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Biomedical subjects

M Sanguinetti

Publications and source records attributed to M Sanguinetti.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Infective endocarditis in valve prostheses].

Prosthetic valve endocarditis (PVE) has existed for about 30 years. Its incidence and mortality have decreased compared to the '60s, but they are still remarkable. The distinction between early and late forms of PVE is still justified, only if considered critically. At present the incidence of early PVE is 1% or less. It is caused mainly by staphylococci, Gram-negative bacilli, and fungi, which infect the prosthesis during or immediately after surgery; it carries a mortality of 30-60%. The incidence of late PVE is approximately 1% per year; pathogenesis and clinical features are similar to infective endocarditis (IE) on native valves. Streptococci are the most frequent causative organisms and current mortality is 25-35%. The diagnosis of PVE can be difficult; a strong clinical suspicion, blood cultures, and echocardiography are the most valuable tools. The antibiotic treatment follows the general indications for IE, but in PVE the associations of 2 or more antibiotics are the rule and need to be used according to established protocols. The occurrence of prosthetic dysfunction, para-annular abscesses, and embolism is frequent in PVE and makes prognosis worse. In all cases of complicated PVE or in those due to resistant organisms, an early reintervention must be associated to medical therapy. The surgical treatment of PVE often implies difficult and complex procedures, but early and long-term results are better than those obtained with medical treatment alone. Pharmacological prevention of embolism remains an unsolved problem. The prophylaxis of early PVE has made remarkable progress in the last 20 years and present results appear hard to improve. The prophylaxis of late PVE requires a more widespread awareness of this problem even outside the setting of cardiology and cardiac surgery.

Anti-Bacterial Agents↗
PubMed1989

[Multiple coronary fistulas to the left ventricle. An unusual cause of myocardial ischemia].

Diffuse communications between the left coronary artery and the left ventricular cavity were found in a 54-years-old man presenting with angina pectoris and reversible ischemia documented on stress Thallium scintigraphy. During atrial pacing the patient experienced chest pain which was accompanied by lactate production. Atenolol, but not nifedipine, did ameliorate the symptoms. The anatomical types and the embriogenesis of coronary microfistulas along with possible mechanisms of ischemia are discussed.

Angina Pectoris↗
PubMed1989

[Postoperative cardiac tamponade limited to the left ventricle].

A case of late postoperative cardiac tamponade causing selective compression of the left ventricle is presented. The patient had undergone aortic valve replacement and presented a picture of severe pulmonary venous congestion and low systemic output. The diagnosis was made on echocardiographic data and because of the failure to respond to inotropic and diuretic therapy. Surgical drainage resulted in a rapid improvement of the patient's hemodynamic functions.

Aged↗
PubMed1988

Biotyping of aerobic actinomycetes by modified killer system.

Forty-four yeasts belonging to the genera Pichia, Candida, Saccharomyces and Kluyveromyces were tested for their potential killer effect on 13 aerobic actinomycetes (6 Nocardia asteroides, 1 N. brasiliensis, 1 N. caviae and 5 Actinomadura madurae). Only a few yeast strains did not display any killer activity against the aerobic actinomycetes studied, thus confirming that the killer phenomenon is widespread among microorganisms. For epidemiological purposes, a killer system was developed. According to their susceptibility to the 9 killer yeasts chosen, it was possible to differentiate the Nocardia and Actinomadura isolates into biotypes. Fitting conditions of the killer system to potential sensitive microorganisms with different characteristics of growth are also discussed.

Actinomycetaceae↗
PubMed1987

A comparison of discharge teaching on the consequences of brain injury.

Cognitive dysfunction is a common consequence of brain injury. Frequently, however, this phenomenon is not discussed with family caregivers before the patient's discharge from the acute care setting. A discharge teaching videotape was developed, which presented how the most common cognitive dysfunctions experienced postbrain injury affect activities of daily living. The ability to extrapolate appropriate patient care techniques after receiving discharge instructions on cognitive dysfunctions was tested by a posttest only experimental design study using a control and experimental group. The results indicated that family caregivers who received instruction on cognitive dysfunction were more informed about brain injury-induced behavior and better prepared to help loved ones compensate for cognitive dysfunctions.

Activities of Daily Living↗
PubMed1986

[Percutaneous embolization of a Blalock-Taussig shunt in an adult].

The technique used in percutaneous embolization of a Blalock-Taussig shunt in a 35-year-old male is described. After selective catheterization of the left subclavian artery leading to the shunt, some spring coils were inserted which completely occluded the shunt. The choice of occluding material is discussed.

Adult↗
PubMed1985

[Hemodynamic and clinical effects of captopril in congestive heart failure].

The acute and chronic effects of Captopril were evaluated in 8 patients (5 males and 3 females, age 49 +/- 17 years) with chronic severe congestive heart failure. Acute hemodynamic effects were studied according to a randomized, double blind, placebo controlled protocol, by using two doses of Captopril (25 and 50 mg). The usual diuretic and digitalis treatment was kept unchanged throughout the trial. The acute administration of placebo associate with the usual doses of diuretic and digitalis was followed after 2 hours by a significant reduction of mean pulmonary wedge pressure (-23%, p less than 0.05). One hour following a single administration of Captopril, the following significant (p less than 0.05) changes were observed, respectively for the doses of 25 and 50 mg: heart rate -9% and -6%, cardiac index +13% and +10%, mean pulmonary wedge pressure -27% and -35%, mean pulmonary arterial pressure -29% and -26%, systemic vascular resistances -20% and -17%. A longer duration of effects on heart rate and cardiac index was noted after the 50 mg dose. All patients received long-term treatment with Captopril 75 or 150 mg daily. The NYHA functional class improved in all cases and there was a significant decrease of the cardio-thoracic ratio (from 0.61 +/- 0.05 to 0.55 +/- 0.09, p less than 0.01). A repeated hemodynamic study after a mean period of 6.5 months (range 2.5-22 months) revealed in 7 cases a sustained effect of the drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

[Precapillary pulmonary hypertension: effect of Captopril].

The immediate and sustained haemodynamic effects of Captopril (CPT), an oral inhibitor of angiotensin converting enzyme, were studied in six patients (pts) with severe pulmonary hypertension (PH) (pulmonary artery pressure: mean +/- SD value = 57 +/- 20 mmHg). Two pts had primary PH, 2 embolic PH and 2 Eisenmenger Physiology (EP). Administration of 100 mg of CPT in a single oral dose produced a significant decrease only in systemic arterial pressure (SAP) (p less than 0.025) and systemic vascular resistance (SVR) (p less than 0.05) in 5 of 6 pts. Heart rate (HR), cardiac index (CI), pulmonary vascular resistance (PVR), pulmonary arterial (PAP), pulmonary wedge (PWP) and right atrial pressure (RAP) did not change significantly. These results were confirmed in a repeat haemodynamic study after 4 months of long-term treatment with 50 or 100 mg of CPT 3 times daily. In 1 pt with EP and severe congestive heart failure (CHF) the same chronic treatment produced a marked decrease in HR (from 114 to 88 b/min), RAP (from 10 to 1 mmHg), PWP (from 15 to 6 mmHg), PVR (from 41 to 30 UR), SVR (from 58 to 43 UR). Systemic CI increased from 1.68 to 2.60 l/min/m2 and pulmonary CI from 1.64 to 2.5 l/min/m2; no changes were seen in PAP and SAP. These data suggest that CPT is not effective on pulmonary haemodynamics in pts with precapillary PH and normal CI whereas the drug seems to influence favourably the pulmonary circulation in pts with PH secondary to or associated with left ventricular failure. The necessity of evaluating not only PVR but PAP as well, in studying the effect of vasodilators especially in pts with precapillary PH and normal CI, is discussed. In fact a reduction of PAR without decrease of PAP, as frequently seen in previous reports, is probably due to a primary increase of CI induced by the drug.

Adolescent↗
PubMed1977

[Infectious endocarditis in patients with intracardiac prosthesis (author's transl)].

Infectious endocarditis involving intracardiac prosthesis continues to be a common and dangerous complication of cardiac surgery, but the incidence and severity of the disease are probably underestimated in this country. 14 cases of prosthetic endocarditis observed in a 5 years period are reported in this paper. 7 were early cases and 7 late cases. Etiology, clinical course, and pathological lesions, were similar in the two groups, while mortality was higher in the first group (100%) than in the second (85%). Delay in the diagnosis, negative blood cultures in a third of all cases, and doubts in indications for surgery, were the main reasons for a higher mortality than usual. Only one patient was reoperated on, unsuccessfully, but no patient who had not improved after two weeks of correct antibiotic treatment, survived; such cases, especially if diagnosis has been late and/or blood cultures negative, should be reoperated on without delay. The greatest efforts should be made in the prevention of the disease and, in particular, pre-operative and late post-operative prophylaxis should become more rigid and systematic.

Adult↗