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1.
Dig Liver Dis ; 52(7): 695-699, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32425732

RESUMO

We conducted a survey to investigate to what extent the fear of COVID-19 has influenced the patients decision to undergo or to cancel endoscopic procedures. We collected data from 847 patients from 13 centres. The main indication for endoscopy was anemia, followed by pain and unexplained weight loss. The percentage of not presenters progressively increased throughout the three weeks of study, from 15.1% at the beginning to 48.2% at the end. 37 (34.2%) upper GI endoscopies and 112 (56.3 %) colonoscopies showed an organic cause explaining the symptoms presented by the patients, respectively; 5 cases of gastric cancer (4.6%) and 16 cases of colorectal cancer (CRC) (6.0%), respectively, were detected; during the second week the percentage of organic diseases found at upper endoscopy was 19 (33.3%) with 5 cancer (8.7%), and 61 (49.1% ) at colonoscopy, with 2 CRC (1.6%); finally, during the third week the corresponding figures were 19 (48.7%) for upper GI examinations, with 3 gastric cancers (7.7%), and 43 (60.5%) with 4 (6.5%) CRC cases found.We conclude that patients weighted the fear of having a clinically relevant disease with the fear of becoming infected by coronavirus, and a relevant percentage of them (29.4%) decided not to attend the endoscopy suites at the scheduled date.


Assuntos
Neoplasias Colorretais , Infecções por Coronavirus , Endoscopia Gastrointestinal , Medo , Pacientes não Comparecentes , Pandemias , Pneumonia Viral , Neoplasias Gástricas , Atitude Frente a Saúde , Betacoronavirus/isolamento & purificação , COVID-19 , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/fisiopatologia , Neoplasias Colorretais/psicologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/transmissão , Surtos de Doenças , Endoscopia Gastrointestinal/psicologia , Endoscopia Gastrointestinal/estatística & dados numéricos , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pacientes não Comparecentes/psicologia , Pacientes não Comparecentes/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/transmissão , SARS-CoV-2 , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/fisiopatologia , Neoplasias Gástricas/psicologia , Inquéritos e Questionários
2.
J Clin Pathol ; 61(10): 1116-8, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18708422

RESUMO

AIMS: Although they are non-specific, minimal intestinal lesions are at the end of the coeliac histological damage spectrum. To investigate whether minimal intestinal lesions in patients without endomysial antibodies are due to coeliac disease, their prevalence, causes and risk of evolving into frank coeliac disease were studied. METHODS: From January 2000 to December 2005, 645 duodenal biopsies were performed. In 209 patients, duodenal biopsies were performed independently of endomysial antibody results. Clinical data and HLA-typing of all the patients negative to endomysial antibodies but with minimal mucosal lesions were re-evaluated. Three years later, they were offered to be seen again, and further investigations were proposed. RESULTS: 14 out of 209 patients had minimal mucosal lesions and negative endomysial antibodies. Two patients were lost to follow-up; in 7/12 patients, symptoms and histological lesions were due to a different condition, not related to coeliac disease. In 11/12 patients, HLA-typing made diagnosis of coeliac disease very unlikely. Only one patient was on a gluten-free diet because of gluten-sensitive symptoms and was DQ2(+)/DQ8(+). CONCLUSIONS: Minimal duodenal lesions in patients negative to endomysial antibodies are rare and are likely to be due to conditions unrelated to coeliac disease.


Assuntos
Duodeno , Enteropatias/patologia , Mucosa Intestinal/patologia , Adulto , Autoanticorpos/imunologia , Biópsia , Doença Celíaca/imunologia , Doença Celíaca/patologia , Diagnóstico Diferencial , Progressão da Doença , Duodenopatias/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Risco
3.
Am J Gastroenterol ; 95(4): 1014-6, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10763952

RESUMO

OBJECTIVE: Little is known about the clinical features and natural history of segmental colitis associated with diverticula. Our aim was to evaluate the incidence of segmental colitis associated with diverticula in patients undergoing colonoscopy, its clinical picture, and its outcome. METHODS: This was a multicenter, prospective study. Patients with inflammatory bowel disease (IBD)-like lesions limited to colonic segments with diverticula were enrolled. Patients were treated with oral and topical 5-aminosalicylic (5-ASA) until remission was achieved; clinical and endoscopic follow-up was planned at 6 wk and 12 months. RESULTS: A total of 5457 consecutive colonoscopies were recorded at five participating institutions; 20 patients (0.36%) met the endoscopic criteria for segmental colitis associated with diverticula. All had lesions in the left colon, and one also had lesions in the right colon. In six cases, a specific diagnosis was made thereafter. The remaining 14 patients (0.25% of colonoscopies; eight men; age range, 49-80 yr) were in clinical and endoscopic remission at the first follow-up visit. At onset, 13/14 had hematochezia, seven had diarrhea, and five had abdominal pain; only one had weight loss. No subject had fever. In all but one case, blood chemistries were normal. Five patients had had similar symptoms previously. Thirteen of 14 patients were in clinical and endoscopic remission at 12 months. CONCLUSIONS: This endoscopic picture is not an exceptional finding. Hematochezia was the main clinical feature, and no relation with gender, age, or smoking habit was found. Blood chemistries were generally normal and the rectum was spared. The histological features were not diagnostic and most patients did not complain of any abdominal symptoms 12 months after enrollment.


Assuntos
Colite/diagnóstico , Doença Diverticular do Colo/diagnóstico , Doenças Inflamatórias Intestinais/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/administração & dosagem , Colite/tratamento farmacológico , Colonoscopia , Doença Diverticular do Colo/tratamento farmacológico , Feminino , Humanos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Masculino , Mesalamina/administração & dosagem , Pessoa de Meia-Idade , Estudos Prospectivos
4.
Ann Ital Med Int ; 13(2): 125-7, 1998.
Artigo em Italiano | MEDLINE | ID: mdl-9734146

RESUMO

The term gastrointestinal stromal tumor describes a heterogeneous group of tumors of mesenchymal origin with particular histologic features. Their classification has recently been made possible thanks to numerous immunohistochemical and ultrastructural studies. We report the case of a patient who came to our attention because of serious anemia due to a gastrointestinal stromal tumor located between the second and third portion of the duodenum. This pathology, although not frequent, should be considered in the differential diagnosis of gastrointestinal bleeding. In these cases it is important to perform careful endoscopic inspection to the third portion of th duodenum, even when previous tracts evidence lesions that could be responsible for the patient's symptoms.


Assuntos
Neoplasias Duodenais/complicações , Hemorragia Gastrointestinal/etiologia , Neoplasias Duodenais/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Células Estromais
5.
Microsurgery ; 18(8): 472-5, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9888352

RESUMO

We report on a clinical case where microsurgical techniques successfully supported traditional surgery in a wide reconstruction between the oropharynx and small bowel. Several years ago, the patient sustained a severe corrosive injury of the upper digestive tract with subsequent esophageal stricture and stiffening; at that time, an emergency gastrectomy was performed. In this case, the restoration of the defect could not rely on the classic colonic interposition. During the operation the ileo-colic flap, well-fitted for tension-free reconstruction, revealed the foreseen inadequacy of its vascularization based on the sole middle colic vascular pedicle. The blood supply to its proximal part was then increased by microanastomosis between the right internal mammary and ileo-colic vessels. The revascularization ensured the viability of the interposed tissue. Oral intake resumed after 3 weeks; nowadays the patient is able to maintain her ideal weight with adequate nutrition.


Assuntos
Colo/cirurgia , Esofagoplastia/métodos , Íleo/cirurgia , Artéria Torácica Interna/cirurgia , Microcirurgia , Adulto , Anastomose Cirúrgica , Colo/irrigação sanguínea , Feminino , Humanos , Íleo/irrigação sanguínea
6.
Am J Clin Nutr ; 66(2): 320-6, 1997 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9250110

RESUMO

Mucosal biopsy specimens obtained by routine endoscopy from 108 human subjects, including one patient with thiamine deficiency, were incubated at 37 degrees C in oxygenated calcium-free Krebs-Ringer solution (pH 7.5) containing tritiated thiamine and [14C]dextran as a marker of adherent mucosal water. The amount of labeled thiamine taken up was measured radiometrically. In subjects with no clinical evidence of thiamine deficiency, 1) thiamine uptake by duodenal mucosa had a hyperbolic time course, reaching equilibrium at 10 min; 2) thiamine concentrations < 2.5 mumol/L were taken up predominantly by a saturable mechanism displaying Michaelis-Menten kinetics (K(m) 4.4 mumol/L and Jmax 2.3 pmol.mg wet tissue-1.6 min-1), whereas higher concentrations were taken up by passive diffusion; 3) thiamine transport had different capacities along the gastrointestinal tract (duodenum >> colon > stomach); and 4) thiamine uptake was competitively inhibited in the duodenum by thiamine analogs, albeit with a different order of potency compared with rats, and was blocked by 2,4-dinitrophenol. In the thiamine-deficient patient, the duodenal saturable uptake was increased, with higher K(m) and Jmax values. In conclusion, physiologic concentrations of thiamine were transported in human small intestine by a specific mechanism dependent on cellular metabolism, whose transporters appear to be down-regulated.


Assuntos
Mucosa Intestinal/metabolismo , Deficiência de Tiamina/metabolismo , Tiamina/metabolismo , Adolescente , Biópsia , Feminino , Humanos , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Tiamina/farmacocinética , Deficiência de Tiamina/patologia
7.
Minerva Gastroenterol Dietol ; 43(1): 41-5, 1997 Mar.
Artigo em Italiano | MEDLINE | ID: mdl-16501467

RESUMO

Gangliocytic paraganglioma is an uncommon and usually benign lesion although some cases with metastasis to regional lymph nodes have been described. It is usually located in the descending duodenum submucosa and more frequently arises in male patients. It comes to clinical attention for discomfort, gastrointestinal bleeding, incidental finding and rarely for obstructive jaundice when it involves the papilla. Even if its histologic and immunocytochemical features have been thoroughly described, its histogenesis is still debated although hyperplastic and amartoma-choristoma theories are well considered. We report a case of duodenal gangliocytic paraganglioma in 46 years old chronic alcoholic man who underwent previous upper endoscopy for discomfort without diagnosing the lesion. This one was observed during a second upper endoscopy that was made for hemathemesis. But it was only after an episode of melena that a third upper endoscopy showed the paraganglioma that still kept hemorrhage stigmata and no other lesions. We describe this case of duodenal gangliocytic paraganglioma with review of the literature.

8.
Am J Gastroenterol ; 91(4): 695-700, 1996 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8677931

RESUMO

BACKGROUND: Numerous therapeutic trials aimed at eradicating Helicobacter pylori (HP) from the gastric mucosa and preventing ulcer recurrence have been carried out; however, an optimal treatment has not yet been established with carefully controlled randomized studies. OBJECTIVE: The aim of our study was to evaluate the efficacy of an association of omeprazole (OM) coupled with two antibiotics in the eradication of HP and prevention of duodenal ulcer (DU) recurrence. METHODS: One hundred and eighty three patients with active DU were randomized under double-blind conditions to receive either OM 20 mg for 4 wk plus amoxycillin 3 g daily and metronidazole 1 g daily during the 2nd and 3rd wk (91 patients, group A) or OM 20 mg for 4 wk plus matching placebo (92 patients, group B). Endoscopy was performed before and at the end of the 4-wk treatment as well as 2, 6, and 12 months later. Biopsies were taken from the duodenum, antrum, and gastric body at each endoscopic examination for HP histological detection and for evaluation of inflammatory changes according to the Sydney system. RESULTS: After 4 wk, 84/86 patients (98%) of group A and 80/86 (93%) of group B were healed of their ulcers. The percentage of eradication was 90% in group A and 1% in group B. During a 12-month follow-up, DU relapsed in 4/63 (6%, including two of three reinfected cases) HP-eradicated group A patients, 4/8 (50%) HP-noneradicated group A patients, and 52/65 (80%) persistently HP-positive group B patients. Rapid, complete, and persistent suppression of gastroduodenitis activity and gastric surface epithelium lesions was observed in most HP-eradicated group A patients, whereas a transient decrease of bacterial colonization and inflammatory scores in the antrum and a transient worsening of corpus gastritis were found in group B patients. CONCLUSIONS: The combined therapy with amoxycillin, metronidazole, and omeprazole is highly effective in both HP eradication and prevention of duodenal ulcer recurrence.


Assuntos
Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Antiulcerosos/administração & dosagem , Úlcera Duodenal/microbiologia , Úlcera Duodenal/prevenção & controle , Gastrite/tratamento farmacológico , Gastrite/microbiologia , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/isolamento & purificação , Metronidazol/administração & dosagem , Omeprazol/administração & dosagem , Adulto , Método Duplo-Cego , Quimioterapia Combinada , Úlcera Duodenal/epidemiologia , Feminino , Seguimentos , Gastrite/epidemiologia , Infecções por Helicobacter/epidemiologia , Humanos , Masculino , Recidiva , Fatores de Tempo
10.
Acta Neurol (Napoli) ; 16(1-2): 29-32, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-8073913

RESUMO

The Authors report on 150 cases of patients suffering from Parkinson's disease. The patients represent 8.3% of total parkinsonian patients and are selected on the basis of clinical and laboratory criteria that allow the diagnosis of "angiopathic parkinsonism" as an autonomous entity. Cerebral blood flow alterations in Parkinson's disease and associated dementing symptoms are also discussed. In conclusion, the Authors emphasize the usefulness of recognizing the "angiopathic parkinsonism" in view of therapeutical implications.


Assuntos
Doenças Cardiovasculares/complicações , Doença de Parkinson/diagnóstico , Terminologia como Assunto , Adulto , Idoso , Gânglios da Base/fisiopatologia , Doenças Cardiovasculares/diagnóstico , Circulação Cerebrovascular , Dopamina/sangue , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Fluxo Sanguíneo Regional , Tomografia Computadorizada por Raios X
11.
Scand J Gastroenterol Suppl ; 201: 28-34, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-8047821

RESUMO

The incidence and mean score of Helicobacter pylori-related, active antroduodenitis, lesions of superficial antral epithelium and duodenal gastric-type metaplasia were higher in endoscopic biopsies from a large series of patients with duodenal ulcer, when compared with asymptomatic patients or patients with non-ulcer dyspepsia. In 65 out of 73 patients with duodenal ulcer who could be followed up, H. pylori was eradicated using a combination of amoxycillin, 3 g daily, metronidazole, 1 g daily, and omeprazole, 20 mg daily. Rapid and permanent (6-month follow-up) abolition of both gastroduodenitis activity and lesions of the gastric surface epithelium was observed in these 65 patients. There was also a progressive decrease in total immune-inflammatory cells but without a substantial change in duodenal gastric-type metaplasia. Similar, but transient and quantitatively less prominent, improvements were observed in the antroduodenal mucosa, which had been temporarily cleared of H. pylori by treatment with omeprazole alone. Conversely, increased gastritis activity, epithelial lesions and immune-inflammatory cell scores were found in the short term in the corpus mucosa, which was not cleared of H. pylori after omeprazole treatment. It is concluded that, of the various H. pylori-related mucosal changes, antroduodenitis activity and antral epithelial lesions most closely reflect the severity of mucosal damage and are probably the most important factors in duodenal ulcerogenesis. Their complete and rapid suppression after bacterial eradication may be a key factor in preventing ulcer relapse.


Assuntos
Amoxicilina/administração & dosagem , Úlcera Duodenal/prevenção & controle , Gastrite/tratamento farmacológico , Gastrite/microbiologia , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Omeprazol/administração & dosagem , Método Duplo-Cego , Quimioterapia Combinada , Úlcera Duodenal/patologia , Mucosa Gástrica/patologia , Gastrite/patologia , Humanos , Metaplasia/tratamento farmacológico , Metronidazol/administração & dosagem
12.
Artigo em Inglês | MEDLINE | ID: mdl-1609509

RESUMO

Helicobacter pylori colonization and the incidence, severity, activity and topography of gastritis were investigated systematically in antrum and corpus mucosal biopsies of 1177 subjects undergoing endoscopy in the absence of gastric complaints (asymptomatic, 49) or for non-ulcer dyspepsia (NUD; 631 patients, 72 of whom had gastric and/or duodenal erosions), active gastric ulcer (GU, 76 patients), active duodenal ulcer (DU, 138 patients), and healed gastric (HGU, 39 cases) or duodenal ulcer (HDU, 230 cases). In the antrum, H. pylori colonization and the incidence, severity and activity of gastritis increased progressively in the sequence asymptomatic, erosion-free NUD, erosive NUD, healed ulcer and active ulcer. The same trend was observed in the corpus as regards H. pylori and gastritis incidence, whereas the severity and activity of gastritis were lower in active DU and erosive NUD and higher in active, proximal GU than in the remaining patients. Active DU and erosive NUD showed the highest incidence of non-atrophic gastritis and lowest type-A or AB atrophic gastritis, while active GU had lowest normal mucosa or type-A gastritis and highest type-B atrophic gastritis. In conclusion, H. pylori colonization and gastritis incidence, severity and, especially, activity of the antrum might all contribute to mucosal erosion and ulceration, whereas the same factors, at least in part and with the exception of proximal GU, seem to have a preventive role when affecting corpus mucosa.


Assuntos
Dispepsia/complicações , Mucosa Gástrica/patologia , Gastrite/microbiologia , Helicobacter/crescimento & desenvolvimento , Úlcera Péptica/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Contagem de Colônia Microbiana , Feminino , Gastrite/complicações , Gastrite/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/patologia
13.
J Neurosurg Sci ; 35(1): 1-8, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1890455

RESUMO

In the present work the main relationships among cerebral blood volume (CBV), cerebrospinal fluid (CSF) dynamics, cerebral blood flow (CBF) and cerebrovascular reactivity following subarachnoid hemorrhage are critically examined and discussed. It is hypothesized that, following the rupture of an aneurysm, antagonistic mechanism which regulate CBF (through a vasodilatation of the arteriolar vessels) and CBV (through a constriction of basal intracranial arteries) are activated, due to the initial increase in intracranial pressure (ICP) the time pattern of ICP and cerebral hemodynamics in the following days can be largely different depending on the state of CSF dynamics. When the CSF outflow is not altered by blood in the subarachnoid space ICP suddenly returns to the basal value, and a normal cerebral hemodynamics is rapidly restored. By contrast, in conditions in which the normal CSF dynamics is impaired, the opposite action of mechanisms regulating CBF and CBV may lead to instability of the cerebrovascular bed, with the result of a maximal dilatation of pial vessels and a strong constriction of basal arteries (spasm). In our opinion the phenomenon of vasospasm can be better understood if the reactivity of basal intracranial arteries is analyzed as a part of the complex physiological system of cerebrovascular regulation.


Assuntos
Ataque Isquêmico Transitório/fisiopatologia , Hemorragia Subaracnóidea/fisiopatologia , Volume Sanguíneo , Líquido Cefalorraquidiano/fisiologia , Circulação Cerebrovascular , Humanos , Pressão Intracraniana , Ataque Isquêmico Transitório/etiologia , Hemorragia Subaracnóidea/complicações , Fatores de Tempo
14.
Pathologica ; 82(1082): 707-17, 1990.
Artigo em Italiano | MEDLINE | ID: mdl-2094841

RESUMO

Helicobacter Pylori (HP) were found in 878 (73%) of 1205 patients undergoing upper G-I endoscopy with multiple biopsies for gastroduodenal diseases. HP were present in similar percentages among patients with active (89%) or healed (81%) peptic ulcer as well as in non ulcerous dyspeptics affected with gastritis (85%). 96% of active chronic gastritis were infected by HP as compared with 55% of quiescent gastritis. Antral gastritis was more frequently active in patients with ulcer diseases (76%) than in dyspeptic and asyntomatic patients (50%). Healed gastric and duodenal ulcers showed decreased incidence of active antral gastritis (69) as compared with active ulcers. Conversely body gastritis was more frequently active in healed (37%) than in overt (18%) duodenal ulcers. 95 histologically normal stomachs as well as 9 cases exhibiting type A gastritis were devoid of HP. High rates of infection were found in 610 cases of chronic gastritis without atrophy as well as in 151 atrophic antral (type B) gastritis. Cytoplasmic vacuolization and swelling of foveolar-superficial cells with adhering bacteria, micropapillae and microerosions were commonly found in HP-infected mucosa. In 16 of 19 children with type B chronic gastritis antibacterial therapy eradicated HP. This was followed by resolution or striking improvement of gastritis and disappearance of epithelial lesions.


Assuntos
Gastrite/microbiologia , Infecções por Helicobacter , Helicobacter pylori/isolamento & purificação , Adulto , Criança , Doença Crônica , Epitélio/patologia , Feminino , Gastrite/epidemiologia , Gastrite/patologia , Humanos , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade
15.
Am J Perinatol ; 7(4): 337-9, 1990 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-2222623

RESUMO

A 28-year-old primigravida woman was referred for ultrasound studies at 27 weeks' gestation. Sonographic examination found enlarged cerebral ventricles, communicating lateral ventricles, bilateral cleft lip and palate. A 2500 gm male infant was delivered at 36 weeks' gestation, after which the diagnosis of septo-optic dysplasia was made.


Assuntos
Disco Óptico/anormalidades , Septo Pelúcido/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Ultrassonografia Pré-Natal
16.
Riv Neurol ; 59(2): 71-6, 1989.
Artigo em Italiano | MEDLINE | ID: mdl-2672281

RESUMO

Cerebral blood flow and intracranial pressure dynamics are affected by two main factors. A first factor is represented by the action of cerebrovascular regulatory mechanisms (controls of cerebral blood volume and cerebral blood flow). Furthermore, intracranial circulation occurs within a rigid space, whose volume must, therefore, remain constant. This second factor explains the presence of a brain volume control, in order to maintain a normal value of intracranial pressure. The mean intracranial pressure value is mainly affected by the pressure-volume characteristic of the intracranial compartment, by the mean cerebral blood volume and by cerebrospinal fluid production and reabsorption processes. On the contrary, the pulsating intracranial pressure component is mainly affected by the intracranial pressure volume relationship and by cerebrovascular compliance; this last, in its turn, is modified by the action of regulatory mechanisms. A better understanding of the relationship occurring between cerebral hemodynamics, cerebrospinal fluid kinetics and intracranial pressure can be achieved with the aid of mathematical models. In particular, mathematical modelling allows the way intracranial pressure and cerebral blood flow are related to the main physical parameters of the intracranial compartment to be pointed out. Moreover, with a mathematical model it is possible to discriminate between the great number of different factors which act simultaneously "in vivo" on the cerebrovascular bed.


Assuntos
Circulação Cerebrovascular , Pressão Intracraniana , Humanos , Modelos Cardiovasculares , Modelos Neurológicos
17.
J Neurosurg Sci ; 32(3): 109-12, 1988.
Artigo em Inglês | MEDLINE | ID: mdl-3225649

RESUMO

The Authors report the results obtained by long-term clinical and radiological evaluation of patients who had undergone cervical multiple bilateral laminectomy to relieve the compression exerted on the cord by different diseases (spondylarthrosis, syringohydromyelia, intramedullary and extramedullary tumours, leptomeningeal cysts and extradural tumours). 98 patients were reviewed, the follow-up ranging from 8 to 24 years (mean 14 years). The results demonstrate that the most severe post-laminectomy changes are recorded in patients with intramedullary lesions and when middle-low cervical spine levels (C4-C7) are affected. The significance of spinal deformities such as kyphosis, spondylolisthesis and swan-neck is also discussed.


Assuntos
Laminectomia , Doenças da Coluna Vertebral/cirurgia , Atividades Cotidianas , Adolescente , Adulto , Criança , Seguimentos , Humanos , Pescoço , Radiografia , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/fisiopatologia , Fatores de Tempo
18.
Am J Perinatol ; 5(3): 226-31, 1988 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3289553

RESUMO

The sonographic findings in nine cases of agenesis of the corpus callosum examined before and after birth are reported. Agenesis of the corpus callosum was suspected in utero due to a typical configuration of the lateral ventricles, which included enlargement of the atria and occipital horns and marked separation of the bodies. In three cases pregnancy was terminated because of severe associated anomalies. In the remaining six cases postnatal ultrasound examination allowed a certain diagnosis by demonstrating the abnormal configuration of the lateral ventricles, varying degrees of enlargement, and upward displacement of the third ventricle and absence of the corpus callosum.


Assuntos
Agenesia do Corpo Caloso , Diagnóstico Pré-Natal/métodos , Ultrassonografia , Ventrículos Cerebrais/anormalidades , Ventrículos Cerebrais/patologia , Corpo Caloso/patologia , Idade Gestacional , Humanos , Recém-Nascido
19.
Neurosurgery ; 22(5): 807-12, 1988 May.
Artigo em Inglês | MEDLINE | ID: mdl-3288898

RESUMO

In the present work, the major correlations among cerebrospinal fluid (CSF) pulsatility, cerebral hemodynamic changes, the action of mechanisms regulating cerebral blood flow and cerebral blood volume, and the main aspects of the intracranial basal artery transcranial Doppler wave form are critically examined. CSF pulsatility is a consequence of rigidity of the craniospinal compartment and the pulsating changes in cerebral blood volume. At low and medium intracranial pressures (ICPs), changes in CSF pulsatility are mainly the result of changes in craniospinal elastance. During severe intracranial hypertension, however, CSF pulse pressure reflects an abrupt increase in cerebrovascular (i.e., cerebral vessel) compliance. The mechanisms controlling cerebral blood flow and cerebral blood volume affect CSF pulsatility through both an alteration in craniospinal blood volume and a change in vascular wall pulsatility. Examination of the main parameters of the Doppler velocity pattern (maximal systolic blood velocity, diastolic blood velocity, and peak to peak pulsatility index) in cerebral basal arteries reveals a significant alteration in the velocity wave form during severe ICP increase (above 60 mm Hg). During moderate ICP increase, when cerebral regulatory mechanisms are effective, the Doppler velocity pattern is not significantly affected by ICP changes.


Assuntos
Encéfalo/fisiologia , Líquido Cefalorraquidiano/fisiologia , Circulação Cerebrovascular , Ultrassonografia , Encéfalo/anatomia & histologia , Encéfalo/irrigação sanguínea , Humanos
20.
J Neurosurg ; 67(3): 333-5, 1987 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-3612266

RESUMO

The authors report long-term results in 17 patients with surgically treated congenital intradural spinal arachnoid cysts. Comparison between the immediate and long-term results demonstrates that surgical removal of the cyst allowed a significant neurological improvement in all cases, but clinical worsening of various degrees was observed later. The authors attempt to explain the results in terms of mechanical and vascular factors.


Assuntos
Aracnoide-Máter/cirurgia , Cistos/cirurgia , Doenças da Medula Espinal/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Cistos/complicações , Cistos/congênito , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/cirurgia , Doenças da Medula Espinal/complicações , Doenças da Medula Espinal/congênito
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