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Biomedical subjects

V Fontana

Publications and source records attributed to V Fontana.

12 recordsLinked to original sources
PubMed1991

A quality control method in cardiac surgical outcome: experience in 462 patients.

The aim of our study is to verify the reliability, reproductiveness and simplicity of a method to control cardiac surgical results. We divided 462 adult patients, operated on for acquired heart disease from October 1989 to January 1991, into five classes according to an individual score which was predictive for their operative mortality risk. The score resulted from 15 different risk factors tested with univariate and multivariate analysis against one event: operative death. The total number of deaths was 12: 2, 2, 1, 2, 5 for each class respectively. When comparing the predicted versus our observed mortality, we found no statistically significant difference, using the chi-squared test. The method we used is highly predictive for surgical mortality risk: it makes the results objectively comparable among different institutions; it is useful as a self-controlled quality method for cardiac surgical activity in any single institution.

Adolescent↗
PubMed1991

Intracoronary streptokinase in unstable angina: a prospective randomised study.

Results of our prospective, randomised pilot trial to evaluate the clinical effects and the angiographic correlates of early thrombolysis in patients with unstable angina are reported. Sixty-seven patients had coronary angiography 10 +/- 8 (median 7) hours after an episode of transient chest pain at rest with reversible ischaemic changes on the electrocardiogram. Patients with left main disease (4), or diffuse coronary disease and unidentified ischemia-producing lesions (13) were excluded, as were those without severe (greater than or equal to 70%) stenosis (10). Intracoronary thrombus was identified at angiography in 7 patients (17%) and complex coronary lesions in 5 (12%) of the remaining 40 patients who were randomised to either intracoronary streptokinase 250,000 IU followed by intravenous heparin along with conventional treatment (20 patients), or to conventional treatment alone (20 patients). All patients received Aspirin. No differences between the streptokinase and the conventional treatment groups were observed with respect to demographic and clinical characteristics at admission to the study. During observation in the intensive care unit for 3 +/- 1 days, 8 patients (40%) with streptokinase and 10 (50%) with conventional treatment were free from angina and infarction (p = 0.75; 95% confidence interval for the difference in response rates = -20 to 40%). There were no bleeding complications and no patient died. Patients enrolled in our study had fewer coronary thrombi at angiography than currently reported. Our data did not show that adjunct treatment with streptokinase and heparin is superior to conventional treatment alone in these patients.

Aged↗
PubMed1991

[Rapid onset aortic stenosis and clinical course in adults. Clinico-hemodynamic correlations].

In 8 patients aged 41-66 years, a second left heart catheterisation done 27-98 months after the first study, demonstrated a pressure gradient across the aortic valve, that had not previously existed, or had been trivial. No significant change of the cardiac output had occurred. All but 1 patient were hypertensive. The etiology was rheumatic in 4, degenerative in 4. Electrocardiographic, radiographic, and echocardiographic evolution could not separate the patients with a gradient greater than or equal to 70 mmHg from those whose gradient was less than or equal to 40 mmHg. The intensity of the aortic component of the second heart sound, however, decreased in all former patients, and in only 1 of the latter. Aortic valvular stenosis can arise and rapidly develop in adult patients. Concomitant rheumatic mitral valve disease, coronary artery disease and hypertension can mask and/or modify symptoms, signs and laboratory findings. Changes of the aortic component of the second sound may suggest its occurrence.

Adult↗
PubMed1990

[Use of a balloon-tipped guidewire to pre-dilate coronary stenosis].

Two cases of coronary angioplasty of very tight stenoses are reported in which, after failure of conventional low-profile catheters, a balloon-tipped guidewire was used to predilate the lesion, with subsequent advancement of a larger balloon catheter over the wire itself to complete the dilatation. It is suggested that this balloon-tipped guidewire can be helpful for safe predilatation of very tight coronary stenoses with no need for complex catheter exchanges.

Aged↗
PubMed1976

[Surgical treatment of postoperative peptic ulcer].

The literature on postoperative peptic ulcer is reviewed and cases observed in the Department of Surgical Anatomy and Operations Course of Turin University in the period 1-I-1968 - 31-III-1975 are presented. 183 operations for primary gastro-duodenal ulcer were carried out. A variety of techniques was employed, including 138 gastric resections using a modified Billroth II technique, with a recurrence of 1.3% encountered only in patients in the specified group. 15 reoperations for postoperative peptic ulcer were performed with the following result: very good in 7 cases, good in 6, and 2 postoperative deaths. The two deaths concerned a simple gastric reconversion and a gastric re-resection with gastro-jejuno-anastomosis. The personal series confirms the statistics presented by numerous foreign workers.

Adult↗
PubMedDate not supplied

Clinical stage I and II endometrial carcinoma: multivariate analysis of prognostic factors.

In 221 patients with FIGO stage I and II endometrial carcinoma, the impact on survival of age at diagnosis, menopausal status, FIGO stage, myometrial invasion, tumor grade and histology was evaluated by univariate and multivariate analysis. At a median follow-up of 50 months (range 45-210), 42 patients had died, and therefore overall survival was 81% (179/221). Univariate analysis showed that age, menopausal status and histology did not influence survival, whereas FIGO stage, myometrial invasion and tumor grade were important prognostic factors. Multivariate analysis showed that tumor grade had a significant and independent impact on survival and confirmed that FIGO stage is the most important parameter influencing survival.

Actuarial Analysis↗