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Biomedical subjects

M Floriani

Publications and source records attributed to M Floriani.

34 records · Page 2Linked to original sources
PubMed1984

Value of Doppler multi-level segmental pressure index in the diagnosis and hemodynamic characterization of totally occlusive aorto-iliac-femoro-popliteal lesions.

Four-level lower limb Doppler S.P.I. (upper thigh; above knee; below knee; above ankle) were evaluated in 275 limbs, 110 of which showed totally occlusive lesions at one or more levels of the aorto-iliac-femoro-popliteal axis on angiographic examination, 65 showed stenosis less than 50% (sclerotic controls) and 100 did not undergo arteriographic examination since they apparently had no lesions (healthy controls). Analysis of the results-carried out using the Student's t statistical method-showed a drop in the S.P.I. close to or over 0.30 between two adjacent levels and was indicative of the presence of an occlusion in the intermediate area. This method therefore allowed the presence and the position of an isolated lesion to be detected. In the case of multiple lesions in series, the proximal one is detected with certainty, whereas the more distal ones can be recognized but not their exact position and extension. Multiple lesions in series are more hemodynamically significant than isolated ones, and proximal lesions more than distal ones.

Aorta↗
PubMed1984

[Evaluation of HDL cholesterol in diabetes mellitus in relation to various types of therapy].

We have examined the HDL-cholesterol and the HDL-cholesterol/total cholesterol ratio on 83 diabetic patients within the age of 45 and 65 and on other 54 control subjects without finding troubles of carbohydrate and lipid metabolism. Important differences haven't emerged comparing these two groups as regards the studied parameters, so we can conclude the HDL-cholesterol doesn't seem to have a determinant value in the pathogenesy and in the quick evolution of the atherosclerotic manifestations in diabetes mellitus. Also when we have divided the diabetic patients into subgroups in relation with the kind of the made therapy and with sex, we haven't found any significant difference about HDL-cholesterol and the HDL-cholesterol/total cholesterol ratio. These data show that the oral therapy (sulphonylureas, biguanides + sulphonylureas) has no influence on the levels of HDL-cholesterol and on HDL-cholesterol/total cholesterol ratio in diabetes mellitus.

Administration, Oral↗
PubMed1980

[Somatosensory epileptic crises].

A retrospective study of 20 patients with somatosensory seizures is undertaken. The cases were obtained from the series of 1000 patient histories from the Division Epilepsy of the Neurological Institute of Montevideo. Several clinical variables are analyzed and especially the etiological factors are studied. A high incidence of surgical treatable causes was found (50%), especially tumor (35%). Similar results are reported by other authors. A comparative study concerning the tumor etiology in somatosensory and in other types of partial seizures is performed. It was found that tumors have the highest incidence of somatosensory seizures. The authors conclude that radiological studies must be undertaken in all cases of somatosensory seizures in seizures in which the underlying etiology is unclear, in order to rule out a surgical process. Computerized Tomography is at present the most important study, excepting those cases in which an arterio-venous malformation is suspected, which should be studied primarily by angiography.

Adolescent↗
PubMedDate not supplied

[Scintigraphy using 99m-TC HM-PAO labeled autologous granulocytes in the diagnosis of Whipple's disease].

Whipple's disease is a systemic disease, mainly localized in the small intestine, that even today shows some difficulties about its etiopathogenesis and diagnosis. The surveys usually used in the diagnosis, among which the biopsy is an indispensable test, have some limits particularly in follow-up. The 99mTc-HM-PAO labelled granulocytes scintigraphy may be a useful alternative method in the evaluation of location and extension of the Whipple's disease. Furthermore, as it is not an invasive method, 99mTc granulocyte scintigraphy may be an important means in establishing the term of the therapy mainly when other methods are not able to exactly confirm the remission of the disease.

Diagnosis, Differential↗
PubMedDate not supplied

Surgical treatment of lesions obstructing the external carotid artery.

Atherosclerotic lesions obstructing the external carotid artery are generally disregarded in the evaluation of patients with symptoms of cerebral ischemia; nevertheless, in the presence of occlusion of the ipsilateral or of both the internal carotid arteries, external carotid artery endarterectomy may be indicated, in order to increase the flow to the brain through collaterals. A lesion of the external carotid artery may be the source of retinal emboli; patients may benefit from surgical treatment of the lesion. The Authors of the present paper operated on 6 such patients, from a total of 230 carotid bifurcation endarterectomies performed in the period between January 1982 and March 1988. Morbidity and mortality were nil and 5 of the 6 patients are free of symptoms after a mean follow-up period of 23 months. One patient died 2 months after surgery due to a myocardial infarction. On the basis of this experience, the Authors discuss indications, surgical techniques and results of the surgical treatment of lesions obstructing the external carotid artery.

Aged↗
PubMedDate not supplied

[Doppler spectrum analysis and traditional angiography in the study of the extracranial tract of the internal carotid artery].

Examination of 88 extracranial carotid arteries using CW Doppler spectrum analysis is compared with the findings of transfemoral conventional arteriography. There is no significant difference (P greater than 0.05) between CWD and angiographic results, although sensitivity, specificity and accuracy are superior for the latter technique. CWD spectrum analysis can underestimate complete occlusion and misinterpret the degree of stenosis, however it is a cheap and rapid procedure that can be used to judge whether particular symptoms are due to identifiable disease and whether selective carotid arteriography is advisable.

Carotid Artery Diseases↗
PubMedDate not supplied

Direct and indirect evaluation of lesions obstructing the carotid bifurcation. A comparison of Doppler spectrum analysis with angiography.

The diagnostic accuracy of real-time continuous wave (c.w.) Doppler spectrum analysis and of indirect periorbital Doppler examination for detecting carotid bifurcation disease was evaluated. The results of non-invasive studies were compared with contrast arteriograms of patients studied for symptomatic cerebrovascular disease (91%) or for asymptomatic bruits (9%). Periorbital examination was insensitive to less than 75% carotid stenoses and sensitivity to severe stenoses or occlusions was respectively 56% and 85% (mean 73%). Mean sensitivity of real-time C.W. Doppler spectrum was 93% and sensitivity to stenoses of less than 45% diameter reduction was equal to 76%, while specificity in identifying normal carotid arteries was 89% for an accuracy of the method of 91%. Positive and negative predicting values were respectively 89% and 93%. Direct Doppler interrogation of the carotid arteries with real-time C.W. Doppler spectrum analysis was able to distinguish operable stenoses from inoperable occlusions in 87% of the cases.

Angiography↗
PubMedDate not supplied

Factors affecting prognosis in acute intestinal ischemia.

The anamnestic, clinical, laboratory, radiological and intraoperative data on 34 consecutive patients affected by acute intestinal ischemia or infarction, caused by superior mesenteric obstructive and nonocclusive pathology were collected and assessed. The aim of this study is the identification of the factors influencing the prognosis which in this disease is still really displeasing, with a mortality of over 90% in many surveys, and 73.5% in this report. The mean age of the 34 patients was 73. Cardiac ischemic disease and or arrhythmias were present in 83.8% of the patients. The most significant prognostic factors were those related to the evolutive stages of the intestinal ischemia. Among the anamnestic ones, the interval between the onset of the symptoms and diagnosis (mortality of 50% if less than or equal to 24 hrs., 86.4% if greater than 24 hrs.). Among the clinical factors, the presence of peritoneal signs was followed by a mortality of 82.3%, in contrast with the 33.3% when the same signs were absent. Also significant was the presence of shock (100% mortality), in contrast with 50% in patients presenting systemic systolic pressure greater than 100 mmHg. Extensive intestinal infarction caused a 100% mortality rate, while early revascularization allowed the survival of 81.8% of the patients treated in the absence of infarction or when irreversible ischemic damage was limited to less than 1 meter of bowel.

Acute Disease↗
PubMedDate not supplied

Intra-operative control of carotid thromboendoarterectomy by Doppler spectrum analysis.

The authors report their experience with intraoperative Doppler spectrum analysis of carotid flow after thromboendoarterectomy. The method seems to be useful in the early localisation of technical defects potentially responsible for postoperative stroke. In 22 patients operated on consecutively, three major abnormalities were detected, one of the internal and two of the external carotid. This enabled immediate reexploration of the involved artery with restoration of normal flow. This kind of examination is also safe, quick and highly accurate. The authors propose it as a substitute to intraoperative arteriography which is routinely performed by some surgeons after carotid thromboendoarterectomy.

Carotid Arteries↗
PubMedDate not supplied

[Doubling of the pre-beta lipoprotein band and coronary risk].

Lipoprotein electrophoresis on cellulose acetate was performed in a series of 100 diabetics in metabolic compensation. Distinct doubling of the pre-beta lipoprotein band was observed in 8 cases, but was no longer present in 3 of these 15 days later. Comparison of these subjects with 10 controls chosen at random, neither group displaying particular lipid composition changes nor significant atherosclerotic risk factors other than diabetes itself, showed that a correlation existed between such doubling and clinically demonstrable peripheral and/or coronary atherosclerosis.

Adult↗
PubMedDate not supplied

[Pancreatic and duodenal injuries. Considerations on 40 observed cases].

Traumatic lesions of the pancreas and duodenum are uncommon. The anatomic situation of the viscera makes early diagnosis of such lesions difficult to be achieved; this fact, together with the high incidence of associated lesions, justify the high morbidity and mortality of duodeno-pancreatic traumas. In the present paper we report the two-decades experience (40 traumatic lesions of the pancreas and/or the duodenum) of the Department of Emergency Surgery, University of Milan. The overall mortality (32.5%), even if correlated with the importance of the duodeno-pancreatic lesions, was strictly dependent to the presence of associated injuries which lead to most of the morbidity and mortality.

Adolescent↗
PubMedDate not supplied

[Gastric leiomyoblastoma: report of our case load].

Leiomyoblastoma of the stomach is a rare nosological entity (0.3% of all gastric tumors). During the last 13 years, the authors observed 7 of such tumors. In this paper, our cases are presented: these are discussed (together with a revision of the literature), particularly focusing on anatomo-pathological, diagnostic and therapeutic problems.

Aged↗
PubMedDate not supplied

[Simultaneous multiregional embolization from a cardiac myxoma. Case report].

Atrial myxoma is the most frequent cardiac tumor. Distal embolization occurs in about one third of the patients with this nosological entity; a simultaneous embolization to three different arterial districts, however, is a rare event. Of particular interest is also, in our opinion, the evolution of the clinical picture and the surgical treatment performed.

Adult↗