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M Fusaro

Publications and source records attributed to M Fusaro.

16 recordsLinked to original sources
PubMed2006

Retrograde posterior tibial artery access for below-the-knee percutaneous revascularization by means of sheathless approach and double wire technique.

Arterial revascularization by means of percutaneous transluminal angioplasty (PTA) is a mainstay in the management of patients with peripheral artery disease and critical limb ischemia (CLI). While cross-over access from the contralateral femoral artery or antegrade access from the ipsilateral femoral artery are most commonly used when approaching subjects with CLI, PTA may occasionally fail when performed from these routes. We hereby report a patient in whom we performed retrograde arterial access through the posterior tibial artery, thus enabling recanalization of a challenging below-the-knee chronic total occlusion. Technical points pertinent to this case are clearly illustrated, including the sheathless approach and the use of a double wire strategy, one advanced ante-gradient and the other concomitantly advanced retro-gradient..

Aged↗
PubMed2005

Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003.

OBJECTIVE: To evaluate the effectiveness of peripheral angioplasty (PTA) as the first-choice revascularisation procedure in diabetic patients with critical limb ischemia (CLI). DESIGN: Prospective study. METHODS: PTA was employed as first choice revascularisation in a consecutive series of diabetic patients hospitalized for CLI between January 1999 and December 2003. RESULTS: PTA was successful performed in 993 patients. Seventeen (1.7%) major amputations were carried out. One death and 33 non-fatal complications were observed. Mean follow-up was 26+/-15 months. Clinical restenosis was observed in 87 patients. The 5 years primary patency was 88%, 95% CI 86-91%. During follow-up 119 (12.0%) patients died at a rate of 6.7% per year. CONCLUSIONS: PTA as the first choice revascularisation procedure is feasible, safe and effective for limb salvage in a high percentage of diabetic patients. Clinical restenosis was an infrequent event and PTA could successfully be repeated in most cases.

Aged↗
PubMed2003

Effect of epoetin on HO-1 mRNA level and plasma antioxidants in hemodialysis patients.

OBJECTIVE: Patients with renal failure and undergoing hemo- (HD) or peritoneal dialysis are under oxidative stress which is thought to contribute to the long-term complications noted in this patient population. One effect of HD-induced oxidative stress is via red blood cell (RBC) membrane lipid peroxidation leading to RBC destruction and anemia. Interaction of this oxidative stress with epoetin (EPO) treatment to increase RBC number and Hb concentration remains unexplored. PATIENTS AND METHODS: This preliminary study used RT-PCR as well as colorimetric based assay approaches to evaluate the effect of EPO-alpha treatment on markers of oxidative stress in hemodialysis patients. Eighteen patients (12 males, 6 females, age range 45 - 68), were treated with EPO-alpha (Eprex) 50 UI/kg thrice weekly over an 8-month study period. Monocytes were isolated at baseline, then monthly thereafter, monocyte heme-oxygenase-1 (HO-1) and plasma Hb and antioxidant power (AOP) were determined. RESULTS AND CONCLUSIONS: Treatment with EPO increased Hb (9.4 +/- 0.7 g/dl to 10.9 +/- 0.5, mean +/- SD p < 0.001). In addition, both monocyte HO-1 mRNA (0.34 +/- 0.08 vs. 0.59 +/- 0.02 d.u. p < 0.001) and plasma AOP (1,379.8 +/- 175 micromol/l to 1,624 +/- 170, p < 0.04) increased. While AOP changes showed no correlation with other indices, increases in HO-1 and Hb were positively correlated using 2 different measures: delta Hb (peak Hb - baseline Hb) vs. delta HO-1 (peak HO-1 mRNA - baseline HO-1 mRNA) as well as delta Hb(5 months-baseline) vs. delta HO-1 (5 months - baseline) mRNA (r = 0.81, p < 0.001 and r = 0.76, p < 0.001; respectively). In conclusion, the increases upon EPO treatment of both HO-1 gene expression and plasma AOP as well as the significant correlation between delta Hb and delta HO-1 mRNA suggest that EPO treatment reduces oxidative stress via a combination of effects. These could potentially include effects on oxidative stress directly as well as effects on the levels and types of antioxidants present in plasma.

Adult↗
PubMed2001

Cigarette smoking is a risk factor for nephropathy and its progression in type 2 diabetes mellitus.

Cigarette smoking is a risk factor for diabetic nephropathy in Type 1 diabetes (T1DM); a few reports support this possibility in Type 2 diabetes (T2DM) as well. Since heterogeneity among populations could exist, we investigated the association of cigarette smoking and nephropathy, and progression of nephropathy in Italian T2DM patients. A retrospective study was conducted in 273 long-duration T2DM subjects with a 3-year follow-up in the out-patient clinic, and at least one access per year. Albumin excretion rate, serum creatinine, and a number of other parameters implicated in the development of diabetic renal disease were evaluated. Progression of nephropathy was defined as the passage from different stages of renal involvement (no renal derangement, microalbuminuria, proteinuric disease or severe nephropathy). At baseline, 13.2% of the subjects had microalbuminuria, and 3.7% proteinuric disease. Microalbuminuria and proteinuric disease were more frequent in actual smokers than in non- and former smokers (chi2=8.35; p=0.015). Progression of nephropathy was less common in non- and former smokers than in smokers (31 of 134, 23%, and 15 of 67, 22%, and 30 of 72, 42%, respectively; chi2=9.32;p=0.009). From logistic regression analysis, smoking (p=0.0012) emerged as the most important factor associated with progression of nephropathy, followed by packyears (p=0.011), HbA1c mean value at follow-up (p=0.024), and total cholesterol (p=0.038). In conclusion, cigarette smoking is a risk factor for progression of nephropathy also in Italian T2DM patients; reducing or quitting smoking should be part of the therapy or of the preventive measures in these patients and their relatives.

Aged↗
PubMed1995

A decision analysis comparing three dosage regimens of subcutaneous epoetin in continuous ambulatory peritoneal dialysis.

Epoetin (recombinant human erythropoietin; EPO) therapy adds a significant cost to the management of end-stage renal disease, the majority of the extra expense being attributable to its acquisition cost. In a Japanese multicentre, randomised, prospective study, a significant dose-dependent response was documented with epoetin given subcutaneously (SC) once a week or once every 2 weeks to patients receiving continuous ambulatory peritoneal dialysis. Three different dosages were studied over 5 months in patients with a haematocrit (Hct) of 0.28 or less, namely 6000U (107 U/kg), 9000U (167 U/kg) and 12,000U (211 U/kg). Epoetin was given weekly for the first 2 months until the target Hct value of 0.33 was reached. The rates of response were 81, 85 and 100% with the 6000U, 9000U and 12,000U regimens, respectively. Subsequently, responders were maintained at the target Hct for an additional 3 months, with the administration frequency eventually being reduced to fortnightly or 4-weekly. Patients in the epoetin 6000U and 9000U groups who did not respond after 2 months' treatment underwent induction and maintenance with the 12,000U regimen. During the maintenance phase, patients receiving the epoetin 6000U and 9000U dosages required weekly (54 and 64%, respectively) or fortnightly (46 and 36%, respectively) injections. Patients receiving the 12,000U regimen were found to require weekly (9%), fortnightly (73%) or 4-weekly (18%) injections. Using these data, we performed a decision analysis that quantitatively incorporated the probability of attaining and maintaining target Hct levels in all patients (i.e. the effectiveness of epoetin), and direct costs as a function of both cumulative doses and injections required in all 3 strategies over 5 months. Decision analysis indicated that the most cost-effective SC epoetin strategy in patients undergoing peritoneal dialysis is epoetin 6000U weekly for 2 months, followed by maintaining the target Hct with weekly or 2-weekly epoetin 6000U for the next 3 months. Nonresponders should restart epoetin therapy using the 12,000U strategy. The 9000U and 12,000U strategies were associated with similar costs, because the economic advantages associated with the lower administration frequency of the 9000U regimen compared with the 6000U regimen were offset by its higher cumulative acquisition cost. In other words, decision analysis indicated that the most cost-effective strategy was to use the lowest effective dose, reserving the highest dosage for patients who do not respond after 2 months. The superiority of this strategy was confirmed by a sensitivity analysis performed on the cost of drug administration, which was varied from zero to $US60 per dose.(ABSTRACT TRUNCATED AT 400 WORDS)

Cost-Benefit Analysis↗
PubMed1994

[Echinococcosis with crural localization. A case report].

The authors report a case of echinococcosis with an atypical localisation. It involved hydatid cysts with a single, extramuscular and extravasal primary right crural localisation. After examining the international literature the authors affirm that this localisation has not been described previously in other reports. They conclude that surgery is vital for the remission of the disease, as is the use of an atraumatic and accurate technique in order to avoid possible sequelae linked to the iatrogenic diffusion of echinococcosis.

Echinococcosis↗
PubMed1989

[Apical granulomas and apical root cysts of inflammatory origin. A statistical study on 328 cases observed at the Ambulatory Services of Odontostomatology of the Ospedale Martini, via Tofane 71, Turin].

328 cases of chronic tooth lesions (apical granulomas and bone cysts) were examined in the Dental Surgery of the Martini Hospital in Turin and many received a later check-up. The complete series was statistically analysed in terms of lesion frequency in the different areas of the dental arch, lesion diameters and the chances of successful surgical intervention.

Humans↗
PubMed1981

[Bilio-digestive shunts. Observations on 72 cases of obstructive jaundice].

The Authors report their experience about 72 operations of bilio-digestive anastomosis done for obstructive icterus from 1972 to 1979, 48 of which due to pathology by neoplastic cause and 24 due to pathology by benign causes. 32 operations of bilio-jejunal anastomosis on ansa in the omega fashion have been done operations of bilio-jejunal anastomosis on Roux's ansa four of which operations of transtumoral drainage in accordance with Rodney-Smith's technic, 16 operations of bilio-duodenal anastomosis.

Adult↗
PubMedDate not supplied

[Lymphatic cyst of the mesentery].

Lymphatic cyst of the mesentery is a rare lesion; one case per 100,000 hospital admissions is reported. A case of lymphatic cyst in a sixty-one-year-old woman is presented. The symptoms are extremely variable, not characteristic and correlated to the location and size of the cyst. Abdominal ultrasonography and computed tomography may lead to a correct diagnosis, which is regularly made at the time of abdominal exploration. In this case the cyst was enucleated from the mesentery with open surgery.

Female↗