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Biomedical subjects

D Pietrini

Publications and source records attributed to D Pietrini.

32 records · Page 2Linked to original sources
PubMed1998

"No allogeneic blood transfusion" protocol for the surgical correction of craniosynostoses. I. Rationale.

Improved anesthesiological and surgical care has resulted in a progressively declining need for allogeneic blood transfusion. In infants with craniosynostosis, however, allogeneic blood transfusion is still performed as a routine procedure. In the present paper, the authors describe a protocol they have devised with the aim of limiting or even avoiding allogeneic blood transfusion even in very young patients, consequently avoiding the risks of infective or immunologic reactions associated with the procedure. The protocol is based on stimulation of the hematopoietic system with erythropoietin, selection of an appropriate age for operation when a favorable balance between fetal and adult-type hemoglobin is established (that is after 4-6 months), preoperative preparation of the autologous blood supply, and intraoperative blood salvage.

Age Factors↗
PubMed1998

"No allogeneic blood transfusion" protocol for the surgical correction of craniosynostoses. II. Clinical application.

The authors describe the results obtained in 13 consecutive cases of craniosynostosis operated on according to a protocol devised at avoiding allogeneic blood transfusion. The protocol is based on pre- and postoperative treatment with erythropoietin, preoperative autologous blood donation, preoperative normovolemic hemodilution and intraoperative blood salvage. Nine subjects were affected by simple forms of craniosynostosis, whereas the remaining 4 presented with oxycephaly or craniofacial syndromes. Five of the 13 children were under 7 months and a further 3, under 10 months of age at the time of the surgical operation. Seven children weighed less than 10 kg. Allogeneic blood transfusion was avoided in 11 of the 13 children considered. Two failures - defined as the necessity to reinfuse the patient with an allogeneic blood transfusion - were recorded, 1 of them resulting from an unexpected hemorrhage during surgery. The results obtained indicate that this protocol designed to avoid allogeneic blood transfusion can be safely applied in the great majority of children with craniosynostosis, even when the surgical correction is carried out early in life.

Blood Transfusion, Autologous↗
PubMed1996

[Phacoemulsification and topical anesthesia. Apropos of 40 cases].

BACKGROUND: To evaluate topical anaesthesia for cataract surgery. METHODS: Thirty-nine patients (40 eyes) underwent cataract surgery by phacoemulsification with topical anaesthesia consisting in instillations of tetracaine eyedrops. Thirty-four eyes were implanted with a foldable lens and 6 eyes received a PMMA lens. Final visual acuity (1 month minimum follow-up), patients reactions (sensibility, pain), anaesthetic and surgery difficulties were specially studied. RESULTS: Mean initial corrected visual acuity was 0.21. Mean final corrected visual acuity was 0.72; 90 % of the subjects experienced no pain. Implantation was the most sensitive moment. Eye mobility was not a problem except during capsulhorexis which had to be done with forceps. CONCLUSION: Simplicity of topical anaesthesia eliminates the complications of the other anaesthetic methods. It is necessary to have a close patient-surgeon relationship. Carefully chosen topical anaesthesia is an interesting alternative.

Aged↗
PubMed1996

[Anterior cellular proliferation and silicone implant. Apropos of a case].

We reported a case of pigmentary glaucoma in an elderly black patient, treated surgically with phacoemulsification associated with automatised trabeculectomy. The patient was implanted with a silicone foldable lens introduced in the capsular bag. Three months post-operatively, visual acuity, well restored after surgery, decreased progressively and, biomicroscopic exam revealed a pigmented cellular membrane. Pathogeny of this membrane is discussed.

Aged↗
PubMed1989

Pediatric neuroanesthesia computerized monitoring system.

The authors describe the development of a computerized on-line monitoring system and its application during major pediatric neurosurgical procedures. The system acquires from monitor by serial communication the values of heart rate, systemic pressures, intracranial and central venous pressures, peripheral and central body temperatures and stores all these data on hard-disk. The system allows the collecting of clinical information, and other data concerning the metabolic and hemodynamic perioperative status of the patient. It also calculates in real time many derived parameters and stores all the measured data, the therapeutical administrations and their temporal relationship with the various surgical procedures on disk for statistical evaluation.

Algorithms↗
PubMed1980

An attempt to control cerebrospinal fluid acidosis in coma due to head injury.

The acid-base status of the arterial blood, jugular venous blood, peripheral venous blood and lumbar cerebrospinal fluid and the free amino acids in the cerebrospinal fluid have been studied in 12 patients suffering from coma due to head injury. They were given S adenosyl-methionine (10 mg/kg/day). Significant statistical differences of acid-base balance and CSF free amino acids have been obtained after the administration of te compound. The clinical and biochemical significance of the use of S adenosyl-methionine in severe brain injuries is discussed

Amino Acids↗
PubMedDate not supplied

An attempt of specific desensitising treatment with gliadin in celiac disease.

Gluten-free diet is the current treatment of celiac disease. We decided to verify the occurrence of histological and serological modification and/or clinical manifestations during a gradual and progressive introduction of gliadin in the diet and if it may induce a tolerance to food, as it occurs in allergic patients. We studied the case of a celiac woman with complete clinical and histological remittance after 10 years of gluten free diet. She took increasing daily doses of gliadin, reaching the final dose of 9 g of gliadin (15 g of gluten) in 6 months. Then she started a free dietary regimen. During the 15-month follow-up period esophago-gastro-duodenoscopy showed normal Kerckring folds and villi. Anti-gliadin, anti-endomysium and anti-tissue-transglutaminase antibodies, as well as the haematological and biochemical parameters remained normal. Our results represent a new approach in research concerning celiac disease, and could provide a future line of study for its management.

Adult↗
PubMedDate not supplied

[Anesthesia in the early surgical therapy of myelomeningocele].

Anaesthetic procedures in surgical repair of meningomyelocele in pediatric patients with particular reference to the problems concerning the specific pathology and the newborn age are reported. Authors consider that surgical repair in the first days of life assures a lesser incidence of leptomeningeal infections and a better functional improvement without an important increase of the anaesthetic risk.

Adolescent↗