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Biomedical subjects

M Pasqualini

Publications and source records attributed to M Pasqualini.

At least 19 recordsLinked to original sources
PubMed1997

Estimating mean pulmonary wedge pressure in patients with chronic atrial fibrillation from transthoracic Doppler indexes of mitral and pulmonary venous flow velocity.

OBJECTIVES: We sought to obtain a noninvasive estimation of mean pulmonary wedge pressure (MPWP) in patients with chronic atrial fibrillation (AF). BACKGROUND: It has previously been demonstrated that MPWP can be reliably estimated from Doppler indexes of mitral and pulmonary venous flow (PVF) in patients with sinus rhythm. Doppler estimation of MPWP has not been validated in patients with AF. METHODS: MPWP was correlated with variables of mitral and pulmonary venous flow velocity as assessed by Doppler transthoracic echocardiography in 35 consecutive patients. The derived algorithm was prospectively tested in 23 additional patients. RESULTS: In all patients the mitral flow pattern showed only a diastolic forward component. A significant but relatively weak correlation (r = -0.50) was observed between MPWP and mitral deceleration time. In 12 (34%) of 35 patients, the pulmonary vein flow tracing demonstrated only a diastolic forward component; a diastolic and late systolic forward flow was noted in the remaining 23 patients (66%). A strong negative correlation was observed between MPWP and the normalized duration of the diastolic flow (r = -0.80) and its initial deceleration slope time (r = -0.91). Deceleration time > 220 ms predicted MPWP < or = 12 mm Hg with 100% sensitivity and 100% specificity. When estimating MPWP by using the equation MPWP = -94.261 PVF deceleration time -9.831 Interval QRS to onset of diastolic PVF -16.337 Duration of PVF + 44.261, the measured and predicted MPWP closely agreed with a mean difference of -0.85 mm Hg. The 95% confidence limits were 4.8 and -6.1 mm Hg. CONCLUSIONS: In patients with chronic AF, MPWP can be estimated from transthoracic Doppler study of PVF velocity signals.

Age Factors↗
PubMed1995

[Complete regression of Barrett's esophagus after drug therapy].

Barrett's esophagus is defined as a disorder in which the normal stratified squamous mucosa of the esophagus is replaced by columnar epithelium. Patients with Barrett's esophagus are at risk to develop an adenocarcinoma of the esophagus. Pathologic gastroesophageal reflux is correlated to the disease and therapeutical options must aim to stop this noxa in order to prevent columnar metaplasia, and subsequent dysplasia and/or neoplasia. The Authors report the case of a patient in whom the complete regression of the metaplasia was observed after medical therapy.

Anti-Ulcer Agents↗
PubMed1995

An estimation of the left ventricular diastolic function from the spectral analysis of the fourth heart sound. A Doppler validated study in hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is a typical primary cardiac disease characterized by diastolic abnormal function due to both prolonged relaxation and decreased compliance (Sanderson et al., 1977; Spirito & Maron, 1990). Since the contribution of the atrial systole to ventricular filling is usually increased, the appearance of a fourth heart sound (S4) is a common finding in HCM. This sound is related to the ventricular compliance and to the atrial contractility. It is generated during the rapid setting into vibration of the left ventricular walls that results from the rapid rush of the blood due to the atrial contraction (Nishimura et al., 1989; Tavel, 1978). The aim of this study is to look for relationships between the frequency peak of S4 and various mono- and two-dimensional echocardiographic parameters in order to identify those cardiac structures involved in its genesis and obtaining an estimation of the stiffness of the acoustic vibrating system with a simply vibratory model (Baracca et al., 1991).

Cardiomyopathy, Hypertrophic↗
PubMed1994

Estimation of left ventricular diastolic pressures from precordial pulsed-Doppler analysis of pulmonary venous and mitral flow.

Because analysis of pulmonary venous flow (PVF) will be extensively used in comprehensive Doppler assessment of left ventricular diastolic function, this study was designed to (1) evaluate the feasibility of PVF measurement in 116 consecutive patients with various cardiac abnormalities by using precordial pulsed Doppler echocardiography; (2) Estimate mean pulmonary capillary pressure (MPCP) and left ventricular end-diastolic pressure (LVEDP) from Doppler variables of PVF and mitral inflow; and (3) evaluate the influence of clinical and hemodynamic variables on PVF Doppler patterns. We adequately recorded anterograde PVF in 96 (82.7%) patients and retrograde PVF in 45 (38.7%) patients. The strongest correlation between MPCP and Doppler variables of PVF was found with systolic fraction (the systolic velocity time integral expressed as a fraction of total anterograde PVF) (r = -0.88; p < 0.001). Age influenced this relation, with progressive increase of the systolic fraction in older patients. A good correlation (r = 0.72; p < 0.001) was found between LVEDP and the difference in duration of the reversal PVF and the mitral a wave. In conclusion, (1) PVF can be recorded adequately in most patients with precordial Doppler echocardiography; (2) left ventricular diastolic pressures can be estimated reliably by precordial Doppler echocardiography; and (3) the clinical meaning of Doppler-derived indexes of left ventricular diastolic performance is age-related.

Adult↗
PubMed1994

[Neonatal hemoperitoneum: role of ultrasonography. Experience with 4 cases].

This study was aimed at investigating the role of US in the newborn with a clinical suspicion of hemoperitoneum. Hemoperitoneum is a dramatic clinical event which may be caused by some obstetrical and fetal factors--breech or complicated delivery, hepatomegaly, macrosomy, anoxic liver congestion being the most frequent causes. Direct or indirect trauma of an abdominal organ during delivery represents the major pathogenetic factor. Clinical symptoms are correlated with the appearance of shock whose intensity is proportional to trauma severity: symptoms may appear even 48 hours after delivery. The authors report their experience with 4 consecutive cases of neonatal hemoperitoneum which underwent US of the abdomen 24 to 72 hours after birth. In the first 3 newborns, US was performed on the basis of a clinical picture of bleeding shock, while in the extant newborn US was performed after a sudden increase in blood transaminase level associated with an obstetrical paralysis of the left arm. The US examinations were performed using a 7.5-MHz sectorial probe unit (Siemens). In all patients, US demonstrated the presence of a liquid effusion in the abdomen which could be referred to hemoperitoneum. In two patients, it was associated with a traumatic focal alteration of the liver parenchyma, in the third with a diffuse subcapsular liver hematoma and, finally in the fourth patient with a disconnected splenic vascular pedicle which was at surgery demonstrated. In conclusion, US is indicated as the most reliable and valuable diagnostic technique in the study of neonatal hemoperitoneum. The authors believe abdominal US to be essential in all the neonatal cases where hemoperitoneum is suspected and in selected cases presenting specific risk factors, to allow a rapid diagnosis and better treatment planning.

Hemoperitoneum↗
PubMed1994

[Intra-oral cancer: immediate reconstruction using a free radial forearm flap].

The radial forearm flaps is ideal for intra-oral reconstruction. In that it offers thin, pliable, hairless skin to replace oral mucosa removed during wide resection in surgical treatment of cancer. The vascularity of the area allows considerable variation in design and size of the flap and offers the possibility of covering structures on different levels and, when bone is included, of carrying out immediate reconstruction of the mandible. The Authors used this flap in 24 patients for intra-oral reconstruction. The ages of the subjects ranged from 30 to 70 years. The arteries and the veins of the flap used for microsurgical anastomosis were radial arteries and superficial veins of the elbow. Neck vessels were superior arteries of the thyroid and jugularis externa vein. Operating time was slightly prolonged when compared to repair employing a myocutaneous island flap. This reconstruction method was completely successful in all 24 patients; in one patient a DIC partially compromised the vascularity of the flap on day 8. Morbidity was observed, resouled, however, with minor surgical procedures. Our results support the choice of this method for intraoral reconstruction.

Adult↗
PubMed1993

[Trauma: when the liver "ruptures".... Our experience of 125 cases].

Liver and spleen are the organs most frequently involved in the blunt abdominal trauma. Prognosis is severe in those cases classified as IV or V according to the More score. The imaging techniques, particularly CT scan, offer today a possibility in the nonoperative management of a selected group of haemodynamically stable patients, therefore reducing the need of surgery. The authors' experience in 125 patients observed from 1983 to 1991 is reported.

Emergencies↗
PubMed1992

[Mirizzi's syndrome type II: a diagnostic and therapeutic problem].

The paper reports a case of cholestatic icterus caused by a large calculus in the infundibulum of the gallbladder with a cholecysto-choledochal fistula and hepato-choledochal block (Mirizzi's type II syndrome). The diagnostic iter complicated the evolution, raising questions regarding the therapeutic strategy.

Biliary Fistula↗
PubMed1991

The Grosse-Kempf nail in femoral and tibial shaft fractures.

Interlocked nailing is a routine method that yields excellent results even in complex fractures of the lower limb. A series of 25 femoral and 29 tibial fractures is reviewed, and both advantages and technical difficulties are discussed. The authors point out that, in very special cases, interlocking nails may be used together with other methods of internal and external fixation.

Adolescent↗