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Biomedical subjects

G Farina

Publications and source records attributed to G Farina.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Biennial experience with aortic valve homografts prepared and preserved in our bank and implanted on the left ventricular outflow tract in adult patients].

A homograft bank was established in 1986 at the Institute of Cardiac Surgery of the Second University of Naples. Since then 163 aortic and pulmonary homografts have been collected, and mostly used for right ventricular outflow tract reconstruction (69 at our Institution and 14 at other Italian Centers). In March 1991 free aortic homografts were first implanted in the left ventricular outflow tract in adult patients with aortic valve and/or root disease, for a total of 15 implantations with a follow-up ranging between 3 and 19 months (mean 10 months). According to the literature and our data, operative mortality for such procedure is not higher than for ordinary aortic valve replacement. With regard to mid-term failure rate and complications, homografts are to be preferred as they don't require anticoagulation. Moreover the best indication to free homograft implantation is active aortic valve endocarditis, especially when annular abscesses are present. Reinfection rate is lesser in these patients compared to those with mechanical or bioprosthetic valves because homografts have no prosthetic material, allow exclusion of abscessual cavities from blood flow and do not require the fixation of a rigid prosthetic sewing ring in an infected, friable annulus. Finally short and mid-term haemodynamic evaluations of such patients are excellent for all the aforementioned reasons as well as for the homograft non obstruction rate.

Adolescent↗
PubMed1994

Long term results of surgery for prosthetic valve endocarditis.

Operative mortality, recurrence and late survival were analyzed in 64 patients operated for prosthetic valve endocarditis (PVE) between 1980-1992: age, sex, drug addiction, early vs. late PVE, micro-organism, sepsis at the time of surgery, indication for surgery, prosthesis type and site were assessed as potential risk factors. PVE developed after replacement for native valve endocarditis in 23 cases (Group A) and after replacement for other valvular disease in 41 patients (Group B). The overall operative mortality was 28.1% (18/64); 16 operative survivors underwent a second reoperation with eight operative deaths (50%), four of them a third procedure with two operative deaths (50%), and one patient had a successful fourth intervention. Female sex (p = 0.015) and sepsis at the time of surgery (p = 0.013), were found statistically significant independent predictors of operative mortality. Age (p:0.002), mechanical valves (p:0.05) and mitral position (p:0.03) were significant predictors of PVE recurrence. None of the risk factors considered were significant for late survival. Twelve-year actuarial survival for all patients was 52.11 +/- 10%; it was 33.3 +/- 13% for Group A and 73.4 +/- 14% for Group B (p:0.04). Patients with mechanical valves and bioprostheses had an actuarial survival of 39.5 +/- 15% and 48.5 +/- 14% respectively with no significant difference. PVE is still a challenging complication of heart valve replacement; patients with PVE after native valve endocarditis have a very poor outcome. Prompt prosthetic replacement is recommended whenever the antibiotic treatment is unsuccessful and/or the hemodynamic status deteriorates.

Adult↗
PubMed1990

[Prosthetic valve endocarditis].

The Authors report their experience of the surgical treatment of cardiac prosthetic endocarditis. Between September 1974 and December 1988, 2,796 cardiac prostheses were implanted. An endocarditis in the follow-up of 23 patients involving 27 prostheses was diagnosed. The operative mortality was high in patients with mitral prosthetic endocarditis; in patients with infected aortic prosthesis operative mortality was low, but there was a high incidence of recurrence. The Authors emphasize the difficulty of diagnosis and the importance of the surgical treatment for eradication of the infection and for resolution of the haemodynamic defect.

Aortic Valve↗
PubMed1990

[Intermediate echocardiographic follow-up of a new model of pericardial prosthesis (Pericarbon)].

The paper deals with the echocardiographic medium-term follow-up of 11 patients fitted with a Sorin Pericarbon bioprosthesis. Four hundred and ninety-seven biological prostheses were implanted during the period January 1975 to December 1988, of which 22 (4.42%) were Pericarbon. The first 11 patients (mean age 55.3 years) who underwent isolated mitral or aortic valve replacement were included in the study. In 5 patients the bioprosthesis was implanted in mitral site, and in 6 in aortic. Post-operative 2D-Doppler echocardiographic tests revealed good hemodynamic performance indices, even in small calibre vessels, and the absence of early malfunctions. Although the number of patients studied is small, the absence of early malfunctions and the technical innovations of the bioprosthesis make it preferable to other pericardiac prostheses.

Adult↗
PubMed1988

Clinico-pathological correlations in the diagnosis of acute myocardial infarction in the elderly.

A series of 200 consecutive patients with autopsy-proven acute myocardial infarction (AMI) was retrospectively studied in order to assess the degree of clinico-pathological agreement and to detect the reasons for disagreement. A correct clinical diagnosis of AMI was made in 86 cases (Group A = 43%) and was missed in 114 cases (Group B = 57%). Atypical presentation and concealed history were more common in group B. The AMI qualified to be the main disease in 83 patients of group A and in 81 of group B and was considered a contributory cause of death in three of group A and in 33 of group B (P less than 0.01). The mean number of diseases coexisting with the main disease for each patient was significantly lower in group A than in group B (P less than 0.01). The mean age was 65.2 +/- 12 years for group A patients and 69.1 +/- 12 years for group B patients (P less than 0.02). With the patients grouped according to age (group I: less than 60 years = 46 cases; group II: greater than or equal to 60 years = 154 cases), the diagnostic accuracy was 61% in group I and 38% in group II (P less than 0.01). Groups I and II did not differ in clinical presentation, ECG and enzyme diagnostic accuracy, while the number of diseases coexisting with the AMI was significantly higher in group II (P less than 0.001). Ageing, the atypical presentation and the coexistence of several diseases seem to account for most of the unrecognized AMI.

Age Factors↗
PubMed1986

Autopsy rate in younger and older hospitalized patients.

A retrospective study of the autopsy rate of the clinico-pathological correlations was made in a group of inpatients. The trend of autopsy rate was observed in all inpatients died in a university hospital during a nine year period (from 1975 to 1983). The agreement between the clinical and pathological death diagnosis was retrospectively controlled in 294 consecutive patients died and submitted to autopsy in the same hospital during a 6 month period (from January to June 1983). The results show that: In the oldest (greater than 60 yrs) patients, the autopsy rate trend was significantly reduced from 1975 to 1983, whereas the hospital admissions and the mortality rate increased. In the youngest subjects (less than 60 yrs), the autopsy rate trend, the hospital admissions and the mortality rate did not significantly change from 1975 to 1983. In all the years considered, the autopsy rate was significantly reduced in the oldest class (p less than 0.001). The agreement between the clinical and pathological diagnosis was observed in 83% of cases in the less than 60 years class and in 63% of cases in the greater than 60 yrs class (p less than 0.001). The association of main disease with other diseases was significantly more frequent in the greater than 60 yrs class with respect to the less than 60 yrs class (p less than 0.01). It has been concluded that the autopsy, especially in the elderly, is absolutely necessary for a better quality control of the clinical diagnosis and of the medical care.

Age Factors↗
PubMed1981

[Effect of bleomycin on DNA-dependent RNA polymerase purified from normal and neoplastic tissues].

The effect of bleomycin was investigated using two forms of DNA-dependent RNA polymerase (A and B) purified from normal tissues and experimental tumours in presence either of Mn2+ or Mg2+ and native or denatured homologous DNA. THe results show that the antibiotic inhibits the enzyme activity of both classes, and the degree of inhibition appears to be influenced by the nature of cation, the highest values being reached with Mg2+. Moreover, the denaturation of DNA modify the bleomycin effect significantly. With regard to cellular damage induced by the drug, the data here reported show that there is not a substantial difference between normal and tumour tissues.

Animals↗
PubMed1979

[Effect of actinomycin D on purified DNA-dependent RNA polymerases from normal and neoplastic tissues].

The effect of low concentrations of actinomycin D was investigated, using two forms of DNA-dependent RNA polymerase (A and B) purified from normal tissues and experimental tumours, in the presence either of Mn2+ or Mg2+, and homologous DNA. The A enzyme activity was strongly inhibited by the antibiotic in presence of Mg2+ and much less in presence of Mn2+. The B enzyme activity was almost suppressed in presence of both cations. The results here reported provide support that the actinomycin D induce a cellular damage of the same extent in normal and tumour tissues.

Animals↗