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Biomedical subjects

G Rosa

Publications and source records attributed to G Rosa.

At least 19 recordsLinked to original sources

Control of post anaesthetic shivering with nefopam hydrochloride in mildly hypothermic patients after neurosurgery.

Postoperative shivering may be prevented by maintaining normothermia intraoperatively or it may be treated using specific drugs. The aim of this study was to compare the efficacy of nefopam hydrochloride (nefopam) to that of clonidine and meperidine in patients undergoing elective neurosurgical procedures. Three groups of patients were included in the study. Patients in group A (60) received i.v., at random, 20 mg of nefopam, 50 mg of meperidine or 150 micrograms of clonidine in the immediate postoperative period. The incidence of shivering and the time at which shivering ceased were noted, along with central temperature and main haemodynamic changes. Group B (20) received i.v., at random, either 10 mg of nefopam or saline before awakening from anaesthesia. The effects of nefopam on central temperature, oxygen consumption (Vo2), carbon dioxide production (VcO2), basal metabolic rate (BMR) and energy expenditure (EE) were investigated. Group C (10) received i.v. 20 mg of nefopam during surgery: cerebrospinal fluid pressure (CSFP), cerebral perfusion pressure (CPP) and electroencephalogram (EEG) were monitored. In group A nefopam stopped shivering in 95% of patients when compared to meperidine and clonidine, which were effective in 32% and 40% of patients respectively. In group B, only 10% of patients receiving nefopam had postoperative shivering, Vo2, VcO2 and EE were significantly lower in patients treated with nefopam than those in the control group. No changes in CSFP, CPP or EEG were observed in group C. In conclusion, nefopam seems to be more effective than clonidine or meperidine in quickly suppressing shivering, without producing significant adverse reactions.

Adult

[Handling of Foley catheter regarding urinary retention syndrome following vaginal surgery].

The post surgical urinary retention syndrome is a frequent problem after vaginal surgery. In many medical centers it is used a transurethral vesical drainage for three to five days with or without vesical reeducation to prevent it. In order to determine the importance of the time of drainage and vesical reeducation in the presence of this syndrome 106 patients submitted to vaginal surgery were studied at random and prospectively, in our service. Patients were distributed in three groups: the first one, with 37 women in which the drainage was withdrawn at 24 hours; in the second group it was retired at 72 hours and in the third group the drainage was removed at 72 hours with previous vesical reeducation. The results show that those patients who were less time under vesical drainage presented a minor frequency of urinary retention after surgery (24.3% vs 30.7% and 43.7%).

Adult

[Laparoscopic surgery. Preliminary experience].

The first 23 cases of surgical laparoscopy carried out in the Obstetrics and Gynecology Department of the Valdivia Hospital are presented. The advantages of this surgical technique and its indication, in anexal pathology, specially in young women who wish to preserve their fertility is emphasized.

Adolescent

[Invasion of the chest wall in primary lung neoplasms].

The authors analyse a series of 5 patients who underwent pulmonary and parietal resection between 1990 and 1993 due to non.microcytoma bronchogenic carcinoma with invasion of the thoracic wall. The patients comprised four men and one woman aged between 45 and 69 years old. Thoracic pain was present in two patients. Pulmonary resection with extrapleural stripping was performed in two patients whereas a block resection from one to five ribs and the corresponding intercostal spaces was performed in the other three patients. The authors' approach is not to perform these operations according to rigid protocols but to adapt them according to the local status of tumour invasion. Therefore to resort to extrapleural resection when there is a free cleavage plane between parietal pleura and rib wall; resection in block of the wall where the carcinoma has infiltrated the endothoracic fascia or deeper. The authors do not report any major complications and record a postoperative mortality rate of 0%. In two cases the thoracic wall was reconstructed using a sheet of Gore-Tex which did not provoke rejection phenomena. Radiotherapy was carried out in cases with positive lymph nodes. The series presented here is too recent to provide significant data regarding survival. However, the only factor seen to influence prognosis in the five patients was the presence or otherwise of lymph node metastasis, irrespective of the histological type and operation performed. The five year survival rate of T3N0M0 patients is in fact similar to that of T2N0M0 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

[Appendicular mucocele. A report of a case diagnosed preoperatively].

Mucocele of the appendix is an unusual clinical entity. Despite a recognized constellation of findings, the diagnosis is not usually made prior to surgical exploration. A 35 year old man is reported in whom clinical evaluation, including US and CT scans, resulted in the correct preoperative diagnosis confirmed at surgery and leading to appropriate operative decisions.

Adult

[Continence in low resections].

Anorectal function is an important problem after low anterior resection procedure. This paper reports the results from 14 patients undergoing to low resection at Surgical Pathology Institute of the University of Verona. In 12 cases the restoration of the bowel continuity has been obtained by colon-anal anastomosis (Parks Operation) and in 3 cases by colo-rectal anastomosis at the anorectal ring level. The patients have been examined in the preoperative and in the postoperative period by clinical and manometric study. The results confirm that low resection does not involve faecal continence.

Anal Canal

[Myomectomy to preserve fertility].

Myomectomies were performed an 38 patients and 69.9% of this patients become pregnant. The importance of this intervention is highlighted for the significance of pregnancy in older women.

Adult

Iron uptake from lactoferrin by intestinal brush-border membrane vesicles of human neonates.

It is uncertain to what extent the binding of human lactoferrin (LF) to its receptor in the intestinal brush-border membrane affects iron uptake in infants. The purpose of this study was to investigate iron uptake from human LF by brush-border membrane vesicles (BBMV) obtained from the small intestine of human neonates. LF was purified from pooled human colostrum. Uptake experiments were performed by incubation of 55Fe-citrate or 55Fe-LF with BBMV, followed by rapid filtration through microporous filters. 55Fe uptake from LF by BBMV was dependent on pH, with a maximum at 7.5, and increased with incubation time, reaching a maximum at 1 min. When 55Fe was bound to citrate, uptake was slower (maximum at 5 min) and not dependent on pH. In both experiments, the maximum uptake of iron bound to LF was about twice that of iron bound to citrate (230 pmol and 105 pmol/mg microvillus protein, respectively). Partial degradation of LF in two fragments resulted in the loss of its capacity to increase iron uptake by BBMV. From these preliminary results we conclude that LF may increase iron absorption during the neonatal period, contributing to the high bioavailability of this mineral in human milk.

Colostrum

Alcohol consumption among high school students and young athletes in north Italy.

Alcohol consumption was assessed among 366 male high school students and 330 young men playing in sports teams. On the average, the athletes drank less wine, beer and spirits than the students and reported fewer drunkenness episodes. The association of alcohol drinking with sporting activity and with some independent variables was estimated by logistic regression techniques, fitting models for ordinal or nominal response variables. Point estimates of the odds ratios and their confidence limits showed: 1) an inverse relationship between alcohol drinking and sporting activity, especially as regards the consumption of spirits; 2) a strong positive relationship of alcohol drinking with both experimental and regular smoking; 3) peer alcohol drinking (best friend's and girlfriend's drinking) was the strongest predictor of the participant's alcohol consumption.

Adolescent

[Hepatic resection. A contribution and its analysis].

The authors outline their experience in the field of resective hepatic surgery, both with regard to benign and malignant pathologies, and analyse the results in relation to indications and techniques, but also focusing attention on the assessment of postoperative functional alterations, in order to evaluate the hepatic reserve and the organ's response to demolitive surgery. All operations were carried put in the First Division of Surgery at the Ospedale Civile, Asti, from January 1989 to September 1992. In all cases, even in major hepatectomies, a "trans-parenchymal" technique was adopted. Before surgery tests were carried out in relation to the topography of disease, its nature, associated pathologies and the functional hepatic reserve. Operative mortality was zero and morbidity was negligible, probably because rigorous selection criteria and indications for surgery were adopted. Morbidity was even restricted in the two patients suffering from HCC on cirrhosis (?) and this may probably be attributed to the limitation of resection to solely oncological purposes and their classification as Child-Pugh's stage A. The results regarding the liver response to demolitive surgery appear to be indicative and revealed a highly significant and discriminating difference between elective and emergency surgery.

Adolescent

Energy cost and efficiency of riding aerodynamic bicycles.

Traction resistance (Rt) was determined by towing two cyclists in fully dropped posture on bicycles with an aerodynamic frame with lenticular wheels (AL), an aerodynamic frame with traditional wheels (AT), or a traditional frame with lenticular wheels (TL) in calm air on a flat wooden track at constant speed (8.6-14.6 m.s-1). Under all experimental conditions, Rt increased linearly with the square of air velocity (v2a); r2 equal to greater than 0.89. The constant k = delta Rt/delta v2a was about 15% lower for AL and AT (0.157 and 0.155 N.s2 x m-2) than for TL bicycles (0.184 N.s2 x m-2). These data show firstly, that in terms of mechanical energy savings, the role of lenticular wheels is negligible and, secondly, that for TL bicycles, the value of k was essentially equal to that found by others for bicycles with a traditional frame and traditional wheels (TT). The energy cost of cycling per unit distance (Cc, J.m-1) was also measured for AT and TT bicycles from the ratio of the O2 consumption above resting to speed, in the speed range from 4.7 to 11.1 m.s-1. The Cc also increased linearly with v2a, as described by: Cc = 30.8 + 0.558 v2a and Cc = 29.6 + 0.606 v2a for AT and TT bicycles. Thus from our study it would seem that AT bicycles are only about 5% more economical than TT at 12.5 m.s-1 the economy tending to increase slightly with the speed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerobiosis

[Medical handling of the tubal pregnancy: results].

We report the outcome of the treatment with intratubal methotrexate (25 mg) administered via laparoscopy in 8 patients with ectopic pregnancy who where treated according to a preestablished protocol. A successful treatment was achieved in 6 patients (75%). Hysterosalpingography was performed in 5 of the patients, and in 4 of them we found bilateral tubal patency. Currently 3 patients have a normal intrauterine pregnancy.

Adult

[Gestational choriocarcinoma in a tubal pregnancy].

We report a gestational choriocarcinoma arising in a tubal ectopic pregnancy. Unilateral salpingectomy and single agent methotrexate chemotherapy achieved a cure. A follow up of two years revealed no evidence of recurrence.

Adult

[Congenital duodenal stenosis. A case treated in adulthood].

The authors report their experience the diagnosis and management of congenital duodenal malformation in adults. They emphasize problems and difficulties in this disease of pediatric age and the physiopathological adaptation in these years. They point out that surgery can modify important metabolic functions and sub-clinical pathological conditions that the malformation made up.

Adult

Effects of low-dose propofol administration on central respiratory drive, gas exchanges and respiratory pattern.

The effects of sedative-hypnotic doses of propofol on respiratory drive and pattern have not yet been extensively described. Repeated small boluses of propofol (0.6-0.3 mg.kg-1) were administered to ten ASA I patients undergoing carpal tunnel release using regional anaesthesia. Airway pressure, capnography and pneumotachography were continuously recorded. With respect to basal values, no significant variations of respiratory rate, minute volume, tidal volume, inspiratory and expiratory time, total expiratory cycle, Ti/Ttot, TV/Ti, P0.1, EtCO2 and blood gas analysis were observed. Low doses of propofol, to maintain conscious sedation of light sleep, have not been shown to cause respiratory depression.

Ambulatory Surgical Procedures