Transcutaneous partial oxygen tension and lung mechanics during methacholine inhaled challenge.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
A Quadri
Publications and source records attributed to A Quadri.
Professional figures in intermediate intensive units.
In Italy, respiratory intermediate intensive care units (IICUs) are not yet considered as autonomous hospital departments. The IICU of the Rehabilitation Department of the Medical Centre of Gussago (12 monitored beds) provides care for respiratory and cardiac patients. Ventilatory assistance and noninvasive modalities both in treatment and monitoring suggest a multidisciplinary approach to the patient. Highly professional figures should, therefore, be singled out to provide care in a respiratory IICU. The medical staff is composed of one anaesthesiologist, one cardiologist and one pulmonologist, who can integrate care when respiratory complications occur in a cardiological patient, or when cardiac events affect a respiratory patient. Nurses are capable of specific activities, especially when ventilatory assistance is required. The presence of a physiotherapist reduces the nursing workload, especially for ventilated individuals. The psychological aspect is undertaken by a specialist. Finally, an expert in nutrition provides an individualized dietary regimen. Our 4 year experience encourages such a multidisciplinary approach. An ideal integration of the professional activities should provide adequate and individual care for patients admitted to an IICU.
Humans↗
Hygroscopic condenser humidifiers in chronically tracheostomized patients who breathe spontaneously.
The aim of this study was to test the usefulness of hygroscopic condenser humidifiers on secretion and on inspired gas temperature in tracheostomized patients. Forty spontaneously breathing chronically tracheostomized patients were divided into two groups: Group 1 received a hygroscopic condenser humidifier connected to the tracheostomy, 24 h daily for 10 days; Group 2, without any protection system, was chosen as the control group. The daily number of tracheal suctions, quantity of aspirate and thickness and colouring of secretions was evaluated. At baseline, and at days 5 and 10, patients were submitted to blood gas analysis, respiratory function tests and sputum analysis. The temperature of gases breathed was measured at rest and during a hyperventilation test, with and without the hygroscopic condenser humidifier. Statistically significant differences were found in thickness and colouring of secretions between the two groups during the period of 10 days. Group 2 showed a significantly greater trend in number of bacteria than Group 1. The group with the hygroscopic condenser humidifier showed respiratory function improvement over time for forced expiratory volume in one second (FEV1) and tidal volume (VT), maximal inspiratory pressure (MIP), and maximal voluntary ventilation (MVV) in comparison to the control group, who did not. Significant differences in the temperature between rest and hyperventilation, with and without a hygroscopic condenser humidifier were also found. In conclusion, a hygroscopic condenser humidifier may be useful in chronically tracheostomized patients who breathe spontaneously, improving viscosity and colouring of secretions, preventing further bacterial colonization, heating inspiratory flow, and helping to improve the functional outcome.
Aged↗
An unusual increase in haemodynamic values in a sleep apnoea syndrome patient with prolonged apnoea.
This case report shows the results of a right heart catheterisation in a patient with sleep apnoea syndrome (SAS). Arterial oxygen saturation (SaO2), heart rate, oronasal flow, and monitoring of electroencephalographic (EEG), sovrayoidal electromyographic (EMG) and thoracoabdominal movements were recorded simultaneously. A mixed apnoea of 180 s was registered, SaO2 fell to 54% and systolic pulmonary artery pressure (sPAP) increased to 130 mmHg. Slowly, haemodynamic values began to normalise with the reappearance of respiratory acts. We can hypothesize that this patient's nocturnal apnoeas may cause frequent and deep negative pleural pressure swings, with severe continuous action on pulmonary circulation. This case report has shown that a SAS patient is capable of developing an adaptative response to an unusual and remarkable systolic pulmonary artery pressure increase, which is mainly due to hypoxic vasoconstriction.
Adult↗
Physical rehabilitation in coronary patients who have suffered from episodes of cardiac failure.
The effects of bicycle training for 5 weeks were evaluated in 12 patients after myocardial infarction with left ventricular dysfunction (left ventricular ejection fraction < 40%) and at least one episode of cardiac failure in the past. The patients were divided into two groups of six according to the Weber classification: Group B (VO2/kg/min: 16-20) and Group C (VO2/kg/min: 10-15). Cardiopulmonary and hemodynamic parameters were evaluated during a maximal exercise test and a simultaneous catheterization of the right side of the heart before and after the training. An increase in the capacity for work was recorded in Group B (p < 0.02), while Group C remained unchanged. A statistically significant increase in minute ventilation (p < 0.05) and VO2/kg/min (p < 0.0006) was recorded in Group B. Group C showed an increase in the mean pulmonary arterial pressure (p < 0.03). All of the other parameters remained unchanged after training. We conclude that physical rehabilitation improves the tolerance to exercise in patients with a mildly depressed cardiac function (Group B) but not in patients with a very depressed cardiac function (Group C).
Cardiac Output↗
Acute exacerbations in severe COLD patients. Treatment using positive pressure ventilation by nasal mask.
We retrospectively evaluated the clinical effectiveness of a treatment schedule with intermittent positive pressure ventilation via nasal mask in 49 patients with acute exacerbations of COLD. According to the ability to successfully tolerate a preliminary trial with NIPPV, patients were submitted either to standard treatment plus NIPPV (25 patients) or to ST alone (24 patients). The ST consisted of medical, oxygen and physical therapy. The NIPPV was delivered by a volume cycled ventilator in control mode at least 4 h a day for five consecutive days a week, for three weeks. Comparison of baseline with measurements performed after 10 and 21 days of treatment respectively showed a significant improvement in PaO2 and in PaCO2 in both groups. After 21 days of treatment, VC, FEV1, inspiratory muscle strength, and dyspnea significantly improved in both groups. No significant difference was found between groups at any time of treatment. We conclude that the treatment schedule of NIPPV used is not more effective than ST alone in acute exacerbations of COLD.
Aged↗
Time course of pulmonary function before admission into ICU. A two-year retrospective study of COLD patients with hypercapnia.
Changes in cardiopulmonary function were retrospectively evaluated back to two years before acute exacerbations requiring ICU admission in 16 COLD patients with chronic hypercapnic respiratory insufficiency (age: 61 +/- 6 years, group A). Fifteen hypercapnic COLD patients matched for age, sex, lung function, and blood gas values not requiring an ICU admission in a period of two years, served as control subjects (age: 66 +/- 7, group B). Periodic assessments of spirometry, arterial blood gas values, echocardiography, body weight, and red blood cell count performed in stable state were compared for differences between groups and changes over a period of two years. The results indicated that basal body weight, rate of deterioration over time in FEV1, VC, blood gas values, bicarbonates, and RVD may be related to the necessity of ICU admission in COLD patients with hypercapnic respiratory insufficiency.
Aged↗
Right ventricular diastolic function in chronic obstructive lung disease.
Early detection of diastolic dysfunction in chronic obstructive lung disease (COLD) patients could have great prognostic value. Echocardiography has been shown to be a useful technique in studying left ventricular diastolic function. A noninvasive method of studying right ventricular diastolic function has not yet been reported. Pulsed Doppler echocardiography was used to assess right ventricular diastolic function in three groups of subjects: Group I: 35 COLD patients with pulmonary hypertension; Group II: 32 COLD patients without pulmonary hypertension; and Group III: 18 control subjects. Ratios between peak atrial filling velocity (A) and peak early filling velocity (E) (A/E), deceleration half times of the right ventricular rapid filling wave (DHT), and the interval between pulmonary valve closure and tricuspid valve opening (isovolumic relaxation times) (Pc-To) were significantly different in Group I in comparison to Groups II and III. Sensitivity of A/E ratio and Pc-To were 82 and 77%, respectively, and specificity 90 and 72%, respectively; positive predictive values were 90 and 75%, respectively, and negative predictive value 82 and 74% respectively. The multiple correlation coefficient between A/E, acceleration time (ACT), DHT, Pc-To and mean pulmonary artery pressure was 0.75 for Groups I and II together. In conclusion 2D echo-Doppler proved to be useful in evaluating right ventricular diastolic function in all hypertensive COLD patients, revealing a high correlation between diastolic parameters and mean pulmonary artery pressure in both normotensive and hypertensive COLD patients.
Echocardiography, Doppler↗
High-performance liquid chromatographic determination of acetone in blood and urine in the clinical diagnostic laboratory.
A method for the determination of acetone in plasma or urine by high-performance liquid chromatography (HPLC) was developed. Plasma specimens are deproteinized with acetonitrile (1:1, v/v) 2,4-dinitrophenylhydrazine (DNPH) is added to the supernatant or to filtered urine samples, similarly treated with acetonitrile (2:1, v/v) to prevent crystallization of the synthesized phenylhydrazone. An aliquot (20 microliters) of the reaction mixture was subjected to HPLC at ambient temperature using a reversed-phase Pecosphere 3 x 3 C18 column with acetonitrile-water (45:55, v/v) as eluent at a flow-rate of 1 ml/min and detection at 365 nm. Hydroxyacetone and acetoacetate phenylhydrazone derivatives do not interfere. The identification of acetone by its retention time was confirmed by comparison with a laboratory-synthesized acetone DNPH derivative. The concentration of acetone, eluted within 3 min, was determined by the peak-height method. The detection limit was 0.034 mmol/l; the relative standard deviations were less than 5% within run (n = 20) and less than 10% between run (n = 20).
Acetone↗
Pharmacological responsiveness of winter depression.
Seasonal affective disorders (SADs) are disturbances of mood bearing a fixed relationship to season. Wintertime depression is the most widely accepted form of SAD. Full-spectrum, bright artificial light is the standard treatment for this syndrome. Tranylcypromine was effective in the treatment of 14 patients meeting both the National Institute of Mental Health and DSM-III-R criteria for winter depression. The average patient experienced a 91 percent reduction in depressive symptoms within 3 to 4 weeks of the initiation of this treatment. Desipramine initially appeared to be an effective treatment for winter depression. Eight patients started treatment with desipramine in October or November. One patient was unresponsive, and 8 patients appeared to be responsive but relapsed in the following 2 to 4 months. Twenty-five patients were subsequently treated with bupropion. One patient was unresponsive to bupropion, but the others experienced a substantial reduction in symptoms. Chronobiologic properties that might explain or predict the effectiveness of drugs used to treat winter depression are discussed.
Adult↗
Coxsackie virus heart disease: 15 years after.
From 1969 to 1973, 68 patients were admitted to the 4th Division of Medicine of the Brescia Civil Hospital with the diagnosis of viral myocarditis. The patients were divided into two groups according to the results of the Coxsackie virus complement fixing antibodies test: Group 1 (42 patients) with a fourfold or greater rising antibody titre; Group 2 (26 patients) with a negative serum test. Both groups were examined after a follow-up period of 15 years. Ten patients from Group 1 died. The diagnoses were chronic myocarditis (three cases); chronic cardiomyopathy-pulmonary embolism (one case); chronic cardiomyopathy-liver cirrhosis (one case); dilated cardiomyopathy-sudden death (two cases); congestive cardiomyopathy (three cases). No Group 2 patients died. The 15-year mortality rate of Group 1 was significantly higher than that of Group 2 (Fisher Test: p less than 0.005). In conclusion, the natural history of Coxsackie virus heart disease is characterized by two possibilities: a complete recovery from a clinical point of view, in some cases with only minor T wave abnormalities, or evolution into a chronic disease (dilated cardiomyopathy) having a high mortality rate within 10 years of the onset of the acute disease.
Cardiomyopathy, Dilated↗
Noninvasive assessment of pulmonary hypertension: a simultaneous echo-Doppler hemodynamic study.
Thirty patients with stable chronic obstructive lung disease (COLD) underwent an echo-Doppler examination before and during right heart catheterization. No statistically significant differences between observations for any of two-dimensional echo-Doppler parameters were found. The measurement of all parameters taken during the catheterization correlated better with mean pulmonary artery pressure (mPAP) than those taken before. This difference was most evident for the isovolumetric acceleration time (r = 0.71 before versus r = 0.85 during the catheterization) and relaxation time (r = -0.75 before versus r = -0.87 during the catheterization). The multiple correlation coefficient for all measured parameters and mPAP was 0.83 before and 0.92 during the catheterization. In conclusion, in patients with COLD, it appears possible to get reliable information about PAP using noninvasive techniques.
Adult↗
[Alpha 1-antitrypsin as a tumor marker].
In this work we intended: a) to confirm the correlation between the increase of serum levels of alpha 1-antitrypsin (ATT) and neoplastic disease; b) to verify in what tumoural diseases the increase of ATT has a specific significance. Therefore we have examined 164 patients: 60 represented the control group and 104 were suffering from neoplastic diseases. We have subdivided the nest group according to histological type and tumour location. The result of this work has demonstrated that the increase of ATT is really determined by the existence of neoplastic disease, more than histological type or location of cancer. The AAT represents a diagnostic index of neoplastic diseases, highly sensitive but little specific.
Carcinoma↗
[A double-blind cross-over trial of a new hypolipidaemic drug (author's transl)].
A double blind cross-over trial has been carried out on the effects of a nicotinic acid compound on 27 patients affected by hyperlipidemia. The subjects have been treated over one year according the following plan: two peroids of 90 days each with the drug and two with placebo. The statistical analysis showed a significant reduction of serum cholesterol triglycerides, phospholipids and total lipids. In 4 patients out of 27, the treatment has not been completed because of drug intollerance.
Adult↗
Coxsackie virus heart disease and cardiomyopathy.
Twenty-two cases of Coxsackie virus heart disease diagnosed from November, 1969, to December, 1971, were re-examined after a period of 42 to 68 months from the acute illness. The patients with hypertension, diabetes, chronic alcohol intake, or aged over 35 were eliminated from the trial. With the purpose of assessing myocardial function, the systolic time intervals were recorded by a noninvasive standard technique. The differences in systolic time intervals between the group of patients with previous viral myocarditis and a group of normal control subjects were not statistically significant. However, the pre-ejection period was clearly prolonged in three patients out of 10, a modification consistent with a depressed myocardial function, as in patients with cardiomyopathy.
Coxsackievirus Infections↗
Preclinical abnormaltiy of left ventricular function in chronic alcoholics.
Left ventricular function of a sample of subjects with chronic alcohol intake, in the form of wine, and without clinical or electrocardiographic signs of heart disease was compared with that of a sample of normal control subjects using non-invasive polygraphic recordings. The statistical analysis has shown significant prolongation of PEP, PEPI, an increase in PEP/LVET, and a shortening of LVET and LVETI in the alcoholic subjects compared with the controls. All these abnormalities may be ascribed to left ventricular malfunction.
Adult↗
[Ventilatory and cardiocirculatory effects of salbutamol].
Explore the source record for details and available documents.
Adult↗