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Biomedical subjects

R Zatelli

Publications and source records attributed to R Zatelli.

At least 19 recordsLinked to original sources
PubMed2002

Air embolism: diagnosis with single-photon emission tomography and successful hyperbaric oxygen therapy.

Venous air embolism may occur when the surgical field is above the level of the heart. We present a case of venous air embolism in a patient undergoing percutaneous nephrolithotripsy in the prone position and presenting with blindness and neurological deficits 8 h later. The clinical diagnosis of paradoxical air embolism was confirmed by early single-photon emission tomography (SPET), whereas magnetic resonance imaging including diffusion-weighted imaging (DW-MRI) was diagnostic only 30 h later. Hyperbaric oxygen therapy was successful. In this case, early DW-MRI scan was inconclusive, but a SPET study of the brain appeared to be useful in confirming the clinical diagnosis. Early hyperbaric oxygen was demonstrated to be a successful therapy.

Adult↗
PubMed1997

Perioperative analgesia for caesarean section: comparison of intrathecal morphine and fentanyl alone or in combination.

In a double-blind placebo-controlled trial we compared perioperative pain relief using different intrathecal opioid regimens given with bupivacaine during spinal anaesthesia for elective caesarean section. One hundred and sixteen patients undergoing elective caesarean section were divided into four groups (A, B, C, D) of 29 patients each. In addition to hyperbaric bupivacaine (12-14 mg), group A received 1 ml of normal saline, group B 25 microg of fentanyl, group C 100 microg of morphine, and group D received both fentanyl 25 microg and morphine 100 microg intrathecally. The quality of intraoperative analgesia was similar in all the groups receiving opioid. The use of the opioids in association, however, was found to increase the incidence of side-effects. The quality of postoperative analgesia with fentanyl, when used alone, was found to be inferior to that with morphine. The combination of opioids offered no advantage over morphine alone.

Clinical Trial↗
PubMed1997

Isofenphos poisoning: prolonged intoxication after intramuscular injection.

We report a unique case of attempted suicide by intramuscular injection of the organophosphate isofenphos which resulted in a muscarinic and nicotinic syndrome lasting 15 days and requiring prolonged mechanical ventilation and hospitalization. The patient, who demonstrated no signs of delayed polyneuropathy on hospital day 25, subsequently died of pneumonia. Toxicological investigations showed isofenphos plasma decay and confirmed the intramuscular route of poisoning. We believe continuous isofenphos absorption resulted in the prolonged intoxication observed in this patient.

Aged↗
PubMed1996

Limitations of jugular bulb oxyhemoglobin saturation without intracranial pressure monitoring in subarachnoid hemorrhage.

We report a case of subarachnoid hemorrhage in which, even after having obtained a normal jugular bulb oxyhemoglobin saturation, cerebrovenous desaturation developed, and brain death occurred. The limitations of jugular bulb oxyhemoglobin saturation without intracranial pressure monitoring are discussed. We conclude that if increased intracranial pressure is suspected, use of jugular bulb oxyhemoglobin saturation monitoring alone would appear to be substantially limited.

Female↗
PubMed1994

Pain relief after caesarean section: comparison of different techniques of morphine administration.

We have studied postoperative pain relief after different techniques of morphine administration given in addition to bupivacaine 15 mg during spinal anaesthesia for caesarean section. In group A, morphine was given both intravenously (10 mg) and orally (30 mg slow release MST) at the end of surgery and continued orally at 8-hourly intervals for 24 h. In group B morphine (80 microg) was given intrathecally only, with the bupivacaine. Both quality of analgesia and duration of action were better in group B, while most side-effects were more frequent in group A where a mild self limiting respiratory depression occurred in 38% of patients. Pruritus was, on the other hand, observed in 48% of patients of group B compared to 7% of the patients of group A. This study suggests that adding 80 microg of morphine to the local anaesthetic used in spinal anaesthesia for caesarean section is a simple procedure that gives excellent results in term of reliability, duration of analgesia and safety.

Journal Article↗
PubMed1991

Rhabdomyolysis and operating position.

Rhabdomyolysis during routine surgery was studied in three groups of patients who had surgery, with limited trauma to muscle, in the lateral and supine positions, and prone on the spinal frame. A range of blood tests was performed (before surgery, and on the first, third and seventh day after operation). These showed that a creatine kinase increase in the 24 hours and the early appearance of myoglobin in the serum were the best indicators. Rhabdomyolysis was associated with the lateral position and long lasting surgery. No blood test before surgery was of any predictive value.

Adult↗
PubMed1990

Acute poisoning with methidathion: a case.

An acute poisoning in a 50-year-old man who ingested approximately 6.2 g of the phosphorus ester methidathion is described. The patient was treated with three haemoperfusions 23, 44 and 115 h after ingestion, with continuous gastric lavage, atropine and pralidoxime administration and with prolonged mechanical ventilation. Haemoperfusion was an ineffective epuration technique since it removed only 0.22% of the ingested methidathion. The clinical course wavered because of a probable redistribution of phosphorus ester from fat to blood. A plasma level higher than 100 micrograms l-1 was associated with the most serious phases. Methidathion was present in the plasma until the sixth day, in the urine until the seventh and in the gastric juice until the eighth. Its absence in the fat biopsy made on the tenth day was an aid to therapy. The phosphorus ester did not inhibit lymphocyte neuropathy target esterase (NTE), neither did it induce development of delayed polyneuropathy.

Acute Disease↗
PubMed1989

[Mathematical approach to the study of the capnographic curve].

An application of Hill's formula in the interpretation of slope of second phase of capnographic curve is suggested. This method can be used to demonstrate an acute rising of airway resistances, but failed to discriminate between normal and chronically broncho-pulmonary obstructed subjects. We suggest that a study of modifications of second phase slope and Q angle can give more information about airway resistances.

Adolescent↗
PubMed1989

[The discriminant function of an early prognostic index in the monitoring of cranial trauma].

A method for statistical evaluation of a prognostic index in head injuries (I.P.T.C.) is described. This index, obtained by the sum of results of clinical and cerebral electrophysiologic tests was precociously carried out on 53 head injured subjects. A multiple regression formula, furnished with better discriminant power than experimental I.P.T.C. is suggested.

Brain Injuries↗