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Biomedical subjects

G Catania

Publications and source records attributed to G Catania.

At least 37 records · Page 2Linked to original sources

[Prognostic stratification of survivors of lst myocardial infarction: evaluation of regional kinetics and ejection fraction by bidimensional echocardiography].

To determine the prognostic value of some echocardiographic indices of left ventricular function (ejection fraction, wall motion score index, left ventricular dimension) in the first year after acute myocardial infarction, we studied prospectively 162 consecutive patients (mean age: 61 +/- 11) who survived the hospital phase of a first acute myocardial infarction. Two-dimensional echocardiography was performed at hospital discharge (mean: 20 +/- 3 days after admission). For the analysis of wall motion, an 11 segment model of the left ventricle was used; from the scoring system of segmental ventricular function (1 = normal, 2 = hypokinetic, 3 = akinetic, 4 = dyskinetic, 5 = aneurysmal) we derived the wall motion score index (sum of assigned number to each segment/11). The echocardiographic ejection fraction was determined using the monoplane ellipsoid formula for the calculation of end diastolic and end systolic volumes in apical four-chamber and two-chamber views; the assumed ejection fraction was the mean value resulting from values of ejection fraction calculated in the two views. The follow-up was protracted from 13 to 36 months (mean: 22 months). Fourteen patients (9%) died as a result of cardiac events within 13 months of myocardial infarction. Of the patients with ejection fraction greater than or equal to 45% (81/162 = 50%) two died (first year mortality = 2.4%); of those with 35-45% ejection fraction (58/162 = 35%) two died (first year mortality = 3.5%); while of those with less than or equal to 35% ejection fraction (25/162 = 15%) ten died (first year mortality = 40%). Of the patients with wall motion score index less than 1.5 (76/162 = 47%) none died in the follow-up period; of those with score index between 1.5 and 1.9 (61/162 = 37%) four died (first year mortality = 7%); of those with score index greater than or equal to 1.9 (25/162 = 15%) ten died (first year mortality = 40%). Thus, ejection fraction and score index have the same predictive value for mortality in the first year after a first acute myocardial infarction. However, an interesting datum is that in the sub-group of patients with less than or equal to 35% ejection fraction and score index less than 1.9 the first year mortality was 15%, while in the sub-group with less than or equal to 35% but score index greater than or equal to 1.9 the first year mortality was 57%.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Prevention of postoperative deep vein thrombosis by two different heparin types.

The effectiveness of two different heparin types in preventing deep vein thrombosis after surgery was studied in 173 patients, randomly assigned to treatment by a new low molecular weight (LMWH) heparin or trade calcium heparin (CH). Both drugs were administered subcutaneously, 2 h before surgery and for 7 days after, at dose of 7,500 anti activated factor X Units once a day in low molecular weight heparin group, or 5,000 International Units t.i.d. in calcium heparin group. Both activated factor X inhibition and activated partial thromboplastin time evaluations were performed before the surgery, and 3 and 7 days after, to monitor drug effects. Results clearly demonstrated that low molecular weight heparin exerts a marked inhibition on plasma activated factor X. On the contrary, calcium heparin was less powerful in inhibiting this coagulation factor. Both drugs revealed a lower effectiveness in increasing activated partial thromboplastin time. Efficacy in preventing postoperative thrombo-embolism appeared about 3 times higher for the new low molecular weight heparin, despite the lower daily administration numbers. No major side effects related to drug were observed in both treatment groups; also hemorrhage frequency was the same. No differences related to the operation type were found in preventive actions of both drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Time-course of anti-Xa effects of calcium heparin and low-molecular-weight heparin given s.c.: insights for thrombosis prevention.

Thirty healthy volunteers underwent a pharmacokinetic study to control the effect of calcium heparin and low-molecular-weight heparin on coagulation factors. Activated partial thromboplastin time (aPTT), thrombin time (TT) and inhibition of activated factor X (Xa) were checked after a single subcutaneous administration of calcium heparin, 5000 IU (CH group); low-molecular-weight heparin 7500 AXaU (LMWH-LD group); and LMW heparin, 15,000 AXaU (LMWH-MD group). The mean values of aPTT rose significantly only after administration of LMW heparin (15,000 AXaU), while no relevant variations were observed after CH and LMWH-LD administration. The effects on TT were also very small and not relevant to an anticoagulant response. The Xa inhibitory effect exerted by the two LMW heparin doses proved substantially higher and longer-lasting than the effect of unfractioned heparin. A statistically significant Xa inhibition was still present 24 h after LMWH-MD administration and 16-20 h after LMWH-LD administration, while 6 h after CH administration no effect was detectable. The laboratory results confirm the marked antithrombophylic action, without relevant anticoagulant effects, already attributed by other authors to the new LMW heparin under study.

Adult↗

Long term results of high selective vagotomy: a 12-year experience.

The long term results (6 to 12 years) of high selective vagotomy are reported. The study includes 470 patients operated electively for uncomplicated duodenal ulcer. The indications for surgery were: persistence of ulcer after medical treatment; recurrent ulcer after repeated treatments with antacids and/or H2 blockers; noncompliance of the patients with the medical treatment for various reasons. The procedure was performed following the technique described by Goligher with minor modifications. Subsequently, a personal technique of intraoperative transesophageal gastric pHmetry was applied for the control of the completeness of vagotomy. The clinical results were classified according to Visick grading. It is concluded that the absence of mortality, the negligible postoperative morbidity, the clinical and functional results make high selective vagotomy the best treatment for uncomplicated duodenal ulcer.

Duodenal Ulcer↗

[Effect of methisoprinol on postoperative immunodepression in subjects with malignant neoplasms].

The authors investigated the state of immunity, before and after surgery, in a group of 6 methisoprinol-treated patients and in a 10-patient control group both affected by malignant neoplasia. All the patients exhibited various degrees of immuno-depression. Versus the control group the group treated with 1-g methisoprinol injections at the dosage of 4 g daily for 7 days after surgery showed a positive effect on post-surgical immuno-depression.

Humans↗

Ultrastructural study of parietal cells before and after parietal cell vagotomy in patients with duodenal ulcer.

The records of 16 patients of a total of 402 who underwent parietal cell vagotomy without a drainage procedure for duodenal ulcer were reviewed. Biopsies of gastric mucosa were taken before the operation and six months, two years and three years postoperatively. Ultrastructural studies using electron microscopy detail the modifications of the parietal cells which are the main target of the vagal denervation procedure. The parietal cells are greatly modified within six months after parietal cell vagotomy with a significant reduction of the secretory surface of the cells and a sharp increase of tubulovesicular formations regain their preoperative morphologic appearance after two to three years but not their secretory capacity.

Adult↗

[Primary closure of the perineum after Miles's abdominoperineal amputation for carcinoma of the rectum (author's transl)].

In view of the results obtained in 32 cases of primary closure of the perineum after amputation of the rectum for cancer, the authors believe that this policy is best after removal of the malignancy by the abdominoperineal approach. Unquestionable advantages are shortening of the patient's hospital stay and a more rapid recovery; the possible disadvantages are relatively rare, from an uncommonly severe dysmetabolic situation to local disorders such as poor hemostasis, contamination of the operation site, inadequate preoperative antibacterial protection, or an unusually large tumor.

Abdomen↗

[Coloportal fistula in ulcerative colitis (massive penetration, through the splenic vein, of barium and air into the portal system during barium enema)].

The authors describe one case of massive penetration of barium and air through the splenic vein into the portal system during administration of a radiopaque enema to a woman suffering from hemorrhagic proctitis in the florid phase. They provide a detailed description of this rare clinical case and discuss the possible etiology and pathophysiology of the observed event.

Barium Sulfate↗

[Intestinal obstruction and incomplete obstruction from mesenteric cyst formation in children (author's transl)].

In the light of three cases of their own observation, of children with mesenteric cysts causing complete or incomplete intestinal obstruction, the authors review the existing literature on the subject, discuss the etiology, clinical aspects, and therapeutic methods for the correction of such pathology, and conclude by calling attention to mesenteric cysts as possible causes of intestinal transit disorders in the pediatric age group.

Child↗