PubMed Health⌕ Search

Biomedical subjects

E Costantini

Publications and source records attributed to E Costantini.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Aneurysm of the hepatic artery. Report of a case].

Hepatic artery aneurysms are considered a rare event even though their report in the literature are becoming more and more frequent. A case of a 50-year-old man with common hepatic artery arterial aneurysm is reported. Initially, aspecific upper abdominal symptoms were found, but the great improvement in the diagnosis of vascular disease allows us to recognize this pathology which has a high risk of rupture so that an aggressive treatment is required.

Aneurysm↗
PubMed1998

The use of arterial allografts in aortic graft infections. A three year experience on eighteen patients.

BACKGROUND: We describe our experience in the treatment of aortic graft infections by replacing them with arterial homografts as suggested by the good results recently described. METHODS: Between March 1994 and March 1997 eighteen patients with infections of the aortofemoral bifurcation segments have been treated. All patients underwent a complete explantation of the infected graft and an in situ revascularization with arterial homograft harvested in multiorgan removal. Eight segments were freshly preserved, 10 were cryopreserved. Four patients were operated as emergencies, of which 3 for aorto-enteric fistulas. All others presented a serious septic state. RESULTS: Three patients died in the early postoperative period: one of acute infarction and two of homograft related causes. In the follow-up there was only one death from acute infarction, a branch occlusion and two allograft enteric fistulas successfully treated by surgery. All surviving patients are submitted to periodical haemodynamic and tomographic control with an average follow-up of 22 months (range 3 months to 3 years) and there has been no allograft degeneration so far. CONCLUSIONS: The use of homologue arterial allografts has shown good results in the treatment of serious aortic graft infections resulting in adequate peripheral vascularization. There have been no significant degenerations to date, either in fresh or cryopreserved allografts.

Aged↗
PubMed1997

The use of bifurcated and not reversed saphenous vein. Report of two cases.

BACKGROUND: This study was designed to determine the use of bifurcated and not reversed saphenous vein in different cases. CASE DESCRIPTION: We report two cases treated in the department of vascular surgery (Busto Arsizio, Varese, Italy) in which different arterial tracts had to be revascularized at the same time using not reversed autologus greater bifurcated saphenous vein. They are two different clinical situations (infection and very distal revascularization) treated by the same surgical technique. The two patients were subjected to angiographic examination in the pre- and postoperative period. During their follow-up, we carried out noninvasive surveillance (Doppler c.w.). The second were also subjected to bacterial culture and antibiogram to establish an adequate antibiotic therapy. The mean follow-up was 22 months: during this period rest pain disappeared and the trophic lesion recovered. CONCLUSIONS: In our experience, the use of not reversed and bifurcated vein was haemodynamically valid and able to maintain an arterial blood flow on the receiving arteries.

Arterial Occlusive Diseases↗
PubMed1996

Autologous adrenal medullary transplant in Parkinson's disease: critical review of our results in 13 patients.

Autotransplantation of the adrenal medullary to the caudate nucleus has been proposed for severe Parkinson's disease (PD). We describe our experience in 13 patients using a transperitoneal approach to the medullary and craniotomy for the implant: the neurosurgical equipe's decision to opt for craniotomy made quick removal of the medullary with minimal morbidity more difficult. The surgical technique are discussed. We evaluated also the impact of the procedure on urinary symptoms and sexual disturbances associated with PD. Results were disappointing. Four patients died post-operatively. The neurological pattern improved in three men and one woman. No significant improvement was observed in the urological and sexual dysfunctions.

Adrenal Medulla↗
PubMed1996

Renal cell carcinoma: histological findings in peritumoral tissue after organ-preserving surgery.

OBJECTIVE AND METHOD: This study assessed the involvement of peritumoral renal cell carcinoma tissue and evaluated the efficacy of partial resection versus enucleation by an anatomopathological investigation into the resection margins in 28 cases of partial nephrectomy. RESULTS: Histological findings showed no peritumoral infiltration in 91.6% of elective partial resections (24 patients) and resection margin involvement in 75% of necessary partial resections (4 patients). CONCLUSION: Although the debate between organ-preserving and radical surgery remains open, the conservative approach can undoubtedly be recommended in selected patients.

Adult↗
PubMed1996

[Femoro-distal revascularization with the saphenous vein in critical ischemias. An analysis of the results obtained and the criteria for choosing the most appropriate method].

Critical ischemia is a pathology which requires the collaboration of a number of specialists and is often burdened by high morbidity and mortality rates. There are several possible therapeutic solutions, although each has its limits. The authors present a series of operated cases and compare the results of two different but alternative surgical methods (in situ and reversed saphena by-pass) depending on the patient's conditions. Perioperative and long-term results were comparable in both groups of patients.

Aged↗
PubMed1994

Impact of thymopentin on the incidence and severity of postoperative infection: a randomized controlled trial.

The effectiveness of perioperative administration of thymopentin in preventing postoperative infection was evaluated in 206 patients with cancer (54 gastric, 152 colorectal) who underwent elective major surgery. Comparable subsets of patients were obtained with respect to age (proportion over 65 years) and nutritional status (patients with serum albumin level less than 30 milligrams or weight loss of 10 per cent or more of usual body-weight were considered to be malnourished). Patients were then randomly assigned to a control group or to a group receiving thymopentin. All patients received perioperative short-term antibiotic prophylaxis and postoperative parenteral nutrition. Levels of CD3-, CD4- and CD8-positive T cell subsets were evaluated before and after surgery in 20 (ten elderly) patients from each group. The severity of postoperative infection was evaluated using a sepsis score. In elderly patients thymopentin prevented the postoperative drop in CD3- and CD4-positive T cell subpopulations that was observed in controls (P < 0.05d). The postoperative infection rate was 17.5 per cent in the group given thymopentin and 24.3 per cent in controls (P not significant). The mean (s.d.) sepsis score was 6.7 (3.1) in the group receiving thymopentin and 9.4 (5.8) in controls (P not significant). Considering only elderly patients, the mean (s.d.) sepsis score was significantly lower in those treated with thymopentin than in control patients (6.9(2.1) versus 11.3(4.7)). In conclusion, administration of thymopentin did not significantly reduce the postoperative infection rate. However, it prevented the drop in number of CD3- and CD4-positive T cells after operation and reduced the severity of postoperative infection in elderly patients.

Adult↗
PubMed1994

Impact of enteral nutrition on intestinal bacterial translocation and mortality in burned mice.

The aim of these experiments was to study the effect of early enteral nutrition with either standard or enriched (arginine, n-3 fatty acids, RNA) enteral formulas on translocation of bacteria from the gut and acute mortality rate following thermal injury. In the first experiment 60 Balb c mice were gavaged with 10(10)Escherichia coli and received a 20% burn injury. In 40 mice enteral nutrition (20 standard, 20 enriched) was started immediately after injury and stopped 36 h later. In the control group (n = 20) aliquotes of Ringer's solution was administered intragastrically. Mortality rate was observed for 10 days post-injury. In the second experiment 60 Balb c mice were gavaged with 10(10)E. coli labelled with biotin(111) Indium and then burned. In 40 mice enteral nutrition (20 standard, 20 enriched) was started immediately after burn. The control group (n = 20) received aliquotes of Ringer's solution. 4 h after injury all animals were sacrificed and liver, lungs, kidneys, spleen and systemic blood were harvested, and radionuclide counts were measured. No animal died after day 3 post-burn. The mortality rate was significantly lower at day 1 in the groups infused with both enteral solutions (15%) compared to controls (30%; p = 0.05). At day 3 the animals fed with the enriched diets showed a lower mortality (5%) versus the standard and control groups (10%). Bacterial translocation to the liver and lungs was significantly higher in Ringer's group than in both enterally fed groups. Early post-burn enteral nutrition reduces both translocation and acute mortality. Supplementation of the diets with specific nutrients appears to exert additional advantages on outcome.

Journal Article↗
PubMed1994

Urethral syndrome: clinical results with antibiotics alone or combined with estrogen.

The urethral syndrome is very frequent in women but the etiology is unknown. In all 77 patients suffering from the syndrome, endoscopy revealed characteristic lesions in the trigonal area. As unidentified bacteria may be responsible, a microbiological investigation was carried out. Wide-spectrum or specific antibiotic therapy was prescribed as required. All patients were also randomized to 2 groups to assess the efficacy of local estrogen therapy. The authors concluded that wide-spectrum antibiotic therapy with macrolide and mepartricin should be the first choice of treatment and that local administration of estrogen does not significantly enhance the benefits achieved through antibiotic therapy. A detailed microbiological investigation is necessary when symptoms persist. Overall a positive result was obtained in 75.32% of the cases (58 patients). The presence of Streptococci negatively influenced the results of specific antibiotic therapy.

Adult↗
PubMed1994

[The therapy of congenital hypothyroidism].

In congenital hypothyroidism precocious diagnosis and consequent replacement therapy are necessary to prevent neurological irreversible damage caused by postnatal thyroid hormone deficiency. Synthetic L-thyroxine is the useful drug, that has to be administered in fasting condition to have the best absorption. Some points about the treatment are still discussed, such initial L-thyroxine dosage, biochemical control parameters and psycho-intellectual outcome in treated patients. The mean initial dosage in Italy increased from 7.5 +/- 2.2 micrograms/kg/day in 1987-90 period to 8.5 +/- 2.5 micrograms/kg/day in 1991, at a mean starting age of 34 and 26 days respectively. Therefore the dosage is modulated on the basis of serum levels of thyroid hormones and clinical signs. Some patients, in spite of a correct dosage of L-thyroxine, show a deficient suppression of TSH circulating level. In our experience this finding is sometimes due to the non-observance of the fasting condition when the drug is administered. Patients precociously identified by neonatal screening and correctly treated have a good mental and statural prognosis. In these patients, the psycho-intellectual development is better than in those diagnosed later clinically.

Child↗
PubMed1993

[Traumatic injuries of the urethra: an echographic study].

US in the lower urinary tract usually explores the bladder and the prostatic urethra. In this study we used US instead of x-rays to visualize the remaining urethra in 42 patients. US was useful in the presence of urethral trauma. The site and extent of injury, particularly peri-urethral lesions (hematomas, urinary collection and abscesses in relation to the urethra) were observed. Ultrasound's efficacy and reproducibility were also useful in post-operative follow-ups.

Adult↗
PubMed1991

[Ultrasonically guided access to the kidney].

Ultrasonography is an ideal procedure to guide and control the diagnostic and therapeutical percutaneous renal puncture. Some procedures considered in pre-echographic period, long, complicated and not free from risks and complications, were transformed in routine manoeuvres by the advent of ultrasound. Nowadays, thanks to the ultrasound guide, is possible to perform a rapid, accurate, safe and without anesthesia puncture of the kidney and of the upper urinary tract. Several procedures contemplating the renal puncture, can be performed in out-patients.

Biopsy↗
PubMed1986

[Therapeutic efficacy of mepartricin in the medical treatment of prostatic hypertrophy].

Fifteen patients in various stages of benign hypertrophy of the prostate were treated with mepartricin (SPA-S-160). Three tablets a day were given for a standard period of 60 days. The pharmacological effect of the drug was assessed both by traditional techniques and modern instrumental examinations like transrectal echography and urodynamic analysis. All 15 patients were studied on the basis of a protocol that incorporated standard diagnostic surveys before the start of treatment, numerous tests after 30 days and at the end of treatment. The overall clinical result was more than satisfactory especially in terms of the reduction in the frequency of daily and nightly urination. The echographic and urodynamic results were less spectacular. The drug was extremely well tolerated.

Aged↗
PubMed1980

[Value of the Di Maria leads in the electrocardiographic diagnosis of posterior myocardial infarct].

Authors retain, on the basis of their experiences, that right chest leads proposed by Di Maria for the infer-posterior and postero-basic myocardium wall study can overall be useful in those cases which had posterior myocardial infarction and where standard leads did not show variations or showed untrustworthy variations. Therefore Authors also supported by vectorcardiographic findings, recommend the routine use of Di Maria leads.

Electrocardiography↗
PubMedDate not supplied

Incidentally detected renal cell carcinoma: role of ultrasonography.

The widespread use of modern diagnostic imaging techniques, especially computed tomography and sonography, has led to the detection of an increasing number of serendipitous renal neoplasms, with no signs nor symptoms related to the neoplastic renal disease. In the last 4 years, 54 consecutive patients (20 females and 34 males) with renal cell carcinoma were reviewed. In 26 patients (48.15 per cent) the diagnosis was made as an incidental finding by an abdominal ultrasound examination. Clear signs and symptoms related to the neoplastic disease were present in 28 cases (51.85 per cent). The pathologic type of each neoplasm was categorized, and each carcinoma was staged. In the patients not surgically treated, the stage was determined on the basis of the diagnostic imaging reports. The results of this study suggest that the incidentally detected tumors are of a significantly lower stage than the symptomatic tumors (Wilcoxon rank sum test: P less than 0.0073 and X2 test: P less than 0.013). Early detection of renal tumors may improve the prognosis and the overall survival of patients with renal cell carcinoma and allow one to plan radical or partial nephrectomy, since local extension has a considerable impact on the operative strategy. Our experience emphasizes the role of ultrasound in the increased early detection of renal cell carcinoma.

Adult↗
PubMedDate not supplied

Recovery of sexual function after nerve-sparing radical retropubic prostatectomy: is cavernous nitric oxide level a prognostic index?

The preservation of NANC nerve fibers (producing nitric oxide, NO) is necessary for erection recovery after retropubic radical prostatectomy (RRP). Yet, it is impossible to establish when and if a patient will recover erections; therefore, we investigate the prognostic value of cavernous blood NO levels on this parameter. Nerve-sparing RRP was performed on 14 patients for localized prostate cancer. We evaluated all patients 3 months after surgery by IIEF score: no patients had erections. A cavernous blood sample was also taken to determine NO levels (as nitrite). Patients were evaluated again 18 months after surgery. In six cases, erectile function was compromised, whereas in seven cases, potency was restored. Statistical analysis showed a relationship between nitrite levels in cavernous blood 3 months after surgery and the recovery or erectile function at 18 months. We propose that cavernous NO blood levels are a prognostic index of erection recovery.

Aged↗