Biomedical subjects

E Ferri

Publications and source records attributed to E Ferri.

At least 19 recordsLinked to original sources

PubMed2002

[The application of argon plasma coagulation (APC) in surgical treatment of inferior turbinates].

For over 20 years, argon plasma coagulation (APC) has been used in open surgery, in laparoscopy and in thoracoscopy for the haemostasis of superficial haemorrhages and for the resection of parenchymatous tissue. This technique is based on the use of a high-frequency current that ionizes an inert gas, the argon; the emission of this latter generates a thermocoagulative effect that is selectively exerted on the superficial surfaces of the mucosa involved. In otorhinolaryngology, it may be seen as a valid alternative to traditional surgical techniques, to a mono- or bipolar electric surgical knife, and to laser surgery. From March to November 2000, 157 patients affected by "inferior turbinate hypertrophy non-responsive to ordinary medical therapy" underwent devitalizing APC surgery. In 20% of the cases (30 patients), the operation was performed under local anaesthesia. In no case was a nasal tampon employed. Twelve months after the operation, 87% of the patients treated (136 cases) had fully resumed normal nasal respiratory functionality, with marked improvement in the air flow and reduction of the unilateral nasal resistance during rhinomanometric evaluation. There were post-operative complications in 2% of the patients (3 cases), all of which were successfully handled through APC (2 cases of epistaxis on the 7th and 9th post-operative day, and 1 case of turbino-septal synechia). In the 13% of the patients (21 cases) in whom the results had been partial or unsatisfactory, the cause of the limited efficacy of the treatment was connected with an improper use of the instrumentation, lack of compliance on the part of the patient, or a concomitant psycofunctional pathology. The statistical study, accomplished via Student's t test, confirmed that the difference between the unilateral nasal resistance values present before the procedure and those measured during the 1-month follow-up were highly significant (t = 11.126, p < .001). The same significant correlation was ascertained between the pre-operative nasal resistance values and those ascertained post-operatively, respectively at 3, 6 and 12 months (p < .001).

Adult↗

PubMed2001

Responsiveness to intravenous administration of salbutamol in chronic obstructive pulmonary disease patients with acute respiratory failure.

OBJECTIVE: In chronic obstructive pulmonary disease (COPD) patients with acute respiratory failure (ARF), bronchodilating agents administered by inhalation have, in general, little effect on dynamic hyperinflation and concurrent static intrinsic positive end-expiratory pressure (PEEPi,st). Since in COPD the severely obstructed segments of the lung may not be reached by inhaled medication, we reasoned that drug efficiency may be enhanced by intravenous administration of the agent. DESIGN: Physiological study. SETTING: Two four-bed surgical-medical ICUs of a university hospital. PATIENTS: Fourteen COPD patients were studied within 36 h from the onset of ARF. MEASUREMENTS AND RESULTS: Static compliance (Cst,rs), minimal (Rmin,rs) and additional (DeltaRrs) resistance of the respiratory system, and PEEPi,st were measured before and after intravenous administration of salbutamol. All patients had limitation of air flow before and after salbutamol administration. On average, after salbutamol there was a small, though significant, decrease in Rmin,rs (-9%), DeltaRrs (-12%) and PEEPi,st (-8%). CONCLUSION: The changes in resistance and PEEPi,st after intravenous administration of salbutamol were too small to be of clinical significance.

Acute Disease↗

PubMed2001

[Results of videonystagmographic (VNG) analysis in vestibular post-traumatic pathology].

From February 1998 to July 1999, 569 patients affected by vestibular disorders--following a whiplash injury and/or a cranial trauma--were studied. The neuro-otological examination included a tonal audiometry, brain stem auditory evoked potentials, clinical and instrumental vestibular tests (caloric test, rotatory test, assessment of visually guided eye movements). The study of eye movements was conducted with the support of the Ulmer video-oculographical system. The aim of the research was to analyse, both from a qualitative and a quantitative perspective, the vestibular and clinical findings. Particular emphasis was laid on the incidence of the "up-beating" nystagmus in different categories of patients, all supported by a statistical study. As a result, an etiopathogenetical hypothesis of the nystagmus was advanced, based on altered otolithic and cervical inputs. At the same time, the importance of the video-nystagmographical system was stressed, to the extent that it leads to a standardised and objective analysis, fundamental for clinical and forensic aspects.

Adolescent↗

PubMed2001

Extended hepatic resection: a 6-year retrospective study of risk factors for perioperative mortality.

BACKGROUND: Extended hepatic resection (more than four liver segments) is a major operative procedure that is associated with significant risk. The purpose of this study was to assess the impact of perioperative variables on in-hospital mortality after extended hepatectomy. STUDY DESIGN: Consecutive patients who underwent extended hepatic resection were studied. The prognostic value of 29 perioperative variables was evaluated using in-hospital mortality as the endpoint. For each variable, the odds ratio (95% confidence interval) for in-hospital mortality was calculated. Those variables with a lower confidence limit > 1 were considered important risk factors. The population was stratified into categories of patients having the same number of risk factors, and mortality was estimated for each group. These data were used to develop a risk assessment algorithm. RESULTS: There were 14 deaths (6%) in 226 patients. Three preoperative variables (cholangitis, creatinine > 1.3 mg/dL, and total bilirubin > 6 mg/dL) and two operative variables (blood loss > 3 L and vena caval resection) appear to be important factors for in-hospital mortality. The mortality associated with the presence of any two of the five factors was 100% (5 of 5), and the mortality associated with the absence of these factors was 3% (6 of 191). CONCLUSIONS: Perioperative evaluation of patients undergoing extended hepatic resection should include the quantitation of mortality risk factors. The combination of any two factors among preoperative cholangitis, elevated serum creatinine, elevated serum bilirubin, high operative blood loss, and vena cava resection may carry a high mortality risk. These results require prospective validation.

Adolescent↗

PubMed2001

In vitro effect of thymosin-alpha1 and interferon-alpha on Th1 and Th2 cytokine synthesis in patients with chronic hepatitis C.

Current evidence suggests that increased expression of Th1-associated cytokines is important for immune-mediated eradication of hepatitis C infection, while an increase in Th2-associated cytokines is associated with persistence of infection. In this study we evaluated the effects of thymosin-alpha1 (TA1), a naturally occurring thymic peptide, and interferon-alpha (IFN-alpha) on cytokine production in peripheral blood mononuclear cells from untreated patients with chronic hepatitis C. We examined the effect of incubation with TA1, IFN-alpha, or both, on production of Th1-associated cytokines (IL-2, IFN-gamma), Th2-associated cytokines (IL-4, IL-10), and synthesis of the antiviral protein 2',5'-oligoadenylate synthetase. TA1 treatment induced a significant increase in production of IL-2 and 2',5'-oligoadenylate synthetase. Smaller increases were also seen after treatment with IFN-alpha, while incubation with TA1 and IFN-alpha together led to an additive or synergistic effect. Incubation with TA1 resulted in a decrease in IL-4 and IL-10, whereas IFN-alpha increased these cytokines. The addition of TA1 to IFN-alpha significantly reversed this IFN-alpha-induced increase. Hence, TA1 treatment could benefit patients with hepatitis C infection by increasing the Th1-type response, fundamental for sustained clearance of hepatitis C; and by decreasing the Th2-type response, associated with persistence of viraemia.

2',5'-Oligoadenylate Synthetase↗

PubMed2001

Determination of metabolic monitor errors and precision under clinical conditions.

BACKGROUND & AIMS: Metabolic monitoring devices used in the critical care setting are subject to a range of conditions that may compromise their accuracy. We sought to investigate the error and precision of the Deltatrac metabolic monitor under these conditions. METHODS: A modified version of the funnel burner, described by Miodownik et al. (8), was ventilated by a mechanical ventilator. This was used to examine the performance of the Deltatrac metabolic monitor over a wide range of inspired oxygen concentrations, minute ventilation, and positive end expiratory pressure at different levels of oxygen consumption and carbon dioxide production. RESULTS: The Deltatrac measured V(O(2)) with a mean error+/-precision of 9.4%+/-19.5% (range, 9.3%+/-1.9%-72.6%+/-13.6%). The mean V(CO(2)) error+/-precision was 1.2%+/-3.1% (range-2.0%+/-1.2%-5.4%+/-3.1%). Error was significantly affected by oxygen concentration and minute ventilation but was largely independent of positive and expiratory pressure. CONCLUSIONS: The methodology of Miodownik et al. permits the expression of metabolic device errors over a wide range of simulated clinical conditions.

Calorimetry, Indirect↗

PubMed2001

[Unusual case of inverted papilloma in a fibro-epithelial polyp of the ureter].

Inverted papilloma of the upper urinary tract is a rare lesion and the differential diagnosis with transitional cell carcinoma is really hard. A case of 49 year-old male with recurrent right flank pain is reported. Excretory urogram suggested a filling defect involving the right mid ureter and bilateral retrograde pyelogram that confirmed a solitary filling defect in the right mid-ureter, while selective urinary cytology was positive for transitional cell carcinoma G1. Conservative therapy was carried out and 2 years follow-up with several excretory urograms and ultrasound studies revealed no recurrence.

Female↗

PubMed2001

[Carcinosarcoma of the larynx: immunohistochemical study, clinical considerations, therapeutic strategies].

Carcinosarcoma is a rare laryngeal neoplasm accounting for less than 1% of all malignancies involving this organ. Given its double epithelial, mesenchymal nature, this neoplasm is described in the literature in many ways: sarcomatoid carcinoma, variants of squamous cell carcinoma with fused cells, pseudoscarcoma, pleumorphous carcinoma, polypoid carcinoma, metaplastic carcinoma. Although not invalidating, cytokeratin positive immunohistochemistry is fundamental for diagnosis. Given the different histopathological pictures, the rareness and heterogeneous natural history of such tumors, it is not surprising there is as yet no agreement as to the treatment of choice. An accurate analysis of the literature indicates that both the therapeutic approach and prognosis are the same as those found for normal squamous cell carcinoma. The authors describe a case of laryngeal carcinosarcoma, analyzing the clinical-therapeutic aspects, histopathological features and immunohistochemistry of this rare neoplasm.

Aged↗

PubMed2000

A comparative study between a calcium channel blocker (Nicardipine) and a combined alpha-beta-blocker (Labetalol) for the control of emergence hypertension during craniotomy for tumor surgery.

We compared the efficacy of the combination of enalaprilat/labetalol with that of enalaprilat/nicardipine to prevent emergence postcraniotomy hypertension. A prospective, randomized open labeled clinical trial was designed to compare the incidence of breakthrough hypertension (systolic blood pressure [SBP] > 140 mm Hg) and adverse effects (hypotension, tachycardia, and bradycardia) between the two drug combinations. Secondarily, the effects of the drugs on SBP, mean blood pressure, and diastolic blood pressure were evaluated over the course of the study. Forty-two patients received enalaprilat 1.25 mg IV at dural closure followed by either multidose nicardipine 2 mg IV or labetalol 5 mg IV to maintain the SBP below 140 mm Hg. SBP was similarly controlled in both groups. There was a marginally smaller incidence of failures and adverse effects with labetalol. Blood pressure profiles were similar for both groups.

Adrenergic alpha-Antagonists↗

PubMed2000

System of automated gas-exchange analysis for the investigation of metabolic processes.

Conventional gas-exchange instruments are confined to the measurement of O(2) consumption (VO(2)) and CO(2) production (VCO(2)) and are subject to a variety of errors. This handicaps the performance of these devices at inspired O(2) fraction (FI(O(2))) > 0.40 and limits their applicability to indirect calorimetry only. We describe a device based on the automation of the Douglas bag technique that is capable of making continuous gas-exchange measurements of multiple species over a broad range of experimental conditions. This system is validated by using a quantitative methanol-burning lung model modified to provide reproducible (13)CO(2) production. The average error for VO(2) and VCO(2) over the FI(O(2)) range of 0.21-0.8. is 2.4 and 0.8%, respectively. The instrument is capable of determining the differential atom% volume of known references of (13)CO(2) to within 3.4%. This device reduces the sources of error that thwart other instruments at FI(O(2)) > 0. 40 and demonstrates the capacity to explore other expressions of metabolic activity in exhaled gases related to the excretion of (13)CO(2).

Calorimetry, Indirect↗

PubMed2000

[Surgical treatment of urologic complications of idiopathic retroperitoneal fibrosis. Our experience].

The chief complications of retroperitoneal fibrosis RPF in the ureteric compression ab extrinseco by fibrotic tissue. In the period 1994 to 1999, we treated two cases of idiopathic RPF: the first case a 49 years aged man, presented a left hydronefrosis and bilateral ureteral displacement to the midline. RMN showed widespreads fibrotic tissue in the retroperitoneal space. At operation, the histological findings was that of aspecific fibrositis. The surgical procedure was ureterolysis and lateralization of both ureters with the aid of a wrapping with a pedicled omental graft. The patient was also treated with metilprednisolon, 8 mg-die, for altogether twelve months, Now he is asymptomatic. The second case, a man aged 60, had a compression of both ureter by fibrotic tissue down to the pelvic tract; the histologic picture was the same of that of the first case. A difficult ureterolysis was carried on, plus an omentoplasty and a left ureteral reimplantation to the bladder. Medical treatment followed, following the above scheme. Seven months after surgery the patient is well. This experience of ours urological complications of RPF is confirmatory of the importance of a sound surgical approach and of a tight follow up as well as a sustained corticosteroid therapy in order to prevent relapse.

Humans↗

PubMed2000

[Pelvic floor rehabilitation as treatment of female urinary incontinence. Our experience].

We refer herein on a simple program of rehabilitation that may be a first approach the treatment of, U.S.I. In our urodynamic service, we treated 38 female patients, affected by this condition, aged between 37-73 years. The same procedure was applied to all the patients, consisting of 10 seances twice weekly, during which we subjected the patients to biofeedback and vaginal electrostimulation of 50 Hz frequency. The results after 3 months were: 38% restored to normal, 51% improved, 11% unchanged; after 1 year were: 27% restored to normal, 49% improved, the remaining unchanged. As a whole, perineal rehabilitation by this technique can be curative in selected cases and, should it be necessary, can be repeated; its advantages are simplicity, low cost and lack of collateral effects. Motivation and compliance on the part of the patients are, anyhow, the chief factor of success. Moreover, the procedure does not preclude alternative treatments. It is suitable to chose cases where surgery is not so, or else is ill-accepted or has failed.

Adult↗

PubMed2000

[Buschke-Löwenstein tumor: report of 2 clinical cases].

In our department two cases of Buschke-Löwenstein tumor were up to day observed. The first case, a man 51 years old, showed a big exophytic growth all over the glans, plus some similar lesions all along the shaft of the penis, besides a bilateral inguinal lymphoadenopathy. The second case was that of a man 70 years old, presenting a single exophytic growth on the glans. Both cases underwent a surgical excision of the lesions. The first patient had a local relapse after one year and a second one after further four months, which were both surgically exsected. Today, both patients are disease-free, being elapsed twelve years and sixteen months respectively. Surgical excision seems therefore to answer well the clinical problem, as for as the rarity of distant spread, the feasibility of conservative removal or reiteration, should it the case, are concerned.

Aged↗

PubMed2000

[Interstitial laser therapy in benign prostatic hyperplasia].

The interstitial laser therapy is a low invasivity system for prostatic benign hyperplasia. We report our experience with Indigo 830e new system where diode laser and optical temperature sensor warrant a laser-induced interstitial thermal therapy able to continuously adjust energy delivery to the tissue.

Aged↗

PubMed2000

[Unusual case of mesothelioma of the tunica vaginalis associated with prostatic adenocarcinoma].

Malignant mesothelioma of the tunica vaginalis testis, is a very rare neoplasm with highly aggressive biological behaviour. It usually occurs in patients aged between 55 and 75 years. A testicular mass is always observed, often accompanied with hydrocele. The response to chemotherapy and radiotherapy is poor. Initial aggressive surgery is necessary. The median survival, without surgical treatment is 23 months. A rare case of malignant mesothelioma of the tunica vaginalis testis, observed in a patient affected by prostate neoplasm is reported. A radical retropubic prostatectomy was performed. The patient was suffering from dysuria and there was a suspect area at the digital examination. Rectal ultrasonography and biopsy showed an adenocarcinoma at T1c clinical stage. A radical prostatectomy was carried out and histology showed an adenocarcinoma, Gleason score 7 pT3bN0M0. Surgery was followed by radiation therapy. After three years, a pleural seroma, a cutaneous mass and testicular nodule were observed and cytological examination showed endothelial cells. Scrotal orchiectomy was performed, because he was suffering from emphysema. Cytological examination confirmed malignant mesothelioma of the tunica vaginalis testis. Only 73 cases of this tumour have been reported in the last 30 years. The therapeutic options for this aggressive neoplasm are discussed. Since chemotherapy and radiation therapy had poor results, a rapid surgical treatment, by radical orchiectomy, is important.

Adenocarcinoma↗

PubMed1999

Chemiluminescent determination of xanthine oxidase activity in milk.

A chemiluminescent method for determining xanthine oxidase (XOD) activity was developed and applied to the assay of milk enzyme activity using a photomultiplier luminometer. Various kinds of milk and cream samples were analysed for XOD content. In pasteurized milk, XOD activity depended on the fat content and in UHT milk it disappeared owing to the heat treatment. Milk sample preparation was very simple, requiring only homogenization at 40 degrees C followed by a 1:10 dilution with UHT ('XOD-free') milk. The assay was carried out at 25 degrees C. The response obtained from XOD standard solutions in milk was linear from 0.1 to 500 enzyme units (U) l-1, but for the actual milk samples values ranged only from 1 to 135 U l-1. The detection limit at 2 SD was 0.1 U l-1 in milk, while in buffer it was 100 times lower. The intra-assay and interassay CV for XOD activity in milk were 6-12%.

Animals↗

PubMed1999

[Treatment approaches to benign paroxysmal positional vertigo. Clinical features in 228 cases of posterior and lateral canalolithiasis].

After having discussed the etiopathogenesis, epidemiology and physiopathology of Benign Paroxysmal Positional Vertigo (BPPV), the authors present their case study covering audiovestibology out-patients treated in the last two years: 228 cases of canalotithiasis-derived BPPV, both posterior (186 cases) and lateral (42 cases). These patients were diagnosed and treated between July 1996 and July 1998 and account for 15% of the 1550 patients complaining of balance and postural disorders seen during that period. Analysis of the results shows BPPV epidemiological data that are practically the same those reported in the literature: greater incidence in females, predominance of posterior canalolithiasis and optimal use of the canalith repositioning techniques. The authors reconfirm the effectiveness of the Semont maneuver and its variations in the treatment of those forms involving the posterior semicircular canal (97% healing). As regards BPPV due to lateral canalolithiasis. The authors feel the vestibular "barbecue" rehabilitation techniques suggested by Lempert--i.e. a 270 degrees rotation starting from the decubitus position on the pathological side, rather than Baloh's traditional 360 degrees rotation--is most suitable for the treatment of BPPV stemming from lateral canalolithiasis. The Lempert technique provided satisfactory results (76% healing) and a reduction in the number of failures (24%).

Adult↗

PubMed1999

[Primitive carcinoid tumor of the middle ear: a case report and review of literature].

Carcinoid tumors are neuroendocrine neoplasms. Their prognosis is nearly always favorable and they rarely affect the middle ear. An accurate review of the literature has shown that since 1980 only 37 cases of primary carcinoid tumor of the middle ear have been described. Diagnostic precision has increasingly improved over the years thanks to the use of modern immunohistochemical techniques and electron microscopy. The treatment of choice is surgical exeresis through a radical tympanomastoidectomy. Distant metastases have never been indicated. The authors present a case of primary tympanic carcinoid tumor, basically extended to the external auditory duct. They underline the clinical aspects, the difficulties in histopathological diagnosis and the treatment strategies applied.

Adult↗