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Biomedical subjects

E Mantero

Publications and source records attributed to E Mantero.

At least 37 records · Page 2Linked to original sources

[Saint's triad].

Explore the source record for details and available documents.

Aged↗

Metformin improves peripheral vascular flow in nonhyperlipidemic patients with arterial disease.

The clinical activity of metformin (N,N-dimethyl biguanide), a widely used antidiabetic agent, on arterial blood flow was evaluated in 15 patients with peripheral atherosclerosis. Flow was determined by quantitative strain-gauge plethysmography; plasma lipid, lipoprotein, and apoprotein levels were repeatedly tested during the cross-over trial, comparing 6 months of drug and placebo administration. Metformin (850 mg tid) significantly increased arterial flow after a standardized ischemia (+17.3% after 3 months and +40.0% after 6 months). The increase in arterial flow was reversible after the switch to placebo was made. The drug was similarly effective, although to a lesser extent (+18.6% after 6 months), when given after the placebo. A highly significant effect of drug treatment, as well as of the sequence of administration, could be established by analysis of variance. In spite of the minimal changes of plasma lipid levels during metformin, a highly significant increase of high density lipoprotein cholesterol (+ 8.3% during the whole treatment) was demonstrated; plasma levels of isoprotein AI-1 were also raised during the metformin period. This controlled experiment confirms data from previous open studies, as well as from a longstanding clinical experience. Although the mechanism of the metformin effect cannot, at present, be defined, the reported results indicate that treatments not markedly affecting plasma lipid-lipoprotein levels may improve vascular function in selected arterial districts.

Adult↗

[Teicoplanin therapy in neonatal and pediatric intensive therapy].

We administered teicoplanin as specific antibiotic therapy for nosocomial "ICU specific" infections with methicillin-resistant Staphylococcus aureus and epidermidis (MRSA-MRSE). The above mentioned drug has been given to 20 patients (15 newborns and 5 not-newborns) admitted into intensive care unit during the years 1988, 1989, 1990 with MRSA-MRSE localized and/or systemic infection, affected by severe disease (RDS, pulmonary edema, congenital cardiac disease, cystic fibrosis) undergoing invasive procedures which presented high nosocomial infective risk (tracheal intubation, mechanical ventilation, venous and arterial cannulation, total parenteral nutrition, etc.). Complete recovery from systemic or localized infection (sepsis, low respiratory tract infection, high respiratory tract infection) occurred in 19 out of 20 patients, with a rate of success of 95%. Teicoplanin treatment lasted from a minimum of nine days to a maximum of thirty days. The dose was 5-6 mg/kg/die in one administration for the first three days, then 4 mg/kg/die. The tolerability of teicoplanin has proven satisfactory, since we had no major side effects during treatment and follow up.

Anti-Bacterial Agents↗

[Nosocomial infections caused by methicillin-resistant Staphylococcus aureus in a pediatric intensive care unit].

We performed an epidemiological investigation owing to the appearance between February and March 1988, of subsequent MRSA infections in our ICU; we also started a checking scheme. At the same time we performed a retrospective-perspective study of 701 patients (310 newborns 391 not newborns) admitted into ICU from 1-1-1987 to 30-6-1988. This study allowed us to settle the presence of MRSA in ICU and the manner in which they become infected. From our study the 4.9% of our patients contracted hospital infections and the 34.2% of these were MRSA infections. The 39.7% of our colonized patients were MRSA. It is really significant the frequency of MRSA colonization (p less than 0.0005) among newborn patients compared with other age patients; in the meantime there is not statistical significance in the frequency of MRSA hospital infections among the two groups. The results of our study show that infections were probably transmitted by the hands of the members of staff and that the reservoir of MRSA are tracheostomized hosts or long term ventilated patients.

Age Factors↗

[Occurrence of hospital infections in a department of pediatric heart surgery].

The incidence of nosocomial infections (NI) and the related risk factors in a Department of Pediatric Cardiovascular Surgery were studied, during a 6 months period. 155 successive admissions were considered. Nosocomial infections were 17 (11%), nosocomial colonizations 18 (11.6%). The most important risk factors for nosocomial infections were: age, cyanosis, duration of hospitalization, hospitalization in Intensive Care Unit and central venous catheter only as a risk factor for sepsis. The most important risk factors for nosocomial colonizations were: tracheal intubation and central venous catheter. In 4 cases the NI was related to nosocomial colonization (2 sepsis, 1 pneumonia, 1 wound infection). The most frequently isolated microorganisms were Pseudomonas aeruginosa and Staphylococcus spp. The Authors found that a longer than 5 days period of antibiotic prophylaxis did not reduce the incidence of nosocomial infections.

Adolescent↗

[Kawasaki disease: a new pediatric nosological entity].

Kawasaki disease (KD) is a new, well characterized pediatric syndrome. In this work the last epidemiologic, diagnostic and clinical data are pointed. Especially the heart-disease and its monitoring and therapy are studied. Our casuistry (5 cases in 4 years) is also presented. The international literature and our clinical experience suggest that KD is more spread than we think and therefore in needs to be studied carefully by the pediatricians.

Adrenal Cortex Hormones↗

[Hepatic duct hypoplasia or Alagille-Odièvre disease].

Five children from one to seven years of age with intrahepatic ductular hypoplasia are presented. Clinical and biochemical characteristics of the disease are specifically considered as well as differential diagnosis. In three patients a severe hemolytic anemia, only partially corrected with vitamine E, was present. All subjects received continuous cholestyramine therapy. Variable follow up from nine months to seven years demonstrated persistent intrahepatic cholestasis with hypercholesterolemia in two cases, clinical and biochemical improvement in one case. One child died two years and six months after diagnosis was made an one patient was lost to follow up. The Authors confirm the literature clinic, diagnostic and therapeutic data concerning ductular hypoplasia, while, on the basis of their experience, the prognosis seems poor also in some cases of syndromic ductular hypoplasia.

Anemia, Hemolytic↗