Search PubMed⌕ Search

Biomedical subjects

A Mautone

Publications and source records attributed to A Mautone.

At least 19 recordsLinked to original sources
PubMed1995

[Planar myocardial scintigraphy with technetium-99m-sestamibi in acute myocardial infarct treated with thrombolytic therapy].

BACKGROUND: Nuclear cardiology permits the estimation of the myocardial infarction size and the result of the thrombolytic therapy. The aim of the study was to demonstrate the feasibility of the planar myocardial scintigraphy with Technetium-99-m-sestamibi in the coronary intensive care unit for the early identification of the infarct size and the result of the thrombolytic therapy. MATERIALS AND METHODS: We considered 10 patients affected by a first myocardial infarction (5 anterior and 5 inferior wall) then treated with thrombolytic therapy (APSAC 30 U. iv) within an interval of 3 hours from the onset of the symptoms. Technetium-99-m-sestamibi was injected before the thrombolytic therapy and the planar imaging was registered after 2-3 hours with a mobile gamma-camera. After 24 hours and before patient discharge we repeated the scintigraphic evaluation. Within 24 hours from the thrombolytic therapy the coronary angiography was performed for the demonstration of patency of the infarct-related artery. The left ventricle myocardial perfusion was divided in the 3 planar projections into 13 segments. The perfusion in each segment was evaluated with a perfusion score: 0 = normal perfusion, 1 = moderately reduced, 2 = severely reduced, 3 = absent. The sum of the hypoperfused segments represented the infarct size. A perfusion score improvement greater than 40% was considered a marker of reperfusion. RESULTS: The infarct size involved 4.4 +/- 1.4 segments in the anterior and 2 +/- 0.6 segments in the inferior wall infarctions (p < 0.05). The scintigraphic imaging made 24 hours after the myocardial infarction allowed the diagnosis of coronary reperfusion in 7 patients. The coronary angiography demonstrated the infarct related artery patency in 9 patients (all with TIMI perfusion score = 3). The nuclear imaging at patient discharge provided the diagnosis or reperfusion in 8 cases and demonstrated an improvement of the myocardial perfusion score in 5 cases. CONCLUSION: The scintigraphic imaging with Technetium-99-m-sestamibi in the patients with a myocardial infarction treated with thrombolytic therapy is feasible with a mobile gamma-camera in the intensive coronary care unit. The quality of planar imaging is good and allows the evaluation of myocardial infarct size and efficiency of thrombolytic therapy. An earlier scintigraphic imaging should be taken into consideration for a more timely non-invasive evaluation of patients who need coronary angiography and, if necessary, a rescue PTCA.

Aged↗
PubMed1995

Development of melanoma throughout two close pregnancies. Case report.

Primary melanoma is the most malignant and the least frequent of all cutaneous tumors. Its incidence in pregnancy varies from 0.1 to 2.8/1000. Up to today, impact of pregnancy on melanoma's course is still a much debated question in the literature. Some earlier reports suggested a particularly serious prognosis for melanoma associated with pregnancy, while more recent studies show that pregnancy may influence relapses without significantly altering survival. This paper reports the case of a woman affected by melanoma, whose clinical conditions became more and more serious during her second pregnancy and the following puerperal period. The progressive impairment of her clinical condition has suggested a correlation between the two close pregnancies and the unfavourable course of her disease.

Adult↗
PubMed1995

[Left ventricular remodelling at 3 months from a first transmural infarct: the effect of physical activity and of the patency of the necrotic artery on changes in volume and segmental kinetics].

OBJECTIVE: Aim of this perspective study was to assess in patients (pts) with a recent first transmural myocardial infarction (MI) the influence of a physical training, of MI location and of the patency of the infarct-related coronary artery on the modification of the left ventricle volumes and wall motion score. METHODS: One hundred and four consecutive pts with a first transmural MI without clinical contraindication (heart failure, moderate or severe mitral regurgitation, severe postinfarction angina, claudication or severe orthopedic problems) were randomly assigned to a rehabilitation group (A) and to a control group (B). Ten days after acute MI all pts underwent a coronary angiography. A complete echocardiographic examination was performed 10 and 90 days after MI, and an ergometric evaluation 20 and 90 days after MI. Ventricle volumes, ejection fraction (EF) and wall motion score were calculated by a two-dimensional echocardiogram. Thirteen pts (12.5%) were excluded from the study because of the bad quality of the echocardiographic images. There were 8 dropouts (7.8%) due to bypass surgery or to coronary angioplasty. Of the 83 pts who have concluded the study 46 (55%) belonged to the Group A and 37 (45%) to the Group B. Thirty-six had anterior MI (20 Group A), 41 inferior MI (22 Group A) and 6 lateral or posterolateral MI (4 Group A). RESULTS: At the base-line the ventricular volumes, the EF, the wall motion score and the Total Work Capacity (TWC) were not different in the two groups. Three months after the MI the pts of the Group A demonstrated, in comparison with the controls, a reduction of left ventricle end-diastolic volume index (EDVi 75.4 +/- 18.1 ml/m2 vs 85.3 +/- 27.9 ml/m2; p < 0.05) and an increased TWC (7146 +/- 3566 Kgm vs 4494 +/- 2728 Kgm; p < 0.001). In the Group A the comparison of the base-line data with those observed 3 months later showed a reduction of the EDVi from 81.9 +/- 16 to 75.4 +/- 18.1 p < 0.05, of the end-systolic volume index (ESVi) from 43.6 +/- 11.9 to 38.1 +/- 14 ml/m2, p < 0.05, of the wall motion score from 6.7 +/- 2.3 to 5.5 +/- 2.9 p < 0.05 and a great increase of the TWC (from 4483 +/- 2407 Kgm to 7146 +/- 3566 Kgm; p < 0.0001). No parameter in the Group B showed any significant modification in the same period. The tendency to reduce the volume and improve the physical performance with exercise training was greater in the inferior MI (ESVi from 41.3 +/- 12.3 to 34.7 +/- 11.6 ml/m2, p = 0.07 - TWC from 4652 +/- 2446 to 8115 +/- 3954 Kgm, p < 0.001) than in the anterior MI (ESVi from 445.8 +/- 10.7 to 42.1 +/- 17.2 ml/m2, p = ns - TWC from 4085 +/- 2103 to 5829 +/- 2256 Kgm, p < 0.05). When comparing pts with an occluded infarct-related coronary artery with TIMI grade 0-2 flow with those with a patent one (TIMI grade 3 flow), no significant differences in any considered parameter except for the collateral vessels score were found (1.48 +/- 0.97 vs 0.29 +/- 1.64 p < 0.05). After 3 months 20 pts presented larger EDVi compared to the baseline, and compared to the 34 pts with a smaller EDVi, they had a higher serum myocardial enzymatic peak (LDH 2035 +/- 1423 vs 1346 +/- 683 p < 0.01, CK 3096 +/- 2339 vs 2099 +/- 1520, p < 0.05) an inferior collateral score (0.47 +/- 0.77 vs 0.67 +/- 1.98, p < 0.01) and they mainly belonged to the Group B (55%). Twenty pts had an initial EF < or = 40% (range 22-40%): 5 of the 6 pts of this group, who increased the EDVi after 3 months belonged to the Group B while 9 of the 10 pts who reduced it belonged to the Group A. CONCLUSIONS: Intensive physical training during the 3 months following a first transmural MI significantly improves the physical performance, reduces the ventricle size and improves the wall motion score. Such improvement could not be found in the control group and is not related to the patency of the culprit coronary artery. The pts with an inferior MI tended to gain a major advantage from the physical activity than the pts with an anterior

Aged↗
PubMed1995

[Our experience with the orthotopic continent colonic neobladder].

In the last years particular surgery operations became refined for the techniques and therapeutics progresses also developed in this field. This has allowed with major security to accomplish engagemently reconstruction operations after removal of the bladder, especially for cases of neoplastic pathology, to offer the patients a more normal quality of life avoiding urinary derivations that should change the performance of "EGO". After the operations of radical cystoprostatovesciculectomy different methods have been presented for the construction of heterotopical and orthotopical neobladder; among these the continent colic orthotopical neovesica of Goldwassern which uses the detubulization right colon, in our opinion could offer best functional and clinic results in virtue of easier execution and to use of minor number of intestinal segments. Moreover, for the peculiar characteristics of colic segment, allow to make a wide tank at low pression with perfect diurnal and nocturnal continence. We have, therefore, presenting the results of our experience regarding 12 cases of continent colic orthotopical neovesica, by Goldwasser, with a follow-up of 1-6 years which have comforted us with the results predicted. Although other techniques may offer similar results we believe that the Goldwasser method is still valid for all the above reasons.

Aged↗
PubMed1995

[Merkel cell tumor. A clinical case].

Merkel's tumor cells represent a rare neuroendocrine neoplasia type which belong to an apudomi group but it's different due to the absence of the biogen amine and hormone polypeptide production. The authors report a rare case of Merkel's tumor cells clinically evident with a great neoformation under the left axilla but already represents at the moment of discovery a notable diffusion with repetition as in hepatic and suprarenal gland. Pointing out not only clinic case having arrived at their observance but also it's important to take note of this particular neoplasia and to suspect it in case of doubt interpretation of clinical tumor.

Aged↗
PubMed1994

[Assessment of the effects of alfuzosin on miction with dynamic echography].

Alfuzosina has a specific antagonist effect on the alfa-1-adrenergic post-junctional receptor posed at urethral laeve musculature, prostatic capsule and vesical trgonum. It's and ideal drug the symptoms of the difficult urinary flow typical of the benign prostatic hypertrophia (IPB) and of some patologies of vesical collum to attenuate. With this work we want to demonstrate the anatomic alterations of vesical collum and prostatic urethra by means of dynamic recording mictional phase with transrectal scan carried out before and after treatment. In this study, 30 patients were divided into three groups of 10 in relation to the pathology: overtone of vesical collum, little benign prostatic ipertrophia and great benign prostatic ipertrophia have included. The patients of each group have also been divided in undergroups of five (selected with the method of double-blind) of which the first treated with alfuzosina 7.5 mg/die for 30 days and the second with placebo. Considering the limits of this study, the analysis of the results have permitted to conclude that the drug has determined a subjective improvement in all patients except those with great IPB, while the objective valuation, reached comparing scan dynamic pictures before and after treatment, has made it possible to visualize an improvement on the opening of the vesical collum and the prostatic urethra after therapy with great variations of the size of che mictional funnel and same prostatic urethra. The alfuzosina is efficacious, in the cases under examination, except the third group were the compression on the urethra was of an elevated degree.

Adrenergic alpha-Antagonists↗
PubMed1994

[Plasma levels of the serum antioxidants (uric acid, ceruloplasmin, transferrin) in term and preterm neonates in the first week of life].

Development of serum antioxidants (ceruloplasmin, transferrin, uric acid and bilirubin) an the 1st, 4th, 7th days of life has been evaluated in 50 healthy NGA newborns (25 preterm with 35 +/- 0.6 week of gestational age and 2270 +/- 150 g of weight, 25 a term with 39 +/- 0.8 week of gestational age and 3480 +/- 220 g of weight) and in apparent absence of oxidant stress. The ceruloplasmin values increase from the 1st to 7th days of life and change significantly at the 4th day between a term and preterm newborns (p < 0.01); the transferrin values reduce significantly an the 1st (p < 0.01) and 7th days of life (p < 0.05); the uric acid values reduce in the two groups an the 1st day (p < 0.01). Our results show in the newborn a prevalent antioxidant activity of the studied substances. The plasma levels of uric acid may be compared, in the first week of life, to the hypoxanthine levels as acute ipoxia gauges.

Age Factors↗
PubMed1993

[Long-term follow-up in patients operated on for aortic coarctation. The echo-Doppler and MRI assessment of left ventricular function and the transisthmic gradient].

BACKGROUND: Hyperdynamic left ventricular function and increased left ventricular mass has been recently reported in the long-term follow-up of patients after successful repair of aortic coarctation (AoCo). METHODS: We studied 35 patients, mean age 22.7 years (range 1-47), following repair of AoCo in order to evaluate: 1) left ventricular mass and systolic function by M-mode echocardiography in comparison with 20 healthy control subjects; 2) the prevalence of systemic hypertension; 3) systolic blood pressure and the trans-isthmic gradient by CW Doppler at rest and after exercise; 4) subjects with a hypertensive response and/or with a significant trans-isthmic gradient during exercise, correlating such parameters with indexes of left ventricular function and the ratio of aortic isthmus/aortic diaphragmatic diameters (AOI/AOD) by means of Magnetic Resonance (MR). At the time of operation, mean age was 12.4 years (range 1 mo-40 yrs) and the follow-up period was 10.1 years (range 6 mo-26 yrs). RESULTS: Left ventricular mass index (Mi) was significantly greater in comparison with that of the controls (96.5 +/- 25 vs 71.5 +/- 16.6 g/m2; p < 0.001); the mean velocity of circumferential shortening (mVCFc) was increased (1.4 +/- 0.25 vs 1.2 +/- 0.16 circ/s; p < 0.005); the end systolic meridional stress (ESS) was decreased (37.3 +/- 11.1 vs 47.9 +/- 13.1 g/cm2; p < 0.005) while the peak systolic meridional stress (PSS) was not significantly different in the two groups. Fourteen out of 35 patients (40%) showed an exaggerated mVCFc for the level of ESS, which indicates an increased inotropic state. Hypertension at rest was present in 10 patients (28%). Mean age at the time of operation of the hypertensive group was higher than that of the normotensive one (21.4 +/- 10 vs 8.9 +/- 8.6 yrs; p < 0.001). All patients showed a small systolic gradient across the side of coarctation repair at rest (mean 13.1 mmHg; range 0-30). The exercise test was stopped in 5 patients because of hypertension (> 250 mmHg); 24 patients (80%) showed an exercise-induced hypertension. The mean gradient at maximal exercise was 25.9 mmHg (range 0-52); 6 patients (20%) developed a diastolic gradient. With MR it was possible to evaluate the anatomy of the aortic arch and the descending aorta in all cases. The mean ratio AOI/AOD was 0.81 (range 0.63-1). The age at the time of operation showed a positive correlation with the systolic blood pressure (r = 0.63; p < 0.001) and with Mi (r = 0.45; p < 0.005). The systolic blood pressure and the gradient at maximal exercise also showed a positive correlation (r = 0.40; p < 0.01). CONCLUSIONS: In the long-term follow-up of patients after successful coarctation repair there are persistent alterations of left ventricular function with hypertrophy, hyperkinesia and increased inotropic state. Hypertension at rest and after exercise could persist despite good surgical results.

Adolescent↗
PubMed1991

[Neonatal infections and premature rupture of fetal membranes].

The premature rupture of the membranes is still a cause of concern due to the related risk of infection and respiratory disorders. The study included sixty-two neonates whose mothers had ruptured their membranes for at least 48 hours (group A) and 42 neonates with a high risk of infection (low birth weight, prematurity) (group B) in order to assess whether antibiotic prophylaxis used in pregnant women with premature rupture of the membranes is sufficient to reduce the risk of severe neonatal infection. The results obtained show that there is an increased frequency of RDS, jaundice and mortality in group A, whereas in group B there was a greater frequency of sepsis and urinary tract infections. Antibiotic prophylaxis therefore allows the frequency of neonatal infections following the rupture of membranes to be reduced, thus enabling the birth to be delayed in order to induce pulmonary maturity.

Anti-Bacterial Agents↗
PubMed1991

[Role of echo-doppler in programming of sequential pacemakers. Evaluation of optimal atrioventricular delay in patients with normal or hypertrophic left ventricle].

2D-echocardiography, together with simultaneous measurement of systolic blood pressure and pulsed doppler examination of the transmitral flow were used to assess the left ventricular (LV) systolic and diastolic function during sequential pacing at 4 different atrioventricular (AV) intervals (50, 100, 150, 200 msec), and VVI pacing under the same rate of 90 beats/min in 13 patients (pts), mean age 61.25 +/- 8.26 years with DDD pacemakers implanted for complete AV block. The pts were divided into 2 groups: group I was comprised of 7 subjects showing no clinical abnormalities and normal echocardiograms, and group II of 6 hypertensive subjects with LV hypertrophy and normal systolic function on echocardiography. There was no change in LV diastolic dimension, but a depression in LV systolic function and contractility were shown by the conversion from DDD to VVI pacing in all pts, particularly in group II VVI pacing caused mitral regurgitation with LV filling pattern changing from beat to beat. By changing the AV interval during DDD pacing, the LV filling pattern was modified in all pts. Systolic performance showed little change in group I, whereas in group II more evident modifications were seen. An optimal AV delay, defined as the delay with maximal stroke volume, was identified in all subjects as being 100 and 150 ms in group I and group II respectively. Echo-doppler can thus provide useful information in choosing the mode of pacing and in programming optimal AV delay. In contrast to normal ventricles the systolic performance in hypertrophic ventricles is highly influenced by variation in the AV delay.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Glycerol erythrocyte lysis test in the 1st month of life in neonates at term and premature infants].

Foetal erythrocytes have an enhanced resistance to osmotic haemolysis that they retain for the first 5 days after birth, particularly in premature newborns. The erythrocyte fragility test was used to study the increased resistance to osmotic haemolysis in 155 healthy newborns (50 NGA born to term, 55 NGA premature and 50 SGA born to term) as well as 31 newborns (20 born to term and 11 premature) with aspecific hyperbilirubinaemia. The drug used was glycerol which is specific in its reaction to alterations in erythrocyte membrane stability and made it possible to assess changes arising in the first month after birth, both naturally and in response to phototherapy. The results show a much higher resistance in neonatal than adult erythrocytes that gradually decrease during the first month after birth without, however, falling to adult levels. No changes in resistance attributable to the phototherapy adopted in newborns with hyperbilirubinaemia were encountered. The glycerol test proved extremely sensitive in the diagnosis of neonatal haemolytic anaemias easy to use so that congenital spherocytosis can be identified earlier than is otherwise possible.

Anemia, Neonatal↗
PubMed1989

[Proposed scoring system for the early diagnosis of infection in neonates].

Infections are currently often responsible for neonatal morbidity and mortality. The present study examines the possibility of reducing this incidence by the early diagnosis of infections. With this in mind the early clinical signs of infection were examined as well as the results of certain quickly and easily performed blood and blood chemical tests which were scored from 0 to 2. The results showed that newborns with scores less than 5 should be considered free of sepsis, those scoring 5-7 should arouse suspicion of sepsis, while sepsis should be considered definitely present in those scoring greater than 7. This scoring system presented 100% sensitivity, 88.2% specificity as well as 100% positive and an 88.2% negative predictive value. The system is therefore considered reliable as well as easy to use.

Humans↗
PubMed1987

Neonatal diabetes mellitus: evaluation of pancreatic beta-cell function in two cases.

Two cases of neonatal diabetes mellitus, a transient form and a permanent form, are described. Comparing their clinical presentations and courses, we exclude the possibility of an early differential diagnosis based on clinical or laboratory data. We hypothesize that only repeated dynamic evaluations of pancreatic beta-cell function could be useful to differentiate the two forms.

Blood Glucose↗