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Biomedical subjects

A Clemente

Publications and source records attributed to A Clemente.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Gastrointestinal hemorrhage].

Acute digestive system haemorrhage is a recurrent cause of hospitalization. As to the upper segment of the digestive system, ulcerous peptic disease is often the cause of this pathology, above all in Western Countries. As to the lower segment, colic diverticula and angiodysplasy represent the most common cause. Bleeding usually clears up spontaneously or with hemodynamic pharmacological help. In some cases, the situation does not improve because of bleeding persistence, so more complex diagnostic and therapeutic techniques are necessary. Instrumental diagnostics is based on endoscopy (once with flexible optical fibre instruments, now with videoendoscopy) whose diagnostic effectiveness is inversely proportional to the latency since the haemorrhagic occurrence. Success is evident in 90-95% of the cases within the first twelve hours. Mesenteric angiography and scintigraphy with marked erythrocytes can solve difficult diagnosis and topographic location on some serious occasions. In every case the risk of complication and death is closely related to the haemorrhagic consistency, the flow of the bleeding, the basic disease, the age and the presence of chronic diseases. The authors examine a personal survey taken from the hospitalization in their own ward during a period of a year.

Adult↗
PubMed1998

[Spontaneous subarachnoid hemorrhage: risk factors].

The precursive factors to SAH are classified into congenital, familial, intrinsic and extrinsic, pointing out the association between cerebral aneurysms and collagenopathies, genetic transmission disease, aneurysm features, habits and systemic disease.

Humans↗
PubMed1996

Diagnosis of traumatic carotid-cavernous sinus fistula by monitoring venous oxygen saturation in the jugular bulb: report of two cases.

OBJECTIVE AND IMPORTANCE: A traumatic carotid-cavernous sinus fistula (CCF) is rarely diagnosed early and may sometimes be missed until clinical signs and symptoms appear. The continuous monitoring of cerebral venous oxygen saturation may reveal the presence of a CCF by means of a fiberoptic catheter that records very high oxygen saturation values when positioned in the jugular bulb. CLINICAL PRESENTATION: We report two cases of early diagnosis of CCFs unexpectedly revealed by monitoring the jugular bulb for venous oxygen saturation values that approximated arterial saturation values. One case was diagnosed on Day 3 after admission, and the other was diagnosed shortly after cannulation of the ipsilateral jugular bulb. INTERVENTION: Confirmation of the diagnosis of CCF was obtained by angiography. Intravascular treatment was performed in one case. CONCLUSION: These cases add another diagnostic role to cerebral venous oxygen saturation monitoring. When high cerebral venous oxygen saturation values rapidly or abruptly reach arterial oxygen saturation, the presence of a CCF must be considered and confirmed by arterial angiography.

Adolescent↗
PubMed1996

[Urodynamic picture in high spinal cord ischemia, induced by addictive use of cocaine. Report of a case].

The authors present a case of spinal cord ischemia at level C2 related to cocaine use. The neurologic pattern was an anterior cord hemisection syndrome. Urodynamic assessment was performed at 6 and 14 months from the neurovascular event. The ice-water test (IWT) showed an uninhibited bladder cooling reflex, despite an areflexic detrusor (at routine filling cystometry). Occult bladder hyperreflexia became overt during the following month and was registered by the second urodynamic assessment. Anatomical bases of spinal cord blood supply are discussed. The authors emphasize the role of the IWT in predicting the development of overt bladder hyperreflexia and thus, spinal shock phase resolution.

Adult↗
PubMed1996

[Tetanus: problems of differential diagnosis in the presence of contemporaneous administration of metoclopramide].

Here we report a clinical case concerning differential diagnosis between tetanus and metoclopramide intoxication. A 67 year old woman was admitted to our intensive care unit complaining of both trisma and four limbs hypertone soon after a massive metoclopramide bolus administration. The patient was affected by a chronicle renal insufficiency and a diagnosis of metoclopramide intoxication was made. The long lasting dystonic symptomatology together with respiratory insufficiency ruled out the hypothesis of drug overdose. The intensive care physicians would take into account that at least a 24 hours clinical observation is mandatory in order to perform a correct diagnosis.

Aged↗
PubMed1995

Pseudomonas aeruginosa aliphatic amidase is related to the nitrilase/cyanide hydratase enzyme family and Cys166 is predicted to be the active site nucleophile of the catalytic mechanism.

A database search indicated homology between some members of the nitrilase/cyanide hydratase family, Pseudomonas aeruginosa and Rhodococcus erythropolis amidases and several other proteins, some of unknown function. BLOCK and PROFILE searches confirmed these relationships and showed that four regions of the P. aeruginosa amidase had significant homology with corresponding regions of nitrilases. A phylogenetic tree placed the P. aeruginosa and R. erythropolis amidases in a group with nitrilases but separated other amidases into three groups. The active site cysteine in nitrilases is conserved in the P. aeruginosa amidase indicating that Cys166 is the active site nucleophile.

Amidohydrolases↗
PubMed1995

[Jejunal diverticulosis: report of a case and review of the literature].

The jejunal diverticula are a rare pathology, they are verifiable with an incidence from 0.06 to 1.3% autoptical reports. Furthermore, only 10-40% of them are symptomatic. Nevertheless, in this case the beginning is often acute because of a perforation or a hemorrhage. In both cases the medical therapy is associated with a mortality rate which is too high to be acceptable, so therefore, emergency surgery is the only possible choice. The authors present a clinical case resulting from their observation with an acute beginning, this case is used as a starting point for an accurate review of the international literature on the subject. The purpose of this study is to contribute to a correct understanding and approach to the problem, above all through an exact preoperative diagnosis so that unnecessary delays in surgery may be avoided when a patient's life is at risk.

Diverticulum↗
PubMed1993

[Liver injury in abdominal trauma. Review of the literature and personal observations].

In patients who suffered abdominal trauma, the liver is the most frequently involved organ, except the spleen. The % rises from 1520% to 30% if trauma is closed or open. Liver injury may spread from a simple parenchymal contusion to a break in vessels or biliary ducts. Life risk is related to hemorrhage. The mortality is due to: 1) extension of the injured liver surface, 2) possible damage to big vessels, 3) intra or extra abdominal associated injury in case of multiple trauma. It is important to known the kind of injury to choose the best therapy, not necessary surgical. The authors report on 15 patients with thoracoabdominal trauma and liver damage, comparing their cases with literature observations.

Abdominal Injuries↗
PubMed1992

[Warthin's tumor of the parotid. The signs of a case].

The authors report a case of Warthin's tumor associated with cat scratch disease placed in 2 nodes. Both arose at the same time and evolved rapidly. Diagnosis was made by histology after their removal. We underline the rarity of the pathology, the frequent diagnosis made after operation and recommend enuclouresection of neoplasm as the first choice, considering the benignity of the lesion and the modest aggression allowed.

Adenolymphoma↗
PubMed1991

Serial multimodality-evoked potentials in severely head-injured patients: diagnostic and prognostic implications.

OBJECTIVES: To assess the prognostic reliability of multimodality-evoked potentials and to evaluate the diagnostic implications and define the limits of these evoked potentials. SETTING: An ICU in a university hospital. DESIGN: Prospective clinical study. PATIENTS: Seventy-three severely head-injured patients aged 10 to 75 yrs. METHODS: Serial recording of brainstem auditory-evoked potentials and somatosensory-evoked potentials between days 1 and 21 after trauma. Comparison between evoked potential findings and prognosis, along with clinical data. RESULTS: Considering the single recordings of both brainstem auditory-evoked potentials and somatosensory-evoked potentials, the accuracy of prognostication in predicting a bad outcome was good only for severely abnormal brainstem auditory-evoked potentials. Serial brainstem auditory-evoked potential recordings and simultaneous recordings of brainstem auditory-evoked potentials and somatosensory-evoked potentials proved to be good prognostic indices in predicting a favorable outcome. Brainstem auditory-evoked potentials correlated well with brainstem reflexes and with pupil asymmetries but did not correlate with Glasgow Coma Scale scores. CONCLUSIONS: Serial recording and the use of a multimodality approach provided the best prognostic capabilities. The main diagnostic implications were: a) the possibility of detecting brainstem compression by means of brainstem auditory-evoked potentials before the appearance of pupil abnormalities; b) the usefulness of brainstem auditory-evoked potentials in monitoring brainstem function in patients undergoing high-dose barbiturate therapy. The main limitations of evoked potentials were the occurrence of peripheral acoustic damage, the electromagnetic sources of artifacts in the ICU, and the administration of ototoxic drugs.

Adolescent↗
PubMed1989

[Products of lipid peroxidation in the blood and respiratory secretions in 3 patients with acute respiratory diseases].

Oxygen free radicals have been suggested to be involved in ARDS pathogenesis. Their production may be caused by leukocyte activation and by administration of high oxygen concentrations. Radicals can oxidize lipids with production of dienes. In order to gather an indirect proof of radical production, dienes were repeatedly assessed in plasma and bronchoalveolar lavage (BAL) samples from three patients affected by ARDS. Plasma levels resulted higher than normal ones in all the patients initially; concentrations in BAL samples were lower than in plasma. Successively dienes decreased progressively in the patient who survived, whereas an increase was observed in BAL samples from the other patients, who died. The last trend was accompanied by a smaller increase in plasma levels.

Adult↗