Biomedical subjects
Publications and source records attributed to G Fabbri.
The preparation of some homologues of 2-(4-cyclohexylphenyl)-3-hydroxypropionic acid, the separation of the diastereomeric race-mates, their attribution to erythro and threo series, and the optical resolution of the enantiomers are described. The optical antipodes were screened for acute toxicity, as well as for antiinflammatory and analgesic activity.
Althesin (CT 1341) was used to induce and maintain anaesthesia by means of the drip technique in 50 patients aged 2-14 yr subjected to long orthopaedic surgery not requiring muscular relaxation. It was found that Althesin, if combined with high doses of analgesics, can provide a stable level of anaesthesia that is deep enough to cater for the most painful surgical procedures, marked cardiocirculatory stability, and no more than slight side-effects, and is easy to handle.
Althesin was employed for induction and anaesthesia maintaining in 50 patients aged from 70 to 89 years undergoing orthopaedic surgery non requiring muscular relaxation. Combined with morphine-like drugs, Althesin is able to provide satisfactory and stable anaesthesia also during long procedures in old and poor-risk patients.
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Despite the obvious benefits of two-stage implants, patients do experience discomfort as they have to continue wearing non-fixed total dentures whilst postoperative healing takes place. These patients would be more comfortable if a functional and esthetically pleasing solution could be arrived at in a shorter time. In an effort to achieve this, the scientific community has researched and fitted ''immediate load'' implants. The current literature states that this procedure, when fitting 4 or more interforaminal implants, is both predictable and reliable. The procedure increases neither the number of implant failures nor the amount of bone lost. In the case reported, 4 implants were inserted and a bar constructed. The practicality of this procedure is seen in reduced time and costs. An initial total denture was used at the start, first as a surgery guide, then as an individual tray for impression, and eventually as final total denture. Fixing the initial total denture to the implant, considerably reduced the time taken in the whole implant procedure and provided the patient with a more comfortable, pleasing solution. The use of the bar prevented the denture from moving, guaranteed full support from the implants, and reduced or prevented the bone loss seen in patients where non-implant supported total dentures have been used. This procedure had the additional benefit of versatility - as it could have been used as an intermediate stage towards providing a more complex prosthesis, such as a Toronto prosthesis.
The authors investigated the role of atrial natriuretic peptide (alpha-hANP 99-126) in essential hypertension by evaluating some hemodynamic and renal effects of acute peptide infusion (1 micrograms/kg for 1 min + 50 ng/kg for the following 20 min) in fourteen subjects: eight mild to moderate, untreated, essential hypertensives (EH) and six normotensive (N) controls, during 2 hour-clearance periods, the 1st after ANP infusion, the 2nd during placebo (PL) administration. The double-blind study was carried out after the patients had rested and fasted overnight. It showed no significant changes in heart rate (HR); instead, compared with placebo, mean blood pressure (MBP) decreased significantly in both groups, beginning from the 3rd min after ANP infusion was begun (N: PL = 87.04 +/- 1.7 mmHg, ANP = 80.9 +/- 3.7 mmHg, p less than 0.0001; EH: PL = 102.6 +/- 3.2 mmHg, ANP = 97.7 +/- 5.9 mmHg, p less than 0.01). Among the urinary parameters we considered, cyclic GMP (cGMP) increased after ANP infusion in all subjects (N: PL = 129.1 +/- 56.3 pmol/mL, ANP = 199.2 +/- 85.4 pmol/mL; EH: PL = 106.55 +/- 56.2 pmol/mL, ANP = 220.03 +/- 92.7 pmol/mL, p less than 0.05); diuresis showed a prompt and significant increase in EH (N: PL = 837 +/- 368 mL, ANP = 1066 +/- 340 mL; EH: PL = 713 +/- 286 mL, ANP = 1043 +/- 280 mL, p less than 0.005), and so did natriuresis (N: PL = 23 +/- 14.3 mEq/L, ANP = 33 +/- 14.6 mEq/L; EH: PL = 25.6 +/- 8.9 mEq/L, ANP = 41.9 +/- 13.8 mEq/L, p less than 0.01); urinary potassium excretion was significantly reduced in EH (N: PL = 18.7 +/- 12.9 mEq/L, ANP = 14.2 +/- 6.9 mEq/L; EH: PL = 16.5 +/- 7.9 mEq/L, ANP = 10.7 +/- 4.8 mEq/L, p less than 0.005), while no changes were noted in glomerular filtration rate (GFR), estimated as creatinine clearance, urinary magnesium, albumin and aldosterone excretion. To investigate other potential mechanisms involved in renal effects of ANP, the urinary excretion of both prostaglandins 6-cheto PGF1-alpha and thromboxane B2 (TXB2), and dopamine were studied. The results showed only a significant decrease of dopamine urinary excretion in EH after ANP administration (N: PL = 50.4 +/- 28.7 micrograms/L, ANP = 45.0 +/- 29.7 micrograms/L; EH: PL = 47.3 +/- 21.5 micrograms/L, ANP = 27.1 +/- 12.7 micrograms/mL, p less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)
Risk factors, neurological, neuroradiological and ophthalmological features of 13 cases of acute pseudotumor cerebri were studied. After a 53-month period of mean follow-up, ophthalmological complications were taken into consideration: one patient (8%) showed unilateral optic atrophy with complete loss of vision, another subject complained of visual field constriction, and a third one of transient horizontal diplopia. Papilledema, which was present in 100% of the patients in the acute phase, persisted in 62%.
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Adenosine triphosphate (ATP) has been effectively used for induced hypotension in man. Atrio-Ventricular (A-V) conduction disturbances have been observed after adenosine bolus injection and during continuous ATP i.v. infusion. The present perspective investigation was designed to determine the incidence of A-V conduction disturbances during ATP-induced hypotension. Thirty-five normotensive healthy patients (ASA I-II) with no preoperative therapy were subjected to the same anesthetic technique for orthopedic surgery. Premedication consisted of diazepam and atropine. Anesthesia was induced with thiopental and fentanyl followed by atracurium for intubation. The maintenance anesthesia consisted of isoflurane (1.5% inspired)-N2O (60%) in oxygen and incremental doses of fentanyl; the lungs were mechanically ventilated. Dipyridamole (0.15 mg kg-1) was given 15 min prior to ATP-infusion. ATP was administered by an infusion pump at a dosage of 0.025-0.05 mg kg-1 min-1. The ECG was recorded with a Mingograph 34 tape-recorder using 3 pregelled electrodes positioned to give an effective V6 lead pattern. MAP was reduced by 25% and HR increased by 6%. The mean duration of ATP-induced hypotension was 75 min +/- 50 and the mean dose of ATP infused was 200 mg +/- 161. Six patients (17%) showed A-V conduction disturbances. There was a I A-V Block (AVB) in 2 cases, a II AVB in 2 cases and a III AVB in 2 cases. In every case the arrhythmia disappeared spontaneously or after ATP-infusion suspension.(ABSTRACT TRUNCATED AT 250 WORDS)
Main circulatory (heart frequency, HF, intra-artery pressure, AP ECG) and respiratory (arterial oxyhemoglobin saturation SaO2, end-tidal CO2) arterial gas-analysis (HGA) parameters were recorded continually during cemented hip arthroplasty in 70 consecutive non-selected patients. The use of cement did not cause any change in the parameters obtained in 21 of the cases, reduction in arterial oxygen pressure (PaO2) ranging from 11% to 38% was observed in 44 cases, associated with simultaneous reduction in ETCO2 in 11 cases. The reduction in ETCO2 was an isolated finding in 5 of the patients. AP decreased by more than 10% in only 2 cases and there was arrhythmia in another 2 cases. These findings are strongly suggestive of pulmonary embolism encouraging the hypothesis of gas embolism previously suggested by other authors. In patients with little coronary or pulmonary reserve use of cement means an increased risk of severe hemodynamic complications.