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M Antonini

Publications and source records attributed to M Antonini.

At least 19 recordsLinked to original sources
PubMed2006

Short communication: antimicrobial drug susceptibility of Staphylococcus aureus from subclinical bovine mastitis in Italy.

The antimicrobial susceptibility of 68 Staphylococcus aureus isolates collected during 2004 from milk of cows affected by subclinical mastitis was examined. The antimicrobial agents tested were the beta-lactams, penicillin G, amoxicillin, ampicillin, cloxacillin, amoxicillin + clavulanate, cephalonium, and cefoperazone; and other drugs including lincomycin, oxytetracycline, doxycycline, and kanamycin. Minimum inhibitory concentrations recorded show that only certain beta-lactamase-resistant penicillins (specifically cloxacillin) or penicillin combinations (amoxicillin + clavulanate) were consistently effective against Staph. aureus, whereas the other beta-lactam derivatives and drugs from other pharmacological groups were either moderately effective or ineffective. Thus, beta-lactamase-resistant penicillins are to be considered the antimicrobial agents of choice for treatment of bovine mastitis resulting from infection by Staph. aureus.

Animals↗
PubMed2005

Subclinical mastitis and antimicrobial susceptibility of Staphylococcus caprae and Staphylococcus epidermidis isolated from two Italian goat herds.

A total of 156 goats from 2 commercial dairy goat farms were monitored for intramammary infections during an entire lactation. Most of the infections (80.7%) observed were due to coagulase-negative staphylococci (CNS) species. In herd 1, nearly all of the infections (96%) were due to CNS species, with Staphylococcus caprae (SCAP) being the most common specific pathogen observed, accounting for about 43% of the infections. In herd 2, the proportion of the infections due to CNS was 67% and Staphylococcus epidermidis (SEPI) was the most common pathogen (48% of infections) and SCAP was not present. Linear somatic cell scores (SCS) were greater in milk from infected udder halves, with an average difference of 0.78 SCS. The SCS for infected udder halves was greater than noninfected for all CNS species, although differences among species were observed. The ranking across CNS species was SCAP > other CNS > SEPI > no infection. However, infections by SEPI tended to be more persistent. Increased SCS was associated with a statistically significant decrease in milk yield, but no effect was observed for intramammary infections (IMI). Ninety-seven isolates of CNS (53 SCAP and 44 SEPI) were investigated for in vitro susceptibility to several antimicrobial agents. Benzylpenicillin was the most effective antimicrobial agent against SCAP and SEPI. A concentration of 0.05 microg/mL was sufficient to inhibit growth of 90% of SCAP colonies, and 0.10 microg/mL yielded a similar effectiveness for SEPI. Amoxicillin and the combination of amoxicillin and clavulanic acid were only slightly less effective. Tetracycline (62.5 microg/mL) and tilmicosin (500 microg/mL) were the least effective treatments for SEPI and SCAP, respectively.

Amoxicillin↗
PubMed2004

Meta-analysis of allograft bypass grafting to infrapopliteal arteries.

OBJECTIVE: To determine graft patency and limb preservation after allograft bypass grafting to infrapopliteal arteries for different allograft materials. DESIGN: Meta-analysis of case series that used survival analysis to describe outcomes. METHODS: Studies published from 1982 through 2003 were identified from electronic databases and pertinent original articles. Four series of cryopreserved arterial allografts, 10 series of cryopreserved vein allografts, three series of cold-storaged vein allografts, and 16 series of umbilical-cord vein allografts were included in separate random-effects meta-analyses. RESULTS: A graphical display of pooled survival curves of graft patency showed cold-storaged veins to have the best outcome in the first 4 years, followed by cryopreserved arteries, umbilical-cord veins, and cryopreserved veins. The respective 5-year pooled patency were 24, 21, 30, and 19%. For foot preservation, the best outcome was achieved with cryopreserved arteries followed by cryopreserved veins, umbilical-cord veins, and cold-storaged veins. A reference meta-analysis of polytetrafluoroethlylene grafts occupied the top position for graft patency and the second position for foot preservation. CONCLUSION: In leg revascularisation for critical ischaemia, graft patency is poor for allografts generally, but using peripheral allografts in repeat attempts at revascularisation is a valid strategy to prevent major amputation. A role for umbilical-cord vein allografts remains uncertain.

Arterial Occlusive Diseases↗
PubMed2003

Preliminary electrochemical characterisation of cytochrome P4501A2-clozapine interaction.

Cytochromes P450 are a large superfamily of heme-thiolate enzymes involved in the metabolism of many different organic substrates such as drugs, fatty acids and toxic compounds. The aim of this work is to analyse the binding between the cytochrome P4501A2, in solution and in gel-matrix, and its substrate (clozapine), utilising voltammetric tests. The interaction measurements were carried out using two different screen printed electrodes (rhodium-graphite and graphite-riboflavin), and the results were compared. It was demonstrated that it is possible to realise a biosensor prototype to detect the presence of clozapine indirectly by chronoamperometry.

Journal Article↗
PubMed2003

Resection and transplantation: evaluation of surgical perspectives in HIV positive patients affected by end-stage liver disease.

PURPOSE: The aim of this study was to evaluate the opportunity of surgical treatment in terms of liver resection or liver transplantation in HIV positive patients affected by an end stage liver disease that referred to our liver unit. METHODS: Among 1350 outpatients who referred to our liver unit from January 2002 to September 2003, thirty-two (2,4%) were HIV positive. The routes of transmission of the viral infection, the related co-infections and the underlying liver disease were recorded. The therapeutic pathway was analysed. The kind and the duration of the surgical procedures were assessed. RESULTS: Fourteen (44%) of these thirty-two patients were not suitable for surgical treatment. Surgery was planned in 9 of 32 HIV positive patients (28%). Four patients (12%) were submitted to liver resection and OLT was performed in five patients (15%). Hepatocellular Carcinoma was present in 4 (44%) of the HIV positive patients considered for surgery. CONCLUSIONS: In conclusion in our centre the 28% of HIV positive out patients had the opportunity to receive a surgical treatment. The candidate to this surgery is mostly young, HCV and/or HBV coinfected and affected by HCC in 44% of cases.

Adult↗
PubMed2001

Segmental distraction osteogenesis of the anterior alveolar process.

PURPOSE: This article describes a nonextraction therapy for patients with anterior tooth crowding in the mandible or with an unfavorable relation between the anterior dentoalveolar area and the skeletal base. The method involves the gradual repositioning of the dentate segment by use of distraction osteogenesis. PATIENTS AND METHODS: The method was applied in 25 patients. Indications comprised skeletal Class II patients with crowding, Class I patients with crowding, and Class III patients requiring decompensation before orthognathic surgery. A special hinge-joint bone plate was developed to allow the rotation of the anterior bone segment into the desired position. The gradual repositioning was achieved with orthodontic appliances. RESULTS: The procedure was successful in all patients. The typical advancement at the incisal edge was 2 to 5 mm. CONCLUSION: This method represents a new approach for nonextraction therapy in the mandible. It requires no soft or hard tissue grafting and results in favorable tissue conditions at the distraction site.

Alveolar Process↗
PubMed2001

[The PiCCO system with brachial-axillary artery access in hemodynamic monitoring during surgery of abdominal aortic aneurysm].

BACKGROUND: The haemodynamic monitor PiCCO System, based on transpulmonary arterial thermodilution, has been used with a brachial-axillary access instead of the femoral arterial access during abdominal aortic aneurysm surgical repair. Accuracy and limitations of pulse contour continuous cardiac output (PCCO) were evaluated on the basis of arterial thermodilution cardiac output. The patterns of cardiac index, preload, afterload and cardiac function parameters were also studied in the different phases of the surgical procedure. METHODS: Twenty consecutive patients were studied. Mean differences (bias) between PCCO and arterial thermodilution cardiac output were calculated by the Bland-Altman test. Analysis of variance with multiple comparison test of haemodynamic variables in the different phases were performed. The correlation coefficients between cardiac index and the volumetric preload variables were also obtained. RESULTS: Brachial artery catheterization was achieved without any major complication. Pulse contour continuous cardiac index (CI) and arterial thermodilution CI values showed overall mean differences (bias) of -0.04 Lámin-1. m-2 (SD 0.8) but after aortic cross-clamping and aortic unclamping they were 0.64 Lámin-1. m-2 (SD 0.57) e -0.57 Lámin-1. m-2 (SD 0.85), respectively (p<0.05). CI, global end-diastolic volume (GEDV) and intrathoracic blood volume (ITBVI) were significantly lower during aortic cross-clamping. CI was not correlated to central venous pressure (r=0.18) but instead, to GEDV (r=0.57) and ITBVI (r=0.65). CONCLUSIONS: PiCCO System with brachial-axillary arterial access was suitable for haemodynamic monitoring of the abdominal aortic aneurysm surgical repair procedures. PCCO must be recalibrated with arterial thermodilution after aortic cross-clamping and unclamping to avoid an over-estimation and an under-estimation respectively. During aortic cross-clamping GEDV and ITBVI indicated a decreased preload. Other haemodynamic variables were less valuable but EVLWI showed an interesting steady increase during the whole procedure.

Aged↗
PubMed1999

Locoregional versus general anesthesia in carotid surgery: is there an impact on perioperative myocardial ischemia? Results of a prospective monocentric randomized trial.

PURPOSE: The incidence of cardiac morbidity and mortality in patients who undergo carotid surgery ranges from 0.7% to 7.1%, but it still represents almost 50% of all perioperative complications. Because no data are available in literature about the impact of the anesthetic technique on such complications, a prospective randomized monocentric study was undertaken to evaluate the role of local anesthesia (LA) and general anesthesia (GA) on cardiac outcome. METHODS: From November 1995 to February 1998, 107 patients were classified by the cardiologist as cardiac patients (IHD; history of myocardial infarction, previous myocardial revascularization procedures, or myocardial ischemia documented by means of positive electrocardiogram [ECG] stress test results) or noncardiac patients (NIHD; no history of chest pain or negative results for an ECG stress test). The patients were operated on after the randomization for the type of anesthesia (general or local). Continuous computerized 12-lead ECG was performed during the operative procedure and 24 hours postoperatively. The end points of the study were ECG modifications (upsloping or downsloping more than 2 mm) of the sinus tachycardia (ST) segment. RESULTS: Fifty-five patients were classified as IHD, and 52 were classified as NIHD. Twenty-seven of the 55 IHD patients (49%) and 24 of 52 NIHD patients (46%) were operated on under GA. Thirty-six episodes of myocardial ischemia occurred in 22 patients (20.5%). Episodes were slightly more frequent (58%) and longer in the postoperative period (intraoperative, 10 +/- 5 min; postoperative, 60 +/- 45 min; P <. 001). As expected, the prevalence of myocardial ischemia was higher in the group of cardiac patients than in noncardiac group (15 of 55 patients [27%] vs 7 of 52 patients [13%]; P <.02). By comparing the two anesthetic techniques in the overall population, we found a similar prevalence of patients who had myocardial ischemia (GA, 12 of 52 [23%]; LA, 10 of 55 [18%]; P = not significant) and a similar number of ischemic episodes per patient (GA, 1.5 +/- 0.4; LA, 1.8 +/- 0.6; P = not significant). Episodes of myocardial ischemia were similarly distributed in intraoperative and postoperative periods in both groups. It is relevant that under GA, IHD patients represent most of the population who suffered myocardial ischemia (83%). On the contrary, in the group of patients operated on under LA, the prevalence was equally distributed in the two subpopulations. CONCLUSION: The results confirm the different hemodynamic impact of the two anesthetic techniques. Patients who received LA had a rate of myocardial ischemia that was half that of patients who had GA. The small number of cardiac complications do not permit us to make any definitive conclusion on the impact of the two anesthetic techniques on early cardiac morbidity, but the relationship between perioperative ischemic burden and major cardiac events suggests that LA can be used safely, even in high-risk patients undergoing carotid endarterectomy.

Aged↗
PubMed1998

Anaesthesia for liver transplantation in cystic fibrosis patients.

INTRODUCTION: Cystic fibrosis (CF) is a disease caused by an inherited genetic defect. While pulmonary and pancreatic abnormalities predominate the clinical spectrum, other organ involvement is common, including liver. The severity of liver disease does not appear to be related to the severity of exocrine pancreatic or lung function. We discuss anaesthesia in four CF patients undergoing liver transplantation. METHODS: We studied haemodynamic and oxygenation modifications during anaesthesia in four patients affected by CF with end-stage liver disease and mild to moderate pulmonary abnormalities. The patients received pancreatic enzyme prior to transplantation and two had insulin-dependent diabetes mellitus. All patients were treated with broad-spectrum antibiotic therapy. After a waiting time ranging one week to three months, all patients were successfully transplanted. General anaesthesia was induced with fentanyl, thiopental and pancuronium, and maintained with isoflurane supplemented by fentanyl in O2:air. Haemodynamic and oxygenation evaluations were made during the main phases of the transplant. After the intubation and at the end of the procedure all patients received a broncho-alveolar toilet through fiberoptic bronchoscopy. RESULTS: During anaesthesia for liver transplantation, PaO2 increased proportionally to the decreasing of Qs/Qt. In postoperative follow-up, Fev1 and FVC improved from preoperative time in all patients. In conclusion, even if cystic fibrosis is a multisystem disease, liver transplantation can be offered to CF patients with endstage liver disease and mild to moderate pulmonary function abnormalities. The four patients are still alive, enjoying good health. The improved respiratory function and quality of life of these children is remarkable.

Adolescent↗
PubMed1998

Inhaled nitric oxide during anesthesia for bilateral single lung transplantation. Case report.

Recently inhaled nitric oxide (iNO) has been used as pulmonary vasodilator without any effect on systemic hemodynamics. iNO has been also used in cardiac and thoracic surgery, involving lung transplantation. In this case report a patient, 41 years old female, affected by bronchiectasis, underwent bilateral sequential single lung transplantation and during one lung ventilation and pulmonary artery clamped iNO allowed to avoid cardiopulmonary bypass and to carry out the procedure successfully.

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↗
PubMed1996

Hemodynamic and metabolic effects of transjugular intrahepatic portosystemic shunt (TIPS) during anesthesia for orthotopic liver transplantation.

Recently, the transjugular intrahepatic portosystemic shunt (TIPS) has been advocated as a safe bridge to orthotopic liver transplantation (OLT). We retrospectively studied 53 consecutive cirrhotic patients who underwent OLT: 27 patients with TIPS were compared to 26 controls. Hemodynamic and oxyphoretic data (Fick method) were collected during six phases of OLT. There were no significant differences in demographic data and Child-Pugh class, nor in surgical time and blood product requirements before the anhepatic phase between TIPS patients and controls. In the TIPS group, we observed a marked hyperdynamic profile with a lower systemic vascular resistance index, higher cardiac index, and depressed oxygen consumption before native liver removal. During the same period, the TIPS group developed a greater acidosis and was treated with a larger amount of NaHCO3. Following the anhepatic phase, no differences between the two groups were detected. All transplantations were successful, and no complications related to TIPS were observed. These results seem to be the consequence of a reduced liver function reserve with a direct hemodynamic effect due to the TIPS.

Acidosis↗
PubMed1996

Intraoperative transcranial Doppler sonography monitoring during carotid surgery under locoregional anaesthesia.

OBJECTIVES: Studies comparing transcranial Doppler ultrasonography (TCD) with other intraoperative monitoring techniques for detecting clamping ischaemia during carotid endarterectomy under general anaesthesia suggest that a reduction of > two-thirds in the mean middle cerebral artery velocity (mMCAv) or a reduction of > 0.4 in the preclamping mMCAv: clamping mMCAv ratio warrants cerebral protection. Our aim was to study the relationship between mMCAvs and clamping ischaemia during carotid endarterectomy in awake patients. MATERIALS AND METHODS: In a consecutive series of 57 patients undergoing carotid endarterectomy under locoregional anaesthesia 51 were monitored by intraoperative TCD, continuous EEG, and neurologic awake testing. RESULTS: Five of the 51 (9.8%) patients had transient clamping ischaemia, which carotid shunting reversed. TCD showed that these five patients had significant lower mean mMCAvs than the other 46 patients, who had no deficits (1.8 +/- 1.1 cm/s vs. 26.2 +/- 8.5, p = 0.0003). Current TCD criteria indicated that four other patients (7.8%) should have been shunted. All four had significantly higher clamping mMCAvs than the five shunted patients (11.5 +/- 1.9 vs. 1.8 +/- 1.1, p = 0.0012). CONCLUSIONS: Intraoperative TCD detected cerebral ischaemia and yielded no false-negative. An mMCAv of 10 cm/s or less may indicate the risk of clamping ischaemia better than the higher threshold currently proposed. This would avoid unnecessary shunting due to false-positives.

Aged↗
PubMed1995

[Anesthesia in experimental single-lung transplantation: hemodynamic and respiratory changes during prostaglandin E1 and nitroglycerin infusion].

INTRODUCTION: The haemodynamic and oxyforetic modifications induced by continuous infusion (c.i.) of Prostaglandin E1 (PGE1) and Nitroglycerin (NG) during experimental lung transplantation have been studied. METHODS: Twenty lung transplants have been performed on pigs (Landrace). Haemodynamic monitoring consisted of ECG, femoral cannulation for arterial pressure and Swan Ganz catheter. Continuous infusion of drugs started during pneumonectomy. Data have been collected in phase 1: after the induction of anaesthesia; in phase 2: 30 min after the start of pulmonary vasodilation in one lung ventilation with left pulmonary artery clamped; in phase 3: 30 min after lung revascularization; in phase 4: at the end of the surgery. The animals have been divided in two groups. Group A consisted of 10 cases treated with 50 ng/kg/min in phase 2 and 25 ng/kg/min in phase 3 and 4 of PGE1; group B consisted of 10 cases treated with 1 ncg/kg/min in phase 2 and 0.5 ncg/kg/min in phase 3 and 4 of NG. RESULTS: In phase 2 and 4 PA, RVSWI, PRVI increased in group B more than in group A (p < 0.05); in phase 3 PA, PAWP increased in group B more than in group A (p < 0.05). DISCUSSION: In our experience PGE1 has shown to be a stronger pulmonary vasodilator than NG. PGE1 can be considered the drug of choice for pulmonary vasodilation in experimental single lung transplantation, even if more investigations are needed for reaching the real goal of this procedure.

Alprostadil↗
PubMed1990

[Hemodynamic and respiratory aspects in orthotopic liver transplantation].

Intraoperative hemodynamic and respiratory data from one-year experience of orthotopic liver transplantation with veno-venous bypass (10 cases) were collected. Seven different phases of OLT was submitted to one way analysis of variance. Variability is due to degree and duration of liver disease. Basal conditions include high cardiac output with low SVRI, elevated Qs/Qt. and low oxygen consumption. Anhepatic phase shows a lower cardiac index due to reduction in ventricular performance too. The functioning graft raises body oxygen consumption above baseline. Last phases show diminution of MAP and LVSWI and a normal Qs/Qt.

Adult↗