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Biomedical subjects

D Lorusso

Publications and source records attributed to D Lorusso.

At least 55 records · Page 3Linked to original sources
PubMed1989

Ulcerative colitis in remission: it is possible to predict the risk of relapse?

A series of anamnestic, clinical, endoscopic and histologic parameters was evaluated in 64 patients with ulcerative colitis in remission to assess whether any of these had predictive value of relapse. All patients with quiescent disease were followed for at least 6 months. The statistical analysis was carried out by means of likelihood chi 2 test, receiver operating characteristic curve, Youden index and stepwise logistic regression. Eighteen patients out of 64 (28%) had a relapse, in a mean period of 9 months after the beginning of the study. The findings of our study suggest that only three factors were useful in selecting a subpopulation with a higher risk of recurrence: (a) a fiber-poor diet; (b) a number of previous episodes of relapse higher than 10, and (c) the presence of extraintestinal manifestations.

Adolescent↗
PubMed1989

Cigarette smoking and ulcerative colitis. A case control study.

In order to examine the relationship between cigarette smoking and ulcerative colitis (UC), we carried out a case-control study of smoking habits in 84 patients with UC and in two different types of controls: 84 taken from a hospital population and 84 from the general population, matched to the cases for age, sex, school education and social class. Non-smokers were found to have a greater UC risk than smokers in both internal controls (Odds ratio = 4.6, 95% CL = 1.8-11.7) and external controls (OR = 10, 95% CL = 3.6-26.9). There was a larger number of ex-smokers among patients with UC than among the controls. Evaluations at the time of disease onset also demonstrated that ex-smokers had a greater relative risk. Furthermore, 84% of the ex-smoker patients had stopped smoking before the onset of symptoms. Conditional multiple logistic regression with the introduction of alcohol (wine) and coffee as additional variable factors to age, sex, education and social class confirmed the independent protective effect of smoking on UC (OR for internal controls = 4.2, 95% CL = 1.7-10.2, OR for external controls = 5.7, 95% CL = 2.3-14.1). These results indicate that non-smokers and especially ex-smokers of cigarettes have a greater risk of UC, and thus confirm the results of other studies.

Adolescent↗
PubMed1988

Cholelithiasis after Billroth II gastric resection.

We evaluate whether Billroth II (BII) gastric resection is a predisposing condition in the formation of gallstones. In our department radiologic and echographic imaging is a routine examination before abdominal surgery. From 1980 to 1985, 202 patients underwent cholecystography or ultrasonography before BII gastric resections for peptic ulcers. The prevalence of cholelithiasis in a random sample of the population of the town near our institution was used to calculate the expected frequency of gallstones. The comparison of the expected and the observed frequencies of cholelithiasis in these patients did not show any statistically significant difference between men and women. All these patients were recalled for a follow-up of the long-term effects of gastric surgery, and 66% (133/202) returned and were examined. They underwent ultrasonography of the biliary tract. Again the observed and the expected (obtained as before) frequencies of cholelithiasis were compared. A statistically significant difference was apparent in male patients. We conclude that BII gastric resection could be a predisposing factor in the formation of gallstones in men.

Adult↗
PubMed1986

Surgical treatment for aggressive giant keratoacanthoma of the face.

A case of aggressive giant keratoacanthoma on the right temple region is described. Histopathologic examination was not definitive for keratoacanthoma, so that clinical considerations were helpful for diagnosis. The neoplasm was treated successfully with surgical excision and immediate repair with skin graft, in spite of one narrow peripheral area of residual disease on the wound surface after resection.

Aged↗
PubMed1981

[Our experience in the treatment of nonneoplastic obstructive pathology of the common bile duct by papillosphincteroplasty (author's transl)].

Starting from a discussion of the controversial views on the indications and correct execution of papillosphincteroplasty (PSP), the Authors report their own experience with the procedure and their first-hand evaluation of its merits, based on a series of 77 patients treated by PSP over the last 3 years (out of a total of 650 patients treated surgically for nonneoplastic pathology of the biliary tract). Their followup to date (up to 3 years after surgery), based on clinical, biohumoral and radiological findings, shows that the long-term results were excellent in 85%, good in 13%, and poor in 2% of the cases.

Adult↗
PubMed1980

[Cimetidine after operations on Vater papilla (author's transl)].

The effectiveness of Cimetidine in preventing complications, like acute pancreatitis and hemorrhagic gastritis, after operations on Vater papilla (ISP) is studied. In patients treated with Cimetidine the volume of nasogastric secretion was smaller and diastasemia and diastasuria treated values returned to the normal range earlier than in non-treated patients. In the latter group a case of pancreatitis and one of post-operative hemorrhagic gastritis were found. The treated patients, instead, did not suffer these complications. It was concluded that Cimetidine after IPS is useful, because it complies with the request that determined its employ.

Adult↗
PubMedDate not supplied

Gemcitabine in epithelial ovarian cancer treatment: current role and future perspectives.

Newer agents and combinations are needed in order to improve current results in ovarian cancer treatment. Gemcitabine is a novel agent that has shown consistent activity as a single agent in the treatment of platinum-resistant ovarian cancer and a favorable toxicity profile. Because of its clinical and preclinical synergism with platinum analogs, gemcitabine has been combined with carboplatin as a convincing approach in the treatment of platinum-sensitive recurrent ovarian cancer patients. Further combination of gemcitabine and other agents, including paclitaxel, is also feasible and has been actively studied in order to establish the role of gemcitabine in the management of treated and untreated ovarian cancer patients.

Adult↗
PubMedDate not supplied

Duodenogastric reflux and gastric mucosal polyamines in the non-operated stomach and in the gastric remnant after Billroth II gastric resection. A role in gastric carcinogenesis?

BACKGROUND: The relationship between bile reflux and gastric cancer is not defined. In order to verify whether a relationship exists, we evaluated the duodenogastric reflux and the mucosal polyamines concentration, polycation compounds actively involved in cell proliferation, in the non-operated stomach and in gastric remnant after Billroth II gastric resection, a precancerous condition. MATERIALS AND METHODS: The study was performed on three groups of subjects: A) 43 subjects with slight dispeptic symptoms, never operated on; B) 54 cholecystectomized subjects; C) 38 subjects operated on Billroth II gastric resection for duodenal ulcer. Duodenogastric reflux was assessed by measuring the concentration of bile acids in gastric juice and expressed as Fasting Bile Reflux in micromol/hour. Gastric mucosal polyamine concentration was assessed by High Performance Liquid Chromatography and expressed in nmol/mg of proteins. RESULTS: The lowest levels of Fasting Bile Reflux (7.95 micromol/hour) and polyamines (7.09 nmol/mg proteins) were observed in subjects never operated on. The middle values were present after cholecystectomy (Fasting Bile Reflux = 18 micromol/hour; polyamines = 8.14 nmol/mg proteins). The highest values were observed after Billroth II gastric resection (Fasting Bile Reflux = 830 micromol/hour; polyamines 11.74 nmol/mg proteins) (Kruskal-Wallis test, p = 0.0001). There was a positive correlation between Fasting Bile Reflux and polyamines (Spearman's rank = 0.33; p = 0.0008). CONCLUSIONS: High levels of duodenogastric reflux observed after Billroth II gastric resection are associated with high polyamine concentration in the gastric mucosa. Bile reflux can be considered an important causal factor of the increased risk of gastric stump cancer after Billroth II gastric resection.

Adult↗
PubMedDate not supplied

[Cholelithiasis after total gastrectomy for gastric cancer].

After gastric resection for peptic ulcer and total gastrectomy for Zollinger-Ellison syndrome, there is an increased prevalence of cholelithiasis. In order to assess whether this increased prevalence also exists after total gastrectomy for cancer, we evaluated the rate of cholelithiasis (echographic diagnosis) both before and after this operation. Between 1980 and 1990, 89 patients underwent total gastrectomy for cancer in the Surgical Department of our Institute. The pre-operative prevalence of gallstones was 5% in the males and 13.8% in the females. Seventy-four of the eighty-nine patients (83%) were examined post-operatively (7 patients with pre-operative cholelithiasis, 3 who died during the post-operative stay and 5 lost to follow-up were excluded from the study). The median post-operative follow-up was 24 months (range 3-115 months). The post-operative prevalence of cholelithiasis in the 74 patients was 39.6% in the males and 19% in the females. We also calculated the expected frequency of gallstones in both the pre- and post-operative groups from prevalence data in the population of the city where our Institute is based (taken from an echographic survey). We then compared the observed frequency of cholelithiasis with the expected frequency and we found that the difference in pre-operative frequencies, both in the males and females, was not statistically significant (p > 0.05). The same was true of the post-operative frequencies in the females (p = 0.48), but in the males there was a statistically significant difference between the observed frequency of cholelithiasis and that expected after total gastrectomy (p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Emergency endoscopy in upper gastrointestinal hemorrhage].

The paper reports a series of 236 patients who underwent emergency esophagogastroduodenoscopy (EGDS) (within 48 hours of hospitalisation) due to hemorrhage of the upper digestive tract. A definitive diagnosis of the of bleeding was made in 233 (98.7%) cases. In 1.3% of cases, endoscopic tests proved negative. The most frequent cause of bleeding was duodenal ulcer, followed by esophageal varices. Hemorrhage was caused in only 46.2% of 80 cirrhotic patients by the rupture of esophageal varices, whereas in the remaining 53.8% of cases the source of hemorrhage was a lesion associated to esophageal varices. Surgery was necessary in 15 patients (6.4%). The death rate within 30 days was 5.5%. In conclusion, emergency EGDS performed within 24 hours of hospitalisation is the most precise diagnostic technique for upper gastrointestinal bleeding.

Adolescent↗
PubMedDate not supplied

[Prevention of duodenal ulcer recurrence by the use of anti H2. Comparison of continuous long-term and seasonal therapy].

The Authors have assessed the incidence of ulcer recidivation in patients with cicatrized bulbar ulcers following anti H2 treatment using two maintenance therapy protocols: 1) 400 mg/day of cimetidine in a single evening dose for 1 year (continuous therapy); 2) the same dose of cimetidine administered at the same time but only for 4 months a year (February-March and September-October) (seasonal therapy). Ninety patients with cicatrized ulcers which had been diagnosed using endoscopy were randomly assigned to the two treatment protocols. Protocols were followed for a least one year with endoscopic controls every 6 months. There were no significant differences between continuous and seasonal therapy in relation to the recurrence of duodenal ulcers (Log Rank test p less than 0.05). Cox's proportional hazard model was used to assess the effect of the two treatment protocols on ulcer recurrence eliminating the influence of sex, age and smoking; it was seen that only smoking influenced the incidence of recidivation (p less than 0.05). These results suggest that seasonal maintenance therapy with anti H2 is as efficacious as continuous therapy in preventing the recurrence of ulcers.

Adult↗
PubMedDate not supplied

[The role of emergency colonoscopy in colorectal hemorrhage].

The diagnosis of lower intestinal hemorrhage usually follows the successive sequence: a) digital rectal examination, b) rectosigmoidoscopy, c) barium enema, d) colonoscopy. This latter method has proven to be the most sensitive. This study is a retrospective examination of the results obtained by emergency colonoscopy on the diagnosis and treatment of lower intestinal hemorrhage. Out of 1258 colonoscopy procedures performed between January 1983 and June 1988 in the Digestive Endoscopy Unit of our Institute, 44 (3.5%) were emergency procedures (within 48 hrs. after recovery) due to lower intestinal hemorrhage. The most frequent causes of hemorrhage found were the following: 1) hemorrhagic colitis (20.5%), 2) polyps (13.6%), 3) hemorrhoids (13.6%), 4) carcinoma (9.0%). The hemorrhagic source was not established in 9 cases (20.5%). The sensitivity of this method was therefore 97.2%. In 6 cases of hemorrhagic polyps treatment to stop bleeding was also possible by means of the colonoscopy (endoscopic polypectomy). In our experience, the emergency colonoscopy was found to be a highly sensitive diagnostic procedure for lower intestinal hemorrhages, permitting even definitive treatment of the lesion in 13.6% of cases with no complications associated with the technique. We feel therefore that, when available, it should be considered the first and foremost exam to be performed for emergency diagnosis of colo-rectal hemorrhages.

Adolescent↗
PubMedDate not supplied

[Chronic inflammatory diseases of the intestine. Extra-intestinal manifestations and perianal complications].

Extraintestinal manifestations and perianal complications were examined in 69 patients with ulcerative colitis (UC) and in 29 patients with Crohn's disease (CD). 17.5% of patients with UC presented an extraintestinal manifestation or a perianal disease against 48% of patients with CD. Over all, joint disease turned out to be the most frequent manifestation, but its frequency is significantly higher in patients with CD (27%) than in those with UC (3%). In the latter the most frequent disease is cholelithiasis (7%). This percentage is the same in both groups of patients. In 1.5% of patients with UC and in 14% of patients with CD perianal complications appeared; all patients with CD showed a colonic involvement.

Adolescent↗