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Biomedical subjects

R Pavia

Publications and source records attributed to R Pavia.

22 records · Page 2Linked to original sources

[Haemothorax and chylothorax: surgical approach].

Diseases causing blood accumulation in the pleural space (or haemothorax) are usually very demanding for diagnosis and require a multidisciplinar therapeutical approach in emergency. So, their treatment should always be immediate and should aim to restore the optimal patient's haemodynamic conditions and to find the site of bleeding. Chylothorax, a lymphatic effusion in the pleural space, is also a very important pathology, as it effects the nutritional and immunological state of the patient causing pleural involvement and respiratory insufficiency. Stabilisation of vital parameters with adequate systemic therapies (blood perfusions, fluids and pro-coagulation factors, TPN) preceeds surgery, which can be the placement of a thoracic drain or emergency thorascopy and/or thoracotomy. The Authors report the casistic of the latest three years for diagnosis and treatment of haemothorax and chylothorax stressing the advantages of a minimal invasive approach for evacuation and identification of the origin of bleeding and haemorrhage and/or lymphatic effusion control.

Adult↗

[Safety and effectiveness of lung volume reduction surgery for treatment of chronic obstructive pulmonary disease].

Lung volume reduction surgery (LVRS) has been proposed and performed in order to decrease dyspnea and improve wordly life without major impairments in oxygen-dependent patients affected by serious chronic obstructive pulmonary disease (COPD) and severe dyspnea that doesn't suffer drastic alterations notwithstanding rehabilitation procedures tailored for the specific case. The purpose of LVRS is to optmize thoraco-pulmonary dynamics, considerably compromised in these patients, relaxing the serious expiratory restraint to airflow and improving the muscular respiratory functionality. In this work the authors bring forth the physio-pathological foundations that justify the use of LVRS, also analyzing data brought by the international literature about surgery guidelines, short-term morbidity and mortality, clinical-functional effects and long-term survival. They also underline the need for careful evaluation research, aimed at getting a precise account of cardio-respiratory functional outcome, that will enable the positive accomplishement of the demanding and risky surgery, especially whenever the pathology has reached remarkable proportions or appears to be bilaterally localized. Only committing to painstaking analysis, setting and customization protocols, the latter especially addressing carefully chosen patients, can the surgeon rely on to achieve both short and long-term positive outcomes.

Humans↗

[Malignant pleural mesothelioma: early diagnosis and multimodality management].

Malignant pleural mesothelioma (MPM) is a cancer with a poor prognosis, and its incidence increase, mainly as a result of exposure to asbestos. Universally acknowledged therapeutic approaches still don't exist at the moment, because of its refractory behaviour to all standard therapies; treatment protocols inclusive of either surgery, radiotherapy or chemotherapy have been largely employed, but usually with little impact on survival. For potentially operable pleural mesotheliomas new treatments tend to combine surgery both with new chemotherapy drugs and radiotherapy, in order to improve remarkably survival rates in selected cases. Other approaches, i.e. palliative, proved to be useful in the treatment of two major symptoms, namely dyspnea and thoracic pain. In this work the Authors are reporting their experience with malignant pleural mesothelioma, stressing the role of videothoracoscopy in the early diagnosis, weighing the radical cancer resection option and the effectiveness of multimodal treatment.

Adult↗

[Post-operative analgesia in thoracic surgery: physiopathological features, therapeutic framework and methodologies].

Pain after surgery is a major handicap for patients as it bounds and decreases ability for spontaneous movement, cough and deep breathing, aiding the onset of complications and invalidating the recovery capabilities of operated patients. In thoracic surgery, the need to compile and employ guidelines for post-surgical pain management has become a pressing requirement in recent years. Currently available protocols include several options of treatment that are frequently a subject in the most recent scientific papers and play a key role, as they constitute the framework upon which building with changes and fixes that take account of incidental circumstances, in relation to both patients and surgery, again for both the organizational and structural features of the surgical environment. Purpose of this job is a thorough analysis of post-operating analgesic treatments for thoracic surgery, introducing the most effective ones currently available as for channels and procedures of administration, as well as possible side effects or complications.

Analgesia↗