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Biomedical subjects

E Camporesi

Publications and source records attributed to E Camporesi.

At least 19 recordsLinked to original sources
PubMed1999

Hyperbaric oxygen therapy for radiation induced hemorrhagic cystitis.

PURPOSE: Radiation therapy has been used successfully to treat pelvic malignancy but morbidity from hemorrhagic cystitis remains a major long-term sequela in 1 to 2% of patients. Obliterative endarteritis secondary to ionizing radiation leads to tissue hypoxia and poor healing. Hyperbaric oxygen therapy has been demonstrated to improve angiogenesis and promote healing in radiation injured tissue, including the bladder. We describe the treatment and long-term followup of a cohort of patients treated with hyperbaric oxygen for hemorrhagic cystitis. MATERIALS AND METHODS: A total of 17 patients (mean age 62 years) with hemorrhagic cystitis received hyperbaric oxygen following failure of standard treatment modalities. Hyperbaric oxygen was administered on a once daily schedule (mean number of treatments 14) until hematuria resolved. Followup ranged from 9 to 60 months (mean 21). RESULTS: Hematuria resolved completely in 11 of 17 patients (64%), 2 had only residual microscopic hematuria, 2 had improvement but died of complications relating to cancer shortly after completion of treatment and 2 had recurrence of gross hematuria. Early application of hyperbaric oxygen was associated with earlier resolution of hemorrhagic cystitis. CONCLUSIONS: Radiation induced hemorrhagic cystitis that does not respond to standard regimens can be successfully treated with hyperbaric oxygen. This modality is well tolerated even in patients debilitated by advanced cancer and blood loss. Long-term remission can be achieved in the majority of patients.

Aged↗
PubMed1993

Positive end-expiratory pressure increases capillary pressure relative to wedge pressure in the closed and open chest.

The pulmonary arterial wedge pressure is used as a measure of left atrial pressure and frequently as an estimate of pulmonary capillary pressure. The arterial occlusion concept has recently been used to derive a pressure that is thought to be more representative of capillary pressure (Pcap) than wedge pressure (Pw). The object of this study was to measure the arterial occlusion Pcap at different positive end-expiratory pressure (PEEP) levels and to compare it with Pw. Anesthetized, paralyzed, supine, and mechanically ventilated dogs were instrumented with a Swan-Ganz balloon tip catheter (7F) for monitoring pulmonary arterial pressure (Pa), for measuring cardiac output (CO; thermodilution technique), and for performing the arterial occlusions. The postocclusion tracings were analyzed for Pcap in a conventional manner: exponential fitting of the data during the 2 seconds immediately postocclusion and back extrapolating to the instant of occlusion. Instant of occlusion was defined as the time when the Pa tracing began to deviate from the normal tracing. Pw was averaged from the data between 8 to 10 seconds after the occlusion. Increasing PEEP between 0 to 15 mm Hg caused a gradual decline in cardiac output in the closed and open chest conditions. Despite this decline, all three pressures (Pa, Pcap, and Pw) rose gradually in the closed chest. However, in the open chest, increasing PEEP from 0 to 4.7 mm Hg had no effect on the pressures, but between 4.7 and 13.4 mm Hg of PEEP, Pa and Pcap increased markedly with minimal change in Pw.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Quality-of-life assessment in a home care program for advanced cancer patients: a study using the Symptom Distress Scale.

Quality-of-life assessment in advanced cancer patients should include the study of physical function, psychological status, social interactions, and symptoms. "Symptom distress" relates to the degree of discomfort caused by specific symptoms. A Symptom Distress Scale, which has been developed by McCorkle and Young, is a self-rating instrument that evaluates 13 symptoms. In the present study, the Italian version of the Symptom Distress Scale (SDS) was used to assess the quality of life in advanced cancer patients. The internal consistency of this version was found to be good (Cronbach's coefficient alpha = 0.78). A sample group of 43 patients treated in a home care program was asked to fill out the SDS on a weekly basis. The scores showed a reduction in symptom distress, which was primarily due to improvement in pain, nausea, and bowel pattern. Home care was less effective in improving concentration and, more generally, psychological aspects. This study confirms the validity of a quality-of-life monitoring system that uses a patient self-rating symptom assessment instrument.

Aged↗
PubMed1993

Effects of clenbuterol hydrochloride on pulmonary gas exchange and hemodynamics in anesthetized horses.

We evaluated the effects of clenbuterol HCl (0.8 micrograms/kg, of body weight, IV), a beta 2 agonist, on ventilation-perfusion matching and hemodynamic variables in anesthetized (by IV route), laterally recumbent horses. The multiple inert gas elimination technique was used to assess pulmonary gas exchange. Clenbuterol HCl induced a decrease in arterial oxygen tension (from 57.0 +/- 1.8 to 49.3 +/- 1.2 mm of Hg; mean +/- SEM) as a result of increased shunt fraction (from 6.6 +/- 2.1 to 14.4 +/- 3.1%) and ventilation to regions with high ventilation-perfusion ratios. In contrast, no changes in these variables were found in horses given sterile water. In horses given clenbuterol HCl, O2 consumption increased from 2.23 +/- 0.18 to 2.70 +/- 0.14 ml.min-1.kg-1, and respiratory exchange ratio decreased from 0.80 +/- 0.02 to 0.72 +/- 0.01. Respiratory exchange ratio and O2 consumption were not significantly modified in sterile water-treated (control) horses. Clenbuterol HCl administration was associated with increased cardiac index (from 57.4 +/- 4.0 to 84.2 +/- 6.3 ml.min-1.kg-1), decreased total peripheral vascular resistance (from 108.3 +/- 9.3 to 47.6 +/- 2.8 mm of Hg.s.kg.ml-1), and decreased pulmonary vascular resistance (from 31.3 +/- 3.8 to 13.6 +/- 0.7 mm of Hg.s.kg.ml-1). Our findings indicated that clenbuterol HCl may potentiate hypoxemia as a result of increased shunt fraction in horses anesthetized by the IV route, and caused changes in hemodynamic variables that were consistent with its ability to stimulate beta 2-adrenergic receptors.

Anesthesia, General↗
PubMed1992

Nursing care planning for terminally ill cancer patients receiving home care.

Nursing home care for terminally ill cancer patients was organized according to nursing care plans that were based on diagnoses as recommended by the North American Nursing Diagnosis Association (NANDA). This study was carried out among a sample of 40 patients receiving home health care for a period of 1 to 19 weeks. More than 697 nursing diagnoses were identified in the study. The most frequently recorded nursing diagnoses were anxiety, constipation, and diminished food intake. Fifteen of the 40 patients in the study were able to complete a weekly self-report of their symptoms. The patients' own descriptions of their symptoms were then compared with their symptoms as identified by nursing staff. There was a congruence in 63% of reported instances. Although nurses' assessments were not always in agreement with the symptoms reported by the patients, agreement was more frequently found with somatic symptoms than with psychological ones. One conclusion is that nursing plans should incorporate multidimensional methods for assessing patients' real needs.

Adult↗
PubMed1973

Contribution of various inspiratory muscles to ventilation and the immediate and distant effect of diaphragmatic paralysis.

The contribution of the diaphragm and that of the other inspiratory muscles (scaleni and all the other extradiaphragmatic muscles) at different levels of tidal volume (VT) and during static inspiratory efforts of various strengths has been studied in supine anaesthetized rabbits by blocking phrenic conduction with an electrotonic current. Rabbits spinalized at T1 were used to measure the separate contribution of the scaleni. When the vagi are left intact there is an hyperactivity of the extradiaphragmatic muscles during the phrenic block which has been ascribed to Hering-Breuer reflexes. The relative contribution of the diaphragm to tidal volume, during quiet breathing, appears to approach 9O percent and is reduced to 75 percent during the maximum tidal volume attained. The scaleni appear to account for about 1/3 of the tidal volume contributed by all the other inspiratory extradiaphragmatic muscles during quiet breathing and their share goes up to 1/2 at the highest ventilation. The contribution of the scaleni starts at the same level of inspiratory output found for all extradiaphragmatic muscles and therefore these muscles should not be considered "accessory" Within the range of VT considered the sternomastoids did not appear to contribute, as shown by the fact that their disinsertion did not change the results obtained in spinalized rabbits. Immediately after block of the phrenic nerves there is a marked decrease of VT which then increases within 10-15 breaths to a steady value, three to four times that of the first breath after the paralysis, which is maintained thereafter. The respiratory frequency decreases immediately to a slightly lower value after phrenic block In control animals and does not change when the vagi are cut. In any case a fairly steady value is maintained thereafter even when various types of stimulation are applied. Only changes in body temperature could change respiratory frequency. Chronically phrenicectomized rabbits show some compensatory phenomena either functionally or morphologically. They become able to change their ventilation when chemical drive is increased. In the external intercostal muscles the myoglobin concentration increases and ultrastructural modifications become apparent.

Animals↗