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Crecchi A, Tozzini A, Benedetti R, Maltinti M, Bonfiglio L. Case report: Intensive rehabilitation program delivered before and after single-event multilevel surgery in a girl with diplegic cerebral palsy. Front Neurol 2024; 14:1323697. [PMID: 38283677 PMCID: PMC10811248 DOI: 10.3389/fneur.2023.1323697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Diplegic cerebral palsy (CP) is often associated with musculoskeletal disorders that contribute to worsen walking function. The standard care in these cases is single-event multilevel surgery (SEMLS) followed by rehabilitation. Our aim was to investigate whether a rehabilitation program starting even before SEML could add a benefit with respect to standard postoperative programs considered by previous research. Methods From 2 months before to 13 months after SEMLS (except for the first month after surgery), the participant underwent a motor training focused on ROM exercises with tactile and kinaesthetic feedback. Walking performance, walking capacity, and quality-of-life were assessed before and after SEMLS at different follow-up times. Results Walking capacity improved 3 months after SEMLS (i.e., earlier than in current literature) and walking performance improved 12 months after SEMLS (instead of simply returning to baseline as previously reported), with a positive impact on quality-of-life. Conclusions This case suggests that a rehabilitation program starting even before SEMLS could add benefits over walking function and quality-of-life of children with diplegic CP compared to postoperative programs only.
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Affiliation(s)
- Alessandra Crecchi
- Unit of Developmental Neurorehabilitation, Maternal and Child Department, Pisa University Hospital, Pisa, Italy
| | - Alessandra Tozzini
- Unit of Developmental Neurorehabilitation, Maternal and Child Department, Pisa University Hospital, Pisa, Italy
| | - Roberta Benedetti
- Department of Translational Research on New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Marco Maltinti
- 1st Unit of Orthopaedics and Trauma, Pisa University Hospital, Pisa, Italy
| | - Luca Bonfiglio
- Unit of Developmental Neurorehabilitation, Maternal and Child Department, Pisa University Hospital, Pisa, Italy
- Department of Translational Research on New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy
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Tonerini M, Orsitto E, Fratini L, Tozzini A, Chelli A, Santi S, Rossi M. Cervical and mediastinal hematoma: presentation of an asymptomatic cervical parathyroid adenoma: case report and literature review. Emerg Radiol 2004; 10:213-5. [PMID: 15290495 DOI: 10.1007/s10140-003-0317-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2003] [Accepted: 09/26/2003] [Indexed: 11/25/2022]
Abstract
The spontaneous rupture with extracapsular hemorrhage of a cervical parathyroid adenoma is a rare cause of cervical and mediastinal hematoma. We describe this case to emphasize that a failure to consider this diagnosis may result in delayed operative intervention with potentially fatal complications.
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Affiliation(s)
- Michele Tonerini
- Department of Emergency Radiology, Santa Chiara Hospital, Via Roma, 56100 Pisa, Italy.
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Abstract
We describe an early CT study of a rare case of blunt traumatic injury to the right submandibular salivary gland, without mandibular bone fractures, in a 30-year-old man after a car accident.
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Affiliation(s)
- Michele Tonerini
- Department of Emergency Radiology, S. Chiara Hospital, via Bonanno Pisano, 56100, Pisa, Italy.
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Tozzini A, Fratini L, Trincavello F, Orsitto E, Tonerini M. Primary heart angiosarcoma with pulmonary metastases. Radiol Med 2002; 103:551-4. [PMID: 12207194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- A Tozzini
- UO di Radiodiagnostica del Pronto Soccorso, Azienda Ospedaliera di Rilievo Nazionale S. Chiara, Pisa
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Abstract
We report the case of a man in which a Hodgkin's lymphoma involved the ureter as the very first clinical situs of the disease. Ureteral involvement in lymphomas is very rare (0.86%-7% and 1%-16%, found in two studies, respectively, of cases of patients with lymphoma examined post mortem) and when it does occur it is secondary to renal involvement or retroperitoneal adenopathies. It is by all means exceptional as an isolated situs of disease. Those cases reported in the literature as presenting lymphomatous involvement of the ureter have always been diagnosed as Non-Hodgkin's lymphomas.
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Affiliation(s)
- A Tozzini
- Department of Radiology, University of Pisa, Italy
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Bulleri A, Tozzini A, Pinto F, Dini P, Pieri L, Orsitto E. [Apropos 4 cases of diaphragmatic rupture due to closed trauma]. Radiol Med 1997; 94:538-40. [PMID: 9465226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- A Bulleri
- Istituto di Radiologia, Università degli Studi, Pisa
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Pieri L, Tozzini A, Orsitto E, Bulleri A, Morelli G. [Urotheliomas of the upper urinary tract. The role of computed tomography in integrated diagnostic imaging]. Radiol Med 1997; 94:202-7. [PMID: 9446126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Transitional cell carcinomas are frequent in the bladder but rare in the renal pelvis. Most upper urinary tract cancers are suspected and detected with urography and retrograde pyelography; CT is important in the questionable cases at US, urography and retrograde pyelography, but it is also useful to detect locoregional disease. We report the findings of 35 patients, with ureteral lesions to assess the role of CT in the diagnosis and staging. MATERIALS AND METHODS Thirty-five patients were examined with US and CT; 27 underwent urography, 16 retrograde pyelography and 4 nephrostomic pyelography, CT staging was made with Hahn's criteria related to TNM (stages CT I, CT II, CT III). All patients underwent surgery and the histologic findings were compared with CT staging. RESULTS CT detected all lesions and characterized them from a morphological viewpoint (intraluminal minus, wall thickening). Using Hahn's CT staging we obtained agreement with histologic findings in 21 of 23 cases in CT stage I, six of 10 in CT stage II and 4 of 5 in CT stage III. CONCLUSIONS CT is an important tool for both diagnosis and therapy because it shows the renal cavities and parenchyma and permits accurate staging, differentiating the tumors localized in the wall from those with local spread or distant metastases. In our experience, CT is not useful to differentiate mucosal from pelvic-ureteral muscle invasion but peripelvic and periureteral fat invasion can be suspected when the infiltrated wall exhibits an irregular and spiculated profile.
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Affiliation(s)
- L Pieri
- Cattedra di Radiologia, Clinica Urologica, Università di Pisa
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8
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Gibilisco G, Tozzini A, Bulleri A, Orsitto E, Pieri L. [Spontaneous retroperitoneal hemorrhage from renal angiomyolipoma. Report of 2 cases]. Radiol Med 1996; 92:660-2. [PMID: 9036470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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9
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Giusti P, Ricci E, Tozzini A, Banti P, Chiarugi M, Neri E, Calderazzi A. [Radiologic diagnosis of small bowel phytobezoar. Report of a case]. Radiol Med 1996; 92:145-7. [PMID: 8966259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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10
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Bulleri A, Tozzini A, Bianchi MC, Orsitto E, Pieri L. [Vertebral echinococcosis. A case studied with computerized tomography and magnetic resonance]. Radiol Med 1996; 92:130-2. [PMID: 8966252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- A Bulleri
- Istituto di Radiologia, Università di Pisa
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Napoli V, Tozzini A, Neri E, Calderazzi A, Gabriele M, Bonaretti S, Vinci G, Vitali C, Molea N. [The imaging diagnosis of Sjögren's syndrome: echography, sialography and scintigraphy compared in the study of the salivary glands]. Minerva Stomatol 1996; 45:141-8. [PMID: 8926981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim of the present study was to evaluate the sensitivity and specificity of the ultrasonography, in comparison with other methods of investigation (scintigraphy, sialography, and biopsy), in scanning morphostructural changes in the parotid gland in patient with Sjögren's syndrome. During the period June-October 1994, 34 patients (5 males and 29 females, age ranged between 20 and 88 years) with "sicca syndrome" underwent to echography, scintigraphy, sialography and biopsy. The diagnosis was confirmed or excluded using the European Community Epidemiologic Committee criteria for Sjögren's syndrome. Twenty-two patients out of 34 were affected by Sjögren's syndrome, while the others resulted as control subjects. The ultrasonographic investigation has shown 76.19% of sensitivity and 30.43% of specificity. Even if echography is a non-invasive method, which could be used as preliminary approach for studying the diffused involvement of the parotid gland, at the status of the art, it is not completely reliable for the global evaluation of the morphostructural changes in patients with Sjögren's syndrome, in comparison with the other techniques. Because of the double nature of the gland injury, it appears to be essential the diagnostic integration between echography and sialography.
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Affiliation(s)
- V Napoli
- Cattedra di Radiologia, Università degli Studi, Pisa
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12
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Gibilisco G, De Liperi A, Giusti P, Tozzini A, Carafoli D, Celandroni A, Rolla M, Calderazzi A. [Short stature due to a partial idiopathic deficiency of the growth hormone. The role of the TW2 method in assessing treatment with r-hGH]. Radiol Med 1996; 91:181-6. [PMID: 8628927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The Tanner-Whitehouse 2 (TW2) method to assess skeletal maturation (reviewed by Nicoletti for the Italian population) was used to study, from January, 1991, to December, 1994, a series of 26 Italian patients. The patients, 18 men (69.3%) and 8 women (30.7%), came from inhomogeneous family stocks and were all affected with short stature due to partial idiopathic GH deficiency; they were treated with replacement therapy with the biosynthetic recombinant human growth hormone (r-hGH). Each patient underwent 3 wrist and left hand radiographs, the first one made on the basis of medical and endocrinologic assessment. The patients were reexamined after one and two years of treatment with the analysis of stature growth and of the skeletal maturation of hand bones. At one year, the average chronological age of our patients was 12.42 year (range: 9.4-15.2 years), their average bone age was 11.13 years (range: 6.5-14 years) and their average height was 137.81 cm (range: 117-155.5 cm). The patients were then retrospectively examined on the basis of bone maturation and final height, at the end of two years' therapy. At the end of treatment, height was above the third percentile in all patients and therefore within the expected personal target on the basis of genetic stature. The TW2 indexes of bone maturation, after one year of treatment, had increased by 44.84% (range: 27-77%) of the total maturation increase at two years. Moreover, after one year of treatment, average stature increase was 55.81% (range: 42-72%) of the total stature increase at two years. After two years of treatment, TW2 indexes showed an average 55.16% increase in bone maturation (range: 23-73%) of total maturation and average stature increase was 44.19% (range: 28-56%) of the total stature increase. Our results confirmed that skeletal growth and bone maturation are two distinct processes. Particularly, we noted that, while after one year of r-hGH therapy skeletal growth (especially in the long bones) prevails over bone maturation, after two years maturation prevails. In conclusion, our experience confirms the TW2 method as a simple and highly informative method which can be used in any radiologic center.
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Pieri L, Tozzini A, Orsitto E, Morelli G, Felipetto R, Minervini R. Transitional cells carcinoma of upper excretory way: a study with traditional radiology, ultrasound and ct. Pharmacotherapy 1996. [DOI: 10.1016/s0753-3322(96)89775-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morelli G, Tozzini A, Orsitto E, Calderazzi A, Giannotti P. [Atypical bone metastasis in a patient with prostatic carcinoma]. Radiol Med 1995; 89:725-7. [PMID: 7617923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- G Morelli
- Istituto di Radiologia, Università di Pisa
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Tozzini A, Giusti P, Ricci E, Gibilisco G, Bani E, Calderazzi A. [A rare case of benign osteopetrosis in childhood]. Radiol Med 1995; 89:520-2. [PMID: 7597235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- A Tozzini
- Istituto di Radiologia, Università di Pisa
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Cartei F, Orsitto E, Pieri L, Dini P, Tozzini A. [Cystic teratoma of the anterior mediastinum. A case report]. Radiol Med 1994; 87:905-8. [PMID: 8041956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- F Cartei
- Cattedra di Radiologia, Università di Pisa
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