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M Caroli

Publications and source records attributed to M Caroli.

At least 19 recordsLinked to original sources
PubMed1997

Management of head-injured patients in the emergency department: a practical protocol.

BACKGROUND: The management of head-injured patients admitted to emergency departments is not standardized. METHODS: The authors performed a retrospective analysis of 10,000 head-injured patients admitted to the Emergency Department of our hospital in a 21-month period and, on the basis of a statistical correlation between each clinical parameter (symptoms and signs upon arrival at the hospital or risk factors) and the presence of intracranial lesions, they propose a practical protocol in an attempt to avoid the overuse or radiologic examinations and yet identify patients with possible life-threatening complications. RESULTS: On the basis of this correlation the patients have been divided into four groups. In the first group (called group alpha) are patients with: no history of loss of consciousness, no vomiting or amnesia, a normal neurologic examination, and minimal if any subgaleal swelling. They can be released into the care of relatives who are given a special instruction sheet (X rays unnecessary). No patient in group alpha had complications of any kind. The second group (group beta) is made up of patients with at least one of the following features: transient loss of consciousness, post-traumatic amnesia, a single episode of vomiting or significant subgaleal swelling. They undergo a computed tomography (CT) scan and if this is normal, only a short period of observation is needed. If CT scan is not available, the skull is X rayed and, if this X ray is negative, the patient is sent home with the warning sheet after an observation period. If a fracture is found, CT scan should be performed promptly. No patient in group beta with normal skull X rays developed intracranial lesions. The third group (group gamma) contains patients with at least one of the following symptoms: impaired consciousness, repeated episodes of vomiting, neurologic deficits, otorrhagia, otorrhea, rhinorrea, signs of basal skull fracture, seizures, penetrating or perforating wounds, lack of cooperation for varying reasons, patients who have undergone previous intracranial operations or been affected by coagulopathy or submitted to anticoagulant therapy, and finally, epileptic or alcoholic patients. They receive a CT scan immediately and, if necessary, again prior to discharge. Six patients in group gamma with GCS = 15 upon admission were operated on for intracranial hematoma. The fourth group (group delta) is composed of comatose patients. Immediately following resuscitation maneuvers and prior to any surgical intervention, they undergo a CT scan. A linear association between the severity groups and the presence of intracranial lesions has been demonstrated. CONCLUSIONS: The present protocol stresses the importance of the patient's clinical and anamnestic evaluation upon arrival in the Emergency Department, especially in minor head injuries.

Adolescent↗
PubMed1997

A new 1-week therapy for Helicobacter pylori eradication: ranitidine bismuth citrate plus two antibiotics.

BACKGROUND: One-week triple regimens are currently the most recommended therapy for the eradication of Helicobacter pylori. No previous study has evaluated the efficacy of a short-term regimen combining ranitidine bismuth citrate with two antibiotics. METHODS: Seventy-two consecutive H. pylori-positive dyspeptic patients were recruited for this randomized, three-centre, open, parallel-group study. They were subdivided into two groups receiving either ranitidine bismuth citrate 400 mg b.d. + clarithromycin 250 mg b.d. and metronidazole 500 mg b.d. (group A) or ranitidine bismuth citrate 400 mg b.d. + clarithromycin 250 mg b.d. and metronidazole 250 mg q.d.s (group B) for 1 week. H. pylori infection was assessed by CLO-test and histology on both antral and corpus biopsies before and at least 4 weeks after the end of therapy. The bacterium was considered eradicated when both tests were negative. Eradication rates and the number of side-effects were evaluated in each group. The Chi-squared test was used for statistical analysis. RESULTS: One patient with only CLO-test positivity was erroneously randomized to group B and four patients dropped out of the study (two in group A and two in group B), mainly because they refused the second endoscopy. In group A, H. pylori was eradicated in 31 of 36 patients (intention-to-treat = 86%; 95% CI = 71-95% and per protocol 31/34 = 91%; 95% CI = 76-98%). Side-effects occurred in 10 patients (27%) and they were generally mild. In group B, H. pylori was eradicated in 29 of 35 patients (intention-to-treat = 83%; 95% CI = 66-93%; and per protocol 29/33 = 88%; 95% CI = 72-97%). Seven patients (20%) complained of modest side-effects. There was no significant difference between the two treatment arms (P = N.S.): no severe adverse events occurred and none of the patients was withdrawn from the study because of them. CONCLUSIONS: The co-administration of ranitidine bismuth citrate plus clarithromycin at low dosage and metronidazole in twice daily doses for 1 week is a short, effective and well-tolerated regimen for the eradication of H. pylori. These findings should provide the impetus for large-scale investigations.

Anti-Bacterial Agents↗
PubMed1996

Trace elements in hair of healthy children sampled by age and sex.

Hair trace element (TE) (Cr, Mn, Fe, Zn, Cu, Br, Rb, Sr, Pb) levels from 336 healthy subjects were measured by the Proton-Induced X-ray Emission (PIXE) method. The subjects were divided in three groups: 157 full-term neonates (75 male and 82 female), 86 children (41 male and 45 female) ages 6 to 11 yr, and 93 adolescents (51 male and 42 female) 11 to 16 yr old. Cu, Zn, Cr, and Br show an increase from birth to 8 yr and then decrease. Fe, Mn, and Sr strongly decrease up to 8 yr and then remain almost stable. Sex differences are present in Fe, Zn, and Br of children and in Cu, Cr, and Br of adolescents.

Adolescent↗
PubMed1995

Enterogenous cyst of the cervical canal: report of a case in a 68-year-old woman and review of the literature.

A case of a cervical enterogenous cyst in a 68-year-old woman with associated vertebral malformation is presented. The diagnostic value of Magnetic Resonance Imaging, positive reaction to Periodic-Acid-Schiff and immunohistochemical staining for carcinoembryonic antigen are emphasized. The literature is reviewed: controversies about embryogenic theories and classification of these lesions are discussed.

Aged↗
PubMed1994

Hypertension prevalence and age-related changes of blood-pressure in semi-nomadic and urban Oromos of Ethiopia.

We evaluated the prevalence of hypertension and the age-related behaviour of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a wide sample of male and female Ethiopian Oromos living in rural or pre-industrial urbanized settings. Blood pressure (BP) was measured in the sitting position after 5 min rest in 5277 Oromos. In the group, 4928 were semi-nomadic shepherds, while 349 came from a town of 60,000 inhabitants where they were involved in low-technology jobs. The first subgroup was composed of 2482 men and 2446 women. All subjects were divided into 3 age groups: 15-44, 45-64, and > or = 65 years. Body weight (BW) and the Quetelet index (QI) were matched to BP levels using Pearson's method. In semi-nomadic men, SBP was 121.4 +/- 8.4 mmHg versus 132.4 +/- 10.4 mmHg in urban men (p < 0.001). In women, SBP was 120.5 +/- 7.9 mmHg versus 128.1 +/- 10.1 mmHg (p < 0.001). The prevalence of hypertension was 0.40% in the semi-nomadic and 3.15% in the urban population. In the latter, significant increases in BW and QI were found, which were significantly correlated to both SBP and DBP. In semi-nomadic men, a 5.33% increase in SBP and a 5.22% in DBP was found between age groups 1 and 2 (p < 0.001 in both). In urban men the increase was 4.77% and 3.41% respectively (p < 0.001). In both male populations no difference in SBP and DBP was observed between age groups 2 and 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Intracranial meningiomas in patients over 70 years old. Follow-up in operated and unoperated cases.

Forty-six cases of intracranial meningioma in patients above 70 years of age form the basis of this study; 34 underwent surgery while 12 did not. The decision to operate was based on the general condition of the patient, evaluated according to the Karnofsky index, neurological conditions, the site and dimensions of the tumor, and the presence of peritumoral edema. The post-surgical mortality rate was 11.5% at 30 days, and 20% at 3 months. Long-term follow-up in both patient groups ranged from 1 to 5 years, and quality of life was evaluated by the Karnofsky index. Five operated patients died during follow-up (only 1 from intracranial pathology); the 22 survivors showed further improvement in their grading level compared to scores immediately following surgery. Among the unoperated patients, 6 died within two years of diagnosis, all from causes related to intracranial pathology; among the survivors, the Karnofsky index was unchanged in 2, and diminished in the other 4 cases.

Aged↗
PubMed1992

Recurrence of brain abscess associated with asymptomatic arteriovenous malformation of the lung.

On the basis of the data provided by literature the majority of patients with an arteriovenous malformation of the lung who develop a brain abscess suffer from hereditary hemorrhagic telangiectasia, or Rendu-Osler-Weber disease. Only nine cases of brain abscesses in which the arteriovenous malformation of the lung was isolated have been described and in all of these, clinical signs and/or alterations in the laboratory data were detected which can be attributed to the arteriovenous malformation itself. The case taken in this article would seem to be the first case of a recurrent brain abscess in a patient not suffering from Rendu-Osler-Weber with a completely asymptomatic arteriovenous malformation of the lung, both from the clinical point of view and from laboratory data. The authors stress the appropriacy of an angiographic pulmonary study in cases of recurrent brain abscesses, even where the chest X-ray has been negative.

Adult↗
PubMed1992

[Neurosurgical aspects of urologic metastases].

Metastases in the central nervous system (C.N.S.) from urological tumors can be spinal or craniocerebral. The experience of 30 patients with spinal and craniocerebral metastases from urological tumors admitted to Neurosurgical Clinic of the University of Milan, is reported. They were 7.5% of the all number of metastases admitted at the Neurosurgical Department, during the same period. The brain metastases constitute 10% of brain metastases diagnosed in this period. Only patients with solitary (to CT scan and NMR) metastasis, and with a general prognosis that allow to an adequate and useful period of survival, are submitted to surgical treatment. 23 patients (76.6%) are surgical treated. The mean survival from the discovery of the C.N.S. metastases was 9 months (9.4 months among surgically treated patients and 7.8 months among those were not operated). Surgical mortality was 13%. Out of patients with survival until 5 months, patients submitted to surgical treatment showed a better quality of life. Our results allow us to affirm that in selected patients surgical removal of solitary metastases, could improve the quality of survival, but is not able to prolong substantially the period of survival.

Adult↗
PubMed1991

Depletion of calcitonin gene-related peptide in perivascular nerves during acute phase of posthemorrhagic vasospasm in the rabbit.

The behaviour of various neuropeptides during early and late vasospasm following experimental subarachnoid hemorrhage has been investigated by several authors. Recently, a reduction of the content of vasodilatory neuropeptides (vasodilatory intestinal peptide, substance P and calcitonin gene-related peptide) has been demonstrated in the perivascular nerves of cerebral arteries after few days from induction of experimental subarachnoid hemorrhage. In the present immunohistochemical study, the authors investigated secretion and expression of CGRP a few minutes after injection of autologous blood into the cisterna magna of the rabbit. The authors propose that the marked decrease of calcitonin gene-related peptide immunoreactivity in the perivascular nerves, observed after experimental subarachnoid hemorrhage, is due to compensatory secretion of the peptide.

Animals↗
PubMed1990

Treatment of intracranial meningiomas in patients over 70 years old.

The neurosurgeon often finds himself in the position to having to decide whether or not to operate on an elderly patient suffering from intracranial meningioma. The decision is rarely easy and the results often disappointing. We studied 46 cases of intracranial meningioma in patients over 70 years of age, 34 patients were operated on while 12 patients were not, although both groups were subjected to long term follow-up. The operative mortality rate was 12%, a rate which increased to 20% at 3 months follow-up. Various unfavourable prognostic factors were taken into consideration, the most significant of which were: poor overall clinical condition, peritumoral oedema, the presence of diabetes mellitus and the duration of surgery. A scored grading system was created to standardize surgical indications in elderly patients with cerebral meningioma. An analysis of the grading system, when applied to patients submitted to surgery, showed that the decreased patients within 3 months of surgery had a score which varied from 7 to 12, with a mean score of 10. The surviving patients had a score averaging from 10 to 16 with a mean of 13. The patients with the lowest scores (7-9) had a 100% mortality rate while those in the upper ranges (13-16) demonstrated a mortality rate of 0%. Among the conservatively treated patients the worst outcome was seen in patients with a grading equal to or less than 12.

Aged↗
PubMed1989

Obesity.

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Child↗
PubMed1987

Solitary plasmacytoma of the calvarium: two cases treated by operation alone.

Two cases of solitary plasmacytoma of the calvarium operated on with radical removal are reported. The two patients were not submitted to postoperative radiotherapy, unlike other cases reported in the literature. The authors stress that solitary plasmacytoma of the calvarium may have a good prognosis if radically removed, and in these cases radiotherapy is not necessary.

Adult↗