Biomedical subjects

F D'Adda

Publications and source records attributed to F D'Adda.

11 recordsLinked to original sources

PubMed2001

[Gastroduodenal artery pseudoaneurysm ruptured at the pancreatic head].

The presence of splancnic aneurysms associated with pancreatitis represents an uncommon evidence (10%) but extremely formidable for the high mortality related to the elevate risk of rupture (50%). A case of a broken gastroduodenal artery pseudoaneurysm plugged in the pancreatic head in a patient with chronic pancreatitis surgically treated is reported. The Authors believe that in presence or in suspicious of peripancreatic pseudoaneurysm bleeding, showed by abdominal echography or CT scan, is mandatory the execution of splancnic and peripancreatic vessels angiography to determine the correct localization of the aneurysm, essential to determining the best surgical treatment. Gastroduodenal artery before the origin from the right epatic artery has been tied in presence of an anatomic variant of origin and division of the hepatic arteries, previously showed with the angiographic examination. The exclusion and the complete thrombosis of the false aneurysm was demonstrated with the intraoperatory Doppler control and confirmed by CT scan before the dismission. This surgical strategy avoid a pancreatic resection, potentially burdened from an higher risk of mortality and morbidity as than the artery exclusion.

Aneurysm, False↗

PubMed2000

[Vascular trauma of the upper extremities].

The aim of this study was to evaluate short- and long-term results of the treatment of upper extremities vascular trauma considering aetiology of the lesions, percentage of limb salvage and residual functional disability. The Authors retrospectively evaluated 17 patients accounting for 21 vascular lesions of the upper extremities (16 arterial and 5 venous injuries). Age, sex, modality of trauma, site of the vascular lesions and of the associated injuries, diagnostic procedures at the admission, ischemic time, arterial and venous repair performed were analyzed. The over all peri-operative mortality was 5.8%. Of the 16 arterial injuries long-term reconstruction viability was obtained in 15 patients (93.7%). In all cases limb salvage was obtained. In 3 patients invalidating functional defects due to associated injuries of the major brachial plexus were observed. The Authors believe that associated nervous lesions are the main factor determining invalidating residual disability. In this series ischemic time, technique of vascular repair performed, associated skeletal injuries didn't influence the functional outcome of the reconstruction.

Adult↗

PubMed1999

Solitary metachronous splenic metastases: an evaluation of surgical treatment.

Splenic metastases occurring after primary tumor removal and apparently solitary have been documented only recently in Literature. They are, most of the times, clinically asymptomatic and their presence is casually determined by ultrasonographic follow-up in subjects otherwise in good conditions. The belief that splenic metastases occur only in disseminated cancer is today no longer accepted. Some Authors consider solitary splenic metachronous metastases eligible for surgical treatment as well as pulmonary or hepatic metastases. In the case presented, surgery was required due to abscess formation of a splenic metastasis, which was not responding to chemotherapy. Our experience, like others reported in Literature, verified a long-term post-operative survival in spite of limited disease-free time. Surgical treatment by splenectomy can be indicated in selected patients, considering that chemotherapy has been proved to be ineffective in the treatment of splenic metastases.

Aged↗

PubMed1994

Cobalt myocardiopathy. A critical review of literature.

Cobalt is regarded as being responsible for a form of myocardiopathy whose pathogenesis and clinical description must still find a specific place in the range of congestive myocardiopathies. In spite of this, epidemiological studies are not sufficient to prove the role of cobalt in inducing myocardiopathy in hard metal workers. This critical review intends to evaluate if hard metal exposure may induce toxic effects on the heart. In this context, the literature considered ranges from pioneer reports on 'beer drinkers' to the more recent papers concerning cases of patients occupationally exposed; subjects who, after a surgical operation died of fulminant heart failure and, lastly, hard metal workers who were examined for their cardiac function. Various pathogenetic mechanisms related to possible cardiac effects in hard metal workers have been analyzed. The most likely should be the inhibition of cellular respiration due to inhibition of the mitochondrial dehydrogenase.

Beer↗

PubMed1994

Cardiac function study in hard metal workers.

The induction of cardiac effects in hard metal workers is uncertain. This study investigates cardiac function of a group of 31 hard metal workers with or without pulmonary disease. The average duration of exposure to cobalt containing dusts was 10.4 years (range 1-30), while the environmental levels of cobalt exposure ranged from 0.09 to 13.6 mg/m3 Co. Cardiac function has been studied by: ECG (electrocardiogram), exercise test (ET), ECG 24 h according to Holter (ECGH), echocardiogram (ECHO) and radionuclide angiocardiography with 99Tc (RNA). The aims of this work were (i) to show the existence of cobalt myocardiopathy in the workers analyzed and, (ii) to find an early indicator of cardiac dysfunction which could be used in the clinical examination of hard metal workers. Within the group of patients with hard metal lung disease, cases of myocardiopathy of doubtful aetiology have been found. The cardiac indexes obtained through RNA show ventricular dysfunction in healthy hard metal workers which could be a manifestation of initial pulmonary artery hypertension or of an early occult cor pulmonale due to an unknown fibrotic lung disease.

Adult↗

PubMed1994

Hard metal disease: eight workers with interstitial lung fibrosis due to cobalt exposure.

Eight hard metal workers exposed to cobalt containing dust (four producers of stone-cutting cobalt-diamond wheels and four grinders of hard metal tools) and affected by interstitial lung fibrosis have been examined. A close relationship between cobalt exposure and clinical findings was observed in six patients who were still working. The clinical picture ranged from minor symptoms to manifestations resembling those of hypersensitivity pneumonitis, with fever, weight-loss, non-productive cough and dyspnea. A restrictive impairment of the ventilatory function was prevalent. The chest roentgenogram of one patient showed a diffuse reticular nodular pattern, while the others presented a mild reticular accentuation of the interstitium. In five patients, bioptic specimens of the lung parenchyma showed interstitial collagenic fibrosis with inflammatory cells infiltrating the alveolar septa. An increased number of lymphocytes and polymorphs was reported in the bronchoalveolar lavage (BAL) fluid from seven patients. Giant multinucleated cells were present in the BAL of four subjects while an inversion of the helper-suppressor ratio was evident in those patients who were still exposed to cobalt when BAL was performed. In this study, the causal role of metallic cobalt inhalation in the etiology of the lung disease is examined and discussed.

Adolescent↗

PubMed1992

Abnormal uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile in a primary cardiac lymphoma.

Abnormally high uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile (99mTc-SESTAMIBI) in the right ventricle and in the septum was observed in a 47-year-old woman initially presenting with dysarthria and left hemiparesis. Endomyocardial biopsy demonstrated a high-grade malignant non-Hodgkin's lymphoma. Complete remission was achieved by combined cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy and radiotherapy of the heart and mediastinum. The post-remission single photon emission tomography (SPET) 99mTc-SESTAMIBI study showed a homogeneous distribution pattern, in agreement with echocardiography computed tomography and magnetic resonance imaging. Increased uptake of 99mTc-SESTAMIBI, a myocardial perfusion agent, has been observed in some benign and malignant tumours. It may prove to be useful in the diagnosis and follow-up of malignancies.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1988

The proposal of the Italian Committee on Occupational Cardiology.

This paper describes a protocol of assessing specific working fitness of post-myocardial infarction patients proposed by the Italian Committee on Occupational Cardiology. After cardiovascular (cross-sectional echocardiography, Holter monitoring and maximal symptom-limited ergometric test) and psychological evaluation (CBA-2.0), two ambulatory ECGs were used during work to confirm the first judgement of specific work fitness expressed by occupational specialists. The preliminary results obtained in 106 uncomplicated male patients (mean age 49 +/- 8 years) show that: (i) return to work (89.6%) at 117 +/- 51 days after the acute event is mainly related to socio-occupational variables rather than to cardiovascular status; (ii) the results of the ambulatory monitoring usually confirm the first judgment of specific work fitness; (iii) heart rate responses recorded during work are unrelated to the judgment of fitness; and (iv) the repeatability of the results observed during the two ambulatory ECGs at work is good.

Adult↗

PubMedDate not supplied

Shock and dyspnea after cardiopulmonary resuscitation: a case of iatrogenic gastric rupture.

Rupture of the stomach is a rarely reported complication of cardiopulmonary resuscitation. The number of cases reported in the literature since 1970 does not exceed 30. We present a recent case of a young woman submitted to cardiopulmonary resuscitation in whom a gastric rupture gave rise to massive pneumoperitoneum with haemodynamic shock and respiratory failure. Major distension of the abdomen and an extensive subcutaneous emphysema were present. After re-establishing the haemodynamic conditions and a diagnostic spiral thoracic-abdomen CT scan, an emergency laparoptomy was performed. We found two linear defects of the lesser curvature of the stomach, which were treated by closure with a primary interrupted two-layer suture. The postoperative recovery was uneventful. Iatrogenic gastric rupture carries a high risk of mortality. A prompt diagnosis and emergency surgical repair are essential for patient survival.

Adult↗

PubMedDate not supplied

[Aneurysms of the superior mesenteric artery].

Splanchnic arteries aneurysmatic pathology is rare, even if, in the last decades it has been noticed an increase of its incidence, owing to the worldwide use of the recent diagnostic tools as echography, TC, MR and angiography. Among visceral aneurysms those of the superior mesenteric artery (SMA) range the 5.5-8%. In the majority of cases SMA aneurysms are of mycotic etiology (60%), of atherosclerotic ones are less frequent, even if their incidence has increased in the last decades. Other causes are exceptional. Dimensions are generally moderate (1-3 cm.), yet aneurysms of a significant diameter, ranging from 4 to 8 cm., are reported in the most recent literature. Aneurysms can be symptomatic with abdominal upper quadrants pain, due to the compressive mass effect on the contiguous structures. In some cases typical signs of claudication abdominis are present. A pulsating epi-mesogastric abdominal mass is present in the 50% of subjects. In the 20% of the cases the patients come to medical attention presenting a situation of hemorrhagic shock for aneurysmatic rupture in the peritoneal cavity, or in the digestive tract, considering also the possibility of a thrombosis with consequent acute bowel ischemia. Urgent surgical operations, when possible, imply an high mortality rate. For these reasons, there is indication of elective surgery for all SMA aneurysms, both symptomatic and of occasional finding. The performable surgical techniques are: proximal and distal ligation, with or without aneurysmectomy, that is the most utilized because commonly performed during emergency operations. This technique requires the presence of a sufficient collateral vascular supply. Endoaneurysmorraphy can be performed only in the case of mild-dimension saccular aneurysms. Revascularization techniques through substitution or by-pass are mandatory in managing voluminous mass aneurysms. It is reported a case of SMA aneurysm of exceptional dimensions (diameter approximatively 10 cm.) that for its enormous volume substituted completely the mesenteric axis, involving the origin of the jejuno-ileal and ileo-colic branches. In this case it has been mandatory the performing of the aorto-mesenteric by-pass technique, distally patch modelled and sutured to the residual posterior SMA wall, on the purpose to allow the revascularization of the emerging jejunal arteries and adapted to the residual distal stump to irrorate ileo-colic branches.

Aged↗

PubMedDate not supplied

[Epidemiology of ischemic cardiopathy in a large iron foundry].

This work examines the coronary disease distribution in a large iron-foundry (7000 workers) with different ways of work and productive technologies, taking into consideration the high incidence and the multiple etiology of risk factors of cardiovascular diseases in the general population. In particular we studied the frequency of coronary disease and its consequence on the workers as far as retirement, death and job modification are concerned.

Coronary Disease↗