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Biomedical subjects

F Mosca

Publications and source records attributed to F Mosca.

At least 271 records · Page 15Linked to original sources
PubMed1990

[Clinico-diagnostic and therapeutic considerations on retroperitoneal liposarcoma].

Two patients with retroperitoneal liposarcoma are presented to determine the accuracy of diagnostic methods and the role of surgical treatment. In both the patients the large retroperitoneal liposarcoma recurred locally after surgery. Histological features, clinical presentation, diagnostic procedures, extent of surgical resection and adjuvant treatment are reviewed. These data suggest that an aggressive surgical approach followed by adjuvant postoperative irradiation is the treatment of choice in primary and recurrent neoplasms.

Aged↗
PubMed1990

Insulin resistance after surgery: normalization by insulin treatment.

1. Injury is known to be associated with variable degrees of tissue insensitivity to insulin. We measured insulin resistance in a group of non-obese, glucose-tolerant patients undergoing major elective surgery with an uncomplicated post-operative course. 2. Shortly after surgery, hyperglycaemia (7.3 +/- 0.6 versus 4.2 +/- 0.3 mmol/l glucose pre-surgery, mean +/- SEM, P less than 0.01) with normal insulin concentrations (73 +/- 15 versus 64 +/- 18 pmol/l) suggested the presence of insulin resistance. Counter-regulatory hormones were raised, whole-body protein oxidation was doubled (P less than 0.01) and energy expenditure was up by 18% (P less than 0.01). 3. Insulin sensitivity was quantified by clamping plasma glucose concentrations at 5.6 mmol/l during 24 h of total parenteral nutrition (15% protein, 55% glucose and 30% fat, supplying 1.25 times the measured resting energy expenditure) with a variable infusion of exogenous insulin. After surgery, eight times more insulin was needed than before surgery (14.14 +/- 1.15 versus 1.78 +/- 0.29 pmol min-1 kg-1, P less than 0.001) to maintain euglycemia. 4. After surgery, stimulation of net carbohydrate oxidation (18.8 +/- 1.4 versus 17.2 +/- 1.8 mumol min-1 kg-1 preoperatively, not significant), suppression of lipolysis and lipid oxidation and inhibition of ketogenesis occurred to the same extent as before surgery. Of the infused nutrients, the glucose was all oxidized, amino acids replaced endogenous protein losses (= neutral nitrogen balance) and lipids were stored. Insulin administration caused no further increment in oxygen consumption or energy expenditure.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbohydrate Metabolism↗
PubMed1990

The penetration of roxithromycin into human skin.

The skin penetration of roxithromycin was studied in 27 surgical patients treated with 300 mg orally followed by three oral doses of 150 mg 12-hourly. Peak plasma and skin concentrations of 7.9 +/- 1.2 mg/l and 31.3 +/- 3.7 mg/kg occurred 2.5 and 4 h after last dosing respectively. The plasma and skin half-lives were 7.7 and 6.0 h, and the mean plasma and skin area under the curve values were 64.3 mg/l.h and 155.3 mg/kg.h. Skin/plasma concentration ratios were 4.9 +/- 0.5, 9.7 +/- 1.2, 7.6 +/- 0.8 and 5.9 +/- 1.1, at 3, 4, 5 and 6 h after last dosing respectively. These results demonstrate that roxithromycin achieves high levels in human skin.

Female↗
PubMed1990

Bullet emboli to the systemic and venous circulation.

The rarity of bullet emboli leads to frequent delays in diagnosis and inadequate early management. Our recent experience with this entity is described, and 153 cases reported in the English-language literature are reviewed and summarized. The majority of cases occurs as a consequence of civilian violence among men in their 20s and 30s. Most bullet emboli follow the direction of blood flow, although 15% of venous bullets cause embolization in a retrograde manner. One in 10 arterial emboli follow a right-heart or venous injury. Arterial bullets are symptomatic in 80% of cases, venous bullets in only one third. The choice of surgical management must be individualized according to the symptoms caused by the bullet and its location in the vascular system. In general, arterial bullet emboli are removed because of symptoms or findings of acute peripheral ischemia. Arterial and venous emboli not causing symptoms should be removed according to the risk of possible displacement and further embolization. Selective intraoperative angiograms and phlebograms can precisely localize the migrating bullet and permit appropriate placement of incisions before removal.

Adult↗
PubMed1989

[Food ileus caused by a phytobezoar of the small intestine].

One case of small bowel obstruction due to phytobezoar is reported. The various aetiological factors are discussed. The clinical features are not typical and small bowel obstruction can be initially recurrent until a complete intestinal occlusion. The diagnosis is not easy, and is nearly always made during urgent laparotomy. Surgical treatment consists of phytobezoar removal by enterotomy. The recognition of high-risk patients and their education to prevent phytobezoar are emphasized.

Bezoars↗
PubMed1989

Effects of two levels of intake of chloride, potassium, and calcium on mineral and acid-base metabolism in premature infants.

Growth (weight, length, mid-upper arm circumference), acid-base status, serum electrolyte levels, and selected parameters of urine (creatinine and electrolyte levels, urine pH, renal net acid excretion, levels of metabolites of aldosterone) were determined serially from the 10th to the 32nd days for 4 weeks in 21 premature infants (birth weight, 1,100-2,000 g) fed either formula A or formula B (formula B was formula A supplemented with chloride, potassium, and calcium). Premature infants fed formula B showed a higher weight gain (31 versus 28.2 g/day), a higher increment of middle-upper arm circumference (0.31 versus 0.24 cm/week), and a decreased renal net acid excretion (1.24 versus 1.92 mEq/kg/day). Almost all premature infants fed formula A and some with a high growth rate receiving formula B showed hypochloruria corresponding to chloride deficiency. Premature infants fed unsupplemented humanized formulas may have an inadequate intake of minerals.

Acid-Base Equilibrium↗
PubMed1989

Agenesis of the cerebellar vermis: otoneurological report in one patient.

We have performed otoneurological examination in a case of vermis cerebelli agenesia, CT scan confirmed. Visuo-vestibular interaction (VST) abnormality, with normal saccades and normal smooth pursuit movements, allows to suppose normal functioning of the flocculus and a damage in the nucleus olivaris inferior and, particular, in the paraolive.

Atrophy↗
PubMed1988

Energy metabolism of surgical patients in the early postoperative period: a reappraisal.

Energy metabolism was measured at the bedside in 22 uncomplicated surgical patients in the early (24 to 48 h) postoperative period with the use of continuous computerized indirect calorimetry with a canopy system. Energy production rates were higher than those predicted by the Harris-Benedict formula both in absolute value (1516 +/- 61 vs. 1387 +/- 49 kcal/day, p less than .05) and when normalized by body weight (BW; 23.5 +/- 0.5 vs. 21.7 +/- 0.5 kcal/day.kg BW, p less than .01) or by lean body mass (LBM; 32.8 +/- 0.8 vs. 30.2 +/- 0.9 kcal/day.kg LBM, p less than .01). Furthermore, surgical patients had higher energy production rates than those measured in 22 overnight fasted, resting healthy subjects matched for age, sex, and body size (23.5 +/- 0.5 vs. 21.8 +/- 0.6 kcal/day.kg BW, p less than .05). In both the patients and the control group, measured energy production bore a direct relation to LBM. We conclude that the early postoperative period of uncomplicated surgery is associated with a small (about 7%) but consistent increase in energy metabolism above the level observed in the overnight fasted, resting healthy individual. This increase appears to be an effect of surgery itself, and is not predicted by Harris-Benedict equations.

Adult↗
PubMed1988

Acute effects of peritoneovenous shunt (Le Veen) on the hemodynamics and gas exchange in patients with hepatic intractable ascites.

The acute effects of the peritoneovenous shunt (LeVeen) on hemodynamics and pulmonary gas exchange in 6 consecutive patients with intractable ascites and cirrhosis were evaluated. After opening the peritoneovenous shunt, there was a marked increase in cardiac index, (from 3.78 +/- 0.4 to 5.86 +/- 0.4 1/min. m2, p less than 0.01), and mean pulmonary artery pressure (from 17.3 +/- 1.9 to 23.3 +/- 1.5 mmHg, p less than 0.05), while a significant decrease in systemic vascular resistances (from 1086 +/- 116 to 694 +/- 52 dynes.sec.cm-5, p less than 0.05) was observed. In all patients there was a drop in arterial oxygen tension (PaO2) (from 76 +/- 3 to 67 +/- 3 torr, p less than 0.01) and an increase in venous admixture (Qsp/Qt) from 13.1 +/- 2 to 18.9 +/- 2%, p less than 0.01). The comparable increase in cardiac output and in venous admixture produced by opening the peritoneovenous shunt, might be related to the massive transfusion of ascitic fluid into the intravascular compartment. It is therefore concluded that this impairment of tas exchange further support discarding an appropriate amount of ascitic fluid at the time of shunt insertion.

Aged↗