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A Mambrini

Publications and source records attributed to A Mambrini.

83 records · Page 5Linked to original sources
PubMedDate not supplied

[Splenectomy for massive splenomegaly. Apropos of 36 cases].

Thirty-six splenectomies for splenomegaly exceeding 1000 grams are reported. The enlargement of the spleen most often was related with a malignant disease (n = 32). Cytopenia was the main indication in 14 cases, and splenectomy was contemplated for diagnosis (n = 12), initial treatment (n = 6), or due to pain (n = 3) or spontaneous rupture (n = 1). Ten patients (27.8%) had an associated surgical treatment. One patient died postoperatively (2.8%) and 12 patients presented with 14 complications (33%) usually with a rapidly favorable evolution. In 11 of 12 cases (91.6%), the operation allowed establishing the diagnosis in cases of splenomegaly with an unknown origin. Lastly, it was always effective to relieve pain and in most cases improved cytopenia. The authors conclude that the patients with massive splenomegaly are improved by splenectomy, although it most often is merely a palliative treatment in cases of malignant hemopathy.

Adult↗
PubMedDate not supplied

[Predictive factors of mortality and morbidity in colectomy patients over 75 years of age. Report of 69 cases].

Sixty nine patients over 75 years old who had a colectomy were retrospectively studied. The carcinoma of the colon represented the main indication for 42 cases (60.9%) and 22 patients (31.9%) were immediately operated. The influence of parameters such as age, sex, visceral defects, emergency, performance of a colostomy or associated intervention, type of colic pathology, was statistically studied. The age (p less than 0.05), emergency (p less than 0.03) and the number of defects greater than or equal to 3 (p less than 0.04) contribute to mortality. The number of defects greater than or equal to 3 (p less than 0.006) contributes to general morbidity. Only complications connected with the operation by itself significantly prolong the duration of hospitalization (p less than 0.02). The authors draw the conclusion that the age by itself is not a contra-indication for operation except in case of associated polyvisceral failure. In addition, it is required to carry out an early detection of colic lesions in elderly subjects in order to contemplate surgery before complications whose prognosis is fearsome (54.5% of death in emergency operation).

Age Factors↗
PubMedDate not supplied

[A new case of gastric and peritoneal anisakiasis].

A further case of anisakiasis is reported, its originality residing in the discovery of two localizations of the affection, gastric and then peritoneal, at four months' interval. This digestive disease is provoked by the larvae of nematodes that are parasites of marine mammals and for which human contamination is due to ingestion of raw or incompletely smoked fish.

Animals↗
PubMedDate not supplied

[Pyonephrosis complicated by a pyogenic psoas abscess. Apropos of a case].

Psoas abscess of pyogenic origin developed secondary to renal infection in a patient with coralliform lithiasis, a favorable outcome being obtained after nephrectomy and drainage of abscess. Clinical diagnosis is difficult but ultrasound and CT scan imaging provide useful data. Other causes of pyogenic abscess are discussed, the most frequent origin being digestive disease.

Abscess↗
PubMedDate not supplied

[Lateral ventral or Spiegel's line hernia. Apropos of 8 new cases].

Eight cases of lateral ventral hernia, or the so-called hernia of the line of Spiegel, included 2 serious cases complicated by a pyostercoral phlegmon. The principal anatomic, clinical and therapeutic features of these hernias are discussed, with emphasis of the probable underestimation of this affection and the value of parietal ultrasound imaging for its early diagnosis in patients with abdominal pain unexplained by a deep visceral lesion.

Adult↗
PubMedDate not supplied

[Obstruction of the small intestine caused by bridles and adherences. Analysis of 157 operated cases].

We retrospectively studied a series of 157 patients who were operated for post-operative occlusion of the small bowel. Our aim was to analyze the clinical and operative aspects with particular emphasis of the factors predicting intestinal necrosis. We also reviewed the literature. There were 103 females and 54 males with a mean age of 61 and 51 years respectively (p < 0.01). Patients with neoplasia, hernia or irradiated bowel syndrome were excluded. Perioperative variables were analyzed and compared with the incidence of intestinal necrosis and post-operative morbidity and mortality. Data were compared with the chi 2 test. The most frequent prior surgery was appendectomy (33%) and pelvic operations (25%). The mean latency period was 15 years and 5 patients (3%) developed immediate post-operative occlusion (mean 7 days). The preoperative interval was 24 hours on the average. The pathologies involved were: bridles 48%, bridles + adherences 35%, adherences 17%. No clinical sign could distinguish between these three categories, but strangulation was more frequent in patients with bridles (p < 0.003). The following factors were significantly related to intestinal necrosis: signs of abdominal defence (p < 0.0002), white-cell-count > 16000 (p < 0.002), systolic hypotension (p < 10(-7)) and the lack of a history of occlusion (p < 0.04). Mortality was 6% (all at age > 70 years). Age was the only factor significantly related to morbidity-mortality. Emergency surgery shoulder be performed for patients at risk of intestinal necrosis, especially elderly patients.

Adolescent↗
PubMedDate not supplied

Stomach preservation in low- and high-grade primary gastric lymphomas: preliminary results.

BACKGROUND: The optimal management of primary gastric lymphomas has yet to be defined. In the past surgery was advocated as the optimal first step for patients with PGL. Recently, an increasing number of studies suggest that chemotherapy is as effective as surgery. METHODS: Fourteen patients with PGL were treated with chemotherapy alone. For patients with low-grade lymphoma, chemotherapy consisted of mitoxantrone 5 mg/sqm on days 1 to 3. Treatment courses were administered every 3 weeks up to a maximum of 6 cycles. Patients with high-grade lymphoma received chemotherapy according to the CHOP schedule every 4 weeks up to a maximum of 6 cycles. Two patients with high-grade lymphoma were treated as low-grade lymphoma patients (one because of age and poor performance status, the other because she refused chemotherapy that would cause hair loss). Two patients with low-grade lymphomas who did not respond to mitoxantrone were crossed over to CHOP. RESULTS: All patients were evaluable for toxicity, 13 for response to therapy and survival. Toxicity was mild or moderate. Neither perforation nor hemorrhage was observed. Eleven patients achieved a complete remission (85%), 1 a partial remission (7.5%) and 1 underwent disease progression (7.5%). At a median follow-up of 12 months (range 4-44 months) all complete responders are alive and disease free. CONCLUSIONS: Although the number of evaluable patients is too small to draw any final conclusions, chemotherapy seems to be as effective as surgery in PGL, and stomach preservation improves the quality of life of the patients.

Adult↗