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E Luna

Publications and source records attributed to E Luna.

47 records · Page 3Linked to original sources
PubMed1981

[Surgery of the rheumatoid forefoot].

The problem of surgery of rheumatoid forefoot is discussed. Particular attention is paid to pre-operative evaluation of the patient, who, in view of the multi-articular involvement of the disease, must be considered as a whole. The importance of the clinical investigation and the collection of radiological, photographic and instrumental data for correct performance of the operation is stressed. Lelièvre's operation of resection and alignment of the metatarsal heads is described by the Authors, with the aims that are proposed. Lastly attention is drawn to skin problems, due to precarious vascularisation especially at the level of the hallux, which in these rheumatoid patients may cause delays in cicatrisation.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Progression of renal insufficiency in the pre-end-stage renal disease setting].

The rate of decline of renal function (RDRF) in the pre-end stage renal disease setting (pre-ESRD) is highly variable. Several factors have been involved as potential modifiers of renal failure progression. This retrospective study attempts to establish which were the main determinants of the RDRF in pre-ESRD patients followed in the predialysis consult. The study group consisted of 230 patients with pre-ESRD not yet on dialysis who were referred to the predialysis consult from January 1998 to July 2002. The mean follow-up time per patient was 356 days. RDRF was assessed as delta of the average of creatinine and urea clearances (CrCl-UCl). Data obtained at time of referral to the predialysis consult were analyzed as potential predictors of the subsequent RDRF. These independent variables included: demographics, comorbid conditions, main hematological and biochemical data, antihypertensive and statin treatment, mean blood pressure, and CrCl-UCl at time of referral. The predictors of delta CrCl-UCl were determined by multiple linear regression analysis. The determinants of the survival without dialysis were established by the Cox regression hazard model, adjusted to renal function at time of referral. Mean CrCl-UCl at time of referral was 10.98 +/- 2.58 ml/min/1.73 m2, and mean delta CrCl-UCl was -0.37 +/- 0.46 ml/min/1.73 m2/month. Patients with diabetic nephropathy and chronic glomerulonephritis had the fastest RDRF, while patients with ischemic nephropathy and chronic interstitial nephritis had the slowest RDRF. Seventy-five patients (46%) required EPO therapy. The best determinants of delta CrCl-UCl were: the 24-hour proteinuria (p < 0.0001), and the hematocrit at time of referral (p = 0.0024). The best determinants of the survival rate without dialysis during the study period were: the proteinuria (in g/24 hours) (R 1, 16; p < 0.0001), the hematocrit at time of referral (OR: 0.88; p < 0.0001), the treatment with EPO (OR: 0.59; p = 0.02), and the diagnosis of diabetes mellitus (OR: 1.59; p = 0.01). In conclusion, apart from the rate of proteinuria, which could represent the best marker of the RDRF in chronic renal diseases, the development of anemia was associated with faster decline in renal function.

Erythropoietin↗
PubMedDate not supplied

[The surgical treatment of nodular thyroid lesions: our experience. Analysis of 462 cases].

Nodular thyroid lesions are the most frequent endocrine diseases in the general population. The surgical procedure is indicated for nodular thyroid tissue degeneration, or when the suppressive pharmacologic therapy is less efficient, even if sometimes both factors are associated. In Authors' study 462 patients were observed who underwent surgical procedures for thyroid diseases between January 1997-April 2003. In the thyroid pathology, either uninodular or multinodular, the surgical therapy adopted is total thyroidectomy, according to other Authors. The aim of total thyroidectomy is to avoid recurrence and simplify long term pharmacologic treatment. Although the question about the surgical approach (total thyroidectomy vs lobectomy) is still open in the case of single monolateral lesions, on the basis of their experience the Authors believe that the first is the best procedure. For diffused or malignant nodular thyroid pathology, on the contrary, total thyroidectomy is widely adopted.

Adult↗
PubMedDate not supplied

[Laparoscopic adrenalectomy: our preliminary experience].

INTRODUCTION: In 1992, Gagner described the first laparoscopic adrenalectomy. Since then this technique has been more and more widely employed and several studies confirmed its advantages, comparing to the traditional approach, in terms of reduction of mean hospital stay and therefore of the health expense. PATIENTS AND METHODS: The Authors' preliminary experience spreads from March to November 2003 when 4 patients were studied and thus underwent a transperitoneal laparoscopic adrenalectomy: 2 of them were affected by Cushing syndrome, 1 by pheochromocytoma in MEN and 1 by an incidentaloma. The transabdominal access in lateral decubitus with 4 trocars was performed. RESULTS: No complication was reported with a minimal need of analgesic drugs. The mean hospital stay was 4 days and all patients were discharged 48 hours after surgery. The mean diameter of nodules was 40 +/- 30 mm. The definitive histological examination showed 2 cortical adenomas, 1 diffuse cortical hyperplasia and 1 pheochromocytoma. CONCLUSIONS: This preliminary report confirms the optimal results of other experienced authors. Further interventions will be necessary for improvements and technical requirements.

Adenoma↗
PubMedDate not supplied

Computerized axial tomography in investigations of the rheumatoid knee.

It is essential when deciding on the therapeutic approach to the rheumatoid knee--medical or surgical--to make a precise and thorough assessment of the joint situation as a whole. In order to overcome the limitations of traditional X-ray methods, the Authors used computerized axial tomography (C.A.T.) to study the knees of twenty rheumatoid arthritis patients. They analysed three particular sections: the first at the level of the subquadriceps bursa, the second through the femoral condyles, and the third through the proximal tibio-fibular joint. C.A.T. permits an assessment of the conditions of the muscles and any hypertrophy of the synovial membrane; this kind of investigation reveals them clearly. It was possible to make an accurate investigation of the femoro-patellar joint and of lesions involving the femoral condyles and tibial plate. The findings indicate that C.A.T. in the study of the rheumatoid knee provides information on the soft tissues that cannot be obtained by traditional radiological methods. It also shows with greater precision the extent and morphology of bone lesions to the joint heads, an extremely important question in planning the use of prostheses.

Arthritis, Rheumatoid↗