Biomedical subjects

L Bertini

Publications and source records attributed to L Bertini.

44 records · Page 3Linked to original sources

PubMedDate not supplied

[Imaging of median sternotomy complications].

Median sternotomy is the surgical technique of chosen for cardiac surgery. Although the complications after median sternotomy are not so frequent, these are associated to elevated mortality. The complications can interest the presternal compartment, the sternal compartment or the retrosternal compartment. Even if the clinical diagnosis of infection is not difficult for the clinician, it is nearly impossible to establish the depth of the infection. Multislice CT, thanks to the possibility to obtain thin layers and three-dimensional multiplanar reconstructions and Volume Rendering, turns out extremely useful for being able to demonstrate the extension and the depth of the infection. Of fundamental importance it is the elaboration of the images, executed on workstation, with which multiplanar reformatted and Volume Rendering images are obtained. The CT turns out useful moreover like guide for the execution of interventional procedures such as aspiration of material for bacteriological characterization or eventual positioning of a catheter for abscess drainage. The Magnetic Resonance, thanks to its high resolution of contrast and to its multiplanarity, finds one of its elective applications in the study of the flogistic and neoplastic processes of the soft tissues. A great limit of the MR is the possible generation of artifacts due to sternal suture.

Cardiac Surgical Procedures↗

PubMedDate not supplied

[New CT and MR imaging techniques in non-traumatic neurological emergencies].

New CT and MR imaging techniques used for non-traumatic neurologic emergencies (represented mostly by ischemic stroke) fulfil the exigency to know quickly and with high accuracy the presence of abnormalities in cerebral perfusion, with the final aim to practise immediately all the treatments needed to prevent the progression of the neurologic damage, by selecting those patients to undergo fibrinolysis, which is useless and not indicated in many occasions. The diagnosis of ischemia is only the first goal reached by these new diagostic tools, while it is nowdays possible and required to stratify the risk factors for the therapy and to accurate select those patients candidates to fibrolnilysis, in order to minimize the risck related to the inadequate treatment choice.

Brain↗

PubMedDate not supplied

[CT and MR virtual colonscopy: indications, limits and comparison with conventional colonscopy].

Virtual endoscopy is a new method for studying the colon; it consists in acquisition of CT and MR images and to elaborate them with a workstation, to create endoluminal vision as like as traditional colonscopy, permitting the complete exploration of colonic lumen, also with stenotic tumors. The analysis of the differences between CT and MR colography shows like these two techniques present both advantages and disadvantages, such as the impossibility to perform MR in patients with pace-maker or in claustrophobic patients and the impossibility to perform CT with iodated agents in patients with renal failure or with a story of adverse reactions. The increased use of these techniques is due to the high sensitivity of last-generation CT and MR machine, to the increased spatial resolution, to specific softwares for digital cleaning of colon, to the introduction of high-end workstations and to the possibility of computed assisted diagnosis (CAD). So, it is desiderable that the increasing spread of multidetector CT devices and the future technical innovations, should have the effect to increase culture and experience in various diagnostic centers about CT-colography, making possible the spreading of virtual endoscopy as a screening tool.

Colonography, Computed Tomographic↗

PubMedDate not supplied

[Imaging of simple and complicated acute cholecystitis].

Acute Cholecystitis is a common disease and it needs to be treated in emergency. In case of complication, surgery is mandatory in 48-72 hours. Ultrasonography (US) is the first diagnostic step in that it allows to identify the signs of major complications, not always visible. Spiral CT identifies complications misdiagnosed at US and allows a correct classification. However, spiral CT is able to depict fluid collections or gas in the wall or in the lumen of the gallbladder or free air in the peritoneum, signs not always depicted by US and which also needs surgical treatment in emergency. If one or more signs of complications are present, CT is mandatory to identify complicated cholecystitis (phlegmonous or empyematous cholecystitis, abscesses, emphysematous, gangrenous, hemorragic or perforated cholecystitis) and to indicate its urgent surgery.

Cholecystitis, Acute↗

PubMedDate not supplied

[Cardiovascular emergencies in dental surgery].

More often to day odontologist must face emergency situations especially of cardiovascular kind. The article reviews the principal clinical aspects: syncope, cardiac arrest, arrhythmias, acute hypertension, acute myocardial infarction. The authors besides describe cardiopulmonary-resuscitation (CPR) techniques. The article ends with some recommendations to prevent cardiovascular emergency and to incite medical and paramedical staff to learn perfectly CPR techniques.

Angina Pectoris↗

PubMedDate not supplied

[Local anesthetics and cardiopathic patients].

Today the number of people who need odontologist is very high, so the risk relative to local anesthesia is increased. The authors, after having remembered local anesthetics pharmacological properties, have analysed the many kinds of cardiovascular disease in relation with possible side effects of local anesthesia. The article ends with the contraindications for local anesthetics and vasoconstrictors use.

Anesthesia, Dental↗

PubMedDate not supplied

[Prevention of infective endocarditis during dental treatment].

About 14% of infective endocarditis seems due to dental treatments and 7% to poor dental hygiene. It's necessary for odontologist to reconnaissance the so called "moderate risk patients" and the "high risk patients". The authors report infective endocarditis prophylaxis program recommended from OMS/European Region (1985). It's also emphasized the role of dental hygiene as an essential precaution for the prevention of infective endocarditis.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Patient-controlled postoperative analgesia in orthopedic surgery: epidural PCA versus intravenous PCA].

OBJECTIVE: To evaluate both effectiveness and incidence of side effects of two techniques of postoperative pain treatment: intravenous and epidural PCA. DESIGN: Prospective analysis of data from two groups of randomized patients. SETTINGS: Orthopedic and trauma center. PATIENTS: Figty ASA class II-III patients undergoing total hip replacement under combined Spinal-Epidural Anesthesia. METHODS: Patients were divided into 2 groups who received different postoperative pain treatment. One group (group PCA) received a patient-controlled intravenous analgesia with morphine 30 mg and ketorolac 90 mg in 100 ml of saline (back-ground infusion 2-4 ml, according to body weith, bolus 1 ml, lockout 5 min, 4 h dose limit 40 ml). PCEA group received a patient-controlled epidural analgesia with morphine 4 mg and bupivacaine 0.125% 100 ml, (background infusion 3-4 ml, according to patient' height, bolus 1 ml, lockout 10 min, 4 h dose limit 25 ml). Postoperative pain intensity was evaluated, through 24 postoperative hours, by a verbal analogue scale (VPS = 0 to 3) and a total pain score (TOTPAR) was calculated for each patient at 6 and 24 postoperative hours. Side effects were recorded and their incidence was obtained for each group. Statistical data analysis was performed by one-way ANOVA and non-parametric tests for ordinal data. Nominal data were analyzed by chi 2 test. p < 0.05 was considered significant. RESULTS: Patient receiving PCEA showed a significant (p < 0.005) decrease of incident pain, while VPS at rest was similar in the two groups. TOTPAR VPS was lower (p < 0.05) in PCEA group both at 6 and 24 postoperative hours. Somnolence was observed more often in PCA patients (8% vs 2%; p 0.05), while no significant differences were noted among other side effects incidence. CONCLUSIONS: Our data show a better control of postoperative pain arising from total hip replacement during PCEA when compared to PCA. It should be emphasized that incident pain is far more decreased by PCEA, so that this technique is particularly indicated when an early postoperative mobilization is required.

Aged↗