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Biomedical subjects

A Farré

Publications and source records attributed to A Farré.

27 records · Page 2Linked to original sources
PubMed1995

Amylase, lipase, pancreatic isoamylase, and phospholipase A in diagnosis of acute pancreatitis.

To determine the utility of serum amylase (AMY), lipase (Lp), pancreatic isoamylase (isoA), phospholipase A (PLA), and urine AMY in the diagnosis of acute pancreatitis, samples of serum and urine were obtained on admission and every day thereafter for 5 days from 384 patients with acute abdominal pain. Diagnostic accuracy, determined as the area under the receiver operating characteristic curve, was > 0.975 for serum AMY, Lp, isoA, and urine AMY. For each of these enzymes, a threshold value (twice to sixfold the upper limit of the reference values) offering diagnostic efficiency > 95% could be determined. In contrast, accuracy and efficiency of serum PLA were low. The profiles of these enzymes in acute pancreatitis decreased in a parallel fashion over 5 days except for PLA. We conclude that diagnostic utilities are similar for serum AMY, Lp, isoA, and urine AMY for acute pancreatitis, provided that an appropriate threshold is established.

Acute Disease↗
PubMed1994

[Laparoscopic hysterectomy. Results in 80 cases].

Our experience is based on laparoscopic hysterectomies performs from August 1992 to May 1994. The purpose of the initial surgical objective is described, as well as different variations of the technique. The procedure was systematized, the operating time was diminished to a considerable extent, thus avoiding intra-operatory complications. Pre-operatory diagnosis and histopathological findings were enumerated. Intra-operatory and post-operatory complications were evaluated. With an increasing development of the technique, a shorter operating time was made possible. The length of hospital stay and its quality were unrelated to the operation time. A quick recovery was reached as regards complete activity of the patients. Laparoscopic hysterectomy performed by an endoscopic-gynecologist surgeon represents an alternative and a new way of thinking.

Adult↗
PubMed1992

Splenic hematoma in acute pancreatitis. Role of coagulation disorders.

Splenic hematomas are infrequent complications of acute pancreatitis. In some cases, local factors that may play a role in the pathogenesis of the hematoma (thrombosis of the splenic artery or veins, intrasplenic pseudocysts, perisplenic adhesions, enzymatic digestion) are found. In the absence of local factors, the etiology of splenic hemorrhage remains unknown. We report two cases of splenic hematoma occurring during an acute necro-hemorrhagic pancreatitis associated with renal failure that required renal replacement therapy (hemodialysis and continuous arteriovenous hemodialysis). In both cases, more than half of splenic parenchyma was affected by multiple infarctions. No local factors responsible for the splenic abnormalities were detected in either case. Thrombosis of the splenic arterial microcirculation and a coagulation disorder consistent with disseminated intravascular coagulation was detected in one patient. In the second patient, coagulation disorders secondary to either liver disease, pancreatitis and its septic complications, or extracorporeal circuit heparinization for renal replacement therapy were present. Coagulation disorders should be considered whenever a splenic hematoma is found in a patient with acute pancreatitis. Disseminated intravascular coagulation may be the etiology of a splenic hematoma in acute pancreatitis.

Acute Disease↗
PubMed1992

[The treatment of a simple pancreatic pseudoaneurysm or one associated with hemosuccus pancreaticus].

When a permanent communication occurs between an artery and a pancreatic pseudocyst, the pseudocyst becomes a pseudoaneurysm. Pancreatic pseudoaneurysms are primarily found in patients with alcoholic chronic pancreatitis. Fistulization of a pseudoaneurysm into the main pancreatic duct results in ductal hemorrhage. From 1980 to 1990, 43 cases of pancreatic pseudoaneurysm and 24 cases of ductal hemorrhage (15 of these secondary to pancreatic pseudoaneurysm) have been published. Pancreatectomy, ligation of the affected vessel (alone or in combination with a drainage procedure), or intraarterial embolization have all been used to treat pancreatic pseudoaneurysms. We herein describe two patients with alcoholic chronic pancreatitis and pancreatic pseudoaneurysm; one patient presented with ductal hemorrhage. The inferior pancreatico-duodenal artery was the affected vessel. Both patients were treated with suture-ligation; an internal drainage was added to the patient presenting with ductal hemorrhage.

Alcoholism↗
PubMed1989

[Microcystic cystadenoma of the pancreas].

Cystadenoma of the pancreas is a rare tumor. In the surgery unit of the Hospital de la "Santa Cruz y San Pablo", of 18 cases of cephalic duodeno-pancreatectomy in the last nine years, we have only observed one case of cystadenoma. The patient was a 70 year-old woman, hypertensive and very obese, who had few symptoms and was diagnosed as pancreatic tumor by echography. CAT, ERCP and abdominal arteriography confirmed the diagnosis. Needle biopsy guided by echography and CAT was negative for malignant cells. In the operation, needle and trucut biopsy revealed benign cystadenoma. Cephalic duodenopancreatectomy was performed. The postoperative period was difficult, and the patient required reoperation within hours for intraperitoneal hemorrhage and again, eight days later, for dehiscence of the pancreatic suture. Finally she recuperated and was released at 38 days. Of all the types of proliferative pancreatic cysts, microcystic or serous adenoma is benign, as compared to mucinous cyst, of clearly malignant potential. However, needle biopsy rarely provides differential diagnosis. In some cases of high surgical risk, the indication for resection can be dubious if the cyst lies in the region of the pancreatic head and its benign nature can be demonstrated.

Cystadenoma↗
PubMedDate not supplied

[Accuracy of imaging techniques and tumor markers in the diagnosis of pancreatic cancer].

OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of: a) three imaging techniques: ultrasonography (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP), and b) the serum tumor markers CEA, CA 19-9 and CA 125, in the diagnosis of pancreatic cancer. PATIENTS AND METHODS: A total of 137 patients were prospectively evaluated. Pancreatic cancer was diagnosed in 25 patients; chronic pancreatitis in 24; acute pancreatitis in 22; extrapancreatic malignancies in 24, and benign digestive disease in 42. The reference interval for each marker was determined in 36 healthy volunteers. Diagnostic accuracy was determined using receiver operating characteristic (ROC) curves. Each diagnostic test was used in order: a) to diagnose pancreatic cancer when the disease was clinically suspected, and b) to differentiate between pancreatic cancer and chronic pancreatitis. RESULTS: CT (0.976-0.888) and US (0.857) diagnostic accuracy resulted greater than the best serum tumor marker CA 19-9 (0.755-0.786) (p = NS), in both diagnostic conditions. To obtain a diagnostic specificity of 90% in pancreatic cancer, the CA 19-9 cutoff level should increase up to 3 and 7.5 folds being in this case better than CEA and CA 125 (p < 0.05). CONCLUSIONS: CT scan offers the greatest accuracy in the diagnosis of PC. Among the tumor markers, CA 19-9 offers the best accuracy in the diagnosis of pancreatic cancer.

Acute Disease↗