PubMed Health⌕ Search

Biomedical subjects

E Zecca

Publications and source records attributed to E Zecca.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Weight gain in the first 2 months of life in neonates with a birth weight less than or equal to 1500 g. A comparison between parenteral nutrition and orogastric feeding].

This study was designed to verify the effectiveness of parenteral nutrition (NP) and continuous nasogastric feeding (AOG) in providing a good caloric intake and a good growth in the very low birth weight infants during the first 60 days of life. The study included 108 preterm babies with birth weight less than or equal to 1500 g: 26 received parenteral nutrition, 82 nasogastric feeding. Infants in NP showed a smaller postnatal weight loss and regained birth weight earlier than the AOG group. Caloric intake greater than 120 kcal/kg/die was achieved in 10.2 days of life in the NP group and in 14.1 days in the AOG group. Full enteral feeding was achieved later in the NP than in the AOG group (25.7 days vs 20.7 days). Weight gain at 60 days of life was better in the NP group (23.2 g/die vs 18.2 g/die), while there was no difference in the head circumference gain. The study shows the efficacy of NP in providing a good caloric intake in the very low birth weight infants in the first weeks of life.

Energy Intake↗
PubMed1991

Continuous subcutaneous infusion of hyoscine butylbromide reduces secretions in patients with gastrointestinal obstruction.

We describe the use of hyoscine butylbromide as a subcutaneous infusion in 3 patients with inoperable malignant bowel obstruction. An objective reduction of drainage from the gastrointestinal tract was observed with the hyoscine butylbromide infusion (60-120 mg/day). We suggest that this effect can be useful in the palliative treatment of vomiting in inoperable bowel obstruction.

Aged↗
PubMed1991

A clinical study on the use of codeine, oxycodone, dextropropoxyphene, buprenorphine, and pentazocine in cancer pain.

The authors report a prospective study on 944 cancer pain patients treated with one of the following opioids: codeine, oxycodone, dextropropoxyphene, buprenorphine, and pentazocine. Level of analgesia, duration of treatment, side effects, and drop out were evaluated for each drug. Twenty-four percent of the patients still benefitted from treatment at the fourth week of study, even if high drug dosages were not used. Pentazocine did not show an evident analgesic effect during the first 2 wk of treatment. The other opioids were found to be valid therapeutic instruments for chronic cancer pain control in a limited number of patients.

Adult↗
PubMed1991

Plasma morphine and morphine-6-glucuronide patterns in cancer patients after oral, subcutaneous, sublabial and rectal short-term administration.

Clinical studies on the effectiveness of morphine administered through different routes are contradictory. In order to further elucidate this point, the plasma concentrations of morphine and its 3- and 6-glucuronated metabolites were measured after short-term oral, sublabial, rectal and subcutaneous administration of the opiate. The bioavailability of free morphine and the 6-glucuronated active metabolite was comparable through the different routes. It was concluded that the choice of the route of morphine administration should be mainly guided by the needs of each individual patient.

Aged↗
PubMed1990

[Prevention of hypocalcemia in low-birth-weight newborn infants: a comparative clinical study on the efficacy of ergocalciferol (Vit. D2) and calcifediol (Vit. 25(OH)D3)].

During the first week of life, 400 IU per day of 25(OH)D3 were given to 126 preterm and 112 full-term, small for date newborn infants, while 1000 UI per day of Vitamin D2 were given to 18 preterm and 27 full-term, small for date newborn infants, in order to compare their effectiveness for the prevention of neonatal hypocalcemia. 67 preterm and 67 full-term newborns were included in the control group. The incidence of late hypocalcemia was reduced from 16.4% to 0 in full-term babies and from 6% to 2.4% in preterm babies by the 25(OH)D3 but not by Vit. D2 administration. The incidence of early hypocalcemia was not modified at all. The Authors suggest 25(OH)D3 administration to prevent the late hypocalcemia and, together with calcium support, to treat the early hypocalcemia in the low birth weight newborn.

Calcifediol↗
PubMed1989

Phenobarbital for treatment of seizures in preterm infant: a new administration scheme.

The serum concentration of phenobarbital used as an anticonvulsant was monitored in 30 preterm babies. The therapeutic serum concentration was achieved with a loading dose of 20 mg/kg i.v., 10 min after administration. Thirty-six hours after loading, it was possible to maintain therapeutic serum levels with a daily intramuscular dose of 5 mg/kg, avoiding toxicity. A comparison of CSF and serum concentrations indicated that the drug passage to CSF is rapid and depends on a brain lesion. Serum monitoring of phenobarbital is important in preterm neonates under 30 weeks gestation and/or with severe pathological complications.

Drug Administration Schedule↗
PubMed1987

Plasma thyrocalcitonin and parathyroid hormone concentrations in early neonatal hypocalcaemia.

During the first week of life serum calcium, phosphorus, magnesium, immunoreactive thyrocalcitonin hormone, and parathyroid hormone concentrations were determined daily in 36 preterm and 29 small for gestational age, full term, healthy infants. Preterm babies with early neonatal hypocalcaemia had significantly higher concentrations of serum thyrocalcitonin hormone in the first four days of life than normocalcaemic preterm babies. Parathyroid hormone concentrations were similar in hypocalcaemic and normocalcaemic infants. In contrast, in the full term group no significant differences were detected in thyrocalcitonin hormone and parathyroid hormone patterns between hypocalcaemic and normocalcaemic subjects. This suggests two different pathogeneses for early hypocalcaemia in low birthweight infants. Hyperthyrocalcitoninaemia seems to be the main determining factor in preterm infants, while a non-hormonal pathogenesis should be considered in full term infants who are small for gestational age.

Calcitonin↗
PubMed1984

Skeletal changes in preterm infants: personal experience.

The incidence of skeletal changes in preterm low-birth-weight infants is rising. This is probably related to today's higher survival rate of these babies. The late positivity of biochemical data and the lack of clinical prognostic signs justify the role of radiology in such pathology. Radiology, however, although useful in detecting rachitic changes, seems to be less sensitive to minimal osteoporotic modifications, for which densitometric studies should be preferred. The authors report their personal experience in 8 cases of skeletal pathology in preterm infants and suggest a radiological follow-up of the skeleton from the 5th to the 12th week of life, whenever a densitometric method is not available.

Bone Diseases↗
PubMed1983

[Study of a group of subjects occupationally exposed to tartaric acid].

The Authors report the results of an investigation carried out in a factory producing tartaric acid in order to evaluate the effects of occupational exposure to this substance. A group of 44 subjects exposed to the acid and a group of 30 subjects not exposed, as a means of control, were submitted to anamnestic questionnaire, othorinolaringoyatric examination, spirometry, bronchodilatation test with salbutamol. Our data show a higher prevalence of oropharyngeal and cutaneous lesions in the exposed subjects, while no difference between the two groups was found for dental, bronchial and gastric lesions.

Adult↗
PubMedDate not supplied

Pain experienced by patients hospitalized at the National Cancer Institute of Milan: research project "towards a pain-free hospital".

According to the data of the literature, the prevalence of pain in cancer patients at various stages of the disease and the settings of care range from 38 to 51%, with an increase of up to 74% in the advanced and terminal stages. Despite published World Health Organization (WHO) guidelines for pain management, 42 to 51% of cancer patients receive inadequate analgesia and 30% receive no analgesics at all. A 3-year Research Project "Towards a Pain-free Hospital", which began one year ago, is ongoing at the National Cancer Institute of Milan. The research is organized in three subsequent steps. In the 1st one, a series of patient- and staff-oriented evaluation tools are used to assess the level of appropriateness of pain communication, assessment, management and control of the in-patients. The 2nd step will implement a number of continuing educational interventions aimed at improving patient awareness and staff knowledge of the appropriate pain assessment and management in order to respond to the patient's pain problem. In the 3rd step, all the assessment tools used in step one will be applied again to establish the prevalence of pain, the causes and intensity and patient satisfaction with pain management and to evaluate the impact of the interventions performed during the 2nd step regarding the overall ability of our hospital to tackle pain emergency in the hospitalized cancer population. The results relative to the 1st step are herein reported, in particular as regards the study on prevalence, causes, severity of pain, the interference of pain with sleep, mood and concentration, the use of pain medications and the relief obtained, the structural validity and internal consistency of the assessment tool used. A total of 258 patients hospitalized for at least 24 h were interviewed by 9 physicians using a brief structured questionnaire prepared ad hoc: 51.5% of the patients presented pain during the previous 24 h caused by surgery (49.6%) or by the tumor mass itself (29.3%). Out of the 133 patients with pain, a high degree (much or very much) of pain at rest was present in 27.1% and pain on movement in 30.8%; 31.6% did not take any analgesic treatment, and 14.3% of the latter reported a high degree of pain at rest and 21.4% on movement. Pain interfered with sleep from much to very much in 28.8% and with irritability and nervousness in 15.9% of the patients. In the 91 patients taking analgesics, 57.2% reported a high degree of pain relief. A high degree of pain and interference, however, was associated with low relief levels. The assessment tool used was shown to have a good structural validity and internal consistency (Chrombach alpha index of interference scale = 0.73). Although the Milan Cancer Institute has the longest tradition in Italy of pain assessment by means of validated tools and pain management according to the WHO guidelines and educational efforts in this field, the results of the study clearly show that it is necessary to persevere with continuing educational and informative programs in order to reduce the frequency and severity of pain and thus improve the quality of life of in-patients.

Adult↗
PubMedDate not supplied

Continuous subcutaneous infusion of ketorolac in cancer neuropathic pain unresponsive to opioid and adjuvant drugs. A case report.

Ketorolac is a new non-steroidal anti-inflammatory drug (NSAID) having a potent nonopioid analgesic activity. Administered by continuous subcutaneous infusion (CSI), its analgesic efficacy has been documented in the treatment of somatic and visceral cancer pain whilst it has been shown to be ineffective in the treatment of neuropathic pain. Here is a description of a cancer patient with neuropathic pain unresponsive to anticonvulsant or antidepressant drugs administered in association or not with oral opioids but who was successfully treated with ketorolac alone via CSI. Furthermore, the analgesia lasted over 75 days of treatment without any significant renal and gastric side effects.

Analgesics, Non-Narcotic↗
PubMedDate not supplied

Pharmacological treatment of cancer pain: alternative routes of opioid administration.

Cancer-related pain is present in 51% of patients at various stages of the disease, and the incidence increases up to 74% in advanced and terminal stages. The World Health Organization proposed and issued very simple guidelines for the pharmacologic treatment of cancer-related pain. According to the guidelines, opioid analgesics are the mainstay of analgesic therapy, and the first choice for drug administration is considered to be the oral route. However, in some clinical situations, the oral route is not feasible, and analgesic drugs consequently have to be administered via an alternative route. For example, this is the case when the patient presents vomiting, bowel obstruction, severe dysphagia, mental confusion and when the opioid dose has to be increased drastically in order to achieve adequate pain control. This review of the literature is aimed at describing the indications, the limits and the main aspects of the pharmacokinetics and pharmacodynamics relative to the alternative routes of administration of opioids most commonly used in clinical practice. Sublingual, rectal, subcutaneous, intravenous, transdermal and spinal administration routes are examined.

Administration, Cutaneous↗
PubMedDate not supplied

Normal neonatal values of ophthalmic and central retinal artery blood flow velocities.

PURPOSE: To define standard values of blood flow velocities and indices in the ophthalmic and central retinal arteries in the neonatal period. METHODS: Forty-two healthy full-term neonates comprised the study population. A color Doppler with mechanical sector probe was used for measuring blood flow velocity in the ophthalmic and central retinal arteries. Systolic, end diastolic, and mean-enveloped velocities were measured, and the resistance index and pulsatility index were calculated. RESULTS: Ophthalmic artery Doppler velocities were similar on the first and third days of life, but increased significantly on the fifth and seventh days of life; resistance index significantly increased during the first week of life, whereas pulsatility index did not change significantly. Doppler velocities of the central retinal artery were similar on the first and third days; they show a delayed increase compared to the ophthalmic artery. Central retinal artery blood flow velocities increased significantly from the third to seventh postnatal day. Resistance index also increased between the first two days and on the fifth and seventh postnatal days, while pulsatility index did not change. CONCLUSION: These data constitute a starting point for studying the possible relationship between eye circulation and pathogenesis of retinopathy of prematurity.

Birth Weight↗
PubMedDate not supplied

[Osteopenia of prematurity. Proposal for clinical-laboratory screening].

Osteopenia is a metabolic bone disease which affects a great deal of preterm infants. X-Ray evaluation is still the main step of the diagnostic and follow-up procedures. The Authors prospectively studied 77 newborn infants with birth weight less than 2500 grams, to identify specific clinical and biochemical features of the osteopenic infants. From the 2nd to the 12th week of life clinical, biochemical and radiological signs of osteopenia were looked for, every 2 weeks: the diagnosis of osteopenia was made on the basis of X-Ray. 26 osteopenic subjects with ga less than or equal to 32 weeks and/or bw less than or equal to 1500 grams were compared with 20 controls with ga less than or equal to 32 weeks and/or bw less than or equal to 1500 grams and with 31 control infants with ga greater than 32 weeks and bw greater than 1500 grams. Wider anterior funtanels, their progressively increasing dimensions, and craniotabe (with the "ping pong ball" sign) were the most characteristic features, as well as the increasing pattern of alkaline phosphatase activity, of the osteopenic babies. The Authors suggest a specific clinical and biochemical score to make the correct diagnosis and a non invasive follow-up in the osteopenic subjects and to avoid dangerous X-Ray exposure to babies that are not osteopenic.

Bone Diseases, Metabolic↗