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Search Results: 1 - 10 of 372 matches for " Gino Zadeii "
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A Rare Neurological Complication of Ranolazine
Jahan Porhomayon,Gino Zadeii,Alireza Yarahmadi
Case Reports in Neurological Medicine , 2013, DOI: 10.1155/2013/451206
Abstract: Myoclonus is not a known side effect of ranolazine. We report a case of myoclonus in a 72-year-old female who underwent cardiac catheterization for angina and was started on ranolazine after the procedure. Two days after ranolazine therapy on 1000?mg per day in divided doses, myoclonus developed, which severely impaired her normal activity. Her symptoms resolved 2 days after discontinuation of ranolazine. Ranolazine was resumed after discharge from hospital with recurrent myoclonus after two days of therapy. The causal relationship between ranolazine and myoclonus was suggested by cessation of myoclonus after ranolazine was discontinued. 1. Introduction Chronic angina is a debilitating condition affecting nearly 6 million Americans. Current standard therapy includes beta-blockers, calcium channel blockers, and long acting nitrates. Some patients may be intolerable to standard therapy due to their side effects [1]. Ranolazine is new agent introduced into clinical practice in 2006. It is an extended release antianginal drug and is intended to act without reducing heart rate or blood pressure. Ranolazine is specifically indicated for the treatment of chronic angina in patients that failed previous anti-ischemic therapy [2]. It is contraindicated in patients with QT prolongation [3]. It has a piperazine compound that belongs to a group known as partial fatty-acid oxidation inhibitors [4]. Initially, the main anti-anginal effects of ranolazine were thought to be related to the actions of ranolazine to shift adenosine triphosphate (ATP) production away from fatty-acid oxidation toward glycolysis [5, 6]. Recent evidence suggests that ranolazine is an inhibitor of the late sodium current which results in a reduction of the intracellular sodium and calcium overload in ischemic cardiac myocytes [7–9]. 2. Case Report This is a 72-year-old female who presented to the emergency department with history of chest pain and non-ST-segment elevation myocardial infarction (NSTEMI). Her past medical history was significant for intermittent chest pain. She underwent cardiac catheterization with placement of 2 drug eluding stents and was started on ranolazine for symptomatic relief of NSTEM with angina. Her medication list included atorvastatin 20?mg daily, clopidogrel 75?mg daily, aspirin 162?mg daily, diltiazam 60?mg four times a day, and ranolazine 500?mg twice daily. She presented 2 days after discharge with myoclonic jerks in her upper and lower extremities. She was readmitted in the hospital for evaluation of myoclonus. At the time of her hospitalization, ranolazine was
Applications of minimally invasive cardiac output monitors
Jahan Porhomayon, Gino Zadeii, Samuel Congello, Nader D Nader
International Journal of Emergency Medicine , 2012, DOI: 10.1186/1865-1380-5-18
Abstract: The ultimate goal of any hemodynamic monitoring system is to provide the clinicians with additional information on the underlying pathological condition and to guide fluid or vasopressor therapy. Cardiac output measurement and its response to therapeutic interventions are frequently used in critically ill patients. As the use of CO monitoring devices increases today, it is necessary to understand the application of such devices in different clinical settings. For many years pulmonary artery catheter (PAC) thermodilution cardiac output assessment was the monitor of choice for the management of critically ill patients. Thermodilution is a modification of the original indicator dilution techniques in which the injectate has a defined volume and temperature from which the thermodilution curve is generated [1]. As with the other indicator dilution techniques, CO is calculated from the area under the indicator thermodilution curve using the modified Stewart-Hamilton equation [2]. PAC was first used in dogs, and subsequently in humans 50 years later [2]. PAC provides valuable measurements, including right atrial pressure, right ventricular pressures, pulmonary artery pressures, pulmonary artery occlusive pressure, mixed venous saturation (SvO2), and CO. The derived hemodynamic variables are systemic and pulmonary vascular resistances. The major obstacle for the use of PAC has been the lack of demonstrating patient benefit and its level of invasiveness. Several prospective trials have demonstrated the lack of benefit from PACs. The PAC-man trial indicated that the routine placement of PACs had no effect on morbidity or mortality, and the ESCAPE trial found no difference in mortality or length of hospital stay when PAC parameters were compared with clinical assessment in the management of severe congestive heart failure patients [3-6]. Furthermore, for using PAC now, many physicians have lost the training, confidence, and familiarity with its use. PAC should probably be used
A Case of Prolonged Delayed Postdural Puncture Headache in a Patient with Multiple Sclerosis Exacerbated by Air Travel
Jahan Porhomayon,Gino Zadeii,Alireza Yarahamadi,Nader D. Nader
Case Reports in Anesthesiology , 2013, DOI: 10.1155/2013/253218
A Case of Prolonged Delayed Postdural Puncture Headache in a Patient with Multiple Sclerosis Exacerbated by Air Travel
Jahan Porhomayon,Gino Zadeii,Alireza Yarahamadi,Nader D. Nader
Case Reports in Anesthesiology , 2013, DOI: 10.1155/2013/253218
Abstract: The developments of new spinal needles and needle tip designs have reduced the incidence of postdural puncture headache (PDPH). Although it is clear that reducing the loss of CSF leak from dural puncture reduces the headache, there are areas regarding the pathogenesis, treatment, and prevention of PDPH that remain controversial. Air travel by itself may impose physiological alteration in central nervous system that may be detrimental to patients with PDPH. This case report highlights a case of a young female patient who suffered from a severe incapacitating PDPH headache during high-altitude flight with a commercial jet. 1. Introduction The first case report of postdural puncture headache (PDPH) was described in about 100 years ago by Bier and his assistant [1]. It was later postulated that PDPH is triggered by leakage of cerebrospinal fluid through the dural rent, but the cause of the pain is probably due to intracranial arterial and venous dilatation [2]. PDPH remains one of the major complications of spinal tap performed for diagnostic purposes. Other adverse events after lumbar puncture include dysesthesia, backache, nerve palsies, infectious processes, and bleeding disorders [3]. The patterns of development of PDPH depend on a number of procedure and nonprocedure-related risk factors. Knowledge of procedure-related factors supports interventions designed to reduce the incidence of PDPH. Despite the best preventive efforts, PDPH may still occur and be associated with significant morbidity [4, 5]. The potential risks for developing PDPH include female gender [6], young adults, repeated attempt with multiple dural punctures, and the size/type and orientation of the needle [7]. Gender is believed to be an independent risk factor for the development of PDPH as demonstrated by the recent meta-analysis by Wu et al. [6]. Clinical presentation of the PDPH or “spinal headache” is usually described as a severe, dull pain, usually frontal occipital, which is irritated in the upright position and decreased in the supine position. It may or may not be accompanied by nausea, vomiting, and visual/auditory disturbances. The onset of PDPH is between 2 to 72 hours, and latency period of up to 15 days has generally been described in the literature [8, 9]. 2. Case Report This is unique case of a young 23 years old middle Eastern female who developed an acute unilateral eye pain and generalized headache with visual disturbances associated with fatigue and weakness in lower extremities for two days. She presented to a local community hospital and was examined by a
Application of Dual Mask for Postoperative Respiratory Support in Obstructive Sleep Apnea Patient
Jahan Porhomayon,Gino Zadeii,Nader D. Nader,George R. Bancroft,Alireza Yarahamadi
Case Reports in Anesthesiology , 2013, DOI: 10.1155/2013/321054
Abstract: In some conditions continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP) therapy alone fails to provide satisfactory oxygenation. In these situations oxygen (O2) is often being added to CPAP/BIPAP mask or hose. Central sleep apnea and obstructive sleep apnea (OSA) are often present along with other chronic conditions, such as chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary fibrosis, neuromuscular disorders, chronic narcotic use, or central hypoventilation syndrome. Any of these conditions may lead to the need for supplemental O2 administration during the titration process. Maximization of comfort, by delivering O2 directly via a nasal cannula through the mask, will provide better oxygenation and ultimately treat the patient with lower CPAP/BIPAP pressure. 1. Introduction Obstructive sleep apnea (OSA) is a complex medical disorder, characterized by repetitive upper airway collapse during sleep. The disease affects individuals of all ages and predisposes to multiple comorbidities, including increased risk of cardiovascular disease [1]. Perioperative apneas appear to be multifactorial in nature. Sedatives and anesthetics have been shown to decrease pharyngeal muscle tone and therefore predispose to apnea [2]. Meanwhile, the patient’s normal arousal responses and reflexes are also compromised by anesthetics [3]. This predisposes to apneic episodes which can be more severe than those associated with natural sleep. While many patients present for surgery with undiagnosed OSA, it is currently recommended that patients who receive ambulatory CPAP preoperatively should continue to have CPAP administered in the perioperative period. Otherwise, the optimal management of OSA in the perioperative period has yet to be elucidated [4]. 2. Case Report A 51-year-old obese male, with a history of daytime fatigue, presented to the anesthesia holding area for urgent appendectomy. He had previously undergone a sleep study several months before with apnea/hypopnea index (AHI) of 35 and a maximum desaturation to the low 60’s. Patient vital signs included a blood pressure of 140/85?mm/Hg, heart rate of 95 beats per minute and respiratory rate of 16 per minute with a temperature of 38 centigrade. His pulse oximetry (SaO2) reading was 91% with 2 liters/minute of nasal oxygen flow. Chest radiography did not show any pathology. He was brought to operating room, and anesthesia was induced with propofol and succinylcholine in a rapid sequence technique. The trachea was intubated with the aid of a GlideScope.
Tietze’s Syndrome in the emergency department: A rare etiology of atraumatic chest pain  [PDF]
Lee Grodin, Gino Farina
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.23056

Tietze’s Syndrome is an uncommon disorder that presents with painful, tender, non-suppurative swelling of the anterior chest wall. We report a case of a female patient who presented to the emergency department with a chief complaint of atraumatic chest pain and swelling of the anterior chest wall. After a thorough history and physical examination, as well as basic laboratory tests and chest radiography, she was diagnosed with Tietze’s Syndrome. The expedient accurate diagnosis of Tietze’s Syndrome is important for the physical and emotional well-being of a patient, and avoids overlooking more dangerous pathologies. Tietze’s Syndrome needs to be considered in the differential diagnosis of a patient presenting with spontaneous swelling of the anterior chest.

Agronomía Tropical , 2003,
Abstract: results of observations and tests performed in venezuela during previous years, in relation to pathogenicity of three cereal srnut fungi are given; a) com smut fungus, ustilago maydis, is acrial and localizad and infects young and developing tissues in any above ground part of the plant, b) sorghurn smut fungus, sphacelotheca sorghi, is stationary and penetrates only thru the embryo during germination, staying inside the plant and revealing itself in the entire panicle after flowering and c) rice grain smut fungus, tilletia (=neuvossia) barelayana, sometimes only partially infeets some rice grain through the flowers. emst's opinions on maize smut pathogenicity process are discussed by the author.
Derechos Humanos: Filosofía, Declaraciones, Jurisdicción
Utopìa y Praxis Latinoamericana , 2005,
Abstract: the author gino capozzi, founder of the institutionalist napolitan phenome- nological school, includes an original and promising exposition based on the contributions of praxeology and praxeologism, in relation to being and what should be the reality of human rights, their genesis, the development of great historic and material systems, of the new families of rights, and their historical and institutional profile. his philosophy is an invitation to widen the hermaneutic horizon of rights as day to day institutions, and of politics as a day to day human life experience.
Large tan(beta) effects in flavour physics
Isidori, Gino
High Energy Physics - Phenomenology , 2007, DOI: 10.1016/j.nuclphysbps.2006.09.115
Abstract: After a short introduction to the SUSY flavour problem, we focus the attention on the MSSM with MFV and large $\tan\beta$. The theoretical motivations and the general features of this scenario are briefly reviewed. The possible signatures in low-energy flavour-violating observables are discussed, with particular attention to the role played by $\BR(P\to\ell\nu)$, $\BR(B_{s,d}\to \ell^+\ell^-)$ and $\BR(\mu\to e \gamma)$
Shedding light on flavour symmetries with rare decays of quarks and leptons
Isidori, Gino
High Energy Physics - Phenomenology , 2007,
Abstract: The impact of rare lepton decays ($\mu \to e \gamma$, $\tau \to \mu \gamma$, >...) and rare $B$ and $K$ decays ($B\to \ell^+\ell^-$, $B\to \ell\nu$, $K\to \pi \nu\nu$, $K\to\ell\nu$, ...) in probing the existence of an underlying flavour symmetry is reviewd. Particualar emphasis is deveoted to the connections between quark and lepton flavour strucutres, in the context of generic effective field theory approach to physics beyond the SM.
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