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Biomedical subjects

G Domenighetti

Publications and source records attributed to G Domenighetti.

At least 55 records · Page 3Linked to original sources
PubMed1989

[The medical team and the campaign for primary prevention of cardiovascular diseases in the Tessin canton].

This study presents the results of a questionnaire research into the subjective perception of the free-practicing doctors in Ticino concerning the primary prevention programme against cardiovascular risk factors, directed to the whole cantonal population by the Social Welfare Department. 93% of the doctors (82% of the population) are aware of the programme and 82% of those interviewed judged it to be useful or very useful. Furthermore, the single initiatives of the programme (TV-advertisements and information-Leaflets) were also evaluated, as well as the frequency of preventive practices during medical visits (information on tobacco risks, blood pressure measurement, treatment of hypercholesterolemia). This study was also analyzed on the basis of questionnaire received before (response rate 41%) and after having sent out a further reminder (final response rate 61%). The results and conclusions did not differ with an increase in the reply rate.

Adult↗
PubMed1986

The night--a dangerous time to be born?

An analysis of perinatal mortality by hour of birth among 10,059 births in Canton Ticino (Switzerland) during the years 1979-1982 showed that fewer births occurred at night than during the day. The variations in number of births by hour of birth were attributed to obstetric practices. The perinatal mortality rate for night-time births was more than twice as high as that for the daytime births (+127%, P less than 0.001) and the rates for night-time births exceeded those for daytime births for 13 of the 19 causes of death examined. A higher proportion of the low and very-low-birthweight babies (less than 2500 g and less than 1500 g) were born at night between 19.00 and 06.59 hours.

Birth Weight↗
PubMed1985

[Respiratory distress syndrome and hypothermia in Wernicke's encephalopathy].

A patient is reported who developed adult respiratory distress syndrome (ARDS) and severe hypothermia during the decompensated phase of Wernicke encephalopathy. The absence of other causes suggests a neurogenic origin for the hypothermia, possibly as a result of lesions localized in the posterior hypothalamus. A hemodynamic study during normothermia, hypothermia and rewarming showed that at body temperatures inferior to 32 degrees C the increase in pulmonary vascular resistances seems not to be the result of a real vasoconstrictor effect in the pulmonary circulation. The Wernicke-Korsakoff syndrome may have a clinical picture similar to delirium tremens, evolving into coma with complications such as hypothermia and, possibly, ARDS.

Humans↗
PubMed1985

[Variable hemodynamic response to nifedipine in pulmonary hypertension secondary to chronic obstructive bronchopathy and pulmonary fibrosis].

The hemodynamic effects of nifedipine s.l. (20 mg) on pulmonary hypertension following chronic obstructive pulmonary disease (COPD) and advanced pulmonary fibrosis (PF) have been studied in 6 patients under stable conditions (3 patients with COPD and 3 patients with PF). Nifedipine induced a significant reduction in mean arterial pressure, right atrial pressure and systemic vascular resistances, with a significant increase in heart rate, right ventricular stroke work index and cardiac index. There was no significant change in mean pulmonary artery pressure, pulmonary arteriolar resistances and oxygen delivery. Individual analysis showed that in 2 patients with COPD there was a real direct vasodilating effect of nifedipine on the pulmonary circulation. In 2 patients with PF, the drug induced an increase in mean pulmonary artery pressure and pulmonary arteriolar resistances. In the last 2 patients, the effect of the drug on the pulmonary circulation was associated with an increase in driving pressure concomitantly with a rise in cardiac output, suggesting recruitment of the pulmonary vessels. In conclusion, nifedipine can dilate pulmonary vessels constricted by hypoxia in patients with COPD, but deleterious effects are observed in patients with pulmonary hypertension following PF.

Blood Pressure↗
PubMed1985

[Hemodynamic and respiratory effects of phentolamine in pulmonary hypertension secondary to chronic obstructive syndrome].

The hemodynamic and respiratory effects of phentolamine i.v. (15-30 mg/h) on pulmonary hypertension following chronic obstructive pulmonary disease (COPD) have been studied in 13 patients under stable conditions. Phentolamine produced a significant reduction in mean pulmonary arterial pressure, right and left ventricular filling pressures and right ventricular stroke work index. Cardiac index and oxygen delivery increased significantly. Individual analysis showed that in 7 patients the driving pressure decreased across the pulmonary circulation with concomitant increase in cardiac output, suggesting a direct vasodilating effect of phentolamine on the pulmonary circulation. Pulmonary gas exchange did not change significantly. In conclusion, in patients with pulmonary hypertension following COPD phentolamine given i.v. may have beneficial effects on right ventricular function and peripheral oxygen delivery without detrimental effect on gas exchange.

Aged↗
PubMed1985

[Cardiovascular prevention in the community: the plurisectorial program of the canton of Tessin].

It describes the primary prevention of cardiovascular diseases carried out in Tessin (Italian-speaking Switzerland). Every single action is addressed to the entire population, actively involving professional associations (doctors, pharmacists, nurses, shop-keepers, etc.) and making use in particular of the collaboration of the mass-media (daily press, radio, television). The described actions concern the struggle against the cardiovascular risk factors through the daily diffusion of tv advertisements, free measurement of arterial pressure, and the possibility of disposing in the majority of regional restaurants of a "Health menu" with a low content of saturated fats and cholesterol. In 1984 every citizen of Tessin has been reached by an average of 24 "preventive messages".

Adult↗
PubMed1984

[Study of bronchial hyperreactivity by inhalation of measured aerosol sprays of methacholine].

As the usual bronchial provocation tests with methacholine are rather cumbersome and time-consuming, an attempt has been made to develop a short screening test for routine use. 143 patients with chronic cough or intermittent dyspnea received methacholine from a pressurised aerosol (puffer). The response was evaluated by spirometric measurement. Among 74 patients with chronic cough, 49 had a favourable response to methacholine. 93% were treated successfully with a bronchodilator. Among 62 patients with dyspnea, 45 reacted favourably to methacholine. All were treated successfully with bronchodilators. The short provocation test protocol with methacholine is easy and safe to perform. In cases of chronic cough and dyspnea it serves to detect hyperreactive patients who can benefit from bronchodilator treatment.

Adolescent↗
PubMed1984

[Are physicians also sick? Results of a survey carried out in French-speaking Switzerland and Tessin].

The results are presented of a study among 466 physicians in French- and Italian-speaking Switzerland concerning their own health. It emerged that 77.7% of the physicians had had at least one disease during the year studied; in 50% of cases the morbidity was linked to stress and emotivity. Cardiovascular pathology was significantly higher than in the average population. The results reveal striking differences between the different categories of physicians: hospital doctors had more cardiovascular diseases and fewer infectious and pulmonary diseases than physicians running a private practice. Psychiatrists have a higher morbidity rate than the average. General practitioners, psychiatrists and surgeons appear to be especially exposed to stress and emotivity. Pediatricians suffer less from this group of diseases but present a morbidity correlated with that seen in practice, suggesting transmission from patient to doctor.

Adult↗
PubMed1984

[Prevalence of hysterectomy and cancer of the uterus in the population of Tessin canton].

The study presents an analysis of the prevalence of hysterectomy during the year 1982 in Canton Ticino, where the rate (507) per 100'000 women is double that found in the West Midlands area of Great Britain (P less than 0,001). No statisticaly significant difference is found in the mortality rate or morbidity rate for tumour of the cervix and body of the uterus.

Adult↗
PubMed1983

[Reduction of pulmonary capillary volume following acute respiratory distress syndrome in adults].

Lung function after adult respiratory distress syndrome was evaluated in 8 survivors whose ages ranged from 20 to 54 years. At the time of the study, 5.5 to 19 months after extubation, all patients were asymptomatic at rest but 6 had mild to moderate exertional dyspnea. Physical examination was normal in 7 patients; lung volumes, flow rates and pulmonary mechanics were minimally altered, mainly in smokers. Chest X-rays showed no major abnormalities. On graded submaximal exercise test, performance was limited by tachycardia and not by ventilation. Resting arterial PO2 was low in 6 patients and increased only in one patient during submaximal exercise. The capillary blood volume was decreased in all patients. The mechanisms of hypoxia during exercise and decreased capillary blood volume, the latter apparently unrelated either to pulmonary microvascular obstruction or to fibrosis, remain unexplained. It is concluded that lung volumes and pulmonary mechanics are restored to normal within 6 months after ARDS, whereas gas exchanges persist after ARDS and are associated with a reduced pulmonary blood volume.

Acute Disease↗
PubMed1982

[Restriction of pulmonary capillary volume, delayed sequelae of immersion in fresh water with respiratory distress syndrome].

Lung mechanics and pulmonary gas exchange studies were performed 6 and 12 months after the accident on 2 survivors of adult respiratory distress syndrome (ARDS) following near drowning in fresh water. The patients (25 and 29 years of age) were nonsmokers and neither had a history of lung disease. Immersion lasted 10 and 20 minutes, and assisted ventilation 19 and 34 days, respectively. The results show that lung mechanics returned to normal within 6 months after the onset of ARDS. Conversely, the ratio of dead space to tidal volume was increased significantly at rest and during exercise, and the ratio of capillary volume to alveolar volume was decreased in both patients. It is concluded that ARDS following prolonged near drowning in cold water causes late abnormalities of gas exchange probably related to decreased pulmonary capillary volume.

Capillary Resistance↗
PubMed1982

[Massive poisoning with cyanide with favorable outcome. Hemodynamic study].

A 60-year-old chemist was admitted two hours after voluntary intake of 600 mg KCL. Upon admission he was in deep coma and bradypneic but non-cyanotic. Arterial blood gas analysis showed severe lactic acidosis; blood cyanide concentration was well above the lethal level. The patient was intubated and artificially ventilated with highly hyperoxic mixtures. Specific treatment included sodium nitrite and sodium thiosulfate. The patient recovered without sequelae despite excessive methemoglobinemia. The hemodynamic study upon admission showed a hyperdynamic status associated with low peripheral resistances and normal filling pressures, a profile similar to that described in response to acute anoxia in experimental animals.

Cyanides↗
PubMed1982

[Near-drowning in an adult: favorable course after a 20-minute submersion].

Cardiopulmonary resuscitation was successful in a healthy 29-year-old woman who had been submerged for 20 minutes in water at 10 degrees C. The evolution was characterized by the development of a multifactorial ARDS (secondary drowning) and sepsis caused by Aeromonas hydrophila and Acinetobacter anitratum. Fibrosing alveolitis caused a restrictive syndrome with severe mechanical impairment and transitory therapy-resistant hypoxemia. It is suggested that prolonged submersion in cold water is also a treatable and completely reversible condition in adults. In our patient without neurological sequelae the pulmonary function studies after 3 months show complete recovery from the mechanical impairment. After a follow-up period of 11 months only mild abnormalities of gas exchange persist.

Adult↗
PubMed1982

Variable hemodynamic response to sodium nitroprusside in hypertensive crisis.

Five patients, three males and two females, admitted with severe hypertensive crisis underwent hemodynamic investigations before and during vasodilator therapy with sodium nitroprusside. In three hypervolemic patients with congestive heart failure and/or renal insufficiency, the drug induced a rapid fall in systemic arterial pressure and a beneficial effect on cardiac performance, as shown by a shift of the ventricular function curves to the left. In two hypovolemic patients, the hemodynamic response was quite different; vasodilator therapy induced a confusing clinical picture characterized by significant fluctuations in blood pressure, a severe fall in cardiac output and clinical signs of shock in spite of normal blood pressure. Hemodynamic response to vasodilator therapy with sodium nitroprusside in hypertensive crisis appears to be directly related to the circulating blood volume. The syndrome of hypertension associated with hypovolemia needs to be recognized promptly in order to avoid inappropriate therapy; in such cases volume expansion under precise hemodynamic monitoring appears to be an effective means of stabilizing the cardiocirculatory conditions.

Acute Disease↗