[Neuroimaging and definition of transient ischemic attack]. / Neuroimaging e definizione di attacco ischemico transitorio.

AIM: Transient ischemic attack (TIA) has to be considered an "alarm bell" of a more or less severe organic or systemic vasculopathy. Positive findings at neuroimaging means tissue damage. The purpose of this retrospective study was to assess the role of neuroimaging in the management of patients presenting with TIA, and to consider the relative implications. METHODS: In a consecutive series of 82 patients (53 males, 29 females, mean age: 65.9±13.1 years) admitted for TIA, it was possible to review the history and the clinical data of 66 patients, including ABCD2 score, laboratory including plasmatic D-dimer, and neuroimaging data including computed tomography (CT) and magnetic resonance imaging including diffusion-weighted with apparent diffusion coefficient measure (DWI-ADC) obtained at diagnosis and by a week later (16 by CT, and 50 by DWI-ADC). Thirty-three patients underwent DWI-ADC within 24 hours from symptoms onset. Statistical analysis has been performed by non-parametric tests (χ2 and Mann-Whitney), and logistic regression by a commercially available software. RESULTS: CT and/or DWI-ADC showed signs of acute ischemic lesions in 23/66 (35%) patients. 12 out of the 35 patients with a 24-hour DWI-ADC follow-up were positive. Statistical analysis showed that positive neuroimaging was significantly associated only with familial history of cardiovascular diseases (P<0.012) and previous TIA/stroke (P<0.046). CONCLUSION: In this patients series, at least 35% of patients with TIA had a positive neuroimaging, especially DWI-ADC. Positive neuroimaging seems an independent factor. Patients with TIA need an early assessment by neuroimaging including DWI-ADC, in order to obtain a correct classification and prognosis.

Benign orbital pseudolymphoma. Case report.

Orbital pseudolymphomas are uncommon benign tumors composed of reactive lymphocytes. The typical clinical presentation is painless onset of ptosis, proptosis, diplopia, or eyelid swelling. Virtually any adnexal structure can be affected, but lacrimal gland, orbital soft tissue, or extraocular muscles are the usual sites of involvement. Historically, treatment has been with oral corticosteroids or localized radiotherapy. We present a case of benign orbital pseudolymphoma.

Manual thromboaspiration technique as a first approach for endovascular stroke treatment: A single-center experience.

BACKGROUND: For intracranial large vessel occlusion in acute ischemic stroke (AIS), a high degree of revascularization in the minimal amount of time predicts good outcomes. Recently, different studies have shown that the direct aspiration first pass technique (ADAPT technique) for AIS obtains high recanalization rates, fast interventions and low costs when it works as first attempt. This study retrospectively describes revascularization efficacy, duration of procedure, intra and post-procedural complications, early and after 90-days clinical outcome in a group of patients who underwent ADAPT as the primary endovascular approach, eventually followed by stent retriever thrombectomy, for recanalization of large vessels in the anterior circulation. MATERIALS AND METHODS: We analyzed clinical and procedural data of patients treated from April 2014 to August 2015. Recanalization was assessed according to the Thrombolysis in Cerebral Infarction score. Clinical outcome was evaluated at discharge and after 3 months (modified Rankin Scale, mRS). RESULTS: Overall, 71 patients (mean age of 69.7 years) were treated. Sites of occlusion were anterior circulation (including seven tandem extracranial-intracranial occlusions). In 39 patients i.v. rtPA was attempted. Recanalization of the target vessel was obtained in 87.3% of cases whereas direct aspiration alone was successful in 46/71cases (64.8%) with an average puncture-to-revascularization time of 43.1 minutes. Symptomatic intracranial hemorrhage occurred in 7.8% and embolization to new territories in 5.6%. In total, 38 patients (53.5%) had a good outcome at 90 days follow-up. CONCLUSIONS: In our series, the manual thromboaspiration technique has been shown as fast and safe, with good rates of vessel revascularization in 87.3% of patients and neurological outcome <3 mRS in 53.5% of patients.

Hemodynamic and Anatomic Variations Require an Adaptable Approach during Intra-Arterial Chemotherapy for Intraocular Retinoblastoma: Alternative Routes, Strategies, and Follow-Up.

BACKGROUND AND PURPOSE: Intra-arterial chemotherapy for retinoblastoma is not always a straightforward procedure, and it may require an adaptable approach. This study illustrates strategies used when the ophthalmic artery is difficult to catheterize or not visible, and it ascertains the effectiveness and safety of these strategies. MATERIALS AND METHODS: A retrospective study was performed on a series of 108 eyes affected by intraocular retinoblastoma and selected for intra-arterial chemotherapy (follow-up range, 6-82 months). We recognized 3 different patterns of drug delivery: a fixed pattern through the ophthalmic artery, a fixed pattern through branches of the external carotid artery, and a variable pattern through either the ophthalmic or the external carotid artery. RESULTS: We performed 448 sessions of intra-arterial chemotherapy, 83.70% of them through the ophthalmic artery and 16.29% via the external carotid artery. In 24.52% of eyes, the procedure was performed at least once through branches of the external carotid artery. In 73 eyes, the pattern of drug delivery was fixed through the ophthalmic artery; for 9 eyes, it was fixed through branches of the external carotid artery; and for 17 eyes, the pattern was variable. Statistical analysis did not show any significant difference in the clinical outcome of the eyes (remission versus enucleation) treated with different patterns of drug delivery. Adverse events could not be correlated with any particular pattern. CONCLUSIONS: Alternative routes of intra-arterial chemotherapy for intraocular retinoblastoma appear in the short term as effective and safe as the traditional drug infusion through the ophthalmic artery.

Influence of cigarette smoking on pituitary and sex hormone balance in healthy premenopausal women.

Plasma gonadotropin FSH and LH, PRL, sex steroids (17-beta E2, E1, and P), SBP binding capacity, and urine estrogens (E1, E2, and E3) were measured in 485 premenopausal healthy women, subdivided according to smoking habits. The aim of the study was to verify if cigarette smoking influences sex hormone balance. Baseline PRL levels were significantly lower (P less than 0.002) in smoker (n = 174) than in nonsmoker (n = 311) women. No difference was found in the other parameters of the two groups, particularly in plasma and urine estrogenic pattern. Our data suggest that smoking directly affects PRL levels by involving the hypothalamic mechanism that regulates PRL secretion.

Motor-evoked potentials in masseter muscle by electrical and magnetic stimulation in intact alert man.

The electromyographic responses of the masseter after different types of transcranial stimulation were recorded with surface and needle electrodes. Magnetic stimulation at 4 cm lateral to the vertex on the biauricular line elicited MEPs in the contralateral masseter (latency 6.9 ms) due to activation of motor cortex or adjacent elements along the cortico-nuclear pathway. The ipsilateral responses to the same stimuli and to more lateral ones had shorter latencies and were ascribed to direct stimulation of the trigeminal nerve, probably its intracisternal portion. This was also the probable origin of the ipsilateral MEPs after both anodic and cathodic bipolar electrical stimulation at 7 and 11 cm lateral to the vertex on the biauricular line.

Dimensional stability of silicone-based impression materials.

This study attempts to demonstrate that the polymerization reaction is not the only factor that affects the shrinkage of silicone-based impression materials because evaporation of the constituents also contributes to the shrinkage. These factors can be evaluated by the study of time-dependent dimensional changes. This is shown both by chemical kinetics and by experimental testing of condensation and addition polymerizing impression materials with different viscosities. Comparison of the different materials shows that the two contributions, polymerization shrinkage, and evaporation shrinkage, can be assessed separately by analysis of the time-dependent shrinkage diagrams. The instability due to the polymerization reaction is complete after a few hours, but the contribution of the constituent evaporation, if present, can have a significant long-term role.

[Echocardiographic study of the left ventricle in chronic alcoholism]. / Studio ecocardiografico del ventricolo sinistro nell'etilismo cronico.

Echocardiographyc has been used to study clinical signs of cardiopathy in 25 chronic alcoholics. Compared to normal control subjects, the alcoholics presented an increase in the left ventricular wall and an increase in the cross section and volume of the left myocardium. The left ventricular cavity was also increased. On the other hand, echocardiographic indices of myocardial contractility, represented by the ejection fraction, rate of circumferential shortening and rate of increase of the thickness of the left ventricular wall from telediastole to telesystole, were within normal limits.

[Food poisoning with marine animal toxins of invertebrate origin]. / Intossicazione alimentare da zootossine marine di origine invertebrata.

The consumption of seafood is increasing and hence the risk of poisoning. For this reason, the study of food poisoning caused by zootoxins from marine invertebrates has become of signal importance. These toxins come from bivalve molluscs and other species. Depending on the type of toxin concerned, poisoning attributable to molluscs may give rise to paralysis, caused by saxitossin, neurotoxic effects (gimbretoxin), or haemolysis (venerupin). Poisoning caused by coelenterates, echinoderms, cephalopods, Neptunea, abalone, crabs and lobsters is less common, and its clinical pictures and pathogenesis have not been fully established. In some instances, toxins presented in the phytoplankton ingested by these animals appear to be responsible, whereas in others its would seem that they themselves elaborate the active principles directly.

[Functional respiratory and blood gas analytical studies of the effects of fenspiride, in oral and intramuscular administration, in chronic bronchopneumopathic subjects]. / Rilievi funzionali respiratori ed emogasanalitici sugli effetti della fenspiride per via orale ed intramuscolare in soggetti broncopneumopatici cronici.

A group of 20 chronic bronchopneumopathics was treated for 15 days with fenspiride orally and i.m. The behaviour of a set of functional respiratory and haemogasanalytic parameters was monitored at various times (basic, 5th, 10th and 15th days). Progressive, significant improvements in VC, FEV1, RV and in related parameters were observed. These were attributed to the drug's anti-inflammatory effect in the respiratory ways as well as to its direct antibronchospastic action. Stress is laid on the excellent clinical tolerance of fenspiride following its oral and i.m. administration.

[Toxic occupational liver diseases. Therapeutic effects of silymarin]. / Epatopatie tossiche professionali. Effetti terapeutici della silimarina.

We considered two groups, one of 35 and the other of 20 patients, with occupational toxic hepatopathy caused by various toxic substances (mostly solvents, paints and glues). The patients were mostly suffering from chronic or subacute forms. We considered the work conditions in the anamnesis, the period of exposure and most important laboratory parameters of hepatic function checked before and after treatment with Silymarin (420 mg/die/os) for the first group and with "placebo" for the second group. Five patients of the first group were diagnosed by biopsy. The treatment with Silymarin has shown slight variations in some parameters. The therapeutic effect is probably not dependent upon the kind of pathogen noxa; it seems instead to be more evident when the exposure period is shorter. The group "placebo" does not show significant variations.

[Behavior of blood gamma glutamyltransferase in workers exposed to hepatotoxic agents]. / Comportamento della gamma-GT sierica in alcune categorie di lavoratori esposti ad agenti epatotossici.

The behaviour of serum GT is evaluated as an indicator of exposure to enzymatic inductors that are potentially hepatotoxic. Serum GT was measured in 437 exposed workers and 149 controls. The statistically significant variation observed in the exposed group probably indicates enzymatic induction.

[Possible risk of liver diseases from exposure to bitumen]. / Possibile rischio di epatopatie da esposizione a bitumi.

The influence of exposure to bitumen on hepatic enzymatic induction was examined. Measurement of serum GT in a group of exposed workers and a control group produced statistically significant results, indicating that exposure to bitumen causes enzymatic induction.

Study of DDT blood level in a group of workers exposed to pesticides.

Blood levels of DDT, DDE, and other DDT metabolites were determined in a group of workers with previous occupational exposure to DDT as spraymen. The larger part of total DDT was in the form of metabolite DDE, which is thought to be introduced into the human body primarily from external sources. Total DDT blood level was correlated positively with both age and occupational exposure (R = 0.58 and 0.52, respectively), and linear regressions between storage and these variables were demonstrated. Although the storage of these compounds in body fat was not studied, the analysis of covariance showed a significant increase of DDT blood level in the group of workers with longer occupational exposure, which was not dependent on age.

[Mandibular surgical prosthesis]. / La protesi chirurgica mandibolare.

The need for prosthesis in patients presenting losses of mandibular substance has been examined, with a subdivision of prostheses into: containment, immediate modelling and reconstructive. Technical difficulties involved in their application are described.

[Oral lichen planus (OLP). Therapeutic guidelines and clinical experience with 71 patients]. / Lichen planus orale (OLP). Orientamenti terapeutici ed esperienza clinica in 71 pazienti.

The authors report the results of a study performed in 71 patients suffering from lichen planus of the mucous membranes and skin. They discuss dermatological and stomatological clinical data in relation to possible basal diseases (hepatopathies, dermopathies, diabetes, hypertension, gastrointestinal diseases, etc.) and other anamnestic data (psychological aspects, drug taking, working activity, etc.). Moreover, they report the results of the clinical protocol used (betamethasone in a gel and vitamin A base) with a follow-up of 5 years and examine the other therapeutic possibilities reported in the literature.

[Fractures of the orbito-zygomatico-malar complex]. / Considerazioni sulle fratture del complesso orbito-zigomatico-malare.

Reference is made to the increasing number and severity of orbito-zygomatico-malar fractures brought about by the greater number of vehicles on the orads and their higher speeds. Fracture lines in such cases very considerably. An account is given of the therapeutical approaches usually followed at the Parma University Odontostomatological Clinic, based on experience acquired in 275 cases.

[Comparison of liposoluble and water-soluble contrast media in sialography]. / Confronto fra i mezzi di contrasto liposolubili e idrosolubili nella scialografia.

Highly, averagely and lightly viscous contrast media most frequently used in radiography of the salivary glands have been compared. It is concluded that the preparation which has so far given the best results is liposoluble but averagely viscous and not too contrasting.

[Gingival hypertrophy due to cyclosporine. A clinico-statistical study in 82 patients]. / Ipertrofia gengivale da ciclosporina. Indagine clinico-statistica in 82 pazienti.

Eighty-two patients were observed at the Dental Department at Parma University. Seventy-six of them had renal transplant and 6 liver transplant. They were in immunosuppressive therapy with cyclosporina, 42 of them were also in calcium antagonist therapy. Gingival hypertrophy was observed in 52 subjects (63.4%) 25 (30%) patients underwent surgical operation, 6 of them (24%) showed a relapse about 3 months after the first operation. Clinical data were measured in accordance with 5 indicators: the level of oral hygiene, cyclosporinemia, contemporaneous use of calcium antagonist, the duration of therapy and the DMF index. By the results obtained, it's possible to suppose that the gravity of the disease is related to the contemporaneous use of calcioantagonist, but it wasn't highly significant (p < 0.05). The degree of oral hygiene was decidedly in relation to the most severe forms of gingival hyperplasia (grade 2-3), (p < 0.001). No relation was found for the duration of therapy, distribution of the DMF index and the level of drugs in the blood.