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Frattini F, Pino A, Matarese A, Carrano FM, Gambetti A, Boni L, Ierardi AM, Carrafiello G, Rausei S, Bertoli S, Dionigi G. Portomesenteric vein thrombosis following sleeve gastrectomy: Case report focusing on the role of pathogenetic factors. Obes Res Clin Pract 2022; 16:170-173. [PMID: 35396195 DOI: 10.1016/j.orcp.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Sleeve gastrectomy has currently become the most commonly performed bariatric. procedure worldwide according to the last IFSO survey, overtaking gastric bypass with. a share of more than 50% of all primary bariatric-metabolic surgery. Gastric leak, intraluminal bleeding, bleeding from the staple-line and strictures are the most common complications. Portomesenteric vein thrombosis (PMVT)after sleeve gastrectomy is. another complication that has been increasingly reported in case-series in recent.years, although it remains uncommon. In this case report is described an extended portomesenteric vein thrombosis after. sleeve gastrectomy interesting splenic vein too with a favorable course and an. uneventful follow-up. We try to search in this case for pathogenetic factors involved in. this complication. CASE REPORT A 42-year old man, with a body mass index (BMI) of 45 kg/m2, with a medical history of Obstructive Sleep Apnea Sindrome (OSAS) underwent laparoscopic sleeve gastrectomy. Early postoperative course was uneventful. Six days after discharge he complained abdominal pain and was admitted at the Emergency Department. A CT scan with intravenous contrast showed an occlusion of the portal vein, of the intrahepatic major branches and an extension to the superior mesenteric vein and the splenic vein. The patient received heparin and oral anticoagulation together with intravenous hydration and proton pump inhibitors. Considering the favourable course the patient was discharged after six days with long-term oral anticoagulation therapy. Anticoagulation with acenocumarol was continued for six months after a CT scan showed resolution of the PMVT without cavernoma. He had no recurrence of symptoms. DISCUSSION Porto-mesenteric thrombosis after sleeve gastrectomy is a rare complication but it has been increasingly reported over the last 10 years along with the extensive use of sleeve gastrectomy. Because PMVT is closely associated with sleeve gastrectomy in comparison with other bariatric procedures, we need to investigate what pathogenetic factors are involved in sleeve gastrectomy. Thrombophylic state, prolonged duration of surgery, high levels of pneumoperitoneum, thermal injury of the gastroepiploic vessels during greater curvature dissection, high intragastric pressure, inadequate antithrombotic prophylaxis and delayed mobilization of the patient after surgery have been reported as pathogenetic factors of portmesenteric vein thrombosis. Most of the cases presented in the literature such as our clinical case resolve with medical therapy, although portal vein thrombus extends into the superior mesenteric vein and the splenic vein. CONCLUSION Portomesenteric venous thrombosis is a rare but serious complication of bariatric surgery, especially associated with sleeve gastrectomy. Diagnosis is based on CT examination with intravenous contrast, and initial therapy is anticoagulation. Etiologic factors reported in the literature include a long duration of surgery, a high degree of pneumoperitoneum, high intragastric pressure after sleeve gastrectomy and thermal injury to the short gastric vessels and gastroepiploic arcade. Limited operative time, controlled values of pneumoperitoneum, careful dissection with energy device of gastric greater curvature, appropriate prophylaxis with low molecular weight heparin may be useful tools to prevent and limit this complication. Nonetheless we have to search which factors may condition the evolution of an extended PMVT as that described in this case towards resolution or to a further worsening clinical state. Early diagnosis? Correct treatment? Undiscovered patientrelated factors?
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Affiliation(s)
- F Frattini
- Department of Surgery, ASST Settelaghi, Varese, Italy.
| | - A Pino
- Division of Surgery, IRCCS Istituto Auxologico Italiano Milan, Università di Messina, Italy.
| | - A Matarese
- Division of Surgery, IRCCS Istituto Auxologico Italiano Milan, Università di Milano, Italy.
| | - F M Carrano
- Department of Surgical Sciences, University of Rome "Tor Vergata", Rome, Italy.
| | - A Gambetti
- Division of Surgery, IRCCS Istituto Auxologico Italiano Milan, Italy.
| | - L Boni
- Department of Surgery, IRCCS Fondazione Cà granda, Policlinico Hospital of Milan, University of Milan, Italy.
| | - A M Ierardi
- Operative Unit of Radiology, IRCCS Fondazione Cà Granda, Policlinico Hospital of Milan, University of Milan, Italy.
| | - G Carrafiello
- Operative Unit of Radiology, IRCCS Fondazione Cà Granda, Policlinico Hospital of Milan, University of Milan, Italy.
| | - S Rausei
- Department of Surgery, ASST Valleolona, Gallarate, Italy.
| | - S Bertoli
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Obesity Unit and Laboratory of Nutrition and Obesity Research, University of Milan, Milan, Italy.
| | - G Dionigi
- Division of Surgery, Endocrine Surgery Unit, IRCCS, Istituto Auxologico Milan, University of Milan, Italy.
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Piantanida E, Gallo D, Dozio E, Trotti E, Piantanida E, Frattini F, Franzi F, Sessa F, Dionigi GL, Sabatino J, Bartalena L, Tanda ML, Ippolito S. Gastric Xanthomatous Hyperplastic Polyps – Just an Incidental Endoscopic Finding? Surg Case Rep 2020. [DOI: 10.31487/j.scr.2020.05.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Laparoscopic sleeve gastrectomy (LSG) progressively became the preferred procedure
worldwide for the treatment of morbid obesity. Occasionally, unknown gastrointestinal diseases may be
incidentally discovered during the procedure or on the histologic gastric specimen. Gastric xanthomas are
uncommon lesions of the lamina propria, composed by foamy macrophages and mixed inflammatory
infiltrate. Rarely, xanthoma cells develop within a gastric hyperplastic polyp. Although usually benign, they
may be associated with pre-malignant conditions or even gastric cancer, making advisable an appropriate
workup.
Case Presentation: A hyperplastic polyp with xanthomatous proliferation was discovered in the gastric
specimen of a young man, suffering from severe obesity and metabolic syndrome. The patient had been
treated with proton pump inhibitors for gastric discomfort for years. After the surgical procedure, the gastric
discomfort rapidly disappeared.
Conclusion: Obesity is often complicated by gastrointestinal abnormalities discovered during ultrasound
or endoscopic procedures. Incidental findings of unknown gastric lesions are common occurrences during
sleeve gastrectomy. Although xanthelasmas per se are harmless, they might coexist with pre-malignant/
malignant lesions, especially when associated with gastric polyps. Thus, prompt intra-operative recognition
and adequate work-up are mandatory. Although cases of gastric polyps or xanthomas are not a novelty, to
our knowledge, this is the first case reporting about the discovery of a gastric hyperplastic polyp with
xanthomatous proliferation on gastric histological piece. From the discussion of this case and of similar
reports in the literature, we advocated for the importance of endoscopic screening in obese patients admitted
for bariatric surgery to address the proper surgical approach and follow-up.
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Galli F, Ruspi L, Frattini F, Di Rocco G, Martignoni F, Dionigi G, Rausei S. Second level lymphadenectomy (D2) in gastric cancer: Is the number of removed nodes really determinant? Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Frattini F, Bonfanti C, Piccoli P, Camurri N, Mantovani P, Terenziani I, Caramaschi G, Rambaldini M, Manzato F, Franchini M. Triple coronary artery bypass graft surgery in a patient with factor VII deficiency: a case report. Haemophilia 2013; 19:e268-9. [DOI: 10.1111/hae.12164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2013] [Indexed: 11/28/2022]
Affiliation(s)
- F. Frattini
- UO Immunoematologia e Medicina Trasfusionale; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - C. Bonfanti
- UO Immunoematologia e Medicina Trasfusionale; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - P. Piccoli
- UO Cardiochirurgia; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - N. Camurri
- UO Cardiochirurgia; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - P. Mantovani
- UO Cardiologia; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - I. Terenziani
- UO Laboratorio Analisi Chimico-Cliniche; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - G. Caramaschi
- UO Laboratorio Analisi Chimico-Cliniche; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - M. Rambaldini
- UO Cardiochirurgia; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - F. Manzato
- UO Laboratorio Analisi Chimico-Cliniche; Azienda Ospedaliera Carlo Poma; Mantova; Italy
| | - M. Franchini
- UO Immunoematologia e Medicina Trasfusionale; Azienda Ospedaliera Carlo Poma; Mantova; Italy
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Franchini M, Urbani S, Amadei B, Rivolta GF, Di Perna C, Riccardi F, Frattini F, Crestani S, Bonfanti C, Formentini A, Quintavalla R, Tagliaferri A. LRP1/CD91 is up-regulated in monocytes from patients with haemophilia A: a single-centre analysis. Haemophilia 2013; 19:e126-32. [PMID: 23387825 DOI: 10.1111/hae.12098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2012] [Indexed: 12/21/2022]
Abstract
The low-density lipoprotein receptor-related protein 1 (LRP1) is an ubiquitously expressed endocytic receptor that, among its several functions, is involved in the catabolism of coagulation factor VIII (FVIII) and in the regulation of its plasma concentrations. Although LRP1/CD91 polymorphisms have been associated with increased FVIII levels and a consequent thrombotic risk, no data are available on LRP1/CD91 expression in patients with inherited FVIII deficiency. With the aim of elucidating this issue, 45 consecutive patients with haemophilia A (HA) (18 severe, 5 moderate and 22 mild HA) were enrolled in this cross-sectional, single-centre survey. The LRP1/CD91 mean fluorescence intensity (MFI) in monocytes from HA patients was significantly higher than that detected in 90 healthy blood donors (105 vs. 67, P < 0.001). This over-expression was independent of hepatitis C virus infection status and varied according to the severity of the haemophilia, being higher in patients with more severe FVIII deficiency. In conclusion, our study documents for the first time that LRP1/CD91 is over-expressed on monocytes from HA patients, with the intensity of expression varying according to the severity of the FVIII deficiency. Further studies are needed to assess the clinical implications of these findings.
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Affiliation(s)
- M Franchini
- Immunohematology and Transfusion Center, Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy.
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Pereira Lopes FR, Martin PKM, Frattini F, Biancalana A, Almeida FM, Tomaz MA, Melo PA, Borojevic R, Han SW, Martinez AMB. Double gene therapy with granulocyte colony-stimulating factor and vascular endothelial growth factor acts synergistically to improve nerve regeneration and functional outcome after sciatic nerve injury in mice. Neuroscience 2012; 230:184-97. [PMID: 23103791 DOI: 10.1016/j.neuroscience.2012.10.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 10/09/2012] [Accepted: 10/10/2012] [Indexed: 12/17/2022]
Abstract
Peripheral-nerve injuries are a common clinical problem and often result in long-term functional deficits. Reconstruction of peripheral-nerve defects is currently undertaken with nerve autografts. However, there is a limited availability of nerves that can be sacrificed and the functional recovery is never 100% satisfactory. We have previously shown that gene therapy with vascular endothelial growth factor (VEGF) significantly improved nerve regeneration, neuronal survival, and muscle activity. Our hypothesis is that granulocyte colony-stimulating factor (G-CSF) synergizes with VEGF to improve the functional outcome after sciatic nerve transection. The left sciatic nerves and the adjacent muscle groups of adult mice were exposed, and 50 or 100 μg (in 50 μl PBS) of VEGF and/or G-CSF genes was injected locally, just below the sciatic nerve, and transferred by electroporation. The sciatic nerves were transected and placed in an empty polycaprolactone (PCL) nerve guide, leaving a 3-mm gap to challenge nerve regeneration. After 6 weeks, the mice were perfused and the sciatic nerve, the dorsal root ganglion (DRG), the spinal cord and the gastrocnemius muscle were processed for light and transmission electron microscopy. Treated animals showed significant improvement in functional and histological analyses compared with the control group. However, the best results were obtained with the G-CSF+VEGF-treated animals: quantitative analysis of regenerated nerves showed a significant increase in the number of myelinated fibers and blood vessels, and the number of neurons in the DRG and motoneurons in the spinal cord was significantly higher. Motor function also showed that functional recovery occurred earlier in animals receiving G-CSF+VEGF-treatment. The gastrocnemius muscle showed an increase in weight and in the levels of creatine phosphokinase, suggesting an improvement of reinnervation and muscle activity. These results suggest that these two factors acted synergistically and optimized the nerve repair potential, improving regeneration after a transection lesion.
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Affiliation(s)
- F R Pereira Lopes
- Programa de Neurociência Básica e Clínica, Instituto de Ciências Biomédicas, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, RJ, Brazil
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Franchini M, Crestani S, Frattini F, Mengoli C, Bonfanti C. Relationship between ABO blood group and bleeding complications in orally anticoagulated patients. J Thromb Haemost 2012; 10:1688-91. [PMID: 22606934 DOI: 10.1111/j.1538-7836.2012.04785.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pereira Lopes FR, Lisboa BCG, Frattini F, Almeida FM, Tomaz MA, Matsumoto PK, Langone F, Lora S, Melo PA, Borojevic R, Han SW, Martinez AMB. Enhancement of sciatic nerve regeneration after vascular endothelial growth factor (VEGF) gene therapy. Neuropathol Appl Neurobiol 2011; 37:600-12. [DOI: 10.1111/j.1365-2990.2011.01159.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Bonadonna P, Perbellini O, Passalacqua G, Caruso B, Colarossi S, Dal Fior D, Castellani L, Bonetto C, Frattini F, Dama A. Systemic Reactions After Hymenoptera Sting And Raised Serum Tryptase Strongly Suggest Clonal Mast Cells Disorders. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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10
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De Ferrari GM, Rordorf R, Frattini F, Petracci B, De Filippo P, Landolina M. Predictive value of programmed ventricular stimulation in patients with ischaemic cardiomyopathy: implications for the selection of candidates for an implantable defibrillator. Europace 2007; 9:1151-7. [DOI: 10.1093/europace/eum230] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Maurizio L, Page E, Galley D, Ritter P, Serio A, Frattini F, Casset C, Cazeau S, Tavazzi L. P4-95. Heart Rhythm 2006. [DOI: 10.1016/j.hrthm.2006.02.750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rordorf R, Scuteri L, Marsan NA, Frattini F, Klersy C, Magrini G, Ghio S, Landolina M, Tavazzi L. AB33-3. Heart Rhythm 2006. [DOI: 10.1016/j.hrthm.2006.02.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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De Ferrari GM, Petracci B, Frattini F, Rordorf R, Cantù F, Campana C, Agnesina L, Landolina M. Long term effects of an aggressive rhythm control strategy in patients with permanent atrial fibrillation and advanced heart failure. Heart Rhythm 2005. [DOI: 10.1016/j.hrthm.2005.02.362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cantù F, De Filippo P, Rordorf R, De Ferrari GM, Frattini F, Petracci B, Russo G, Cerrone M, Landolina M. Fast-slow and slow-slow form of atrioventricular nodal reentrant tachycardia sustained by the same reentrant circuit: a case report. Ital Heart J 2005; 6:80-4. [PMID: 15773279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
It has been suggested that a reentrant circuit confined to the posterior extensions of the atrioventricular node underlies both fast-slow and slow-slow types of atrioventricular nodal reentrant tachycardia (AVNRT). According to this hypothesis the fast-slow reentrant circuit would be formed by two slow pathways, located in the rightward and leftward posterior extension of the atrioventricular node. Thus, the fast pathway would act as a bystander with respect to the reentrant circuit. We describe the case of a 40-year-old woman with several episodes of palpitations unresponsive to antiarrhythmic drugs. The ECG during symptoms showed a narrow QRS tachycardia with a long ventriculo-atrial interval and a negative P wave in the inferior leads. Electrophysiological study showed the inducibility of a slow-slow AVNRT which rapidly shifted to a fast-slow AVNRT without any change in the duration of the tachycardia cycle. Our observation is in agreement with the hypothesis that the fast-slow reentrant circuit consists of two slow pathways with the fast pathway acting as a bystander.
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Affiliation(s)
- Francesco Cantù
- Department of Cardiology, IRCCS Policlinico San Matteo, Pavia, Italy.
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Landolina M, Petracci B, De Ferrari GM, Frattini F, Cantù F, Rordorf R, De Filippo P. Periodic conduction and 2:1 block from the left atrium to the pulmonary vein during radiofrequency ablation. Ital Heart J 2004; 5:872-5. [PMID: 15633445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Paroxysmal atrial fibrillation is often initiated by foci in the pulmonary veins (PVs); the junction between the PVs and the left atrium (LA) has become the target of radiofrequency (RF) ablation performed to isolate the PVs. Ectopic atrial beats originating from the PVs propagate to the LA with a characteristically long conduction time, often with a conduction delay or block within the PV or at the PV-LA junction. However, details about the conduction properties within the PVs and across the PV-LA junction are still scanty. We report a unique case of LA-PV decremental conduction caused by RF applications. New insights into the electroanatomical characteristics of the PV-LA junction are provided. The present report demonstrates, for the first time in humans, that decremental conduction may be related to the progressive damage of the conducting myocardial bundle due to RF energy applications.
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Affiliation(s)
- Maurizio Landolina
- Electrophysiology and Arrhythmia Unit, Department of Cardiology, IRCCS Policlinico San Matteo, Pavia, Italy.
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Paglione M, Grassi M, Marinoni G, Pistorio A, Frattini F, Marinoni A. [Development of a physical performance scale for patients with implanted pacemakers]. Epidemiol Prev 2001; 25:13-20. [PMID: 11296528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The development and the validation of the Pavia Physical Performance Scale (PPPS) is here presented. PPPS is a new instrument evaluating the physical performance of pacemaker implanted patients. Data comes from a cross-over clinical trial on the efficacy of two functions of the pacemaker device. Primary end-point is the improvement of the physical performance together with the quality of life. We used data of 168 patients actually enrolled and interviewed with the Pavia Physical Performance Scale. We first selected 30 Likert-type items; then we applied a statistical methodology of Homogeneity Analysis (HOMALS). We verified the homogeneity of the scale and the internal consistency (Cronbach's alpha = 0.92). With the same methodology, we developed the final version of PPPS. The final version lists 20 items; based on the results of the psychometric analysis, we turned the Likert-type scoring into a binary scoring (1 = no limitation of physical activity, 0 = limitation or never tried). The external validity, trough an Analysis of Variance of PPPS mean scores within New York Heart Association classes (NYHA), has been performed. We found a negative linear trend of PPPS scores and NYHA classes. That means an association between high PPPS scores (good physical performance) and low NYHA classes (also good physical capacity). The Pavia Physical Performance Scale (PPPS) could be proposed as a valid and consistent scale aimed to evaluate physical performance in pacemaker implanted patients. We suggest to use it in the clinical practice in addition to more traditional techniques.
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Affiliation(s)
- M Paglione
- Dipartimento di scienze sanitarie applicate, Università di Pavia.
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Barazzoni G, Anguissola R, Caprotti A, Rodino C, Marinoni G, Arcidiacono S, Frattini F, Solcia M. [Vein patency in patients with pacemaker implanted via subclavian vein: digital phlebography assessment]. Radiol Med 1997; 93:552-5. [PMID: 9280937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Venous thrombosis is a well-known complication of permanent cardiac pacemaker implantation, particularly, chronic occlusion of the subclavian vein is reported to occur in 20-33% of the cases where the percutaneous approach is performed. We examined 135 asymptomatic patients with digital venography to asses the frequency of venous thromboses causing stenosis and occlusion of the subclavian or anonymous arteries in pacemaker carriers. We considered both one- (44) and two-chamber (91) pacemakers and investigated a possible statistically significant difference between them: we found 21 venous thromboses (15%), seven of them in one-chamber pacemakers (15.9%) and 14 two-chambers pacemakers (15.3%). None of our 94 male and 41 female patients was on anticoagulants or had any evidence of coagulation disorders. Venography was performed 39.3 months (mean) after pacemaker implantation (range: 3-120 months). We conclude that digital venography is a simple and relatively noninvasive method permitting better depiction of subclavian, anonymous and caval veins than Doppler US and also showing some vascular abnormalities which may complicate pacemaker implantation.
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Affiliation(s)
- G Barazzoni
- Istituto di Radiologia dell'Università, IRCCS Policlinico S. Matteo, Pavia
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Greco P, Chiarello M, Chiarello E, Frattini F, Servadio G. [Rhabdomyolysis in meningoencephalitis caused by echovirus]. Minerva Anestesiol 1992; 58:477-9. [PMID: 1508364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report one case of atraumatic rhabdomyolysis associated with Echo group viral encephalitis, not complicated by acute renal failure. Clinical and bio-humoral outlines are described, characterized by favourable evolution despite high muscular enzymatic peaks. We emphasize that the positive course is probably due to the early institution of prophylactic measures, and that, anyway, the subject still remains exposed to major rhabdomyolysis risk in the presence of stress factors, including general anesthesia.
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Affiliation(s)
- P Greco
- Servizio di Anestesia e Rianimazione, Ospedale di Circolo, Busto Arsizio, Varese
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Bardellini S, Frattini F, Chiarello E, Mantovani R, Greco P, Bobbio Pallavicini F. [Proposal for a protocol of investigation on sleep disorders in patients in resuscitation. Score evaluation in relation to the severity of the case and the degree of sedation of the patient]. Minerva Anestesiol 1991; 57:901-2. [PMID: 1961544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- S Bardellini
- U.O. Anestesia e Rianimazione, Osp. di Busto Arsizio, Pavia
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Castelli R, Centemeri D, Frattini F, Greco P. [Fatal shock in a case of Lyell's syndrome]. Minerva Anestesiol 1986; 52:345-50. [PMID: 3561820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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