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Biomedical subjects

C Militello

Publications and source records attributed to C Militello.

At least 37 records · Page 2Linked to original sources
PubMed1992

Hormonal treatment of unresectable pancreatic cancer with LHRH analogue (goserelin).

Recently non-controlled clinical trials reported encouraging results using a suppressive endocrine treatment in patients with unresectable pancreatic cancer. In this study 15 patients were given an LHRH analogue every 4 weeks (goserelin 3.6 mg), while 18 patients with advanced stage pancreatic carcinoma were given only symptomatic therapy. All patients treated with goserelin had sexual hormone suppression. Follow-up included abdominal ultrasound or computed tomography scan every 3 months; Ca 19-9 assay and routine laboratory blood tests were performed every month. No partial or complete response, no performance status or Ca 19-9 level changes were found. No significant difference in survival was seen in the two groups of patients. This study suggests that goserelin is unlikely to have a major influence on the survival of patients with advanced pancreatic carcinoma and casts further doubt upon the hormone-dependence of this neoplasm.

Aged↗
PubMed1987

Forecast of surgical risk in pancreatic cancer.

Over a 22 year period, 305 patients underwent operations for pancreatic cancer. Seventy-one patients who only underwent a laparotomy and 60 patients with defective data were excluded from our study. The remaining 174 patients were analyzed to find a clinically applicable algorithm to allow the preoperative surgical risk to be evaluated in a single patient. One hundred twenty-six had undergone a bypass operation (Group I) and 48, a potentially curative resection (Group II). The two groups were divided into the following three risk groups according to the postoperative course: D, patients who died during the first postoperative month; C, patients with postoperative complications; and U, patients with an uneventful course. Preoperative weight loss, duration of jaundice, serum bilirubin level, total protein level, and age of every patient were collected and transformed into a three-score ordinal scale. Stepwise discriminant analysis of these data enabled us to correctly classify 88 percent of the patients who underwent palliative operations and 83 percent of those who had pancreatic resection. This method is useful in identifying the risk group for a single patient using individual preoperative variables. It may, moreover, suggest the most suitable treatment for each patient with pancreatic cancer.

Adult↗
PubMed1986

Surgical experience with adenocarcinoma of the ampulla of Vater.

Between 1968 and 1982, 13 patients in this study had a pancreaticoduodenectomy (PD), one patient had a total pancreatectomy, two had an ampullectomy, and one patient had a choledochoduodenostomy for neoplasia of the ampulla of Vater. The operative mortality was zero, and the 5-year actuarial survival rate for the 16 resected patients was 52.6 per cent. From a review of the literature, the authors evaluated 1,894 PDs and 61 ampullectomies. The operative mortality rate was 14 per cent and 3 per cent, respectively. The 5-year survival rate was 21 per cent for PD and 23 per cent for ampullectomy. However, 187 patients with negative lymph nodes who underwent PD had a 5-year survival rate of 39 per cent. PD resection is fully warranted for ampullary tumors. Ampullectomy should be reserved only for high surgical risk patients.

Adenocarcinoma↗
PubMed1984

Exocrine pancreatic function in diabetic rats treated with intraportal islet transplantation.

Streptozotocin-diabetic rats with chronic pancreatic fistula show severe impairment of secretin-stimulated pancreatic secretion while the action of pancreozymin remains unchanged. Intrahepatic transplantation of islets of Langerhans restores the response of ductal cells to secretin; physiological control of insulin secretion appears to be essential for exocrine function.

Animals↗
PubMed1984

Duodenal leiomyosarcoma and its multiple recurrences: good surgical result after three years of follow-up.

Duodenal leiomyosarcoma is a rare tumor and its current prognosis is poor. A case of duodenal leiomyosarcoma is described which recurred five years after the first intestinal resection, and was treated successfully with pancreaticoduodenectomy (PCD), extensive small bowel resection, and transverse, descending and sigmoid colon removal. The patient is still alive three years after this operation. Preservation of the stomach and the first duodenal portion after PCD most likely reduced the malabsorption, which is expected following such radical intestinal resection. This experience suggests an aggressive surgical approach to duodenal leiomyosarcomas, even when metastases are present.

Bile Ducts↗
PubMed1983

Cystic neoplasms of the pancreas.

Seven cases of cystic neoplasms of the pancreas (5 cystadenomata and 2 cystadenocarcinomata) are reported. While cystadenomata were localized in the tail of pancreas, cystadenocarcinomata were localized in the head. Only one case was asymptomatic and evidenced in the course of other type of surgery. Preoperative diagnosis of cystadenoma was assessed only in one case. All benign forms were treated with radical resection. Only palliation was possible for malignant forms. The moderate malignancy of cystic tumors as compared to the more common pancreatic adenocarcinoma is underlined. A more careful intraoperative diagnosis and surgical resection are therefore advocated, whenever possible.

Adult↗
PubMedDate not supplied

Central venous catheter guidewire replacement according to the Seldinger technique: usefulness in the management of patients on total parenteral nutrition.

While on total parenteral nutrition (TPN), 37 patients underwent replacement of a central venous catheter (CVC), during which a wire introducer was used, according to the Seldinger technique. In 25 patients, the CVC was placed in the superior cava via the subclavian, and, in 12, via the jugular vein. Overall, 82 CVC changes were performed.: 74 for assumed CVC sepsis, 6 as preventive treatment, and 2 for partial catheter displacement. Catheter tip culture proved to be positive in 25 of 119 CVC examined. The catheters were defined as sterile when the tip culture was negative; contaminated, when the tip culture was positive and peripheral blood culture was either negative or positive for different bacteria; septic when both tip and blood were positive for the same bacteria. The results indicated that 10 catheters were contaminated and 17 were septic. Eight previously sterile CVC were found positive after the exchange: 3 were removed at the end of TPN in asymptomatic patients, and 5 were successfully resterilized by means of one more change. Guidewire replacement allowed CVC sterilization of 22 of 24 catheters (91.6%). No complications due to the catheter-changing method were seen.

Bacterial Infections↗