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Biomedical subjects

O Chiara

Publications and source records attributed to O Chiara.

26 records · Page 2Linked to original sources
PubMed1983

The cardiorespiratory impairment in cirrhosis and sepsis. An experimental interpretation using octopamine infusion.

The effects of octopamine on systemic and pulmonary circulation and on respiratory parameters have been studied in ten O2 100% breathing pigs. A rise in cardiac index (CI) due to an increase in the dynamics of the left ventricle and a progressive hypoxemia, notwithstanding the hyperventilation, was found. The decrease in arterial O2 tension was due to a rise in the pulmonary shunt fraction (QS/QT). The statistical analysis of cardiorespiratory parameters demonstrated that the high flow state linked with a non-Starling mechanism was the causing factor of a ventilation: perfusion ratio (VA/QT) decrease, which led to the rise in QS/QT. Also, a decrease in the lung compliance simultaneous to the increased blood flow was observed. It is suggested that octopamine may play a role in the pathogenesis of the cardiorespiratory hemodynamic impairment of cirrhosis and sepsis where high levels of this false neurotransmitter were observed.

Animals↗
PubMed1980

[Modifications of the respiratory mechanism induced by administration of 18, 19, 20-trinor-17-cyclohexyl-13, 14-dehydro PGF 2 alpha methyl ester].

The effects on pattern of breathing, on compliance and respiratory resistances of PGF 22 were investigated in anaesthetized pigs before and after vagosympathectomy. A marked increase in respiratory resistance and a decrease in lung compliance simultaneously with a pulmonary congestion were observed. The respiratory changes were considered secondary both to a vagal reflex and to the hemodynamic impairment.

Airway Resistance↗
PubMed1980

[18,19,20-trinor-17-cyclohexyl-13,14-dehydro PGF 2 alpha methylester as the cause of hypertension in pulmonary circulation].

The hemodynamic effects of a synthetic compound of PGF 2 alpha have been studied before and after vagosympathectomy. Synthetic PGF 2 alpha caused a marked hypertension in the pulmonary circulation linked with the vasoconstrictor action of this substance on the small lung vessels. A slight hypotension was observed in the denervated animal where the highest values of pulmonary pressure were reached. The authors conclude that this fact may be due to an inhibition of the vasoconstrictor systemic tone secondary to the pulmonary hypertensive state.

Animals↗
PubMed1979

[Effects of octopamine on pulmonary circulation of the pig].

The perfusion of octopamine in pig produces an increase of cardiac output with decrease of pulmonary vascular resistances. The changes in lung circulation depend by a direct action of this drug on nervous control of vascular walls because when the pulmonary shunt increase the effect is not correlated to changes a pattern of breathing.

Animals↗
PubMedDate not supplied

Analysis of deaths due to injury in Milano: preliminary results.

We reviewed all trauma deaths occurring in the urban area of Milan during one year. Autopsy reports were cross-referenced with pre- and in-hospital records and the Injury Severity Score was calculated by a senior surgeon. Causes of deaths were defined as central nervous system injury (CNS), hemorrhage (HEM), combined central nervous system injury and hemorrhage (CNS + HEM), and burns (BURN). Places of death were considered the scene (DOS), during transportation (DOA), the emergency room (DER), and hospital. Two multidisciplinary commissions reviewed patient reports and deaths were judged non-preventable, possibly preventable or frankly preventable, using the unanimous decision rule. The TRISS method was used to calculate the probability of survival for in-hospital deaths. Overall trauma deaths were 255 with 78.04% blunt and 16.08% penetrating traumas. Burns accounted for 5.88%. CNS and CNS + HEM caused 171 (67.05%) deaths. DOS were 91, DOA 48, DER 34, and in-hospital deaths 33. Victims found dead (49 individuals) were excluded from further analysis. The commissions classified 56.31% of deaths as non-preventable, 32.03% as possibly preventable and 11.65% as frankly preventable. The Injury Severity Score decreased from DOS to in-hospital deaths (p < 0.05). The preventability rate was higher for in-hospital deaths (p < 0.05). The results of this study suggest that the development of a tiered trauma system in Milan is mandatory.

Adult↗
PubMedDate not supplied

[Trauma registry at the Niguarda Ca' Granda Hospital of Milano: epidemiology and quality assessment].

OBJECTIVE: In a Trauma System, Trauma Registry allows the assessment of epidemiology and quality of patient care. MATERIALS AND METHODS: Data about trauma patients admitted to Ospedale Niguarda Emergency Department from October 1, 2002 to June 30, 2003 with ICD9CM code 800-939.9 and 950-959.9 were prospectively recorded. Injury severity score (ISS) and revised trauma score (RTS) were calculated and probability of survival (Ps) was derived. RESULTS: During the study period 1811 trauma patients were admitted, and 271 (14.96%) were consistent with triage criteria of severity. Among these, survivors were 220 (81.18%) and blunt trauma 95.94%. Injuries of the central nervous system with (11.76%) or without (50.98%) hemodynamic instability or hemodynamic instability alone (31.37%), were the principal causes of death. An ISS greater than 15 was observed in 61.25% with an overtriage of 38.75%. Seventy seven patients accepted without triage criteria of severity died or were admitted to intensive care unit with an undertriage of 5%. Ps among victims was 22.35 +/- 27.19 and possible preventable deaths were 6 (11.76%). No frankly preventable death was recorded. DISCUSSION: Standard pre-hospital triage criteria are associated with significant over and undertriage. Data collection using large population-based data base increases epidemiologic value of trauma registry. Analysis of Ps identifies cases who need clinical discussion to assess adequacy of treatment. CONCLUSIONS: Prospective data collection in a trauma registry may provide all informations useful to improve quality of trauma patient care.

Adult↗
PubMedDate not supplied

Laparoscopic splenectomy: A retrospective review of 75 cases.

Laparoscopic splenectomy (LS) is considered a safe procedure for spleens of normal size as well as for larger spleens. Seventy-five consecutive patients underwent LS. Splenomegaly was defined by diameter >15 cm and by weight >400 g. Thirty patients had splenomegaly. The outcomes with spleens <15 cm and spleens >15 cm were compared. LS was successfully completed in 73 cases (97.4%). Spleens >15 cm required longer operating time and were associated with greater blood loss (P < 0.001), longer hospital stay, and more complications. Two patients needed blood transfusion. No overwhelming postsplenectomy infection was registered, and operative mortality was zero.

Adolescent↗