol↗

[Proposed method for double-blind study of reflexotherapy phenomena].

The Authors report their experience with the placebo, an essential step in the clinical study of reflexotherapy. They assert that also in this branch of medicine it is possible to carry out a "double blind" clinical experimentation by means of placebo, that is, an essential condition in order to develop a scientific assessment of both the limits and the potentialities of reflexotherapy.

Acupuncture Therapy↗

[Gow-Gates block for beginners].

The study was carried out with two groups of 49 patients to evaluate the incidence of failures and re-injections when the blockade of the mandibular nerve was carried out according to Gow-Gates by untrained young dentists. Such an incidence was compared to that of the blockade of the inferior alveolar nerve by the same dentists trained for this specific task. Both the observed failures and re-injections in the Gow-Gates blockade progressively decrease and disappear, theoretically, after 50 blockades, while they remain almost constant in the inferior alveolar nerve blockade. The induction of the blockade was more prolonged after the Gow-Gates blockade (9 minutes) compared to the inferior alveolar nerve blockade (7 minutes). The pain induced by the injection, that due to the anesthetic and that experienced during the subsequent surgery were lower after the Gow-Gates blockade.

Adult↗

[Double-blind analysis of the possibilities of the use of trazodone in sedation of ambulatory dental patients].

The sedative properties of trazodone were the object of a double blind study in dental out-patients, comparison being made with diazepam. It was observed that oral trazodone possesses considerable tranquillizing activity. It has no side-effects either after intake or during return home. The use of capsules containing 50 mg of trazodone is recommended. At this dose, sympathetic hyperactivity is also inhibited. Diazepam doses of 15 mg lead to mental sedation and inhibition of symptoms due to sympathetic hyperactivity but, unlike trazodone, diazepam possesses hypnotic acitivity and side-effects that make its use dangerous in patients who cannot be taken home by somebody else, or who have to drive a car.

Adult↗