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Biomedical subjects

G Rizzo

Publications and source records attributed to G Rizzo.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

Surveillance and rescue of pancreas grafts.

BACKGROUND: Technical failure rates are higher for pancreas allografts (PA) compared with other solid organs. Posttransplant surveillance and prompt availability of rescue teams with multidisciplinary expertise both contribute to improve this result. We herein report a single institution's experience with posttransplant surveillance and rescue of PA. METHODS: A retrospective survey was performed of a consecutive series of 177 whole organ pancreas transplants in 173 patients. Antithrombotic prophylaxis was used in all recipients and tailored on anticipated individual risk of thrombosis. During the first posttransplant week, all PA were monitored with daily Doppler ultrasonography. Surgical complications were defined as all adverse events requiring relaparotomy during the initial hospital stay or the first 3 posttransplant months. RESULTS: A total of 26 relaparotomies were performed in 25 patients (14.7%). One recipient needed two relaparotomies (0.6%). Graft rescue was attempted in patients without permanent parenchymal damage at repeat surgery and in 12 recipients diagnosed with nonocclusive vascular thrombosis. Overall 25 grafts (96.3%) were rescued and one was lost. One-year recipient and graft survivals in patients with versus without complications potentially leading to allograft loss were 92.6% and 63.0% versus 94.4% and 94.3%, respectively. Excluding complications for which graft rescue was not possible, 1-year graft survival rate increased to 78.7%. CONCLUSIONS: Close posttransplant surveillance can allow rescue of a relevant proportion of PA developing nonocclusive venous thrombosis or other surgical complications. Further improvement awaits better understanding of biological reasons for posttransplant complications jeopardizing PA survival and the development of more effective preventive measures.

Graft Rejection↗
PubMedDate not supplied

Neoral versus prograf in simultaneous pancreas-kidney transplantation with portal venous drainage: three-year results of a single-center, open-label, prospective, randomized pilot study.

BACKGROUND: The preferential use of tacrolimus (Prograf) over cyclosporine microemulsion (Neoral) in simultaneous pancreas-kidney transplantation (SPKTx) is mainly based on historical, retrospective studies. We herein report the 3-year results of a single-center, prospective, randomized comparison of the two calcineurin inhibitors in the setting of mycophenolate mofetil (MMF)-based immunosuppression and portal drainage of pancreas allografts. METHODS: Between May 2001 and August 2004, 47 SPKTx recipients who were stratified by recipient sex, were alternatively assigned to treatment with Neoral (n = 22) or Prograf (n = 25). Concurrent immunosuppression included induction treatment with basiliximab and maintenance with MMF and steroids. RESULTS: After a median follow-up of 24.0 months, all patients remained in the study arm into which they were initially enrolled. No pancreas rejection episode was observed. One acute kidney rejection was recorded in the Neoral arm (4.5%) as compared with 7 (28.0%) including one steroid-resistant episode, in the Prograf arm (P = .03). The cumulative incidence of adverse events was 31.8% (n = 7) in the Neoral arm compared with 92.0% (n = 23) in the Prograf arm (P < .0001). One patient died in each study arm. Patient, pancreas, and kidney survivals overlapped at 1- and 3-years posttransplant, namely all 95.4% for the Neoral arm compared with 95.8%, 91.8%, and 95.8%, respectively, for the Prograf arm (P > .05). CONCLUSIONS: We conclude that in MMF-based immunosuppression there is no convincing evidence that Prograf should be preferred to Neoral in SPKTx.

Antibodies, Monoclonal↗
PubMedDate not supplied

An assisted automated procedure for vessel geometry reconstruction and hemodynamic simulations from clinical imaging.

In this paper a method is described to obtain realistic 3-D geometric models of vascular districts from clinical tomographic 3-D images. The aim is the simulation of individual local hemodynamics by means of computational fluid-dynamics (CFD). As a test case, the method is applied to the carotid bifurcation. Attention is focused on the minimisation of the time demanding costs. The proposed procedure has been automated whenever possible and takes about 2h from the acquisition of the images to the attainment of the simulation results, a time lapse compatible with diagnostic exigency.

Aged↗
PubMedDate not supplied

Correlation of SPECT and PET cardiac images by a surface matching registration technique.

Complementary information provided by Single Photon and Positron Emission Tomography (SPECT and PET) in nuclear cardiology allows a better comprehension of the physiopathology of the heart. In this work a surface matching registration technique is evaluated in the spatial correlation of SPECT and PET cardiac images. The method is based on matching correspondent anatomical surfaces extracted from transmission (TR) SPECT and PET studies, usually performed for attenuation correction. The accuracy of the technique was evaluated by phantom experiments and on patient data (201Tl SPECT and 13NH3 PET perfusion studies). An application of the method is presented for the correlation of SPECT 201Tl perfusion and PET 18FDG metabolic studies in the evaluation of myocardial viability.

Ammonia↗
PubMedDate not supplied

Head holder for PET, CT, and MR studies.

A new head holder for the fixation and repositioning of the patient head in PET, CT, and MR scanners has been designed and tested. With this device, a bidimensional correlation between functional and anatomical brain images can also be obtained. Head fixation and repositioning are achieved using the patient's dental morphology as an anatomical reference. With a dentistic material, a mold of the patient's teeth is obtained in a few minutes. The molding substance rests on a plastic support, fixed to the head holder. Each time the patient undergoes a new study, his/her personal mold is used, ensuring accurate head repositioning. External markers fixed on the head holder (made visible in lateral PET and CT projection images, midsaggital MR images, and also on the axial images) make it possible to record and recognize the angular orientation and the position of the brain in the three-dimensional space, to correlate images of the same patient obtained with different neuroimaging modalities, and to accurately reposition patients for follow-up studies. The head holder was tested on several subjects. Fixation and repositioning accuracy of within 2.5 mm were achieved in the three-dimensional space. Orientation accuracy was 1 degree.

Equipment Design↗
PubMedDate not supplied

MRI, antibody-guided scintigraphy, and glucose metabolism in uveal melanoma.

To evaluate the usefulness of structural and biochemical imaging techniques for the diagnosis of uveal melanoma, 12 patients with choroidal melanoma were examined. Magnetic resonance imaging was used in 11 of 12 patients, as one had a metal prosthesis. All the subjects underwent single photon planar scintigraphy (SPPS) and single photon emission computed tomography (SPECT) using the 99mTc-labeled F(ab')2 of the anti-melanoma monoclonal antibody 225.28S ([99mTc]MoAb) and positron emission tomography (PET) using [18F]fluorodeoxyglucose ([18F]FDG). Magnetic resonance identified 6 of 11 melanotic lesions (definite melanomas) and 4 of 11 hypomelanotic lesions (probable melanomas), whereas in one case it was inconclusive. [99mTc]MoAb uptake was observed in 5 of 12 lesions using SPPS and 8 of 12 lesions using SPECT. [18F]FDG uptake was observed in 3 of 12 lesions by PET. These results demonstrate that both MR and radioimmunoscintigraphy are sensitive techniques for the diagnosis of choroidal melanomas and suggest that the detection of melanomas by MR, SPPS, and SPECT is largely dependent upon their size. The validity of these conclusions was verified in four subjects in whom the diagnosis was based on MR and/or SPECT findings only and confirmed by histology. The finding that only some of the uveal melanomas of larger size are visualized based on [18F]FDG uptake suggests that melanomas can have either high or low glucose consumption.

Choroid Neoplasms↗
PubMedDate not supplied

Intrauterine growth retardation and fetal cardiac function.

Intrauterine growth retardation is a pathology which is found in 3-10% of all pregnancies and it is associated with around 20-25% of all fetal intrauterine deaths and with long-term neurologic sequelae. It presents an increased risk of distress during labor and delivery and a greater risk of perinatal mortality. The causes of IUGR and the cardiac and venous Doppler in normal fetuses are analyzed, and the hemodynamic cardiac modifications in IUGR fetus are discussed. The fetal cardiac function in intrauterine growth retardation shows a redistribution of the fetal cardiac output, which tends to favor the left ventricle as the mechanism to compensate for the uteroplacental insufficiency. The Doppler velocity indices are modified as the fetal condition progressively deteriorates and they represent an important tool for the management of the complicated pregnancy.

Cardiac Output↗
PubMedDate not supplied

[Behavior of Vibrio cholerae strains of the biotype El Tor isolated in Apulia in 1973, in relation to various antibiotics and chemotherapeutics].

The tests carried out on the strains of Vibrio cholerae of the El Tor biotype, isolated during the epidemic in Apulia in 1973, brought to light the sensitivity of all the strains to various antibiotics and chemotherapeutic substances. Only one initially sensitive strain, when it was isolated again in the same patient, proved to be resistant to tetracycline. On the basis of this discovery and others communicated in published works, the Authors outline the problems posed by the emergence of antibiotic-resistant strains, especially when the resistance involves R factors.

Ampicillin↗