Biomedical subjects

S Saletta

Publications and source records attributed to S Saletta.

4 recordsLinked to original sources

PubMed1995

Transesophageal echocardiography for the initial evaluation of the widened mediastinum in trauma patients.

Traumatic disruption of the thoracic aorta is an injury that is rapidly fatal if not recognized and treated early. Increasingly, transesophageal echocardiography (TEE) is being used to evaluate the thoracic aorta after trauma with reported sensitivity and specificity rates of up to 100%. To confirm these results, we instituted a protocol using TEE as the initial diagnostic study for excluding a ruptured thoracic aorta in patients with widened mediastinum. All TEE studies were done by experienced cardiologists; 96% were done in the trauma receiving area. TEE studies were classified as positive, negative, or indeterminant. Indeterminant studies were those in which the diagnosis of aortic injury could not be excluded based solely on TEE findings. Because we were interested in using TEE as a "definitive" diagnostic modality, indeterminant studies were regarded as positive for our analysis. This protocol was used in 114 trauma patients over a 3-year period. TEE identified five thoracic aortic disruptions--three confirmed by aortography and two by thoracotomy. TEE was read as indeterminant in 17 patients and further investigation with aortography showed no aortic injury in these patients. TEE was negative in 89 patients who had no further evaluation and were subsequently discharged or who died from other injuries. TEE failed to reveal significant lesions in three patients who had aortograms that revealed disruptions requiring thoracotomy. The use of TEE for the definitive diagnosis of ruptured aorta in this series yields a sensitivity of 63% and a specificity of 84%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Study of IL-2, IL-6, TNF alpha, IFN gamma and beta in the serum and synovial fluid of patients with juvenile chronic arthritis.

In the last few years the important role played by various cytokines in the pathogenesis of chronic inflammatory diseases has emerged. In the present study, serum and synovial fluid levels of IL-2, IL-6, TNF alpha, IFN beta and IFN gamma were evaluated in a group of 66 patients with juvenile chronic arthritis (JCA). At the same time the ESR, CRP, hemoglobin, immunoglobulins, platelet count and Ritchie index were measured. In the serum of pauciarticular patients, IL-6 and TNF alpha levels were only slightly elevated compared with controls, but there was no correlation between these cytokines and clinical and other laboratory parameters. Serum IL-2 and IFN gamma were undetectable. In contrast, in the synovial fluid IL-6 levels were very high in all of the patients examined and there was a significant correlation between synovial fluid IL-6 levels and Ritchie's articular index. TNF alpha tended to be elevated but to a lesser extent, while synovial fluid IL-2 and IFN gamma were undetectable or very low, as in the serum. In polyarticular and systemic patients, on the other hand, serum IL-6 was elevated and statistically correlated with the majority of the laboratory parameters and with the Ritchie articular index. TNF alpha levels were only slightly elevated; on the other hand, IL-2 and IFN gamma were undetectable. There was an inverse correlation between IFN beta levels and the Ritchie articular index and a significant correlation with hemoglobin levels. In conclusion, our study demonstrates that not only IL-1 (as shown in other studies), but also IL-6 and to a lesser extent TNF alpha play a central role in the pathogenesis of JCA. IFN beta on the other hand, would seem to play an anti-inflammatory role.

Adolescent↗

PubMedDate not supplied

[Spontaneous pneumomediastinum in an adolescent].

Spontaneous pneumomediastinum is defined as nontraumatic mediastinal air leak in patients without underlying lung disease. In children and adolescents it is rarely described and is likely to be underdiagnosed. We describe a case. The aetiopathogenesis, clinical findings, diagnosis and treatment are discussed.

Adolescent↗

PubMedDate not supplied

Localized scleroderma after infection with Epstein-Barr virus.

Over a period of three years (1989-1992) five children suffering from localized scleroderma were seen at the Department of Pediatrics of the University of Trieste. Evidence of a previous infectious mononucleosis (IM) was present in four out of five patients. The clinical history of these four children is reported. The association between the appearance of scleroderma and a previous viral infection is not surprising. However, in the pediatric literature there is only one case of progressive systemic sclerosis (PSS) developing in a 15-month-old girl less than one month after she contracted IM. The presence of shared epitopes between an Epstein-Barr virus protein, BOLF1, and the hypervariable region of HLA associated with the pauciarticular form of JCA, recently reported, could provide a key to the pathogenesis of other collagen diseases such as scleroderma.

Adolescent↗