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Biomedical subjects

A Marassi

Publications and source records attributed to A Marassi.

11 recordsLinked to original sources
PubMed1999

Splenectomy for idiopathic thrombocytopenic purpura: comparison of laparoscopic and conventional surgery.

BACKGROUND: This study aimed to compare the safety, efficacy, and clinical benefits of laparoscopic splenectomy (LS) to open splenectomy (OS) in patients with idiopathic thrombocytopenic purpura (ITP). METHODS: The results from 14 consecutive patients who underwent LS for ITP were reviewed and compared with the results from patients who underwent OS for the same disease. Demographics, concomitant disease on admission, and platelet counts were evaluated, as were details of the surgical procedure, postoperative physiologic status, and hospital stay. RESULTS: Mean operative time was 88.3 min for OS and 146.4 min in LS group (p < 0.05). The conversion rate to open splenectomy was 7.1. Therapeutic response to splenectomy was 92.8% in the LS group and 86.6% in the OS group. Bowel canalization, return to liquid diet, and length of hospital stay were all significantly delayed in the OS group as compared with those who underwent LS (p = 0.01, p = 0.02, p = 0.005, respectively). In the OS group the morbidity rate was 13.3%, whereas in the LS group it was 7.1%. CONCLUSIONS: Laparoscopic splenectomy represents a valid alternative to conventional splenectomy in the treatment of ITP.

Adult↗
PubMed1995

A postgraduate teaching course in laparoscopic surgery.

A teaching course in laparoscopic surgery was addressed to 21 young postgraduates as a part of their general surgery program with the aim of making them familiar with the basic principles of laparoscopic surgery. The methodology was based on tutorial teaching and "learning by problems"; the students worked in little groups elaborating check lists, discussing problems, and practising with laparoscopic training devices. Theoretical learning, practical abilities, and efficacy of tutorial teaching were investigated at the end of the course: the participant's understanding of instrument function, mastering of equipment, and solutions to clinical problems were good, as were the efficiency and pleasantness of the didactic method. Tutorial teaching seems to be a valid model for basic training in laparoscopic surgery in a modern medical education program.

Education, Medical, Continuing↗
PubMed1991

[Lymph node localization of gastrinoma. Diagnosis and treatment].

The case of a 48-year old woman with a lymph node localization of gastrinoma is reported. The preoperative workup (US-scan, TC-scan and NMR) made it possible to detect and localize the lesion. A conservative surgical approach was decided according to the latest literature reports which showed a favourable course in patients with lymph node gastrinoma. Surgical resection has been accomplished. The patient's hormone level was normal at one-year follow-up.

Female↗
PubMed1991

[Analysis of the results of 264 cases of small breast carcinoma treated with conservative surgery and radiotherapy].

From January 1981 to December 1987, 264 patients affected with small breast cancers were treated with quadrantectomy plus axillary dissection and radiation therapy on the breast remnant (QUART). Mean age of the patients was 53 years; 124 of them were less than or equal to 50 years old (46.9%); 85 had axillary nodal metastases (32.2%), and 58 presented a primary tumor with pathologic size (greater than 2 cm) (22.9%). Overall actuarial survival at 3 and 7 years, according to the Kaplan and Meyer method, was 95.5% and 85.3%, respectively; NED survival was 85.9% and 77.4%. Twenty patients died (19 of cancer). Local relapses were 6 (2.3% on the whole and 13.3% on the whole of recurrences observed at follow-up). Local relapses were central in the quadrantectomy scar in 4/6 patients. Histology and site of the primary lesion were not correlated with a major risk of local failure. Isolated recurrences in the breast did not worsen survival. Nodal failures were 5 (1.9% on the whole of cases; 11.1% on the whole of failures). Our study confirms the role of QUART as an effective and reliable method in the treatment of small breast carcinomas.

Adult↗
PubMed1990

Familial protein S deficiency presenting as deep vein thrombosis occurring during pregnancy.

Subjects with congenital deficiency of protein S, a natural anticoagulant which serves as a co-factor for the antithrombotic activity of activated protein C, are at risk of thrombosis. We describe a family in which deep vein thrombosis-occurring during pregnancy in three members with abnormally low protein S activity - was the only manifestation of congenital heterozygous protein S deficiency. Early diagnosis and active treatment of protein S deficiency should be pursued in any woman with a family history of thrombosis, who is planning pregnancy.

Adult↗
PubMed1984

Protein C: a new plasma protein related to postoperative hypercoagulability.

Protein C is a vitamin-K dependent plasma protein, whose activation is catalyzed by alpha-thrombin. Unlike vitamin-K dependent coagulation factors, activated Protein C is an anticoagulant enzyme. Purpose of the present study was to evaluate the pathophysiology of Protein C in patients undergoing minor and major elective surgery. A third group of patients were operated for cancer of the gastrointestinal tract. Protein C levels have significantly decreased in all patients in third postoperative day, while this decrease occurred since the first postoperative day in the case of cancer patients. This suggests that Protein C is consumed after surgery in its anticoagulant and profibrinolytic activity. The acquired Protein C deficiency may be related to postoperative hypercoagulability and increased risk of deep vein thrombosis.

Adolescent↗
PubMedDate not supplied

Prevention of postoperative deep vein thrombosis in cancer patients. A randomized trial with low molecular weight heparin (CY 216).

Sixty-one consecutive patients were enrolled in a randomized, controlled trial of thromboprophylaxis with a low molecular weight heparin (Seleparina, CY 216) in major abdominal oncological surgery. Thirty patients received 2 x 3,825 anti-Xa international units of CY 216 subcutaneously on the day of surgery followed by a single daily 3,825 anti-Xa international units injection for 7 days; thirty-one patients did not receive any form of prophylaxis. The occurrence of deep vein thrombosis (DVT) was detected by 125I-labelled fibrinogen leg scan. Postoperative DVT developed in 2 patients in the CY 216 group and in 11 patients in the control group (6.8% vs 35.4%, p < 0.01). Although there was a higher postoperative transfusional requirement in the group receiving CY216 (p < 0.05), the total number of patients transfused was similar in the two groups (14 vs 13). On day 1 after surgery, the two patients who later developed DVT in the CY216 group had plasma anti-Xa activity significantly lower (p < 0.01) than the remaining patients. As a good relationship was found between plasma anti-Xa activity and body weight, adoption of a personalized dosage schedule might improve efficacy of CY 216 prophylaxis.

Abdomen↗