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Biomedical subjects

P G Giacomini

Publications and source records attributed to P G Giacomini.

14 recordsLinked to original sources
PubMed2004

Impaired postural control in patients affected by tension-type headache.

Sixteen subjects, affected by chronic tension-type headache (TTH) accordingly to the International Headache Society Classification (1988) criteria, in presence of tenderness in pericranial muscles,with a mean age of 37+/-11.8 years, and ten healthy volunteer subjects, age and sex matched, were submitted to postural analysis by Static Posturography (S.Ve.P. Amplaid). Aim of the study was to evaluate whether patients with TTH have disturbed postural control, as compared to normal subjects. Postural analysis considered all posturographic variables but focused on spectral frequency analysis of body sway. In both open (OE) and closed eyes (CE) condition, spectral frequency analysis showed a significantly increased body sway at low (OE= p < or = 0.01; CE= p < or = 0.01) and middle (OE= p < or = 0.01; CE= p < or = 0.01) frequencies on the antero-posterior (y) plane and at low frequencies (OE= p < or = 0.05; CE= p < or = 0.05) on the lateral (x) plane. Statistical analysis was performed using the Student's t test for unpaired data, p value 0.05 defined significant. The proprioceptive input seems to be predominant at middle and high frequencies in maintaining posture, our results seem then to suggest a proprioceptive disturbance in TTH patients. The disturbance is likely related to chronic pericranial muscle contraction and tenderness. Posturography and spectral analysis may help not only in the diagnosis of a postural disturbance but even more in the follow-up of TTH patients, during and after a medical and/or a rehabilitative treatment.

Adult↗
PubMed2001

A case of solitary nasal schwannoma.

A case of solitary neurilemmoma is presented. The patient was a 35-year-old male with progressive nasal obstruction due to a neoformation of the left vestibule. After the surgery the pathological diagnosis was neurilemmoma.

Adult↗
PubMed2001

Saccadic eye movement and visual pathways function in diabetic patients.

We assessed saccadic eye movements (SEM) and the visual evoked potentials (VEP) with the aim to evaluate whether a correlation exist between SEM and visual pathways function, in insulin-dependent diabetes mellitus (IDDM) patients. In IDDM patients we observed significantly longer SEM latency, while SEM velocity and accuracy were similar to those of the controls; VEP showed a significant delay of the latencies and significant reduction of the amplitudes in IDDM patients no relationship between SEM and VEP parameters were found. In conclusion SEM latency delay suggest an impairment of the saccadic eye movement system, while impaired VEP may be ascribed to a dysfunction of the visual pathways. The lack of correlation between VEP impairment and SEM latency delay suggests that in our IDDM patients the delay of saccadic latency could be ascribed to a difuse neuronal problem exceeding the visual pathways disfunction.

Adult↗
PubMed2001

[Postural changes in systemic sclerosis: preliminary results].

Systemic Sclerosis (SSc) is a generalized disease of unknown etiology which frequently presents neurological involvement of the central or peripheral nervous system. Besides various types of neuropathies, at times postural alterations of uncertain genesis can be found. Such alternations have never undergone organic study. The present work evaluates the static posture of subjects suffering from SSc without any subjective otoneurological symptoms. A total of 30 subjects-10 normal volunteers and 20 patients suffering from SSc-underwent full clinical examination, immunological testing (immunoglobulin; ANA; anti-ENA, anti-centromere, anti-SCL70, anti-DNA, anti-cardiolipin antibodies; C3, C4; circulating immunocomplexes) and capillaroscopy of the periunguis vallecula. The capillaroscopy data showed 2 distinct general pictures of sclerodermic microangiopathy: 1) a "slow pattern", not particularly aggressive, where capillarectasia and neoangiogenesis prevail; 2) an "active pattern", highly aggressive, where architectural disorder, capillary loss with the formation of avascular areas prevail. The 20 SSc subjects following the same therapy and free of any significant otoneurological, vasculo-metabolic or osteoarticular pathologies and the 10 healthy volunteers of compatible age and sex, underwent computerized Static Posturography (S.Ve.P-Amplaid). The immunological examinations showed that all patients were positive for ANA, 12 tested positive for anti-SCL70 antibodies and 7 for anti-centromere antibodies. The results of posturography showed a significant increase in parameter: "surface" and "standard deviation of velocity" with closed eyes. Spectra frequency analysis, processed using a personal method, showed a significant increase in panfrequency oscillations vs. the controls on both axes and both with eyes open and closed. The preliminary results of this study, which from reviewing the literature we believe to be the first of its kind performed, appear to indicate a subclinical suffering upon postural control in SSc: the alterations in the posturographic spectral frequency analysis indicate that all postural control mechanisms are extensively compromised, causing a pluriplanar, multifrequency destabilization both with and without the use of vision.

Adult↗
PubMed1999

Impaired saccadic eye movement in diabetic patients: the relationship with visual pathways function.

The aim of this study was to evaluate whether a correlation existed between saccadic eye movements and visual pathways function in diabetic patients. Saccadic or fast Eye Movement System (EMS) and Visual Evoked Potentials (VEPs) were assessed in 20 insulin-dependent diabetic mellitus (IDDM) patients without long-term complications and in stable metabolic control and in 21 age-matched control subjects. In IDDM patients we observed significantly (p<0.01) longer EMS latency, while EMS velocity and accuracy were similar to those of controls; VEPs showed a significant delay in N75, P100, N145 latencies and significant reduction of N75-P100 and P100-N145 amplitudes. In IDDM patients no relationships between EMS and VEP parameters were found. In conclusion, EMS latency delay suggests an impairment of the saccadic eye movement system, while impaired VEPs may be ascribed to a dysfunction of the visual pathways. The lack of correlation between VEPs impairment and EMS latency delay suggests that in our IDDM patients the delay of saccadic latency cannot be exclusively related to a visual pathways dysfunction and could be ascribed to a diffuse neuronal involvement.

Adult↗
PubMed1998

[Cervical lymphangioma in the adult: a report of a significant case].

UNLABELLED: Lymphangioma in the adult is quite rare: the most common localization in the head and neck region is at the posterior triangle of the cervical lateral region (75%). Moreover, it favors the right latero-cervical area (72%) thus supporting a disembryogenetic pathogenesis. Indeed, according to Dowd and Goetsch, the lymphatic tissues are rearranged in this area, creating the principle head and neck drainage. The presence of disembryogenetic alterations in the lymphatic architecture could go on unnoticed until the lymphatic circulation equilibrium is altered by some anatomo-functional event compromising the involved area. CLINICAL CASE: G.P., a 41-year-old male, presented a swelling in the right submandibular region since approximately 4 months and which had increased in size over the last 30 days. The case history revealed that, at the age of 18 he had been admitted to the hospital for surgical removal of an angiomatose phlegmonous neoformation while, at the age of 18 38, he had undergone surgery for a lipoma in the right temporo-zigomatic area. Head and neck CT using a contrast medium revealed a formation of mixed density, predominantly liquid, apparently multiloculated. The patient underwent surgery, via a right submandibular cervicotomy approach, to remove the cystic neoformation and attached submandibular gland. In addition, the plurilobate mass showed submentonier, parapharyngeal, subdigastric and subhyoid extensions. Histology led to a diagnosis of "cystic lymphangioma". The clinical case reported is quite unusual in that:--the submandibular (anterior triangle) location is rare, accounting for only 6.25% of the cervical manifestations;--the previous case history of this patient underlines the importance of an embryogenic alteration in the regional lymph network;--this condition, clinically manifest in infancy as a submandibular (angiomatose) phlegmon became latent in adulthood after surgery for right temporo-zigomatic lipoma. In light of the above data, it can be hypothesized that a disembryogenetic origin of the adult lymphangioma, associated with a predisposition (scarred areas further compromising the lymph vessel architecture) and some precipitating event (surgical trauma in adulthood), have lead to delayed development of the amartoma.

Adult↗
PubMed1998

Laryngeal metastasis from a signet ring cell carcinoma of the colon. A case report and review of the literature.

Secondary involvement of the larynx and pharynx by malignant neoplasms arising in contiguous structures is well known, but metastases to the larynx from distant tumors are rare. In the present paper a case of signet ring cell carcinoma of the transverse colon metastatic to the left pyriform sinus is reported. A review of the literature identifies 7 other published cases of metastases to the larynx from a colon carcinoma.

Aged↗
PubMed1997

Contribution of central neuropathy to postural instability in IDDM patients with peripheral neuropathy.

OBJECTIVE: To evaluate the contribution of central neuropathy on postural impairment observed in diabetic patients with peripheral neuropathy. RESEARCH DESIGN AND METHODS: Central sensory and motor nervous propagation, nerve conduction velocity, and static posturography were assessed in the following age-matched subjects: 7 IDDM patients with peripheral neuropathy (group DN), 18 IDDM patients without peripheral neuropathy (group D), and 31 control subjects (group C). Somatosensory-evoked potentials (SEPs) during tibial nerve stimulation were recorded, and the spine-to-scalp sensory central conduction time (SCCT) was evaluated. Motor-evoked potentials (MEPs) were recorded from leg muscles during magnetic transcranial brain stimulation, and the scalp-to-spine motor central conduction time (MCCT) was evaluated. The following posturographic parameters were calculated from the statokinesigram: trace length, trace surface, velocity of body sway with its standard deviation, and VFY (a parameter derived from the velocity variance and the anteroposterior mean position of the body). RESULTS: SCCT was significantly higher in the DN group than in the C and D groups (P < 0.001). MCCT was similar in all groups. Posturographic parameters were all significantly impaired in the DN group (P < 0.01). While posturographic parameters showed a direct relationship with some parameters of peripheral nerve conduction, no correlations were observed with SEP and MEP central conduction time. These results were also confirmed by logistic regression, which indicates peripheral neuropathy as the only implicating factor in postural instability (odds ratio 0.22, 95% CI 0.07-0.75) after data reduction by means of factor analysis. CONCLUSIONS: Although diabetic patients with peripheral neuropathy show a delay in central sensory conduction, postural instability may be fully explained by the presence of peripheral neuropathy.

Adult↗
PubMed1997

[A rare case of angiolymphoid intramasseteric hyperplasia].

A white caucasian male 38-year-old has come to our Department with an intramasseterin neoformation. The histopathological report has been angiolymphoid hyperplasia. Surgical approach is discussed considering at the same time the peculiarity of this rare type of intervention.

Adult↗
PubMed1996

Postural rearrangement in IDDM patients with peripheral neuropathy.

OBJECTIVE: To evaluate the influence of diabetic peripheral neuropathy on postural strategy. RESEARCH DESIGN AND METHODS: Static posturography and nerve conduction velocity were performed in the following age-matched subjects: 10 IDDM patients with peripheral neuropathy, 23 IDDM patients without peripheral neuropathy, and 21 control subjects. All subjects with signs or symptoms of postural instability were excluded from the study. The following posturographic parameters were drawn: 1) velocity of body sway, expressed as mean velocity and average of the SDs, 2) VFY, the parameter derived from the velocity variance and the anteroposterior mean position of the body (this parameter monitors the postural strategy pursued by the subject), and 3) fast Fourier transformation on the x (FFTX) and y (FFTY) planes, spectral analysis of the frequencies of body oscillation on frontal (x) and anteroposterior (y) planes. RESULTS: Mean velocity and its SD were higher in IDDM patients with peripheral neuropathy than in control subjects and IDDM patients without peripheral neuropathy (P < 0.001). VFY was increased in IDDM patients with peripheral neuropathy versus control subjects and IDDM patients without peripheral neuropathy (P < 0.01). A direct relationship was found between parameters of posturography and some parameters of nerve conduction tests. CONCLUSIONS: Diabetic patients with peripheral neuropathy demonstrate a shift from physiological ankle control to hip postural control as monitored by specific posturography analysis.

Adult↗
PubMed1995

Body sway in diabetic neuropathy.

OBJECTIVE: To evaluate the influence of peripheral neuropathy on body sway assessed by posturography. RESEARCH DESIGN AND METHODS: The age-matched study subjects included 10 insulin-dependent diabetes mellitus (IDDM) patients with peripheral neuropathy (DN), 23 IDDM patients without peripheral neuropathy (D) according to the San Antonio Consensus Conference guidelines, and 21 control subjects (C). All subjects with symptoms and/or clinical signs of postural instability were excluded from the study. RESULTS: The trace surface was significantly larger in the DN than in the C and D groups (P < 0.05), and the trace length was longer in the DN than in the C and D groups (P < 0.01). Mean velocity was faster in the DN than in the other two groups (P < 0.001). A direct relationship was found between the parameters of posturography and some parameters of the nerve conduction velocity. CONCLUSIONS: Diabetic patients with peripheral neuropathy demonstrate a relative deficit in their ability to maintain posture. Posturography allows an early disclosure of the failure of postural control.

Adult↗
PubMedDate not supplied

Evaluation of abnormalities of orthostatic postural control in systemic sclerosis.

OBJECTIVE: Systemic sclerosis (SSc) is a multi-systemic disease of unknown etiology characterized by damage to the small arteries, arterioles and capillaries. The documented occurrence of various neuropathies in SSs patients led us to hypothesize that there is a potential for postural control impairments in such disease. This study was aimed at evaluating the orthostatic postural control of SSc patients who do not manifest balance or hearing symptoms. METHODS: Postural stability was assessed in 36 female SSc patients by means of a static computerized posturography technique. Their immunological and microvascular condition were evaluated by means of blood tests and microcapillaroscopy of the digital vessels. Posturography and microcapillaroscopy were performed before and after treating the patients with Iloprost. In order to compare results, posturography was also carried out on a control group composed of 10 healthy women of similar age. Both groups were studied in two different sensory conditions, i.e. with eyes opened and with eyes closed. RESULTS: Posturography results showed relevant differences in body sway between patients and control subjects. Fourier spectral analysis of body sway showed that, independently from visual control, SSc patients exhibit a higher level of low/middle frequency oscillations (both on the lateral and the anteroposterior axis). No relationship was established between disease stage and postural performance. CONCLUSION: This study seems to indicate a subtle neurophysiological dysfunction in the orthostatic postural control of female SSc patients. Further tests on the somatosensory neurological function of SSc patients may help support the above mentioned findings.

Dizziness↗