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Biomedical subjects

P Campisi

Publications and source records attributed to P Campisi.

16 recordsLinked to original sources
PubMed2001

Hyalinizing trabecular adenoma versus papillary thyroid carcinoma in a child.

Hyalinizing trabecular adenoma (HTA) of the thyroid gland is a rare, benign neoplasm predominantly diagnosed in middle-aged women. There is mounting evidence in the medical literature, however, to suggest that HTA may represent an encapsulated variant of papillary thyroid carcinoma (PTC). This report describes an unusual case of PTC in a child initially diagnosed as HTA. Establishing an accurate diagnosis has important management implications for the pediatric patient.

Adenoma↗
PubMed2001

Sequential parapharyngeal abscesses.

Deep neck infections are not unusual in either the pediatric or adult populations. Multiple, and recurrent abscesses are found not infrequently, especially in immunocompromised and debilitated persons. It is very rare to find sequential parapharyngeal abscesses without identifiable etiology in an otherwise healthy pediatric patient while receiving appropriate, culture-directed, intravenous antibiotics. This could be due to underestimation of the extent of the infection by CT scanning. The use of intravenous clindamycin as a first-line therapy may not be sufficient if a large phlegmon exists. We describe a case of sequential, bilateral parapharyngeal abscesses in a 3-year-old patient.

Anti-Bacterial Agents↗
PubMed2000

Foreign body aspiration following unconventional use of a metered dose inhaler.

PURPOSE: Aspiration of a foreign body may be life-threatening. This report describes laryngeal obstruction after inhalation of a piece of a Turbuhaler which resulted from a patient tampering with the device. CLINICAL FEATURES: A 27-yr-old man disassembled a Turbuhaler and inadvertently aspirated a plastic dispensing medication disc (22 mm diameter) while attempting to inhale the remnant terbutaline sulfate which accumulated on it. Although the patient was hoarse, he was not in acute respiratory distress. X-ray revealed the disc lodged in the larynx below the vocal cords. The patient was immediately transferred to an operating theatre, and a drying agent (glycopyrrolate), judicious sedation (midazolam and fentanyl) and O2 were administered. The airway was anesthetized with lidocaine 4% delivered using high-flow O2 through an atomizer. Direct laryngoscopy revealed a partially obstructed view of the disc lodged distal to the vocal cords which was inaccessible for retrieval. Loss of consciousness was subsequently induced by spontaneous mask ventilation with sevoflurane (in O2). The airway was visualized using a suspension laryngoscope and the foreign body was removed with grasping forceps. The patient was awakened, transferred to the ICU and given 4 mg decadron i.v. every eight hours (two doses). Laryngoscopy prior to discharge indicated good mobility of the vocal cords and normal glottic structure. CONCLUSION: Aspiration of a foreign body is a potentially life-threatening situation requiring coordination between anesthesiologist, surgeon, and nursing staff. Anesthetic goals include avoidance of upper airway obstruction and maintenance of adequate ventilation while the foreign body is retrieved. Provisions must be made for tracheostomy if these goals cannot be realized.

Adult↗
PubMed2000

MultiDimensional Voice Program analysis in children with vocal cord nodules.

Computer-assisted voice analysis has recently been introduced as a noninvasive approach to the management of paediatric dysphonia. The aim of this study was to determine which parameters of voice analysis distinguish vocal cord nodules from normal patterns. Following diagnosis by flexible nasolaryngoscopy, 12 male children with vocal cord nodules, aged 7 to 12, underwent voice analysis by MultiDimensional Voice Program (MDVP; Kay Elemetrics, Lincoln Park, NJ, USA). These subjects were divided into two age groups (7-9 years, n = 5; 10-12 years, n = 7) and compared to age-matched controls. Results suggest that across all age groups, subjects with vocal cord nodules had statistically significant (p < .01) elevations in absolute jitter, jitter percent, relative average perturbation, pitch period perturbation quotient, smoothed amplitude perturbation quotient, and fundamental frequency variation. Further studies are required to assess the role of MDVP in the diagnosis of other voice pathologies and the monitoring of voice therapy.

Child↗
PubMed1998

Enhanced in vivo alpha1- and alpha2-adrenoceptor-mediated venoconstriction with indomethacin in humans.

Vasodilator prostaglandins are released in vitro from endothelium during adrenergic stimulation. We hypothesized that indomethacin would block this production in vivo and increase venoconstriction to alpha1- and alpha2-stimulation but not to the nonadrenergic agonist PGF2alpha. Hand vein distension was measured in 24 normal subjects (23.0 +/- 0.5 yr) during local infusions of phenylephrine (8-12,000 ng/min), clonidine (3-7,000 ng/min), or PGF2alpha (1-2,048 ng/min) plus indomethacin (3 microg/min) versus saline on two separate days. Dose-dependent venoconstriction to phenylephrine occurred in all subjects, with a parallel shift to the left with indomethacin (P = 0. 003) and a decrease in the phenylephrine 50% effective dose (1,009 vs. 241 ng/min, geometric means, P = 0.012). Venoconstriction to clonidine was more variable, with most subjects eliciting a biphasic response (initial venoconstriction followed by attenuation). With indomethacin, the dose-response curve was displaced up and to the left (P = 0.005), and peak venoconstriction was increased (51.1 +/- 6.8 vs. 27.2 +/- 5.3% of control, P = 0.018) without a biphasic response. In all subjects, PGF2alpha elicited dose-dependent venoconstriction that was not altered by indomethacin. Thus venous alpha1- and alpha2-stimulation results in release of vasodilator prostaglandins that antagonize the venoconstrictor response. This modulates the sympathetic response of venous smooth muscle and may be important in diseases with endothelial dysfunction.

Adrenergic alpha-Agonists↗
PubMed1997

Role of adenosine in the ethanol-induced potentiation of the effects of general anesthetics in rats.

Acetate, derived from ethanol metabolism in the liver, is released into the circulation and utilized in many tissues including the brain. The subsequent metabolism of acetate results in the production of adenosine that has a number of effects in the central nervous system. The purpose of the present studies, therefore, was to investigate the contribution of metabolically generated adenosine to the ethanol-induced potentiation of the inhalational agents isoflurane and sevoflurane. Changes in the anesthetic requirement for isoflurane and sevoflurane were determined in rats using the tail-clamp procedure. Both ethanol and sodium acetate reduced anesthetic requirement for isoflurane and sevoflurane in a dose-dependent fashion. The effect of acetate on anesthetic requirement was completely blocked by the administration of the adenosine receptor blocker, 8-phenyltheophylline. The ethanol-induced reduction in anesthetic requirement, however, was only partially blocked by 8-phenyltheophylline. Direct intracerebroventricular (i.c.v.) administration of the water-soluble adenosine receptor blocker, 8-sulfophenyltheophylline, also completely blocked the effect of acetate and partially blocked the effect of ethanol. This i.c.v. administration demonstrates that the actions of ethanol and acetate on anesthetic requirement are a central nervous system effect. The i.c.v. administration of the adenosine A1 receptor subtype agonist, R-phenylisopropyl adenosine, potentiated the anesthetic effects of isoflurane and suggests that the A receptor mediates the observed potentiation of anesthetic effect. This is further supported by the concomitant administration of 5-N-ethylcarboxamido adenosine, a non-selective adenosine agonist, with the selective A1 antagonist, 8-cyclopentyltheophylline, showing A1 receptor potentiation of anesthetic requirements. The studies show that (1) acetate potentiates the anesthetic effects of the inhalational anesthetics, sevoflurane and isoflurane; (2) acetate contributes in part to the effect of ethanol on anesthetic potency through metabolically generated adenosine; (3) these effects are likely mediated via adenosine A1 receptor subtypes.

Acetic Acid↗
PubMed1991

Central nervous system effects of acetate: contribution to the central effects of ethanol.

Acetate, resulting from ethanol metabolism in the liver, is released into the circulation and is utilized in a number of tissues, including the brain. In its metabolism, acetate leads to the production of adenosine, a powerful physiological mediator. We have investigated the effect of acetate on central nervous system (CNS) function in rodents. Sodium acetate in doses resulting in blood concentrations comparable to those attained after the administration of 1 to 2 g/kg ethanol, had significant CNS effects. Both ethanol and acetate produced a dose-dependent impairment of motor coordination. This effect of acetate was fully blocked by the adenosine receptor blocker 8-phenyltheophylline (8PT), whereas the dose-response relationship for ethanol was shifted to the right by about 30%. The inspired concentration of sevoflurane to achieve anesthesia was significantly reduced by both these agents. General anesthesia was potentiated in a dose-dependent fashion by ethanol and by acetate. The effect of acetate on anesthetic requirements was fully blocked by 8PT. The effect of ethanol on sevoflurane anesthetic requirements was inhibited by 22 to 35% by 8PT. Locomotor activity in mice was reduced by acetate in a dose-dependent fashion, an effect that was also fully blocked by 8PT. On the other hand, ethanol at a dose of 1 to 2 g/kg increased locomotor activity. This likely results from a direct stimulatory effect of ethanol, opposed by an inhibitor effect of acetate. The administration of 8PT enhanced the stimulation of locomotor activity induced by ethanol. In conclusion, acetate, a product of ethanol metabolism has significant CNS effects that can either potentiate or antagonize the effects of the ethanol molecule per se.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗
PubMed1990

[The activity of psychiatric consultancy within a general hospital. The relationship and institutional implications].

The consultancy activity performed by Biella Ward of the local general hospital in 1979-1987 is described. After presenting data regarding the quantity and nature of consultancy requests, the medico-hospital cultural background relating to mental suffering is analysed. The hospital often tends to address only the patient's bidimensional aspects, excluding his internal being. Because of a mutual, tacit contact between physician and patient, the moment of admission is seen as a "somatic repair service". The psychological crisis usually arises in the form of the breakdown of the contract when the possible uncertainty of diagnosis and the prolongation of clinical examination affects the personality. In the specific case of Biella Psychiatry, the forced closure of the Psychiatric Diagnosis and Care Service about six years ago helped push the Psychiatrist towards a "liaison" role.

Hospitals, General↗
PubMed1990

[An epidemiological study of psychiatric emergencies at the Biella Department of Emergencies and Admissions in the 5 years of 1983-1987].

The psychiatric intervention procedure at the Emergency and Registration Department (ERD) of Biella Hospital is examined. After a short introduction in which some general data are provided regarding Health Unit no. 47 of Biella and Unit no. 48 of Cossato, the data collected by the ERD psychiatric register are analysed. Data on ERD arrival modalities are reviewed and the type of diagnosis attributed by the psychiatrist to patients examined at the ERD is examined. The various types of responses given by the psychiatrist after consultancy are then presented. The time bands in which the request for psychiatric intervention mainly fall are then noted. The paper closes with remarks on the effectiveness over time of psychiatric intervention at the ERD.

Emergencies↗
PubMedDate not supplied

Outpatient treatment of spontaneous pneumothorax in a community hospital using a Heimlich flutter valve: a case series.

This is a case series of 14 consecutive patients treated as outpatients for spontaneous pneumothorax (SP) (1 January 1992 to 31 December 1995) by one surgeon in a community hospital setting. The purpose of this study was to examine the appropriateness and financial implications of routine outpatient management of SP with closed tube thoracostomy and the Heimlich valve. All 14 patients reviewed were successfully managed as outpatients, although 3 required an overnight admission because of anxiety, pain, or vasovagal reaction. The routine outpatient treatment of all cases of SP not requiring definitive surgical intervention may have saved more than $16,000.00 for the hospital and an estimated $500,000.00 for the province of Ontario during the 1993-1994 fiscal year. Our findings suggest that the Heimlich valve is an appropriate alternative for the management of SP in a nonteaching community hospital setting, with benefits to the patient and to the health care system.

Adolescent↗
PubMedDate not supplied

[Psychopharmacologic prescription at a public service. Examination of a group of patients admitted to the psychiatric service of diagnosis and therapy].

The use of psychodrugs in patients admitted to an SPDC over a period of thirty days is considered. During this period two questionnaires were administered, addressed respectively to the nursing staff and their patients. The purpose of the questionnaires was to investigate experience relative to the psychodrug on the part of the patient and the nurse who administers it. The results tend to confirm basic hypotheses: the psychodrug often takes on meanings that go beyond pure biochemical action to become mediators of complex, significant relational exchanges. Precaution in the of the psychodrug must therefore consider biological side-effects as well as relational ones.

Adult↗