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Biomedical subjects

G Gualtieri

Publications and source records attributed to G Gualtieri.

At least 37 records · Page 2Linked to original sources
PubMed1998

The efficacy of noninvasive mechanical ventilation on nocturnal hypoxaemia in Duchenne's muscular dystrophy.

The aim of this 2 yr follow-up study was to evaluate the efficacy of nocturnal noninvasive mechanical ventilation in a group of 10 Duchenne's muscular dystrophy (DMD) patients who desaturated during the night but had normal daytime blood gases: mean (range) age 18.3 (15-22) yrs; mean (SD) vital capacity (VC) 752.5 (460-1,308) mL; mean time in bed (TIB) with arterial oxygen saturation (Sa,O2) < 90% 22.8% of total TIB (range: 16.6-32.0); mean arterial oxygen tension (Pa,O2) 10.3 (9.3-11.7) kPa (78 (70.0-87.8) mmHg); mean arterial carbon dioxide tension (Pa,CO2) 5.9 (4.8-6.5) kPa (44.3 (36.3-48.5) mmHg). All the patients were noninvasively ventilated during the night with a bilevel positive pressure ventilation (BiPAP) devise in spontaneous mode in order to correct the episodes of nocturnal desaturation. Nocturnal Sa,O2 values normalized during nocturnal noninvasive mechanical ventilation, and daytime sleep-disordered breathing disappeared, for the entire study period. No statistically significant differences were observed between baseline and follow-up daytime blood gas values, although a slight increase in Pa,O2 was found. During the follow-up, VC declined at a rate of 79.1 +/- 25 mL.yr-1, less than that generally reported in the past in untreated patients in the same age range. In conclusion, our data suggest that patients with advanced Duchenne's muscular dystrophy with pronounced nocturnal desaturation, not fulfilling criteria for imperative ventilation, could be successfully treated with "elective" nocturnal ventilation with immediate benefits consequent to the correction of the nocturnal blood gas anomalies and with long-term benefits related to the preservation of residual respiratory function, delay of development of chronic hypercapnia and thus the requirement for imperative mechanical ventilation.

Adolescent↗
PubMed1997

Comparison between intravenous and subcutaneous recombinant human erythropoietin (Epoetin alfa) administration in presurgical autologous blood donation in anemic rheumatoid arthritis patients undergoing major orthopedic surgery.

BACKGROUND AND OBJECTIVES: Intravenous (i.v.) Recombinant erythropoietin (Epoetin alfa) is effective in allowing autologous blood donation in patients unable to donate because of anemia. We undertook this open pilot study in order to asses whether a low subcutaneous (s.c.) dose of Epoetin alfa would prove as effective and well tolerated as the higher i.v. dose. Such a move would also decrease costs. MATERIALS AND METHODS: A total Epoetin alfa s.c. dose of 800 IU/kg was compared with a total i.v. dose of 1,800 IU/kg. Twenty-two rheumatoid arthritis patients, unable to donate because of hemoglobin (Hb) < 11 g/dl, received 300 IU/kg of IV Epoetin alfa twice weekly for 3 weeks (11 patients), or 100 IU/kg of s.c. Epoetin alfa twice weekly for 3 weeks plus an i.v. bolus of 200 IU/kg of Epoetin alfa at the first visit (11 patients). At each visit, all patients received 100 mg of i.v. iron saccharate and when the hematocrit (hct) > or = 34%, 350 ml of autologous blood (AB) were collected. RESULTS: No significant differences were observed between the 2 groups of treated patients in terms of units of AB collected (2.6 +/- 0.6 vs. 2.5 +/- 0.5 units for i.v. and s.c. groups, respectively), ml of RBC produced during the study period (291 +/- 99 vs. 337 +/- 65 ml for the i.v. and s.c. groups, respectively), or in the degree of reduced exposure to allogeneic blood in comparison with the control group. CONCLUSIONS: Lower dose of Epoetin alfa (reduced by 56%), supplemented by i.v. iron, is as effective and well tolerated as higher doses administered i.v., supplemented by i.v. iron.

Adult↗
PubMed1996

Inhaled sodium cromoglycate to treat cough in advanced lung cancer patients.

C-fibres probably represent the common final pathway in both ACE inhibitors and neoplastic cough. A recent report demonstrated that inhaled sodium cromoglycate is an effective treatment for ACE inhibitors' cough; this effect might be due to the suppression of afferent unmyelinated C-fibres. We tested the hypothesis that inhaled sodium cromoglycate might also be effective in lung cancer patients who presented with irritative neoplastic cough. Twenty non-small-cell lung cancer (NSCLC) patients complaining of cough resistant to conventional treatment were randomised to receive, in a double-blind trial, either inhaled sodium cromoglycate or placebo. Patients recorded cough severity daily, before and during treatment, on a 0 to 4 scale. The efficacy of treatment was tested with the Mann-Whitney U-test for non-parametric measures, comparing the intergroup differences in the measures of summary of symptom scores calculated in each patient before and after treatment. We report that inhaled sodium cromoglycate can reduce cough, also in NSCLC patients and that such reduction, observed in all patients treated, is statistically significant (P < 0.001). Inhaled sodium cromoglycate appears to be a cost-effective and safe treatment for lung cancer-related cough.

Administration, Inhalation↗
PubMed1995

Respiratory bronchiolitis-associated interstitial lung disease: a case report with bronchoalveolar lavage findings.

We report a case of respiratory bronchiolitis-associated interstitial lung disease in a young asymptomatic heavy cigarette smoker. Diagnosis was achieved by examination of specimens obtained from open lung biopsy, but retrospective evaluation of bronchoalveolar lavage findings offer some circumstantial suggestions. We provide evidence for the nature of inclusions contained in alveolar macrophages. Problems related to the classification of respiratory bronchiolitis-associated interstitial lung disease are also discussed.

Adult↗
PubMed1994

Use of recombinant human erythropoietin to assist autologous blood donation by anemic rheumatoid arthritis patients undergoing major orthopedic surgery.

BACKGROUND: In rheumatoid arthritis (RA) patients undergoing orthopedic surgery, anemia is the major factor in the use of allogeneic blood. STUDY DESIGN AND METHODS: To determine whether recombinant human erythropoietin (rHuEPO) could allow preoperative autologous blood procurement and reduce allogeneic blood exposure, 11 RA patients who were unable preoperatively to deposit blood for autologous use because of their anemia (baseline hematocrit < 34% [0.34]) and who were scheduled for primary total hip replacement or total knee replacement were treated intravenously with 300 U per kg of rHuEPO in combination with intravenous iron saccharate (100 mg), given twice weekly for 3 weeks. The transfusion treatment was compared with that in 12 control patients with comparable baseline hematologic values who underwent the same operation. RESULTS: Control patients could not preoperatively deposit any blood for autologous use, while all but one of the rHuEPO-treated patients deposited 2 or more units (mean, 2.6 +/- 0.6; range, 2-4) (p < 0.001). The control group received more allogeneic units (2.6 +/- 1.6 vs. 0.8 +/- 0.8) (p = 0.009). Moreover, 50 percent of the rHuEPO-treated patients, as compared with 8 percent of controls, completely avoided allogeneic transfusion. CONCLUSION: Recombinant human erythropoietin is safe and effective in stimulating erythropoiesis, allowing preoperative donation of blood for autologous use, and reducing exposure to allogeneic blood for RA patients who are unable preoperatively to deposit blood because of anemia.

Adult↗
PubMed1993

Oxygen-dependent reduction of a nitroxide free radical by electron paramagnetic resonance monitoring of circulating rat blood.

The effects of fraction of inspired oxygen (FiO2) on the reduction of a nitroxide free radical were studied by X-band electron paramagnetic resonance (EPR) monitoring of circulating rat blood. The decay half-life of the metabolism/elimination phase increased significantly by 24 +/- 8% during hyperoxia and decreased significantly by 16 +/- 4% during hypoxia.

Animals↗
PubMed1993

Morphometric and microanalytical analyses of alumina wear particles in hip prostheses.

We analysed tissues harvested during 24 retrievals of hip joint prostheses, with one or both articular components made of alumina. We describe the morphology of wear particles, measure their size and analyse their chemical composition. We relate histopathological aspects to the parameters that characterize ceramic wear particles, and notice that tissue reaction relates to the physical aspect and amount of wear debris and does not necessarily depend on their chemical composition.

Aluminum Oxide↗
PubMed1993

Electron paramagnetic resonance imaging of a model of a beating heart.

This paper presents an apparatus that permits synchronization of the signal acquisition from a moving sample in electron spin resonance imaging experiments. The apparatus has been designed to observe a perfused beating heart and includes all the necessary apparatus to stimulate the heart and to synchronize the signal acquisition on this stimulus. The apparatus is completed by a low-frequency electron paramagnetic resonance bridge operated at 1.5 GHz, a re-entrant cavity for the sample and air coils to obtain the field gradients. Tests were carried out on a phantom consisting of a thin-walled silicon rubber tube of the approximate dimensions of a rat heart. The phantom movements are obtained by inflating and deflating the tube with a peristaltic pump that can be reversed by computer. The acquisitions are taken in synchronization with the pump positions. The hardware used to drive the pump and to synchronize the acquisitions is also described.

Animals↗
PubMed1993

Respiratory function in precapillary pulmonary hypertension.

Since dyspnoea on exertion is very often the first symptom of precapillary pulmonary hypertension (PPH), either from chronic thromboembolic pulmonary hypertension (CTEPH) or from idiopathic pulmonary hypertension (IPH), these patients are often first examined in a pulmonary function laboratory. We carried out a retrospective study (1987-1992) on pulmonary function in 34 patients diagnosed to have PPH by means of specific diagnostic tools, out of 5,467 patients first attending our laboratory. Nine suffered from IPH, 10 from CTEPH and 15 from Eisenmenger physiology. This last group differed from the others, since its diagnosis had been known for a long time and the stage of the disease was more advanced, when pulmonary function tests were performed in our laboratory (with a view to transplantation). Respiratory function, blood gases and arterial oxyhaemoglobin saturation (HbSaO2) during exercise (Bruce protocol), diffusing capacity of the lungs for carbon monoxide (DLCO), shunt fraction (QS%) (approximation obtained from arterial oxygen tension (PaO2) after 100% oxygen breathing) had been evaluated. In the first two groups, in contrast to other reports, we could observe no obstructive defect. Only 20% of the subjects had restrictive defects, however mild. The typical functional picture of these patients revealed normal lung volumes, normal or slightly reduced DLCO, mild hypoxaemia with hypocapnia, severe HbSaO2 drops during exercise, and pathological QS%. We conclude that every time a patient presents with breathlessness at rest or on exercise, a normal chest X-ray and respiratory function tests, pulmonary hypertension must be suspected and subject to specific and invasive tests. More severe functional impairment was observed in the PPH from the Eisenmenger disorder. This might be due to a more advanced stage of this type of hypertension at the time of our observation and/or to the different mechanisms of the diseases themselves.

Adult↗
PubMed1992

Comparison of cemented ceramic and metal-polyethylene coupling hip prostheses in ankylosing spondylitis.

Two groups of patients suffering from ankylosing spondylitis were treated by total hip arthroplasty. Twenty-one patients (37 hips) were treated with cemented metal-polyethylene prosthesis, whereas 18 patients (36 hips) had cemented ceramic coupling implants. The two groups had similar preoperative clinical data. The average follow-up period was seven to eight years for both. Each patient was graded clinically (pain, function, range of motion, deformities) and roentgenographically (radiolucent lines, etc.). Patients with metal-polyethylene implants showed important modifications of the bone around the implant. Clinical and roentgenographic results were relatively good in patients with ceramic implants. The results underline the importance of the friction coupling of the implant.

Adult↗
PubMed1991

Electron paramagnetic resonance spectroscopy on isolated rat heart: a technical note.

Spin labels have been measured directly in the isolated rat heart, perfused by the Langendorff method, using a 1500 MHz low frequency electron paramagnetic resonance spectrometer. This apparatus was previously employed to measure spin label pharmacokinetics of nitroxide sensitive to oxygen in whole mice. The heart was introduced in a resonant cavity to measure the uptake and clearance of free radicals. Various kinetic parameters were measured and are discussed, taking into account the features of the Langendorff apparatus.

Animals↗
PubMed1990

Whole mouse nitroxide free radical pharmacokinetics by low frequency electron paramagnetic resonance.

The in vivo uptake distribution and reduction of the oxygen-sensitive nitroxide spin label PCA in the mouse monitored by low frequency electron paramagnetic resonance (EPR) spectroscopy are reported. Spectra were obtained from the head and liver regions of pentobarbital anesthetized mice during different circulatory and ventilatory conditions. Identical clearances were found in these regions during normoxia. Moderate hypoxia (10% O2-90% N2) did not significantly affect the spin label reduction rate.

Animals↗
PubMed1990

Arthroprosthetic reimplantation with bioceramics.

The study analyzes the results obtained in 50 cases of arthroprosthetic substitution surgery performed as a result of "aseptic detachment of the implant"; it involves a consecutive series of operations performed between 1979 and 1983. In all of the cases ceramic-ceramic cemented prostheses were implanted. The results, which were generally satisfactory, confirmed the excellent properties of alumina (low wear, elevated tolerance).

Adult↗
PubMed1986

Metal ions in body fluids after arthroplasty.

We measured levels of metal ions in urine and plasma of 17 patients 7-15 years after they had a Co-Cr-Mo alloy total hip replacement. They had higher levels of cobalt and chromium than controls. No case of skin sensitivity to the investigated metals was observed. The values of cobalt and chromium in plasma and urine were considerably lower than in professionally exposed groups and do not represent a toxic hazard for the patients.

Aged↗
PubMed1986

The treatment of acetabular fractures.

The results are reported of 52 acetabular fractures treated surgically and followed up for 6 to 16 years. The cases were sufficiently comparable for statistically significant analysis. Satisfactory results were obtained in 34 cases (65%), and poor in 18 (35%). The poor results were due to: epiphyseal necrosis (8%), secondary arthritis (17%), periarticular ossification (9%). The treatment of these poor results is discussed, including the indications for intertrochanteric osteotomy and, in particular, total hip replacement.

Acetabulum↗