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Biomedical subjects

M Simone

Publications and source records attributed to M Simone.

At least 37 records · Page 2Linked to original sources

[Staplers in bladder sutures].

Staplers are still little used for suturing a cystotomy. The basic reason for this reluctance is the inadvisability of using non-absorbable material in the lumen of the urinary tract, as this may be the nucleus for the formation of stones. It must be remembered, however, that a correct suture of a cystotomy should be carried out in two layers: one internal mucous layer, consisting of a continuous suture of absorbable material, and a more superficial suture of the margins of the vesical detrusor. The latter can be performed with a linear stapler, as it is completely outside the mucous layer. More recently, linear staplers with absorbable staples have appeared on the market, by which cystotomy sutures can be performed in a single layer.

Evaluation Studies as Topic↗

[Effects of nifedipine in patients with chronic obstructive bronchitis and pulmonary hypertension undergoing artificial respiration].

During an acute decompensation of chronic obstructive pulmonary disease (COPD) associated with pulmonary arterial hypertension (PAHP), the right cardiac ventricle is unable to tolerate the increased workload required to overcome the increase in pulmonary arterial pressure (Ppa). As a result, the cardiac (CI) and systolic (SI) indices decrease much more than in those patients without PAHP. This study aimed to evaluate the effects of nifedipine on haemodynamic parameters and oxygen availability (QO2) when given to mechanically ventilated COPD patients with PAHP during an acute decompensation. The series included 14 patients aged 68 +/- 8 yr, admitted to an intensive care ward for an acute decompensation of COPD, with Ppa greater than 20 mmHg. They remained haemodynamically stable throughout the study period. The measurements were made 20 min after the Swan-Ganz and radial artery catheters were set up (t0), and one hour after administration of 10 mg sublingual nifedipine (t1). Thereafter this agent was given three times a day. A further set of measurements were carried out in seven patients, 24 h after the first dose of nifedipine (t2). At t1, there was a significant increase in CI (+12.3%) and QO2 (+14.1%), whereas Ppa, indexed pulmonary vascular resistances, indexed systemic vascular resistances (SVRI) and PaO2 decreased significantly (-9.2%; -20%; -12.8% and -6.4% respectively). At t2, QO2 was significantly higher (+18.4%), whereas Ppa and SVRI were significantly lower, than at t0. PaO2 and the shunt fraction (Qs/Qt) returned to basal values, with a significant decrease in Qs/Qt when compared with t1.(ABSTRACT TRUNCATED AT 250 WORDS)

Hemodynamics↗

[Bronchial stenosis of vascular origin in pulmonary arterial hypertension].

A case is reported of bronchial stenosis due to a vascular cause in a patient with chronic obstructive lung disease, cor pulmonale and pulmonary arterial hypertension. This led to right lower lobe atelectasis and acute respiratory failure (pHa 7.24; PaCO2 85 mmHg; PaO2 44 mmHg) with important right-to-left shunting. This diagnosis was only suggested on day 7 by fibreoptic bronchoscopy and confirmed a week later by tomography and digital angiography. Nifedipine, used to reduce the pulmonary arterial hypertension, increased the cardiac index (31.min-1.m-2 to 3.3.1.min-1.m-2) and oxygen transport (488 ml.min-1.m-2 to 554 ml.min-1.m-2), despite increasing the shunt effect (Qs/QT: 26% to 31%). This and the antiinflammatory action of methylprednisolone were probably responsible for the favourable outcome.

Aged↗

[Mediastinal infusion by a multilumen central venous catheter].

A case of mediastinal perfusion by a left internal jugular vein catheter is reported. The catheter was of Shaldon type with six lateral side-holes. The patient displayed progressive pulmonary oedema and peripheral vasoconstriction, whereas clinically the catheter seemed to work quite well. Only radiological control with injection of radiopaque dye demonstrated mediastinal penetration of the catheter tip including the most distal side-hole. The five more proximally located holes remained in intravascular position. The authors advocate radiographic catheter control with radiopaque dye in every catheterized patient demonstrating cardiorespiratory manifestations of unknown origin.

Catheters, Indwelling↗