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Biomedical subjects

C Farina

Publications and source records attributed to C Farina.

At least 127 records · Page 7Linked to original sources
PubMed1990

European experience with itraconazole in systemic mycoses.

Since January 1985 more than 100 patients with deep fungal infections have been treated with itraconazole (200 to 400 mg/day) in Northern Italy. Evaluation of the drug efficacy and tolerance was possible in one patient with sporotrichosis, in 34 with aspergillosis, and in 36 with cryptococcosis (mainly patients positive for human immunodeficiency virus). Response to itraconazole alone was obtained in the case of sporotrichosis and in 24 of 34 patients with different forms of aspergillosis (of the 18 patients with invasive pulmonary aspergillosis, 15 were cured). Patients with cryptococcosis received itraconazole for active infection and/or for prevention of relapse. Active infection was treated successfully with itraconazole alone in 9 of 12 patients and with itraconazole plus flucytosine in 8 of 10 patients. Of the 31 patients who received itraconazole maintenance therapy for up to 27 months, 4 (13%) had relapses; 14 (45%) did not have relapses, and decline of serum antigen was detected in 12 of them; and 13 (42%) were completely cured (serum antigen titer dropped to zero). With the exception of hypokalemia in one patient, itraconazole was well tolerated even in patients who received the drug for several months or years.

Antifungal Agents↗
PubMed1989

Percutaneous transluminal angioplasty versus surgery for subclavian artery occlusive disease.

Twenty-one patients who underwent percutaneous transluminal angioplasty (PTA) for proximal stenosis of the subclavian artery were compared with 15 patients who underwent carotid subclavian reconstruction. This represents the first attempt to directly compare the two procedures. All patients had routine Doppler examination during follow-up. Mean follow-up was 30 +/- 24 months after PTA and 40 +/- 25 months after surgery. The incidences of procedural complications were similar (PTA one complication, surgery two complications). Although better early results were achieved in patients who underwent PTA (actuarial patency: PTA 91 percent, surgery 87 percent), after dilatation, we observed a continuous deterioration of the hemodynamic status of the artery, which led to a high rate of late restenosis (actuarial patency: PTA 54 percent, surgery 87 percent). There were no significant changes postoperatively. The specific role of each procedure is analyzed in view of the new acknowledgment of the clinical importance of proximal subclavian artery disease.

Angioplasty, Balloon↗
PubMed1989

Extrathoracic and transthoracic management of vascular disease of the aortic arch branches: a 16-year experience.

To determine factors influencing results of operation for proximal brachiocephalic arterial disease, a 16-year review of 74 consecutive patients was undertaken. A total of 62 subclavian, 14 common carotid, 6 innominate, and 2 vertebral arteries were revascularized during 79 procedures. The approach was transthoracic in 12 operations and extrathoracic in 67. Mean follow-up was 57 +/- 45 months. Two patients (2.5%) died of stroke after extrathoracic revascularization of the common carotid artery. Cumulative 5-year and 10-year freedom from neurological events was 81% and 75%, respectively. The best results were obtained with transthoracic procedures, with revascularization of the subclavian artery rather than the common carotid artery, and in operations performed in patients without associated distal carotid disease. In view of the recent progress in operative techniques and postoperative surgical care, the choice between the transthoracic approach and the extrathoracic approach should not be biased; rather, they should remain equal and viable alternatives based on anatomical and clinical features of the individual patients.

Adult↗
PubMed1989

Clinical evaluation of non-radiometric BACTEC NR 660 system for routine detection of bacteremia.

A study was undertaken to evaluate the sensitivity, accuracy and practicability to a two-bottle nonradiometric blood culture system (BACTEC NR 660) with the two bottle conventional blood culture system in use in our laboratory. A total of 592 sets of four blood culture bottles were collected from adults in a twenty-week period, giving 126 positive sets. The conventional system recovered 121 isolates, whereas the BACTEC NR 660 system recovered 97 microorganism. The difference in the recovery rate was not statistically significant. Contaminant isolates were detected with greater frequency in the conventional system (p less than 0.001). Microorganism were recovered faster in one or both BACTEC NR 660 bottles than in conventional system (p less than 0.001). Our study confirms that BACTEC NR 660 system is suitable for routine detection of bacteremia.

Bacteriological Techniques↗
PubMed1989

Decrease of diffusion of glycosylated albumin in retinal microcirculation by peptide fraction from bovine factor VIII.

The diffusion of the glycosylated albumin in the retinal vascular system has been studied in male New Zealand rabbits, using fluorangiographic techniques. A first group of animals was treated for 15 days with the peptide fraction from bovine Factor VIII (Vueffe); a second group, used as control group, was treated with physiological solution. At the end of treatment, glycosylated albumin was made fluorescent and then injected into the marginal vein of the rabbit. The direct observation and the photometric measurements performed on the digitized photograms with an image processing system showed a considerable reduction in retinic capillary diffusion of glycosylated albumin in the animals treated with the peptide fraction. The substance used in the study might therefore be of importance in the treatment of systemic disease with retinic vascular damage.

Angiography↗
PubMed1989

Thrombolysis of graft occlusion using high dose urokinase. An alternative to surgical treatment?

Two cases of acute leg ischemia from unilateral occlusion of an aorto-bifemoral graft, treated with high-dose urokinase intra-arterial infusion, are reported. This therapy allowed identification of the cause of thrombosis, recanalization of the graft and planning of reoperation. Indications for intra-arterial thrombolytic therapy and advantages of urokinase vs streptokinase are discussed.

Aged↗
PubMed1989

Magnetic resonance imaging of abdominal aortic grafts.

The widespread use of abdominal aortic grafting procedures and increasing awareness of related complications suggests the need for a reliable and non-invasive diagnostic technique which will allow early detection of both occlusive and non-occlusive complications. Ultrasound is generally used with satisfactory results, but has several limitations, whereas MRI has shown great promise in the study of cardiovascular disease, being non-invasive, multiplanar and multiparametric. The present research aims to evaluate MRI in the follow-up of abdominal aortic grafts, attempting to define its significance as a screening procedure in non-selected patients. MRI is reliable in ascertaining the normality of the graft as well as the complications, these being partial or total thrombosis, pseudoaneurysms and perigraft collections. The data obtained are highly satisfactory and are almost always superior to those achieved with ultrasound and CT.

Aorta, Abdominal↗
PubMed1989

Operative strategies in patients with symptomatic internal carotid artery occlusion.

A 15-year experience with 98 patients who underwent extracranial artery reconstruction for symptomatic internal carotid artery occlusion is reviewed. Thromboendarterectomy of the occluded carotid artery resulted in unacceptably high mortality and morbidity rates, and long-term patency of the internal carotid artery was rarely achieved. Carotid endarterectomy on the side opposite the occlusion proved to be successful in relieving nonlateralizing symptoms of cerebral ischemia, whereas results were less encouraging in patients with focal symptoms in the hemisphere ipsilateral to the occlusion. External carotid artery reconstruction on the side of the occlusion was successful in relieving focal symptoms. Surgical treatment in patients with symptomatic internal carotid artery occlusion should be planned in each patient on the basis of symptoms and anatomic pattern.

Actuarial Analysis↗
PubMed1989

Popliteal aneurysms.

A 15 year experience with 50 popliteal aneurysms in 36 patients is reviewed. Forty-seven popliteal aneurysms were atherosclerotic while three were related to entrapment of the popliteal artery. Fourteen asymptomatic popliteal aneurysms were observed preoperatively during a mean period of 26 months. Ischemic complications developed in five of these. At admission, 16 limbs were asymptomatic (group 1) while the other 34 limbs presented with ischemic symptoms (group 2). No operation was performed upon three limbs, and another two were surgically explored and amputated. No operative deaths resulted from 45 vascular reconstructions. Results from follow-up study of one to 176 months (a mean of 57 months) revealed a late patency rate of 62 per cent. The late patency rate of autologous saphenous vein (ASV) was 100 per cent; polytetrafluoroethylene (PTFE) and Dacron (polyester fiber) grafts had a patency rate of 74 and 34 per cent, respectively (ASV versus PTFE, p = N.S.; ASV versus Dacron, p less than 0.002). The rate of late salvage of limbs was 88 per cent. The bypass grafts of group 1 and those performed upon limbs with good runoff fared significantly better than others (p less than 0.05 and p less than 0.001). The risk of natural complications of popliteal aneurysms and the good results from surgical treatment suggested that a revascularization procedure in the asymptomatic stage is always recommended. The use of PTFE grafts for repair of popliteal aneurysms is justified when the ASV is not available. The use of Dacron grafts is no longer indicated.

Aged↗
PubMed1989

Subclavian artery revascularization: a comparison between carotid-subclavian artery bypass and subclavian-carotid transposition.

Extrathoracic revascularization has become the most popular form of surgical treatment of symptomatic subclavian disease. Despite the many theoretical advantages, subclavian-carotid transposition (SCT) has not gained wide popularity. During a 15-year period, 46 patients underwent carotid-subclavian bypass (CSB) or SCT for symptoms referable to occlusion of the subclavian artery. Follow-up ranged from 2 to 148 months (mean, 46.9 months). Seven-year actuarial patency rate was 100% for SCT and 86% +/- 7% for CSB (p = NS). Mean operative time and intraoperative blood loss were significantly reduced for SCT (p less than 0.05). After CSB a continuous deterioration of the hemodynamic status of the reconstruction was noted, whereas there were no significant changes after SCT (p less than 0.05). Whenever feasible, SCT should be considered the operation of choice for patients with symptomatic severe subclavian artery disease.

Adult↗
PubMed1989

[Prevention of acute neonatal respiratory insufficiency. A method of conditioning the baboon lung during cesarean section].

Preterm baboons at 140 +/- 3 day gestation (term 182 +/- 7 days) have been subjected to lung conditioning, consisting of a series of prolonged inflations of the lungs at 35 cm H2O, followed by approximately 10 min of application of continuous positive airway pressure (CPAP) equal to 15-20 cm H2O, before umbilical cord interruption. The aim of this study was to evaluate, in a primate experimental model, the safety and efficacy in the prevention of neonatal RDS of a technique so far experimented on only in ovine models. Thoraco-pulmonary compliance exceeded the value of 0.2 ml (cm H2O)-1.kg-1 in only 1 animal out of 5 (20%), which didn't develop illness, versus 69% of positive results achieved with the same technique in lambs at 128-130 day gestation, an experimental model considered in the literature as equivalent to a 140 +/- 3 day gestation baboon as far as it concerns incidence and severity of RDS. The application of lung conditioning was easy and safe (as previously reported), but its effectiveness in a primate model is still to be defined.

Animals↗
PubMed1988

Ultrasonographic features of carotid plaque and the risk of subsequent neurologic deficits.

In a prospective study, 214 consecutive patients considered not to be candidates for surgical intervention were evaluated by means of duplex scanning. Of the patients, 135 had no symptoms and 79 had a history of previous neurologic symptoms. In 139 sides duplex scanning demonstrated nonhemodynamic stenosis (lumen diameter reduction, less than 50%) and in 99 sides, hemodynamic stenosis (lumen diameter reduction, 50% or greater). Of the 238 carotid artery plaques examined, 167 were homogenous and 71 were heterogenous. During a mean follow-up of 34 months, 27 new focal neurologic deficits occurred. Patients with previous symptoms had a higher incidence of new deficits (18/79 vs 9/135) (p less than 0.01). The severity of the stenosis and the presence of a heterogenous plaque were statistically correlated with the occurrence of new deficits (p less than 0.001). Multivariate analysis showed that the ultrasonographic pattern and the severity of the stenosis were independent variables. We conclude that a heterogenous plaque should be considered an unstable plaque with the possibility of causing cerebral ischemia.

Aged↗
PubMed1988

Influence of knee flexion on femorodistal bypass hemodynamics.

The influence of knee flexion on the hemodynamics of ten Below Knee (B.K.) femoro-popliteal by-passes (mean follow-up 45 mos. min. 2-max. 134) has been studied by means of Doppler Pressure Index (P.I.) and Pulse Volume Recorder (P.V.R.). In all patients operative indication was limb salvage and the graft material was autologous saphenous vein (ASV) in 5 cases, PTFE in 3 and Dacron in 2. Calf and ankle P.I. and P.V.R. wave amplitude modifications have been evaluated bilaterally just after the beginning of knee flexion (80 degrees) and at 10 and 15 minute intervals. The knee flexion influenced detrimentally (p less than 0.025) the P.I. (calf: -10.9% at the beginning, -17.8% at 10 min. and -20.5% at 15 min.; ankle: -7.4% at the beginning, -13.6% at 10 min. and -16.5% at 15 min.). P.I. was minimally affected by knee flexion in non-grafted limbs (-3%). No consistent P.V.R. modifications were observed.

Blood Pressure↗
PubMed1987

[Comparison of 2 different blood culture systems: liquoid-BHI and hemoline performance diphasique].

The Liquoid-BHI, biphasic blood culture system, was compared with a conventional blood culture bottle (Hemoline performance diphasique) in 3125 paired blood cultures. Both systems were inoculated with equal volumes of blood (5 ml). Streptococcus spp. (P less than 0.02) and S. epidermidis (P less than 0.05) were recovered from BHI system. In contrast, P. fluorescens (P less than 0.02) were recovered in conventional system. No important differences were found for other bacteria and fungi. For optimal detection of microorganisms, however, the biphasic BHI system should be paired with conventional bottle.

Bacteria, Aerobic↗
PubMed1986

HAV epidemics in lower Valle Seriana (Bergamo): 1968-1984.

The observation of an HAV epidemic in Alzano Lombardo (Lower Valle Seriana, Bergamo) in 1984 induced to an epidemiological retrospective inquiry of previous epidemics happened in the above territory from 1968, to attain a comparative checking of epidemiological aspects. Organizative structural modifications on the overmunicipal water-cistern-management and the building of suitable sewers collector together with a better sanitary education become necessary against HAV, and they can be considered the only opportune prophylaxis.

Adolescent↗