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Biomedical subjects

E Morandi

Publications and source records attributed to E Morandi.

29 records · Page 2Linked to original sources
PubMed1986

Hyperalimentation of jaundiced patients on percutaneous transhepatic biliary drainage.

Although percutaneous transhepatic biliary drainage (PTBD) restores hepatic and renal function in patients with obstructive jaundice, it is not certain whether it reduces the rate of complications and death after biliopancreatic surgery. We studied the possibility that the operative risks of jaundiced patients are related to malnutrition and the usefulness of hyperalimentation with PTBD to reduce the incidence of complications. Sixty-four patients with obstructive jaundice and serum bilirubin greater than 200 mumol/l were randomized into two treatment groups (n = 32) with PTBD or PTBD + hyperalimentation. Four patients were withdrawn from the latter group, two for metastatic cancer and two for complications of PTBD. Before starting hyperalimentation, the incidence of malnutrition was assessed by biochemical, immunological and anthropometric tests: malnutrition was found in 70 per cent of the patients. All the patients had good recovery of hepatic function but patients treated with PTBD alone still had high mortality (12.5 per cent) and morbidity (46.8 per cent) after biliopancreatic surgery. When hyperalimentation was provided to patients on PTBD for a period of 20 days before the operation, the incidence of complications fell to 17.8 per cent and mortality to 3.5 per cent. These results suggest that the combined use of PTBD and hyperalimentation, improving both hepatic function tests and the nutritional status of jaundiced patients, can reduce the rate of complications after biliary and pancreatic surgery.

Bile↗
PubMed1982

Persistent immunologic abnormalities in long term survivors of kidney transplantation: role of different immunosuppressive treatments.

Although immunosuppressive treatment with corticosteroids and azathioprine has become a widely employed and highly effective mode of therapy in a variety of conditions, its influence on cellular and humoral immunity is still somewhat intriguing and controversial. In order to further investigate the status of the immune system during various maintenance immunosuppressive treatments, we have studied a group of 32 long term survivors of kidney transplantation who were treated with different immunosuppressive regimens. The present investigation demonstrates the presence of a persistent defect of T and B peripheral lymphocytes in long term kidney transplant recipients. Moreover, it shows that the immune deficits are influenced by the time-dose schedule of the maintenance immunosuppressive therapy but not by the duration of the treatment. In particular methylprednisolone in a daily dose schedule (8 mg per day as a single oral dose in the morning) with or without azathioprine (1.5-3 mg/kg per day as a single oral dose in the morning) produces a global defect of T and B cell populations, while the same dosage of methylprednisolone administered every other day (16 mg every other day as a single oral dose in the morning) in association with daily doses of azathioprine exerts a sparing effect on T cell populations. The humoral parameters do not show definite abnormalities. The factors that may have contributed to the genesis of the immune imbalances we have detected are discussed.

Adolescent↗
PubMed1982

Different survival of long-term kidney transplant recipients treated with daily or alternate day corticosteroids.

To define the effect of different immunosuppressive treatments on survival of long-term kidney transplant recipients, we have followed, for a period of four years, a group of 18 long-term survivors (more than three years) of kidney transplantation who were subjected to two different corticosteroid regimens (daily or alternate day corticosteroids) plus azathioprine. THis study not only confirms that an alternate day corticosteroid treatment reduces the incidence of infectious episodes and of side effects, but also suggests that it may steadily improve the survival of these patients. One of the six patients who performed an alternate day corticosteroid regimen died and only one lost renal graft function. On the contrary, three of the twelve patients who received daily corticosteroids died of causes related to immunosuppressive treatment, while another five patients lost renal graft function. A very low level of peripheral blood lymphocytes, of early E rosette and E rosette-forming cells was detected in patients who died of causes related to immunosuppressive treatment.

Adrenal Cortex Hormones↗
PubMed1979

[Some parameters of cellular immunity in renal transplantation after more than three years].

This paper evaluates the cellular immune system of 16 cadaver kidney transplant recipients more than three years after transplantation. The number and percent of active E rosette forming cells, of E rosette forming cells and of IgG and IgM bearing lymphocytes were determined; the blastogenic response of peripheral blood lymphocytes to PHA and PWM was studied in homologous and autologous serum. Significant alterations of the tests performed were found in patients who had undergone kidney transplant, suggesting a pathogenetic role of chronic immunosuppressive therapy but not excluding other possible factors.

Adolescent↗
PubMedDate not supplied

Migraine: traditional or "innovative" treatment? A preliminary case-control study.

The aim of this preliminary case-control study was to compare, in patients with migraine and PFO, transcatheter closure of PFO vs. medical treatments. Twelve patients were treated with antimigraine drugs and twelve underwent percutaneous transcatheter closure. All patients were followed-up for 12 months. Our preliminary results seem to confirm that, compared to medical treatment, PFO closure is by far more effective in reducing both frequency, duration and intensity of migraine attacks. Furthermore, the occurrence of prodromal aura is almost abolished.

Adolescent↗
PubMedDate not supplied

[Pneumocystosis of splenic localization in the course of HIV infection: a new indication for splenectomy. Description of a case].

Pneumocystis carinii is a common cause of interstitial pneumonitis in AIDS patients: it affects 85% of patients with cell-mediated immunodeficiencies. Extrapulmonary infection is much more infrequent and it is observed only in these patients who receive aerosolized pentamidine prophylaxis because of minimal systemic distribution of the drug. No case of extrapulmonary disease was observed in patients receiving systemic prophylaxis for Pneumocystis carinii with cotrimoxazole. The pathogenesis of extrapulmonary infection is not clear: it is probably connected with hematogenous or lymphatic dissemination from the lung. In a small number of case is due to reactivation of extrapulmonary foci or to a new infection. The management of disseminated infection of Pneumocystis carinii is medical: only recently a combination of medical and surgical approach was proposed for a patient with extrapulmonary infection. We report a case of 29 years old patient with AIDS with a demonstrated pulmonary and splenic localisation of pneumocystis carinii submitted to surgical splenectomy. The surgical decision was taken for several reasons: no response to medical therapy, the relative good general condition of the patient despite the immunological status, the presence of thrombocytopenia and abdominal pain in the left upper quadrant, and the risk of rupture of spleen. The post-operative course was eventful. We support splenectomy for splenic infection of Pneumocystis carinii in very small selected cases and only with palliative intent.

Adult↗