Biomedical subjects

E Puglia

Publications and source records attributed to E Puglia.

3 recordsLinked to original sources

PubMed1992

[Intra-individual variation of cerebral blood flow velocity in sleeping and awake children].

A considerable intraindividual variability of blood flow velocities in the middle and posterior cerebral artery was found in 74 children by continuous transcranial Doppler recording during EEG registration. The coefficient of variation of the mean flow velocities in the posterior cerebral artery was higher than in the middle cerebral artery, and higher in restless children than in calm children. During hyperventilation the mean flow velocities decreased to about 50 per cent of the baseline values. They increased to 130-140 per cent of the baseline values after hyperventilation. Repeated variations of the velocities of more than 30 per cent of the baseline values were observed during non-REM sleep in the majority of the children. They may be caused by a lower damping of the cerebral autoregulatory response. The intraindividual variability of cerebral blood flow velocities in children has to be kept in mind in pathological conditions and during Doppler monitoring.

Arousal↗

PubMed1982

Strut fracture and disc embolization of a Björk-Shiley mitral valve prosthesis: localization of embolized disc by computerized axial tomography.

The case of a patient who survived strut fracture and embolization of a Björk-Shiley mitral prosthetic disc is presented. Prompt surgical treatment was directly responsible for survival. In addition, computerized axial tomography of the abdomen aided in localizing and retrieving the embolized disc, which was lodged at the origin of the superior mesenteric artery. A review of similar case reports from the literature supports our conclusions that the development of acute heart failure and absent or muffled prosthetic heart sounds in a patient with a Björk-Shiley prosthetic heart valve inserted prior to 1978 should raise the possibility of valve dysfunction and lead to early reoperation.

Adult↗

PubMed1980

Aortoenteric fistulas: a preventable problem?

The results of management in 22 patients with secondary aortoenteric fistula are reviewed to determine whether this condition can be prevented. In 14 patients who had resection of an aneurysm, the fistula developed in spite of adequate coverage of the synthetic graft. Most fistulas occurred at sites of anastomosis (81%). Half the patients presented with sudden massive gastrointestinal hemorrhage; however, in 40% hemorrhage had occurred up to 18 months before admission. Endoscopy is the most useful diagnostic modality, but the condition must first be suspected. The most successful definitive management of this problem was removal of the graft and revasoularization of the lower limbs by insertion of an extra-anatomic bypass graft. The overall mortality in the series was 60% and the operative mortality 47%. The preventive aspects of this complication and technical details of the aortic and duodenal closure are discussed. The authors believe that this serious complication of aortic bypass grafting may be prevented by ensuring that the suture line is adequately separated from the small bowel and duodenum.

Aorta↗