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L Rizzo

Publications and source records attributed to L Rizzo.

At least 37 records · Page 2Linked to original sources
PubMed1998

Iohexol plasma clearance in determining glomerular filtration rate in diabetic patients.

The plasma clearance of iohexol has recently been proposed as a new method for estimating GFR. The iohexol plasma clearance was compared with that of 51Cr-EDTA in 32 diabetic patients (12 IDDM, 20 NIDDM; age 23-70; diabetes duration 1-35 years) with normal to impaired renal function (serum creatinine: 0.8-6.4 mg/dL). Bolus i.v. injection of 51Cr-EDTA (1 muCi/kg) was followed by 5 mL slow i.v. injection of Omnipaque (Nycomed, Oslo, Norway). Samples for radioactivity and iohexol analysis were drawn at 0, 5, 10, 15, 30, 60, 90, 120, 150, 180, 210, 240, 270, 300 min (+360 and 420 min if serum creatinine > 2.0; +1440 min if > 5.0 mg/dL). Iohexol was assayed in duplicate by HPLC throughout a Nova-Pak C18 column (Waters-Millipore, USA). Only the second peak obtained during elution of iohexol (about 4.5 min) was used for calculation. Dilution tests show highly linear regressions for concentrations between 3.25-650 micrograms/mL (r = 0.99). Imprecision of iohexol assay (the whole procedure from deproteinization to chromatography) was: intra-assay 1.4 +/- 1.5%, mlsd (95% CI: 1.0-1.8%); inter-assay 3.0 +/- 2.7% (1.4-4.6%). Iohexol plasma clearance ranged between 12.9 and 150.9 mL/min, while 51Cr-EDTA plasma clearance between 11.9 and 149.8 mL/min with excellent correlation (iohexol = 0.95 51Cr-EDTA + 2.49; r = O.995). Mean CV between the two methods was 1.7% (range 0-4.9%) with a significant negative correlation (r = 0.5 I, p = 0.007) with the GFR levels. Correlation between repeated measurements, performed in eight patients, was excellent (r = O.994, P = 0.0001). In diabetes, GFR measured by plasma clearance of iohexol shows an excellent agreement with plasma clearance of 51Cr-EDTA throughout a wide range of renal function. Iohexol provides an accurate alternative method for measuring GFR.

Adult↗
PubMed1998

Clinical usefulness of technetium-99m-HMPAO-labeled leukocyte scan in prosthetic vascular graft infection.

UNLABELLED: The infection of a prosthetic vascular graft (PVGI), although rare, is the most severe complication in reconstructive vascular surgery. The early diagnosis of this complication reduces the death rate from surgery. Aortofemoral graft infections differ clinically from peripheral graft infections in significant ways. The aim of this article is to evaluate separately the reliability of the 99mTc-HMPAO-labeled leukocyte scan or white blood cell count (WBC) in the early detection of both aortofemoral and peripheral graft infections. METHODS: One hundred sixty-two WBCs were performed on 129 consecutive patients with suspected aortofemoral (122 scans) and peripheral (40 scans) graft infection and in a 12-patient control group. Patients with suspected PVGI were categorized into three groups on the basis of their signs and symptoms on readmission: (a) patients with specific signs of graft infection (Group A); (b) patients with nonspecific signs of graft infection (Group B); and (c) patients with anastomotic aneurysms (Group C). Gram's stains of the perigraft exudate and graft cultures were performed and used as the gold standard in patients who underwent surgery. An 18-mo clinical follow-up was done to assess the presence or absence of graft infection in patients who did not have surgery. RESULTS: In patients with suspected aortofemoral graft infections, the overall sensitivity, specificity and accuracy of WBCs (Groups A, B, C) were 100%, 92.5% and 97.5%, respectively, whereas sensitivity, specificity and accuracy calculated in the patients with nonspecific signs of graft infection (Groups B, C) were 100%, 92.3% and 96.9%, respectively. In patients with suspected peripheral graft infections, sensitivity, specificity and accuracy were 100%. CONCLUSION: The white blood cell scan seems a reliable diagnostic method for early diagnosis of PVGI, and it is more useful in aortofemoral graft infections.

Blood Vessel Prosthesis↗
PubMed1997

MRI diagnosis of intramedullary metastases from extra-CNS tumors.

The purpose of this study was to evaluate the topography, morphology and contrast enhancement of the intramedullary metastases (IM) from extra-CNS neoplasms. We report the results of a multicenter retrospective study on 18 patients with 26 IM examined with a 0.5T MR imaging system; intravenous injection of Gd-DTPA was performed in all cases. We found that the lesions are most frequently single, oval shaped, and small, with little or no deformation of the spinal cord (14 of 26 IM). They appear isointense on spin-echo T1-weighted images (24 of 26 IM), with a homogeneous and generally nodular high contrast enhancement after Gd-DTPA injection (21 of 26 IM), and present on T2- and proton-density-weighted sequences with a pronounced perilesional, pencil-shaped hyperintensity of the surrounding cord which is more evident in the cranial part of the cord referring to the IM.

Breast Neoplasms↗
PubMed1997

Bacterial and clinical criteria relating to the outcome of patients undergoing in situ replacement of infected abdominal aortic grafts.

OBJECTIVES: In a retrospective non-randomised study we assessed the outcome after in situ replacement of infected knitted Dacron abdominal aortic grafts in patients without septicaemia or retroperitoneal abscesses. We also assessed whether the specific bacterial infection influenced outcome. MATERIALS AND METHODS: Over the 5 years studied, 18 patients (9 with perigraft infection and 9 with aortoenteric erosion) underwent in situ replacement of aortofemoral grafts. All patients were haemodynamically stable, none required emergency treatment. Preoperative assessment included CT, MRI, leukocyte-labelled scintigraphy, and bacterial cultures whenever possible. Infected grafts were totally excised and replaced in situ with standard PTFE prostheses. Bacterial diagnosis included intraoperative Gram-staining and postoperative graft cultures. None of the patients had retroperitoneal collections or proximal anastomotic dehiscence. All patients had 6 week intravenous antibiotic therapy. RESULTS: One patient died of myocardial infarction, and another of haemorrhagic shock from proximal anastomotic dehiscence, accounting for a graft-related mortality of 6%. Dehiscence resulted from a polymicrobial infection. Mean 37 month surveillance showed no amputations and no graft-related infections. CONCLUSIONS: In clinically and bacteriologically selected patients, total in situ replacement of infected abdominal aortic grafts offers an excellent outcome.

Adult↗
PubMed1997

General anaesthesia versus cervical block and perioperative complications in carotid artery surgery.

PURPOSE: To compare the influence of anaesthetic technique on perioperative complications in patients undergoing carotid endarterectomy. MATERIAL AND METHODS: In a retrospective study of 1020 consecutive patients who underwent carotid artery surgery over 10 years, perioperative neurologic and cardiologic complications and the use of an internal carotid artery shunt were compared in 337 patients (33%) treated under general anaesthesia and 683 (67%) under cervical block. The two groups had similar characteristics. The most frequent surgical indication was symptomatic carotid artery disease (91.5%). The remaining patients had asymptomatic severe internal carotid lesions (> 70%). RESULTS: The overall perioperative stroke rate was 1.9%, the death-stroke rate 0.7% and the cardiac complication rate 0.8%. The perioperative stroke rate was higher in the general anaesthesia group than in the cervical block group (3.2% vs 1.3%, p = 0.01). Cardiac complication rates were similar in the two groups. A carotid artery shunt was used in 75 patients (22%) receiving general anaesthesia and in 92 patients (13%) receiving cervical block (p = 0.0004). The causes of stroke in the cervical block group were intraoperative embolism (4 cases, 26%), perioperative thromboembolism (7 cases, 58%) and clamping ischaemia (1 case, 16%). Mechanisms causing stroke in the general anaesthesia group remained unidentified or uncertain. CONCLUSIONS: Cervical block anaesthesia yields better perioperative results than general anaesthesia probably because it allows more reliable cerebral monitoring, reducing or even eliminating perioperative strokes related to clamping ischaemia. It facilitates detection of the mechanism underlying intraoperative stroke allowing surgical techniques and intraoperative management to be modified accordingly. Cervical block anaesthesia significantly reduces the need for internal carotid artery shunting.

Adult↗
PubMed1997

Transcapillary escape rate of albumin in type II diabetic patients. The relationship with microalbuminuria and hypertension.

OBJECTIVE: To study why in type II diabetes, microalbuminuria, a marker of generalized vascular dysfunction, and hypertension have been linked with both renal and cardiovascular organ damage. RESEARCH DESIGN AND METHODS: To investigate the effect of moderately elevated blood pressure on vascular damage, the transcapillary escape rate of albumin (TERalb) was measured by intravenous injection of purified 125I-human serum albumin in 9 healthy control subjects (group 1), 9 nondiabetic hypertensive subjects (group 2), and 73 nonobese type II diabetic patients stratified as follows: group 3: 17 normoalbuminuric-normotensive subjects; group 4: 22 normoalbuminuric-hypertensive subjects (systolic blood pressure [sBP] > or = 140 mmHg or diastolic blood pressure [dBP] > or = mmHg or both); group 5: 16 normotensive subjects with microalbuminuria (albumin excretion rate [AER]: 20-200 micrograms/min); and group 6: 18 microalbuminuric-hypertensive subjects. RESULTS: Groups 3-6 had similar age, sex, duration of diabetes (group 3: 7.8 +/- 5.5; group 4: 9.7 +/- 8.7; group 5: 12.1 +/- 8.1; and group 6: 10.7 +/- 8.3 years), BMI, HbA1c (7.8 +/- 1.1, 7.5 +/- 1.5, 8.7 +/- 1.5, and 7.7 +/- 1.1%, respectively), blood glucose, and lipid profile. Systolic and diastolic blood pressure did not differ in the three hypertensive group (group 2: 154 +/- 3/99 +/- 6; group 4: 149 +/- 13/95 +/- 6; group 6: 154 +/- 15/91 +/- 9 mmHg) and were significantly lower (P < 0.001) in group 3 (126 +/- 12/76 +/- 7), group 5 (128 +/- 11/77 +/- 5), and healthy control subjects (group 1: 133 +/- 7/81 +/- 4). TERalb was similar in control subjects (5.77 +/- 1.06%/h) and in normoalbuminuric-normotensive subjects (5.81 +/- 1.51%/h) but significantly higher (P < 0.0001) in microalbuminuric subjects with or without hypertension (9.11 +/- 1.65 and 8.60 +/- 1.50%/h, respectively) as well as in normoalbuminuric diabetic patients with hypertension (8.10 +/- 2.27%/h) and in essential hypertensive subjects (8.12 +/- 1.68%/h). CONCLUSIONS: By stepwise regression, TERalb was related (step 1) to log-AER (r = 0.30) or to the presence of microalbuminuria (r = 0.36) and (step 2) to dBP (multiple r = 0.40) or to the presence of hypertension (multiple r = 0.51) in the whole diabetic cohort (groups 3-6). TERalb was related to dBP (r = 0.47) or to the presence of hypertension (r = 0.56) only in normoalbuminuric diabetic patients (groups 3 and 4) and to log-AER (r = 0.56) or the presence of microalbuminuria (r = 0.68) only in normotensive patients (groups 3 and 5). In type II diabetic patients, TERalb was elevated in subjects with increased albuminuria, irrespective of blood pressure levels, but also was independently related to the presence of mild-to-moderate systemic hypertension.

Adult↗
PubMed1997

[Accident during retinal fluorescein angiography].

OBJECTIVE: To evaluate adverse reactions frequency following fluorescein i.v. administration to perform retinoic angiography (ARF). DESIGN: Retrospective study. SETTING: Eye Clinic of the University of Florence. MATERIALS AND METHODS: 6524 patients undergoing 10,003 ARF. PARAMETERS EVALUATED: For each patient age, sex, concomitant diseases, previous ARF, allergic history and any adverse reaction were evaluated. RESULTS: Adverse experiences were described in 7.5% of 6524 patients. Most of the observed reactions were mild: nausea (3.8%), vomiting (0.43%), vasovagal phenomena (1.18%), anaphylactoid reactions (1.84%). A major rate of adverse reactions were observed in patients previously submitted to ARF who reported in the anamnesis a previous adverse reaction, and in those with a positive allergic history. Severe reactions occurred in 0.27% of patients, but only in 2 of 6524 patients a rianimatory treatment (0.03) was necessary. CONCLUSION: From the data retrospective analysis it was observed that the manifestation of mild adverse effects was to be expected in many cases. It was therefore possible to point out classes of patients at risk (patients who reported a previous adverse reaction after ARF and patients with positive allergic history). Unfortunately it was not possible to expect and so to prevent the severe effects. Thus it is recommended to perform ARF in an adequately equipped room.

Adolescent↗
PubMed1996

Reducing pain of first trimester abortion under local anaesthesia.

The study aimed to estimate the pain related to first trimester abortion under local and general anaesthesia. One hundred and eighty-one women undergoing abortion of first trimester under local anaesthesia and 198 under general anaesthesia were interviewed 1 h after the end of the procedure. About 50% of all women described their experience as less painful than expected. Over 50% of the women described the pain during the procedure as mild or moderate according to the verbal rating scale. The step-up logistic regression analyses identified four important variables: time interval less than 2 min from local anaesthesia injection to the beginning of the procedure (RR = 3), lack of choice between local and general anaesthesia (RR = 1.9), history of frequent use of analgesics (RR = 1.9) and nulliparity (RR = 1.7). These data indicate that skillfully performed abortion with local anaesthesia is a procedure tolerated by most women. Moreover, because it carries lower risk of complications and costs less, its use should be encouraged.

Abortion, Induced↗