Biomedical subjects
A Ferrara
Publications and source records attributed to A Ferrara.
The adverse effects of high oral osmolal mixtures in neonates. A review and a study of the osmolality of calcium preparations.
In both animals and humans, there are numerous clinical, physiologic, and morphologic alterations that occur when hypertonic solutions are introduced into the alimentary tract. The most serious adverse effect observed in the human infant is necrotizing enterocolitis. A short in vitro study analyzing osmolalities of drug-formula mixtures at various dilutions, conducted by the authors, showed that an unacceptable degree of high osmolality may be achieved in the preparation of common medications used in newborn nurseries. Although review of the literature confirms that, in general, the osmolalities of mixtures fed to newborns should not exceed 460 mOsm/kg H2O, lower levels would be preferable in ill and low birth weight newborns. When possible, consideration should be given to the use of parenteral medication for the critically ill neonate. Ideally, the osmolalities of mixtures fed to newborns should be measured if they are not known or cannot be calculated.
Live attenuated varicella vaccine in children with leukemia in remission.
One-hundred-ninety-one children with acute leukemia in remission for at least one year were immunized with 1 or more doses of live attenuated varicella vaccine. All were susceptible to varicella prior to vaccination. The only significant side effect was mild to moderate rash, seen especially in children with maintenance chemotherapy temporarily suspended for one week before and one week after vaccination. Children with rash were at some risk (10%) to transmit vaccine virus to varicella susceptibles with whom they had close contact.
A prospective study of relationships between benign gastric ulcer, Candida, and medical treatment.
Results of a multicenter prospective study on the relationships between benign gastric ulcer, Candida, and medical treatment is reported. In a group of 66 patients, mycetes were seen in six cases (9.1%). Candida-contaminated ulcers were diagnosed solely by histological examination, with periodic acid-Schiff staining being more effective than hematoxylin and eosin staining. All contaminated ulcers were healed by treatment either with cimetidine alone, or combined cimetidine-carbenoxolone, without antimycotics. No cases of Candida-contaminated ulcers were seen after 6 wk of treatment. The finding of contamination was more common in older patients. Under the conditions of our study, Candida-contamination of benign gastric ulcers does not affect the rate of healing, does not need specific treatment, and has no particular endoscopic features. Cimetidine or carbenoxolone treatment was not associated with persistence of the fungus.
[Effect of verapamil on the sinus node and atrioventricular conduction in the canine heart].
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Impact of intermittent prolonged asphyxia in rat sucklings on growth and development.
Each of four litters of newborn rats was categorized first by sex and then within each litter, each sex-specific group was randomized into three treatment groups: an experimental (asphyxiated on 4 consecutive days from birth), a partial control (asphyxiated once on the fourth day of life), and a control group (never asphyxiated). Asphyxiation was carried out by enclosing pups individually in air tight fixed volume jars until they attained 30 second apnea. Weight and physical and reflex development of the rat pups were assessed daily. The data was analyzed by using ANOVA and ANCOVA to adjust for birth weight.
In-vitro antibacterial activity of cefotetan.
The in-vitro activity of cefotetan, a recently developed cephamycin, was investigated under various experimental conditions. The compound showed moderate activity against Staphylococcus aureus and Streptococcus pyogenes, no activity against Pseudomonas aeruginosa and Streptococcus faecalis, but a high activity against Enterobacteriaceae, including beta-lactamase-producing strains. Haemophilus influenzae also was fairly susceptible. The MBC was usually equal to or two- or fourfold higher than MIC. Medium composition, pH and inoculum size had minimal influence on its activity. About 50% of recent clinical isolates of Bacteroides fragilis were susceptible to cefotetan, but some were highly resistant. Killing curves of cefotetan against different bacterial strains indicated that it was rapidly bactericidal at concentrations equal to MIC or two- to fourfold higher. However, some strains showed regrowth after initial inhibition. Combination of cefotetan with aminoglycosides, or with cefazolin, cefotaxime, moxalactam or piperacillin resulted either in synergy, addition or indifference according to the bacterial strain and the nature of the combination. Antagonism was never observed. Human serum protein binding varied from 75 to 86% according to the assay method. Binding with horse serum protein was about 28%.
Biological response to a musculo-tendinous prosthesis in the rabbit.
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[A case of primary lymphosarcoma of the rectum].
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[Mesenteric fibromatosis following total colectomy for familial polyposis. A rare case of Gardner's syndrome].
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Questions about tcPO2 transport study.
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Utility of M-mode echocardiography for early identification of infants with persistent pulmonary hypertension of the newborn.
The clinical syndrome of persistent pulmonary hypertension of the newborn (PPHN) still carries high mortality in spite of improved neonatal care. The purpose of this prospective study was to assess the utility of M-mode echocardiography for the early identification of infants with PPHN prior to clinical deterioration. Echocardiograms of 51 infants who needed fractional inspiratory oxygen (FIO2) greater than or equal to 0.25 to maintain adequate PaO2 within 36 hours of life were compared to those of 115 healthy full-term and preterm newborns. Of the 51 infants, ten had elevated systolic time interval ratios of both ventricles simultaneously (ventricular pre-ejection period to ventricular ejection time [RPEP/RVET greater than or equal to 0.50, LPEP/LVET greater than 0.38]). All of these newborns had PPHN that was manifest clinically by 11 to 30 hours of age. The echocardiographic findings preceded clinical deterioration by at least one to five hours in all cases. The other 41 infants had clinical courses consistent with uncomplicated pulmonary disease. These data indicate that systolic time interval ratios, although not accurate measures of pulmonary arterial pressure and/or pulmonary vascular resistance, permit early identification of infants with PPHN and separation from others with uncomplicated pulmonary disease.
[Current therapeutic aspects of polycythemia vera].
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Temperament of asthmatic children. A preliminary study.
The temperamental profile of a group of 12 asthmatic children between 3 and 7 years of age was compared to those of two comparison groups, each consisting of 12 normal well children and 12 children of the same age range with chronic eczema, allergic rhinitis, or both, but without asthma. The children with asthma differed significantly from the comparison groups in their temperamental profile, which was characterized by lower rhythmicity (reguluarity), lower adaptability, lower intensity of reaction, lower mood value, and lower persistence. The results indicate the need for further longitudinal studies of large populations of children with asthma to explore the implications and behavioral consequences of "the asthma temperament, and its interaction with other developmental factors.
Effect of subinhibitory concentrations of antibiotics on the emergence of drug resistant bacteria in vitro.
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Relationship between chronic PaCO2 and total body buffering capacity in patients with chronic obstructive lung disease.
17 subjects were carefully selected among 150 patients with COLD: all patients with one or more conditions or diseases that could alter the physiological response to chronic hypercapnia were eliminated. During a period of 13 to 28 days, the acid-base response to slow carbon dioxide changes was studied in the selected patients. Total body buffering capacity was expressed as dH+a/dPaCO2 and showed to be an inverse function of chronic PaCO2 (defined as the value of PaCO2 in clinical and acid-base steady status for each patient), according to the previous suggestions of Weiss and Dulfano and to the report of Ingram and co-workers during acute carbon dioxide changes in the same patients.
[Effect of prolonged nicotinic acid load on the tolbutamide test].
The action of prolonged, high doses of nicotinic acid on carbohydrate metabolism has been studied. Results were discordant and did not throw light on the problem, and nor does the literature.
[The treatment of acid-base imbalance in the intensive care of respiratory diseases].
After giving an outline of pneumogenic respiratory insufficiency, signally that deriving from chronic obstructive bronchopulmonary disease, the Authors describe the intensive care of respiratory insufficiency, first from the anesthesiologist's point of view and then in a broader medical sense. In regard to the latter, the Authors emphasize the importance of material equipment and staff training and teamwork; they also list a number of possible iatrogenic disorders in intensive care. Next they discuss medical aids and more specifically the machinery designed to assist respiration, such as pulmonary ventilators and the "iron lung", as implements that can be used to advantage in medical wards. Then they describe the elements to be used for a correct assessmnet of the severity of respiratory insufficiency, under the following subheadings:--state of coma, if present;--state of acid-base balance, oxemia, and water and electrolyte balance;--circulatory compensation or failure;--need for correcting bronchial obstruction. Through several representative examples concerning the medical correction of alterations of CO2, pH, electrolyte composition, and water and blood volumes, they describe the therapeutic measures to be undertaken particularly as regards the metabolic sequels (alkalosis or acidosis) that may occur in the course of treatment. Coming next to intensive care utilizing mechanical devices, they stress the importance of monitoring the parameters of humoral balance during (and even more so, after) said treatment, in view of avoiding the emergence of iatrogenic disturbances such as the reventilation syndrome and the syndrome of post-hypercapnic metabolic alkalosis.