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Biomedical subjects

D Sacerdoti

Publications and source records attributed to D Sacerdoti.

77 records · Page 5Linked to original sources
PubMed1982

Renal haemodynamic in essential hypertension assessed by 133-Xenon washout and selective renal angiography.

The renal and intrarenal haemodynamic pattern in 17 patients with essential hypertension of different severity and duration was studied by means of the 133-Xenon washout technique and the selective renal angiography. The mean and the cortical renal blood flows were on average significantly decreased as compared to the controls. A good agreement was found between the reduction in renal perfusion and the degree of vascular abnormalities as shown by angiography; on the contrary no correlation was found between the impairment in renal blood flow and the degree and/or duration of hypertension.

Adult↗
PubMedDate not supplied

Randomised trial of nadolol alone or with isosorbide mononitrate for primary prophylaxis of variceal bleeding in cirrhosis. Gruppo-Triveneto per L'ipertensione portale (GTIP)

BACKGROUND: The risk of having a first cirrhosis-associated variceal bleed is lowered by about 50% by beta-blockers. Use of beta-blockers is currently recommended for patients with cirrhosis and oesophageal varices that are at risk of bleeding. We aimed to test the effectiveness of isosorbide mononitrate as an adjunct to the beta-blocker nadolol in the prophylaxis of first variceal bleeding in these patients. METHODS: We did a randomised multicentre study to compare the non-selective beta-blocker, nadolol, with nadolol plus isosorbide mononitrate in 146 relatively well (Child-Pugh score < or = 11) patients who had oesophageal varices at risk of bleeding. Patients on nadolol alone received a single oral 40 mg daily dose. Every second day the dose was titrated to achieve 20-25% decrease in resting heart rate (maximum dose 160 mg daily). Patients receiving both drugs received nadolol as above then isosorbide mononitrate was added starting with 10 mg orally twice daily, which was increased to 20 mg unless hypotension or severe headache occurred. The main endpoint was the occurrence of variceal bleeding of any severity. Patients were followed up for up to 40 months. FINDINGS: During the study period 11 of 74 patients from the nadolol alone group and four of 72 from the nadolol plus isosorbide mononitrate group had variceal bleeding (log-rank test p = 0.03). Cumulative risk of variceal bleeding was 18% in the nadolol group and 7.5% in the combined treatment group (95% CI for difference 1-25%). Two patients in each group had a non-variceal bleed related to portal hypertension. 14 patients from the nadolol only group and eight from the combined treatment group died during the study period (log-rank test p = 0.09). Four and eight patients, respectively, had to discontinue one of the drugs because of side-effects. INTERPRETATION: Nadolol plus isosorbide mononitrate is significantly more effective than nadolol alone in the primary prophylaxis of variceal bleeding in relatively well patients with cirrhosis, and has few side-effects.

Administration, Oral↗
PubMedDate not supplied

Automatic speech recognition in vitreo-retinal surgery. A project for a prototypal computer-based voice-controlled vitrectomy machine.

In the past half decade automatic speech recognition techniques, software and hardware technology have matured enough to support sophisticated medical applications. The project described aimed at introducing a computer-based, voice-controlled prototype system in a simulated vitreo-retinal surgery scenario. The aim was to provide the surgeon with a tool that could significantly improve the quality and ease of work and shorten the duration of intervention. The speech recognition system allows voice entry of simple commands to simulate surgical instrument control, including the infusion pump, vitreous cutter and diathermy. The project relies on a Markov-based, speaker-dependent, commercial isolated-word recognizer, and consists of a specific recognition vocabulary and application software, created and developed by the authors. Results have been encouraging. The system performed well under the test conditions, proving robust, simple to use and accurate (over 97% average word recognition rate). On the basis of their experience, the authors believe that automatic speech recognition technology, though suffering from some limitations such as the need for training, speaker dependence and a relatively small vocabulary, and requiring extensive testing under operating conditions, merits further development and opens new perspectives for a possible new generation of surgical instruments.

Artificial Intelligence↗
PubMedDate not supplied

Cardiac involvement in liver cirrhosis.

Since liver cirrhosis involves most organs and systems, it can be defined as a systemic disease. Involvement of the cardiocirculatory system is crucial during the course of cirrhosis due its pathophysiological, clinical and therapeutic relationships with the liver. Cardiovascular and circulatory alterations are frequently observed in the late stages of cirrhosis and involve subclinical latent cardiomyopathy with hyperdynamic circulation characterized by increased cardiac output and decreased peripheral resistance. The pathogenesis of these hemodynamic alterations is still uncertain. These alterations should be taken into serious consideration during programming of therapy for the complications of cirrhosis, in particular ascites (diuretic treatment; paracentesis, LeVeen peritoneal-venous shunt) and portal hypertension (drug treatment with beta-blockers and/or vasodilators for the prevention of variceal bleeding).

Animals↗