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Biomedical subjects

A Manfredi

Publications and source records attributed to A Manfredi.

At least 37 records · Page 2Linked to original sources
PubMed1986

Effect of sodium ipodate and iodide on free T4 and free T3 concentrations in patients with Graves' disease.

Graves' hyperthyroid patients were treated daily for 10 days with 1 g sodium ipodate, a cholecystographic agent which exerts a blocking effect on the peripheral conversion of T4 to T3, or with 12 drops of saturated solution of potassium iodide (SSKI). Serum concentrations of free T4 (FT4) and free T3 (FT3) were measured before, during and 5 and 10 days after the administration of each drug. Sodium ipodate treatment induced a rapid decrement of serum FT4 concentrations which declined from 48.9 +/- 6.6 pg/ml to 26.0 +/- 2.7 pg/ml. In these patients serum FT3 concentrations declined from 12.4 +/- 2.0 pg/ml to 2.5 +/- 0.4 pg/ml. Ten days after sodium ipodate withdrawal, serum FT4 and FT3 concentrations returned to baseline values. In patients treated with SSKI serum FT4 concentrations declined from 51.1 +/- 8.8 pg/ml to 11.3 +/- 1.4 pg/ml and FT3 from 15.7 +/- 2 pg/ml to 2.6 +/- 0.3 pg/ml. Moreover, after therapy interruption serum free thyroid hormone concentrations returned to baseline values in these patients. Serum FT4 pattern during the study was not different between the two groups of subjects whereas serum FT3 concentrations were significantly lower in patients treated with sodium ipodate. These findings indicate that SSKI and sodium ipodate are effective in inducing a rapid decrement of serum free thyroid hormone concentrations. Therefore the employment of these drugs may be useful in the treatment of patients with thyroid storm and those undergoing thyroidectomy.

Adult↗
PubMed1986

Goiter size and thyroid function in an endemic goiter area in northern Italy.

Thyroid function was studied in a large number of subjects residing in Varsi, a town in the province of Parma, Italy. In this area, endemic goiter associated with moderate iodine deficiency [59 +/- 3 (+/- SE) microgram iodine/g creatinine], as defined by WHO criteria, affects 65% of the population. Serum T4, T3, thyroglobulin (Tg), and TSH concentrations were measured by RIA in 1218 subjects. The TSH response to TRH was determined in 108 subjects selected randomly from the groups with different grades of goiter. No significant change in serum T4 concentrations was found in subjects with different grades of goiter. Serum T3 concentrations were higher in subjects with the larger goiters. Serum Tg concentration progressively increased, and serum TSH progressively decreased with increasing goiter size. The TSH response to TRH was diminished in subjects with larger goiters. The findings of decreasing serum TSH concentrations and blunted TSH responses to TRH as goiter size increased suggest the possibility of autonomous thyroid function in the larger goiters in subjects residing in this area of moderate iodine deficiency.

Adolescent↗
PubMed1985

Comparative effects of sodium ipodate and iodide on serum thyroid hormone concentrations in patients with Graves' disease.

Patients with thyrotoxic Graves' disease were treated daily for 10 d with 1 g sodium ipodate, an iodine rich X-ray contrast agent which impairs outer ring (5'-) deiodination of T4 to T3, or with 12 drops of a saturated solution of potassium iodide (SSKI). T4, T3 and reverse T3 (rT3) concentrations were measured before, during, and 5 and 10 d after the administration of each drug. SSKI therapy induced a decrease in the serum T4 concentration from 14.7 +/- 1.3 microgram/dl (mean +/- SE) to a nadir of 7.9 +/- 0.9 on days 9 and 10 of therapy, all values reaching the normal range by day 9; a decrease in the serum T3 concentration from 402 +/- 43 ng/dl to a nadir of 143 +/- 20 on day 10, remaining elevated in all patients until day 5 and decreasing into the normal range in all except one patient on days 9 and 10; and no change in the serum rT3 concentration. Serum T4 and T3 concentrations returned to baseline values 10 d after withdrawal of SSKI. In contrast sodium ipodate therapy induced only a modest decrease in the serum T4 concentration from 15.1 +/- 0.7 micrograms/dl to a nadir on day 9 of 11.3 +/- 1.0 and serum T4 remained above the normal range in most patients until day 8; a striking and rapid decrease (within 12 h) in ther serum T3 concentration from 340 +/- 36 ng/dl to mean values ranging from 79 to 85 during the last 5 d of therapy, with most values below the normal range during the last 3 d; and a marked increase in the serum rT3 concentration from 111 +/- 15 ng/dl to a peak value of 376 +/- 59 on day 5.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Cholecystectomy in cirrhotic patients].

The Authors describe 19 patients affected by hepatic cirrhosis, treated because of cholecystic lithiasis during the period 1978-82 on a total number of 473 cholecystectomies performed. The hepatic damage was defined by hepatic function tests and biopsy. A 25% postoperative complications was observed in cirrhotic patients and only an 8% in the other 454 cholecystectomies. Mortality for the first group was 21% and 0,45% in the second group of patients. The data observed in the cirrhotic group seem related to frequent necessity of blood or plasma transfusion and jaundice in damaged livers. The high mortality and morbidity in cirrhotic patients suggest a surgical indication only for already complicated biliary lithiasis.

Adult↗
PubMed1980

[Primary carcinoma of the gallbladder: report of 41 cases (author's transl)].

The Authors described their experience in 41 patients operated on because of gallbladder cancer. The overall mortality was 20%. Four cases suitables for a "radical" wide resection showed an average survival of 8 months, while 2 on 3 patients with in "situ" carcinoma treated by simple cholecystectomy are still alive at more than 3 years, the other dying after five years because of disease not related to the gallbladder cancer. The bad general prognosis of the disease is mainly related to the delayed diagnosis together with the anatomical relations of the gallbladder as demonstrated by the discouraging survival in the "radically" widely resected patients. It must be considered consequently categorical to realize an early cholecystectomy, the only possible preventive procedure, in the height risk patients.

Carcinoma↗
PubMed1980

[Haemobilia as sign of hepatic artery aneurysm (author's transl)].

The Authors described a case of left hepatic artery aneurysm giving ris to haemobilia. A wide discussion is held on clinical and diagnostic aspects on this situation, often causing operations following each other, before that a correct surgical treatment is indicated. The patient underwent the left hepatic artery ligature, at present considered the choice method in the treatment of haemobilia following ruptured hepatic artery aneurysm.

Aneurysm↗
PubMed1980

[The poststenotic subclavian artery dilatation (author's transl)].

Two poststenotic subclavian artery dilatations are described. The distinction between a poststenotic dilatation and aneurysm is based on arteriography, showing associated with explorative arteriotomy, if needed. In the case of even wide poststenotic dilatation, the first rib only should be removed. The first rib resection in the described patients controlled after 2 and 7 years, was followed by reduction of arterial dilatation in one case and by stabilization in the other. This result confirms that arterial grafting must be considered only in the treatment of true poststenotic aneurysm.

Adult↗
PubMed1979

[Transduodenal papillosphincterotomy in treatment of biliary lithiasis].

The Authors report 180 cases of transdudenal papillosphincterotomy. Medium follow-up at 5 years revealed a complete recovery in 87 of 100 controlled patients. Nine cases revealed persistence of some degree of dyspepsia, while a second operation was necessary for the remaining patients to remove recurrent calculi in 2 cases and because of Oddi's stenosis in other two cases. A 4,4% mortality operative was observed, following postoperative pancreatitis in 1,1%, duodenal fistula or haemorrhage in 1,6%, and 1,6% from other causes. On the basis of their results the Authors conclude that transduodenal papillosphincterotomy is an effective procedure in treating complicated lithiasic biliary disease when respecting the reported indications.

Ampulla of Vater↗
PubMed1979

[Plunging and intrathoracic goiters].

The authors report 21 cases of cervico-substernal and 9 cases of mediastino-cervical goiters. On the base of their experience they remark that the diagnosis of topographic mediastinal extent of goiter has never been a problem in the mean time that it remains difficult to recognize the possible tumoral nature of the lesion, also utilizing both thyroid angiography and superior caval phlebography. Removal of 27 of 30 goiters was effecuted by cervical approach alone. In two cases a thoraco-lateral approach was added to remove endothoracic neoplastic goiters and in the last case a partial sternotomy was necessary. The authors conclude that the occasional use of sternotomy is not the result of an aprioristic decision, but the consequence of a correct removal obtained through the cervicotomic approach, also for large mediastino-cervical goiters.

Adult↗
PubMed1978

[Traumatic chylothorax. A further indication for total parenteral nutrition].

Successful and rapid resolution of a serious cases of traumatic chylothorax by means of conservative management with TPN is reported. This method is clearly indicated as a mean of making up the calorie and amino acid need when litres of chyle are being lost every day. In addition, by resting the digestive tract it brings about a massive decrease in the production of lymph in the mesenteric district and thus leading to easier and earlier sufficiency of the collateral lymph drainage routes. The rapid decrease in quantity and the change over from chylous to serous chest drainage liquid after TPN are evidence of its soundness. An immediate lymphographic control revealed complete section of the duct. Two months later, collateral diaphragmatic and azygos circulation was observed. It is felt, therefore, that TPN extends the range of conservative management of posttraumatic and postoperative chylothorax.

Adult↗
PubMed1977

[Traumatic thrombosis of the peripheral arteries].

Ten cases of post-traumatic arterial thrombosis are described. The anatomopathological, diagnosis and therapeutic aspects of peripheral artery lesions of this type are examined. Surgical exploration followed by reconstruction are dictated by the presence and degree of seriousness of ischaemia; they are not subordinate to arteriography, itself not always necessary. Resection of the confused segment and reconstruction is the management of choice. Thrombectomy and thromboendarteriectomy cannot be considered as rational operations, even though they can be used in a few special cases, such as iatrogenic forms. Reconstruction is best achieved by direct anastomosis or with the aid of venous grafts. A prosthesis, on the other hand, is liable to produce less satisfactory long-term results.

Adult↗
PubMed1977

[Clinical and therapeutic aspects of duodenal diverticula].

The Authors present 33 cases of duodenal diverticula, 12 of which underwent surgical therapy. They analyse the clinical and therapeutic problems entailed in this surgica entity with particular reference to the frequency and gravity of emorrhagis complication. Concerning the surgical approach of ampullar and iuxta ampullar diverticula, Authors experience seems to advise indirect operations.

Adult↗
PubMedDate not supplied

Iodothyronine and thyrotropin concentrations after iodoamide administration for angiographic studies.

In order to study the effect of iodoamide (a contrast medium widely used for urographic and arteriographic studies) on thyroid function, seventeen subjects were studied before and after arteriographic examinations employing this contrast compound. Serum concentrations of T4, T3, rT3 and TSH were not modified during the observation period by the administration of iodoamide. This finding is in contrast with the observation that iopanoic acid and ipodate, used for cholecystographic examinations, can reduce the serum concentrations of T4 and T3 with a concomitant increase in rT3. Therefore, iodoamide is not useful in the treatment of hyperthyroidism.

Adult↗