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F Palladino

Publications and source records attributed to F Palladino.

24 records · Page 2Linked to original sources
PubMedDate not supplied

Endoscopic pancreatic stenting in pancreatic cancer.

Most pancreatic carcinomas are unresectable at the time of diagnosis; therefore, palliative treatment is very often the main concern of clinicians in this setting. The main symptoms resulting in the need for palliation in pancreatic cancer are obstructive jaundice, duodenal obstruction and pain. Therapeutic endoscopy plays a major role in the palliation of obstructive jaundice by stent placement into the biliary ducts. Initial experience has also been gained recently with endoscopic placement of expandable metallic stents to treat gastric outlet obstruction. Much less is known about the possible role of endoscopic pancreatic stenting in patients with unresectable pancreatic carcinoma. The main indication for pancreatic ductal stenting is 'obstructive' pain related to meals in patients with dilated main pancreatic duct beyond the stricture and intraluminal brachyradiotherapy. The technique of endoscopic pancreatic stenting does not substantially differ from that applied on the biliary tree. When technically possible, placement of 10 French plastic stents is preferred. According to the authors' indications, only about 15% of patients with advanced pancreatic cancer (55 of 355 in the present study) may potentially benefit from this technique. Pancreatic stenting may be obtained in more than 80% of these selected patients, with low morbidity (less than 10%) and no procedure-related mortality. According to the authors of the present and other studies reported in the literature, about 60% of patients treated because of 'obstructive' pain become symptom-free, and another 20% to 25% significantly reduce the amount of analgesic drugs required. Intraluminal brachyradiotherapy with 192iridium in the main pancreatic duct is a feasible and safe method to deliver high radiation doses to the tumour while sparing adjacent organs. Brachyradiotherapy may be performed alone or in conjunction with external beam radiotherapy. Because of the small number of patients suitable for this treatment, only a multicentre study will be able to detect whether intraluminal brachyradiotherapy in pancreatic cancer may have any positive impact on survival.

Abdominal Pain↗
PubMedDate not supplied

MRI assessment of ventricular function.

Cine-MRI is a robust non invasive technique able to assess regional and global systolic function of both ventricles. Conventinal cine-MRI was used for LV global function parameters both on horizontal long axis and vertical long axis, applying area-length methods, as in echocardiography. Recent developments of segmented k-space techniques allowed breath-held cine-MRI, making possible a rapid acquisition of the entire ventricles, both left and right. Using the Simpson's rule volumes are estimated with high accuracy, without any geometrical assumption; this method is considered gold standard for global function assessment. Regional function is studied by cine-MRI both qualitatively and quantitatively, as it represents the best technique in defining endo- and epi-cardial borders. The ability of quantify wall thickness and wall thickening makes cine-MRI highly suitable for stress-imaging, both in ischemia detection and viability assessment. Tagging is a novel technique, able to assess the complex mechanism of myocardial contraction and to quantify myocardial strain. Finally MRI is also able to assess diastolic function with phase velocity mapping.

Exercise Test↗
PubMedDate not supplied

[Composite bypass using endarterectomized autologous superficial femoral artery. A valid concept in the extension of lower limb salvage surgery].

Saphenous vein is nowadays the material of choice performing on femoro-distal revascularisation; when this is not available, it is important to use a material which gives the closest approximation of an ideal conduit and for same time an easy handling during the execution of the anastomosis. Although vein's degenerative alterations are very rare, it has now been shown that there is widespread destruction of the endothelium among infrainguinal vein grafting, producing a relatively thrombogenic surface. These factors may contribute to the initial failure rate of these bypasses. For this reason we suggest to employ a segment of thromboendarterectomized SFA (superficial femoral artery) as a distal part of a composite bypass. Twenty-four composite bypasses were performed using three different methods over a total of 123 femoro-distal revascularizations. Eighteen months follow-up showed more than 50% and more than 75% patency rate comparing type B (graft or thromboendarterectomized SFA + autogenous saphenous vein) and type C (thromboendarterectomyied SFA + graft). We believe, waiting for a wider follow-up, that this technique could be a valid alternative to a femoro-distal revascularization when saphenous vein is not available.

Adult↗
PubMedDate not supplied

Successful vascular reconstruction after inadvertent femoral artery "stripping".

A case of total stripping of the femoral axis secondary to saphenectomy is reported. This type of accident is followed by amputation unless quickly recognised and corrected. A combined saphenous vein and PTFE graft interposed between the origin of the superficial femoral and the distal part of the posterior tibial remained patent for three months. Its eventual thrombosis, however, did not result in loss of the limb, because a sound compensatory circulation had been established in the meanwhile. It is therefore felt that repair surgery is always worth attempting, even in the case of extensive arterial lesions that will otherwise necessitate amputation.

Adult↗