Biomedical subjects

S Lari

Publications and source records attributed to S Lari.

42 records · Page 3Linked to original sources

PubMedDate not supplied

Low back pain in tumors: diagnosis and treatment.

On the basis of the authors' experience in the treatment of 257 skeletal neoplasms of the lumbar spine, the features of back pain, which in 96% of the cases constitutes the first symptom of these diseases, are discussed. The overall clinical aspects firstly depend on the stage of the primary tumor: latent, active, aggressive for benign tumors; intra- and extra-compartmental for malignant tumors. Symptoms may include elements which suggest specific lesions, such as osteoid osteoma, eosinophilic granuloma, aneurysmal bone cyst, or high-grade malignant tumors such as Ewing's sarcoma, while lumbar metastasis from carcinoma do not seem to have distinctive features. Site and localization of the tumor are also important variables. The treatment of neoplastic back pain depends on diagnosis, and cannot be adequate if it is not planned on the basis of a complete preoperative study, taking into account not only surgery, but also adjuvant therapy.

Adolescent↗

PubMedDate not supplied

[Hypotension controlled with ATP in orthopedic surgery: incidence of atrio-ventricular conduction disorders].

Adenosine triphosphate (ATP) has been effectively used for induced hypotension in man. Atrio-Ventricular (A-V) conduction disturbances have been observed after adenosine bolus injection and during continuous ATP i.v. infusion. The present perspective investigation was designed to determine the incidence of A-V conduction disturbances during ATP-induced hypotension. Thirty-five normotensive healthy patients (ASA I-II) with no preoperative therapy were subjected to the same anesthetic technique for orthopedic surgery. Premedication consisted of diazepam and atropine. Anesthesia was induced with thiopental and fentanyl followed by atracurium for intubation. The maintenance anesthesia consisted of isoflurane (1.5% inspired)-N2O (60%) in oxygen and incremental doses of fentanyl; the lungs were mechanically ventilated. Dipyridamole (0.15 mg kg-1) was given 15 min prior to ATP-infusion. ATP was administered by an infusion pump at a dosage of 0.025-0.05 mg kg-1 min-1. The ECG was recorded with a Mingograph 34 tape-recorder using 3 pregelled electrodes positioned to give an effective V6 lead pattern. MAP was reduced by 25% and HR increased by 6%. The mean duration of ATP-induced hypotension was 75 min +/- 50 and the mean dose of ATP infused was 200 mg +/- 161. Six patients (17%) showed A-V conduction disturbances. There was a I A-V Block (AVB) in 2 cases, a II AVB in 2 cases and a III AVB in 2 cases. In every case the arrhythmia disappeared spontaneously or after ATP-infusion suspension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗

PubMedDate not supplied

Anesthesia and perioperative treatment in large resections of the pelvic girdle.

The authors examine 24 patients submitted to resection of the pelvic girdle in neoplastic pathology, illustrating the perioperative anesthesiologic procedures used. Sudden variations in blood and plasma volume and increasing hypothermia constitute the main problems. The prevention of hypothermia and continuous invasive monitoring of hemodynamic parameters and of oxygen saturation in mixed venous blood (SvO2) are of primary importance.

Adolescent↗

PubMedDate not supplied

Pulmonary embolism associated with use of bone cement during hip arthroplasty.

Main circulatory (heart frequency, HF, intra-artery pressure, AP ECG) and respiratory (arterial oxyhemoglobin saturation SaO2, end-tidal CO2) arterial gas-analysis (HGA) parameters were recorded continually during cemented hip arthroplasty in 70 consecutive non-selected patients. The use of cement did not cause any change in the parameters obtained in 21 of the cases, reduction in arterial oxygen pressure (PaO2) ranging from 11% to 38% was observed in 44 cases, associated with simultaneous reduction in ETCO2 in 11 cases. The reduction in ETCO2 was an isolated finding in 5 of the patients. AP decreased by more than 10% in only 2 cases and there was arrhythmia in another 2 cases. These findings are strongly suggestive of pulmonary embolism encouraging the hypothesis of gas embolism previously suggested by other authors. In patients with little coronary or pulmonary reserve use of cement means an increased risk of severe hemodynamic complications.

Aged↗

PubMedDate not supplied

[Experimental isovolemic hemodilution. Study of tissue perfusion with Hb 3% in swine].

BACKGROUND: The aim of the study is to evaluate the limits of the compensatory mechanisms and the tissue damages caused by the low oxygen content during severe normovolemic hemodilution in pigs. METHODS: The experimental procedure was performed in 10 animals after general anaesthesia was induced and iso-hypervolemic hemodilution to Hct 10% was maintained for five hours without any intensive care. Hemodynamic, biochemical and ultrastructural parameters were detected before and at the end of hemodilution in addition to analysis of oxygen delivery/uptake and mitochondrial enzymes function. RESULTS: The collected data show: the initial good compensatory mechanism was subsequently exhausted; five animals demonstrated cardiac ischemia and low CO and two of them died before the end of the experiment; no hemodynamic and hemoxymetric data predicted the cardiac ischemia; the dilution caused alterations of some detected biochemical parameters such as hemocoagulation; no evidence of morphologic and ultrastructural tissue damage or interstitial edema; decreasing in mitochondrial enzymes activity significant only for NADH-related. CONCLUSIONS: In conclusion, it seems that, in pigs at least, the compensatory mechanisms can keep a sufficient tissue oxygen supply throughout the experimental time with the exception of cardiac muscle.

Animals↗

PubMedDate not supplied

Major vertebral surgery: intra- and postoperative anaesthesia-related problems.

A personal experience concerning vertebral excision and resection in a single stage for neoplasm is discussed. The surgery requires anaesthesia of long duration, hemodynamic stability, compensation of significant blood loss, monitoring of heat loss, maintenance without injury of prolonged prone position. Experience, with 24 cases lasting an average of 14.5 hours proves that inhalation or intravenous anaesthesia with a strong analgesic component is satisfactory. Normal heat saving systems reduce intraoperative hypothermia. Transfusion is always abundant, autologous contribution is moderate. Hemodilution is well-tolerated up to Hb 7%; below this amount there may be problems of a hemodynamic and coagulative nature. The quantity and quality of filling is guided by monitoring of pre-loading pressures and availability of oxygen. There were no critical complications; all of the patients left the hospital in good condition.

Adult↗