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Biomedical subjects

A Mapelli

Publications and source records attributed to A Mapelli.

At least 19 recordsLinked to original sources
PubMed1992

Nimesulide in the treatment of advanced cancer pain. Double-blind comparison with naproxen.

In a clinical double-blind study, the analgesic efficacy and the side-effects of nimesulide (Aulin, CAS 51803-78-2) and naproxen administered to 68 patients affected by advanced cancer pain were compared. Patients were treated with non-steroidal anti-inflammatory drugs according to the first step of the pharmacological analgesic scale of the WHO. The dose administered was 200 mg b.i.d. (every 12 h) for nimesulide and 500 mg b.i.d. (every 12 h) for naproxen. From this study the analgesic effect and the tolerability of the two drugs appeared to be similar. Both drugs resulted to be effective with a low incidence of adverse events that may be related to their use.

Adult↗
PubMed1991

Fibrinolytic (rt-PA) therapy for superior vena cava thrombosis in a multiple trauma patient.

An adult multiple trauma patient (head injury with coma, blunt chest trauma, bone and pelvis fractures) developed superior vena cava thrombosis which extended to the right atrium as a complication of central venous catheterism. Since a four day heparin therapy was unsuccessful, the patient was treated with recombinant tissue-type plasminogen activator (rt-PA), 100 mg over three hours. Thrombolysis with rt-PA was not associated with cutaneous or internal bleeding and was partially effective (improvement of the clinical picture, disappearance of the right atrium thrombus, superior vena cava still occluded). Although our patient could have benefited from an additional administration of rt-PA, we did not start a second course because the risk of major hemorrhage increases over 100 mg. For its relative clot-selectivity rt-PA could be indicated when fibrinolytic treatment is required in multiple trauma patient, but safe and more efficacious regimens have still to be defined.

Adult↗
PubMed1990

1,2-Dichloropropane (DCP) toxicity is correlated with DCP-induced glutathione (GSH) depletion and is modulated by factors affecting intracellular GSH.

Acute 1,2-dichloropropane (DCP) poisoning in humans is relatively frequent in Italy, where DCP is widely diffused as a constituent of commercial solvents and dry cleaners. In this study we have investigated the effects of DCP on intracellular glutathione (GSH) content in main target tissues of male Wistar rats, i.e. liver, kidney and blood, in order to establish if a correlation between DCP-induced GSH depletion and tissue damage exists. Administration of DCP (2 ml/kg body weight orally) caused a dramatic loss of tissue GSH occurring 24 h after DCP intoxication, followed by a slow restoration approaching physiological levels after 96 h. GSH depletion was associated with a marked increase in serum GOT, GPT, 5'-nucleotidase, gamma-glutamyl transpeptidase, alkaline phosphatase, urea and creatinine, and a significant degree of hemolysis. When animals were pretreated with a GSH depleting agent, buthionine-sulfoximine (BSO) (0.5 g/kg body weight) i.p. 4 h before DCP intoxication, an increase of overall mortality was found, significantly different from the group of animals treated with DCP alone. On the contrary, the administration of a GSH precursor, N-acetylcysteine (NAC) i.p. (250 mg/kg body weight) 2 and 16 h after DCCP intoxication prevented the dramatic loss of cellular GSH and reduced the extent of injury in target tissues, as demonstrated by laboratory indices. Furthermore, statistical analysis of the data revealed a correlation between: (1) depletion of liver GSH and increase in serum GOT, GPT, 5'-nucleotidase, (2) depletion of kidney GSH and increase in serum urea and creatinine and (3) depletion of blood GSH and the occurrence of hemolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

5'-Nucleotidase↗
PubMed1990

[D-glucaric acid. A new method proposed to investigate damage from exposure to anesthetic gas and vapors].

Acute exposure and hepatotoxicity following full anesthetic doses is controversial, despite various experimental trials. On the other hand, microsomial enzyme induction following the chronic use of anesthetic gases and vapours, even with minimal metabolism, has been established. Therefore, there is increasing interest in the field of prevention to develop techniques and instruments to minimize pollution of anesthetic vapours and screening methods to detect early liver-damage. We have evaluated the reliability of D-Glucaric Acid test in monitoring microsomial enzyme induction after anesthesia. We evaluated urinary excretion of D-Glucaric Acid before and after exposure to anesthetic gases in 53 subjects, including medical personnel and patients. Statistical analysis of these data confirm the usefulness of this technique to assess acute liver damage in patients undergoing general anesthesia (postoperative increase of 10.5 microns/l as average value of urinary acid excretion, chi 2 = 9.8; p less than 0.01). This technique is also valuable in demonstrating damage in operating room personnel due to chronic exposure (base values greater than 12 microns/l in anesthesiologists with a 9 microns/l increase at the end of surgical intervention, chi 2 = 8.1; p less than 0.01). Data of patients submitted to local anesthesia are more difficult to interprete. They presented a decrease in acid urinary excretion (less than 10 microns/l; chi 2 = 1.93; p less than 0.2) probably due to hemodynamic changes which occurred during spinal block or due to degree of sedation related to de-afferentation itself.

Adult↗
PubMed1990

[The preventive minitracheotomy as support in difficult intubations: a proposition. Description of a clinical case].

The authors suggest preventive minitracheotomy as a support technique in difficult endotracheal intubation, and report their experience in a case of surgical operation to remove a bony neoformation of C1 and C2 posterior arcs. Endotracheal intubation, difficult because no part of the glottis could be seen, was made possible by preventive minitracheotomy. In this way sedation, myorelaxation and excellent oxygenation during following manoeuvre that resulted atraumatic, were obtained. The small cannula of minitracheotomy was maintained closed during the operation and open for 24 hours thereafter to prevent obstructive complications. It was then removed.

Adult↗
PubMed1990

Blood transfusion during cesarean section. A 12 years' retrospective analysis.

Transfusional practice over the last 12 years was investigated retrospectively in 1618 women submitted to lower-segment cesarean section. The overall percentage of transfused patients was low (2.4%) and it has become lower in the last four years (1.1%), in concomitance with the development of better knowledge of tissue oxygenation and with the fear of transmitting infectious diseases, factors which have led anesthesiologists to employ blood only when strictly required. Three conditions greatly increased the risk of bleeding: placenta previa, abruptio placentae and coagulation disorders. Previous cesarean section, fetal distress, dystocias and hypertensive disorders of pregnancy did not increase the risk of bleeding and no difference was found between elective and non-elective surgery. Since for elective surgery two units of blood were crossmatched, the crossmatched/transfused ratio (C/T ratio) was very high (60.8/1). To improve blood bank service efficiency, for surgical operations like cesarean section which rarely require blood, it is possible simply to recur to a type and screen (TS) procedure instead of crossmatching blood, but for categories of patients identified as being at high risk of bleeding--placenta previa, abruptio placentae, coagulation disorders--it is advisable to have crossmatched blood available in the operating theatre.

Abruptio Placentae↗
PubMed1988

A new method for separate lung ventilation.

Separate lung ventilation is obtained with selective intubation of the main bronchus by an appropriate cuffed tube inserted through a standard orotracheal tube. Ventilation is carried out separately through the bronchial tube on one side and the residual tracheal tube lumen on the other side. This method, used in 144 patients, greatly simplifies the technique of bronchial intubation and offers many advantages over commercially available double-lumen tubes.

Bronchi↗