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Biomedical subjects

G Frova

Publications and source records attributed to G Frova.

At least 19 recordsLinked to original sources
PubMed2001

Application of the self-inflating bulb to a hollow intubating introducer.

BACKGROUND: The aspiration test, performed by a self-inflating bulb (SIB), is a simple and reliable method to detect an accidental esophageal intubation. The aim of the study, in case of employment of a hollow intubating introducer (HII), was to verify the possibility to directly perform the test with the introducer and its efficacy in allowing the detection of its position. METHODS EXPERIMENTAL DESIGN: prospective, randomized study. ENVIRONMENT: operating theater in a university hospital. PATIENTS: adult patients, without evidence of gastro-esophageal or tracheobronchial pathologies, scheduled for elective surgery. INTERVENTIONS: patients were randomized in two groups T (HII was placed in trachea) and E (HII was positioned in the esophagus). Under general anesthesia, a HII was placed in either the trachea or the esophagus. A blinded anesthesiologist connected the SIB to the HII and performed the test twice. MEASUREMENTS: the anesthesiologist inferred the position of the device, based on the re-inflation observed. RESULTS: One hundred subjects were studied. In group E patients, a prompt and complete re-inflation of the bulb was never observed and the anesthesiologist correctly inferred the position of the HII. Occasionally (3.5% of cases), in group T patients, a prevented or incomplete re-inflation of the bulb occurred, leading to an incorrect judgment of the HII position. CONCLUSIONS: The aspiration test with the SIB allows the proper detection of the introducer in esophagus. When used in combination with a HII, both time and local trauma associated with an erroneous, introducer-guided esophageal intubation in case of difficult laryngoscopy may be reduced.

Adolescent↗
PubMed2000

[Injury of the long thoracic nerve after LRA, which etiology? Clinical case].

The long thoracic nerve supplies the serratus magnus muscle. Its injury causes "winging" of the scapula and functional limitation of the upper limb. Such lesion is mostly due to chronic trauma, occasionally iatrogenic. This case report presents a case of serratus magnus muscle paralysis following an anesthetic block of the brachial plexus performed at the time of a minor orthopedic surgery of the wrist, in a young healthy woman who was a tennis player. The observed lesion seemed to have been caused by the anesthetic technique employed, but, at the same time, it is impossible to rule out, in the etiology of the disease, a role of other predisposing factors, such as the intense sport activity above mentioned, or of concurrent factors, such as an incorrect position in the immediate postoperative period.

Adult↗
PubMed2000

[Percutaneous tracheostomy: technological development].

PDT based on Seldinger's technique is gaining wide acceptance in ICU patients, but the procedure has undergone various modifications during the past thirty years. The ten most known procedures and the target of their innovating content are briefly examined. The incidence of complications desumed from the literature, wide in some cases and limited or absent in others, is also considered. In many cases, the technological modifications of original procedures had two fundamental objectives: to increase it's safety and to reduce the operator-depencence of the procedure. According to the review of the literature (and our experience too) the increasing interest for percutaneous tracheostomy is the justified conclusion of the technological development of some dilatative techniques. With an appropriate training and the continuous endoscopic guidance, it is possible today to perform PDT in critically ill patients of ICU with a very low total complication rate. Even if the comparison between different techniques is not rich enough on prospective randomized studies, the global low rate of hemorrhage complications, of wound infection and of poor cosmetic result are surely demonstrated and probably related to the small skin incision and the tight fitness between tissues and the tracheostomy tube.

Critical Care↗
PubMed1999

A randomly amplified polymorphic DNA marker specific for the Bacillus cereus group is diagnostic for Bacillus anthracis.

Aiming to develop a DNA marker specific for Bacillus anthracis and able to discriminate this species from Bacillus cereus, Bacillus thuringiensis, and Bacillus mycoides, we applied the randomly amplified polymorphic DNA (RAPD) fingerprinting technique to a collection of 101 strains of the genus Bacillus, including 61 strains of the B. cereus group. An 838-bp RAPD marker (SG-850) specific for B. cereus, B. thuringiensis, B. anthracis, and B. mycoides was identified. This fragment included a putative (366-nucleotide) open reading frame highly homologous to the ypuA gene of Bacillus subtilis. The restriction analysis of the SG-850 fragment with AluI distinguished B. anthracis from the other species of the B. cereus group.

Amino Acid Sequence↗
PubMed1999

[Anesthesia accidents: accidental esophageal intubation].

Accidental oesophageal intubation is a common mistake in inexperienced anaesthetists, but unrecognized oesophageal intubation is fortunately a rare event because, in anaesthetic malpractice claims, it frequently resulted in death or brain damage. The connection of these complications with the lack of experience of the anaesthetist and/or the difficult intubation is not so evident in the literature. The precocious detection of tube dislocation depends on the systematic verification of endotracheal tube position after insertion. The paper describes the clinical and instrumental tests used for detecting tracheal or oesophageal intubation. Clinical signs are often unreliable and, between technical tests, capnography is the most reliable of correct tracheal positioning if waves are regular and repeated; when unavailable, the negative pressure aspiration test is a simple and reliable alternative.

Anesthesia↗
PubMed1998

Organizational aspects of donor procurement activity in the North Italy Transplant programme (NITp).

In Italy, organ procurement is insufficient to meet patient need. The aim of this study was to estimate the potential donor pool, quantify nonused donors, identify causes of nonretrieval, and evaluate the impact of some hospital organizational problems on organ procurement. In 1995 a questionnaire was sent to 103 intensive care units (ICUs) in 92 hospitals of the NITp area. Out of 432 potential donors identified, 239 (55.3%) were used. Causes of nonretrieval included family refusal (51.7%), clinical reasons (43.9%) and organizational problems (4.4%). In comparison with 1990 and 1993 data, a higher percentage of donors were used and the donors lost for organizational reasons had decreased significantly, while no significant differences were observed in the number of donors lost for family refusal and for clinical reasons. The marked improvement in donor procurement in NITp from 1990 to 1995 was probably as result of measures aimed at motivating ICU personnel and solving their organizational difficulties.

Humans↗
PubMed1998

PCR fingerprinting of whole genomes: the spacers between the 16S and 23S rRNA genes and of intergenic tRNA gene regions reveal a different intraspecific genomic variability of Bacillus cereus and Bacillus licheniformis [corrected].

Genomic diversity in 21 strains of Bacillus cereus and 10 strains of Bacillus licheniformis was investigated by random amplified polymorphic DNA (RAPD) analysis, which samples the whole genome, and by two PCR fingerprinting techniques sampling the hypervariable spacers between the conserved 16S and 23S rRNA genes of the rRNA gene operon (ITS-PCR) and regions between tRNA genes (tDNA-PCR). RAPD analysis showed a remarkable diversity among strains of B. cereus that was not observed with the rRNA and tRNA intergenic-spacer-targeted PCR, where all the strains showed practically identical fingerprints. A wide variability among the B. cereus strains was also observed in the plasmid profiles, suggesting that the genetic diversity within B. cereus species can arise from plasmid transfer. One contribution to the diversity detected by RAPD analysis was determined by the presence of large extrachromosomal elements that were amplified during RAPD analysis as shown by Southern hybridization experiments. In contrast to the strains of B. cereus, the 10 strains of B. licheniformis were grouped into two clusters which were the same with all the methods employed. The 16S rRNA genes were identical in all 10 strains when examined using single strand conformation polymorphism analysis after digestion with Alul and Rsal. From these data we hypothesize two different evolutionary schemes for the two species.

Bacillus cereus↗
PubMed1981

[Double-blind study of lysine acetylsalicylate in the control of postoperative pain of somatic origin].

In 61 patients submitted to subdural anesthesia for orthopedic operations, postoperative somatic pain was treated by double-blind iv injection of lysine acetylsalicylate 1.8 g or placebo randomly. Patients with persistent pain received methadone 10 mg im. No placebo response was obtained; LAS had similar but shorter effects than methadone. No significant side effect was observed.

Adult↗