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Biomedical subjects

L Berra

Publications and source records attributed to L Berra.

5 recordsLinked to original sources
PubMed2003

Bacterial colonization of the respiratory tract following tracheal intubation-effect of gravity: an experimental study.

OBJECTIVE: To explore the role of the horizontal orientation of endotracheal tube and neck on bacterial colonization of the respiratory tract in anesthetized sheep on mechanical ventilation, without use of antibiotics. DESIGN: Prospective animal study. SETTING: National Institutes of Health research laboratory. SUBJECTS: Anesthetized, paralyzed, and ventilated sheep. INTERVENTIONS: Sheep were randomized into five groups and managed as follows: Group IS contained sheep that were not intubated and were immediately killed. Group HU4 contained six sheep that were mechanically ventilated for 4 hrs, with head and endotracheal tube elevated 30 degrees from horizontal. Group HU72 contained seven sheep that were prone, mechanically ventilated for 72 hrs, and managed the same as group HU4. Groups G and Gf each contained seven sheep that were prone on a lateral body rotation device, mechanically ventilated for 72 hrs, with neck and endotracheal tube horizontal. Group Gf received nasogastric enteral feeding. MEASUREMENTS AND MAIN RESULTS: At the end of the study, sheep were examined postmortem, and a total of 11 tissue samples were taken from the trachea, the five lobar bronchi, and the five lobar parenchyma, for qualitative and quantitative culture. Group HU72 had significant decrease in Pao2/Fio2 and heavy bacterial colonization in all sheep. Groups G and Gf retained excellent lung function; lung bacterial colonization was no different from the IS group. CONCLUSIONS: The horizontal orientation of the endotracheal tube and neck, through lateral body rotation, showed no altered airway colonization and maintained excellent gas exchange and lung function in our animal model.

Animals↗
PubMed2003

New approaches for the prevention of airway infection in ventilated patients. Lessons learned from laboratory animal studies at the National Institutes of Health.

Despite early diagnosis and appropriate antibiotic therapy, ventilator-associated pneumonia (VAP) remains the leading cause of death from hospital-acquired infection in ventilator-dependent patients. Strategies to prevent bacterial colonization of the trachea and lungs are the key to decrease mortality, hospital length of stay, and cost. It is well established that the VAP can result from entry of infected oropharyngeal/gastric secretions into the lower airways. Aspiration may occur during 1) intubation, 2) mechanical ventilation through leakage around the tracheal tube cuff, 3) suctioning of the tracheal tube when bacteria can detach from the biofilm within the tube, or 4) areosolization of bacterial biofilm during mechanical ventilation through the tracheal tube or the ventilator circuit biofilm. From experimental studies in sheep, we drew 3 relevant conclusions: 1) The tracheal tube and neck should be oriented horizontal/below horizontal to prevent aspiration of colonized secretions and subsequent bacterial colonization of the lower respiratory tract. 2) Continuous aspiration of subglottic secretions (CASS) can lower bacterial colonization of the respiratory tract, but at the price of severe tracheal mucosal damage at the level of the suction port. 3) Coating the interior of the tracheal tube with bactericidal agents can prevent bacterial colonization of the tube surface and of the entire respiratory circuit, during 24 hours of mechanical ventilation.

Biofilms↗
PubMed1995

[Sexual dysfunction in men and epilepsy].

Sexual dysfunctions may represent a symptomatological aspect of epilepsy or it may be a consequence of the pharmacological therapy. This kind of trouble is frequently associated to primary generalized epilepsy and focal secondary epilepsy. In our investigation we considered a group of 30 males during treatment with drugs like phenobarbital, carbamazepine and valproate, at the "Center for the Study and the Treatment of Epilepsy", University of Turin, using a sexological and psychosomatic questionnaire. The purpose was the analysis of the sexuality in relation to a specific kind of epilepsy or to a particular drug.

Adolescent↗
PubMed1993

[Diagnosis-specific psychotherapy].

The paper outline the fundamental features of a psychotherapeutic method which combined and integrates a psychosocial approach with a biological one. The basic concepts which justify an integrated approach are illustrated and the main stages of the technique are described. The treatment focuses on the definition of a diagnosis in line with the criteria of DSM-III-R; based on the diagnosis the therapist tries to identify the possible interactions between the symptomatic characteristics of the mental illness and its implications in a psychosocial context, before analysing them together with the patient. The method can be combined with all major traditional models of psychotherapy and does not rule out more in-depth analysis.

Female↗