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Biomedical subjects

R Cacciola

Publications and source records attributed to R Cacciola.

11 recordsLinked to original sources
PubMed2000

[Delayed diagnosis of odontoid fracture after whiplash trauma of the cervical spine].

Fractures of the odontoid process represent about 10-20% of all diagnosed cervical spine fractures. Approximately 35% of these fractures are classified as Type II according to Anderson and D'Alonzo. They can be potentially unstable especially if combined with a dens displacement of over 6 mm. In severe cervical spine trauma, these fractures do not usually cause difficulties in diagnosis. However, in whiplash injuries, which are very common and only rarely associated with such fractures, the surgical management can be complicated if they are underestimated. These patients can present without significant neurological deficits or the situation can be complicated due to intoxication or additional trauma. Under these circumstances in particular, the diagnosis can be delayed or missed, if no strict protocols for diagnostic effort in all whiplash injuries are employed. A case of delayed diagnosis of an odontoid fracture in a neurological asymptomatic patient after whiplash injury is presented.

Adult↗
PubMed1998

Sputum eosinophilia is more closely associated with airway responsiveness to bradykinin than methacholine in asthma.

Hyperresponsiveness of the airways to various spasmogenic stimuli is a characteristic feature of bronchial asthma. However, the association between the different stimuli to which asthmatic airways are hyperresponsive and airways inflammation is not completely understood. We have investigated the relationship between airway inflammation and airway hyperresponsiveness in asthma, as assessed by bronchoprovocation tests to methacholine and bradykinin, two well defined bronchoconstrictor agonists. Sputum induction by hypertonic saline and methacholine and bradykinin challenges were performed in 14 nonsmoking subjects with mild-to-moderate asthma. Airway responsiveness to either agonist did not correlate with sputum neutrophils, lymphocytes, and macrophages. Whilst the absolute number of eosinophilia failed to be significantly related to methacholine responsiveness (r=-0.47; p=0.09), it correlated markedly and significantly with provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (r=0.72; p<0.01). When expressed as % of total cell counts, sputum eosinophils correlated with both types of responsiveness (r=-056; p=0.04 and r=-0.76, p<0.001, respectively). Although the concentration of eosinophil cationic protein (ECP) in the sputum correlated with the absolute numbers of eosinophils (r=0.62; p<0.02), no correlation was found between ECP levels and the airway responsiveness to any of the agonists tested. In subjects with mild-to-moderate asthma, airway responsiveness to bradykinin is more strongly associated with the magnitude of eosinophilic inflammation in the airways than methacholine. This finding underlines the selectivity of diverse agonists in assessing airway hyperresponsiveness and cellular inflammation in asthma.

Adolescent↗
PubMed1997

A case of acute deterioration in asthma symptoms induced by isoniazid prophylaxis.

The present case report describes a 10-year-old boy with clinical history of steroid-dependent asthma who developed severe exacerbation of his respiratory symptoms upon isoniazid administration. Subsequent control of his asthma symptoms was re-established and maintained only after isoniazid withdrawal. This case is the first to emphasize the dangers of isoniazid administration in patients who have asthma.

Acute Disease↗
PubMedDate not supplied

Diabetes in the elderly: remarks from an epidemiological study carried out in a town in south-eastern Sicily (Militello V.C.).

Longer mean life span and life expectancy of diabetics and increased factors that favor onset of type II diabetes have determined greater prevalence of diabetes in the elderly population. According to HANES II, it is 17% in the elderly in U.S.A. We carried out an epidemiological study on the over 65 year olds in Militello V.C. and examined 910 elderly subjects (72.05% of the total elderly population). All were tested for peripheral fasting blood glucose, body weight and height and filled out a questionnaire with general and diabetological questions. The values recommended by the NDDG were used to diagnose diabetes. One hundred and sixty-one diabetics (25 newly diagnosed) were observed (17.69%). Onset had occurred before age 65 (aged diabetics) in 72 cases and after 65 in 89 (senile diabetics). Mean blood glucose was 152.91 +/- 55.56 mg/dl. Our results indicated that sulfonylureas and/or biguanides are first choice treatment. By grouping the diabetics on the basis of age at onset and duration of disease, a fall in the number of cases treated with diet alone and hypoglycemic drugs and an increase in patients on insulin were seen in aged diabetics as the disease evolves. On the contrary, there was a rise in the number of senile diabetics on hypoglycemic drugs.

Age Factors↗
PubMedDate not supplied

Continuous subcutaneous insulin infusion: a long-term study.

The authors report data obtained from a 3-year study of CSII and humanized insulin (semi-synthetic human insulin) administered to 18 insulin-dependent subjects in the outpatient clinic. The aim of this study was to evaluate the validity of insulin pumps in long-term treatment. Metabolic parameters were significantly improved (p less than 0.001) in the first month and remained so with only slight alterations throughout treatment. The authors underline some metabolic problems (ketosis) caused by malfunctioning of the insulin pumps, by the difficulties with the infusion system or by nodular skin lesions at the infusion site. Only these lesions called for treatment to be discontinued in 4 patients. The highest incidence of nodular skin lesions was seen after one year's uninterrupted treatment and they seem connected to the duration of treatment rather than to the patients' negligence (inadequate hygiene, delayed needle substitution). The authors conclude that CSII treatment is valid over short-term periods, whereas it presents drawbacks over long-term administration.

Adolescent↗
PubMedDate not supplied

[Current status of the overlapping suture in the treatment of aponeurotic and incisional hernias].

The authors report their results in a series of 213 patients affected by ventral hernia and operated with the overlapping suture technique, between 1970 and 1991. After having reported on the patients features and the circumstances of the treatment, they describe the different reconstructive times in their overlapping suture technique of the abdominal wall and the personal modifications brought about during their twenty years experience. According to the quality of the obtained results (< 5% of recurrence rate), the authors underline the efficiency of the technique that today in the time of the mesh prosthesis use, seems to guarantee good results even in the therapy of certain large eventrations.

Adolescent↗
PubMedDate not supplied

Anaphylactic reaction to oral prednisone: a case report and review of the literature.

Reports of corticosteroid anaphylactic reactions are rare in the medical literature. We describe the case of a nonatopic 17-year-old girl with bronchial asthma and aspirin intolerance who developed a dramatic anaphylactic reaction to oral prednisone. She recovered with shock therapy and intravenous administration of diphenhydramine and hydrocortisone. Intradermal testing with a wide range of steroid preparations gave positive results to prednisone. No reactions occurred to methylprednisolone and hydrocortisone. This case and the brief review of the literature which follows emphasize the danger of prednisone administration in patients who have asthma and a history of drug intolerance.

Administration, Oral↗