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Biomedical subjects

P Guerrini

Publications and source records attributed to P Guerrini.

At least 19 recordsLinked to original sources
PubMed1992

[Carotid artery injury: value of Doppler screening in head injured patients].

A case is reported of a patient with a traumatic aneurysm of the intracranial part of the carotid artery occurring after a traffic accident. The patient was admitted in coma (Glasgow score 5), and presented with a depressed fracture of the frontal and parietal bones, a fracture of the left petrous pyramid and of the left anterior clinoid process, as well as of the right tympanic bone and temporomandibular joint. The borders of the left carotid canal seemed unaltered. Despite the lack of localised neurological signs, cervical and transcranial Doppler ultrasonography was carried out. Intracranial carotid blood flow was found to be altered on both sides. Angiography showed a false carotid aneurysm on the left side (carotid siphon portion C3), and a moderate irregular stenosis of the C2 part on the right. There were no brain lesions on the CT scan. Prophylactic treatment with heparin was started. The patient recovered normal consciousness within a fortnight. The false aneurysm increased in volume and was treated by embolisation. Flow speeds in the carotid siphons also returned to normal. The usefulness of routine screening of patients with petrous bone fractures with Doppler ultrasound is discussed.

Adult↗
PubMed1992

[X-ray computed tomography of thoracic injuries. Apropos of 40 cases].

On chest radiographs, the precise assessment of thoracic injuries consecutive to blunt trauma is often compromised by the nonspecific appearance of many lesions. Furthermore, significant injuries are frequently overlooked. However, the management of the patients with chest trauma is still often based primarily upon clinical and radiographic findings and Computed Tomography (CT) is often performed secondarily on the basis of unexplained clinical signs or suspected radiographic abnormality. Some authors have reported that CT was a highly sensitive method for detecting thoracic lesions frequently not seen or underestimated on conventional supine chest radiographs. However, the value that these new CT findings could have in the therapeutic management of these patients, have not been systematically investigated to our knowledge, except in a limited series suggesting that the course of critically ill patients could be substantially altered after thoracic CT. In order to estimate the role of early CT in the management of patient care, we report the therapeutic consequences of CT findings in forty patients who we report the therapeutic consequences of CT findings in forty patients who had a thoracic CT within few hours following a chest injury. We showed that early thoracic CT scan in patients with blunt trauma detected significantly more lesions than did chest X-Ray and appreciably modified the treatment modalities in 70% of our patients. We then recommend that all the patients admitted in ICU after chest trauma undergo a thoracic CT scan as soon as possible in order to optimize their treatment modalities.

Adolescent↗
PubMed1990

[Subcutaneous tunnelization of the subclavian vein. A bacteriological study of 400 catheters in hematologic intensive care].

Infectious complications are the highest risk in hematology. In this study, subclavian approach and tunnellization are reviewed. Four hundred (400) catheters were evaluated by the Isolator Culture method. Catheters are left in place a long time (mean time 30 days). Colonization occurs rarely (about 10.5%). In hematology, subclavian tunnelized catheter occurs to be a safe and reliable central venous catheter.

Adult↗
PubMed1990

[Short- and long-term outcome of 250 patients admitted in surgical intensive care units after multiple injuries].

Two hundred and fifty polytrauma patients (mean age: 30 years) had been hospitalizated in the same trauma center, along a period of two years. Hospital mortality rate was 33% (11% in the first day). The mean I.S.S. of alive patients was 25, and 35 for dead patients. Long term survey was analysed by three questionnaires (before one year, between one and two years and after two years). Answer rate was about 80%. Sixty hundred p. cent of patients worked less than one year after multiple trauma, and 80% between one and two years; 75% noted that their family life was normal less than one year after injury; 80% presented sequelae two years after; they were subjective in 60% of cases. These sequelae did not interfere with family life or work. There was no parallelism between objective sequelae and duration of work stop in one side and gravity of lesions (I.S.S.) in other side.

Adult↗
PubMed1990

Contribution to the assessment of steroid therapy in the prevention of respiratory distress syndrome in the neonate.

The respiratory distress syndrome (RDS) is a physiological manifestation of neonatal pulmonary immaturity and it is still the major cause of neonatal morbidity and mortality. In order to promote early fetal lung maturity when a preterm delivery is anticipated, a number of pharmacological agents have been investigated. Corticosteroids, in particular, have been extensively used and the results of several trials are reported in literature. A cohort of 246 consecutive singleton preterm infants, liveborn at the Obstetric Clinic of Ferrara University during a 5-year period, was studied to assess whether antenatal steroid therapy reduces the incidence of RDS. Respiratory distress developed in 18.6% of 102 babies who received treatment and in 15.3% of 144 controls, without difference at the statistical analysis. According to previous studies, a lower incidence of RDS was only observed in the treated females compared to non-treated controls (35% vs 46%) at the gestational age of 28-33 weeks. Since the efficacy of steroids seems to be restricted to a very small and specific group of babies, who, moreover are relatively mature by modern intensive care standards, the Authors suggest that the prevention of RDS and its related complications should rely much more on appropriate surveillance and management of the mother and infant than on specific pharmacological interventions.

Adrenal Cortex Hormones↗
PubMed1986

Gastrointestinal tract anomalies--neonatal medical problems.

The role of early diagnosis on the short-term prognosis of 55 infants with gastrointestinal tract malformations admitted to three neonatal intensive care units is reviewed. In this series antenatal diagnosis does not appear associated with better prognosis. The severity of the disorder and the association with other malformations are the most important determinants of outcome.

Abnormalities, Multiple↗
PubMed1985

CT findings in eclampsia.

Cranial CT was performed in five patients with eclampsia: densitometric modifications were present in all cases. Only one patient, who later died, displayed multiple foci of cerebral haemorrhage; all others presented bilateral, symmetrical, nonenhancing hypodensities with mass effect interpreted as cerebral oedema. At CT performed 7-14 days after interruption of the pregnancy, these characteristic hypodense lesions were no longer present while neurological symptoms disappeared.

Adolescent↗
PubMed1982

[Posterobasal infarction and right bundle branch block: value of computerized vectorcardiography].

The object of this study was to determine the vectocardiographic criteria of posterobasal myocardial infarction associated with right bundle branch block. Seventeen patients were examined; all had clinical and enzymatic evidence of myocardial infarction, associated with the unusual appearances of right bundle branch block with an isolated R wave in V1 and V2. The Frank X, Y, and Z axes were treated by computer to obtain a detailed octonal study of the QRS and T loops. Vectors of special interest were determined: the maximum maximorum vector and the QRS half surface vector (module, azimuth, elevation, appearance time). The octonal and total surface are of the QRS and T loops and the spatial angle of the maximal vectors of the two loops were calculated. These cases were characterised by clockwise rotation of the QRS loop in the horizontal plane. The maximal QRS vector had a decrease module (1,29 mV +/- 0,49), an azimuth greater than 20 degrees (42,8 degree +2- 20,3) an appearance time of 55,7 +/- 12,1, and an elevation which was either positive or negative depending on the presence or absence of an associated left anterior hemiblock. The half-surface vector was superimposed on the maximal vector: module (1,09 mV +/- 0,39), azimuth (45,2 degrees 23,5(and appearance time (62,0 +/- 11,7 ms). The posterior surfaces were nil or negligible (less than 1 p. 100). The T loop had a clockwise rotation in the horizontal plane and its maximal vector projected anteriorly in 8 patients. The appearances observed in these 17 cases were different to those of isolated right bundle branch block. The classical causes of anterior ORS loops could be excluded easily: right ventricular hypertrophy, Wolff-Parkinson-White syndrome, intraventricular conduction defect. The following criteria were retained in the diagnosis of posterobasal infarction associated with right bundle branch block:--principally, clockwise rotation of the QRS loop in the horizontal plane;--anterior displacement of the maximal vector with an azimuth of over 20 degrees;--disappearance of the posterior forces;--associated with the usual criteria of right bundle branch block;--clockwise rotation of the T wave loop in the horizontal plane.

Bundle-Branch Block↗