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Biomedical subjects

C Binelli

Publications and source records attributed to C Binelli.

11 recordsLinked to original sources

[Body changes during pregnancy].

Pregnancy induces numerous changes in the physiology of the woman. Those changes are necessary for the embryo and fetus to have a normal growth, and for the woman to adapt to that physiologic event. A 50% raised cardiac flow is the consequence of increased systolic flow and cardiac frequency. Blood volume is about 40% larger than in non-pregnant woman. It is the consequence of enlargement of the plasmatic volume (50%), and the red cells mass (30%). Those different changes explain the physiologic anemia of pregnancy. The main part of the blood volume increase corresponds to an enlargement of the venous system, but without any change of the central venous pressure. Arterial pressure remains unchanged throughout the pregnancy, or sometimes gently decreases (10%). Those changes are more important during an effort, particularly during the labor. Increase of cerebral blood flow (as a consequence of a raised cardiac flow) is limited by the cerebral autoregulation. As a consequence, there is no evidence for dramatic cerebral hemodynamic changes during pregnancy. Nevertheless, autoregulation is less effective for arterial pressure over than 150 mmHg, what can induce an hemorrhagic stroke. Blood levels of steroïd (progesterone, oestrogens) and peptidic (HCG, HPL) hormones are increased. Oestrogens are said to make capillary fragile, and progesterone is responsible for the enlargement of the venous system. In order to prevent an hemorrhagic accident, pregnancy induces a lack of fibrinolysis, and an excess in coagulation. The consequence is the ability of the pregnant and post-partum woman to develop venous thrombosis.

Blood Physiological Phenomena↗

Management of choledocholithiasis during pregnancy by magnetic resonance cholangiography and laparoscopic common bile duct stone extraction.

Management of common bile duct (CBD) stones during pregnancy is a difficult problem. The authors reported the case of a patient who was 22 weeks' pregnant who had a symptomatic CBD stone successfully treated by the association of magnetic resonance cholangiography and laparoscopic CBD stone removal. The patient delivered a healthy baby boy at 39 weeks. Magnetic resonance cholangiography and laparoscopic CBD exploration is a viable option in the management of CBD stones in pregnant patients that carries a low risk for the fetus while preserving the advantages of minimally invasive surgery for the mother.

Adult↗

Results of duodenopancreatectomy for solitary pancreatic metastasis from renal cell carcinoma.

The pancreas is an uncommon site of metastasis from renal cell carcinoma. We present five patients with solitary pancreatic metastasis from renal cell carcinoma located in the head of the pancreas, treated by duodenopancreatectomy. There were no perioperative deaths. Mean survival was 48 months; three patients were alive at the end of the study (at 27, 46, and 88 months, respectively) and two patients died, at 13 and 70 months. The 3- and 5-year survival rates of our patients together with 22 previously reported patients were 86% and 68%, respectively. We advocate aggressive surgical treatment when the metastatic disease is limited to the pancreas.

Carcinoma, Renal Cell↗

Metastatic gastric cancer arising from breast carcinoma: endoscopic ultrasonographic aspects.

Linitis plastica of the stomach was diagnosed in four patients. Endoscopic ultrasonography (EUS) was performed in four cases; they were monitored by EUS and had their treatment adapted accordingly. According to the present study, the typical criteria of gastric linitis at EUS are: (a) rigidity of the gastric wall; (b) a wall thickness exceeding 6 mm; (c) a second enlarged layer marginally more echogenic than the fourth hypoechogenic layer (muscularis propria); (d) a third hyperechogenic enlarged layer; and (e) a poor demarcation between layers. Gastric linitis appears more likely to be specific metastasis from lobular breast carcinoma. In most of the follow-up cases, EUS showed correlation with a subsequent decrease of the CA15.3 level. At present, EUS seems to be the most effective and least invasive examination for clinical diagnosis and treatment surveillance of secondary gastric linitis arising from infiltrating lobular carcinoma (ILC) of the breast.

Aged↗

[Is ultrasound screening for ovarian cancer possible in 1998?].

Ovarian cancer is the most common cause of gynecologic cancer death, as most patients present with advanced disease, in which the prognosis is poor. Five year-survival is only 35% for all stages, while it exceeds 90% in stage I. Consequently, there has been heightened interest in the development of screening modalities that can detect ovarian cancer at an early stage to reduce the mortality of this disease. Unfortunately, transvaginal sonography and color Doppler imaging still have a high false positive rate and low specificity increasing the number of surgical procedures, even among women with a strong family history of ovarian cancer. Psychological impact and economical cost has also to be discussed when considering such programs.

Abdomen↗

Inhibin assays of ovarian cyst liquid obtained by needle aspiration may allow differential diagnosis between functional and organic cysts.

Radioimmunoassays of estradiol, CA125 and inhibin were carried out on ovarian cyst fluid samples. The samples were taken from ten women with functional cysts and 15 women with organic cysts. Statistical analysis shows that estradiol and inhibin assays allows satisfactory differential diagnosis between functional and organic cysts. However, the inhibin assay provides more precise results and appears to be a more reliable marker than estradiol. The differential diagnosis between the two types of cyst would indicate the use of coelioscopic surgery especially in the case of organic cysts, avoiding unnecessary risks for patients with functional cysts.

Adult↗

[Granulomatous mastitis and corynebacteria infection. Two case reports].

Diagnosis of granulomatous mastitis must be based on a multidisciplinary approach. First, it's necessary to eliminate carcinomatous mastitis. Usually, the diagnosis is unknown except for tuberculous and sarcoidosis granulomatous mastitis. On observations in two cases of Corynebacterium granulomatous mastitis, we discussed the diagnosis and therapeutic approach. When there is a clinical suspicion of granulomatous mastitis, surgical biopsy with immediate histological analysis and bacteriological culture of mammary tissue should be performed. This multidisiplinary approach should reduce the number of idiopathic granulomatous mastitis observed. Antibiotic treatment is required after biopsy or surgical excision of granuloma.

Adult↗

[Stenosis of the rectum secondary to an invasive adenocarcinoma of the prostate. Apropos of 3 cases].

There exist rare cases in which a prostatic carcinoma invades the perirectal space producing an extrinsic rectal stenosis. Three cases are discussed. Differential diagnosis with a rectal tumor is difficult clinically, but endorectal ultrasound and deep rectal biopsies must provide the correct diagnosis in most cases. Hormonotherapy is recommended, but prognosis is reserved.

Adenocarcinoma↗

[On the use of an anabolic hormone in the acute myocardial infarction. Experimental trial on 486 patients (author's transl)].

An anabolic hormone, methandrostenolone, was shown to be able to decrease significantly the cicatrization-time on animals with induced sperimental acute myocardial infarction (AMI). A controlled clinical trial was performed on group of 246 patients affected by AMI, giving them methandrostenolone at dose of 25 mg im.m. per day, for the first ten days from the beginning of symptoms. An omogeneous group of 240 patients with AMI was used as control. The mortality rate resulted 13,4% in the treated group 18,7% in the control's. 10 patients in the treated group (4,2%) died of cardiac failure versus 17 (7,1%) in the control group, 9 (3,7%) of cardiac rupture in the former versus 6 (2,4%) in the latter. As far as these differences are concerned statistical significance was not reached. A larger number of patients would be requested.

Aged↗