Pancreaticogastrostomy for trauma: an alternative to distal pancreatectomy.
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Adult↗
Biomedical subjects
F Ghimenton
Publications and source records attributed to F Ghimenton.
Abdominal content containment: practicalities and outcome.
BACKGROUND: Alternatives to fascial closure of the abdominal wall are increasingly used in critically ill patients. They pose practical and logistical problems in management which are described in this single-institution study. METHODS: Between January 1994 and December 1997, 157 predominantly young male patients (100 trauma and 57 non-trauma) underwent temporary abdominal content containment (t-ACC) using plastic bags or polyglactin mesh. Indications for t-ACC were severe sepsis requiring reoperation, abdominal compartment syndrome, abdominal wall tissue loss or a combination of these. A total of 385 laparotomies were performed. RESULTS: Two t-ACC procedures failed owing to technical error and two were complicated by enteric fistulas. Six patients underwent early definitive abdominal closure within 15 days. The remaining survivors had a protracted hospital stay (mean(s.d.) 44.6(26.6) days) and all developed incisional hernias which were challenging to repair. The overall mortality rate was 44 per cent. CONCLUSION: Plastic bags were cheaper and as effective as polyglactin mesh for t-ACC. Survivors require a multidisciplinary approach in management, undergo a protracted hospital stay and later need complex incisional hernia repairs.
Abdominal Injuries↗
Congenital alimentary tract abnormalities presenting in adolescence and young adulthood.
Intestinal atresias and duplications of the alimentary tract commonly present in the neonatal period or early infancy, but in rare cases they can persist and present de novo during adolescence. We report on these two abdominal congenital anomalies, the clinical presentations of which in adolescence and young adulthood are unique.
Adolescent↗
Dextromethorphan test for evaluation of congenital predisposition to lung cancer.
We report the results of an investigation conducted in 992 healthy control subjects (854 adults and 138 adolescents) and in 116 subjects with lung cancer (LC) for the purpose of detecting those individuals with a possible genetic predisposition to lung cancer. The test consists of the oral administration of 64 mumol of dextromethorphan (DMP) with collection of urine samples over the following 8-h period and urine assay of the drug (DMP) and its main metabolite, dextrorphan (DOP). The ratio of the urinary concentrations of DMP to those of DOP is called the metabolic ratio (DMP/DOP) and is inversely proportional to the DMP demethylation rate. The pattern of the metabolic ratio (Log10 DMP/DOP) allowed, using a maximum likelihood approach, the identification of three subpopulations in the 854 control subjects (adults): (1) probable homozygous extensive metabolizers with Log10 DMP/DOP < -1.74 (73.1 percent); (2) probable heterozygous intermediate metabolizers with Log10 DMP/DOP in the -1.74 to -0.40 range (22.3 percent); and (3) probable homozygous poor metabolizers with Log10 DMP/DOP > -0.4 (4.6 percent). Most of the patients with LC (89 percent) were probable homozygous extensive metabolizers. As the latter have a cancer risk that is 2.54-fold greater than that of intermediate metabolizers (95 percent confidence interval [CI]: 1.37 to 4.73) and 7.43-fold greater than that of poor metabolizers (95 percent CI: 1.01 to 54.5), their identification by means of the DMP test may be particularly useful for subjects exposed to environmental and occupational carcinogens. The phenotype test used is similar to that of the debrisoquin test, but presents the advantage that DMP is a widely used, harmless drug with a faster and simpler urinary assay procedure.
Adolescent↗
[Thyroid nodular pathology: retrospective study of 917 surgical interventions].
A retrospective investigation of the surgical cases of seven hospitals in the Veneto region was made in order to assess the malignancy rate in thyroid nodular pathology, and the predictive value of scintiscanning with positive indicator.
Adenocarcinoma↗