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M D'Arienzo

Publications and source records attributed to M D'Arienzo.

16 recordsLinked to original sources
PubMed2006

High volume and low concentration of anaesthetic solution in the perivascular interscalene sheath determines quality of block and incidence of complications.

BACKGROUND AND OBJECTIVE: In the perivascular sheath of the brachial plexus, the volume of anaesthetic solution determines the quality of anaesthetic cover. Fibrous septa may divide the perivascular space into compartments, leading to inadequate diffusion of the anaesthetic solution. The aim of our study was to obtain good anaesthesia and less complications using high volume of low concentration anaesthetic solution, overcoming the obstacle of the septa with a double approach to the scalene sheath. METHODS: Sixty patients scheduled for shoulder capsuloplasty received both Winnie interscalene brachial plexus block and Pippa proximal cranial needle approach. The patients were randomly assigned to two groups. A constant dose of local anaesthetic was administered to each group: Group I (30 patients) received high volume (60 mL of anaesthetic solution) and Group II (30 patients) received low volume of solution (30 mL of anaesthetic solution). Sensory and motor block in the upper limb and complications were evaluated. RESULTS: In all the patients the quality of anaesthesia obtained at the surgical site was excellent. In Group I also the areas supplied by the medial cutaneous nerves of the arm and forearm, ulnar, median and radial nerves were blocked (P < 0.002). Complications were only observed in Group II and consisted of bradycardia and hypotension (66% of the patients) and phrenic nerve paresis (27% of the patients). CONCLUSIONS: The lower concentration of the anaesthetic solution avoids complications while increased volume provides good analgesic cover. The combination of the Winnie interscalene plexus block and the Pippa proximal cranial needle approach should contribute to fill up the scalene sheath overcoming the septa obstacles.

Adrenergic Agonists↗
PubMed2006

MRI quality control tools for procedures and analyses.

Quality control in MRI includes acceptance tests on the installation of a new scanner and tests representative of the system's performance during clinical practice. The first tests are time consuming and carried out to evaluate the agreement of the system with the prescribed procurement specifications. The second tests identify the equipment malfunction requiring maintenance are not time consuming and are suited to a busy clinical scanner. The paper evaluates the feasibility of the AAPM protocols (1,2) and proposes procedures and practical tools to achieve this purpose. The MRI images, captured from the scanner and transferred in DICOM (Digital Imaging and Communications in Medicine) format by a local network, are analyzed by computerized worksheets and commercial software.

Calibration↗
PubMed2000

The Ilizarov fixator in trauma: a 10-year experience.

We reviewed the clinical results of 332 fractures treated with the Ilizarov external fixator between 1984 and 1993. The locations of the involved bones were: tibia, 247 (including 28 with tibial pylons); femur, 47; humerus, 21; forearm, 12 and calcaneus, 5. The clinical outcomes of this series were retrospectively evaluated by radiological and clinical rating systems. In the tibial fractures, results in 71.1% were categorized as excellent or good, without deep infection; 63.3% of the tibial pylon fractures, mostly open, also showed excellent or good results. In the femoral fractures, which were mostly localized at the metaphysis or distal epiphysis, 72% showed excellent or good results, but the patients com-monly complained of knee stiffness. Limitations of range of movement (ROM) in the elbow and the wrist were common in patients with forearm fracture, but ROM was regained after physical therapy. According to the clinical results of the present study, we believed that Ilizarov external fixation was best indicated for tibial fractures, because of its advantage of allowing early weight-bearing. Ilizarov external fixation was also best indicated for: (1) open fractures, (2) comminuted fractures, (3) intra-articular fractures, and (4) fractures with bony defect.

Adolescent↗
PubMed1999

Bilateral acetabular fracture without trauma.

In the absence of trauma fracture of the acetabulum is an extremely rare injury. We describe a 70 year old man who spontaneously developed fractures in both acetabulae due to bony insufficiency. It was successfully treated by bilateral total hip replacement.

Acetabulum↗
PubMed1991

[Ledderhose's disease].

The authors describe the clinical appearance of Ledderhose disease and emphasize the association with Dupuytren disease. They report on a series of patients treated at the 2nd Orthopedic Unit of University of Florence and describe the operating technique used. They believe that the procedure of removal of nodules must always be performed in association with careful exeresis of normal tissue, employing total aponeurectomy only in revision surgery.

Adult↗
PubMedDate not supplied

The surgical treatment of spinal cord compression caused by tumorous metastases. A review of 91 cases.

Spinal cord compressions as a result of metastases are of considerable importance with regard to the quality of life and life expectancy of the cancer patient. Although surgical treatment has contributed to a considerable improvement in the life conditions of these patients, some questions still exist, particularly with regard to the choice of the time to operate. Thus, a total of 91 patients submitted to decompression were studied, taking into consideration different factors such as anatomo-radiographic findings, temporal parameters regarding occurrence of compression, and relative neurologic findings. Compression was incomplete in 44% of cases, complete in 45%, and complete with vertebral collapse in only 11%. Furthermore, it was observed that the group with partial compression included the lowest percentage of patients who resumed walking (57.5%), as compared to those with complete block (65.85%), or complete block associated with vertebral collapse (70%). This contradiction is confirmed by the observation that the resumption of walking was longer in cases with total block as compared to those with partial block. These results, apparently paradoxical ones, may be explained on the basis of the different duration of compression in the two groups. In fact, if we analyze the data relative to the interval of time between the occurrence of neurologic symptoms and surgery, we observed that patients with partial block were those in which surgical indications were made a longer period of time after the onset of symptoms. Surgical indications must be made at the first sign of deficit, regardless of the degree of compression present in the radiologic documentation, in order to avoid the transformation of reversible functional medullary changes into irreversible structural lesions.

Adolescent↗