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Biomedical subjects

A Gamba

Publications and source records attributed to A Gamba.

At least 55 records · Page 3Linked to original sources
PubMed1989

Clinical experience with a new pulsatile pump for infant and pediatric cardiopulmonary bypass.

A pulsatile pump of new concept has been developed for infant and pediatric cardiopulmonary bypass (cpb) (Parenzan-Fumero pump). A segment of elastic tubing is compressed by a pneumatically driven pushing plate under control of a microprocessor. Flow parameters such as pulse rate and stroke volume can be set. The pump can be synchronized with the patient's ECG for counterpulsation heart assist. A total of 87 open-heart procedures were performed using randomly either a conventional roller pump or the Parenzan-Fumero pump (respectively 39 and 48 patients). A previously published cpb protocol and anesthetic regimen were adopted in all cases. The results show increased cooling and rewarming rate (p less than 0.05) and urinary output, decreased vascular resistance, intensive care unit time and need for blood transfusion in the pulsatile group compared to the continuous perfusion group. In the pulsatile group, mortality was significantly lower (10.4% vs 25.6%) and low cardiac output syndrome was less frequent in the post-operative course.

Cardiopulmonary Bypass↗
PubMed1989

[Cerebral and renal aspergillosis in a patient with orthotopic heart transplant: diagnosis, treatment and follow-up].

A cardiac transplant recipient developed systemic aspergillosis with abscesses from aspergillus fumigatus in the brain and the right kidney. Surgical resections were performed (lobectomy for the brain abscess, partial resection for the renal abscess followed, after extension of the infection, by right nephrectomy) combined with therapy with itraconazole, a new antimycotic agent. Recovery from the infection was obtained and at 18 months of follow-up the patient feels well without signs of recurrences of the infection.

Aspergillosis↗
PubMed1989

Treatment of postoperative pain: comparison between administration at fixed hours and 'on demand' with intramuscular analgesics.

From the data in the literature it can be seen that 40% of the surgical population has insufficient postoperative analgesia. Many reasons have been given for this: pain control delegated to the doctor on duty and/or the nursing staff; administration of drugs 'on demand', if the patient asks for them, or the nurses feel it to be necessary; fear of causing side effects such as respiratory insufficiency; or provoking addiction by giving narcotics. The aim of this paper is to evaluate the intensity of pain, the side effects, the degree of activity, anxiety, feeling of weakness and the mood of patients surgically treated for oncological diseases of the thorax and upper abdomen, comparing two different antalgic approaches. Thirty-five patients were studied. Pain was treated on demand with a narcotic, or an anti-inflammatory drug, or not treated at all; 20 patients were treated with analgesics given at predetermined hours, following the regime: methadone 10 mg intramuscularly (i.m.) every 12 h from the first to the third day following surgery and sodium diclofenac 75 mg (i.m.) every 12 h from the fourth to the seventh day. Results showed that patients treated with analgesics given intramuscularly at fixed hours have a significantly better pain control during the whole week of treatment (P less than 0.001), on average sleep more (P less than 0.001), spend more time standing or sitting and fewer hours lying down (P less than 0.001), have a higher performance status and feel less weak (P less than 0.05) than the group of patients treated with drugs 'on demand', or not treated at all.

Abdominal Neoplasms↗
PubMed1984

Two-stage correction for tetralogy of Fallot.

The policy for surgical treatment of tetralogy of Fallot in younger patients is still controversial. Our overall 14-year experience has been reviewed with regard to the factors influencing mortality for both shunts and corrective procedures. An attempt has been made to evaluate our current expected cumulative mortality for two-stage correction in patients under 2 years of age. From November, 1966 through April, 1983, 440 shunts and 647 total corrections were performed. Patients under 2 years of age, and those with unfavorable anatomy and/or physiology, generally underwent two-stage correction. Early correction was occasionally performed in this age group on patients with very favorable anatomy, or in case of early shunt failure. Retrospective standard statistical analysis was carried out in order to evaluate the influences of the year of operation, age, and operative technique on mortality. The overall early mortality of shunt procedures was 5.7% (11.4% below and 3.5% over 6 months of age). Since 1978 it has dropped to 2.8% (4.2% below and 2.1% over 6 months). The Waterston shunt had a higher (7%) operative mortality than the Blalock (3%) or Goretex (2.6%) shunts. The overall early mortality of total corrections was 15.1% (25.2% below and 13.5% over 2 years of age). It has dropped to 6.9% since 1978 (29.9% below and 6.2% over 2 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Surgical treatment of the tetralogy of Fallot with a single pulmonary artery].

Eleven patients with Tetralogy of Fallot and congenital or acquired absence of one pulmonary artery (PA) have been operated upon at the Department of Cardiac Surgery of Ospedali Riuniti-Bergamo-Italy. Eight children had agenesis of the left PA, one of the right PA and two had complete occlusion of the right PA after a palliative operation. Four patients had only a palliative procedure (one Blalock-Taussig, two Waterston, three PTFE shunts) with one operative death. Two patients underwent a two-staged procedure, that is an initial shunt (one Blalock and one PTFE shunt) followed by subsequent total correction. Five patients underwent primary total correction. No operative death occurred among the patients who had total correction. Right ventricular outflow reconstruction has been accomplished with an infundibular patch in one patient, an external valved conduit in two patients, and a transanular patch plus orthotopic bioprosthesis in 4 patients. One patient with a valved conduit died one year postoperatively in right heart failure caused by pulmonary hypertension. The pulmonary vascular disease was probably due to pulmonary microembolization following the severe hemolysis that lasted for twenty days in the early postoperative period. The nine surgical survivors are in good general condition with maximum follow-up of 7 years. The surgical approach either in case of palliation or in case of corrective surgery is finally discussed. In our experience TOF with unilateral absence of a PA is a congenital anomaly that can be corrected with results comparable to those of uncomplicated TOF.

Abnormalities, Multiple↗
PubMed1983

The binding of bilirubin to albumin. A study using spin-labelled bilirubin.

Binding between human serum albumin and a spin-labelled derivative of bilirubin was investigated by circular dichroism, fluorescence quenching, electron spin resonance and visible spectroscopy. The orders of magnitude of the binding constants obtained by flurorescence quenching and electron spin resonance spectroscopies were 10(7) and 10(3) 1 . mol-1, respectively. These data suggest that most spin-labelled bilirubin interacts with human serum albumin at the side not holding the spin-labelled side-arm. CD measurements showed the presence of at least two sites, associated with opposite Cotton effects. It is worthy of note that the Cotton sign of the first site is inverted with respect to the corresponding one of bilirubin. CD measurements on mixed systems (spin-labelled bilirubin/human serum albumin/bilirubin) were also performed. The decomposition of the ternary curves shows that the rotatory power of bilirubin bound to human serum albumin is higher in the ternary system than in the binary (bilirubin/human serum albumin). The corresponding CD measurements for the binding between spin-labelled bilirubin and bovine serum albumin are also reported and discussed.

Animals↗
PubMed1983

Surgical treatment of tetralogy of Fallot. Recent experience using a prospective protocol.

Two hundred eighteen consecutive patients with tetralogy of Fallot (TOF) underwent surgical treatment under a prospective protocol during a three-year period (January 1978 to December 1980). No patient was refused the operation. Eighty-three patients had palliative operations without hospital deaths (50% less than 1 year of age). One hundred thirty-five had total correction with 5 hospital deaths (3.7%; 70% C.L. = 2.0 to 6.2). Thirty-five of them had had palliation in the first year of life (one hospital death at time of correction). Incremental risk factors were young age (p less than 0.0002), transannular patch (p = 0.13) and primary repair (p = 0.38). Significant stenosis in the pulmonary artery branches were eliminated utilizing an original table of relationship between the diameter of the expected normal pulmonary valve annulus and the calculated diameter of the branches. The immediate post-repair peak systolic pressure ratio between right and left ventricles (Prv/lv) was only 0.39 and the incidence of transannular patches was remarkably low (34%). It is concluded that surgical management of tetralogy of Fallot can be achieved, today, with a very low hospital mortality reserving a two-stage procedure only for small infants (less than 1 year of age). Accurate criteria for the reconstruction of the right ventricle outflow tract (RVOT) can easily allow very low rates of transannular patches and postoperative RV hypertension with an ultimate better preservation of the RV function.

Adolescent↗
PubMed1983

Surgical treatment of non-critical right ventricular outflow tract obstruction with intact ventricular septum in patients over one year of age.

Between March 1966 and May 1982, 257 patients with clinically noncritical right ventricular outflow tract obstruction with intact ventricular septum (RVOTO/IVS) underwent elective open-heart correction, with an overall early mortality of 3.9%. Age ranged from 13 months to 48 years (mean 6.6 +/- 6.5 - median 5). We describe three different anatomical types, for which a standardized surgical approach is suggested. When one or more of the following features--small right ventricular cavity; rigid infundibular stenosis; hypoplastic pulmonary annulus and trunk; dysplastic cusps--were present, the mortality (10.6%) was significantly higher than in isolated valvular stenosis (2.2%) or in valvular plus dynamic infundibular stenosis or isolated low-lying stenosis (2.5%). In a series of 159 consecutive patients operated upon since September 1974 the cumulative early mortality was 1.3%. Late results on 202 patients (mean follow-up period of 25.6 +/- 22.6 months) are good in 90.6% and fair in 8.9% of the cases. One patient died of encephalitis 2 years after the operation. We believe that a more precise characterization of the underlying lesions and a more liberal use of different surgical techniques to minimize residual gradients, iatrogenic pulmonary incompetence and impairment of right ventricular contractility, may decrease early mortality and improve overall results.

Heart Defects, Congenital↗
PubMed1981

Mitral insufficiency and aortic valve stenosis in infancy associated with endocardial fibroelastosis, surgical treatment and long-term results.

Surgical treatment of mitral insufficiency and aortic valve stenosis associated with endocardial fibroelastosis has not been well documented. We treated 2 infants with this complex lesion: in one case it was possible to repair the mitral valve. The long-term results are quite encouraging and emphasize that this lesion should be treated early to avoid the risk of compromising the left ventricular function, although the chance of a valve replacement in an infant can be high.

Aortic Valve Stenosis↗
PubMed1980

Behavioural tests in peri- and post-natal toxicity study in rats of trithiozine (Tresanil) [4-(3,4,5-trimethoxythiobenzoyl)-tetrahydro-1,4-oxazine].

During the biological research on trithiozine [4-(3,4,5-trimethoxythiobenzoyl)-tetrahydro-1,4-oxazine], a substance with gastric antisecretory action, a study on peri- and post-natal toxicity was conducted in rats, during which an attempt was made to set up a series of tests which would consist of the study of the behaviour of offspring in their first 21 days of life. To confirm the validity of these tests, a parallel peri- and post-natal toxicity study was carried out with two compounds phenobarbital and diazepam, known to be active on the CNS and likewise known to pass from plasma into milk. The three compounds in question were administered by the oral route to pregnant rats from the 15th day of pregnancy to the 20th day after delivery in the following dosages; trithiozine: 100-200-500 mg/kg/day, phenobarbital: 60-100 mg/kg/day, diazepam: 30-60 mg/kg/day. The offspring were submitted, between their 14th and 20th day of life to the cheminée test, traction test, righting reflex test and avoidance test. The cheminée and avoidance tests proved to be the most suitable for studying neonatal behaviour. The percentage of success in these two tests decreased in a statistically significant manner for the groups treated with phenobarbital and diazepam, while trithiozine did not produce any variations in neonatal behaviour.

Animals↗