Biomedical subjects

Massimiliano Tuveri

Publications and source records attributed to Massimiliano Tuveri.

4 recordsLinked to original sources

PubMed2006

Numerical modeling of 1D arterial networks coupled with a lumped parameters description of the heart.

The investigations on the pressure wave propagation along the arterial network and its relationships with vascular physiopathologies can be supported nowadays by numerical simulations. One dimensional (1D) mathematical models, based on systems of two partial differential equations for each arterial segment suitably matched at bifurcations, can be simulated with low computational costs and provide useful insights into the role of wave reflections. Some recent works have indeed moved in this direction. The specific contribution of the present paper is to illustrate a 1D numerical model numerically coupled with a model for the heart action. Typically, the action of the heart on the arterial system is modelled as a boundary condition at the entrance of the aorta. However, the left ventricle (LV) and the vascular network are a strongly coupled single mechanical system. This coupling can be relevant in the numerical description of pressure waves propagation, particularly when dealing with pathological situations. In this work, we propose a simple lumped parameter model for the heart and show how it can be coupled numerically with a 1D model for the arteries. Numerical results actually confirm the relevant impact of the heart-arteries coupling in realistic simulations.

Animals↗

PubMed2004

Abdominal aortic aneurysms: virtual imaging and analysis through a remote web server.

The study describes the application of a web-based software in the planning of the endovascular treatment of abdominal aortic aneurysms (AAA). The software has been developed in the framework of a 2-year research project called Aneurysm QUAntification Through an Internet Collaborative System (AQUATICS); it allows to manage remotely Virtual Reality Modeling Language (VRML) models of the abdominal aorta, derived from multirow computed tomography angiography (CTA) data sets, and to obtain measurements of diameters, angles and centerline lengths. To test the reliability of measurements, two radiologists performed a detailed analysis of multiple 3D models generated from a synthetic phantom, mimicking an AAA. The system was tested on 30 patients with AAA; CTA data sets were mailed and the time required for segmentation and measurement were collected for each case. The Bland-Altman plot analysis showed that the mean intra- and inter-observer differences in measures on phantoms were clinically acceptable. The mean time required for segmentation was 1 h (range 45-120 min). The mean time required for measurements on the web was 7 min (range 4-11 min). The AQUATICS web server may provide a rapid, standardized and accurate tool for the evaluation of AAA prior to the endovascular treatment.

Angiography↗

PubMedDate not supplied

[Pneumoperitoneum: is exploratory laparotomy always indicated?].

Pneumoperitoneum usually indicates a surgical emergency because of visceral perforation in 85 to 95% of cases. Spontaneous pneumoperitoneum without peritonitis is a rare phenomenon which poses a dilemma for the surgeon who is faced with this problem. Some cases of pneumoperitoneum can and should be managed conservatively. We report three cases of pneumoperitoneum and describe their outcomes. Two cases were treated conservatively, and one underwent laparotomy but no perforated viscus was found. We review the aetiological mechanisms and the pathophysiology of the appearance of intra-abdominal free gas. Furthermore, a compilation of other aetiologies of pneumoperitoneum without peritonitis as reported in the literature is presented. Pneumoperitoneum, preceded by a reasonable clinical history in a patient with an adequate abdominal examination, may warrant continued observation, thus avoiding an unnecessary laparotomy.

Aged↗

PubMedDate not supplied

Atypical Mondor's disease mimicking a strangulated Spigelian hernia in a patient with a deep venous obstruction. A case report.

Mondor's disease is a rare entity characterised by thrombophlebitis of the subcutaneous veins of the anterolateral thoraco-abdominal wall. The condition is usually benign and self-limiting. We report on a case of an inguinal localization of the disease, occurring on a dilated superficial epigastric vein acting as a collateral pathway due to a left ilio-femoral venous obstruction. The patient was referred to our department with a diagnosis of strangulated Spigelian hernia. General physical examination and ultrasonographic studies ruled out a complicated abdominal hernia and the presence of malignant disorders. A diagnosis of inguinal Mondor's disease in association with a chronic deep venous obstruction of the left ilio-femoral venous axis was made. The patient was treated with conservative therapy. Warfarin was promptly started in order to impede progression of the thrombotic process to the ipsilateral great saphenous vein. Though atypical Mondor's disease is usually a benign, self-limiting process, it can cause unusual clinical patterns that might give rise to clinical dilemmas for the surgeon.

Adult↗