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Biomedical subjects

P Pietri

Publications and source records attributed to P Pietri.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Successful cardiac transplantation after 38 days of circulatory assistance with a heterotopic artificial heart].

The survival of a patient with irreversible cardiac failure on the cardiac transplantation waiting list was assured for 38 days by circulatory assistance with heterotopic Pierce Donachy prosthetic ventricles and followed by successful cardiac transplantation. This method of circulatory assistance is relatively simple to install from the technical point of view and provides a satisfactory haemodynamic result whilst waiting for a compatible donor organ. Several complications, some of them serious, were observed. Some were related to the patient's poor preoperative condition: acute renal failure, disorders of coagulation. These regressed slowly when the patient's haemodynamic status improved. On the other hand, septic problems and local haemorrhage were inherent to this technique. These are the commonest complications reported by other authors. Although the mortality rate during the period of circulatory assistance may appear to be high, this technique remains a valuable method of survival for selected patients and does not affect the chances of success of ulterior cardiac transplantation.

Acute Kidney Injury↗
PubMed1989

[Detection of acute rejection by Doppler echocardiography in orthotopic cardiac transplantation. Prospective comparative study with endomyocardial biopsy].

In a prospective study of 23 patients who had undergone orthotopic heart transplantation we tried to assess the value of doppler-echocardiography in the detection of acute graft rejection. For this purpose, 220 echocardiographic records were compared with the results of endomyocardial biopsies performed at an interval of less than 12 hours. The parameters investigated by TM and two-dimensional echocardiography were: morphological parameters (including septal echodensity), left ventricular mass and systolic function parameters. Diastolic parameters (isovolumetric relaxation time [IVR], transmitral gradient half-decrease time [T 1/2] and proto-end-diastolic mitral velocity ratio [E/A] were measured by TM echocardiography and pulsed doppler velocimetry. The best doppler-echocardiographic criteria for graft rejection were a more than 15 ms reduction of IVR, a more than 15 p. 100 increase of myocardial mass, and a more than 30 p. 100 increase of teh E/A ratio, the corresponding sensitivities for histological rejection being 82, 76 and 74 p. 100 respectively. In contrast, T 1/2 and systolic function studies seemed to be disappointing. Finally, the increase of septal echodensity enabled rejection to be diagnosed with an excellent (92 p. 100) specificity but an insufficient sensitivity. Thus, none of the parameters measured were sensitive enough, taken separetely, to replace endomyocardial biopsy. However, the combined use of the most sensitive of them should make it possible to reduce the frequency of systematic biopsies.

Acute Disease↗
PubMed1986

[Complications of vascular prosthesis].

The main complications deriving from the use of vascular prostheses in the surgical reconstruction of the arteries are thrombosis, infection and the appearance of pseudoaneurysms. Among 233 aorto-femoral b.p., prosthetic thrombosis occurred in 45 patients creating the need for 66 reoperations, 19 early and 47 tardive. In 387 aorto-iliac reconstructions, infection arose early in 11 cases, tardively in 6. Out of 1118 vascular reconstructions there were also 28 pseudoaneurysms (2.5%). After remarks on the aetiopathogenesis of such complications, methods that can be used to prevent them are discussed and personal results of treatment are presented.

Aneurysm↗
PubMed1984

Telethermography and axillary node status as predictors of early relapse in breast cancer: preliminary report.

The authors report on 141 primary, non-metastatic, breast cancer patients with a minimum follow-up of 12 months after surgery to a maximum of 5 years. All cases were studied according to the patterns of the preoperative telethermography (TH) and nodal status (N). Prognosis was evaluated in terms of incidence of relapse. A statistically significant correlation was found between TH+ and early relapse, and for N+, but there was no correlation between TH and N, both for negative and positive values. The results suggest a complementary prognostic value of the two parameters.

Breast Neoplasms↗
PubMed1981

[Current indications for lumbar sympathectomy in obstructive arteriopathies of the lower extremities].

Reference is made to personal experience (421 lumbar sympathectomies in 1640 vascular operations carried out over the last ten years) and the results of an enquiry addressed to more than 200 Italian surgeons are cited for the proposition that the indications for this operation are still the subject of disagreement, while its results occasionally appear to be contradictory. It is felt that the procedure is best reserved for cases in the second initial or intermediate stage, and should only be employed in advanced 2nd-stage, and 3rd and 4th stage patients whose poor general condition is a contraindication to reconstruction (indication of necessity). Other parameters to be taken into consideration include: age, site and type of the obliterating disease, ineffectiveness of drug management, and concomitant diseases (if any). Sympathectomy plus reconstructive surgery should only be used in cases where the run-off seems unsatisfactory.

Amputation, Surgical↗
PubMed1980

[Use of laminar flow apparatus in vascular surgery].

Post-operative infection is one of the main risks attached to surgery, especially when synthetic materials or artificial prostheses are employed. The fundamental principles of laminar flow apparatuses are described, with particular reference to one employing a horizontal flow and fluid bulkheads. During the first two years of its use, this particular apparatus has reduced cases of infection from prostheses in vascular surgery from 5.5 to 1.8%.

Air Conditioning↗
PubMed1980

[Clinical aspects and therapy of malignant neoplasms of the anal margin and canal].

The Authors, on the base of their experience by the Institutes of Surgical Semeiotics at the Trieste University and of Surgical Pathology at the Padua University, report 30 cases of malignant neoplasms of the anus and the anal canal. 17 patients were males and 13 females. Pathological, clinical and diagnostic problems are discussed. The Authors stress the value of surgical therapy, consisting in a simple local excision or in a wide abdominoperineal resection in conformity with the distinctive features of every single neoplasm. The surgical strategy against nodal metastases is proposed, and the results which are obtained by combining surgery and irradiation are analysed. It is opinion of the Authors that surgical therapy is the most suitable approach for radical treatment of these neoplasms, even if early experience with multimodality therapy is promising to be a great success.

Adenocarcinoma↗