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Biomedical subjects

R Palomba

Publications and source records attributed to R Palomba.

At least 19 recordsLinked to original sources

[The utility of bispectral index monitoring in general anesthesia].

BACKGROUND: The Bispectral Index (BIS), a parameter derived from the electroencephalograph, has been shown to correlate with increasing sedation and loss of consciousness. This study was designed to investigate whether using BIS would improve anaesthetic drug management and immediate recovery after anaesthesia. METHODS: 160 patients undergoing abdominal surgery were studied. The patients were randomised to receive either propofol or sevoflurane anaesthesia. In each group 40 patients were anaesthetised with BIS monitoring and 40 without BIS. In BIS groups, propofol and sevoflurane dose was adjusted to achieve a target BIS values between 40-60 during the whole procedure. Drug consumption, intraoperative responses, times of recovery after anaesthesia and a "Clinical Quality Scale of Recovery" score were recorded from blinded observators. RESULTS: Demographic data were similar between groups. BIS monitoring improved the immediate recovery after propofol anaesthesia, while no significant differences were observed in patients receiving sevoflurane. The consumption of both propofol and sevoflurane significantly decreased (30 and 40%, respectively). There was no significant differences in the incidence of intraoperative responses between groups. The BIS groups had a higher percentage of patients with better ICU assessments. CONCLUSIONS: BIS monitoring decreased the consumption of both propofol and sevoflurane and facilitated the immediate recovery after propofol anaesthesia. Intraoperative course was not changed. These findings indicate that the use of BIS may be a valuable guide of the intraoperatively administration of propofol and sevoflurane.

Adolescent↗

Comparative FISH-mapping of the prion protein gene (PRNP) on cattle, river buffalo, sheep and goat chromosomes.

Comparative FISH-mapping of the prion protein gene (PRNP) was performed on cattle (BTA), river buffalo (BBU), sheep (OAR) and goat (CHI) chromosomes using a PCR-product as a probe and R-banding. PRNP was mapped to BTA13q17, BBU14q15, OAR13q15 and CHI13q15 according to standard nomenclatures. These chromosomes and bands were homoeologous among the four species, confirming the high degree of gene and chromosome banding conservation among bovids. Furthermore, the assignment of PRNP to river buffalo and goat chromosomes allowed us to indirectly assign the bovine syntenic group U11 to specific chromosomes, since it is the first in situ localization on BBU14 and CHI13.

Animals↗

[Comparison between balanced anesthesia and total intravenous anesthesia in videolaparocholecystectomy].

The aim of this work was to assess which anaesthetic technique is more suitable to the performance of videolaparocholecystectomy (VLC), particularly seeking for a faster and more comfortable recovery, although saving the maximum safety of the patient. A comparative investigation between two different anaesthetic techniques was carried out in 40 patients scheduled for VLC; the procedure's average length was 110.3 +/- 32.8 minutes and pneu- moperitoneum was obtained with 12-15 mmHg of CO2. Patients (32 females and 8 males, average age 52.3 +/- 8 years and ASA class 1, 2, 3, were randomized in two groups. The first group was administered total intravenous anaesthesia (TIVA): propofol+ fentanyl+pancuronio bromide; the second one received balanced narcosis:TPS+ Isoflurane+Pancuronio bromide. The following parameters were monitored at set times: SAP, DAP, HR and EtCO2; statistical analysis was performed by analysis of variance. The quality of recovery was assessed by Steward's test and analyzed by Student's "t" test. The data obtained from analysis of the intraoperative parameters showed no significant differences between the two groups; on the contrary a statistically significant difference was found with regard to the quality of recovery (p > 0.5 at 5' from the extubation). Thus, the comparative study showed the efficacy and safety of both techniques, but TIVA allowed a faster and more comfortable awakening with shorter time to recovery of consciousness. This, together with the reduced requirements of analgesic drugs in the postoperative period and the lack of air pollution, seems to suggest that TIVA is to be preferred for laparoscopic surgery.

Anesthesia, General↗

Expression of the human apolipoprotein AI gene fused to the E. coli gene for beta-galactosidase.

The human apoAI gene was expressed in E. coli by in-frame fusion to a modified beta-galactosidase gene present in plasmid pUR291. The fused beta-galactosidase-apoAI gene product was expressed at a high level and was recognized by an anti-human apoAI antiserum. Besides the fused protein, at least one degradation product having an Mr similar to that of beta-galactosidase was present in high amounts in bacterial extracts. These results and those of a pulse-chase experiment indicate that degradation took place only in the apoAI moiety of the chimeric protein.

Apolipoprotein A-I↗

[Intestinal obstruction and incomplete obstruction from mesenteric cyst formation in children (author's transl)].

In the light of three cases of their own observation, of children with mesenteric cysts causing complete or incomplete intestinal obstruction, the authors review the existing literature on the subject, discuss the etiology, clinical aspects, and therapeutic methods for the correction of such pathology, and conclude by calling attention to mesenteric cysts as possible causes of intestinal transit disorders in the pediatric age group.

Child↗

[Current views concerning the etiopathogenesis of reflux esophagitis in children].

Esophagitis is caused by a gastro-esophageal reflux sometimes reflecting anatomical inadequacy of structures that secure the relationships between the cardia and the diaphragm, fundus of the stomach, and other surrounding viscera, but more often due to functional deficiency of lower esophageal sphincter (LES), this representing the main factor for maintenance of the mechanism of cardial continence. Manometric studies of intraluminal pressures in the esophagus have revealed the presence of a high-pressure segment in the distal esophagus, where a mean pressure of 12-13 mm Hg obtains over a length of 3 or 4 cm. In the first two weeks of extrauterine life the LES is between 0.5 and 1 cm long, with a pressure of 3 mm Hg; pressure values in the LES equal adult values at about one month of age, showing that neuromuscular control of the sphincter has been achieved. Gastro-esophageal reflux, however, is very common in the newborn and not enough by itself to cause peptic disease of the esophagus; this requires the concomitance of morphological defects of the esophageal mucosa and/or dynamic-functional disturbances. This, according to the authors, is why esophagitis actually occurs in only about 60% of patients with radiologically and pHmetrically demonstrated gastro-esophageal reflux.

Age Factors↗

[Clinical picture and diagnosis of reflux esophagitis in children].

Whereas a burning retrosternal pain irradiating upward is the main symptom of reflux esophagitis in the adult, this symptom is usually not extant in children. Rather, the child will show unaccountable vomiting, stunted growth, anemia of unknown etiology, and respiratory disturbances. The pathologic condition more often associated with reflux esophagitis is hypertrophic stenosis of the pylorus, which is in fact regarded as one of the causes of the esophageal disorder. Reflux esophagitis may lead to ulceration and hemorrhage, and may evolve into cicatricial retraction and esophageal stenosis, the latter sometimes quite tight. The condition is diagnosed in light of radiological examination and endoscopy. Whit older children, one may add the Bernstein test and pressure and pH readings. The paper concludes by pointing out the different diagnostic approach in the newborn and small baby on the one hand and in older children on the other.

Child, Preschool↗

[Current trends in the treatment of reflux esophagitis in childhood].

A problem of some complexity is the management of pathological gastro-esophageal reflux due to the presence of cardio-hiatal malformation, malposition of the cardia and gastric tuberosity, a congenitally short esophagus, and the like. Sometimes, however, there is no demonstrable morphological aleration and the condition, characterized by primitive hypotonia of the LES, goes under the name of infant chalasia of the esophagus. The general policy is to try first a conservative treatment consisting of dietary and postural measures and the administration of metoclopramide and d;ugs that protect the esophageal mucosa; this stage, however, should not be prolonged beyond 6 weeks. The presence of gastro-esophageal reflux associated with hiatal hernia; the presence of severe esophagitis or peptic stenosis of the esophagus and the persistence of symptoms after an adequate period of conservative therapy constitute as many indications for surgical correction. Good results can be obtained by restoring or strengthening the failing function of the LES, as is done quite successfully with funduplication after Nissen or with method of Belsey-Mark IV.

Antacids↗

[Current criteria of treatment of angiomas].

The authors set out their therapeutic trend in the treatment of angioma and the criteria governing the use of the various therapies according to the type of dysplasia and its clinical course; they then report on the results obtained in a series of 400 cases. Only 22 cases with unfavourable trend (evolution of lesion) were observed, whereas the others exhibited spontaneous regression (85 cases), arrest of evolution (50 cases) or regression or cure (243 cases).

Adrenal Cortex Hormones↗