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Biomedical subjects

D Danieli

Publications and source records attributed to D Danieli.

At least 19 recordsLinked to original sources
PubMed1991

[Ceftazidime in common infections in childhood. Experience in 262 cases].

We analyzed the clinical data collected from an open multicentre study (in 40 Hospital and University centres) with aim to evaluate clinical and bacteriological efficacy and safety of Ceftazidime (CTZ) in common infections of pediatric patients. The data were from 262 patients (137 M, 125 F) mean age 5.13 +/- 3.65 yrs (range 3 m. to 12 yrs). 158 pts with low respiratory tract infection, 32 pts. with upper respiratory tract infection and 72 pts. with urinary tract infection, were treated with CTZ (dose 50 mg/kg/die; i.v. or i.m.) for a mean of 9.4 days. The overall success rate was 96.2% (76.7% cured + 19.5% improved). In the evaluable cases (108) the bacteriological eradication rate was 92.18%. The safety of CTZ was good; adverse events (2 rash and 1 diarrhoea) were observed only in 3 patients. All events had moderate intensity and did not require drug withdrawal.

Age Factors↗
PubMed1991

[Carotid thromboendarterectomy. Comparison of two anesthesiologic techniques].

The authors have examined two homogeneous groups of patients suffering from "carotid stenosis", operated by TEAC with two different techniques of anaesthesia: general and local-regional (block). Neurological and cardiovascular complications have been recorded in pre and post-operative period. The results analysed statistically with the Pearson test, were homogeneous. However the authors, on the basis of their experience, prefer local-regional (block) anaesthesia for good haemodynamic stability and a better neurologic control. Moreover the block anaesthesia was better in patients.

Aged↗
PubMed1989

Low-grade astrocytomas: treatment with unconventionally fractionated external beam stereotactic radiation therapy.

Fourteen patients with nonoperable low-grade astrocytomas were treated with unconventionally fractionated stereotactic radiation therapy. The target volume was defined with computed tomography (CT) performed under stereotactic conditions. The treatment was carried out with a technique producing multiple noncoplanar arc irradiation, with the center of the target volume placed at the isocenter of the linear accelerator. A total dose of 16-50 Gy was administered in either one fraction or two fractions 8 days apart. The concentration of dose within the target volume allowed reduction of dose absorbed by adjacent critical structures of the intact brain. Patients were followed up for 11-48 months. Twelve of 14 patients had a partial or complete response to treatment, as demonstrated by CT. Stereotactic radiation therapy appears to be effective in the control of small radioresistant cerebral neoplasms, without damaging surrounding healthy tissues.

Adolescent↗
PubMed1989

Pathology of bronchial asthma and animal models of asthma.

We reviewed studies on pathology of status asthmaticus, asymptomatic asthma, and of animal models developed to study the pathogenesis of asthma. In status asthmaticus airway occlusion by mucous plugs, desquamed epithelium, goblet cell hyperplasia, submucosal glands hypertrophy, increased smooth muscle, basal membrane thickening, inflammatory infiltration of the bronchial mucosa are observed, together with focal areas of alveolar wall destruction in lung parenchyma. At variance with active asthma, in which almost invariably inflammatory cells infiltrate the mucosa, only scarce airway inflammation is reported in asthmatics between attacks. The majority of the animal models developed so far have been addressed to investigate the mechanism of the transient hyperreactivity that is associated with exacerbations of asthma, while little information is available on the structure-function relationship on long-lasting hyperresponsiveness.

Airway Obstruction↗
PubMed1988

Validity of stereotactic biopsy as a diagnostic tool.

254 patients affected by intracranial lesions underwent stereotactic biopsy in our department from 1978 to 1986. Target localization was achieved by CT. Multiple biopsy sampling was performed by cup microforceps or sliding cannula. Operative mortality was limited to 2 cases. Definitive tumour diagnosis including type and approximate grading was obtained in 211 (83%) patients. Diagnostic failures have been investigated from the neuroradiological point of view. Failure rate is low in solid tumours with CT homogeneous appearance and clear-cut borders, gradually increases in non homogeneous tumours, necrotic haemorrhagic or cystic, and is high in non classifiable lesions, generally hypodense at CT, with indefinite borders. In the authors opinion the variability of diagnostic retrieval in different types of lesions must be taken into account when proposing stereotactic biopsy.

Biopsy↗
PubMed1988

Fatal asthma in a subject sensitized to toluene diisocyanate.

We report the case of a 43-yr-old car painter who died within 1 h of exposure to a polyurethane paint in the workplace. A diagnosis of asthma induced by toluene diisocyanate (TDI) had been established 6 yr before, when he underwent inhalation challenges with carbachol and with TDI. The subject had airway hyperresponsiveness to carbachol (PD20FEV1 carbachol = 0.32 mg; normal value greater than 1.0 mg) and developed an early and long-lasting asthmatic reaction after exposure to TDI in the laboratory. Although it was recommended that he change his job or stop using paints containing isocyanates, he continued to work as a car painter, taking antiasthmatic drugs both at work and at home to control asthma symptoms. On Monday, October 6, 1986, at 11:30 A. M., he developed a severe attack of asthma while he was mixing the 2 components of a polyurethane paint. Taken to hospital, he was dead on arrival. Autopsy showed no evidence of cardiac or brain disease; lungs were overinflated, the cut surface showed grey glistening mucous plugs in in the airways. Histologic examination showed denudation of airway epithelium and thickening of the basement membrane with infiltration of the lamina propria by polymorphonuclear leukocytes, mainly eosinophils, and diffuse mucous plugging of bronchioles. Bronchial smooth muscle appeared hyperplastic and disarrayed, and lung parenchyma showed focal areas of alveolar destruction adjacent to areas of perfectly intact alveolar walls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[A clinical case].

Explore the source record for details and available documents.

Angina Pectoris↗
PubMed1984

[Benign epithelial neoplasms of Vater's ampulla. Usefulness of the "epithelial dysplasia" concept in prognosis and surgical strategy].

The surgical behaviour in front of the benign epithelial tumors (adenomas) of Vater's ampulla is object of discrepancies due to the possible malignant evolution of such neoplasms. The authors stress the basic importance of a careful examination of histological bioptic material before and/or during operation, which, through the identification of the degree of epithelial dysplasia, may lead to the choice of the tecnique to be adopted. In 2 of the 3 cases reported by the authors, showing a low degree dysplasia of the papillary tumor, a submucous papillectomy was performed; in the third case, where histology showed severe dysplasia and some other elements of risk were present (patient's age and macroscopic features of the tumors), the surgeons performed a duodenopancreatectomy. Semiseriated histological sections of the surgical specimen revealed the presence of carcinomatous areas. The authors think simple papillectomy to be the surgical procedure to follow when low grade dysplasia of ampulla is documented, and duodenopancreatectomy to be performed in high risk conditions as high grade dysplasia and macroscopic features suggestive of malignancy. In addition, the authors deal with epidemiology, clinics and instrumental diagnostics of such benign neoplasms of ampulla, on the basis of their own experience and the review of the few cases reported in literature.

Adenoma↗
PubMed1983

[Retroperitoneal tumors. Tactics, technics and surgical results].

Out of 33 cases of retroperitoneal tumours (TRP), collected throughout 11 years (1970-1981), 8 (24%) resulted benign, 25 (76%) malignant. Liposarcoma resulted the most frequent tumour. In 11 of the 25 cases of malignant TRP (44%), a radical removal of the tumour was performed; in 8 (32%), a palliative demolition, and in the remaining 6 (24%) a simple diagnostic laparotomy. In 10 of the 19 demolitive operations (53%) the removal was extended to contiguous organs: kidney, adrenal glands, colon, pancreas, spleen, bladder, stomach. The postoperative mortality was 6%. The cases of recurrence after operations considered radical were 5 (45%). Out of the 8 patients suffering from benign neoformations, 7 underwent simple removal, and result recovered. The global survival for malignant TRP was 20% after 5 years and 8% after 10 years; as related to the cases subjected to radical removal, it results 45% and 18% respectively. The Authors maintain the essential function of computerized axial tomography (TAC) in the preoperative anatomo-topographic outlining of the retroperitoneal mass and in the early recognition of the remote recurrences. An aggressive surgical behaviour seems to be presently the primary therapeutical solution; nevertheless, the encouraging results obtained through the complementary treatment (radiotherapy and chemotherapy) command the necessity of a pluridisciplinary management of the treatment of TRP as an essential condition for the improvement of the remote results.

Adult↗
PubMed1983

[Primary malignant neoplasia of the exocrine pancreas: epidemiological findings, risk factors, early diagnosis. Personal case reports, 1970-1981].

The Authors report their own casuistry of malignant tumours of exocrine pancreas, collected in the period from 1970 up to 1981. The question was of 214 cases, namely 136 of head and 78 of body-tail or diffused. The male/female ratio was 2.3:1, the most affected decades were 6th and 7th, with a range of 27-86 years. The resecability was 27% for tumours of head and 24% for those of tail; the operative mortality was 10.8% and 17.6% respectively; the survival after 3 years was 6.8% (head) and 5.8% (body-tail), after 5 years 6% (head) and zero (body-tail). In analysing the etiopathogenetic rôle of some factors and some pathological associations, the Authors particularly point out the predisposing rôle of both tobacco smoke and diabetes, remarked in 50% and 33% of the cases observed, respectively. From a symptomatologic standpoint, the symptoms are subdivided into initial symptoms (retrospectively interpreted as first manifestation of the disease), symptoms of alarma (leading to the attending physician's), symptoms at the entrance (hospitalization), and importance is given to the exploitation of the initial symptoms for the purpose to reach a diagnosis as precocious as possible, since 40% of the tumours of head are hospitalized only after 8-16 weeks and 33% of the tumours of body-tail after 16-32 weeks from the arising of the first symptom.

Adult↗
PubMed1983

[Cystic neoformations of the retroperitoneal space (4 case reports)].

Based on the study of four cases of retroperitoneal cysts, the complex histopathogenesis of these neoplasms - the clinical diagnosis of which has recorded substantial progress thanks to the use of the computed tomography - has been analyzed. The practice of exeresis, though comparatively simple and radical in most cases (as recorded in 3 out of the 4 cases reported) owing to the little adhesions of these neoplasms to the contiguous anatomical formations and also to their histological benignity, may, in some instances, present such unexpected difficulties due to the expansion in volume and the complex and delicate anatomical connections, that palliative operations have to be opted for.

Adult↗
PubMed1983

[Bilemia. Considerations apropos of a case].

The Authors report a case of bilemia, a complication of hepatic biopsy. They analyse the physiopathogenetic problems and those of surgical tactics, and emphasize the importance of retrograde and/or interoperative cholangiography ii the diagnostics of such disease.

Adult↗
PubMed1981

[Insular tumours of the pancreas (author's transl)].

The use of immunohistochemistry and radioimmunological assay of the pancreatic polypeptides in the plasma has contributed substantial advances to the histophysiopathology and preoperative diagnosis of tumours of the endocrine pancreas and the related functional syndromes. Consequently, in addition to furthering knowledge on clinical pictures already known for some time, it has been possible to define new categories of the disease which were previously misunderstood or confused with others. The physiopathology and diagnostic methodology (clinical, biohumoral and instrumental) of each main known syndrome (insulinoma, Zollinger-Ellison Syndrome, Verner-Morrison disease and glucagonoma) are described in detail; there are notes on hormonal syndromes that are not fully known and which constitute a field of research in evolution (pluriendocrine and carcinoid syndromes, polypeptidoma, somatostatinoma, nesidioblastosis). The problems of preoperative preparation, intraoperative diagnostic tactics and surgical technique are illustrated. Lastly the possibilities of alternative therapeutic treatment are outlined.

Acute Kidney Injury↗
PubMed1980

[Cavitary lesions and carcinoma of the pancreas. Diagnostic difficulties and errors].

Among 197 pancreatic and periampullar tumours operated between 1970 and 1979, an associated cystic of pseudocystic lesion was found on 15 occasions (a rate of 16%). In 10 cases it was a question of pseudocysts located at the bodytail, while the tumour occupied a distinct site (periampullar tumour or carcinoma of the head); in 5 cases the cavitary lesion coincided with the tumour (2 endocrine tumours of the head, 2 cystoadenocarcinomas and one adenocarcinoma of the body-tail). In 6 cases (of which 5 operated) the error in diagnosis led to misappreciation of the tumour: only 3 of these cases could be treated with radical surgery. In the other 9, correct diagnosis was possible from the start and in 6 radical surgery was performed. Stress is placed on the need for prompt and early diagnosis, in order to allow adequate treatment of the tumour in line with the canons of radical action.

Adenocarcinoma↗
PubMed1979

[The biological results of duodenocephalopancreatectomy. Clinical evaluations based on a long-term follow-up].

The authors discuss the main features of the complex pathophysiology of patients subjected to duodenocephalopancreatectomy, and particularly the difficulties inherent in clinical assessment of the digestive and metabolic impairment consequent upon the duodeno-gastro-pancreatic mutilation. Out of a total of 57 cases of this description, they singled out for recheck 23 patients who had undergone duodenocephalopancreatectomy not less than six months and not more than seven years before (chronic pancreatitis, 11 cases; various malignancies of the periampullar area, 10 cases; Zollinger-Ellison syndrome, 1 case; retroperitoneal lymphoma, 1 case). Seventy-six per cent of patients who had been gainfully employed were able to resume their jobs after surgery. Steatorrhea, assessed in terms of fecal fats, was present in all cases; notwithstanding, 70% of the patients gained weight (average increase 7 kg). All patients were on enzyme replacement therapy. Only 4% developed diabetes, and none developed postoperative peptic ulcers. Conversely there was a high incidence (65%) of bone structure reshuffling, signally osteoporosis, probably imputable to steatorrhea and vitamin D malabsorption, plus the often associated increase of serum alkaline phosphatase activity.

Adult↗
PubMed1979

[Alteratiions of calcium and phosphorus metabolism in patients treated with duodenoencephalopancreatectomy].

In a followup study of 14 patients treated by duodeno-cephalo-pancreatectomy at least one year before, the authors detected radiological evidence of bone tissue reshuffling in 64 per cent of the cases. Of these, 70 per cent showed high serum alkaline phosphatase content not attributable to cholestasis, liver metastasis, or specific bone disease. The authors call attention to the significance of this biochemical parameter for diagnostic purposes and therapeutic guidance.

Adult↗