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Biomedical subjects

M Valente

Publications and source records attributed to M Valente.

At least 289 records · Page 16Linked to original sources
PubMed1975

[Myocellular necrosis by cathecolamines in pheochromocytoma (author's transl)].

A case of myocellular necrosis by cathecholamines in a patient presenting pheocromocytoma is reported. Death was due to cerbral apoplexy. The histological findings are quite specific and show myofibrillar degeneration with substitution of the normal striation by coarse sarcomeric transversal bands. The possible role of necrosis by catecholamines in sudden deaths and non-coronary myocardiosclerosis is emphasized.

Adrenal Glands↗
PubMed1972

Counseling parents of retarded children.

Recently pediatricians have become more interested in the retarded child and his family and have come to realize that they have been ill-prepared to face the many problems that continually arise. A basic understanding of the role of parents and their aspirations, coupled with a knowledge of interviewing, techniques will enable them to face these problems with greater assurance. In addition, a knowledge of the community facilities and resources is necessary. This will entail direct contact with schools, parent groups, state hospitals for the retarded as well as state and local agencies which deal with the retarded.

Child↗
PubMedDate not supplied

Comparison of accuracy and cost of disposable, nonmechanical pumps used for epidural infusions.

BACKGROUND AND OBJECTIVES: Temporary epidural catheter pumps are used to infuse analgesics in patients with chronic intractable pain. Three brands of disposable, nonmechanical pumps adapted for epidural infusion were tested to determine their flow rate efficacy and their cost effectiveness. METHODS: Three pump models were tested: the Baxter (2C1075), Homepump (H100020), and SurgiPEACE (SP500-24). Manufacturers of each unit claim to provide a constant 2-mL/h flow rate. A standard setup was used to simulate both the insertion of the catheter into the epidural space and the environmental conditions consistent with patient ambulation. Reservoirs were filled with water and allowed to infuse into a collection receptacle, and flow rates were measured hourly. Four trials were performed with four separate units and flow rate measurements were averaged to determine a flow rate pattern over the entire infusion period. Data were graphed as the percentage of expected flow rate (% of 2 mL/h) versus infusion time (hours), the 90-110% range being defined as acceptable. RESULTS: All pumps initially infused at a rate above 110% for the first 3-6 hours, after which a steady decline in flow rate was observed. The Homepump produced a flow rate in the acceptable range for the greatest part of its infusion period (41%), followed by the SurgiPEACE (34%), and the Baxter unit (10.4%). The Baxter unit was also cumbersome to handle and therefore difficult to fill. The Homepump unit was easily handled but offered considerable resistance to filling, with partial loss of fluid. The SurgiPEACE unit was easy to handle and fill; however, in two of the units tested, an initial blockage was encountered, and manual patency of the connector and/or catheter had to be established. CONCLUSIONS: All three units deviated considerably from the claimed flow rate of 2-mL/h, both at the beginning and at the end of the infusion. Presumably, the decreasing flow rates are responsible for the diminishing pain relief often experienced by patients over the course of the infusion. The Homepump unit appeared to be the most cost-effective and the easiest to handle and maintained an acceptable infusion rate for the greatest percentage of the infusion period. The considerable cost benefit of using a nonmechanical disposable pump as opposed to a costly but more reliable computerized pump appears to warrant further product improvement and development.

Analgesia, Epidural↗
PubMedDate not supplied

The behavior of Italian family physicians regarding the health problems of women and, in particular, family planning (both contraception and NFP).

The hospital-centered trend that has dominated medical culture and the management of health care during this entire century has, in the last few years, undergone a reversal in Italy. Conditions in other countries suggest that similar changes have or will become increasingly common. The family physician today manages many of the functions previously handled by hospitals and specialists. In the field of reproductive health, family physicians are responsible not only for diagnosis and treatment, but also for prevention and education. The present study considers this new context with the objective of investigating the knowledge and behavior of Italian family physicians in the field of women's health, with particular regard to family planning (including natural family planning), through (1) a qualitative study (focus groups) of a small group of family physicians and (2) a questionnaire sent to 500 family physicians throughout Italy. The results of the focus group are summarized in the form of obstacles that the family physician finds in providing family planning services and proposals for change. The results indicate that because of their holistic approach, the family physician is an appropriate provider of family planning services although continued use of specialists' services, changes in logistics of the family physicians' practice, increased gender sensitivity, and additional training and information are necessary. The results of the questionnaire (121 responses, 24.2%) indicate that the Italian family physician currently lacks certain important information about family planning and would require logistical support to provide these services but is interested in acquiring information and is an appropriate family planning provider. An additional challenge for encouraging family practitioners to provide natural methods is that they favor a "medical" approach rather than a "behavioral" one in their treatment preferences for several other conditions.

Contraception↗
PubMedDate not supplied

Histological study of the removed testes of patients after acute monolateral spermatic cord torsion.

Infertility is frequent in patients after spermatic cord torsion usually when the twisted testis is not removed and becomes atrophic. The mechanism seems to be autoimmune. To see if the atrophic testis may be the source of antigens we carefully examined the histology of atrophic testis of 6 patients. The two patients that had spermatic cord torsion more than 3 years before surgical removal did not show recognizable testicular structures while the other patients that had spermatic cord torsion less than 1 year still showed some spermatogonia in the tubules and some spermatozoa in the epididymis. We think that the surgical removal of the atrophic testis after more than 1 year from the acute episode is of doubtful utility for preventing or blocking the autoimmune phenomenon because testicular antigens are absent and the autoimmune mechanism is able to maintain itself.

Acute Disease↗
PubMedDate not supplied

Hepatocellular carcinoma in cirrhotic liver in Trieste.

One hundred consecutive cases of hepatocellular carcinoma (HCC) in cirrhosis observed at autopsy were studied and their pathological aspects were compared with those reported in the literature. The results, which are representative of HCC epidemiology in a geographical area where cirrhosis is mostly due to alcohol abuse, show that similarities in the architectural pattern of HCC and weight of the liver exist between our material and samples with different aetiology and epidemiology. A relationship between the histological grade of HCC and its propensity to metastasize was demonstrated. The reported better prognosis of clear cells per se could not be confirmed, although clear cell HCC occurred exclusively in grade 2. It was also demonstrated that the relationship between grading and staging was strongly influenced by the association of HCC with cirrhosis, which is a fact that is usually overlooked by the common staging (and grading) methods.

Aged↗
PubMedDate not supplied

Pulmonary endothelial cell modifications after storage in solid-organ preservation solutions.

During lung preservation, the vascular endothelium is probably the first site of damage and these lesions are considered the main limiting factor in solid-organ preservation. In the present study, the ultrastructural changes in the endothelial cells of human pulmonary artery hypothermically stored (at 4 degrees C) for 6 and 12 h in Euro-Collins, University of Wisconsin and Ringer-lactate solutions were compared. The arteries obtained from three patients who underwent pneumonectomy were divided into 20 segments and preserved in the three solutions mentioned. The specimens, which were fixed in osmic acid, were examined using transmission electron microscopy. Transmission electron microscopy indicated that the cells stored in the University of Wisconsin solution either for 6 or 12 h were the best preserved, while the most severely damaged cells were those stored in Euro-Collins solution, even after just 6 h. The cells stored in Ringer-lactate showed an intermediate level of damage. The data from an ultrastructural grading scale, which quantified the damage to the cytoplasm, mitochondria and nucleus, were in broad agreement with the general transmission electron microscopy observations. Analysis of variance of the grading scale data showed that there were statistically significant differences between the groups after both 6 and 12 h storage (P < 0.05).

Aged↗
PubMedDate not supplied

[Uro-radiographic investigations in patients with tumors in the large bowel (author's transl)].

At the Istituto Nazionale Tumori, from 1970 to 1974, 154 patients with cancer of the large bowel underwent urography; 80 cases before surgery and 74 after surgery. Preoperative findings, correlated with neoplasia, were found in 4 patients, while non-neoplastic lesions were found in 32 patients. During postoperative evaluation, 21 patients showed lesions by locoregional diffusion of the neoplasia with involvement of the ureters especially by metastatic nodes. Less frequent was the finding of bladder involvement. 30 patients presented lesions due to surgery. Urography is useful for evaluating patients with neoplasia of the large bowel, especially after surgery and during follow-up.

Anus Neoplasms↗
PubMedDate not supplied

[Reliability and value of diagnostic lymphography in carcinoma of the sigmoid, rectum and anus (author's transl)].

From 1963 to 1973, 253 patients with cancer of the sigmoid, rectum and anus underwent diagnostic lymphography at the Istituto Nazionale Tumori of Milan. In 218 patients lymphography was performed as part of the intial diagnostic work-up, while in 35 it was done during the follow up period, after surgery. The accuracy of radio-histological correlation was 95%. This confirms the reliability of diagnostic lymphography and its clinical usefulness. In view of these results, this diagnostic tool is essential in the initial evaluation in patients with carcinoma of the anus, because lymphography was superior (28%) to the clinical inspection (6%) in the evaluation of the inguino-iliac lymph nodes. Lymphography is also useful in rectal cancer since it permits, in case of nodal metastases, selection of a group of patients in whom the therapeutic program should be revised. The exam is useless in cancer of the sigmoid. In the small group of patients who had lymphography in the follow up period, this technique was the only to show, in symptomatic patients, the presence of pelvic and/or para-aortic nodal metastases. Lymphography is also useful in these patients for the evaluation of the results of the radio/chemotherapy on involved nodes.

Anus Neoplasms↗
PubMedDate not supplied

Post-thoracotomy diagnostic and staging conversion rates of clinically staged I lung cancer.

The accuracy of stage I lung cancer assessment achieved by traditional clinico-diagnostic staging was retrospectively evaluated in 164 consecutive patients who underwent thoracotomy. The diagnostic conversion rate was 6.7% (1 carcinoid and 10 innocent pulmonary lesions) and occurred only in the subset of patients lacking preoperative pathologic confirmation (15%). The conversion rate to unresectable tumor extent was 8% (11/153), and local spread was the main cause of unresectability (5.5%). The staging conversion rate was 29% (43/153): the conversion rate for nodal evaluation was double that of primary tumor evaluation (24% versus 12%), but conversion to anatomically unresectable nodal diffusion occurred in only one patient (0.6%). The ability of the surgeon to convert the wrong diagnosis was scanty without extemporary biopsy, and 7 patients with innocent lesions underwent standard resection for primary cancer. Surgical staging was a precise as pathological staging in primary tumor evaluation, but was faulty in nodal evaluation (15% error in sN- and sN1-2 assessment). It is concluded that following stage I lung cancer assessment by traditional means, supplementary examinations are requested for a better sensitivity of pathological confirmation and a better refinement of local spread. Better nodal evaluation has less value until a biologic limit to surgery for anatomically resectable nodal diffusion is universally accepted.

Adult↗
PubMedDate not supplied

Nutritional support in patients with cancer of the esophagus: impact on nutritional status, patient compliance to therapy, and survival.

AIMS AND BACKGROUND: The multimodal approach to patients with esophageal squamous cell carcinoma often includes polychemotherapy combined with radiation therapy. Cancer dysphagia and drug-related anorexia, mucositis and vomiting can all lead to malnutrition. The aim of this study was to analyze the impact of the administration of enteral nutrition (EN) on the patient's nutritional status, tolerance of chemotherapy and radiotherapy, and final oncological outcome. METHODS: Fifty esophageal cancer patients who were to be submitted to chemotherapy (days 1-4 5-fluorouracil (FU) 1 g/m2/day and cisplatin (CDDP) 100 mg/m2/day 1) for two cycles plus radiotherapy (31 Gy) were referred to the Nutrition Support Unit prior to any therapy due to their malnourished status. Twenty-nine dysphagic patients received nutrition via tube (37 kcal/kg/day + 2.0 g proteins/kg/day for 34 days), while 21 others who were not dysphagic were given a standard oral diet (SD). The patients who received EN had a more severe weight loss than the SD patients (16.8% vs 12.8%, P <0.02). RESULTS: The dose of administered EN represented 86% of the planned support, and 70% of the nutritional therapy was administered in the home setting. Administration of EN support resulted in stable body weight and unchanged levels of visceral proteins, while SD patients had a decrease in body weight, total proteins and serum albumin (P <0.01). There was no difference between the two groups in terms of tolerance and response to cancer therapy, suitability for radical resection and median survival (9.5 months). CONCLUSIONS: EN in patients with cancer of the esophagus undergoing chemotherapy and radiotherapy is well tolerated, feasible even in the home setting, prevents further nutritional deterioration and achieves the same oncological results in dysphagic patients as those achieved in non-dysphagic patients.

Adult↗