Biomedical subjects
Publications and source records attributed to M Fiori.
The authors report the case of a man with acquired immune deficiency syndrome (AIDS) who was admitted to the hospital because of an organic mental syndrome with affective and delusional features.
The diagnosis of depression has traditionally been based on clinical history and behavioral observations. While objective laboratory tests will further our understanding of the pathophysiology and perhaps aid in the management of depression, a critical examination of the application of these techniques in clinical psychiatry is warranted by their increasing use. The utility for clinicians of the dexamethasone suppression test (DST), urinary MHPG assay, and tricyclic antidepressant plasma level assay is reviewed.
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Histochemical and biochemical evaluation of cerebral tissue fibrinolysis following cranioencephalic trauma was studied in 20 cases seen at necropsy, with varying periods of survival after injury. Fibrinolysis was mainly located at the vasal intima and was very intense in areas rich in vascularised connective tissue, such as the dura mater. Its activity diminished soon after injury to reach minimum values during the first day. Thereafter it remained at very low levels in sites with gross lesions, whereas it returned to nearly normal values elsewhere on the 2nd or 3rd day. Attention is drawn to the territorial character of this pattern. Extension of these results to the fields of diagnosis and treatment, however, is considered premature.
DNA sequences from BK virus have been detected by measurements of reassociation kinetics in DNA preparations isolated from five of 12 human tumor tissues and three of four human tumor cell lines; no DNA sequences from BK virus could be found using the same assay in DNA samples obtained from nontumor tissues removed from various patients. Whether or not this association is trivial, indicative of infection by BK virus, or correlative with the tumor state must await the testing of additional samples of normal and tumor tissues as well as a definition of the physical state of the genome of BK virus.
OBJECTIVE: To evaluate the clinical effectiveness of contact transscleral cyclophotocoagulation (CTCP) with diode laser. DESIGN AND PATIENTS: Forty-eight seeing eyes and 20 blind and painful eyes of 68 patients suffering from refractory glaucoma were treated using a diode laser (EOS3000, Laser Science) coupled with a 400-microns optic fiber ending in a 3-mm focusing tip. Sixteen to twenty 3.9-J (2.6 W x 1.5 to 2.5 s) laser spots were placed over 360 degrees, 1.5 mm from the corneolimbal junction. RESULTS: In the seeing-eye group, the follow-up was 20.7 +/- 8.14 months, pre- and posttreatment IOPs were 37.1 +/- 11.27 and 19.5 +/- 8.73 mmHg respectively (p < 0.0001), and success (IOP > 2 and < or = 21 mmHg) was 70.8%. No significant visual acuity change was found in the successful eyes, whereas a significant visual acuity reduction was found in the unsuccessful cases (p = 0.03). In the blind-eye group, the follow-up was 20.5 +/- 8.54 months, pre- and post-treatment IOPs were 50.7 +/- 15.05 and 20.6 +/- 13.99 mmHg respectively (p < 0.0001), and success (remission of pain) was 100%. As for complications, one seeing eye developed a spontaneously-resolved vitreous hemorrhage and one seeing and one blind eye became hypotonic, though no phthysis was observed. No conjunctival or lens damage was detected, and no scleral thinning was revealed by ultrasound biomicroscopy. No case of sympathetic ophthalmia was found. CONCLUSIONS: Diode laser can be successfully employed for CTCP in refractory glaucoma.
PURPOSE: Viscocanalostomy is a new, non-penetrating procedure for glaucoma surgery. We started a prospective study to assess the effectiveness and safety of the operation. Materials and methods. Up to March 1998 we enrolled 33 patients (33 eyes) suffering from glaucoma, uncontrolled despite maximum medical therapy, who underwent viscocanalostomy according to Stegmann's technique. A complete ophthalmological examination was performed the day before surgery and on days 1 and 7 postoperatively. Further visits were scheduled at months 1, 3, 6 and 12. RESULTS: In four eyes Schlemm's canal was either missed or not deroofed properly, and the procedure was converted into simple trabeculectomy. After a mean follow-up of 3.0 +/- 2.6 months (range 1-10), success defined as IOP > 2 and < 21 mmHg with no medication was obtained in 86.2% of the cases (25/29); 23 out of 29 eyes (79.3%) had IOP > 2 and < 16 mmHg. In the 25 successful eyes, mean IOP was 27.7 +/- 9.5 mmHg (range 13-48) preoperatively and 12.0 +/- 3.0 mmHg (range 7-18) (p < 0.0001) at the end of the follow-up period. Mean VA ranged from 0.35 +/- 0.34 to 0.32 +/- 0.32 (n.s.). Intraoperative complications included: Descemet rupture (7), with iris plugging in two cases; choroidal deroofing (3), irregular incision of Schlemm's canal (2). Postoperative complications included: self-resolving 2-mm hyphema (4); IOP spike (1); inadvertent filtering bleb (2); hypotony with choroidal detachment for one week (1). CONCLUSIONS: In this short-term study, viscocanalostomy proved effective and safe in lowering IOP in glaucomatous eyes.
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BACKGROUND: The majority of patients with hepatocellular carcinoma (HCC) cannot undergo surgery because of multifocality, location or advanced cirrhosis. Our experience with percutaneous radiofrequency ablation for treatment of patients suffering from unresectable hepatocellular carcinoma is described here. PATIENTS AND METHODS: Fifteen patients (ten men and five women) with eighteen primary hepatocellular tumors underwent percutaneous radiofrequency ablation. The mean diameter of the HCCs was 32 mm (ranging from 15 mm to 62 mm). The patients were treated under ultrasound guidance using either a 18-gauge internally cooled electrode or a 14-gauge electrode with four expandable hooks. RESULTS: Complete necrosis was achieved in 15 lesions after one session of RF ablation. The persistence of a small portion of viable tissue was seen in two lesions. One lesion was not evaluable. After a mean follow-up period of 9.2 months (range 3-24 months), eleven patients (76%) showed no sign of local or distant recurrence, one patient developed a new lesion and one of two patients with persistence of viable tissue obtained a complete necrosis after the injection of percutaneous ethanol. Moreover, a major complication (intraperitoneal bleeding requiring surgical treatment) and three minor complications (1 pleuric effusion and 2 perihepatic fluid collections that resolved spontaneously) were observed. CONCLUSION: RF ablation is a simple, well-tolerated and effective procedure for the treatment of unresectable hepatocellular carcinomas.
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We have carried out the first study in Italy on the cognitive remediation by a new computerized system developed by IBM and called THINKable. Statistical analyses revealed that on some measures there was a significant improvement in the level of performance of the subjects at the time of the posttreatment assessment compared with the pretreatment assessment. Disorders of memory and higher cognitive functioning improved by structured retraining, independently of attention. Improvement has been matched by changes in the patients real-word functioning. Senile patients also took advantage from cognitive training. They were already followed before as outpatients and had no spontaneous recovery. The role of personal computers in neuropsychological training is discussed.
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