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Biomedical subjects

E Ferri

Publications and source records attributed to E Ferri.

At least 19 recordsLinked to original sources
PubMed2006

Incident reporting in anesthesia: misidentification of propofol concentrations due to similarities in drug packaging.

We report three cases of misidentification of propofol concentrations due to similarities in drug packaging, which were identified by the incident reporting system. Incident reporting is an approach used to assess the incidence of adverse and potentially adverse events, established to manage the contributing factors and to develop appropriate strategies to prevent errors in anesthesia. Inadvertently, 2% propofol was administered instead of 1%, causing overdosage and prolonged anesthesia in two consecutive patients in the same operating room. The third case was a near-miss that occurred in another operating room of the hospital: a syringe containing 2% propofol instead of 1% was prepared by the nurse, but the anesthesiologist checked the concentration before the induction of anesthesia. The errors occurred due to the presence of similar propofol packaging in the operating rooms. They were the result of both human error because the anesthesia personnel forgot to check the propofol concentration, and system failure, due to the color code of the packaging. In our experience, incident reporting detected the recurrence of drug related errors. Therefore, a preventive strategy was put in place by eliminating 2% propofol packaging from the operating rooms. This paper highlights the need for a cultural shift in the way we collect information on incidents, and it is an example of effective improvement to prevent drug error by reducing the complexity of the system.

Adult↗
PubMed2006

Bioluminescent bacteria assay of veterinary drugs in excreta of food-producing animals.

The residues of pharmacological treatments on food-producing animals, present in the manure dispersed on agricultural land, can impact environmental and human health through toxic, genotoxic, and drug-resistance development effects. Biotoxicity assays can easily reveal the presence of noxious substances and those based on bioluminescent bacteria (BLB) are particularly simple and rapid. A BLB assay was developed as microplate format by using various strains of Vibrio sp. and was employed to evaluate their response to pure antibiotic solutions and to residues extracted from excreta of antibiotic treated pigs and turkeys. The residues were quantified by HPLC analysis. The BLB assay can be proposed as an easy-to-perform screening tool to assess the presence of residues due to undeclared current, or recently ended, pharmacological treatments, as well as to evaluate their permanence in manure.

Animals↗
PubMed2005

[Combined intratympanic and intravenous dexomethasone to control vertigo in Meniere disease].

OBJECTIVE: To verify the result in the use of intratympanic corticosteroids, combined with intravenous, in patients with Meniere disease (MD). MATERIAL AND METHODS: Ten patients with vertigo due to MD in stages 4-5 or 6 were included in the study. Combined intratympanic and intravenous dexamethasone was infiltrated. The number of episodes among the months 18 and 24 of treatment, comparing them with the number of episodes 6 months before treatment (according to the norms of the American committee for the hearing and the equilibrium, 1995) are studied. RESULTS: All patients improved significantly. In one of them treatment was repeated after 6 months. A number of patients with hearing improvement were observed. CONCLUSIONS: The use of combined dexamethasone may be useful to control vertigo due to MD, to avoid or to be a prior step to other more aggressive treatments.

Administration, Topical↗
PubMed2005

Maxillo-ethmoidal chloroma in acute myeloid leukaemia: case report.

Chloroma, also called Granulocytic Sarcoma or Myeloid Sarcoma, is a rare malignant extra-medullary neoplasm of myeloid precursor cells. It is usually associated with myelo-proliferative disorders but its appearance may precede the onset of leukaemia. Chloroma may be found in several extracranial sites. Involvement of the head and neck region is uncommon. Differential diagnosis is often difficult and includes acute lymphoblastic leukaemia, large cell NHL, lymphoblastic lymphoma and Ewing's sarcoma. The case is presented of a maxillo-ethmoidal chloroma occurring in a case of poor prognosis acute myeloid leukaemia, emphasizing the clinical and cyto-histological features and problems concerning differential diagnosis.

Acute Disease↗
PubMed2002

[The application of argon plasma coagulation (APC) in surgical treatment of inferior turbinates].

For over 20 years, argon plasma coagulation (APC) has been used in open surgery, in laparoscopy and in thoracoscopy for the haemostasis of superficial haemorrhages and for the resection of parenchymatous tissue. This technique is based on the use of a high-frequency current that ionizes an inert gas, the argon; the emission of this latter generates a thermocoagulative effect that is selectively exerted on the superficial surfaces of the mucosa involved. In otorhinolaryngology, it may be seen as a valid alternative to traditional surgical techniques, to a mono- or bipolar electric surgical knife, and to laser surgery. From March to November 2000, 157 patients affected by "inferior turbinate hypertrophy non-responsive to ordinary medical therapy" underwent devitalizing APC surgery. In 20% of the cases (30 patients), the operation was performed under local anaesthesia. In no case was a nasal tampon employed. Twelve months after the operation, 87% of the patients treated (136 cases) had fully resumed normal nasal respiratory functionality, with marked improvement in the air flow and reduction of the unilateral nasal resistance during rhinomanometric evaluation. There were post-operative complications in 2% of the patients (3 cases), all of which were successfully handled through APC (2 cases of epistaxis on the 7th and 9th post-operative day, and 1 case of turbino-septal synechia). In the 13% of the patients (21 cases) in whom the results had been partial or unsatisfactory, the cause of the limited efficacy of the treatment was connected with an improper use of the instrumentation, lack of compliance on the part of the patient, or a concomitant psycofunctional pathology. The statistical study, accomplished via Student's t test, confirmed that the difference between the unilateral nasal resistance values present before the procedure and those measured during the 1-month follow-up were highly significant (t = 11.126, p < .001). The same significant correlation was ascertained between the pre-operative nasal resistance values and those ascertained post-operatively, respectively at 3, 6 and 12 months (p < .001).

Adult↗
PubMed2001

Responsiveness to intravenous administration of salbutamol in chronic obstructive pulmonary disease patients with acute respiratory failure.

OBJECTIVE: In chronic obstructive pulmonary disease (COPD) patients with acute respiratory failure (ARF), bronchodilating agents administered by inhalation have, in general, little effect on dynamic hyperinflation and concurrent static intrinsic positive end-expiratory pressure (PEEPi,st). Since in COPD the severely obstructed segments of the lung may not be reached by inhaled medication, we reasoned that drug efficiency may be enhanced by intravenous administration of the agent. DESIGN: Physiological study. SETTING: Two four-bed surgical-medical ICUs of a university hospital. PATIENTS: Fourteen COPD patients were studied within 36 h from the onset of ARF. MEASUREMENTS AND RESULTS: Static compliance (Cst,rs), minimal (Rmin,rs) and additional (DeltaRrs) resistance of the respiratory system, and PEEPi,st were measured before and after intravenous administration of salbutamol. All patients had limitation of air flow before and after salbutamol administration. On average, after salbutamol there was a small, though significant, decrease in Rmin,rs (-9%), DeltaRrs (-12%) and PEEPi,st (-8%). CONCLUSION: The changes in resistance and PEEPi,st after intravenous administration of salbutamol were too small to be of clinical significance.

Acute Disease↗
PubMed2001

[Results of videonystagmographic (VNG) analysis in vestibular post-traumatic pathology].

From February 1998 to July 1999, 569 patients affected by vestibular disorders--following a whiplash injury and/or a cranial trauma--were studied. The neuro-otological examination included a tonal audiometry, brain stem auditory evoked potentials, clinical and instrumental vestibular tests (caloric test, rotatory test, assessment of visually guided eye movements). The study of eye movements was conducted with the support of the Ulmer video-oculographical system. The aim of the research was to analyse, both from a qualitative and a quantitative perspective, the vestibular and clinical findings. Particular emphasis was laid on the incidence of the "up-beating" nystagmus in different categories of patients, all supported by a statistical study. As a result, an etiopathogenetical hypothesis of the nystagmus was advanced, based on altered otolithic and cervical inputs. At the same time, the importance of the video-nystagmographical system was stressed, to the extent that it leads to a standardised and objective analysis, fundamental for clinical and forensic aspects.

Adolescent↗
PubMed2001

Extended hepatic resection: a 6-year retrospective study of risk factors for perioperative mortality.

BACKGROUND: Extended hepatic resection (more than four liver segments) is a major operative procedure that is associated with significant risk. The purpose of this study was to assess the impact of perioperative variables on in-hospital mortality after extended hepatectomy. STUDY DESIGN: Consecutive patients who underwent extended hepatic resection were studied. The prognostic value of 29 perioperative variables was evaluated using in-hospital mortality as the endpoint. For each variable, the odds ratio (95% confidence interval) for in-hospital mortality was calculated. Those variables with a lower confidence limit > 1 were considered important risk factors. The population was stratified into categories of patients having the same number of risk factors, and mortality was estimated for each group. These data were used to develop a risk assessment algorithm. RESULTS: There were 14 deaths (6%) in 226 patients. Three preoperative variables (cholangitis, creatinine > 1.3 mg/dL, and total bilirubin > 6 mg/dL) and two operative variables (blood loss > 3 L and vena caval resection) appear to be important factors for in-hospital mortality. The mortality associated with the presence of any two of the five factors was 100% (5 of 5), and the mortality associated with the absence of these factors was 3% (6 of 191). CONCLUSIONS: Perioperative evaluation of patients undergoing extended hepatic resection should include the quantitation of mortality risk factors. The combination of any two factors among preoperative cholangitis, elevated serum creatinine, elevated serum bilirubin, high operative blood loss, and vena cava resection may carry a high mortality risk. These results require prospective validation.

Adolescent↗
PubMed2001

In vitro effect of thymosin-alpha1 and interferon-alpha on Th1 and Th2 cytokine synthesis in patients with chronic hepatitis C.

Current evidence suggests that increased expression of Th1-associated cytokines is important for immune-mediated eradication of hepatitis C infection, while an increase in Th2-associated cytokines is associated with persistence of infection. In this study we evaluated the effects of thymosin-alpha1 (TA1), a naturally occurring thymic peptide, and interferon-alpha (IFN-alpha) on cytokine production in peripheral blood mononuclear cells from untreated patients with chronic hepatitis C. We examined the effect of incubation with TA1, IFN-alpha, or both, on production of Th1-associated cytokines (IL-2, IFN-gamma), Th2-associated cytokines (IL-4, IL-10), and synthesis of the antiviral protein 2',5'-oligoadenylate synthetase. TA1 treatment induced a significant increase in production of IL-2 and 2',5'-oligoadenylate synthetase. Smaller increases were also seen after treatment with IFN-alpha, while incubation with TA1 and IFN-alpha together led to an additive or synergistic effect. Incubation with TA1 resulted in a decrease in IL-4 and IL-10, whereas IFN-alpha increased these cytokines. The addition of TA1 to IFN-alpha significantly reversed this IFN-alpha-induced increase. Hence, TA1 treatment could benefit patients with hepatitis C infection by increasing the Th1-type response, fundamental for sustained clearance of hepatitis C; and by decreasing the Th2-type response, associated with persistence of viraemia.

2',5'-Oligoadenylate Synthetase↗
PubMed2001

Determination of metabolic monitor errors and precision under clinical conditions.

BACKGROUND & AIMS: Metabolic monitoring devices used in the critical care setting are subject to a range of conditions that may compromise their accuracy. We sought to investigate the error and precision of the Deltatrac metabolic monitor under these conditions. METHODS: A modified version of the funnel burner, described by Miodownik et al. (8), was ventilated by a mechanical ventilator. This was used to examine the performance of the Deltatrac metabolic monitor over a wide range of inspired oxygen concentrations, minute ventilation, and positive end expiratory pressure at different levels of oxygen consumption and carbon dioxide production. RESULTS: The Deltatrac measured V(O(2)) with a mean error+/-precision of 9.4%+/-19.5% (range, 9.3%+/-1.9%-72.6%+/-13.6%). The mean V(CO(2)) error+/-precision was 1.2%+/-3.1% (range-2.0%+/-1.2%-5.4%+/-3.1%). Error was significantly affected by oxygen concentration and minute ventilation but was largely independent of positive and expiratory pressure. CONCLUSIONS: The methodology of Miodownik et al. permits the expression of metabolic device errors over a wide range of simulated clinical conditions.

Calorimetry, Indirect↗
PubMed2001

[Unusual case of inverted papilloma in a fibro-epithelial polyp of the ureter].

Inverted papilloma of the upper urinary tract is a rare lesion and the differential diagnosis with transitional cell carcinoma is really hard. A case of 49 year-old male with recurrent right flank pain is reported. Excretory urogram suggested a filling defect involving the right mid ureter and bilateral retrograde pyelogram that confirmed a solitary filling defect in the right mid-ureter, while selective urinary cytology was positive for transitional cell carcinoma G1. Conservative therapy was carried out and 2 years follow-up with several excretory urograms and ultrasound studies revealed no recurrence.

Female↗
PubMed2001

[Carcinosarcoma of the larynx: immunohistochemical study, clinical considerations, therapeutic strategies].

Carcinosarcoma is a rare laryngeal neoplasm accounting for less than 1% of all malignancies involving this organ. Given its double epithelial, mesenchymal nature, this neoplasm is described in the literature in many ways: sarcomatoid carcinoma, variants of squamous cell carcinoma with fused cells, pseudoscarcoma, pleumorphous carcinoma, polypoid carcinoma, metaplastic carcinoma. Although not invalidating, cytokeratin positive immunohistochemistry is fundamental for diagnosis. Given the different histopathological pictures, the rareness and heterogeneous natural history of such tumors, it is not surprising there is as yet no agreement as to the treatment of choice. An accurate analysis of the literature indicates that both the therapeutic approach and prognosis are the same as those found for normal squamous cell carcinoma. The authors describe a case of laryngeal carcinosarcoma, analyzing the clinical-therapeutic aspects, histopathological features and immunohistochemistry of this rare neoplasm.

Aged↗