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D Garcea

Publications and source records attributed to D Garcea.

16 recordsLinked to original sources
PubMed2004

Skip lesion of the cecum associated with proctitis: an atypical case of ulcerative colitis.

The authors report the clinical case of a patient who underwent total colectomy for acute ulcerative colitis. The unusual element in this case was the presence of a lesion ('skip lesion'), typical of ulcerative colitis, in the periappendiceal area of the cecum, which was discontinuous to the main site of disease located in the rectum and left colon. The presence of skip lesions, whose clinicopathological relevance is still unknown, would seem to disprove the widely held view that ulcerative colitis involves only the mucous membrane of the large intestine, with inflammatory processes of varying intensity, but without intervening normal areas. The alteration in mucosal immune response by sharing of some factors as bacterial flora, stasis and secretory products is a suggestive pathogenetic supposition.

Acute Disease↗
PubMed2003

Small bowel perforation after incomplete removal of percutaneous endoscopic gastrostomy catheter.

Percutaneous endoscopic gastrostomy (PEG) is a well-established technique for providing long-term nutritional support. The advantages and most frequent complications have been widely documented, but less is known about the danger of removing or replacing a PEG by cutting the device at skin level without endoscopic assistance to ensure the removal of the inner part. Laparotomy is often required in elderly and high-risk patients to relieve an intestinal obstruction or perforation. We describe a fatal case of small bowel perforation, resulting from the inability to remove an inner bumper.

Carcinoma↗
PubMed2000

Initial experience with breast biopsy utilizing the Advanced Breast Biopsy Instrumentation (ABBI).

The Advanced Breast Biopsy Instrumentation (ABBI) system combines a cylindrical single-use biopsy device with digital stereotactic imaging that achieves targeting of radiographic lesions to +/- 1 mm. This minimally invasive technique uses digital stereotactic imaging to perform excisional biopsies of suspicious, nonpalpable mammographic lesion. This allows complete removal of specimens in a one-step procedure that does not involve separate trips to radiology and then surgery. The authors' initial 170 cases utilizing the ABBI system were reviewed. The accuracy of specimen targeting, the success rate of lesion removal, and operative complications were some of the issues assessed. Five cases were not suitable for the procedure: the mammographic lesion was not visualized in one, and the breast was too thin on compression in four. There was successful removal of the lesion in 165 of the remaining cases. There were no local wound complications, and patient satisfaction was high in all completed biopsies. The ABBI system is an effective new form of minimally invasive breast surgery. It provides complete excision of mammographic abnormalities.

Adult↗
PubMed1992

Post-surgical deep vein thrombosis prevention: evaluation of the risk/benefit ratio of fractionated and unfractionated heparin.

An open controlled study was carried out to assess the efficacy and tolerance of a new low molecular weight heparin for the prevention of post-surgical deep vein thrombosis and pulmonary embolism. Forty-five patients undergoing abdominal surgery mainly for neoplasm, gallstones and gastric ulcers were administered 7,500 AXaU of low molecular weight heparin subcutaneously, 2 hours before surgery and once a day for 7 days after. Heparin calcium (15,000 IU subcutaneously per day) was used as a comparison drug in 45 control subjects, matched for age, sex and type of operation. Deep vein thrombosis was identified with clinical parameters, radio-labelled fibrinogen uptake test, echo-doppler and venography; pulmonary embolism with clinical examination, chest X-rays and/or scintigraphy. No episodes of deep vein thrombosis occurred in the low molecular weight heparin-treated patients, whilst there was 1 episode, without pulmonary embolism, in the control group. The consumption of blood and haemoderivatives for transfusions was higher in the heparin calcium group. Only in this group, furthermore, did 5 patients have to suspend antithrombotic treatment due to severe haemorrhages. General tolerance of the two drugs was identical and very good.

Aged↗
PubMed1990

[Endorectal echography as a guide to the surgical approach to tumors of the median-lower rectum].

There is no difference in the late results of destructive and conservative surgery in the treatment of rectal cancers, provided that preoperative staging is correct. Thirty-two patients with medium-low rectal cancer underwent endorectal US to evaluate local cancer spread; the aim was allow the correct surgical treatment to be carried out. US findings were compared with pathology: US diagnostic reliability was 93.75%, with 1 case of understaging (T2 as T1) and 1 case of overstaging (T2 as T3). Endorectal US, thanks to its high reliability, is therefore of basic importance because it allows the best local therapy to be chosen and risk margin to be determined. Moreover, US correctly evaluates the degree of parietal infiltration and local spread, thus helping preserve a more or less wide resection margin during destructive surgery. Therefore, endorectal US stands out as a basic research method in the correct preoperative staging of medium-low rectal cancers according to T, thus allowing a rational surgical approach and helping avoid not only unnecessary destructive surgery but also local recurrences.

Humans↗
PubMed1989

Adjuvant chemotherapy with fluorouracil and CCNU in colon cancer. Results of a multicentric randomized study.

To establish the effectiveness of adjuvant chemotherapy in patients with colon cancer after radical surgery, from 1980 to December 1983, 263 patients were randomized in a multicentric study to no further treatment (131 patients) or to a combination of fluorouracil (5-FU) (400 mg/m2 i.v., days 1-5) and lomustine (CCNU) (100 mg/m2 per os on day 5) every 6 weeks for 9 cycles (132 patients). The two groups were well balanced for age, sex, histology, tumor and nodal extent. Chemotherapy was not given to 30 of the 132 randomized patients, and of 98 treated patients only 38 completed the entire protocol. Analysis, as intention to treat, at 54 months did not show any significant difference between the two treatment groups in terms of relapse-free survival (surgery alone, 74.5%; surgery + adjuvant chemotherapy, 70.9%; p = 0.91). In contrast, a significant difference was observed in overall survival (surgery alone, 78.8%; surgery + adjuvant chemotherapy, 60.8%; p = 0.04). The sites of relapse were identical in the two treatment arms. In conclusion, from this study it appears that adjuvant chemotherapy with 5-FU and CCNU seems to have no efficacy in the cure rate of colon cancer patients.

Aged↗
PubMed1989

[Cloacogenic carcinoma].

Four cases of cloacogenic carcinoma (CC) observed between 1982 and 1987 out of 175 operations performed in the same period for anorectal tumors are reported. All the patients underwent abdominoperineal resection; 3 of them are still alive at 16.30 and 42 months from surgery respectively. The fourth died for neoplastic diffusion after 12 months. Epidemiological, clinical and therapeutic features of this rare tumor are discussed.

Adult↗
PubMed1988

[Desmoid tumors].

Explore the source record for details and available documents.

Abdominal Muscles↗
PubMed1982

Effects of morphine on human pancreatic secretion: studies on pure pancreatic juice.

Data concerning the effects of morphine on human pancreatic secretion are fragmentary and inconclusive. In the present study, we evaluated the effects of morphine on pure pancreatic secretion in nine subjects with external transduodenal drainage of the main pancreatic duct performed after biliary tract surgery. Intravenous infusion of a small dose of morphine, 40 microgram/kg/h, during pancreatic stimulation with secretin and cholecystokinin, caused a significant increase in volume, bicarbonate, and calcium secretion, and a significant decrease in protein secretion. The stimulatory effect on water and electrolyte secretion was rapid and much more pronounced, reaching about 45-50% of the control levels, whereas the inhibition of protein output was slightly delayed and of lesser magnitude, reaching about 20-25% of the control values. Both effects were long-lasting. The addition of naloxone, potent opiate antagonist, prevented in part the effects of morphine on pancreatic secretion, suggesting that specific opiate receptors might be involved in these effects.

Adult↗
PubMedDate not supplied

[Leiomyosarcoma of the rectum].

Two cases of leiomyosarcoma of the rectum observed between 1980 and 1990 are reported. Both patients underwent abdominoperineal resection: one is still alive at three years from surgery, whereas the other died for neoplastic diffusion after three years. Epidemiological, clinical and therapeutic features of this rare tumor are discussed.

Aged↗
PubMedDate not supplied

[Reservations in the routine use of preoperative urography in colorectal carcinomas].

The diagnostic utility of preoperative intravenous urography (IVU) carried out in patients with carcinoma of the large bowel is still controversial. In the period between 1978 and 1984 only 8 out of the 347 patients undergoing surgery for carcinoma of the large bowel showed urinary tract involvement at operation. IVU had been carried out in 106 patients before surgery. The survey results agreed with histological reports in 103 case records: 101 true negative, 2 true positive. Two false positive cases and one false negative were also found. Among the eight patients who at surgery revealed urinary tract involvement, only in three IVU had been proposed; in the remaining 5 cases it had not been requested. It may be suggested that the early recognition of colon carcinoma does not allow the neoplasia to further develop in the urinary tract, at least not in as high a percentage as in the past. We therefore deem it necessary to use at first less invasive and faster methods, such as echography, limiting IVU to those cases where a well-grounded clinical suspicion or a previously executed echography suggest deeper investigation.

Adult↗
PubMedDate not supplied

[Transrectal ultrasonography in the study of recurrences in patients surgically treated for rectal neoplasms].

The value of transrectal US is known in the preoperative staging of rectal cancer but remains debated in the follow-up of the patients submitted to anterior resection or local therapy. The authors report their experience with the postoperative follow-up of 80 patients submitted to 125 transrectal US exams to study method reliability. The results were 9 true positive, 2 false positive, 113 true negative and 1 false negative cases, with 90% sensitivity, 98.3% specificity and 97.6% accuracy rates. Positive predictive value was 81.8% and negative predictive values was 99.1%. Twelve patients were submitted also to MRI which correctly diagnosed one false negative result of transrectal US. Twenty-one patients were examined also with transrectal Doppler and color-Doppler US: in rectal cancer recurrences the peak velocity of hemorrhoid vascular flow was higher than in non-recurrent patients. On the basis of our results, transrectal US deserves to be included in the postoperative follow-up of the patients submitted to anterior resection or to local therapy for rectal cancer. Moreover, according to our preliminary findings, Doppler and color-Doppler US can improve transrectal US reliability in detecting local recurrences.

Female↗