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P. Feltracco E. Serra M. Milevoj C. Carollo S. Barbieri A. Vitale E. Gringeri U. Cillo O. Milanesi C. Ori 《Transplantation proceedings》2013
Advances in surgical techniques and follow-up of patients with complex congenital heart disease who were corrected in childhood increasingly survive to adolescence or adulthood. Increasingly anesthesiologists encounter these cases for major noncardiac surgery, including orthotopic liver transplantation (OLT) wherein there is an augmented risk of significant perioperative hemodynamic instability. We performed a successful OLT in a 12-year-old boy with end-stage cryptogenetic liver fibrosis and hepatopulmonary syndrome who was born with a double outflow right ventricle, pulmonary atresia, and pulmonary artery hypoplasia corrected at the age of 1 month. By the time he was considered for OLT his altered pulmonary valve apparatus resulted in severe pulmonary regurgitation, dilated right atrium and ventricle, and elevated right heart pressures. After a temporarily successful angioplasty he was at first placed on the waiting list, then removed, and finally relisted following implantation of a prosthetic pulmonary valve that resulted in significant reduction of right heart pressures. 相似文献
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Rune Haaverstad Nicola Vitale R. Ian Williams Alan G. Fraser 《Scandinavian cardiovascular journal : SCJ》2013,47(2):95-99
Objective : Epicardial ultrasound scanning was applied during coronary surgery to assess coronary artery stenoses and quality of distal graft anastomoses, with special emphasis to the left anterior descending artery (LAD). Design : Twenty-three patients with coronary artery disease (M:F 19:4, mean age 65.0 - 9.5 years) had coronary artery bypass grafting (CABG) on cardiopulmonary bypass. Intraoperative scanning of coronary artery stenoses and graft anastomoses was performed with a new 10 MHz linear array Vingmed transducer connected to a GE Vingmed System FiVe echocardiography unit. Coronary stenoses detected by ultrasound were compared with preoperative angiograms. Intraoperatively, coronary graft flow was assessed with a Medi-Stim transit-time flowmeter. Results : Twenty LADs were investigated. In 17 LADs (85%) stenoses were clearly identified. In three LADs (15%) stenoses were not identified because LADs were deeply intramyocardial or the stenosis was very proximal. There was a significant correlation between LAD stenoses detected by ultrasound and angiogram ( R = 0.7; p < 0.01). Mean number of grafts was 3.8 - 0.9. Of 26 LAD anastomoses assessed, good images were obtained in 22 cases (84.4%); the mean LAD diameter measured 1 cm below the anastomosis was 1.6 - 0.2 mm. In two LADs images were rated fair and in two LADs images were poor because of intramyocardial LAD. No technical error of the anastomoses was detected. All grafts had good flows as ascertained by flow measurements. Conclusion : Epicardial ultrasound scanning with the new 10 MHz transducer allowed satisfactory imaging of coronary stenoses and graft anastomoses. Factors limiting the quality of imaging are proximal lesions, intramyocardial vessel, vessel tortuosity, and extensive calcifications. Epicardial ultrasound scanning with updated technology should become a further advancement to graft assessment during off-pump coronary surgery. 相似文献
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Salvatore Giovanni Vitale Ilaria Marilli Melissa Lodato Alessandro Tropea Antonio Cianci 《Updates in surgery》2013,65(4):265-270
It has already been proven that ovarian cancer is the sixth most common cancer among women, and it is considered the leading cause of death by gynecologic cancer in developed countries. This article is a literature review based on the use of cytoreductive surgery matched with adjuvant chemotherapy in advanced-stage ovarian cancer. According to the statistics, the difficulty of obtaining an early diagnosis results in a delay in the disease treatment and as a consequence, in many cases, ovarian cancer is still diagnosed in the advanced stage of the disease. Primary surgery is performed, in addition to diagnosis and staging, to achieve optimal cytoreduction. The purpose of this article is to review the different surgical approaches in the management of epithelial ovarian cancer, specifically the high-stage disease, with a special concentration on the most recent therapeutic additions to our current knowledge, such as hyperthermic intraperitoneal chemotherapy and new therapeutic drugs. Surgical treatment still plays a pivotal role in the management of advanced-stage ovarian cancer. Complete cytoreduction continues to be, when feasible, the objective to be attempted in the surgical treatment of advanced ovarian cancer. Obviously, the success of the operation depends on numerous factors, including patient selection, the locations of tumors, and surgeon expertise. To offer patients the best possible outcome with the least accompanying morbidity, strong consideration should be given to the referral of such patients to expert care centers for primary surgery, because it may be the best means currently available for improving overall survival. 相似文献
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Danilo Manari Massimo Manara Andrea Zurini Giovanni Tortorella Mauro Vaccarezza Nicolò Prandelli Davide Ancelotti Marco Vitale Prisco Mirandola Daniela Galli 《Sport Sciences for Health》2016,12(2):221-226
Purpose
Maximal oxygen consumption (VO2max) and oxygen consumption at anaerobic threshold (VO2AT) are commonly measured parameters to test elite soccer players; however, studies relating metabolic parameters of professional soccer players with performance and best fitting to the field role are scarce. Our aim was to study the relations of VO2max and VO2AT with the field role of elite soccer players to generate a robust dataset with a solid statistical analysis.Method
Over a 12-year period we performed 953 field evaluation tests of VO2 max and VO2AT on 450 elite soccer players of 13 professional teams by incremental, continuous and exhausting test modified from Conconi’s test. Statistical analysis was performed by one-way ANOVA followed—when appropriate—by Tukey post hoc test. Effect size was evaluated by the Cohen D test and η partial squared test. Statistical significance was set for p < 0.05.Results
VO2max mean values increased at the beginning of season by 1.073 ± 0.06 respect to pre-season then decreased again up to pre-season levels and remained stable, while VO2AT did not change during time. VO2max differences were also related to players’ field role. VO2max mean value for Goalkeeper was 50.85 ± 4.2, for central Defender was 57.58 ± 4.3, for Winger-sides back was 60.53 ± 5.02, for Midfielder was 59.53 ± 5.08, for Forward was 56.52 ± 4.14. On the contrary, as expected, VO2AT percentage variations among the roles were not significant.Conclusions
VO2max is the choice parameter to consider for the metabolic compliance of athletes to the field role requirements, consequently influencing training programs, recovery and injury prevention strategies.70.
Giuseppe Rengo Gennaro Pagano Dino Franco Vitale Roberto Formisano Klara Komici Laura Petraglia Valentina Parisi Grazia Daniela Femminella Claudio de Lucia Stefania Paolillo Alessandro Cannavo Emilio Attena Teresa Pellegrino Santo Dellegrottaglie Alessia Memmi Bruno Trimarco Alberto Cuocolo Pasquale Perrone Filardi Dario Leosco Nicola Ferrara 《European journal of nuclear medicine and molecular imaging》2016,43(13):2392-2400