Biomedical subjects

C Iannuzzi

Publications and source records attributed to C Iannuzzi.

24 records · Page 2Linked to original sources

PubMedDate not supplied

[Mortality and clinico-prognostic significance of risk factors in geriatric surgery].

A prospective study for assessment of operative risk in elderly patients was carried in 1182 adult patients, 14 yrs or more, surgically treated not for urgency during 1985 in six Italian centres. Looking for meaningful relations among prognostic factors and outcome of disease is a relevant topic in biomedical of surgical risk was the use of multiple logistic function. Anamnestic, clinical and surgical variables were "explicative" variables, while occurrence of death and postoperative complications were "response" variables. Multipathology (myocardiosclerosis, respiratory failure) frequently associated with advanced age (greater than 70 yrs) contribute to determine the prognosis in surgery of elderly patient. Stepwise logistic regression model was applied to a set of preoperative and operative factors, five of which were found to significantly correlate with death: nutritional status, renal failure, reintervention, bacterial contamination during surgery, age greater than 70 years. From our data some conclusion may be drown: it is emphasized the major role of surgical factors in affecting the postoperative risk; among clinical variables, renal failure furnishes the most relevant contribution to prognosis; advanced age itself does not substantially affect the surgical risk, its role being confounded by association with other pathologies.

Adult↗

PubMedDate not supplied

Immunogenicity of a killed E. coli 0111:K58 vaccine administered orally to children.

A killed E. coli 0111:K58 vaccine was administered by the oral route to 16 children ranging from 3 months to 7 years of age. The antibody response was measured at different times after the vaccination through the titration of agglutinating antibodies in serum and in fecal extracts, and the detection of specific IgA immunoglobulins in the intestinal content. All vaccines developed antibody response detectable both inserum and in fecal samples. Coproantibodies tended to appear earlier and to attain higher titers than circulating antibodies; they were all least in part IgA immunoglobulins, since the content of specific IgA in the fecal extracts was proportional to the agglutinating titer.

Administration, Oral↗

PubMedDate not supplied

[Alternative methods of the pancreatico-jejunal anastomosis in resective pancreatic surgery].

Pancreaticojejunostomy is still followed by an unacceptable mortality and it warns the necessity to find and to verify more safe alternative methods in the management of pancreatic stump. In this work we analyze the results concerning 14 cases of pancreatic resections in which a pancreaticojejunostomy was not performed but the stump was closed with a mechanical stapler. Distal pancreatectomy with stapler was characterized by a low morbidity (11%) without mortality; this technique is therefore certainly reliable and it may be preferred for its facility and its rapidity. Pancreaticoduodenectomy with stapler has not appeared sufficiently sure, however, some technical improvements, as additional ligation of the pancreatic duct, the pharmacological inhibition of the exocrine secretion and a more extensive resection, seem to be able to make this technique as much reliable.

Anastomosis, Surgical↗

PubMedDate not supplied

[Cystadenoma of the pancreas: the clinical and preoperative diagnostic problems].

Pancreatic cystadenomas must be considered in the differential diagnosis of all cystic neoplasms of the pancreas. On the basis of a clinical observation, the authors discuss the most important clinical and diagnostic findings of pancreatic cystadenomas with special regard for what concerns the mucinous type. The authors underline the extreme difficulty of a correct preoperative diagnosis and discuss, after a wide literature review, the utility and the validity of the various imaging, cytological and immunohistochemical preoperative diagnostic procedures. In most cases the final diagnostic confirmation comes from the histology on the resected specimen; therefore all cystic neoplasms, no matter their location within the gland, which are not clearly identified pre or intraoperatively, should be surgically treated and removed.

Adult↗

PubMedDate not supplied

Duodeno-jejunal tumors. Report of 9 cases and literature review.

Nine patients with tumors of the duodenum and the jejunum are described herein and the Literature is reviewed. Of the six patients with a duodenal tumor, five had an adenocarcinoma and one a Brunner's gland adenoma. A predominance of inframpullary tumors was observed within the duodenum. Jaundice and abdominal pain were, respectively, the most common presenting symptoms of the tumors localized in the periampullary and inframpullary region. Treatment was curative in four and palliative in two cases. Duodenopancreatectomy was the treatment of choice for periampullary tumors whereas segmental resection was performed in the only resectable distal duodenal tumor. Of the three patients with jejunal neoplasms, one had an adenocarcinoma arising in the efferent loop of a Billroth II gastrojejunostomy performed 40 years before and two had an high malignant lymphoma. All three the tumors could be resected. According to the Literature, our results show that: 1. The diagnosis of duodeno-jejunal tumors is usually late: 2. Although of critical importance in the improvement of the overall diagnostic accuracy, endoscopy may be inconclusive or even misleading if the entire duodenum is not explored; 3. If duodenopancreatectomy is mandatory for periampullary tumors, segmental resection seems to be an adequate procedure for tumors of the distal duodenum since it does not ignore lymphatic nodes, can be easily performed and has a low postoperative complication rate.

Aged↗

PubMedDate not supplied

Elective cholecystectomy in selected cirrhotic patients.

Of the 53 cirrhotic patients with cholelithiasis observed at our Institution from 1978 to 1991, 31 were operated on. Twenty-eight Child-Pugh class A, two class B and one class C patients underwent elective cholecystectomy with (5 cases) or without (26 cases) common bile duct exploration. Among the symptomatic patients, nine (18.7%) were refused for surgery because the risk was estimated to be too high. Symptoms ranged from mild-moderate abdominal pain to typical biliary colic. Acute biliary inflammatory complications as cholecystitis or cholangitis could be detected in the clinical history of 5 patients (16%). Although a common clinical feature, jaundice was directly related to gallbladder or common bile duct stones only in one half of the cases. A total of 18 postoperative non-lethal complications occurred in ten patients (32.2%), with haemorrhage from the gallbladder bed being the most frequent event. Bleeding was associated with increased prothrombin time more than 1.5 seconds above the control (p < 0.01) but severe haemorrhage occurred only when the platelet count was less than 100.000/ml (p < 0.05). Common bile duct explorations increased the risk of bleeding. Two of the 3 class B or C patients developed ascites (p < 0.05). It is concluded that elective cholecystectomy can be performed without mortality in selected and symptomatic patients with adequate hepatic functional reserve.

Adult↗