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1.
Acta Otorhinolaryngol Ital ; 37(5): 416-422, 2017 Oct.
Article in English | MEDLINE | ID: mdl-29165436

ABSTRACT

The aim of this study is to report our results in a group of prelingually deafened adults, who followed an oralist rehabilitation programme, and submitted to cochlear implant at our institution. We evaluated 30 prelingually deafened adult patients, 18 males and 12 females, median age 35 years, of a group of 36 prelingually deafened adult patients consecutively submitted to unilateral cochlear implantation at the ENT Unit of the University of Pisa. After implantation, patients achieved significant benefits in terms of speech perception skills, including the ability to have telephone conversations in some cases, quality of life and their own perception of disability. According to literature data, the results herein reported are quite variable but generally satisfactory. Procedures other than traditional speech perception measures should be used to evaluate the benefits of cochlear implant in such patients, to compressively evaluate the global benefits, not only in terms of speech perception, but also in terms of quality of life and daily life.


Subject(s)
Cochlear Implants , Deafness/surgery , Patient Reported Outcome Measures , Quality of Life , Speech Perception , Adolescent , Adult , Female , Humans , Male , Middle Aged , Quality Improvement , Treatment Outcome , Young Adult
2.
Acta Otorhinolaryngol Ital ; 36(1): 29-37, 2016 Feb.
Article in English | MEDLINE | ID: mdl-27054388

ABSTRACT

With the implementation of universal newborn hearing screening (UNHS) programmes and early diagnosis and treatment of hearing problems, the need has clearly emerged to implement and carry out a systematic and coordinated protocol for the aetiological diagnosis of permanent hearing impairment (PHI). Within the framework of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", it has been decided to consider the problems relative to aetiological diagnosis of child PHI within UNHS programmes. The specific objective was to apply a shared diagnostic protocol that can identify the cause in at least 70% of cases of PHI. For this part of the project, four main recommendations were identified that can be useful for an efficient aetiological diagnosis in children affected by PHI and that can offer valid suggestions to optimise resources and produce positive changes for third-level audiologic centres.


Subject(s)
Deafness/diagnosis , Hearing Loss/diagnosis , Child , Early Diagnosis , Hearing Loss/etiology , Hearing Tests , Humans , Infant, Newborn , Neonatal Screening
3.
Acta Otorhinolaryngol Ital ; 36(1): 51-9, 2016 Feb.
Article in English | MEDLINE | ID: mdl-27054391

ABSTRACT

The implementation of regional protocols for newborn hearing screening and early audiologic diagnosis represent the first step of the entire diagnostic, rehabilitative and prosthetic programme for children with permanent hearing impairment. The maximum benefit of early diagnosis can indeed be obtained only by prompt rehabilitation aimed at fostering the child's communicative, linguistic and cognitive development. Within the framework of the CMM 2013 project of the Ministry of Health entitled "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the problems concerning the promotion of the global development of children with PHI through an early rehabilitation project based on shared knowledge and scientific evidence. In this project, our specific aim was to define the features and modes of access to a precise and specialised rehabilitation project for the small hearing-impaired child within three months from audiologic diagnosis. Three main recommendations relative to assessment and rehabilitation aspects of early care emerged from the study.


Subject(s)
Hearing Disorders/therapy , Hearing Loss/therapy , Child , Hearing Disorders/diagnosis , Hearing Loss/diagnosis , Humans , Infant , Infant, Newborn , Neonatal Screening
4.
Radiol Med ; 88(3): 277-84, 1994 Sep.
Article in Italian | MEDLINE | ID: mdl-7938735

ABSTRACT

The laser represents one of the most interesting new methods of vascular surgery. As for laser-assisted angioplasty, the major clinical experience has come with Nd: Yag and Argon lasers. The authors comment on the 1989-1992 series of cases consisting of 51 arteries recanalized with a Nd:Yag laser--the patients were 42 men and 9 women, their mean age being 56.6 years. Four iliac obliterations, 36 femoropopliteal and 11 popliteotibial obliterations were treated surgically, according to the single anatomical radiologic circumstances. The immediate results showed 41 recanalizations (80.4%) 3 perforations (5.9%), 6 dissections (11.8%) and 2 distal emboli (3.9%). The long-term results, with a follow-up period ranging 6 months to 4 years (average: 1.8 years), were investigated with seriated c.w. Doppler, Doppler US and digital venous angiography and showed, in 34 examined patients, 22 patencies (64.7%), 8 stenoses > 50% (23.5%) and 3 occlusions (11.8%). These findings prove the value of laser-assisted--both percutaneous and surgical--angioplasty in the treatment of arterial occlusions both alone and combined with surgery. The results, whose positivity comes also from an eclectic interaction with surgery, and mostly from a systematic enhancement of the laser channel with balloon angioplasty, could be markedly improved upon by means of more selective and effective equipment.


Subject(s)
Angioplasty, Balloon, Laser-Assisted/methods , Arterial Occlusive Diseases/surgery , Leg/blood supply , Adult , Aged , Anesthesia, Local , Angioplasty, Balloon, Laser-Assisted/adverse effects , Angioplasty, Balloon, Laser-Assisted/instrumentation , Angioplasty, Balloon, Laser-Assisted/statistics & numerical data , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/epidemiology , Chronic Disease , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Care , Premedication
5.
Nephron ; 63(1): 54-7, 1993.
Article in English | MEDLINE | ID: mdl-8446252

ABSTRACT

To evaluate the usefulness of the captopril test for identifying renal artery stenosis (RAS) and renovascular hypoplasia (RAH), we studied 48 hypertensive patients. In 20 hypertensives with screening procedures indicating renovascular disease and in 28 essential hypertensives (EH), the plasma renin activity (PRA) responses to an oral test dose of captopril (50 mg) were studied. A 60-min post-captopril PRA increase of 150% (or 400% if baseline PRA < or = 3 ng/ml/h) was considered as positive. Renal angiography was performed in all cases. Among the 20 renovascular hypertensive patients, RAH in 9 and RAS in 11 subjects were proved by angiography. The captopril test in all patients with RAH resulted negative (mean PRA increase 50%); furthermore, the test identified 7 of the 11 RAS (mean PRA increase 477.6%); sensitivity and specificity for RAS were 64 and 88.8%, respectively. In the EH group, there were 3 false-positive subjects (mean PRA increase 122%). This study demonstrates that the PRA responses to a test dose of captopril are a useful screening test for distinguishing RAH from RAS, and for identifying the latter in hypertensive patients. These data also suggest that in subjects with RAH, hypertensive disease may not renin dependent.


Subject(s)
Angiotensin-Converting Enzyme Inhibitors/pharmacology , Kidney Diseases/diagnosis , Renal Artery Obstruction/diagnosis , Administration, Oral , Adolescent , Adult , Aged , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Captopril/administration & dosage , Captopril/pharmacology , Diagnosis, Differential , Female , Humans , Hypertension, Renovascular/etiology , Hypertension, Renovascular/physiopathology , Kidney/diagnostic imaging , Kidney/metabolism , Kidney/pathology , Kidney Diseases/blood , Kidney Diseases/congenital , Male , Middle Aged , Radiography , Renal Artery Obstruction/blood , Renin/blood , Renin-Angiotensin System/physiology
6.
Minerva Chir ; 47(15-16): 1241-8, 1992 Aug.
Article in Italian | MEDLINE | ID: mdl-1407622

ABSTRACT

The Authors consider the complex diagnostic problems of cerebrovascular disorders, with particular concern to angiography and echography. After a complete analysis of different aspects of angiographic and echographic lesions, considering their experience, they identify chances and limits of the two methods, they draw the conclusion that each of the two techniques has a proper role, and only a correct correlation between them can depict correctly the pathologic lesions.


Subject(s)
Cerebral Angiography , Cerebrovascular Disorders/diagnostic imaging , Evaluation Studies as Topic , Humans , Ultrasonography
7.
Minerva Urol Nefrol ; 43(4): 311-6, 1991.
Article in Italian | MEDLINE | ID: mdl-1812577

ABSTRACT

Authors describe renal failure in a young woman with solitary pelvic kidney. Renal malformation was associated with genital and bone malformations that can be accounted for by the close relationship linking the genito-urinary and vertebral apparatuses during the first weeks of intrauterine life. Palpebral malformation which occurs very rarely in cases with renal malformations as reported in the literature was ascribed to hereditary factors. Changes of some indexes (serum and urine electrolytes, plasma renin and aldosterone) observed during the evolution of renal failure appear to confirm the role played by potassium in hormone balance and suggest repeated tests and dietary adjustments.


Subject(s)
Abnormalities, Multiple , Bone and Bones/abnormalities , Eyelids/abnormalities , Kidney Failure, Chronic/complications , Kidney/abnormalities , Uterus/abnormalities , Adult , Female , Humans
8.
Recenti Prog Med ; 81(9): 581-4, 1990 Sep.
Article in Italian | MEDLINE | ID: mdl-2263754

ABSTRACT

We studied 45 hypertensive subjects to evaluate the usefulness of captopril test for identifying renal artery stenosis and small congenital kidney with the hypoplasia of the renal artery. In 18 hypertensives with hippuran renogram indicating renovascular disease, and in 27 essential hypertensives, the plasma renin activity (PRA) responses to an oral test dose (50 mg) of captopril were studied. A 60-minute post captopril PRA increase of 150% (or 400% if baseline PRA less than 3 ng/ml/h) was considered as positive. Digital venous angiography was performed in all cases. In the group of 18 subjects small congenital kidney in 7, and renal artery stenosis in 11 subjects were detected by angiography. Captopril test resulted negative in all patients with small congenital kidney (mean PRA% increase 58). The test identified 7 of the 11 renal artery stenoses (mean PRA% increase 477), sensitivity and specificity were 64% and 100% respectively. In the essential hypertensives-group, mean PRA% increase was 122; there were three false positives, and both sensitivity and specificity were 88%. This study demonstrates that the PRA response to oral captopril test is a useful screening test for distinguishing small congenital kidney from renal artery stenosis and for identifying the latter in hypertensive patients.


Subject(s)
Captopril , Hypertension/etiology , Kidney/abnormalities , Renal Artery Obstruction/diagnosis , Renal Artery/abnormalities , Adolescent , Adult , Aged , Humans , Middle Aged , Renal Artery Obstruction/complications , Renin/blood
9.
Minerva Chir ; 45(7): 477-80, 1990 Apr 15.
Article in Italian | MEDLINE | ID: mdl-2142518

ABSTRACT

In this paper the Authors discuss about femoral anastomotic pseudoaneurysms. They throughly consider the etiopathogenesis of this late complication of arterial prothesic surgery, pointing out the different hypothesis currently discussed. Particularly from this analysis it can be concluded that the choice of appropriate prothesic grafts and the weakness of an eventually endarterectomized arterial wall are the principal determinants in causing pseudoaneurysms. Between the different therapeutic choices the opportunity of an interposition graft is underlined, except for (rare) cases when an extra-anatomic bypass must be preferred.


Subject(s)
Anastomosis, Surgical/adverse effects , Aneurysm , Femoral Artery , Aged , Aneurysm/etiology , Aneurysm/surgery , Blood Vessel Prosthesis , Female , Humans , Male , Middle Aged , Polyethylene Terephthalates
10.
J Cardiovasc Surg (Torino) ; 31(1): 87-91, 1990.
Article in English | MEDLINE | ID: mdl-2324190

ABSTRACT

Six patients with no hemodynamically significant atherosclerotic lesions of the lower limb arteries but with ischemic changes of the feet or toes were studied and diagnosed as having atherothrombotic microembolism. All patients were non claudicators and had peripheral Doppler examinations on admission. Five patients experienced more than one separate episode of microembolization involving both extremities. None presented with a history of heart disease or diabetes. Biplanar arteriograms revealed in every case atherosclerotic degeneration of the aorta without any obstructing lesions and anatomical arterial continuity between the aorta and the site of distal embolization. Three patients who refused operation, were treated conservatively, with a combination of dipyridamole plus aspirin. Three other patients had surgical repair of their atheromatous infrarenal aorta: in two cases thromboendarterectomy was performed, and in the other a Dacron bifurcated graft interposition. No amputations resulted in the patients treated medically, but one of the surgical group lost one toe. This study confirms that atherothrombotic microembolism from an ulcerated atherosclerotic aorta is a potential threat to the extremities and indicates that the optimal therapy for this syndrome has yet to be found.


Subject(s)
Aortic Diseases/complications , Arteriosclerosis/complications , Embolism/etiology , Foot Diseases/etiology , Adult , Aged , Aorta, Abdominal , Aortic Diseases/drug therapy , Aortic Diseases/surgery , Arteriosclerosis/drug therapy , Arteriosclerosis/surgery , Aspirin/therapeutic use , Dipyridamole/therapeutic use , Drug Therapy, Combination , Embolism/physiopathology , Female , Foot Diseases/physiopathology , Humans , Male , Middle Aged , Recurrence , Toes/blood supply
11.
Minerva Chir ; 45(1-2): 29-35, 1990 Jan.
Article in Italian | MEDLINE | ID: mdl-2139922

ABSTRACT

PTA represents a slightly invasive method for treatment of iliac arteries stenoses. The Authors present their experience about this topic and discuss current indications in the use of this technique. They believe that beyond the already defined indications, such as treatment of short stenoses, transluminal angioplasty can be employed for long stenoses too, eventually combined with limited surgical procedures. They stress the importance of combining traditional PTA with new percutaneous or intraoperative Argon Laser technology, that surely will contribute to broad its indications and to improve its results.


Subject(s)
Angioplasty, Balloon , Arterial Occlusive Diseases/therapy , Iliac Artery , Aged , Arterial Occlusive Diseases/diagnostic imaging , Evaluation Studies as Topic , Humans , Iliac Artery/diagnostic imaging , Middle Aged , Radiography
12.
Minerva Chir ; 44(9): 1349-51, 1989 May 15.
Article in Italian | MEDLINE | ID: mdl-2761736

ABSTRACT

Personal experience of intraoperative anterograde phlebography of the internal spermatic vein is reported. The use of this technique is suggested for controlling the result of internal spermatic vein ligature in cases of type I varicocele according to Coolsaet, diagnosed by preoperative retrograde phlebography. Early data make it possible to conclude that intraoperative anterograde phlebography is a valuable aid in reducing the frequency of recurrences.


Subject(s)
Phlebography/methods , Varicocele/surgery , Adolescent , Adult , Evaluation Studies as Topic , Humans , Intraoperative Care , Ligation , Male
13.
Minerva Chir ; 44(7): 1103-6, 1989 Apr 15.
Article in Italian | MEDLINE | ID: mdl-2747950

ABSTRACT

Personal experience of thromboses of the inferior vena cava is presented and pathogenetic and symptomatological aspects stressed. In addition, in relation to the results presented and reported data, it is concluded that the role of surgical therapy is fundamental to integrate the thrombolytic and anticoagulant treatment of these severe forms of deep venous thrombosis.


Subject(s)
Thrombosis/surgery , Vena Cava, Inferior , Anticoagulants/therapeutic use , Female , Fibrinolytic Agents/therapeutic use , Follow-Up Studies , Humans , Male , Middle Aged , Thrombosis/diagnostic imaging , Thrombosis/drug therapy , Tomography, X-Ray Computed , Vena Cava, Inferior/diagnostic imaging
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