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Biomedical subjects

M Palombi

Publications and source records attributed to M Palombi.

11 recordsLinked to original sources
PubMed1995

Dipyridamole echocardiography and 99mTc-MIBI spect dipyridamole scintigraphy for cardiac evaluation prior to peripheral vascular surgery.

Coronary artery disease accounts for most of the early and late mortality and morbidity associated with vascular surgery. Cardiac pre-operative evaluation is mandatory for the assessment of cardiac risk. The aim of this study is to compare dipyridamole scintigraphy with 99mTc-MIBI (MIBI-dipy) and dipyridamole echocardiography (ECHO-dipy) and to evaluate their capability in identifying cardiac risk for strong events such as death, unstable angina or myocardial infarction. METHODS. Sixty consecutive patients (mean age 67 +/- 7) were enrolled. 52 performed ECHO-dipy, 51 MIBI-dipy. 40 patients went to aorto-femoral or aorto-iliac graft replacement and 15 to vascular angioplasty. Five patients did not undergo surgery. RESULTS. Eighteen patients (30%) had stress defects and 9 patients also rest defects with MIBI-dipy. Six patients new asinergic areas at ECHO-dipy. Three pts died in the first year follow-up for a cerebrovascular event, a myocardial infarction and a sudden death respectively. Sensitivity and specificity, positive and negative predictive value were 100%, 69%, 16%, 100% for MIBI-dipy and 66%, 94%, 40%, 98% for ECHO-dipy. CONCLUSIONS. As other authors reported, stress scintigraphy is a pre-operative test showing high sensitivity but with no satisfying specificity. Stress echocardiography, in our population, can produce a good negative predictive value. It is a less expensive and widespread clinical tool useful in the evaluation of preoperative patients. Its positive predictive power is not satisfying but it is shared with all non-invasive pre-operative tests available now.

Aged↗
PubMed1994

Median time from seroconversion to AIDS in Italian HIV-positive haemophiliacs: different parametric estimates.

The purpose of this study was to estimate the median incubation time between human immunodeficiency virus (HIV) infection and onset of acquired immunodeficiency syndrome (AIDS), using three parametric models and six estimates of seroconversion time. Study subjects were 732 HIV-positive haemophiliacs enrolled in the Italian Registry of patients with congenital coagulation disorders. Seroconversion time was estimated for each subject according to six different criteria, based on three distributions of seroconversion (uniform, uniform on three sub-intervals and truncated Weibull) and two indices synthesizing each distribution (median and median of three random values). The estimated seroconversion times were subsequently used as starting points in the analysis of incubation. This was performed applying Kaplan-Meier non-parametric survival analysis, and fitting to incubation data three probability density functions, representing three different situations with respect to the hazard of developing AIDS following seroconversion (namely Weibull (WE), generalized exponential (GE) and log-logistic (LL)). The cumulative incidence over an 8-year period ranged from 14.9 to 17.8 per cent when applying the Kaplan-Meier method, from 14.1 to 17.2 per cent when using the WE function, from 14.5 to 17.3 per cent when using the GE function and from 14.4 to 17.3 per cent when using the LL function, depending on the estimate of seroconversion time used. Similarly, the median incubation times ranged from 12.6 to 15.0 years with the WE function, from 14.0 to 16.5 years with the GE function, and from 13.4 to 16.1 years with the LL function. The presence of a bound on the increase of the hazard function seems to affect the incubation more strongly than the eventual decrease following the attainment of the maximum risk. This may be due to the decrease in the hazard beginning when most of the seropositive subjects have already developed AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Alternative therapy of deep venous thrombosis in patients at hemorrhagic risk].

The authors report on the pharmacological employment of defibrotide in the treatment of a case of deep vein thrombosis (DVT) of the left iliac-femoral veins in a patient with a high-risk of hemorrhage (haematuria from kidney neoplasm, rupture of basilar artery aneurysm, urethral bleeding from catheter trauma). Alternatively to the traditional thrombolytic and anticoagulants, not indicated here for their haemorrhagic risk potential, defibrotide promptly resolved the DVT without any major effect on blood coagulation parameters. Initially, 1 gr of defibrotide in 250 ml of glucose-1-phosphate solution was administered twice-daily for the first two days when improvement had been observed. An additional 5 days of therapy was continued under the same regimen, then 400 mg intravenously every 2 hours for 14 days, and 400 mg intramuscularly every 24 hours until the 30th day. The patient was dismissed from the hospital on therapy with indobufen 200 mg orally, and elastic support stocking. After 6 months the patient is well. An echo color Doppler evaluation showed a normal venous blood flow through the femoral, iliac and caval veins, and venous blood reflux in the iliac-femoral and femoral saphenous veins due to valvular insufficiency. Caval filters, although recognized by many institutions as a preferred method of protection against pulmonary thromboembolism especially in patients with a contraindication to anticoagulation therapy or recurrent pulmonary embolism, was not used in this case, since the patient was critically ill. From this case report and the review of the literature it seems that defibrotide may represent a valid alternative therapy in the treatment of DVT, especially in high risk haemorrhagic patients.

Aged↗
PubMed1992

Effects of different parametric estimates of seroconversion time on analysis of progression to AIDS among Italian HIV-positive haemophiliacs.

The purpose of this study was to estimate seroconversion time using different parametric methods and to assess their influence on the estimation of the incubation time between HIV infection and onset of AIDS. Study subjects were 712 HIV-positive haemophiliacs enrolled in the Italian National Registry of patients with congenital coagulation disorders. Seroconversion time was estimated using the mid-point of each seroconversion interval (MID), the median of each interval under an estimated uniform distribution with cutpoints at December 1981 and December 1985 (MUU), the median of each interval under an estimated Weibull distribution (MUW), and the median of three random values drawn from each interval under the Weibull distribution (RUW). Kaplan-Meier survival analysis showed that the cumulative incidence of AIDS over a 7-year period was 11.6 per cent (SE 1.3 per cent) when using the MID estimate of seroconversion time, 10.8 per cent (1.2 per cent) with the MUU estimate, and 13.4 per cent (1.3 per cent) and 12.3 per cent (1.3 per cent) when using MUW and RUW estimates, respectively. This study demonstrates that the estimate of seroconversion time does not seem to be a major factor affecting estimates of AIDS incidence since the different techniques for estimating HIV seroconversion time yielded very similar results.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Spinal cord stimulation (SCS) in peripheral ischemic pain.

Between 1982 and 1987, 45 patients suffering from painful symptomatology caused by peripheral vascular disease, not curable by medical or surgical therapy, were implanted with epidural neurological stimulators. Measurements used in evaluating the effectiveness of the method were pain control, walking distance, and development of trophic problems. With most patients, we noted a satisfactory and long-lasting degree of pain control. Walking distance increased to a surprising degree. Trophic lesions smaller than 3 sq cm healed, while lesions of greater size required amputation of the limb. Transcutaneous oxygen tension (TcpO2) was used to study the effects of SCS on peripheral circulation in implanted patients. In addition, TcpO2 was calculated in 15 patients before and during the percutaneous test to predict the effectiveness of SCS. Regression of painful symptomatology was achieved only in patients whose TcpO2 improved during the course of the testing. Therefore, this method provides an objective measure for the implantation of neurostimulator.

Arteriosclerosis↗
PubMed1981

[Circadian rhythm of retinal critical fusion frequency (CFF)].

The measure of the fusion critical Frequency investigates the cerebral and retinal blood circulation. It has been carried out by means of Modugno-Rispoli apparatus in 11 subjects with a circadian procedure. A circadian rhythm was detected in right eye, left eye and both eyes with acrophases respectively at 11,57, 11.19 and 11.31 hrs. It is concluded that the existence of the oscillations of the cerebral vascular efficiency could have a practical implications in both diagnosis and therapy of related disease.

Adult↗
PubMedDate not supplied

Acute renal failure occurring during intravenous desferrioxamine therapy: recovery after haemodialysis.

A patient with transfusion-dependent thalassemia was undergoing home intravenous desferrioxamine (DFX) treatment by means of a totally implanted system because of his poor compliance with the nightly subcutaneous therapy. Due to an accidental malfunctioning of the infusion pump, the patient was inadvertently administered a toxic dosage of the drug which caused renal insufficiency. Given the progressive deterioration of the symptoms and of the laboratory values, despite adequate medical treatment, a decision was made to introduce haemodialytical therapy in order to remove the drug and therapy reduce the nephrotoxicity. From the results obtained, haemodialysis can therefore be suggested as a useful therapy in rare cases of progressive acute renal failure caused by desferrioxamine.

Acute Kidney Injury↗