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Biomedical subjects

D Desiderio

Publications and source records attributed to D Desiderio.

At least 19 recordsLinked to original sources
PubMed1998

Critical issues in early extubation and hospital discharge in thoracic oncology surgery.

Of the 3,231 thoracic procedures performed between July 1, 1994, and June 30, 1996, 8.9% of patients were ventilated postoperatively; 3.1% required an intensive care unit (ICU) stay of a median of 8 days. Of those patients admitted to the ICU, 29% died; 10% of patients requiring postoperative ventilation were subsequently admitted to the ICU. The majority of thoracic surgical patients are extubated at the end of the procedure. Those patients that are left intubated and go to the ICU have a higher mortality rate and a prolonged hospital stay.

Anesthesia, General↗
PubMed1994

Streptococcus pneumoniae in human immunodeficiency virus type 1-infected children.

The purpose of this study was to characterize systemic Streptococcus pneumoniae disease in human immunodeficiency virus type 1 (HIV-1)-infected children. All cases of bacteremia and meningitis caused by S. pneumoniae among children less than 18 years old were collected by review of the Microbiology Laboratory records at the Bellevue Hospital Center during the period August 1, 1978, through July 31, 1993. There were 31 bouts of systemic S. pneumoniae disease in 19 of 235 HIV-1-infected children cared for by the Pediatric Infectious Disease staff and 116 bouts in 113 children not known to be HIV-1-infected. Four of the 19 HIV-1-infected children had multiple episodes of S. pneumoniae bacteremia as compared with 3 of 113 in the general population (P = 0.008). The frequency of serotypes and distribution of infections by season of the year did not differ between the 2 groups. The median ages at the time of the S. pneumoniae infection were 1.8 and 1.1 years for the HIV-1-infected children and the general population of children, respectively, when those children with multiple episodes were included for their initial episode only (P = 0.06). In the HIV-1-infected patients, 10 episodes were associated with pneumonia, 5 with pneumonia and otitis media, 5 with otitis media only, 1 with pneumonia and meningitis, 1 with meningitis only and 1 with periorbital cellulitis; 5 had no apparent focus of infection. One episode of pneumonia was complicated by lung abscess and there were 2 deaths. Most HIV-1-infected patients recovered without significant sequelae, and the clinical course of their systemic infections did not appear to be markedly different than that of healthy children.

AIDS-Related Opportunistic Infections↗
PubMed1989

Phorbol dibutyrate inhibits release and action of endothelium-derived relaxing factor(s) in canine blood vessels.

The effects of phorbol esters on endothelium-dependent relaxations evoked by ACh and the calcium ionophore A23187 were analyzed in isolated canine femoral and coronary arteries mounted in organ chambers or in a bioassay system. In rings of femoral and coronary arteries, phorbol 12,13-dibutyrate (PDBu) (10(-7) M) evoked contraction (ED50 2.9 x 10(-8) M) and depressed endothelium-dependent relaxations to ACh (4-fold increase in ED50 and 72% depression of maximal response). PDBu depressed maximal relaxations to A23187 by 50% but had no effect on ED50. The inactive phorbol ester 4-alpha-phorbol didecanoate (10(-7) M) did not evoke contractions and had no effect on endothelium-dependent relaxations to ACh or A23187. Endothelium-independent relaxations to sodium nitroprusside were not effected by PDBu (10(-7) M) in femoral or coronary arteries. In bioassay experiments, selective treatment of perfused femoral artery segments with PDBu (10(-8)-10(-6) M) caused concentration-dependent inhibition of basal and ACh- (10(-6) M) and A23187-(10(-6) M) induced release of endothelium-derived relaxing factor (EDRF) (as assessed by relaxation of superfused bioassay coronary artery rings without endothelium). PDBu inhibited these responses with different potency: basal (10(-8) M) greater than ACh (10(-7) M) much greater than A23187 (only partial inhibition at 10(-6) M).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗
PubMed1986

Penicillin tolerant group A streptococci.

A penicillin (PCN) tolerant [minimal inhibitory concentration (MIC) less than or equal to 0.02, minimal bactericidal concentration (MBC) = 3.10 micrograms/ml] group A streptococcus (GAS) was recovered from the bone aspirate of a child with osteomyelitis. The penicillin therapy with 200,000 micron/kg X day, and subsequently ampicillin 360 mg/kg X day, resulting in a serum ampicillin concentration of 74 micrograms/ml, failed to achieve a serum bactericidal effect greater than 1:2. Ninety-nine additional isolates of GAS obtained from 99 infants and children with pharyngitis were randomly selected for study. Organisms were screened for tolerance by macrobroth dilution determination at 0.05 and 1.0 microgram/ml of penicillin. Twenty-two of 100 organisms had MICs = 0.05 microgram/ml and MBCs = 1.0 microgram/ml; further tests were performed on these organisms. Twenty of the 22 strains (20% of all GAS) grown in Mueller-Hinton broth with 2% sheep blood were tolerant to penicillin at 24 hr, with MICs less than or equal to 0.02 and MBCs = 0.39 microgram/ml. When retested at 48 hr the MBCs of the 20 tolerant strains had decreased: three strains by twofold, three strains by fourfold, four strains by eightfold, one strain by 16-fold, and nine strains by 40-fold or greater. Seven strains were not tolerant after 48 hr of incubation. The detection of tolerance was media dependent; only nine strains were tolerant when grown in Todd-Hewitt broth. Tolerance to GAS was more frequent than generally suspected. The phenomenon of tolerance, and potentially delayed killing may alter prophylaxis and therapy of GAS disease and merits further investigation.

Chickenpox↗
PubMed1981

Effect of dexamethasone on the synthesis of dipalmitoyl phosphatidylcholine.

Glucocorticoids are known to enhance surfactant production by stimulating the formation of phosphatidylcholine. This study was performed to determine the effect of steroids on one of the pathways involved in the incorporation of palmitic acid into phosphatidylcholine--the 'deacylation-reacylation pathway'. Palmitoyl CoA synthetase, lysopalmitoyl cholineacyltransferase and phospholipase A2 were enhanced significantly as a result of direct administration of dexamethasone into 27-day fetal rabbits. Cycloheximide inhibited the steroid induced enhancement of activity. Immunologic studies demonstrated an accelerated rate of synthesis of palmitoyl CoA as a result of the dexamethasone treatment. The data suggest that steroids are capable of inducing enzymes of the 'deacylation-reacylation pathway' involved in palmitate incorporation into phosphatidylcholine thereby contributing to the acceleration of dipalmitoyl phosphatidylcholine biosynthesis.

1-Acylglycerophosphocholine O-Acyltransferase↗
PubMed1981

The effects of terbutaline on the acid base balance and circulation of chronically instrumented pregnant sheep.

Terbutaline is considered an effective beta agonist with beta 2 character, for the inhibiton of labor. Its safety was evaluated in twelve infusions of 1,500 micrograms over 30 min, to 8 'steady state' pregnant sheep of 110--134 days of gestation. Experimentation was performed at least 4 days postoperatively. Maternal (n = 12) and fetal (n = 7) arterial blood samples were drawn at 0, 10, 20, 30, 60- and 90 min from the start of the infusion. Uterine blood flow (UBF), blood pressure (BP), and heart rate (HR) were monitored continuously. Maternal pCO2, bicarbonate (HCO-3), and base excess (BE) decreased significantly during the infusion. Maternal pH, pO2, and O2% saturation of the hemoglobin (O2%) remained constant. Maternal hemoglobin (Hb) increased significantly at 10 min. A significant maternal hypotension and tachycardia followed the infusion. UBF decreased by 26% at the end of infusion, recovering by 60 min. Fetal pH, pCO2, Hb, O2%, BP, HR, HCO-3, BE, and CO2 content all remained stable for the duration of the experiment. Fetal arterial pO2 transiently increased at 10 min. No other significant fetal effects were observed.

Acid-Base Equilibrium↗
PubMed1981

Effect of nicotine sulfate on the hemodynamics and acid base balance of chronically instrumented pregnant sheep.

The maternal and fetal effects of nicotine sulfate (15 mg/10 min) upon the hemodynamics and acid-base balance were evaluated in 9 intravenous infusions to 5 chronically instrumented pregnant sheep preparations of 97-117 days of gestation. Experiments were performed from 2 to 11 days postoperatively. Maternal (n = 9) and fetal (n = 8) arterial blood samples were simultaneously drawn at 0, 10, 30 and 60 min from the start of infusion. Maternal arterial pH transiently increased from 7.47 +/- 0.01 to 7.51 +/- 0.01 units (p less than 0.01) at 10 min. Maternal arterial base deficit simultaneously fell from -2.41 +/- 1.3 to -0.3 +/- 1.1 mEq/l (p less than 0.01). Maternal blood pressure increased during the infusion from 90.8 +/- 3.8 to 118.7 +/- 5.6 mm Hg (p less than 0.005) at 10 min, remaining elevated at 30 min. Maternal heart rate transiently rose from 97 +/- 6 to 107 +/- 6 beats/min (p less than 0.01) at 1 min, returning to control levels by 10 min. 10 min into infusions a decrease in uterine blood flow was recorded as 28.7 +/- 9.0% (p less than 0.02) below preinfusion values. A gradual recovery to -8.5 +/- 2.9% ws observed (p less than 0.025) at 60 min. Fetal blood pressure also decreased transiently from 52.6 +/- 2.3 to 50.2 +/- 2.0 mm Hg (p less than 0.05) during the infusion. Fetal arterial PCO2 fell from 41.1 +/- 3.1 to 37.2 +/- 2.5 mm Hg (p less than 0.05) at 10 min. A transient increase was seen in fetal heart rate from 197 +/- 12 to 215 +/- 15 beats/min (p less than 0.05) at 30 min. No significant changes were seen in fetal arterial PO2 and O2% saturation of hemoglobin. All maternal and fetal values except uterine blood flow returned to preinfusion levels by 60 min.

Acid-Base Equilibrium↗
PubMed1981

Effect of aminophylline on the synthesis of dipalmitoyl phosphatidyl choline in fetal rabbit lung.

Aminophylline (A) administration to pregnant rabbits resulted in accelerated formation of phospholipids, the known important components of pulmonary surfactant [1]. The present study was undertaken to determine the effect of A on one of the pathways involved in the incorporation of palmitic acid into phosphatidyl choline (PC)--the "deacylation-reacylation pathway." A was injected intraperitoneally into rabbit fetuses at 27 days of gestation and its effect on palmitoyl CoA synthetase (PCS) and lysopalmitoyl choline acyl transferase (LPC-AT) were studied. Only LPC-AT was enhanced significantly (P less than 0.05) as a result of direct administration of A. This study supports the suggestions by previous investigators that antenatal administration of aminophylline may prove to be an effective means of enhancing lung maturation by stimulating the formation of pulmonary surfactant production before premature delivery. However, the dose that was used in this experimental study was far more than the usual clinical dose that had been suggested previously.

1-Acylglycerophosphocholine O-Acyltransferase↗
PubMed1981

Effects of isoxsuprine on maternal and fetal acid-base balance and circulation.

Prematurity is a large contributing factor to neonatal morbidity. An obstetric alternative to premature labor is administration of isoxsuprine, an effective inhibitor of uterine contractions. Six crossbred unanesthetized pregnant ewes were used to determine the effects on fetal and maternal cardiovascular and acid-base status of 10 maternal intravenous infusions of 30 mg isoxsuprine over 30 minutes (1 mg/min). Isoxsuprine caused slight maternal hypotension and a transient acidosis, both of which returned to baseline values within 60 minutes. Maternal tachycardia persisted throughout the experiment. A slight decrease in the oxygen percent saturation of the hemoglobin and the calculated O2 content was observed after the infusion. There was no significant change in uterine blood flow. Maternal lactate concentration transiently increased at 60 minutes only. In the fetus, isoxsuprine caused transient hypotension and tachycardia. Fetal arterial PCO2, calculated bicarbonate concentration, and O2 content all decreased slightly at 45 minutes only. Fetal hyperglycemia was observed after the infusion throughout the experiment. All other fetal values returned to baseline levels within 60 minutes. It is suggested that 30 mg isoxsuprine can cause tolerable maternal and fetal metabolic and physiologic effects when administered intravenously to the unanesthetized pregnant ewe.

Acid-Base Equilibrium↗
PubMed1980

Studies of circulation and acid-base balance in pregnant sheep: I. The effect of aminophylline infusion.

The maternal and fetal effects of aminophylline on hemodynamics and acid-base and blood gas balances were evaluated by 11 infusions to four chronically catheterized sheep at 114-142 days' gestation. Maternal and fetal arterial blood samples were drawn for baseline determination at 15-minute intervals. Mean maternal and fetal pH levels and heart rates increased significantly. Respiratory alkalosis was indicated by a concomitant fall in mean maternal carbon dioxide pressure. We conclude that aminophylline infusion (5.6 mg/kg of body weight/15 min) to pregnant sheep may cause maternal and fetal tachycardia and alkalosis, with a possible increase in uterine blood flow, but no changes in fetal blood gas status or blood pressure.

Acid-Base Equilibrium↗
PubMed1980

Studies of circulation and acid-base balance in pregnant sheep: II. The effect of magnesium sulfate infusion.

Ten infusions of magnesium sulfate, in clinical doses for toxemia therapy, were administered to seven chronically catheterized ewes at 109-126 days' gestation. Maternal and fetal Mg++ concentrations in arterial serum indicated hindered placental passage. A significant decrease in maternal arterial oxygen pressure and hemoglobin was seen at 15 minutes. A significant increase in maternal arterial carbon dioxide pressure and transient maternal hypotension and tachycardia were seen at five minutes. Fetal effects of maternal infusion were minimal and transient. All maternal and fetal parameters returned to control levels by 90 minutes.

Acid-Base Equilibrium↗
PubMed1979

Effects of ethanol on the circulation and acid-base balance of pregnant sheep.

Nine infusions of 15 cc/kg/120 min of 9.5% ethanol were administered to 4 chronically catheterized ewes, at 109-135 days' gestation. Stabilization periods ranged from 6 to 28 days postoperatively. Maternal and fetal concentrations of ethanol were almost identical (r = 0.9925), with peak levels of 122 +/- 20 mg/100 ml (mean +/- 1 SE) and 121 +/- 19 mg/100 ml, respectively, at the end of infusion. Maternal pH decreased from 7.50 +/- 0.02 to 7.44 +/- 0.02 (P less than 0.005) at 120 minutes. Maternal glycemia increased from 76 +/- 14 mg/100 ml to 162 +/- 23 mg/100 ml (P less than 0.005) at 120 minutes. Maternal heart rate, blood pressure, PO2, O2 content, PCO2, and bicarbonate remained unchanged. Fetal PO2 increased during and following infusion from 18.9 +/- 0.9 mmHg to 22.0 +/- 1.0 mmHg (P less than 0.005) at 180 minutes. Fetal blood pressure increased from 51.3 +/- 3.1 mmHg to 53.7 +/- 3.3 mmHg (P less than 0.01) at 30 minutes. Fetal pH, PCO2, glucose, and lactate levels remained unchanged. The authors conclude that ethanol crosses the sheep placenta readily, causes maternal acidosis and hyperglycemia, and increases fetal PO2, blood pressure, and heart rate without any effects on fetal acid-base status.

Acid-Base Equilibrium↗
PubMed1977

Naltrexone and cyclazocine. A controlled treatment study.

The induction side effects of cyclazocine and naltrexone were compared in double-blind placebo-controlled studies involving 40 patients (20 for each drug). These studies were carried out with a twice-a-day dosage regimen. Naltrexone produced fewer side effects than cyclazocine. Naltrexone side effects fell to levels indistinguishable from those of placebo in the "induction after placebo" phase. In contrast, cyclazocine "induction after placebo" produced an even higher level of side effects than found in its induction. In no case was naltrexone discontinued because of side effects. On the other hand, three of 20 cyclazocine-treated patients discontinued the drug because of distressing side effects. No toxicity was noted with either agent. The controlled data reported supports the clinical impression that naltrexone produces fewer induction side effects than cyclazocine.

Administration, Oral↗