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Biomedical subjects

J Fusciardi

Publications and source records attributed to J Fusciardi.

42 records · Page 3Linked to original sources
PubMed1984

[Enterobacter cloacae. In vivo emergence of a variant resistant to new beta-lactams during treatment with lamoxactam-gentamicin].

In a patient recently operated for an abdominal gun wound, and given gentamicin-cephalosporin (cefoxitin for one day, then moxalactam) for 11 days, treatment failed as a result of emergence of a E. cloacae variant resistant to beta-lactams only, i.e. carbenicillin, mezlocillin, cefamandole (CFM), cefoperazone (CPZ), cefotaxim (CTX) and moxalactam ( MOX ). The initial susceptible strains isolated from blood cultures (SH1, SH2) and the resistant ones isolated 11 days later from pancreatic pus (RP) and blood cultures ( RH1 , RH2 ) shared the same chemotype. MICs of CFM, CPZ, CTX, and MOX were much higher (1 000 to 4 000 fold) for RH1 than for SH1. The biochemical mechanism of resistance showed the six following features: loss of antimicrobial activity of CFM, CTX and MOX added to RH1 cultures; much higher (1 500 fold) beta-lactamase activity for RH1 than for SH1 (iodometric and microacidimetric methods); beta-lactamases focusing at the same pl (greater than 8) produced by RH1 , RP and also, but only after induction, SH1 and SH2; cephalosporinase-type beta-lactamase according to the enzymatic activity profile; restoration of RH1 's susceptibility to CFM, CTX and MOX merely by adding cloxacillin; apparently unchanged crypticity for RH1 . The enzymatic mechanism (cephalosporinase hyperproducing variant) seems very likely.

Adult↗
PubMed1982

[Prevention of per-operative myocardial ischemia with continuous nitroglycerin infusion].

The aim of this work is to assess the possible beneficial effects of intra and post operative nitroglycerin infusion in patients with disabling angina pectoris (Class III of the New-York Heart Association). We thus compared the occurrence of myocardial ischemia detected by means of continuous electrocardiographic recording of lead V5 in 31 patients which were divided in two groups. The control group (I) included 16 patients, group II included 15 patients undergoing similar surgical procedures, given a permanent nitroglycerin infusion. Mean dose of nitroglycerin was 0,91 +/- 0,18 micrograms . kg-1 . min-1. An ischemic type S T segment depression occurred in 15 out 16 patients in group I and in only 3 out of 15 patients in group II (p less than 0,001). No S T segment depression occurred following a decrease of more than 25 p. 100 in systolic blood pressure in 8 patients of group II at the time of induction. These hypotensive episodes were easily corrected by decrease of the nitroglycerin infusion rate associated with a rapid blood volume expansion. The very high incidence of intra operative myocardial ischemia in control group demonstrates the severity of the coronary disease in the observed patients. The significantly lower frequency of ischemic S T segment depression observed in the patients given nitroglycerin infusion suggests that this drug is highly effective in preventive myocardial ischemia in patients with severe coronary artery disease. The administration of nitroglycerin in our patients had been easy to control, blood pressure reaching normal value within a few minutes after decrease of the rate of drug infusion when needed.

Aged↗
PubMed1977

[Acquired Von Willebrand disease with chronic lymphocytic leukaemia and angiodysplasia (author's transl)].

The onset of an haemorragic syndrome in a patient with chronic lymphocytic leukaemia led to the diagnosis of acquired von Willebrand's disease secondary to an anti-von Willebrand factor antibody. Multiple angiodysplasia were shown by an arteriography done for a ruptured femoral arterial aneuvrism. The relationship between angiodysplasia and acquired von Willebrand disease are discussed.

Aged↗