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Biomedical subjects

G Foti

Publications and source records attributed to G Foti.

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

[Aortic valve replacement in old age. The results and follow-up echo-Doppler study of the prostheses].

BACKGROUND: To analyze the results of aortic valve replacement in elderly patients and to evaluate the hemodynamic performance of valvular prostheses, we have retrospectively studied the patients 70 years of age or older, who consecutively underwent aortic valve replacement in our Center. METHODS: From January 1988 to December 1992, a series of 112 patients aged 70 to 88 years (mean 74.8 +/- 3.8 years) underwent aortic valve replacement; 49.1% of patients were male; aortic valvular lesion was: stenosis in 65.2%, insufficiency in 9.8% and mixed stenosis and insufficiency in 25.0%. In 73.2% isolated valve disease was present; in 25.0% coronary artery disease was associated. Preoperatively 58.9% were in New York Heart Association class III, and 29.5% were in class IV. Concomitant extracardiac diseases were present in 73.2%. The types of valve prostheses employed were: mechanical tilting disc (28 cases), mechanical bileaflet (40 cases), bioprosthesis (44 cases). A significantly favourable relationship between body surface area and size of prostheses was evident. RESULTS: Overall hospital mortality was 8.9% (5.4% for elective isolated aortic valve replacement) with significant difference (p = 0.006) related to criteria for surgical indication (elective 6.4%, urgent 10.0%, emergency 37.5%). Valvular lesion, age, sex, associated coronary artery bypass surgery, the values of peak and mean aortic valve gradient, the relative wall thickness and the presence of extracardiac disease have not been identified as risk factors for hospital mortality. The mean follow-up of the 102 discharged patients is 27.1 +/- 16.5 months (range 2 to 64 months). Eight late deaths (7.8%) occurred; the overall actuarial freedom from all deaths (excluding hospital mortality) was 95.6 +/- 2.2% at 1 year and 88.6 +/- 4.0% at 3 and 5 years. Five non fatal valve related complications occurred: hemorrhage in 4 cases (1.8% pt/yr) and hemolysis in 1 case (0.4% pt/yr). Ninety-seven percent of patients were found to be in NYHA functional class I or II. Comparative echocardiographic evaluation of the prostheses showed significant differences in mean gradient: regarding 21 mm size lower in bileaflet than in tilting disc and regarding 23 mm size lower in bileaflet than in tilting disc or bioprostheses. CONCLUSIONS: Aortic valve replacement has proved to be safe and effective in the elderly population and is considered the procedure of choice for aortic valve disease. Although we consider mandatory to choose the valve substitute matching different physiopathological and psychological attitudes of individual patient, mechanical prostheses and particularly bileaflet type for size < or = 21 mm should be preferred.

Aged↗
PubMed1993

Effects of short-term oxygenation changes on acute lung injury patients undergoing pressure support ventilation.

We investigated the effects of short-term oxygenation changes upon the neuromuscular respiratory drive (airway occlusion pressure [P0.1]), minute ventilation (VE), and respiratory rate (RR) in 12 acute lung injury patients undergoing pressure support ventilation. We ventilated the patients first at a high level (H1) of oxygenation, then at intermediate (I), at low, and again at the high (H2) level. The H1 and H2 periods showed no differences. In the H1, I, and L periods, PaO2 was 158 +/- 68, 75 +/- 12, and 55 +/- 6 mm Hg, respectively. Decreasing oxygenation caused very significant increases in VE, RR, and P0.1. Differences in RR, VE, and rapid shallow breathing index were significant at step H1 versus I. Changes in P0.1 appeared to be higher when the H1 value was higher than normal. An arterial oxygenation target higher than the generally accepted 60 mm Hg level may decrease both RR and VE.

Humans↗
PubMed1992

An interrupter technique for measuring respiratory mechanics and the pressure generated by respiratory muscles during partial ventilatory support.

We evaluated the airway occlusion maneuver as a method to estimate respiratory resistance, respiratory elastance and the pressure generated by respiratory muscles in ICU patients breathing in the PSV mode. The airflow was interrupted at selected flows or volumes during inspiration by a computer-driven rapid occlusion pneumatic valve. The airway occlusion was maintained for 2 to 3 s. From the airway pressure tracing we obtained various measurements of pressure. We then computed the pressure generated by the patient's inspiratory muscles. The method was validated by two different approaches in two groups of patients: the Pes and the CMV protocols. We conclude that the airflow interruption method can be used to measure basic respiratory mechanical parameters in PSV patients. The method also offers an opportunity to evaluate Pmusc,aw and the respiratory work performed by the patient.

Adolescent↗
PubMed1990

Fluorine microanalysis in teeth.

Fluorine content in dental tissues has been measured by using nuclear reactions with high energy proton beams and detecting alpha particles and/or gamma rays emitted from fluorine nuclei. The sensitivity of the nuclear analysis reaches 0.1 mg/g and the depth distribution of fluorine atoms can be determined up to 5 mum. The depth resolution is about 0.3 mum with alpha particles and 0.1 mum with gamma rays. Distributions of fluorine both in surface enamel and in cross section of teeth were measured by using a proton probe 500 mum in diameter. A systematic increase in the fluorine concentration has been observed in the healthy incisors dental enamel (1-3 mg/g) with respect to the molar ones (0.5-1 mg/g). A comparison between the fluorine content in healthy teeth and in pathological ones was made.

Alpha Particles↗
PubMed1990

[Clinico-epidemiologic considerations in cases of acute viral non-A, non-B hepatitis (NANB)].

Personal experience with a series of 69 cases of non-A, non-B viral hepatitis out of 164 cases of acute viral hepatitis observed at hospital admission between January 1985 and June 1988 is reported. Agreement is expressed with other Italian series as regards the incidence of sex, of the most involved age classes, of the most affected professional categories and of the incubation period of posttransfusional forms. The prevalence of sporadic forms over those transmitted intraparenterally and more prolonged course in icterus patients and in parenteral forms is pointed out.

Acute Disease↗
PubMed1990

Long-term cardiopulmonary bypass by peripheral cannulation in a model of total heart failure. The decompression of the left heart through a percutaneous helical spring positioned within the lumen of the tricuspid and pulmonary artery valves.

We performed long-term closed-chest cardiopulmonary bypass in an animal model of total heart failure (induced ventricular fibrillation). The extracorporeal system included a venous reservoir, a roller pump, a membrane lung, and a blood pulsator system. We cannulated the right external jugular vein for venous drainage and the right subclavian artery for arterial return. To decompress the left heart we passed by percutaneous cannulation a special helical spring mounted on a Swan-Ganz catheter (Baxter Edwards Divisions, Irvine, Calif.) and positioned it to rest within the pulmonary artery and tricuspid valves, which rendered them partly incompetent. After induced ventricular fibrillation, blood flow was raised to keep the central venous pressure at baseline values. The lungs were ventilated with 5% carbon dioxide in room air. During bypass, mean pulmonary artery pressure was 10.0 +/- 1.7 mm Hg, mean wedge pressure 11.9 +/- 1.8 mm Hg, and mean blood pressure 95.2 +/- 5.6 mm Hg. After 2 days (four animals) and 3 days (two animals) the hearts were defibrillated. There was immediate ejection from both sides of the heart. All sheep were weaned from bypass within 29 +/- 11 minutes and their lungs were ventilated with room air within 42 +/- 34 minutes. At autopsy hearts and lungs grossly appeared normal. We conclude that the percutaneous helical spring resting within right heart valves provided excellent decompression throughout the study, with full recovery of heart and lung function on defibrillation.

Animals↗
PubMed1989

[Visceral leishmaniasis as an opportunistic infection. Our experience].

A case of visceral leishmaniasis in a female patient suffering from acute nonlymphoid leukaemia is reported. Stress is laid on the atypical nature of the clinical picture, falsified by the underlying disease, and attention is called to the behaviour of Leishmania as an opportunistic agent in the immunodepressed host.

Female↗