Assessing Wolf motor function test as outcome measure for research in patients after stroke.

BACKGROUND AND PURPOSE: The Wolf Motor Function Test (WMFT) is a new time-based method to evaluate upper extremity performance while providing insight into joint-specific and total limb movements. This study addresses selected psychometric attributes of the WMFT applied to a chronic stroke population. METHODS: Nineteen individuals after stroke and with intact cognition and sitting balance were age- and sex-matched with 19 individuals without impairment. Subjects performed the WMFT and the upper extremity portion of the Fugl-Meyer Motor Assessment (FMA) on 2 occasions (12 to 16 days apart), with scoring performed independently by 2 random raters. RESULTS: The WMFT and FMA demonstrated agreement (P<0.0001) between raters at each session. WMFT scores for the dominant and nondominant extremities of individuals without impairment were different (P0.05) from the dominant and nondominant extremities of individuals without impairment. The WMFT and FMA scores were related (P<0.02) for the more affected extremity in individuals after stroke. CONCLUSIONS: The interrater reliability, construct validity, and criterion validity of the WMFT, as used in these subject samples, are supported.

[Type III entrapment syndrome of the popliteal artery. Presentation of a clinical case with diagnostic and therapeutic discussion]. / Sindrome da "entrapment" della poplitea tipo III. Presentazione di un caso clinico con discussione diagnostica e terapeutica.

Following a short review of the various types of possible abnormalities in the popliteal artery entrapment syndrome, a case is presented which was misdiagnosed for more than 2 years. Problems concerning the differential diagnosis are discussed together with details of the surgical approach performed using the medial incision and the PTFE prosthesis.

[Echography in the study of thoracic pathology. I--Indications and limitations]. / L'ecografia nello studio della patologia toracica. Nota I--Indicazioni e limiti.

The role of echography in the study of the thorax is evaluated: after reporting the technical limits due to the peculiar anatomy of this region, personal experience is presented. This method extremely precise to define the solid or liquid nature of tightly adherent to the chest wall lesions, but it is non specific to assess their benign or malignant behaviour. Ultrasounds have their on limits in drawing the extension of such lesions; these limits have been overcome by CT and MR. Finally the usefulness of the method in studying the diaphragm and its pathology is briefly described.

[Computerized tomography in Peyronie's disease. Clinico-radiological comparison]. / La TC nella malattia di La Peyronie. Confronto clinico-radiologico.

The diagnostic capabilities of Computed Tomography (CT) in the study of Peyronie's disease are assessed. Twenty-four patients, with different symptoms and a variety of findings on physical examination (from normal to large painful plaques), were studied with third-generation CT equipment. CT defined the normal pattern of the albuginea, as a hyperdense (ranging from 80 to 100 HU) thin and regular line on the periphery of the corpora cavernosa. Pathologic features such as irregularities, disruptions and calcifications of the tunica can be identified; irregularities are shown as circumscribed zones of hyper or hypodensity, disruptions as small or large areas of complete absence of the thin regular line of albuginea. Calcifications are identified as hyperdense nodular or plaquelike areas of 200-300 HU. When physical examination and CT patterns are compared, the reliability of the method is revealed. It provides an accurate definition of the albugineal lesions, imaging all abnormalities detected on physical examination and demonstrating additional, non-palpable and doubtful lesions. Physical examination and CT findings concurred in 19 cases (79%), whereas disagreement was observed in 5 (12%). In 3 cases CT showed calcified plaques not revealed on physical examination; in 2 cases the plaques revealed by palpation were not confirmed by CT. Furthermore there may be a connection between CT aspects of the albuginea and the hystological findings in the disease: irregularities could represent the early stage, interruptions the mid-stage and calcifications irreversible final abnormalities. CT, being a non-traumatic, harmless diagnostic method, improves the clinical evaluation of the patient and can facilitate the choice of the most suitable therapeutic modalities, as well as the follow-up of their results.

Lymphocyte transformation test in drug-induced toxic epidermal necrolysis.

Lymphocyte transformation tests (LTT) to drugs remain widely used in drug reactions, despite controversies about their real usefulness. We tested the lymphocytes of 12 patients recovering from a drug-induced Toxic epidermal necrolysis (TEN). There was no difference between the amounts of thymidine incorporated when patients' lymphocytes were cultivated with culprit or innocent drugs. In both situations the lymphocytes from patients reacted like the lymphocytes from controls cultivated with the same panel of drugs. These negative results do not exclude that a hypersensitivity reaction may play a role in the physiopathology of TEN. Anyhow, they clearly indicate that testing lymphocyte transformation to drugs has no practical value in the diagnosis of TEN.

[Value of ultrasonics and computerized axial tomography in the staging of renal neoplasms]. / Valore dell'ultrasonografia e della tomografia assiale computerizzata nella stadiazione delle neoplasie renali.

Sonographic (US) and computed tomographic (CT) images obtained in 47 patients with renal cancer have been reviewed; attention was paid to detection of neoplastic spread to structures surrounding the tumor, presence of lymph node metastases and of thrombosis of renal vessels and to identification of distant metastases. The results of the revision process were then compared with surgical or autoptic findings. In a relatively high number of patients, a complete examination of the upper abdomen could not be performed by US, due to patient habitus or bowel gas; on the contrary, a diagnostic study could be obtained by CT in virtually all cases. Furthermore, differentiation of stage I and stage II lesions could never be obtained by US; only CT gave this possibility. As regards the sensitivity of the two methods, in patients with stage III or stage IV disease, US showed relatively lower sensitivity in the diagnosis of lymph node metastases, but it was significantly less sensitive in the study of distant metastases. On the contrary, the specificity of the two imaging methods was similar, and US gave better results in the evaluation of renal vein or inferior vena cava thrombosis.