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Biomedical subjects

M Ratti

Publications and source records attributed to M Ratti.

At least 19 recordsLinked to original sources
PubMed2002

Transvaginal color Doppler ultrasound for de novo ovarian carcinoma. How a good chance can be missed.

Early de novo ovarian cancer is one of the most challenging entities in gynecologic oncology as early diagnosis is extremely difficult. We describe the case of a 77-year woman who had incidental diagnosis of normally shaped ovaries with low resistance blood flow. Despite the suspicious finding and despite the documentation of elevated serum CA 125 levels she did not undergo surgery. Twelve months later she was found with an enlarged ovary. Laparotomy documented a stage IIIB ovarian carcinoma. Lack of communication among subspecialists and incomplete acceptance of new diagnostic aids contributed to this disappointing case.

Aged↗
PubMed2000

Mammography with synchrotron radiation: phase-detection techniques.

The authors evaluated the effect on mammographic examinations of the use of synchrotron radiation to detect phase-perturbation effects, which are higher than absorption effects for soft tissue in the energy range of 15-25 keV. Detection of phase-perturbation effects was possible because of the high degree of coherence of synchrotron radiation sources. Synchrotron radiation images were obtained of a mammographic phantom and in vitro breast tissue specimens and compared with conventional mammographic studies. On the basis of grades assigned by three reviewers, image quality of the former was considerably higher, and the delivered dose was fully compatible.

Absorption↗
PubMed1993

[Hemodynamic variable analysis in patients with systemic arterial hypertension undergoing physical exercise].

PURPOSE: To verify the exercise-induced hemodynamic changes in moderate hypertensive patients. METHODS: Twenty nine patients were studied and they were submitted to cycloergometer supine exercise (50w and 100w) during cardiac catheterization. The hemodynamic variables were measured: cardiac index (CI), stroke volume (SV), systemic arterial resistance (SAR), pulmonary arterial resistance (PAR), wedge pressure (WP), right atrial pressure (RA), systolic arterial pressure (SP), diastolic arterial pressure (DP), mean arterial pressure (MP) and heart rate (HR). To evaluate the cardiac function, the patients were divided in two groups: GI with CI > 2.5 ml/min/m2 and GII CI < 2.5 ml/min/m2. RESULTS: During exercise, patients from GI and GII were similar-according to MAP, RA, WP, and HR. On the other hand, GI and GII exhibited different (#) behavior regarding SV, PAR and SAR. During the three exercise conditions, rest (R), 50w and 100w it was observed: a) PAR-R = 50 = 100 (GI); b) MP, PAR, WP, SV, SAR-R #50 #100 (GI); c) HR, PAR and SAR-R #50 #100 (GII). There was no correlation between the cardiac function (CI, SV) and the circulatory adjustment (PAR and SAR) or the pressure curve (SP, DP, MP) and HR. CONCLUSION: The results suggest that the cardiac function of GI patients depends, mainly, on the inotropism, while in GII patients it depends on the decrease of the afterload (PAR and SAR). Those changes may appear even in the late exercise stage (100w), with a bias to attain the GI levels. Those observations suggest functional changes in vasomotor tone of GII patients.

Adult↗
PubMed1993

[Randomized study comparing mitral valve replacement with and without preservation of mitral ring chordae tendinae papillary continuity].

PURPOSE: To demonstrate the importance of the preservation of mitral annulus-chordae tendineae-papillary muscles continuity in mitral valve replacement. METHODS: We studied 21 patients who were submitted to mitral valve replacement, divided in two randomized groups: group 1, 12 cases who undergone mitral valve replacement, with preservation of the posterior leaflet and correspondent chordae tendineae; and group 2-9 cases who undergone conventional mitral valve replacement, excising the mitral valve apparatus. The left ventricular function was studied both, in the pre and post operative period, by echocardiography, cardiac catheterization, and radioisotopic study. The statistical analysis was done by the Wilcoxson's test. RESULTS: There were no early post operative deaths. Analyzing the results of the ejection fraction by the radioisotopic study we found a significant difference (p = 0.03) between the percentual decrease of the two groups. The results of the fractional shortening were higher in group 1 than in group 2, however not significant. The left ventricular diastolic diameters average was lower in group 1 than in group 2, so as the left atrium diameter. We found a decrease in left ventricular end-diastolic pressure in group 1, however there was an increase in group 2, by the cardiac catheterization. There was a proportional increase in group 1 both in lung artery and lung capillary pressures. There was a significant difference (p = 0.05) between the average values of right ventricular diastolic pressure. CONCLUSION: There is better preservation of left ventricular function in group 1.

Adult↗
PubMed1990

[Immunosuppressive drugs for the treatment of active myocarditis in children. Hemodynamic evaluation].

PURPOSE: To analyse hemodynamic parameters (left ventricles ejection fraction, cardiac index, mean pulmonary wedge pressure and left ventricle diastolic diameter, in a group of children with active myocarditis (diagnosed by endomyocardial biopsy) pre and post treatment with conventional therapy and immunosuppressive drugs (isolated prednisone or prednisone associated with azathioprine or cyclosporine). PATIENTS AND METHODS: Forty-four pediatric patients with active myocarditis were studied. Twenty males and 24 females from 10 months to 15 years old (median = 1.3 years). All patients were submitted to hemodynamic study and endomyocardial biopsy. The hemodynamic parameters mentioned above were analysed before and after the proposed therapy. The patients were distributed in group according to the admission in the protocol, group I (9 pts)--conventional therapy (CT); group II (12 pts)--CT plus prednisone; group III (16 pts)--CT plus prednisone plus azathioprine; group IV (13 pts)--CT plus prednisone plus cyclosporine. RESULTS: Forty-four patients were submitted to four different groups of therapeutic protocol. The hemodynamic parameters were analysed in each of them. Left ventricle ejection fraction were no significantly different in the pre and post therapeutic scheme in group I and II, they were significantly higher (p less than 0.05) in group III and IV. The same happened with cardiac index. The mean pulmonary wedge pressure no presented statistical differences in group I and II before and after treatment but significantly lower lends were observed in group III and IV. The same behavior were noted in the left ventricle end diastolic diameter. CONCLUSION: The association of azathioprine or cyclosporine to prednisone presented better results in the left ventricle function, when compared with conventional drugs or isolated use of prednisone, based in the analysis of same hemodynamic parameters.

Adolescent↗
PubMed1990

[Simulated epileptiform discharges during the replay of a lengthy EEG recording].

Reviewing a longterm-EEG magnet-recording on the video system of the play-back unit "Mobile Oxford Medilog 9000" EEG patterns appeared, which imposed as epileptiform discharges. They seemed to correlate with the paroxysmal clinical disturbances the patient had experienced and noted in a diary, and could be printed out on a normal EEG-apparatus. Following investigations demonstrated the artificial origin of this EEG patterns: They appeared in fact only using the switches of the play-back unit for the fast back- and forward winding. The time-correlation between clinical and electroencephalographic episodes was simulated by the search of selected EEG-sequences based on the clinical episodes noted from the patient.

Diagnostic Errors↗
PubMed1989

[Surgical treatment of tetralogy of Fallot associated with an anomalous coronary vessel].

Anomalous coronary arteries crossing the outflow tract of the right ventricle in tetralogy of Fallot have a prominent surgical importance in total correction. The unintentional section of these arteries is followed by a high mortality. In the period between 1977 and 1987, 475 patients with tetralogy of Fallot were operated on. Fourteen of these patients had anomalous coronaries crossing the right ventricle. Three of the patients were less than one year of age. Eleven patients were male. Diagnosis was performed in the operating room in 13 patients. Twelve patients had the anterior descending artery originating from the right coronary, and two presented single left coronary arteries. During the surgical procedure two patients had the anomalous coronary artery divided; in one a saphenous vein bypass graft was used and in the second and end-to-end anastomosis was performed. In the remaining 12 cases, a transverse ventriculotomy (one case), extensive dissection of the anomalous coronary artery (two cases), a palliative procedure (one case), a valved conduit between the right ventricle and the pulmonary artery (one case) and total correction through the atriopulmonary approach (seven cases) were performed. No immediate mortality was observed and there was one late death. The authors suggest that, whenever anatomical conditions permit, the atriopulmonary approach should be preferred in the repair of tetralogy of Fallot associated to anomalous coronary arteries.

Child↗
PubMed1985

Impaired in vitro growth of PHA induced T lymphocyte colonies in hemodialyzed renal failure patients.

Using an in vitro method that allows the study of the colony forming capacity of phytohemagglutinin stimulated peripheral blood T lymphocytes, we have detected an impaired T cell colony formation in hemodialyzed renal failure patients. By contrast a near normal pattern of responses was observed in patients treated with a conservative therapy. The poor in vitro T cell responsiveness of hemodialyzed patients was not corrected by supplementing the cultures with an adherent cell contitioned medium prepared from normal donors. We conclude that an intrinsic defect of the T cell colony forming capacity exists in hemodialyzed patients.

Adult↗
PubMed1982

[Disseminated intravascular coagulation. II. Therapeutic problems].

The treatment of DIC often presents problems that are not easily solved given the difficulty of interpreting symptoms and haematological findings, the seriousness of the clinical situation and the rapid development of disease phenomena. Diagnostic questions must be answered before physiopathologically rational therapy can be applied. The identification and cure of the condition which triggers coagulation are also of primary importance in selecting a therapeutic response. Apart from specific treatment of the causal disease, the treatment of DIC is based on the one hand on the use of anticoagulants (heparin) to halt intravascular coagulation and transfusional integration with haemoderivatives and platelet concentrates to correct the haemostasis deficiency secondary to such massive consumption. On the other, direct methods are needed to control the state of shock, cardiorespiratory compromise and acute renal insufficiency which often complicate the course of the defibrination syndrome. Therapeutic success depends on timely intervention allied to the employment of adequate measures for each individual case.

Antifibrinolytic Agents↗