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Biomedical subjects

L Martinelli

Publications and source records attributed to L Martinelli.

At least 127 records · Page 7Linked to original sources

[Aneurysms of the coronary arteries. Apropos of a case of bilateral aneurysm successfully treated by surgery].

Successful surgical management of multiple aneurysms of the coronary arteries by means of an aorto-coronary by-pass was later followed by equal success in the treatment of a double aneurysm of the carotid siphon. The literature appears not to contain any previous report of such an association. The pathogenesis, complications and therapeutic management of this uncommon branch of coronary pathology are discussed.

Aneurysm↗

[Surgical treatment of aneurysms of the thoracic aorta. Presentation of personal cases].

Six cases of aneurysm of the thoracic aorta, four located in the 1st segment and two in the 3rd, are reported. The four cases in the ascending aorta presented a different aetiology: a) aneurysm on aortic stenosis (case 1); b) atheromatous aneurysm (case 2); c) aortic dissection (case 5); d) aneurysm due to dystrophy of the media in a patient with Marfan's disease (case 6). 3 tubular prosthetic substitutions of the ascending aorta were made (with a valvular substitution and commissural relocation associated with right aorto-coronary venous by-pass) and one plastic intervention on the aorta with valvular substitution. The aneurysms of the descending thoracic aorta presented traumatic aetiology and were treated with resection-dacron graft, using femoral artero-venous partial CEC.

Adult↗

[Aorto-coronary by-pass. Personal experience based on 342 cases operated on between April 1971 and December 1974 (author's transl)].

The authors report on the casuistry of aorto-coronary by-pass operations they performed between April 1971 and December 1974, discussing the criteria which indicate the necessity of operating, the principles of the operative techniques, and the results obtained. Out of a total of 342 operated cases, there was an operative mortality (within 30 days) of 3% in isolated by-pass cases, and 4% if one includes associated operations. In 3,5% of patients, postoperative necrosis was present. Almost the same values were found in the smaller group (66 cases) which underwent urgent by-pass operations. The authors consider that the aorto-coronary by-pass operation is a very useful treatment, both for stable and unstable angina, as long as the anatomo-functional conditions exist.

Adult↗

[Changes in intraerythrocyte electrolytes in open-heart cardiosurgical interventions].

The changes of erythrocyte Na, K, C1, and Mg during open-heart surgery were studied in 10 patients undergoing aorto-coronary bypass and in 10 patients undergoing valvular replacement and chronically treated with digitalis and diuretics. The results showed: initial Mg levels lower in both groups of patients than in 10 healthy subjects utilized as controls (p less than .01); higher initial Na levels in patients treated with digitalis and diuretics than in controls (p less than .001); no electrolyte change during extracorporeal circulation; significantly increased Na values at the end of surgery and in the 1st postoperative day, that were probably caused by erythrocyte damage during CPB. The increase was observed following the CPB because of the slow rate of erythrocyte Na changes.

Aged↗

Analysis of folate and vitamin B12 in beta thalassemia minor.

To evaluate whether anemia of heterozygote beta thalassemic subjects depends on folate or vitamin B12 deficiency, the serum values of these two vitamins were assessed in 176 adult subjects: 81 healthy heterozygote beta thalassemic subjects, 76 healthy normal controls and 15 subjects with microcytic iron deficient anaemia and no thalassemic trait. Mean serum folate and vitamin B12 levels in heterozygote beta thalassemic subjects were not statistically different when compared to control groups. No statistically significant correlation was found between mean serum levels of the two vitamins and hematocrit in beta thalassemic carriers and in normal subjects.

Aged↗

Three-year experience with human cytomegalovirus infections in heart transplant recipients.

One hundred twenty-four patients underwent heart transplantation over a 3-year period. All patients were monitored for human cytomegalovirus (CMV) infection if at risk for primary CMV infection or in the presence of CMV-related symptoms. Rapid diagnosis of CMV infection relied on virus isolation and identification or viral antigen detection by using monoclonal antibodies to CMV immediate early or early antigens. In addition, "in situ" hybridization was used to detect viral DNA in tissue samples. Specimens examined included peripheral blood polymorphonuclear cells for CMV viremia and antigenemia determination, together with the most appropriate clinical samples when organ involvement was suspected. There was a 100% (6/6 patients) incidence of primary CMV infection in seronegative recipients of hearts from seropositive donors, whereas no CMV infection occurred in the three seronegative recipients receiving a transplant heart from CMV-negative donors. CMV hyperimmunoglobulin prophylaxis did not prevent primary CMV infection. Five of the six patients with primary CMV infection were symptomatic. In addition, 15 patients (13%) had symptomatic recurrent CMV infection. The most frequent symptoms associated with CMV infection (either primary or recurrent) were fever (19 patients) and pneumonia (eight patients). CMV viremia was detected in 17 patients either before or concomitantly with the appearance of fever. CMV was isolated from bronchoalveolar lavage in all cases with pneumonia; however, another pathogen was associated with CMV and appeared to be the major cause of pneumonia in 75% of these patients (6/8). Twelve patients (five with primary and seven with recurrent CMV infections) were treated with ganciclovir.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Viral↗

Average life expectancy of heterozygous beta thalassemic subjects.

In order to define the lifespan of heterozygous beta thalassemic subjects as compared to non thalassemic subjects, the authors prospectively studied all patients deceased during a period of 76 months at St. Camillo Hospital of Comacchio (Ferrara), located in the Po delta, a region with high prevalence of thalassemia minor. No statistically significant differences were found in the average life expectancy between the thalassemic and non thalassemic groups.

Heterozygote↗

Echo-controlled endomyocardial biopsy.

Endomyocardial biopsy is an essential procedure for the diagnosis and grading of rejection in heart transplant patients. Direct control of the bioptome positioning has classically been obtained by fluoroscopy. Starting in June 1988, at our institution an alternative approach involving the use of two-dimensional echocardiography was introduced in clinical practice. In 125 patients 1591 biopsies have been performed: 445 under echographic control and 1146 under fluoroscopic control with 3.6 and 4.5 samples/biopsy, respectively. The percentages of inadequate samples caused by biopsy site sampling were 0.4% and 1.3%, respectively, in the two groups. Cardiac perforation has occurred twice in the fluoroscopic group; it has not been observed in the echographic group. One case of iatrogenic tricuspid regurgitation was detected in each group. We now consider echocardiography the method of choice to guide the bioptome. We prefer it to fluoroscopy because it eliminates the risks of x-ray exposure, increases the number of sampling sites in cases of echocardiographic evidence of rejection, can be easily performed as a bedside procedure, allows choice and variation of sampling sites, and permits monitoring of cardiac complications during and after the procedure. A randomized clinical trial is probably needed to assess with statistical significance the superiority of the echographic-controlled biopsy.

Biopsy↗