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Biomedical subjects

A Lamazza

Publications and source records attributed to A Lamazza.

17 recordsLinked to original sources
PubMed1999

[A rare case of gastric bleeding due to left-sided portal hypertension].

The authors report an uncommon gastric bleeding rate due to splenic hilum compression by a pancreatic cyst. The syndrome to be brought back to some sectorial portal hypertension form (left-sided portal hypertension) is difficult to diagnose because of absence of esophageal varices and other portal hypertension signs in an unchanged liver functionality patient. To put a correct diagnosis about gastric bottom bleeding varices without hepatic origin, the authors recommend to use arteriography and CT. Surgical treatment is proved to be the election one because of useless attempt of bleeding control through hepatic artery endoscopic sclerosis or embolization.

Diagnostic Errors↗
PubMed1998

Endoscopy in the treatment of benign biliary strictures.

BACKGROUND/AIMS: Operative endoscopy is now the method of choice for treating numerous biliary tree diseases. In the treatment of benign strictures of the biliary tree, endoscopy serves as an alternative to surgical interventions. We evaluated the efficacy of endoscopic biliary stents in the treatment of benign biliary strictures. PATIENTS: Fifty-three consecutive patients with benign strictures of the biliary tree underwent endoscopic placement of one or more 10-12 Fr endoprostheses. Thirty-nine patients (73.6%) had iatrogenic strictures and 14 had inflammatory strictures (in 8 patients due to gallstones and in 6, chronic pancreatitis). Of the 53 patients, 20 (37.7%) had strictures classified as Bismuth type I, 23 (43.3%) Bismuth type II, 7 (13.2%) Bismuth type III and 3 (5.7%) Bismuth type IV. RESULTS: None of the patients died during the study period; three patients (5.6%) had immediate endoscopy-related complications treated conservatively. Late complications developed in 47.1% of the patients: 11.3% had cholangitis amenable to medical therapy, 5.6% had dislodged endoprostheses and 30.2% had obstructed endoprostheses. The reason why blocked stents accounted for most of the long-term complications in this series was that endoprostheses were not changed electively: they were changed only when clinical and laboratory signs indicated obstruction. Follow-up (6-84 months) in 42 of the 56 patients. 20 after stent removal, showed that 71.4% had an excellent outcome, 14.3% good results and 14.3% needed surgery. CONCLUSION: In benign biliary stricture endoscopic stenting is the first approach, providing definitive treatment or preparing patients for surgery.

Cholestasis↗
PubMed1997

[Diagnostic and therapeutic approach to kidney injuries].

The Authors report a wide review of the literature on open and blunt renal traumas. All the problems related to this pathology as well as all the instrumental and laboratory tests currently available for the correct diagnosis are illustrated. Both conservative and surgical management are also discussed.

Humans↗
PubMed1995

[Aneurysm of the celiac trunk: review of the literature and report of a clinical case].

After reviewing current and past medical Literature regarding celiac axis aneurysms the case of a 70 year-old emphysematous patient with an aneurysm of the celiac axis measuring 6 cm in diameter is reported. The patient's pulmonary function testing status strongly precluded a surgical option. Angiographic embolization of the aneurysm was then performed. The Authors observed that embolization with immediate occlusion of all afferent vessels of the celiac axis leads to no serious short or long-term consequences as long as an adequate collateral hepatic circulation is maintained through the gastroduodenal and inferior pancreaticoduodenal arteries. This case would appear to be the first described in the Literature and the Authors hold this technique to be a valid alternative whenever a surgical procedure would be difficult or impossible to perform.

Aged↗
PubMed1995

[Electrohydraulic intracorporeal lithotripsy in the treatment of "difficult" calculi of the common bile duct. Report of a caseload].

The Authors report their experience in 38 cases (January 1990-Septembre 1994) of "difficult" gallstone disease of the main bile duct treated with electrohydraulic intracorporeal lithotripsy. Nineteen patients were affected with giant stones of the biliary tree, 6 with multiple stones of the main bile duct, 13 with stones of one or both hepatic ducts. The approach to the biliary tree was peroral transpapillary in 16 patients and transhepatic in the remaining 22. Twenty-five patients were previously submitted to surgery of the biliary tree (13 hepaticojejunostomy, 8 choledochoduodenostony, 4 papillostomy), while 5 had required a cholecystectomy, and 6 a gastroresection according to Billroth II. In 80% of the cases two lithotripsy sessions were enough to achieve the complete clearing of the bile duct. There was no mortality and morbidity was 5.3%. Total clearing was obtained in 97.4% of the cases. 6-48 months after treatment 37 patients still do not show clinical, laboratory or echographic signs of gallstone stasis or disease relapse.

Adult↗
PubMed1994

The usefulness of biliary drainage for restoring liver function in obstructive jaundice.

In eighty patients with obstructive jaundice treated with percutaneous or endoscopic drainage, the results of biochemical liver-function tests (serum bilirubin, transaminase, gamma-glutamyl transferase, alkaline phosphatase, and albumin) were analyzed to evaluate the return of liver function after biliary decompression. Before decompression all the patients had increased serum concentrations of all the liver-function indicators measured. Conjugated bilirubin normalized within 7 days in 67.5% of the patients and within 14 days in 94.5%. The other serum responses normalized as follows: glutamic oxaloacetic transaminase (7 days in 45%, 14 days in 100%); glutamic pyruvic transaminase (7 days in 46.2%, 14 days in 100%); gamma-glutamyl transferase (7 days in 56.2%, 14 days in 89.1%); alkaline phosphatase (7 days in 52.5%, 14 days in 90.4%); and albumin (7 days in 100%, 14 days in 90.4%). The low mortality and morbidity rates in this series of patients with obstructive jaundice: 0% and 7% after endoscopic and 2.1% and 10.4% after percutaneous drainage suggest that biliary drainage has a valuable place in the preparation of jaundiced patients for surgery and in some cases provides a definitive intervention.

Adult↗
PubMed1987

[Tiropramide chlorhydrate in premedication for endoscopic retrograde cholangiopancreatography and its effects on the motor activity of Oddi's sphincter].

The activity of tiropramide chlorhydrate in the pre-medication for the endoscopical examinations has been evaluated. In particular ERCP has been studied considering as parameters the timing of the different stages of the examination and the activity of Oddi's sphincter. At the end of endoscopy the pressure of the sphincterial region was measured a 3-way miniature catheter. Patients included in the study were divided into two different groups: group A treated with tiropramide chlorhydrate and diazepam vs group B treated only with diazepam. The group with patients pre-medicated with tiropramide chlorhydrate presented a significant reduction in the timing of the different stages of endoscopy. Endoscopy was better tolerated. Manometry showed an antispastic action of the drug without side effects. An important reduction of the degree and duration of the sphincterial phase activity, with a possible improvement of biliary defluxion into the duodenum, was observed.

Adult↗
PubMed1986

Effects of pinaverium bromide in the premedication of endoscopic retrograde cholangio-pancreatography and on motor activity of the sphincter of Oddi.

A double-blind study was carried out in 18 patients with biliary and pancreatic disease to assess the use of pinaverium bromide in premedication for endoscopic retrograde cholangio-pancreatography and its effects on motor activity of the sphincter of Oddi. Patients were divided at random into three groups. One group received 100 mg pinaverium bromide twice daily for 3 days before and then 100 mg 1 hour before the examination, the second group received placebo, and the third had no medication. All patients received 10 to 20 mg diazepam intravenously 10 minutes before endoscopy. Assessments were made of the transit time of various endoscopic phases and patients' tolerance of the procedure. The effects of treatment on the sphincter of Oddi were estimated by means of endoscopic manometry. The results showed that pinaverium bromide allowed transit time reduction in endoscopic procedure, a greater tolerance on the part of the patient and marked reduction in the amplitude and duration of the phasic activity of the sphincter.

Adult↗
PubMedDate not supplied

["Strawberry" gallbladder: review of the literature and our experience].

The term "strawberry gallbladder" refers to an anatomo-pathological aspect which is included in the wider chapter of gallbladder cholesterolosis. Introducing their experience, the Authors summarize the hypotheses through the years proposed about the etiopathogenesis of this condition the clinical symptoms that it can produce and the diagnostic strategies used to identify it. Moreover the Authors underline that the "strawberry gallbladder" continues to be reported with a significant frequency. They also confirm the opportunity of surgical treatment of symptomatic patients as a valid alternative to medical therapy which is not always effective, it is long lasting, often complex and not completely side effects lacking.

Adult↗
PubMedDate not supplied

[Arteriomegaly: a clinical case report and review of the literature].

The authors report a case of arteriomegaly and underline the importance of a correct diagnosis. A review of the literature, in fact, confirms the incidence of the disease is higher than usually believed. Therefore, a complete diagnostic evaluation is necessary to recognize the disease and assure the adequate treatment.

Aged↗
PubMedDate not supplied

[Septic complications in emergency surgery: our experience and a review of the literature].

Surgical infections represent one of the main causes of postoperative morbidity and mortality, especially in emergency surgery, with negative consequences on health costs. The Authors examined 2002 cases of emergency admission for surgical pathologies at the I Surgical Department of the University of Rome ¿La Sapienza¿ from 1987 to 1992. Overall septic complications were 13,7%, with a mortality rate of 1,2%. The Authors underline the lack in Italy of either an accurate system for monitoring septic complications or a useful method for data collection. At last the attention is focused on the main causes of septic complications, their diagnosis and treatment.

Adolescent↗
PubMedDate not supplied

[Renal injury in childhood].

The Authors report a case of blunt renal trauma in a nine-year-old boy. Clinical and therapeutic approaches are discussed in the light of a wide review of the literature.

Accidents, Traffic↗
PubMedDate not supplied

[Simplifies case record in emergency surgery].

The Authors present an original case record simplified for urgency and emergency, with the aim to allow a quick and exact framing of the "acute" and consequently with a great saving of time. This is possible also thanks to the simple but efficacious graphic representation of the human body and his main districts. Moreover, it is possible to report data in a computerized system.

Emergencies↗
PubMedDate not supplied

Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation.

BACKGROUND/AIMS: The purpose of this study was to determine the effects of a high-fiber diet and fluid supplementation in patients with functional chronic constipation. METHODOLOGY: One hundred and seventeen patients with chronic functional constipation (aged 18-50 years) were randomly divided into two treatment groups. For two months both groups consumed a standard diet providing approximately 25 g fiber per day. Group 1 (58 patients) was allowed ad libitum fluid intake, while Group 2 was instructed to drink 2 liters of mineral water per day. Compliance was monitored throughout the study and results were assessed in terms of bowel-movement frequency and laxative use. RESULTS: Fiber intake was similar in the two groups, while total daily fluid intake in Group 2 (mean 2.1 liters) was significantly greater than that of Group 1 (1.1 liters)(p < 0.001). In both groups, there were statistically significant increases in stool frequency and decreases in laxative use during the two-month trial, but both changes were greater in Group 2 (stool frequency: p < 0.001 vs. Group 1; laxative use: p < 0.001 vs Group 1). CONCLUSIONS: A daily fiber intake of 25 g can increase stool frequency in patients with chronic functional constipation, and this effect can be significantly enhanced by increasing fluid intake to 1.5-2.0 liters/day.

Adolescent↗