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Biomedical subjects

C Lorenzini

Publications and source records attributed to C Lorenzini.

At least 19 recordsLinked to original sources
PubMed2005

Laparoscopic cholecystectomy in children with chronic hemolytic anemia. Is the outcome related to the timing of the procedure?

BACKGROUND: The aim of this study was to evaluate whether the outcome in children with chronic hemolytic anemia (CHA) and cholelithiasis undergoing laparoscopic cholecystectomy (LC) is related to the operation timing. METHODS: From June 1995 to December 2004, 46 children with CHA were referred to our division of surgery for cholelithiasis. All 46 children were asymptomatic at the time of the first visit, and an elective LC was proposed to all of them before the onset of symptoms. The operation was accepted in the period of study by 24 children and refused by 22. The patients were divided into three groups (group A, asymptomatic; group B, symptomatic; and group C, emergency admitted) depending on clinical presentation and operation timing, and the respective outcomes were compared. RESULTS: Elective LC in asymptomatic children (group A) is safe with no major complications reported. In children who refused surgery (groups B and C), we observed four sickle cell crises, four acute cholecystitis, and two choledocholithiasis, and all these complications were related to waiting. Two sickle cell crises occurred in symptomatic children waiting for surgery during biliary colic. The risk of emergency admission in children with cholelithiasis and CHA awaiting surgery was found to be high: 28% of the children admitted in emergency after a mean of 32 months (range, 22-36). Morbidity rate and postoperative stay increased when children with hemoglobinopathies underwent emergency LC. CONCLUSIONS: Elective LC should be the gold standard in children with CHA and asymptomatic cholelithiasis in order to prevent the potential complications of cholecystitis and choledocholithiasis, which lead to major risks, discomfort, and longer hospital stay.

Adolescent↗
PubMed2002

Efficacy of ropivacaine compared with ropivacaine plus sufentanil for postoperative analgesia after major knee surgery.

This study compared the analgesic efficacy of an epidural infusion of ropivacaine and ropivacaine with sufentanil following major knee surgery. In a double-blind clinical trial, 115 adult patients received either epidural ropivacaine (R group, 2 mg.ml(-1)), or ropivacaine (2 mg.ml(-1)) with sufentanil (RS group, 1 microg.ml(-1)), using a patient-controlled epidural analgesia technique. Pain scores (visual analogue scale, VAS, and the simple descriptive scale, SDS), side-effects, motor block and treatment quality were recorded at 6, 12 and 24 h after the insertion of the epidural catheter. In the RS group, analgesic efficacy was significantly greater than in the R group between 12 and 24 h following insertion of the epidural catheter (VAS: 92.9% vs. 72.9%, p = 0.009). There was no significant difference during the other periods. Pruritus, nausea and vomiting were significantly more frequent in the RS group. Good postoperative analgesia was obtained with an epidural infusion of ropivacaine (2 mg.ml(-1)). When this local anaesthetic was administered with sufentanil, there was an improvement in the analgesic effect but a significant increase in the number of patients who reported adverse effects. The differences were more pronounced 12 h after the beginning of the analgesic schedule. This study failed to demonstrate any worthwhile clinical benefit from the addition of sufentanil.

Adolescent↗
PubMed1997

[US or CT-guided percutaneous drainage of pancreatic pseudocyst].

Authors, after illustrating the pathogenesis of Pancreatic Pseudocysts (PPC) and classifying them into secondary to acute pancreatitis and arising in course of chronic pancreatitis, underline that the use of Ultrasound (US), CT-scan, Magnetic Resonance, Endoscopic Retrograde CholangioPancreatography and, above all, percutaneous drainage of the cysts has modified the therapeutic approach to this pathology. They describe indications and technique of US or CT-guided percutaneous drainage, and report their experience about 12 cases of PPC secondary to acute pancreatitis and 4 of PPC arising during chronic pancreatitis. They analyze the limits of this technique (risk of infections, recurrences, fistulas), and conclude that Percutaneous Drainage of Pancreatic Pseudocysts is a useful therapeutic approach in the treatment of PPC secondary to acute pancreatitis, while its use is complementary to surgery in the treatment of PPC due to chronic pancreatitis.

Acute Disease↗
PubMed1997

[Principles of rehabilitation of patients with ileostomy].

Authors, believing that ileostomy is the cause of serious clinical, functional and psychological consequences, dwell upon principles of rehabilitation, which aim is the reinstatement of ileostomized patients into daily life. The most important aspect is to select the position of the stoma; it is necessary to consider some technical and functional aspects. The Authors examine local problems of the stoma, the unstable electrolytical balance, and report some therapeutical aspects. They expose early and late complications after surgical therapy and conclude underlining the advantages of a rapid social reinstatement of patients with an ileostomy.

Activities of Daily Living↗
PubMed1997

[Day-surgery treatment of pilonidal sinus].

Authors discuss ethiopathogenus of pilonidal disease after a historical background and support acquired-congenital theory. Open and closed treatment are reported on the acute and chronic phases, highlighting economical advantages of closed method. Carbon-dioxide laser on Authors experience was very useful to prevent complications and to shorten healing time in open method.

Adolescent↗
PubMed1996

[Ambulatory treatment of inguinal hernia].

The Authors report their experience about the inguinal hernioplasty operation by implantation of prostheses in prolene following the Licthenstein technique. Prolene mesh strengthens the inguinal canal wall, with no suture tension point. The technique is performed under local anesthesia, in day-hospital system, consenting the patient a rapid reinstatement in the social-working ambit.

Adolescent↗
PubMed1995

[Hemangiopericytoma: diagnostic-therapeutic considerations].

The Authors report a clinical case of hemangiopericytoma recently observed. The biological behaviour of this tumour presents a character of unforeseeableness and, in every chance, needs a long period of follow-up. Based on literature data, the Authors report some diagnostic-therapeutic precise information and underline the scanty reliability of the prognostic factors.

Abdominal Muscles↗
PubMed1995

[Compression suturing devices in surgery of lateral colostomies].

The Authors refer their experience about two cases of colo-colic anastomosis executed by employment of biofragmentable ring BAR (Valtrac). The Authors used, for the bowel fragments preparation, the ASP-50 rake, overcoming the frequent inconvenient of mucosa extroversion thanks to circumferential mucosectomy extensive for a few mm. of colic fragments. Based on BAR (Valtrac) behaviour and the obtained results, in accord with the most other Authors, they conclude affirming that the compression anastomosis represents a simple methodology, sure and reliable for closing of the lateral colostomies.

Anastomosis, Surgical↗
PubMed1994

[Tumor markers in malignant anorectal pathology].

The Authors note the limits and the more rational directions of using the several tumour markers that they utilized in the study of the neoplastic pathology of the anus-rectum. They particularly point out the benefit as "dynamic indices" of variation of the tumor mass during the neoplasm's progress and treatment. For these neoplasies any new marker offers advantages of diagnostic accuracy and a greater specificity more CEA. Nevertheless other markers used appear interesting as biochemical parameters for tumour growth. The study and the tumour marker's development supported, in recent years, the introduction of new diagnostic methods that include the utilization of monoclonal localization of the tumour mass.

Adenoma↗
PubMed1991

[The usefulness of cytodiagnosis in nonpalpable breast lesions].

The paper underlines the importance of early diagnosis in the treatment of breast tumours and emphasises the value of cytodiagnosis as a very sensitive and specific predictive method for detecting impalpable lesions. In conclusion, the Authors affirm that cytodiagnosis, together with the introduction of new diagnostic instruments such as the TRC Mammotest, allows the diagnostic and therapeutical approach to impalpable breast tumours to be improved. It adds to the already high sensitivity of mammography and to the high predictive specificity of cytology, thus contributing to the reduction of the so-called "bioptic cost".

Adult↗
PubMed1989

[Clinical remarks on acute volvulus of the cecum].

On the basis of a case of acute volvulus of the caecum, the rarity of the condition is stressed and its aetiopathogenetic and clinical aspects analysed, particular emphasis being laid on therapy.

Acute Disease↗
PubMed1987

[Aminoglutethimide in the treatment of metastasizing breast carcinoma in old age].

After first analyzing the basic pathophysiological aspects and the mechanism of action of aminoglutethimide, the authors report on their experience with the use of this steroid biosynthesis inhibitor in a group of geriatric patients with advanced cancer of the breast. After illustrating the results of their study, the authors conclude by stressing that the use of this drug appears to improve the quality of life of the patients with a significant increase in rates of complete or partial remission of the neoplastic disease.

Aged↗
PubMed1984

[Colo-rectal precancerous conditions: anatomo-pathologic and clinical aspects].

The authors, after emphasizing the value presently ascribed to the conception of "epithelial displasia" as initial histologic and cytologic alteration, common to all groups of patients with high risk of development of colorectal cancer, review the mani precancer lesions of large intestine. As a conclusion, they affirm the main target one presently aims at for the screening in groups with high risk is to precociously identify the stage of transformation of epithelial displasia into carcinoma, so as to be able to set up a timely treatment.

Adenoma↗
PubMed1975

[Lymphocyte depletion through experimental anastomosis of the thoracic duct and cervical esophagus].

In 25 dogs, a short segment of the left subclavian vein, adjacent to the connection of the thoracic duct, was dissected free with its jugular branch and ligated. An end-to-side anastomosis, using interrupted sutures was performed in two layers, between the side of the cervical esophagus and the proximal part of the jugular vein. This vein, acting as a reservoir, remains connected to the thoracic duct by the isolated segment of the subclavian vein. The original aspect, of our technique is the use of a catheter placed into a branch of the vein near the site of the anastomosis and through which a saline solution with heparin (1 mg/kg) and penicillin (40.000 U/kg) is injected daily. The catheter emerged on top of the dog's neck, and continuous perfusion was provided by a chronofusor. The catheter was removed after one month. In 30% of the dogs, the anastomosis was found patent after more than 6 weeks. This has been proved by fibro-esophagoscopy after injection of a solution of patent blue in the jugular catheter ; lymphangiograms obtained by direct injection of radio-opaque material through the jugular catheter, and a decrease in lymphocyte counts to 4% of the total white blood cell count, compared to 30% in the controls. There was no significant loss of weight in the surviving dogs.

Animals↗