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Biomedical subjects

A Terranova

Publications and source records attributed to A Terranova.

11 recordsLinked to original sources

Ultrasound detection of abdominal lymph nodes in chronic liver diseases. A retrospective analysis.

AIM: To retrospectively evaluate the prevalence of lymph nodes of the hepato-duodenal ligament in a group of patients with chronic liver disease of various aetiologies and to investigate what clinical, aetiological and laboratory data may lead to their appearance. MATERIALS AND METHODS: One thousand and three patients (554 men, 449 women) were studied, including 557 with chronic hepatitis and 446 with liver cirrhosis. The presence of lymph nodes near the trunk of the portal vein, hepatic artery, celiac axis, superior mesenteric vein and pancreas head was investigated using ultrasound. RESULTS: Lymph nodes were detected in 394 out of the 1003 study patients (39.3%); their number ranged from one to four, with a diameter ranging between 0.8 and 4 cm. The highest prevalence was in the subgroup of patients with primary biliary cirrhosis (87.5%), followed by patients with hepatitis C virus (HCV; 42%), patients with HCV and hepatitis B virus (HBV; 41.3%), autoimmune hepatitis (40%), and HBV alone (21.2%). In the alcoholic and idiopathic subgroups prevalence was 9.5%, while in the non-alcoholic steatohepatitis and haemochromatosis subgroups it was 0%. HCV RNA was present in 97 out of 103 lymph node-positive patients and in 141 out of 168 lymph node-negative HCV-negative patients (p<0.003). Lymphadenopathy frequency increased as the liver disease worsened (chi(2) MH=74.3; p<0.0001). CONCLUSION: Despite the limitations of a retrospective study, our data indicate a high prevalence of lymphadenopathy in liver disease patients; ultrasound evidence of lymph nodes of the hepato-duodenal ligament in a given liver disease may most likely suggest a HCV or an autoimmune aetiology and a more severe histological picture.

Abdomen↗

Clinical errors in emergency medicine: experience at the emergency department of an Italian teaching hospital.

The level of commitment in the analysis of clinical errors made in the emergency department (ED) is currently focused on organization and processes rather than on individual action. Four major cases of clinical errors made in the ED of a teaching hospital were investigated. Analysis suggested that the process of clinical decision making and the overreliance on the use of patterns during the cognitive process had a major role in causing the errors, rather than factors related to procedures or organization. It appears hard to design system changes and tactics to significantly reduce the probability of making errors associated with the cognitive process involved in clinical decision making. The authors have initiated a systematic analysis of errors made during the diagnostic workup in their ED, and the rate of clinically significant errors is tracked. A file is being created with the purpose to use it for teaching and orientation of all new staff.

Aged↗

[The management of syncope in the hospital: the OESIL Study (Osservatorio Epidemiologico della Sincope nel Lazio)].

BACKGROUND: While syncope is generally considered a frequent finding in clinical practice, no clear epidemiological evidence is available about the relevance of such an event in the general population of Italy. METHODS: The OESIL Study was designed and undertaken in 15 hospitals of the Italian region of Latium in order to assess the percentage of emergency-room visits and admissions due to syncope, as well as to analyze the in-hospital diagnostic work-up performed for this condition. RESULTS: During a two-month observation period, 781 (372 males and 409 females, mean age 55.2 (22.8 years) consecutive patients came to the emergency rooms of the 15 hospitals included in the investigation due to a syncope spell (0.9% of emergency room visits); 450/781 patients (57.6%) were subsequently hospitalized (1.3% of all admissions): 48.0% of the admissions were admitted to a general medical ward, 29.3% to an observation ward, 13.3% to a cardiology section, 1.6% to a neurology section and 7.8% to other clinical sections (neurosurgery, general surgery). The mean duration of in-hospital stay was 6.9 (5.8 days; range 1-40 days). During the hospitalization period, 93.1% of patients underwent an ECG, 51.0% an EEG, 44.3% a CT scan of the central nervous system, 40.2% an echocardiogram and 19.5% a tilt-test. The syncope spell was considered to have a cardiovascular origin in 33.8% of the cases and a non-cardiovascular in 11.6% of the cases, while the origin was unknown in 54.4% of the cases. CONCLUSIONS: Collected data support the idea that syncope represents a frequent event in the general population and is responsible for a significant percentage of emergency-room visits and hospital admissions. However, the performance of conventional diagnostic work-ups is far from being satisfactory.

Adult↗

The effects of diabetes mellitus on wound healing.

Diabetes mellitus delays wound healing. Hyperglycemia leads to osmotic diuresis and subsequent decreased oxygenation and perfusion. It also limits PMN functioning and produces malnutrition by increasing hormones that cause catabolism. With meticulous monitoring of blood glucose levels and intensive insulin therapy of the postsurgical patients with diabetes, hyperglycemia can be reduced. If hyperglycemia is contained at a level less than 200 mg/dl, attention can be focused on supportive measures to promote wound healing.

Diabetes Mellitus↗

[Surgical disimpaction and orthodontic repositioning of a retained upper central incisor in the maxilla].

Surgical disinclusion and orthodontic repositioning of superior central incisor retained in the maxillary. A clinical case of inclusion of a permanent central incisor in a nine-year-old patient subjected to combined surgical/orthodontic treatment is reported, the purpose being to demonstrate and confirm the relative simplicity and indisputed advisability of conservative treatment in the case of young patients suffering from dental retention.

Child↗

Cell renewal and cancer risk of the stomach: analysis of cell proliferation kinetics in atrophic gastritis.

We examined cell proliferation kinetics of gastric mucosa in 28 patients affected by chronic atrophic gastritis by means of autohistoradiography of biopsies incubated with tritiated thymidine. The results have been compared with those obtained from 12 patients with normal gastric mucosa. In chronic atrophic gastritis, patients showed a proliferative pattern similar to controls. The remaining patients had an increased number of replicating cells together with an expansion of the proliferative compartment towards the surface of the mucosa. These results suggest that in chronic atrophic gastritis, as far as cell proliferation is concerned, two subgroups of patients with two different levels of risk of developing gastric cancer exist. The first one, showing an expansion of the proliferating area, probably is at higher risk. As a matter of fact, such an abnormality expresses an alteration of cell growth control similar to that observed in preneoplastic conditions of the colon and in gastric mucosa of animals treated with carcinogenic substances.

Adult↗