Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma最新文献

{"title":"Use of surfactant for prevention of respiratory distress syndrome in newborn infants in spontaneous breathing. A randomized multicentre clinical pilot-study.","authors":"J M Dambeanu,&nbsp;S Parmigiani,&nbsp;B Marinescu,&nbsp;G Bevilacqua","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of administration of surfactant to premature infants in the delivery-room on respiratory distress syndrome (RDS) and short-term (28 days) mortality and outcome in a developing country where mechanical ventilators for infants were not available at the time of the study and neonatal mortality rate is extremely high.</p><p><strong>Design: </strong>Babies with gestational age 28-33 wks were randomly assigned to receive porcine surfactant prophylaxis (200 mg/kg endotracheally) in the delivery-room or routine assistance in 4 hospitals in Romania. After randomization, supplemental oxygen and continuous airway positive pressure were allowed if available. No rescue treatment was allowed. Diagnosis of RDS was done by means of Silverman score > or = 3 within 24 hrs + requirement of supplemental oxygen > or = 40%. Other examinations were performed depending on local availability.</p><p><strong>Results: </strong>53 babies were analyzed, and 28 were given prophylaxis while 25 resulted controls. The two groups did not differ for gestational age and birth weight (mean values for prophylaxis and control infants respectively: 30.6 +/- 1.6 vs 30.2 +/- 1.7 wks and 1457 +/- 258 vs 1397 +/- 388 g.), nor for sex, type of delivery and Apgar score. Mortality 0-28 days was 42.8 vs 48% in the prophylaxis vs control group (p = ns), due prevalently to intracerebral haemorrhage in both groups. Babies given surfactant tended to die later than controls. The Silverman score resulted significantly reduced in the first 24 hours in the babies given prophylaxis vs the controls (p < 0.05) and values of PaO2/FiO2 ratio were almost constantly higher in the babies that received surfactant compared to the control infants during the first three days of life, even if the differences were not significant.</p><p><strong>Conclusion: </strong>Our data confirm that prophylaxis of RDS with surfactant in the delivery-room is able to improve the clinical conditions of the babies, however without the complete support of neonatal intensive care it does not resolve the problem of survival and unfavourable outcome in the babies with the lowest gestational ages. This kind of approach might anyhow facilitate the transport of the baby from a peripheral delivery-room to few equipped neonatal intensive care units to be created.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"68 Suppl 1 ","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20895637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Video-assisted major pulmonary resections (lobectomies)].","authors":"L Spaggiari,&nbsp;P Solli,&nbsp;P Carbognani,&nbsp;M Rusca","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>New applications of the video-assisted technique for the management of intrathoracic diseases continue to be developed, including major lung resections for cancer. The differences in the techniques proposed from various centers reflect the fact that the procedure is not accurately standardized yet and that prospective randomized trials with long-term follow-up data are needed. The authors report the results of their preliminary experience with a mini-invasive modern approach for video-assisted anatomic lobectomy: an utility muscle-sparing minithoracotomy through the auscultatory triangle. Eight patients successfully undergone this surgical procedure (7 for non-small cell lung cancer in early stage, 1 for benign disease). No mortality, nor complications (including minor morbidity: i.e. rib fractures) were recorded. Medium hospital stay time was 9.25 days (range 7-16) and chest drainage time 6 days (range 4-11). This operation proved to be technically feasible, although an accurate selection of patients and an adequate training in thoracoscopic procedures are mandatory. According to the more recent literature no significant differences are noted in operation's time, postoperative pain, chest drainage time, hospital stay compared to the standard posterolateral thoracotomy incisions. Otherwise the approach described enables to perform a truly \"conservative\" operation in conformity with the philosophy of the minimal invasive surgery and the patient's comfort and functional recover 2-3 weeks after surgery seems to be improved.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"68 3-4","pages":"73-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20897516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of allergies of infants: breast-feeding and special formulas. Influence on the response to immunization.","authors":"G P Salvioli,&nbsp;G Faldella,&nbsp;R Alessandroni,&nbsp;E Marchiani,&nbsp;M E Grandolfo,&nbsp;F Novello","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Infant formulas containing partially hydrolyzed cow milk-proteins are used for the prevention of allergy when maternal milk is not available, and, in preterm infants, also for improving gastric emptying. The nutritional adequacy of such formulas has not yet been completely defined. As the type of feeding may influence the antibody response to immunization, the aim of the present study was to evaluate the antibody response to oral polio virus immunization in term infants and to acellular pertussis and hepatitis B immunization in preterm infants, exclusively fed a partially hydrolyzed cow-milk formula during the first 5 months of life, in comparison with exclusively breast-fed infants. Active immune response occurred in all the infants after the second dose of immunization and no significant difference in the antibody titres was found according to the type of milk. On the basis of these results, it seems that protein nutrition based exclusively on a partially hydrolyzed formula does not impair the response to immunization in both preterm and term infants.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"68 Suppl 1 ","pages":"21-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20895634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prosthetic hernia surgery. Our experience].","authors":"G Pugliano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>795 cases of inguinal and femoral hernia repair, utilizing polypropylene meshes, were performed during the period 1/1/91-31/3/97. The Trabucco repair was performed in 301 cases (37.8%), while the Lichtenstein technique in 494 (62.2%). In the last two years the Lichtenstein technique was preferred to homogenize the results. Local anesthesia was used in 89% and follow-up, in 69% cases, has ranged from two months to six years. The most important complications were 12 hematomas (1.6%) and 4 infections (0.5%). There were two recurrences (0.3%), due to a technical error.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"68 3-4","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20897513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The transmanubrial approach for tumors of the superior thoracic aperture].","authors":"L Spaggiari,&nbsp;P Solli,&nbsp;P Carbognani,&nbsp;L Cattelani,&nbsp;A Bobbio,&nbsp;M Rusca","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A considerable difficulty in surgical management of apical chest tumors is represented by the potential involvement of the thoracic outlet anatomic structures (i.e.: vertebral body, subclavian vessels, first rib). Among the various techniques proposed, the anterior trans-cervical approach popularized by Dartevelle significantly improved the radical treatment of these tumors. This approach offers a wide access to the thoracic outlet with satisfactory control of subclavian vessels, safe dissection of brachial plexus and upper part of the mediastinum, permitting a radical treatment. However, this approach is associated invariably with aesthetic deformity, severe impairment in shoulder mobility (due to medial half clavicle sacrifice) and respiratory failure in case of chest wall resection. The authors present their experience with an alternative approach, the trans-manubrial osteomuscular sparing approach to anteriorly situated apical chest tumors recently standardized by Grunenwald and Spaggiari. From June 1996 to June 1997 5 patients were operated on through this approach: 3 non-small-cell lung cancer, 1 pseudotumor, 1 desmoid tumor of the first rib. In 2 cases the resection was extended respectively to the vertebral body (D1-2-3 hemivertebrectomy) and to the subclavian vessels. This patient died on 10-postoperative day for massive pulmonary ernbolism, whereas no other complications were recorded. This technique compared to the approach popularized by Dartavelle presents the same oncological radicality, with a better surgical exposure and with the complete sparing of osteomuscular components that allow the maintainance of shoulder girdle movements associated excellent functional and cosmetic results.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"68 5-6","pages":"107-13"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20897801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The absorbing peripheral lymphatic apparatus and blood vessels of the vermiform appendix: the 3-dimensional and ultrastructural aspects].","authors":"G Azzali,&nbsp;M L Arcari,&nbsp;D Grandi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We studied the lymphatic angiotectonics of the vermiform appendix of the rabbit, using direct injection of Neoprene latex, electron microscopy and three-dimensional models. We observed that the vermiform appendix is made of absorbing lymphatic vessels distributed among the tubular glands of the tunica mucosa. Moreover, these absorbing lymphatic vessels continue through the straight vessels into a vast, basket-like lymphatic network, which envelopes the medium and basal portions of each single lymphoid follicle. In addition, the vessels of this network reach the submucosal network, whose vessels are peculiar in shape and size. The submucosal network, in turn, drains the lymph through the small caliber intramuscular vessels in the valved subserous precollector lymphatic vessels. We also highlighted the ultrastructural characteristics of the absorbing lymphatic vessels, which completely lack openings at the contacts between the adjacent endothelial cells, which were always joined by specialized junction complexes. Moreover, we reported the presence of intraendothelial channels which we affirm are dynamic morphologic entities, through which lymphocyte migration from the peri-interfollicular lymphoid tissue inside the absorbing lymphatic vessels takes place.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"68 5-6","pages":"119-28"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20897803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absence in human milk of bovine beta-lactoglobulin ingested by the mother. Unreliability of ELISA measurements.","authors":"E Bertino,&nbsp;A Coscia,&nbsp;S Costa,&nbsp;D Farinasso,&nbsp;G Prandi,&nbsp;C Fabris,&nbsp;M Cavaletto,&nbsp;M G Giuffrida,&nbsp;A Conti","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the presence of bovine beta-LG in breast milk.</p><p><strong>Methods: </strong>Human milk samples from 14 healthy non-atopic women on diets with different cow's milk contents were examined. The total concentration of beta-LG immuno-like proteins (beta-LGIP) was determined by enzyme linked immunosorbent assay (ELISA). Identification of antigens was done by N-terminal sequencing.</p><p><strong>Results: </strong>beta-LGIP reactivity of the milk from subjects on different diets was not significantly different. Human lactoferrin, beta-casein and alpha-lactalbumin, were identified as cross-reacting antigens.</p><p><strong>Conclusions: </strong>False-positive results in ELISA determinations of bovine beta-LG in human milk might be due to cross-reactions between polyclonal antibodies and different protein antigens.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"68 Suppl 1 ","pages":"15-9"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20895633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of the new milks for infants: fatty acids, nucleotides, selenium.","authors":"C Agostoni,&nbsp;M L Giannì,&nbsp;A Gamboni,&nbsp;M Giovannini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Several studies have focused on the composition of macro- and micro-nutrients of human milk in order to define a gold standard for the composition of infant formulas. Human milk contains animal-fats mainly characterized by the presence of long-chain polyunsaturated fatty acids (LCPUFA) of both the n-6 and n-3 series which have structural and functional roles, particularly in preterm infants. It is still discussed whether dietary LCPUFA may have positive effects on the neurodevelopmental steps of term infants too. Nucleotides are low-molecular weight compounds. They seem to enhance the intestinal growth and maturation as well as the immune function, and play a role in energy metabolism. Selenium is involved in protective reactions. Despite there is no scientific consensus to support the use of LCPUFA in term formulas, it is advisable to improve formulas just to approach more closely the composition of human milk. As long as nucleotides are concerned further studies must be carried out in order to define their efficacy and safety. The potential generation of hydroxy radicals from the new molecules added to formulas point out also the protective role of antioxidant molecules such as selenium in infant nutrition.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"68 Suppl 1 ","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20895635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Brainstem auditory evoked potentials in neonatology: the method and results in a group of normal newborns].","authors":"E Pasanisi,&nbsp;S Bacciu,&nbsp;G Fava,&nbsp;M Dallatomasina,&nbsp;A Bacciu,&nbsp;M Negri,&nbsp;F Piazza,&nbsp;S Montali","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Brainstem evoked responses audiometry was performed on 10 newborn infants. They ranged in postnatal age from 19 hours to 5 days and in estimated gestational age from 39 to 42 weeks. Clicks of 0.1 msec duration were presented at a rate of 11.4 per second. Measurements were made at 50, 80 and 100 dB. Wave V latencies were evaluated at 50, 80 and 100 dB HL in order to measure the auditory threshold. The latency of wave V is the datum of interest. Wave V responses were obtained bilaterally at 50 dB HL. Waves I and III latencies were measured at 100 dB HL.</p>","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"67 5-6","pages":"191-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20892774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continent perineal colostomy by electrostimulated graciloplasty in abdominoperineal resection. A preliminary report.","authors":"V Violi,&nbsp;L Roncoroni,&nbsp;A S Boselli,&nbsp;C De Cesare,&nbsp;M Livrini,&nbsp;A Peracchia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite the tendency toward sphincter-saving surgical procedures, a small proportion of rectal cancers must still be treated by abdominoperineal resection (APR). The physical, psychological and social consequences of a permanent abdominal stoma are a challenge to perform a continent perineal colostomy. Most of the attempts originate from experiences with gracilis muscle transposition in the treatment of fecal incontinence, in particular Pickrell's operation. Functional results are however conditioned by the fact that the transposed muscle takes up a different function and its natural evolution, if not adequately stimulated, consists of atrophy and fibrosis. The most important series of graciloplasty in APR is reported by Cavina and coworkers (75 cases from 1985 to 1993), who at first obtained good functional results by external electromyostimulation (EMS) and biofeedback, then registered a further improvement using internal, continuous low-frequency EMS by implantable pulse generators (IPG). The surgical technique involves, after APR: bilateral dissection of the gracilis up to the proximal neurovascular pedicle and detachment of the distal tendon; mobilization of the muscles, through the subcutaneous tissue, into the perineum, where the colonic stump is drawn out; positioning the right gracilis behind the colonic stump, as a puborectalis sling, and the left gracilis around it, in a sort of \"alpha\" configuration; suturing the colonic stump to the perineal skin; optionally, temporary diverting loop colostomy. The operation is completed by the insertion of two electrodes near the nerve, for external or internal EMS (in the last case: implantation of IPG). The external EMS may be carried out by current cardiac temporary electrodes, drawn up through the skin of the iliac area. It is aimed at preserving the trophism and the contractility of the muscle and enabling the patient to learn a new function of continence (actually, it is a \"pseudocontinence\"), thanks to a program of intermittent stimulation and biofeedback. Electrodes and other devices are not expensive. The internal EMS requires specific electrodes, connected to an IPG, implanted in a subcutaneous abdominal pocket. The continuous stimulation gives rise to a tonic activity of the gracilis, resulting in higher resting anal pressure and \"true\" continence. The IPG is programmed under telemetry control, step by step until the most suitable EMS parameters are reached. A magnet allows the patient to turn the IPG \"off\" of \"on\", according to the necessity to void the bowel. A complete set of 1 IPG and 2 electrodes costs about $10,000. Cavina reports good continence in 71% of the cases treated by external EMS and 100% of the patients with IPG. Our first graciloplasty in APR was performed in April 1994. Since then we have carried out 6 operations. Because of its high cost, we decided that, at least at a first phase, the IPG should be implanted, from the 7th month on, only in disease-free patients,","PeriodicalId":6943,"journal":{"name":"Acta bio-medica de L'Ateneo parmense : organo della Societa di medicina e scienze naturali di Parma","volume":"67 3-4","pages":"131-42"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20895942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}