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Biomedical subjects

D Turco

Publications and source records attributed to D Turco.

16 recordsLinked to original sources
PubMed2006

PTFE mesh in renal allograft compartment syndrome.

We report a case of anuria in a 42-year-old female kidney transplant patient that occurred secondary to extrinsic compression from a large kidney being placed extraperitoneally in a small iliac fossa. Prompt reexploration in the immediate postoperative period resulted in salvage of the graft with restoration of kidney function. The abdominal wall was reconstructed using prosthetic mesh, which decreased the compartment pressure within the iliac fossa sufficiently to allow the renal vein patency and the kidney perfusion. We think that this tension-free surgical technique should be applied in those cases in which the retroperitoneal space is less than the size of the kidney to avoid renal allograft compartment syndrome or incisional hernia.

Adult↗
PubMed2006

Use of marginal donors in kidney transplantation: our experience.

The use of elderly donors has been advocated to expand the organ donor pool because of increased needs and the organ shortage. The aim of this study was to analyze whether the use of elderly donors and marginal kidneys affected the outcome of renal transplantations. Herein we presented data on 126 kidney transplantations performed from January 1996 to September 2003 using 32 marginal donors (group A) and 94 ideal donors (group B). We analyzed the medical and surgical complications and the graft survivals at a median follow-up of 18 months. Medical and surgical complications occurred in 22% and 5% versus 7% and 4% in groups A and B, respectively. The mean cold ischemia time and the mean age were greater for patients undergoing kidney transplantations from marginal donors. No differences were observed in graft survival in groups A and B. In conclusion, our data suggested that with an appropriate strategy and a correct selection of patients, marginal kidneys can be safely used to decrease the gap between demand and supply.

Cadaver↗
PubMed2000

Hospitalization for peptic ulcer bleeding: evaluation of a risk scoring system in clinical practice.

BACKGROUND: Upper gastrointestinal tract haemorrhage is a common cause of hospitalization: resource utilization in management of peptic ulcer bleeding varies considerably with no apparent effect on patient outcome. Several risk score systems based on endoscopic and clinical data have been proposed and validated in order to aid patient management. AIM: To assess clinical reliability of a scoring system and to define guidelines to improve efficiency of patient management without reducing efficacy METHODS: We considered all patients admitted to our unit for bleeding peptic ulcer over a one-year period. Every patient had an early endoscopy (within 12 hours) and therapy according to the appearance of the ulcer defined by Forrest classification. All subjects were classified into low-, intermediate- and high-risk patients on basis of clinical and endoscopic features according to "Cedar Sinai Medical Center predictive index" which was applied retrospectively in first six months then perspectively for the last period using the results obtained from first semester. For each risk group, we compared Length of Hospital Stay number of blood units used in transfusion, rebleeding rate, need for surgery as well as mortality in the two periods, using Student t test. We correlated Length of Hospital Stay and every score parameter by applying analysis of variance to results over the one-year period. RESULTS: Study population consists of 91 patients. Recurrent bleeding was observed in only three entering the high-risk group, only one of whom needed surgery Overall mortality was 9.8% (9 patients, only one for rebleeding). Variance analysis showed that the only parameter of the "Cedar Sinai Medical Center predictive index" which correlated with Length of Hospital Stay was comorbidity (p < or =0.05). Comparing the two periods, a close application of the score in the last six months allowed Length of Hospital Stay to be reduced in low-risk patients (t test with p=0.004) resulting in early discharge of 33% of cases without affecting patient outcome. CONCLUSIONS: This study confirms the reliability of the "Cedar Sinai Medical Center predictive index" in clinical practice improving the strategy of applying economic resources. Longer Length of Hospital Stay of intermediate- and high-risk groups is influenced more by comorbidities than by endoscopic findings. Early discharge was possible in one third of low risk patients. An accurate evaluation clinical para meters on admission together with early endoscopy may achieve the goal of reducing costs with a correct patient management.

Adult↗
PubMed1994

Cocaine alters the onset and maintenance of maternal behavior in lactating rats.

Though much attention has been devoted to the behavioral and physiological consequences of cocaine abuse in offspring, little is known regarding the effects on the maternal behavior of the cocaine-exposed dam. We examined whether cocaine affects the initiation (late pregnancy) and/or maintenance (postpartum [PP]) phases of full maternal behavior (FMB; retrieving, grouping, and crouching over six pups) in Sprague-Dawley female rats. In Experiment 1, cocaine (5.0 or 10.0 mg/kg) or saline was administered on PP day 5 or 6 and FMB scored. Both dosages significantly disrupted FMB, particularly crouching, though 10.0 mg/kg had a greater effect on FMB. Experiment 2 (using 10.0 mg/kg cocaine) examined specific elements of the disruption and found significant reductions in proportion of females engaging in FMB, as well as increases in the latencies to contact, retrieve, lick, group, and crouch over pups. In Experiment 3 osmotic pumps containing 20 mg cocaine/kg/day or saline were implanted SC in day 14 pregnant rats. FMB testing was performed on days 1-2 postpartum together with a T-maze pup-retrieval test on postpartum days 3-5. Cocaine disrupted FMB in the homecage, in general, rendering the females less attentive to young, but was without effect in the T-maze tests. Cocaine--perhaps owing to its purported dopaminergic activity--may operate through motivational mechanisms to disrupt FMB in the postpartum maintenance phase; and through effects on late pregnancy levels of prolactin (a hormone which stimulates FMB), to disrupt maternal behavior during the initiation phase.

Animals↗
PubMed1991

[Ventricular hypoplasia in congenital heart diseases].

Twenty-seven cases of autopsy showing hypoplasia of one of the ventricular cavities, prevalently the left, were selected from a series of 103 congenital cardiopathies (1979-1990). In 9 cases ventricular hypoplasia formed part of complex malformative syndromes with a well-known physiognomy: a further 18 cases showed a complete (9 cases) or incomplete (9 cases) hypoplastic heart syndrome. Subjects were prevalently female and the presence of other malformations indicating a genetic dysfunction was less evident than in other cardiopathies. The different pathogenetic hypotheses are discussed in the light of macro- and microscopic morphological factors, of which the most plausible is that involving an anomalous position or orientation of the musculo-membranous folds which give rise to the septation system of the various metamers of the cardiac tube.

Autopsy↗
PubMed1986

Normalization of bronchial exocrine pathology after endobronchial treatment with ambroxol.

A clinical study was performed on nine adult in-patients suffering from chronic intercrisis bronchopneumopathy, to evaluate whether a local endobronchial treatment with ambroxol could be effective in stabilizing the secretory activity of bronchial glands modified by phlogistic injury. The patients underwent bronchoscopic examination and deep biopsy, before and after treatment with local medication of ambroxol every other day for 30 days. In addition to morphometric measurements, detailed histochemical examinations were performed on the secretion of mucous acinic and glandular excretory ducts. The trial proved that the treatment with ambroxol stimulates serous acini, restoring normal production of sulphomucins and also of mucous acini, increasing the metabolic activities of acid glycoproteins and proportionally curtailing the excessive synthesis of glycoproteins. Ambroxol can therefore be considered a mucoregulating drug.

Adult↗
PubMedDate not supplied

[Cardiac malformations with septal defects. Apropos of a case of biloculate heart with transposition and aortic atresia].

The Authors describe a case of uniatrial univentricular heart with a right transposition and atresia of the aorta. This case forms part of an autoptic series of 74 congenital cardiopathies with defects of the septal system: monometameric (52 cases), polymetameric (22 cases), and limited (66 cases) or broad DIA, DIV or FAP types (8 cases). Having outlined the correlations between the type of defect and the complex morphogenetic events, whose close integration leads to a continuous septal system, the Authors focus their attention on the common associations between septal defects and other cardio-vascular anomalies (66 cases). The analysis of findings supports hypothesis that many of these are due to alterations in the position and direction of individual septal buds are should be seen against the overall background of septal pathology. Under these circumstances the pathogenetic importance of alterations of the complex movements presented by the cardiac type during the course of septal development and, to an event greater extent, possible alterations of the embryonal hematic flow are underlined.

Aortic Valve↗
PubMedDate not supplied

[Hepato-biliary complications of estro-progestin therapy].

A brief account of the most frequently observed side-effects of the protracted administration of oestroprogestinic substances is followed by a detailed explanation of the damage they may cause to the hepatobiliary apparatus: cholestatic icterus; cholesterolic biliary lithiasis; benign and malignant liver neoplasias. Reference is made to the liver diagnosis problems the practitioner may encounter when dealing with patients treated with these substances. Stress is laid on the need for close monitoring of tolerance and the possible effects of oestroprogestinic management on liver and bile function.

Carcinoma, Hepatocellular↗