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Biomedical subjects

A Mercatello

Publications and source records attributed to A Mercatello.

At least 73 records · Page 4Linked to original sources
PubMed1988

Myocardiotoxicity of 5 fluorouracil.

We report a case of specific myocardiotoxicity due to 5 F.U. not previously described in man. A 41-year-old man was admitted to the ICU for heart and renal failure, appearing 24 h after 5 days treatment with 5 F.U. and cis-platinum. Dopamine was necessary to maintain blood pressure. Two-D echocardiography and a right heart catheterisation confirmed the alteration of myocardial contractility. After 2 weeks a complete cardiac recovery occurred.

Adult↗
PubMed1988

Bacteremia following cardiac arrest and cardiopulmonary resuscitation.

After out of hospital CPR thirty three resuscitated patients were studied for bacteremic complications. Thirteen patients (39%) had two or more positive blood cultures during the twelve hours following CPR. Source of superinfection was a central venous catheter in one case (staphylococcus). The twelve other bacteremic patients had fetid diarrhea a few hours after admission. The same organism were found in blood and faeces (streptococcus D, Escherichia coli, Pseudomonas aeruginosa, acinetobacter, enterobacter). Mesenteric ischemia caused by a low cardiac output may explain the diarrhea and the intestinal origin of the septicemia. All patients (12 cases) with diarrhoea and bacteremia died. Patients who recovered without neurologic sequelae (4 cases) had never been septic and never had diarrhea.

Adult↗
PubMed1988

[Pharmacokinetics of high-dose melphalan (200 mg/m2) in a case of total renal insufficiency].

The pharmacokinetics of the alkylating agent melphalan was determined in a dialysed patient, 30 years old, who underwent unilateral orchidectomy for a malignant testicular tumor. Melphalan was included in a polychemotherapy treatment with eight 1-h infusions of 230 mg of etoposide (VP 16), then one 5-min infusion of 370 mg of melphalan (200 mg/m2) followed by autologous bone marrow grafting (ABMG). In this patient, melphalan pharmacokinetics was different from that of patients without important renal dysfunction for the area under the concentration curve (1,324 mg.l-1.min). However, with a melphalan elimination half-life of 80 min, ABMG could be performed, as usually, 24 h after melphalan administration. Plasma alpha-fetoprotein (AFP) concentrations showed that chemotherapy was efficient. Furthermore, we observed a modification of etoposide kinetics due to melphalan.

Adult↗
PubMed1987

[Intracranial hypertension in comatose bacterial meningitis].

The intracranial pressure of 31 patients with bacterial meningitis, in a comatose state and with a score lower than 6 on Glasgow's scale, was monitored by means of an extradural captor in order to detect intracranial hypertension and optimize its treatment. All patients had intracranial hypertension during the first 48 hours. Brain perfusion pressure was inferior to 50 mmHg in 5 cases. Computed tomography of the brain showed cerebral oedema in 16 cases. Twenty (64%) of the patient survived, 15 of them without sequelae. Monitoring intracranial pressure in patients with bacterial meningitis and coma makes it possible to optimize treatment and shows that a less than 50 mmHg brain perfusion pressure is associated with a 100% death rate.

Adolescent↗
PubMed1987

[Pharmacokinetics of ceftriaxone in hemodialysis].

The influence of hemodialysis on the pharmacokinetics of ceftriaxone was studied in 5 patients with chronic renal failure, with a glomerular filtration rate of less than 5 ml/min, and treated by regular hemodialysis. A single dose of 2 g ceftriaxone was administered IV at the end of a hemodialysis, and venous samples were drawn 12 and 24 h thereafter. Two hemodialysis were performed at the 44th (HD1) and the 92nd (HD2) hour, and blood samples were drawn simultaneously on arterial and venous sides of the dialyzer at the onset of HD1 and at the end of HD2. Plasma ceftriaxone concentrations were measured on each sample by both microbiological and chromatographic (HPLC) methods. In these patients, ceftriaxone kinetics are considerably longer than in normal subjects, with an elimination half-life of 16 h, an apparent distribution volume of 800 ml/kg, but without decrease of plasma clearance, except in one patient who had hepatic cytolysis at the time of injection. Plasma concentrations on both sides of dialyzers, or before and after hemodialysis, are not significantly different, and the mean hemodialysis clearance ranges between 26 and 30 ml/min/m2 dialyzer area. According to these data, the dose-interval between successive administrations of ceftriaxone 2 g IV should be 48 h in patients with chronic renal failure, and supplemental doses do not appear necessary after hemodialysis.

Adult↗
PubMed1986

[Bacterial infections and early Plasmodium falciparum malaria].

Two cases of Plasmodium falciparum malaria associated with bacterial infections--streptococcus A septicemia and Legionnaires' disease--are described. The association of these two infections is probably not incidental, and the hypothesis of Plasmodium falciparum induced immuno-deficiency is discussed.

Adult↗
PubMed1986

[Treatment of moderate or severe infections using imipenem/cilastatin. 41 cases based on a multicenter protocol].

Imipenem and cilastatin in combination have a broad spectrum in vitro with a strong killing activity on most bacteria. Using a multicenter study design, we investigated 41 patients with moderate or severe infections: septicemia in 18 cases (Gram negative rods in 10, Gram positive cocci in 7 and combination of both in 1), pneumonia in 7, osteitis in 4, soft tissue infection in 7, infection of the genitourinary tract in 6 and miscellaneous infections in the remaining cases (1 abscess of the pancreas, 1 typhoid fever, 1 presumptive endocarditis). All of the bacteria were susceptible to imipenem/cilastatin: MICs ranged from 0.02 to 0.8 mg/l and MBCs from 0.015 to more than 10 mg/l. All patients except one recovered or improved under imipenem/cilastatin. The patient who failed to respond had septicemia due to a methicillin-resistant Staphylococcus aureus with a MBC and MIC above 10 and 0.5 mg/l respectively. Tolerance was outstanding: only 4 patients had adverse effects requiring withdrawal of the drug.

Adult↗
PubMed1986

[A case of hepatic and splenic peliosis occurring in the puerperium after normal pregnancy].

The authors report a case of Peliosis of the liver and of the spleen that occurred at term after a normal pregnancy that lasted 38 weeks. The delivery was complicated by amniotic infection with hemorrhagic shock and uterine inertia that gave rise to the need for a sub-total hysterectomy in order to stop the bleeding. The progress of the case was made worse by the development of the disseminated intra-vascular coagulation syndrome with septicaemia and pulmonary oedema. When the operation was carried out to stop the bleeding it was noted that the liver was enlarged, hard, smooth and dark in colour and the histological specimen showed a major degree of Peliosis hepatis. The same lesions were found in the region of the spleen and a lymph node. The patient died 14 days after delivery of acute renal failure together with cerebral oedema and septic shock. The authors consider that the aetiology of the Peliosis could be due to hormone changes of pregnancy associated with septicaemia. The anatomical evolution of Peliosis hepatis to widespread necrosis of the parenchyma makes it possible to understand that the condition of diffuse intra-vascular coagulation will not improve in the presence of hepato-cellular insufficiency.

Adult↗
PubMed1984

[Local low-dose thrombolytic treatment with sequential urokinase-plasminogen in deep central venous thrombosis].

Four patients with recent central deep vein thrombosis (pelvis-superior mediastinum) were treated by local low dose infusions of urokinase (500 to 1000 IU/kg/h for 6 to 9 hours) followed by plasminogen (20 to 30 microkatals/h for 2 to 3 hours) associated with simultaneous anticoagulation with heparin. The treatment was continued for 83 to 160 hours until control phlebography showed dissolution of the thrombus. There were no haemorrhagic complications despite the presence of a number of risk factors which contraindicated treatment by a systemic route. Fibrinogen and FDP levels did not alter significantly. This therapeutic approach is worth considering and should be integrated among the therapeutic options available for cases of central deep vein thrombosis.

Adult↗