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Biomedical subjects

V Lanza

Publications and source records attributed to V Lanza.

At least 19 recordsLinked to original sources
PubMed2005

Refeeding syndrome in early pregnancy. Case report.

Refeeding syndrome is a very serious disorder that is not often observed today, as it is more common during times of mass starvation or war. Nowadays, it is sometimes found in patients suffering from anorexia nervosa or neoplastic diseases. A case recently treated in our Intensive Care Unit is described. The patient was pregnant and suffering from Crohn's disease. It is emphasized that although refeeding syndrome is often fatal if not treated early, it is easily prevented or treated with adequate nutritional support.

Acid-Base Imbalance↗
PubMed2002

[Assessment of operating theatre procedures and quality of perioperative anaesthesia using a computer system for collecting anaesthesiological data].

BACKGROUND: In order to manage the operating theatre and guarantee constant improvement in the quality of procedures, it is indispensable to be able to have available a computerised workstation to enable the team to collect data and analyse them. METHODS: We used our anaesthesia department's computer workstation to retrospectively analyse operating sessions over a 16 month period during which organisational adjustments were made to optimise patient turnover and maximise the utilisation of operating theatres. Meantime we studied and compared the trend in anaesthesiological quality through the use of certain structural, process and outcome indicators. RESULTS: During the period under study an improvement was noted in the efficiency of operating theatre procedures (reduction in entry time of the first patient into the theatre, time between one case and the next and subutilisation of the operating theatre, p<0.05). As regards data on the quality of anaesthesiological assistance to the patient, no significant differences were noted when comparing the four periods examined. CONCLUSIONS: To make the operating complex work more efficiently, it is necessary to have available a computer system that makes it possible to continuously monitor theatre operation. The improvement initiatives undertaken led to a more effective utilisation of the operating theatre but did not produce a significant increase in productivity. In spite of the increased work load, analysis of the trend in quality indicators as regards anaesthesiological procedures did not reveal any modification.

Anesthesia↗
PubMed1996

Automatic record keeping in anaesthesia--a nine-year Italian experience.

In 1986, in Buccheri La Ferla Hospital, Palermo, an anaesthesia information management project was started. Its aim was to develop a computerized anaesthesia workstation. Today, the system is in daily clinical use and has reached most of its original goals: Automatic collection of physiological signals and patient monitor trends is possible by means of analog-digital conversion or by using serial data transfer. A centralized display is included in the system to allow easy control of the progress of the anaesthetic procedures in the hospital. Available in the workstation, there is an on-line help function to assist pharmacological calculations and administration of anaesthesia drugs. Mail messages can be sent to different anaesthesia workstations and data can be shared between them. Information collected during preoperative visits is automatically transferred from a portable personal computer to the system. There is a nine-year patient data-base with both preoperative and perioperative anaesthesia information which can be accessed from each of the workstations. Today, the system is in daily routine use and comprises eight anaesthesia workstations and two portable personal computers used for preoperative visits. The operation schedule with anaesthetists' notes is printed both for surgical wards and for O.R., using information stored from preoperative visits to the system. For automated data collection a trend resolution of one minute has been used. The postoperative orders are printed from the system in the recovery room and given to the wards with the patient. The feedback from the seventeen anaesthetists and twenty-four nurses who use the system routinely is positive. Today, 16,000 patient records are available in the database. This number increases by 3,300 every year. With increasing computer utilization in patient treatment there have been no legal or administrative controversies. Based on nine years' experience, it is clear that the use of computers in anaesthesia practice improves quality of patient care.

Analog-Digital Conversion↗
PubMed1994

Informatics in palliative care.

A computerized documentation system for palliative care would allow immediate availability of patient data and rapid evaluation of treatment. To develop such a system, many problems must be resolved, including choice of data and type of display. A preliminary screening of information and the introduction of codes to show some parameters are necessary to achieve a good result. We describe a program that allows data entry, storage of data, rapid display and printout of data, and recording of history, previous therapy, pathologic, physical, and laboratory findings, diagnosis, mechanisms and site of pain, drugs, and symptoms. Further improvements and problems are discussed.

Female↗
PubMed1994

[In vitro and in vivo effects of propofol on the hemoglobin dissociation curve].

This study assessed in vivo and in vitro the effects of propofol on the affinity of hemoglobin for oxygen in seven ASA 1 adults. For the in vivo study, venous blood samples were withdrawn before and after premedication, after the injection of 2.5 mg.kg-1 of propofol and after 15 minutes of maintenance at an infusion rate of 0.2 mg.kg-1.min-1. For the in vitro study, propofol was added to the blood withdrawn before premedication in order to obtain two samples at a concentration of 1 microgram.mL-1 and 2 micrograms.mL-1 respectively. Propofol changed neither in vivo, nor in vitro, the P50 and the number of Hill indicating the angle of the slope of the dissociation curve, nor in vivo the concentration of 2,3-DPG.

Adolescent↗
PubMed1991

GATA repeats in the genome of Asellus aquaticus (Crustacea, Isopoda).

A 500 bp fragment of Drosophila genomic DNA containing 37 copies of the tetranucleotide GATA was used to probe, by Southern DNA blotting and in situ hybridization, two natural populations of the isopod crustacean Asellus aquaticus collected from the Sarno and Tiber rivers. This species does not have a recognizable sex chromosome pair. In a number of males from the Sarno population chromomycin A3 staining reveals a heteromorphic chromosome pair. The heterochromosome has two blocks of heterochromatin. After digestion of genomic DNA with six restriction endonucleases and hybridization with the GATA probe, the two populations exhibit different fragment length patterns. No sex-linked pattern was observed in either population. In situ hybridization to chromosomes of males and females from the Sarno population does not reveal any sex-specific pattern of labelling and indicates a scattered distribution of GATA sequences on most chromosomes with some areas of preferential concentration. The heterochromatic areas of the male heterochromosome are not labelled.

Animals↗
PubMed1991

The effect of N2O on the oxyhemoglobin dissociation curve is mediated by CO2.

In order to test whether the previously reported effect of N2O on the oxyhemoglobin dissociation curve (ODC) depends upon the presence of 2, 3 DPG or CO2, the blood of healthy subjects was balanced in microtonometers at 37 degrees C with gas mixtures containing N2O but CO2 depleted. Samples of the same blood were exposed to the above gases after incubation at 37 degrees C for 24 hours in order to deplete them of 2, 3 DPG. After a 10 minute tonometry, the hemoglobin saturation and the pH were measured. The pH was corrected into 7.4.P50 increased 5.7% in fresh blood and 5% in 2, 3 DPG depleted blood after samples exposure to N2O. No effect of N2O on P50 was found in samples exposed to gas without CO2. The authors conclude that the effect of N2O on the ODC is mediated by CO2.

2,3-Diphosphoglycerate↗
PubMed1990

[Continuous infusion peridural analgesia in labor].

A technique of continuous infusion epidural anesthesia was used during labour in 933 patients divided into three groups according to age: Group A (14-18 years old), Group B (19-35 years old) and Group C (greater than 35 years old). Infusion was carried out using the following system: a PVC pressurized bag containing 0.3% marcain connected to 2 flow regulators which ensured a flow of 6 ml/h. During the dilatation phase, 85% of patients received sufficient analgesia, whereas 15% required extra boluses. During the expulsive phase 80% of patients received adequate analgesia of the perineal plane, 12% received an extra bolus of marcain 0.3% and local anesthesia was performed in 8% to allow infiltration. Instruments were required in 5.6% of patients in Group A, 11.3% in Group B and 7.4% in Group C. The incidence of Caesarian section was 5.6% in Group A, 9% in Group B and 14.8% in Group C. No maternal complication was observed. Epidural anesthesia via continuous infusion was therefore shown to be an efficacious and safe method for ensuring analgesia during labour.

Adolescent↗
PubMed1989

[A quick and simple method for estimating the oxyhemoglobin dissociation curve].

The methods currently available for assessing the oxyhaemoglobin dissociation curve parameters are expensive, lengthy, require a large volume of blood, and the results obtained are modified by anaesthetic gases. The equipment required for the method described includes: a microtonometre, microcuvettes, 3 gas bottles containing different oxygen, carbon dioxide and nitrogen mixtures (4.5%, 5.6%, 89.9%; 3.5%, 5.6%, 90.9%; 2.5%, 5.6%, 91.9% respectively), a microxymetre, and a micropHmetre. The samples in the microcuvettes are incubated at 37 degrees C in a gas flow of 45 ml.min-1 from the bottles. SO2 is then read using the microxymetre. P50, i.e. PO2 at 50% saturation, is calculated, as well as Hill's number "n" (the angle of the oxyhaemoglobin dissociation curve). The PO2 required for Hill's formula is also calculated from the atmospheric pressure, the water vapour partial pressure, and the oxygen fraction in the gas bottle used. Normal values obtained by this method were P50: 26.5 +/- 1.5 mmHg; Hill's number: 2.65 +/- 0.35. The method presented here, requiring only 300 microliters of blood, is cheap, reliable, not affected by anaesthetic drugs, and quick.

Blood Gas Analysis↗
PubMed1989

[Evaluation of the liberation of urinary necrosis enzymes (NAG-AAP) after administration of plasma expanders: study of dextran 40, hydroxyethyl starch and polymerized gelatin].

We studied the 24-hour urinary elimination of enzymatic markers of renal tubular necrosis (NAG-AAP) in 21 patients (mean age 34.6 years old) who were treated with plasma expanders before peridural anesthesia. The patients were divided into three groups of seven subjects each: - 14 ml/Kg -1 of dextran 40 was administered to group 1 - 14 ml/Kg -1 of gelatin was administered to group 2 - 14 ml/Kg -1 of hydroxyethyl starch was administered to group 3. Urinary elimination of N-acetylglucosaminidase and of alanine aminopeptidase was determined in the 24-hour urine the day before surgery (controls), the day of surgery (G1) and the day after surgery (G2). The values of the samples, taken after plasma expander administration, did differ significantly from the control values (G1, G2). Therefore the administration of 14 ml/Kg -1 of dextran, gelatin or hydroxyethyl starch does not affect the renal tubular epithelium.

Acetylglucosaminidase↗
PubMed1988

Effects of halothane, enflurane, and nitrous oxide on oxyhemoglobin affinity.

To test whether anesthetics alter hemoglobin O2 affinity, venous blood was sampled from 27 healthy subjects before and during general anesthesia for appendectomy with halothane, enflurane, or nitrous oxide anesthesia. 0.110-ml aliquots of blood were equilibrated in microtonometers at 37 degrees C with known PO2 levels in gases containing 0%, 0.5%, 1%, 2%, or 3% halothane, 0%, 1%, 2%, 3%, or 4% enflurane, or 60% N2O. pH was then measured and PO2 corrected to pH = 7.4. Saturation was determined spectrophotometrically (Radiometer OSM-2). P50 computed from this PO2 and measured saturation was increased 5% (P less than 0.01) when blood was tonometered with N2O, but not in blood samples taken during N2O anesthesia and then equilibrated without N2O. Halothane and enflurane had no effect. 2,3 DPG was not affected by any agent. The authors conclude that inhalational agents in use today do not cause the oxygen dissociation curve to change in a way which might jeopardize the patient's oxygenation.

Adolescent↗
PubMed1987

Hemodynamics, prolactin and catecholamine levels during hemorrhagic shock in dogs pretreated with a prolactin inhibitor (bromocriptine).

Bromocriptin, a dopaminomimetic drug, causing inhibition of prolactin secretion, was used in experiments on haemorrhagic shock in dogs. 5 dogs were treated with bromocriptine (0.4 mg.day-1) for two days; a further 5 dogs were used as control animals. 30% of the blood volume was drawn from each dog. Mean arterial blood pressure, heart rate, central venous pressure, acid-base status, prolactin, GH and catecholamine levels were checked before blood letting and monitored until 1 hour after blood letting. Animals treated with bromocriptine showed a significant decrease of the mean arterial blood pressure and of the prolactin rate and a significant increase of catecholamine levels. Control animals, instead, showed a significant increase of the prolactine and catecholamine rates. The results obtained suggest that bromocriptine can constitute an additional hypotensive factor in subjects with acute haemorrhage. A considerable amount of research work previously carried out has shown a close correlation between stress and hyper-prolactinemia. The increase of prolactinemia and the effects of bromocriptine on this hormone during surgical stress is particularly interesting due to its possible implications (Lanza V. et coll., 1983). In previous experiments involving animals it was found that Prolactin exerts positive chronotropic and hypertensive effects (Horrobin D.F., 1977) whilst bromocriptine is a potent agonist of D2 dopaminergic receptors (Thorner M.O. et coll., 1980). Dopamine was found to be particularly useful in the clinical treatment of shock thus suggesting an involvement of peripheral D2 receptors. On the basis of these observations we have considered it worthwhile to investigate the haemodynamic effects of bromocriptine in haemorrhagic shock.

Animals↗
PubMed1986

[Neuroendocrine response to anesthesia with isoflurane].

The effects during surgery of a new halogenated volatile anaesthetic, isoflurane, on the hypothalamo-hypophyseal-thyroid-suprarenal axis were studied. In fact, it was important to prove whether this new halogenated anaesthetic would provide better protection, for the patient, from surgery and anaesthetic stress compared with other anaesthetic agents in use. The study was carried out in 16 young class ASA I patients who were to undergo appendicectomy. Before and during operation, blood was taken to measure ACTH, cortisol, TSH, T3, T4 and PRL plasma levels. A remarkable increase of PRL, cortisol and T4 plasmatic rate was found, especially at the end of the operation. It was concluded that isoflurane, just like enflurane, did not prevent the increase of PRL, cortisol and T4 that usually takes place during surgery.

Adolescent↗