Search PubMed⌕ Search

Biomedical subjects

M Santini

Publications and source records attributed to M Santini.

At least 145 records · Page 8Linked to original sources
PubMed1994

[Iatrogenic lesions of cranial nerves during endarterectomy of the carotid artery].

Cranial nerve injuries may result from carotid endarterectomy. In a retrospective study of 222 surgical procedures, from July 1982 through June 1990 only three cranial nerve injuries were documented (1.35%). In a prospective study of 79 carotid endarterectomies performed from July 1990 through June 1992, there were 11 nerve injuries (13.9%), fortunately most of them were temporary. We conclude that carotid endarterectomy is associated with a much higher incidence of local nerve injury than retrospective surveys would indicate.

Cranial Nerve Injuries↗
PubMed1993

Usefulness of transesophageal pacing during exercise for evaluating palpitations in top-level athletes.

The aim of this study was to verify the use of transesophageal atrial pacing in reproducing tachyarrhythmias in 22 top-level athletes symptomatic for palpitations, with no evidence of arrhythmias or cardiac anomalies by the standard noninvasive diagnostic techniques. The transesophageal stimulation protocol was divided in 2 sections: at rest and during exercise on the bicycle ergometer in the upright position. Although transesophageal pacing at rest did not induce any arrhythmias in 18 of 22 athletes, during exercise it induced tachyarrhythmias. This occurred in all 16 athletes who had palpitations during physical activity. Electrophysiologic characteristics of induced atrial tachyarrhythmia suggested reentry within the atrioventricular node in 9 of 18 athletes: atrial fibrillation in 5, atrial flutter in 2, orthodromic reciprocating tachycardia due to concealed anomalous pathway in 1, and automatic atrial tachycardia in 1. This study stresses the clinical importance of palpitations during physical exercise and shows that transesophageal pacing performed during exercise is an important diagnostic tool in reproducing the previously described symptoms and in detecting the underlying tachyarrhythmias.

Adolescent↗
PubMed1993

[Chemo-antibiotic prophylaxis in general surgery. A study of 1722 cases].

Up until now the problem of surgical infections has been one of the most important which surgeons must confront daily. In 1989 our Institute began programs for control and surveillance of surgical infections; these include, among others, the use of chemo-antibiotic prophylaxis protocols applied to all of the patients hospitalized for surgery. The authors report two years application of three protocols of chemo-antibiotic prophylaxis related to 1722 patients, in which we pointed out the passage from 27.6% of infected cases in the control group to 10.2% infected cases in one of the groups subject to prophylaxis. In these cases the antibiotic prophylaxis also acted reducing in a spectacular manner the incidence of clinically not significant infections.

Anti-Bacterial Agents↗
PubMed1993

Do steroid-eluting electrodes really have better performance than other state-of-the-art designs? The Italian Multicenter Study Group on Low Output Stimulation.

A multicenter study evaluated the performance of atrial and ventricular unipolar leads with porous steroid-eluting and platinized grooved electrodes. A total of 563 leads were implanted in 451 patients. These included 311 ventricular and 97 atrial steroid-eluting electrodes; and 112 ventricular and 43 atrial leads with platinized electrodes. Mean follow-up was > or = 1 year. At implant there were no significant differences in threshold parameters in either chamber. Chronically, however, the steroid-eluting lead consistently had significantly lower pacing thresholds in both chambers. For example, after 360 days implant, steroid-eluting electrodes had 0.23 +/- 0.10 msec ventricular thresholds at 0.8 V compared to 0.45 +/- 0.3 msec in the platinized group (P < 0.0001). In the atrium, the steroid-eluting lead's 6-month thresholds at 0.8 V were 0.15 +/- 0.06 msec compared to 0.9 +/- 0.8 msec for the platinized electrode (P < 0.01). The chronic ventricular QRS amplitudes were significantly greater for the steroid-eluting electrode (P < 0.0005). There were no significant differences in atrial sensing and no incidence of atrial undersensing in the study. The low and consistent thresholds of the steroid-eluting electrodes would have permitted pacing in the ventricle at < or = 2.5 V without compromising safety factor in 99.4% of the patients. The other 0.6% required 5 V temporarily. In the atrium, 100% of the patients could have been paced safely at reduced output. In spite of this, 63% of the implanters lacked the confidence to use reduced outputs.

Dexamethasone↗
PubMed1993

[Heart failure and arrhythmias: the role of ACE inhibitors].

Mortality of patients with congestive heart failure (CHF) is high; > 40% of deaths are sudden, most often due to sustained ventricular arrhythmias (VA). In such patients frequent ventricular premature beats (VPB) and non sustained ventricular tachycardia (NSVT) are common. The relationship between VA and an increased risk for sudden death has been reported for patients with recent myocardial infarction. Although such relationship is uncertain for patients affected by dilated cardiomyopathy, many authors have reported an association between the frequency and the complexity of VA and the risk of sudden death. Many factors are responsible for VA in CHF: structural abnormalities, electrolyte imbalance, hemodynamic impairment, pharmacologic therapy and abnormal activation of neurohormonal system. ACE inhibitors have reduced VA in several experimental models, suggesting that these drugs decrease heart vulnerability to arrhythmogenic stimuli such as reperfusion and electrical stimulation. Many clinical trials have demonstrated that ACE inhibitors decreased VPB frequency and the prevalence of NSVT. Although ACE inhibitors decrease VA frequency, the reduction in cardiac mortality observed in CONSENSUS31 and in SOLVD32 trials was due only to a decrease in the progression of CHF. Recently the results of V-HeFT II33 trial have shown that the reduction in VA prevalence observed in patients treated with enalapril paralleled a reduction of sudden death. Factors that may contribute to the reduction in VA by ACE inhibitors include: increase in serum potassium; unloading of the ventricle; decrease in myocardial oxygen consumption. However, the most important factor seems related to their interference on neurohormonal system whose abnormal activation is the main mechanism of CHF progression.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1993

[Angioimmunoblastic lymphadenopathy with dysproteinemia: personal experience with 3 cases and review of the literature].

OBJECTIVE: We report personal experience on 3 cases of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD). We stress the prognostic and therapeutic aspects of this rare disease, that remain still unclear in recent literature. DESIGN: We performed a retrospective study on 3 cases of AILD, with a mean follow-up of 32.6 months (range 30-36). SETTING: Internal Medicine Unit. PATIENTS: We observed three patients, 2 males and 1 female, with a mean age of 65 years (range 51-72), with AILD confirmed by histopathological exams and evidence of unfavorable prognostic features at the time of diagnosis. INTERVENTIONS: 2 patients received polychemotherapy with cyclophosphamide+prednisone; cyclophosphamide + vincristine + prednisone. One patient was treated with low doses of prednisone (25 mg/day). MEASUREMENTS: We evaluated the degree of response (absent, partial, complete) an the time of survival (< 18 months or > 24 months). RESULTS: Response to therapy was partial in all patients; 1 patient underwent a severe bone marrow depression. All patients were alive for more than 24 months. CONCLUSIONS: The clinical course was independent of therapy (intensive or symptomatic) and prognostic criteria in all 3 patients. At present AILD is considered as a potentially malignant disease. Polychemotherapy must be used as a first choice treatment.

Blood Protein Disorders↗
PubMed1993

[The implantation of a heterologous prosthesis in reparative abdominal-thoracic surgery. Experience with the use of clindamycin in preventing prosthesis-related infection].

The authors point out how infection of heterologous prosthesis, widely used in surgery, can be a dramatic event. On the other hand, antibiotic prophylaxis is difficult because of the difference between "in vitro" and "in vivo" activity of many antibiotics, due to the production, by many bacteria, of the so-called glycocalyx. This would allow bacteria to clump and adhere to many surfaces, forming micro-colonies, causing delay in phagocytosis, and reducing the efficacy of antibiotics. On the basis of their, although limited, experience, the authors suggest, for the prophylaxis of prosthesis infection, the use of antibiotics such as clindamycin, able to reduce glycocalyx production.

Abdominal Muscles↗
PubMed1992

[Takayasu disease in the genesis of cerebrovascular insufficiency. Description and considerations of a clinical case].

The authors in explaining their limited clinical experience relative to one single case, describe the peculiarity of Takayasu's disease and its rare incidence in western populations. The case under observation because of its peculiar rarity had been underestimated and treated in a completely inappropriate manner. Important instrument in its diagnosis is the High Resolution echography which in determining the diagnosis favors and speeds up the diagnostic therapeutic iter.

Adult↗
PubMed1992

[Myointimal hyperplasia caused by vascular suture. A case report and general considerations].

Smooth muscle cell proliferation is a step of the repair process after vascular injury. A similar process occurs after percutaneous transluminal angioplasty and can lead to intimal hyperplasia and vascular restenosis. We have recently observed this process in an anastomotic restenosis after saphenous vein by-pass in the popliteal artery. We suppose that myointimal hyperplasia can also be an aspecific response to surgical intimal injury.

Aged↗
PubMed1991

[Aneurysm of the abdominal aorta and stenosis caused by compression of the celiac tripod in a young woman with tuberous sclerosis and previous mesoblastic nephroma].

Tuberous sclerosis, first described by Bourneville in 1880, is a syndrome characterized essentially by mental deterioration, seizures and cutaneous sebaceous adenoma; an association with malformative lesions of the kidney and cardiovascular apparatus has been documented. Recently a case of a young woman with tuberous sclerosis has come to our observation; she was also affected by abdominal aortal aneurysm and stenosis due to compression of the truncus coeliacus; previously she operative elsewhere for right nephrectomy for breakage of nephric right arterial aneurysm: the histological examination of the removed kidney manifested the presence of a mesoblastic nephroma and afterward tuberous sclerosis was diagnosed. The angiomyolipomatosis evidence confirmed the suspicion of a notable inclination to polydistrict malformations in tuberous sclerosis.

Adult↗