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Biomedical subjects

M Romagnoli

Publications and source records attributed to M Romagnoli.

At least 19 recordsLinked to original sources

Alignments and clinical results in conventional and navigated total knee arthroplasty.

In this prospective, randomized, controlled study, we compared the performance of conventional and navigated total knee arthroplasties. Component alignment was measured in 60 patients operated on using navigation and in 60 patients operated on using the conventional technique. The groups then were divided into a subpopulation to measure alignments of the distal femoral cuts in the three anatomic planes, the proximal tibial cut in the frontal and sagittal planes, and the resulting lower limb mechanical axis in the frontal plane. Postoperative weightbearing long-view radiographs were evaluated as were clinical results using three standard questionnaires at 28 months followup. The intraoperative measurements (mean +/- standard deviation) at the resection planes showed navigated surgeries result in more accurate alignments than conventional surgeries for the femur: in the frontal plane, 0.1 degrees +/- 0.9 degrees and 0.7 degrees +/- 1.6 degrees valgus, respectively; in the sagittal plane, 1.1 degrees +/- 1.8 degrees and 2.8 degrees +/- 2.0 degrees flexion; and in the transversal plane, 0.1 degrees +/- 1.2 degrees and 0.9 degrees +/- 1.7 degrees internal rotation. The navigated technique also reduced the number of cases with final mechanical axes greater than 3 degrees from 20.0% to 1.7%. Postoperative radiographs showed better component alignment using navigation, particularly at the femur. However, clinical scoring systems showed this radiographic improvement did not necessarily result in a better clinical outcome at short-term followup.

Aged↗

Inpatient pulmonary rehabilitation: does it make sense?

Among the nonpharmacological therapies, pulmonary rehabilitation (PR) is particularly appropriate for patients with chronic respiratory impairment who, despite any optimal drug management, are still symptomatic and experience restriction in every day activities. Pulmonary rehabilitation performed in inpatient, outpatient, or home settings demonstrates short- and long-term clinical efficacy. Although disease severity does not inherently dictate candidacy for exercise training, the degree of physiological and functional impairment may influence setting in which the training should occur. Therefore, inpatient rehabilitation is generally best-suited for the most sick and most disabled patients. The overall results from the literature confirm that the inpatient setting for a PR program is a feasible option and does not necessarily result in higher direct costs when balanced against duration and effectiveness in terms of improved outcomes.

Hospitalization↗

Effects of random and systematic perturbations in a one-dimensional photonic crystal wavelength converter.

We study the problem of the tolerance to fabrication errors in one-dimensional photonic crystal wavelength converters. In particular we consider the case of wavelength conversion obtained via quasiphase matching (QPM) based on a periodic amplitude modulation of the fundamental wave (Bloch-mode-QPM). Both numerical simulations of a waveguide-based structure and experimental results in an AlGaAs thin-film multilayer show that the proposed QPM mechanism is extremely tolerant to both systematic and random errors in the periodicity and duty cycle of the grating.

Journal Article↗

Determination of moisture fraction in wood by mobile NMR device.

A mobile NMR probe has been used as a non-destructive and non-invasive tool for water content analysis on wood samples. The porosity index, express as the fraction of the sensitivity volume of the probe occupied by water, is here proposed as an alternative to the moisture content index, namely the amount of water mass with respect to the mass of dried sample. In principle the method can be applied to any kind of porous media that has not detectable proton signal from the rigid matrix as, for instance, in building materials. In wood, where proton signal can be detected also from cellulose and others macromolecular components, some considerations and artifices are here proposed for eliminating this contribution. The method has allowed performing moisture volume fraction analysis on wood samples characterized by different wood species, cutting and moisture contents. The NMR data of moisture detection as volume fraction have successfully been compared with those obtained by the gravimetric method.

Journal Article↗

Psychic and occlusal factors in bruxers.

BACKGROUND: The aim of this study was to investigate the existence of associations between bruxism and psychic and occlusal factors. METHODS: Participants in this study (n=85) were recruited from the Section of Odontostomatology, Deparent of Neuroscience, University of Pisa, Italy. They were split into two groups, bruxers (n=34) and non-bruxers (n=51), on the basis of the presence of both clinical and anamnestical indicators of bruxim. All participants were administered two self-reported validated questionnaires to evaluate (MOODS-SR) and panic-agoraphobic (PAS-SR) spetra. A number of occlusal variables (deep-bite: cross-bite, open-bite, mediotrusive and laterotrusive interferences, slide RCP-ICP, laterotrutsive guides, canine and molar classes) were also recorded. RESULTS: With regards to occlusal factors, the only association was revealed between bruxism mediotrusive interferences (p < 0.05). As for psychiatric investigation, significant differences between bruxers and controls emerged for the presence of both depressive (p < 0.01) and manic symptoms (p < 0.01) in MOODS-SR, and for stress sensitivity (p < 0.01), anxious expectation (p < 0.05), and reassurance sensitivity symptoms (p < 0.05) in PAS-SR. In particular, both mood (p < 0.01) and panic-agoraphobic (p < 0.05) spectra symptoms seem to differentiate bruxers from controls in males, while in females strong differences emerged for stress sensitivity symptoms (p < 0.05). CONCLUSIONS: It can be confirmed that certain psychic traits are present in bruxers, while occlusal factors are not useful parameters to discern bruxers from non-bruxers.

Adult↗

Efficacy of tizanidine hydrochloride in the treatment of myofascial face pain.

AIM: The aim of the present investigation was to evaluate the usefulness of tizanidine hydrochloride in the treatment of myofascial pain of the masticatory muscles. METHODS: This work is a preliminary report of clinical experience with the use of tizanidine hydrochloride at the Section of Prosthetic Dentistry, Department of Neuroscience, University of Pisa, Pisa, Italy. During the period from January 2000 to March 2003, 145 patients were given Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I group I diagnosis of myofascial pain in the absence of any painful temporomandibular joint condition. Seventy-eight subjects agreed to suspend any kind of treatment they had undergone and to start assuming tizanidine hydrochloride (SIRDALUD) 4 mg/die per os (2 2- mg tablets a day, 1 in the morning and 1 after dinner) for 2 weeks. All underwent a clinical assessment according to RDC/TMD guidelines at baseline time and were re-evaluated at the end of the treatment period. RESULTS: At the end of the treatment period all patients had improved; 42/78 patients (53.8%) showed absence of clinical symptoms; 18/78 (23.1%) showed a good improvement, still presenting a low number of painful sites, but not satisfying RDC/TMD parameters for diagnosis of myofascial pain; 18/78 (23.1%) showed only a slight improvement, still presenting a high number of painful sites and satisfying RDC/TMD parameters for diagnosis of myofascial pain. CONCLUSION: Given the absence of papers on the use of tizanidine hydrochloride in the treatment of myofascial pain of the masticatory muscles, the present investigation could provide some preliminary data about its possible efficacy. Randomized and controlled clinical trials are needed to confirm these results.

Adult↗

Nuclear localisation of p65 in sputum macrophages but not in sputum neutrophils during COPD exacerbations.

BACKGROUND: Exacerbations represent an important feature of the clinical manifestation and natural history of chronic obstructive pulmonary disease (COPD). Nuclear localisation of p65 is a signal of nuclear factor-kappaB (NF-kappaB) activation. A study was undertaken to evaluate whether NF-kappaB activation is modified in sputum cells during COPD exacerbations. METHODS: Total and nuclear p65 immunoreactivity was measured by immunocytochemistry in the sputum cells of 11 smokers with moderate COPD during an exacerbation and after 6-8 weeks of clinical stability. RESULTS: Total sputum cell count was significantly increased during exacerbations from a median (IQR) of 880 (510-1865) to 1914.5 (1065-3205) x 10(3)/ml (p<0.05). The main inflammatory cells in the sputum were neutrophils (83.2 (75.4-92.3)%) and macrophages (14.7 (2.6-21.6)%) and their relative proportion did not change during exacerbations. Nuclear staining for p65 was absent in sputum neutrophils, both during exacerbations and in the stable phase. In contrast, the percentage of macrophages expressing nuclear p65 increased significantly during exacerbations from a median (IQR) of 16 (7-24)% to 41.4 (6-69)% (p<0.05). CONCLUSIONS: NF-kappaB appears to be activated in sputum macrophages but not in sputum neutrophils during exacerbations of COPD

Aged↗

Early interception of skeletal-dental factors predisposing to temporomandibular disorders during child development.

Temporomandibular disorders (TMD) comprise a heterogoneous group of pathologies or dysfunctions of the temporomandibular joints and their related neuromuscular systems. The multifactoral etiology of these disorders raises serious diagnostic and therapeutic problems. A modern approach demands close collaboration between a number of specialists in order to create the best possible treatment plan. The progressive nature of certain forms of TMD, combined with the major advantages deriving from early treatment, encourage the dental surgeon to carry out early interception of all those dental and/or skeletal anomalies which may determine the dysharmonic function and development of the facial mass, even though such anomalies may not represent the sole causes of the various forms of TMD. The general practitioner, and to an even greater extent the pediatrician, may therefore play a role of primary importance as those medical influences capable of early detection of TMD risk situations.

Age Factors↗

A spectrum approach for the assessment of manic-depressive symptoms accompanying temporomandibular disorders.

AIM: Temporomandibular disorders (TMD) are a number of conditions which are frequently associated with depressive symptoms, but the possible existence of some form of manic-depressive illness in TMD patients has never been investigated. The aims of this work were to evaluate the reliability of a newly adopted spectrum model of psychopathology to detect depressive symptoms in TMD patients, and to produce pilot data on the presence of manic symptoms in TMD patients. METHODS: Ninety-one consecutive TMD patients (72 females, 19 males; mean age 26.3) and 26 TMD-free subjects (21 females, 5 males; mean age 24) were administered a validated questionnaire to evaluate mood spectrum (MOODS-SR). Helkimo's Clinical Dysfunction Index (CDI) was calculated for all patients. One-way ANOVA and Bonferroni's post-hoc test for multiple comparisons were used to compare mean MOODS-SR scores of the groups identified as TMD-free (CDI=0), mild dysfunctionals (CDI=1), moderate or severe dysfunctionals (CDI= or >2). RESULTS: Total scores of domains evaluating depression were significantly higher in moderate or severe dysfunctionals than in both TMD-free (mean difference 8.87+/-3.5; p=0.017) and mild dysfunctionals (m.d. 9.41+/-2.62; p=0.001). As regards manic symptoms, differences between groups were not significant (F=1.299; p=0.277). CONCLUSION: Our findings support the reliability of MOODS-SR to detect depressive symptoms associated with TMD. The hypothesis that depressive symptoms in TMD patients could be an expression of a more complex manic-depressive illness has to be rejected, since no differences between TMD patients and TMD-free subjects have been revealed for the presence of manic symptoms.

Adult↗

The intriguing association between prematurity and neonatal isolated submandibular suppurative sialadenitis.

Submandibular suppurative sialadenitis occurring as an isolated lesion in the neonatal period is extremely rare. A case of a preterm newborn, who developed an isolated submandibular suppurative sialadenitis is described. A literature review highlighting salient points on this topic is also presented. In particular, an important role of prematurity in the etiology of this pathological condition is shown and discussed.

Ceftazidime↗

Eosinophilic inflammation in sputum of poorly controlled asthmatics.

Despite full effective treatment, asthmatic patients often present with poorly controlled asthma. Airway eosinophilia is associated with asthma, but its relationship with asthma control is still undetermined. To investigate the relationship between airway eosinophilia and asthma control, cellular and biochemical markers of airway inflammation were measured in 19 subjects with poorly controlled asthma, 16 subjects with asthma under control and eight normal volunteers. The severity of asthma was mild-to-moderate persistent in 23 patients (14 poorly controlled) and severe prednisone-dependent in 12 subjects (five poorly controlled). Induced sputum was analysed for total and differential cell counts, leukotriene E4 (LTE4), eosinophil cationic protein (ECP), regulated on activation, normal T-cell expressed and secreted (RANTES), and interleukin (IL)-8. Sputum eosinophils, LTE4, ECP and RANTES levels (but not IL-8) were significantly higher in patients with poorly controlled asthma as compared to patients with controlled asthma. By contrast, sputum cells and sputum inflammatory markers were not different among groups of patients with different severity of asthma. These results suggest that sputum eosinophilia is associated with poorly controlled asthma rather than with the severity of asthma.

Adult↗

[Histological and ultrastructural characteristics of jaw-closing muscles. A review].

The aim of this work is giving, through a wide literature review, a detailed analysis of the histological and ultrastructural characteristics that distinguish masseter and temporal muscles from the other skeletal muscles. Furthermore we'll explain the functional meanings of these differences. We developed the following points: fibre type composition and relative frequency of the various fibre types, fibre size, myosin composition, capillarization and age-related changes. With standard staining method for the myofibrillar ATPase, besides the two main fibre types, I and II, in the masticatory muscles a moderate share of IM fibres with intermediate stainability, which usually don't appear in adult skeletal muscles, are shown. The relative frequency of the various fibre types is also peculiar, with a prevalence of type I fibres in almost every portion of the masseter and temporal muscles, which therefore are functionally slow muscles. Another unusual characteristic is also the mean diameter of type I fibres, that are commonly larger than type II fibres. This finding suggests that masticatory muscles are adapted to carry out specially prolonged and fatiguing tasks. The findings about contractile protein patterns and the changes in myosin heavy chain composition during ageing are also relevant. The deep differences between jaw-closing and limb and trunk muscles are reviewed on the basis of their special functional activities.

Aging↗

Evaluation of a reformulated CHROMagar Candida.

CHROMagar Candida is a differential culture medium for the isolation and presumptive identification of clinically important yeasts. Recently the medium was reformulated by Becton Dickinson. This study was designed to evaluate the performance of the new formula of CHROMagar against the original CHROMagar Candida for recovery, growth, and colony color with stock cultures and with direct plating of clinical specimens. A total of 90 stock yeast isolates representing nine yeast species, including Candida dubliniensis, as well as 522 clinical specimens were included in this study. No major differences were noted in growth rate or colony size between the two media for most of the species. However, all 10 Candida albicans isolates evaluated consistently gave a lighter shade of green on the new CHROMagar formulation. In contrast, all 26 C. dubliniensis isolates gave the same typical dark green color on both media. A total of 173 of the 522 clinical specimens were positive for yeast, with eight yeast species recovered. The recovery rates for each species were equivalent on both media, with no consistent species-associated differences in colony size or color. Although both media were comparable in performance, the lighter green colonies of C. albicans isolates on the new CHROMagar made it easier to differentiate between C. albicans and C. dubliniensis isolates. In conclusion, the newly formulated Becton Dickinson CHROMagar Candida medium is as equally suited as a differential medium for the presumptive identification of yeast species and for the detection of multiple yeast species in clinical specimens as the original CHROMagar Candida medium.

Candida↗

Partial reversibility of airflow limitation and increased exhaled NO and sputum eosinophilia in chronic obstructive pulmonary disease.

We investigated the relationship between the reversibility of airflow limitation, the concentration of nitric oxide (NO) in exhaled air, and the inflammatory cells in the sputum of patients with stable chronic obstructive pulmonary disease (COPD). We examined nine normal healthy control subjects and 20 nonatopic patients with COPD. Ten patients had no reversibility of airflow limitation (increase in FEV(1) of < 12% and < 200 ml after 200 microg of inhaled salbutamol), and 10 patients had partial reversibility of airflow limitation (increase in FEV(1) of < 12% but > 200 ml after 200 microg of inhaled salbutamol). Exhaled NO levels were higher in COPD patients with partial reversibility of airflow limitation than in those with no reversibility of airflow limitation (median 24 [interquartile range 15.3 to 32] ppb versus 8.9 [4.6 to 14.7] ppb; p < 0.01). Compared with healthy control subjects, only COPD patients with partial reversibility of airflow limitation had increased concentrations of sputum eosinophils. We conclude that, in patients with stable COPD, even a partial bronchodilator response to inhaled salbutamol is associated with increased exhaled NO and sputum eosinophilia, suggesting that these patients may have a different response to treatment than do those without reversible airflow limitation.

Administration, Inhalation↗

[Indications for selective arterial embolization in the treatment of epistaxis].

After posterior packing has failed, the treatment of choice for severe, recurrent posterior epistaxis is arterial ligature, usually through a transantral approach to the Internal Maxillary artery (LTA) or selective percutaneous embolization (EP). The advantages and disadvantages of each technique are discussed by various Authors. A critical review of the literature brings to light the discrepancies between the results of various studies: in a series by Strong et al. and in a review of the literature EP proved more effective than LTA (90-94% vs. 85-89%). On the contrary, using personal data Cullen and Tami reported that the results are analogous. As regards complications, these proved slightly more frequent, but minor, with LTA while the rare complications with EP were more serious. The per-patient costs fundamentally depend on the type of hospital management and the availability of a treatment center; the results of the various studies are not analogous in this regard. The specific indications for the choice of which technique to use include: LTA: ethmoid artery hemorrhage, severe arteriosclerosis of the carotid compartment and allergy to the contrast medium; EP: cardiovascular instability, severe anemia and all conditions which are contraindications for general anesthesia. In the cases studied by the Authors, of the total 203 patients admitted to hospital for posterior epistaxis between May 1995 and November 1999, 12 (5.9%; on the average 2.6 pt/yr) showed values lower than those found at other Centers. A total of 13 EP procedures were performed and the result was positive (stopping the hemorrhage) in 11 (91.7%). In one post-traumatic case there was a recurrence which could not be controlled by EP and thus the Authors resorted to surgical ligature. All the patients underwent fibroscopy after the posterior packing was removed and before establishing the indications for EP. A full 50% of the patients treated showed arterial hypertension and in all patients except the one with multiple traumas, the pre-embolization angiography showed the presence of submucosal teleangiectasia in the site of the epistaxis. This report supports the hypothesis that, in the presence of triggering factors (hypertension, pregnancy), untreatable epistaxis is sustained by a submucosal vascular malformation. On the other hand, it also asserts that although the patient evaluation to determine the EP treatment was less invasive than that used in other Centers, it was able to identify the patients with this malformation, thus validating the clinical criteria used.

Adult↗

Eosinophilic inflammation assessed by induced sputum in corticosteroid-dependent asthma.

Sputum induction can be used to study airway inflammation in asthmatics. However, it has not been used in patients with corticosteroid-dependent asthma requiring long-term oral corticosteroids. The aim of the study was to assess the number of eosinophils and the levels of eosinophil cationic protein (ECP) in sputum of 17 corticosteroid-dependent asthmatics by comparison with nine mild untreated asthmatics, 10 moderate asthmatics receiving inhaled steroids (ICS) and 11 healthy subjects. In the 17 corticosteroid-dependent asthmatics, we examined sputum eosinophil markers on two occasions and correlated with the control of asthma. Eosinophils were undetectable in controls and were detected in 63.8% of asthmatics. There were no significant differences between the three groups of asthmatics. ECP levels were significantly increased in ICS or corticosteroid-dependent asthmatics by comparison to controls and mild asthmatics. There was no significant difference between ICS and corticosteroid-dependent asthmatics. During follow-up, corticosteroid-dependent asthmatics with a controlled disease had no significant change in eosinophil numbers or ECP levels. On the other hand, corticosteroid-dependent asthmatics with recent exacerbations had a non-significant increase in eosinophil numbers and a significant increase in ECP levels. This study shows that ECP levels may be more accurate than eosinophil numbers in assessing exacerbations in corticosteroid-dependent asthmatics.

Adolescent↗

Safety and cellular assessment of bronchial brushing in airway diseases.

Bronchial brushing is a useful method for morphological and functional studies of bronchial epithelial cells (BECs) in various diseases. This technique has been found to be generally safe, but its safety in asthma and chronic bronchitis has not been fully assessed. The purpose of this study was to determine 1, whether bronchial brushing is a safe method in asthmatic and chronic bronchitis patients of differing severity and 2, to characterize the BECs obtained in terms of number, viability and purity. We evaluated 25 asthmatics of variable severity, 19 chronic bronchitis patients and 26 normal volunteers. Bronchoscopy and bronchial brushing were performed in a standardized manner by the same investigator. Safety was assessed by clinical follow-up of all subjects; continuous monitoring of arterial oxygen saturation during the procedure with a digital oximeter was carried out in a subsample of subjects. No complications were observed clinically during the procedure. There was a minimal fall in arterial oxygen saturation without a significant difference between the three groups of subjects. A consistent number of BECs was recovered and their viability, assessed by the trypan blue exclusion test, in asthmatics and chronic bronchitis patients was significantly lower than in controls (P < 0.05). Bronchial brushing is well tolerated and may be a valuable method of obtaining BECs in asthmatic and chronic bronchitis patients.

Adult↗