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Biomedical subjects

A Masi

Publications and source records attributed to A Masi.

At least 37 records · Page 2Linked to original sources
PubMed1994

Cardiopulmonary resuscitation in elderly patients hospitalized in the 1990s: a favorable outcome.

OBJECTIVE: To compare the clinical characteristics and survival of elderly and younger hospitalized patients who sustain cardiac arrest and receive cardiopulmonary resuscitation (CPR) in the 1990's and to assess predictors of survival. DESIGN: Retrospective survey of cardiac arrest database and hospital charts, plus telephone follow-up. SETTING: 450-bed acute care teaching hospital. STUDY POPULATION: Seventy-eight hospitalized patients 70 years or older and 73 hospitalized patients under 70 years of age. MEASUREMENTS: Survey of cardiac arrest data base, hospital charts, and telephonic follow-up to allow (1) comparison of clinical characteristics, survival, and long-term follow-up between two age groups and (2) univariate and multivariate analysis of predictors of mortality. MAIN RESULTS: Pre-arrest clinical characteristics were not significantly different between the age groups. Prior to arrest the majority of patients were functionally active, and over one-third were hospitalized for acute coronary artery syndromes. In approximately 85% of the patients, the arrest was witnessed, and 70% of the patients had their cardiac rhythm monitored at onset of the arrest. Survival was not significantly different between the age groups; 26% of the total 151 patients were discharged. No significant difference was noted in pre-post arrest functional status of survivors. Survival at 1, 2, and 3 years in elderly and younger survivors was 86% versus 80%, 76% versus 67%, and 71% versus 61%, respectively. Multivariate analysis identified the presence of coronary artery disease, admission systolic blood pressure, and functional level to be independent pre-arrest predictors of mortality. At the time of the arrest, the initial cardiac rhythm and duration of CPR were found to be independent predictors of mortality. CONCLUSIONS: Elderly patients hospitalized in the 1990's who receive CPR have outcomes similar to younger patients who receive CPR. The favorable outcome in the elderly patients may reflect patient selection: the majority of our patients were functionally active prior to hospitalization, without multiple serious illnesses; many were hospitalized for acute coronary artery syndromes; and, in most cases, the arrest was witnessed with the patient's cardiac rhythm monitored at onset of the arrest.

Adult↗
PubMed1993

[CT-guided thoracic biopsy. Personal experience with DBNH Haaga 20 G needles].

CT-guided fine-needle biopsy of the chest is nowadays a conventional diagnostic procedure, which can be furtherly improved so as to increase its diagnostic sensitivity and to reduce complications. We studied a series of possible improvements over a 2-year period (1990-1992). In our radiology department 164 CT-guided biopsies were performed in 130 men and 34 women. DBNH Haaga 20-G (15 cm) needles (Cook, Denmark) were used. This kind of needle is a coaxial cutting-edge needle used for simultaneous cytological and histological sampling. Exams were performed with a Philip Tomoscanner CX-S (scanning time: 2.8 seconds). Of 164 tissue samples, 153 (93.4%) were adequate for histological diagnosis. As for suspected neoplastic disease, our results demonstrated 108 true positives, 27 true negatives, 18 false negatives and no false positive. Sensitivity, specificity and diagnostic accuracy were 85.7%, 100% and 88.2%, respectively. In 24 cases there were minor complications--i.e., 5 cases of parenchymal hemorrhage and 19 cases of minor pneumothorax. In one case only there was major pneumothorax which required surgical drainage. On the basis of our experience, we suggest the use of such coaxial catheters as the DBNH Haaga type for the collection of both histological and cytological material because this needle reduces the need for repeated invasive and potentially dangerous maneuvers.

Adult↗
PubMed1989

Methodological evaluation of a new chemiluminescence immunoassay for thyrotropin using acridinium ester-labelled antibody.

A recently available immunochemiluminometric assay (ICMA) for TSH developed by Ciba Corning Corp. has been evaluated. This system (Magic Lite) uses an acridinium-ester-labelled antibody and magnetizable particle for bound-free separation. In each assay only two calibrators are carried out and used to re-scale a manufacturer-generated curve stored in the memory of the luminometer. The precision of the response (RLU) estimated by all duplicates of 14 runs was about 4% for responses greater than 12,000 RLU (corresponding to a concentration interval 0.7-113 microIU/ml) and worsened in the lower range (up to 10% CV); the sensitivity, computed from the mean within-assay precision profile, was 0.028 microIU/ml; the between-assay precision ranged from 4.6 to 13.1 CV%. Regression analysis of ICMA results (y) against consensus values of Behring IRMA (x) on 15 QC sera assayed in an inter-laboratory survey (concentration range 1-30 microIU/ml) gave y = -0.003 + 0.98x indicating a good agreement of the two techniques. Similar conclusions have been derived from the comparison of the ICMA results (y) in the low TSH concentration range (less than 1 microIU/ml) against the IRMA Boots Celltech (x) on 80 patient samples (y = 0.04 + 1.04x).

Acridines↗
PubMed1988

[Diagnosis by imaging in renal and urinary tract malformations. Comparison of echography and traditional radiological studies].

The diagnostic sensitivity of Ultrasound (US) was studied in 142 children with suspected kidney and urinary tract malformations. According to the clinical tests performed the patients underwent excretory urography (EU) and/or voiding cystouretrography (VCU); the results were compared to US findings. In the 75 patients with malformations, US proved to be extremely sensitive in abdominal renal ectopies, in "horseshoe" kidney, and in congenital obstructions of the ureteropelvic and vesico-ureteral junctions. US showed a higher sensitivity than EU in identifying multicystic kidney and in most cases of hypodysplasia. On the other hand, VCU was more accurate in vesico-ureteral reflux studies; US should thus be used in the follow-up of the patients undergoing medical therapy. EU must however be considered as the most important tool in the evaluation of early renal injuries and their possible development.

Adolescent↗
PubMed1985

Diagnostic approach to hepatic hemangiomas detected by ultrasound.

Eighty cases of hepatic hemangioma were studied using ultrasound. In one group consisting of 28 subjects a final diagnosis of hepatic hemangioma was supported by arteriography (21 cases) or surgery (7 cases). In the remaining 52 cases, the diagnosis was uncertain and the normal clinical and biochemical findings with the ultrasound follow-up studies at intervals of 3, 6 and 12 months, made a diagnosis of hemangioma highly probable. Twenty-nine cases (9 cases of the first group and 20 of the second) were also evaluated by Tc-99m colloid and in vivo Tc-99m-labelled red blood cell scintigraphy. On the basis of ultrasound appearance and internal structure, hemangiomas may be divided into three groups: hyperechoic pattern (of which there were 16 cases in our study), cystic or anechoic pattern (5 cases), and complex pattern (7 cases). Fifty-two cases of uncertain diagnosis showed hyperechoic focal lesions with rounded, well-defined margins and no clinical or biological abnormalities. Differentiation from malignant forms must be approached according to the specific ultrasound pattern observed and the presence or absence of symptoms. Only in cases of hyperechoic, well-defined lesions detected in asymptomatic patients may a reliable diagnosis of hemangioma be made. The use of in vivo Tc-99m-labeled red blood cell scintigraphy (Tc-99m RBC scintigraphy) is useful in hyperechoic and cystic forms having a diameter greater than 3 cm. Complex forms invariably require additional studies, using complementary procedures (angiography, angio-CT) to confirm diagnosis.

Adult↗
PubMed1982

Ribosome changes induced by irradiation of isolated rat liver in vitro.

Changes produced in ribosome populations by gamma irradiation of isolated livers (rat) are reported. The main effect was the increase in free ribosomes due to the liberation of membrane bound ribosomes. The radiation apparently injures the binding-site of the large ribosomal subunit, detaching its structural proteins. The disassembled ribosomes are rapidly catabolized by cell RNase. The amount in total and free ribosomes of the livers as a function of the radiation dose was assessed. The relative insensitivity to radiation of the free ribosome pool is discussed in terms of its implications for repair and transformation of the cells.

Animals↗
PubMed1981

The effects of captopril on blood pressure in essential hypertensive patients with low or normal plasma renin activity. Interference with autonomic nervous system.

Captopril was administered to 12 essential hypertensive patients with low or normal plasma renin activity in order to evaluate its effectiveness in decreasing blood pressure and to determine whether the inhibition of converting enzyme could interfere with sympathetic neural activity. Captopril, at the doses of 150-450 mg/die, normalized blood pressure in 5 patients (responders) and had no effect on 7 patients (non responders). A significant decrease in heart rate was observed in all patients. Captopril failed to significantly increase plasma renin activity in all patients. Supine plasma levels of catecholamines were significantly higher in responders compared with non responders and decreased significantly after treatment with captopril. The physiological study we performed on all patients suggests an overall integrity of the baroreceptor reflex arc and vascular reactivity to stress before as well as after treatment with captopril. On the contrary, the bradycardia induced by diving test was significantly greater after treatment than before therapy. These findings suggest that the antihypertensive effect of converting enzyme inhibition may be partly due to interference with sympathetic neural activity. Moreover captopril seems to exert an important effect on parasympathetic activity irrespective of blood pressure changes.

Adult↗
PubMed1980

[Thoracic duct in CT (author's transl)].

After an anatomical and anatomo-radiological introduction, the authors describe the morphological aspect of the thoracic duct examined by means of lymphangiography performed during computed tomographic examinations.

Humans↗
PubMed1979

[Multi-institution, multidisciplinary radiology and endoscopy trial of the diagnostic accuracy of the double contrast examination of the stomach surface].

In 12 X-ray and gastroenterology departments 1570 patients, clinically suspected to have a gastric pathology, have been examined by double contrast (surface) examination of the stomach followed by gastroscopy. Diagnostic accuracy was 93% in respect of endoscopic data, assumed correct by hypothesis. On the basis of a cost and benefit evaluation, made according to the well known criteria, a wider routine use of the double contrast technique is proposed.

Adolescent↗
PubMedDate not supplied

[Histologic microbiopsy with 14 G needle in the diagnosis of breast lesions. Experience with 1000 cases].

PURPOSE: We report our experience with large core biopsy (LCB: 14-Gauge needles) of questionable or suspicious breast lesions detected at mammography and/or US. All biopsies were performed under instrumental guidance. We also report on technique, costs, time, advantages and disadvantages of the method and, finally, give precise indications on when and why large core biopsy is needed. MATERIAL AND METHODS: From january 1996 to may 2000 we performed 1000 microhistologic biopsies on breast lesions at the Unità Integrata di Senologia, Azienda Ospedaliera Careggi, Florence; 650 (65%) were non palpable lesions. Large core needles were used (14-Gauge caliber). In the majority of cases (70%) we used US guidance, in the others a stereotactic guidance was employed. RESULTS: Microhistologic biopsy allowed accurate characterization in most cases. Inadequate samples were obtained in 15 cases. The false negative rate was 6%. Surgery was needed to characterize the lesion unquestionably in 13 cases only. CONCLUSION: In agreement with literature reports, our results confirm large core biopsy as an adequate alternative to surgical biopsy and, to some extent, to FNAC, thanks to its moderate invasiveness, low costs, short execution time, little patient discomfort and high sensitivity (93.98%) and specificity (99.7%).

Biopsy, Needle↗
PubMedDate not supplied

Screening of lung cancer with low dose spiral CT: results of a three year pilot study and design of the randomised controlled trial ''Italung-CT''.

PURPOSE: To report the results of a three-year observational pilot study of lung cancer screening with low dose computed tomography (CT) and to present the study design of a randomised clinical trial named as ''Italung-CT''. MATERIALS AND METHODS: Sixty (47 males and 13 females, mean age 64+/-4.5 years) heavy smokers (at least 20 packs-year) underwent three low-dose spiral CT screening tests one year apart on a single slice or multislice CT scanner. Indeterminate nodules were managed according to the recommendations of the Early Lung Cancer Action Project. RESULTS: and Indeterminate nodules were observed in 33 (55%) of the subjects (60% at the baseline screening test, 24% at the first annual test and 16% at the second annual test). The size of the largest indeterminate nodule was <5 mm in diameter in 20 subjects, 10 of whom showed the nodule at the baseline test. Forty-five subjects (75%) completed the first annual test and 42 (70%) the second annual test. One (1.6%) prevalent lung cancer (adenosquamous carcinoma) and one (2.2%) incident lung cancer (small cell cancer at the first annual examination) were observed, as well as a pulmonary localisation of Hodgkin's lymphoma (at the second annual test). In addition, one subject underwent lung surgery for a chondromatous hamartoma. CONCLUSIONS: The results of the pilot study are substantially in line with those of other observational studies of greater sample size. This justifies optimism about the reliability of the results in the screened arm of the ''Italung CT'' trial which has just begun.

Female↗
PubMedDate not supplied

[Preoperative staging of rectal carcinoma by transrectal echography combined with pelvic computerized tomography].

The accurate staging of rectal carcinoma is very important for treatment planning. The histological data obtained from the surgical specimens of 22 patients with rectal carcinoma were compared with pre- and postoperative endorectal US findings and with preoperative CT results. According to an adapted version of the Astler and Coller classification, the different degrees of tumor spread into the rectal wall were represented as follows: stage A: 1 patient; stage B1: 5 patients; stage B2: 6 patients; stage C1: 1 patient; stage C2: 8 patients and stage D: 1 patient. Preoperative staging, based on the overall results of CT and US, was in agreement with histology in 19 of 22 cases. Individual analysis of US and CT results, in comparison with histological data, showed US staging accuracy to be 77.3% (17/22 patients). US accuracy in demonstrating tumor spread into the rectal wall (stages A, B1, C1) was 100% (7/7 patients); US was 70% accurate in lymph node detection (7/10 patients) and 93.3% accurate in demonstrating perirectal infiltration (14/15 patients). CT diagnostic accuracy was 66.7% (10/15 patients) in the evaluation of perirectal lymph nodes, but tumor spread into the rectal wall (stages A and B1) could not be evaluated. While admitting the primary role of US in the staging of rectal carcinoma, according to our results a combination of US and CT yields a more accurate preoperative diagnostic picture.

Aged↗