Search PubMed⌕ Search

Biomedical subjects

A Brienza

Publications and source records attributed to A Brienza.

At least 37 records · Page 2Linked to original sources
PubMed1988

Right ventricular ejection fraction measurement in moderate acute respiratory failure (ARF). Effects of PEEP.

Eight patients mechanically ventilated for acute respiratory failure were submitted to increasing levels of PEEP, from 0 to 15 cm H2O. Right ventricular ejection fraction (RVEF) and end-diastolic volume index (RVEDVI) were measured using the fast response thermistor Swan-Ganz catheter. PEEP induced a linear decrease of cardiac index, while the pulmonary artery pressure increased. In three patients (group A) with a RVEDVI larger than 120 ml at ZEEP, RVEF decreased and RVEDVI increased with PEEP. In the other five patients (RVEDVI less than 120 ml, group B), RVEF was unchanged and RVEDVI decreased at PEEP 15 cm H2O. This study suggest that RV changes induced by PEEP are probably a function of the initial RVEF and RVEDVI.

Acute Disease↗
PubMed1988

Evaluation of exercise-induced Q-wave amplitude changes and their clinical value.

We studied the influence of exercise level, severity of coronary artery disease (CAD), presence of previous myocardial infarction (MI), anterior or diaphragmatic, on the clinical value of exertional Q wave changes (Delta-Q). We retrospectively evaluated the exercise electrocardiograms of 62 patients without angiographic evidence of CAD and 133 patients with CAD; 28 of them had single (SVD) and 105 multivessel disease (MVD). Forty-one patients had a previous diaphragmatic MI and 23 anterior. The sensitivity, specificity and predictive value of Delta-Q were compared to the ST criterion. The exercise level affected Delta-Q. ST and Delta-Q had similar specificity and predictive values. The extent of CAD did not affect the sensitivity of Delta-Q and this method was better than ST to detect SVD patients. The Delta-Q criterion was equally as efficient as ST in MVD patients without MI and with diaphragmatic MI. The loss of septal forces on resting electrocardiograms made useless Delta-Q analysis on patients with anterior MI. The improvement of sensitivity in SVD patients by Delta-Q might be of clinical value since these latter are frequently not diagnosed by the ST criterion.

Adult↗
PubMed1987

[Diagnostic value of changes in the Q wave induced by exertion].

In order to evaluate the diagnostic value of exercise-induced Q wave changes and its relationship with the extent of coronary involvement and presence and location of a previous myocardial infarction, we examined the stress electrocardiograms of 188 consecutive patients with chest pain. Coronary arteriography shoved single vessel disease (SV) in 28 patients and multivessel disease (MV) in 130 patients; a previous myocardial infarction was present in 64 patients. The Q wave amplitude was measured as average of ten values in CM5 at rest and at peak exercise; a Delta-Q less than 0, i.e. reduction or no change of Q wave at peak exercise, was considered a positive response for coronary artery disease. The Delta-Q criterion shoved a significantly better sensitivity than ST depression, as a whole, but this improvement was nullified when patients with anterior myocardial infarction were excluded; as well specificity of Delta-Q although better than ST, did not allow a significant improvement for the diagnostic value of stress test. We also evaluated the diagnostic accuracy for multivessel coronary artery disease of both criteria positive was 78% whereas the negative predictive value of both criteria negative was 91%. We concluded that the exercise-induced Delta-Q less than 0 is a good indicator of coronary artery disease, although not superior to ST depression; the negativity of both criteria seems to be highly reliable for the exclusion of multivessel coronary artery disease.

Adult↗
PubMed1983

Ceftazidime in treatment of acute pulmonary exacerbations in patients with cystic fibrosis.

The pharmacokinetics and clinical efficacy of ceftazidime, a cephalosporin with activity against Pseudomonas aeruginosa, were studied in children with cystic fibrosis. Ceftazidime had high in vitro activity against P. aeruginosa strains isolated from our patients, with a mean MIC90 of 8 micrograms/ml. The first dose of 50 mg/kg IV of ceftazidime achieved serum concentrations of 40.8 +/- 19.7 micrograms/ml at one hour and 3.8 +/- 1 micrograms/ml at four hours after administration (mean values +/- SD). The MIC90 was exceeded by serum concentrations for up to three hours. The elimination of the drug from the blood followed a biexponential decay with an elimination half-life of 60.4 +/- 6.8 min and a total body clearance of 6.0 +/- 3.1 ml/min/kg. Renal clearance of the drug accounted for 75% of the total clearance; these are higher values than those reported for adults. Peak concentrations of ceftazidime in the sputum two hours after a single administration were 4.13 +/- 2.06 micrograms/ml; after seven and 14 days of treatment, sputum concentrations were significantly lower. Eleven children with acute pulmonary exacerbation were treated for 14 days with ceftazidime at a dose of 150 mg/kg/day (12 treatment courses). Significant clinical and radiologic improvements were obtained in nine of 12 patients. In six of 11 cases the P. aeruginosa count decreased by 10(4) CFU/ml. Ceftazidime was well tolerated, and no side effects appeared during treatment.

Acute Disease↗
PubMed1980

[Intensive treatment of septic shock].

In order to identify a septic shock syndrome, the Limulus test (positive results in 10 cases out of 12) is preferable to hemoculture (positive in 9 cases out of 22), as a valid tool for a precocious diagnosis and to support both the clinical diagnosis and the precocious case finding of the septic conditions. According to the Authors, as far as intensive treatment is concerned, the simultaneous finding of the central venous pressure (CVP) and the lung capillary (LC) allows an accurate evaluation of the rate of cardiac impairment and the alterations to the distribution of blood volume in connection with treatment. The Authors have also reported the data related to the clinical course of illness and mortality rate (68%) in 21 cases of septic shock, as well as the hemodynamic parameters with the pertinent correlations (CVP-PAP-Pcp and Da-v) in 12 patients affected by septic shock from the very beginning and throughout the whole period of treatment.

Critical Care↗