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Biomedical subjects

J Fioravanti

Publications and source records attributed to J Fioravanti.

7 recordsLinked to original sources
PubMed2000

Angiotensin-converting enzyme inhibitor therapy for ventricular dysfunction in infants, children and adolescents: a review.

Angiotensin-converting enzyme (ACE) inhibitors have become an important part of the pharmacologic armamentarium in the battle against treatment of ventricular dysfunction. There have been a number of large controlled, randomized trials in adults with both asymptomatic and symptomatic ventricular dysfunction, which confirm the safety and efficacy of this category of drugs for the treatment of this potentially lethal condition. ACE inhibitors may be used to treat infants, children and adolescents with asymptomatic and symptomatic ventricular dysfunction as well. The data supporting their use in children is less complete than that concerning the treatment of adults. We review here the various causes of ventricular dysfunction and congestive heart failure (CHF) in infants, children, and adolescents; the data available regarding treatment of these conditions with ACE inhibitors, and the safety and efficacy of these drugs for the various conditions. The pharmacokinetics and proposed mechanisms of action of ACE inhibitors in children are reviewed, as are speculated long-term results of ACE inhibitor use in cohorts of growing children. Recommendations are made for future studies.

Journal Article↗
PubMed1998

Pericardial effusion and tamponade as a result of percutaneous silastic catheter use.

Percutaneous Silastic catheters (PSCs) are used in premature infants to deliver total parenteral nutrition. We report two cases in which migration of the catheter into the right atrium resulted in rapid onset of shocklike symptoms. Pericardial effusion and tamponade were diagnosed by echocardiography. Subxiphoid pericardiocenteses were performed, with immediate clinical improvement. In both cases, fluid withdrawn from the pericardial space was analyzed to be hyperalimentation and intravenous fat emulsion. Pericardial effusion and tamponade should be suspected in any infant with a PSC line in place who develops sudden onset of shocklike symptoms.

Cardiac Tamponade↗
PubMed1994

Nurse practitioners' effectiveness in NICU.

The effectiveness of Neonatal Nurse Practitioners (NNPs) in a Level III Neonatal Intensive Care Unit (NICU) was evaluated by using a retrospective medical records review. Two groups of infants received care in a Transitional Care Unit (TCU), one by house officers and the second cared for by NNPs. Medical diagnoses, lengths of stay, hospital charges, discharge/transfer disposition and hospital readmissions were studied. No differences were found in DRG codes, discharge disposition, hospital readmission or number of infants transferred from TCU to NICU because of deteriorating condition. Though the infants cared for by the NNPs had significantly lower birth weight and lower gestational age, they averaged 2.4 fewer days in the hospital and $3,491 less in total hospital charges than the group cared for by house officers. This study confirms that NNPs can provide care comparable to house officers in a Level III NICU and be more cost effective.

Efficiency, Organizational↗