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M Zanello

Publications and source records attributed to M Zanello.

34 records · Page 2Linked to original sources
PubMed1981

[Total parenteral nutrition in pediatric surgery].

The authors emphasize theoretical and practical aspects which do of TPN a very important therapeutic support in paediatric surgery, especially of newborn. Authors report synthetically their cases of the last two years; then they discuss some aspects related to TPN (management) linging in particular over possible complications. Authors conclude affirming that the risk of such complications in well equipped Intensive Care should be not considered a brake to utilization of TPN, basic support to survival and good results in the most serious paediatric surgical pathology.

Burns, Chemical↗
PubMed1980

[Is d-tubocurarine dangerous for the fetus and the newborn infant?].

A survey of a series of caesarean section done under general anesthesia with the aid of muscle relaxation obtained by repeated doses of d-tubocurarine evidenced a tendency to worsen the Apgar index. In the light of the cases and from the literature some hypotheses are here discussed; the most reliable are based upon the fact that injections of the curare before the plasma half life of the drug end by increasing the materno foetal gradients permitting the transplacentar passage of the d-tubocurarine.

Adult↗
PubMed1979

Alterations in the enzyme profile in intensive care patients undergoing total parenteral nutrition.

Total parenteral nutrition (TPN) has been demonstrated to be an effective therapeutic means in improving the clinical course of the critically ill patients. Various metabolic complications are described; the cause of some of these remain unclear. The changes in some plasma enzyme indices (GOT, GPT, GIDH, LDH, HBDH, CPK, ChE, AP, gamma-GT) in two groups of critically ill patients undergoing TPN (group with more marked enzyme alterations and group with less marked alteration) were examined. Two types of alterations were found: (1) early increase of some enzymes (GOT, GPT, GIDH); (2) constant increase of plasma enzyme level during TPN (AP, gamma GT). These two evolutionary patterns were more evident in the complicated group and the enzyme changes were statistically significant for GOT and GPT (P = 0.05) and not significant for initial values of G1DH, ap and gamma-GT. Both groups presented constant elevated plasma values of LDH, HBDH, CPK and depressed constant ChE value during treatment; the difference was not significant in both groups for the same enzymes. The data were interpreted from a functional point of view; that is they were related to both the metabolic post-aggressive state and TPN. A relationship between the rate of protein catabolism and the inductive increase of some enzymes (GOT, GPT, G1DH) was found. Whereas a final induction in the energy metabolism is suggested for other enzymes (LDH, HBDH), the alteration of CPK, AP, gamma-GT and ChE was interpreted as dependent on: (1) direct muscular trauma (CPK); (2) functional increase in relation to the duration of TPN (AP and gamma-GT); (3) possible depressed malnutritive synthesis (ChE). The improvement of the enzymatic patterns with the early use of TPN and with the improvement of clinical and nutritional conditions was emphasized.

Adolescent↗
PubMed1978

Metabolic changes during prolonged total parenteral nutrition in intensive care.

Intensive care patients receiving prolonged total parenteral nutrition (TPN) developed alterations of liver function tests, seen in the activity of certain serum enzymes. Hepatomegaly and jaundice sometimes appeared. The changes in chemical pathology were in serum transaminases activity (GOT, GPT, GDH); alkaline phosphatase and gamma-glutamyltranspeptidase as indices of cholestasis; lactate dehydrogenase, hydroxybutyrate dehydrogenase and creatine phosphokinase, as enzymes related to energy metabolism; pseudocholinesterase, as a protein metabolism-related enzyme. The possible causes of these alterations in critically ill patients undergoing TPN are considered and a functional final metabolic interpretation is proposed.

Alanine Transaminase↗
PubMed1976

[Thoracic injuries and resuscitation. Case reports and critical review].

A series of 68 chest injuries treated at the Resuscitation and Intensive Care Unit. S. Orsola Policlinic, Bologna, between May 1967 and December 1973 is presented. Treatment was given by the staff of the anaesthesia and resuscitation service and the chest surgery section, 2nd Surgical Clinic, University of Bologna. The types of case observed and the treatment methods employed are bierfly explained, together with the clinical and statistical data. Emphasis is laid on the relation between clinical course and blood gas values. The value of tracheostomy and protracted intubation is discussed, together with the utility of antalgic and psychosedative management. The increased frequency of bronchopneumonic complications is noted. Encouraging results obtained by surgical stabilisation of movable flaps by means of Kirschner wires are reported. While this method admittedly requires thoracotomy, this in itself has the advantage of enabling existing pleural and pulmonary lesions to be repaired.

Adolescent↗
PubMedDate not supplied

Using elderly donors in liver transplantation.

AIM: Elderly donors are half of the grafts available in our center for liver transplantation. We retrospectively investigated their characteristics, outcomes, and variables related to graft failure. MATERIAL AND METHODS: From 1996 to 2003, 540 (46.4%) of 1163 donors were older than 60 years of age and 236 grafts (43.4%) were transplanted, whereas the others were refused. The clinical investigated variables were examined among this cohort. RESULTS: The median age of donors increased from 37 to 62 years. Donors older than 60 years of age were more often refused than younger ones (66% vs 44%); HCV-positive (9.9% vs 5.4%); HbcAb-positive (18.6% vs 12.6%), and steatotic (35.7% vs 13.9%; P < .01). Among donors older than 60 years, the main parameter to refuse the graft was the grade of steatosis. The variables related to the graft loss from donors older than 60 years were as follows: model for end stage liver disease (MELD) recipient >15 (65% vs 39%), cold ischemia time >10 hours (25% vs 13%), high blood losses (3987 +/- 4764 vs 2664 +/- 2043 mL), and year of liver transplantation after 2000 (26% vs 46%; P < .01). The 1-, 3-, and 5-year graft survival rates were significantly lower among donors older than 60 years than other donors: 75%, 65%, and 62% versus 85%, 83%, and 78%, respectively (P < .001). CONCLUSION: Donors older than 60 years of age provided liver transplants to half of our recipients. The graft survival rate of these organs was lower than that of younger donors and to improve it the other risk variables for poor outcome should be reduced, including MELD score of the recipient and prolonged cold ischemia time.

Adult↗
PubMedDate not supplied

Preliminary results of immunosuppression with thymoglobuline pretreatment and hepatitis C virus recurrence in liver transplantation.

Induction with thymoglobulin, a potent anti-thymocyte polyclonal antibody, has been recently reported to allow minimization of postoperative immunosuppression in organ transplantation. The relationship with recurrence of hepatitis C virus (HCV) after liver transplantation (LT) has never been investigated. We report herein on the outcome of 22 HCV+ patients receiving thymoglobulin pretreatment and minimal immunosuppression after liver transplantation. Patient survival and acute rejection rates were good, with remarkably low dosages and levels of immunosuppression achieved with thymoglobulin, and without exposing patients to an elevated risk of rejection. A progressive weaning of the primary immunosuppressant was also possible in the majority of patients without complications. The HCV recurrence rate was similar to that reported in the literature, although lower HCV RNA viral loads were obtained with thymoglobulin and a mild histologic course. Although our results need to be validated in large cohort studies, our experience shows that minimization of immunosuppression with thymoglobulin is effective to protect against rejection and demonstrated a positive impact on HCV recurrence that deserves further investigation.

Antilymphocyte Serum↗