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Biomedical subjects

F Pomerri

Publications and source records attributed to F Pomerri.

At least 19 recordsLinked to original sources
PubMed2002

Treatment of heart failure and ascites with ultrafiltration in patients with intractable alcoholic cardiomyopathy.

BACKGROUND: In Western countries the excess of alcohol intake causes, secondary, non ischaemic cardiomyopathy and cirrhosis. Frequently, therapy is not effective so ultrafiltration was tried on patients affected, with positive effects on life quality. We tried to verify utility and tolerance to peritoneal ultrafiltration in a group of subjects affected by heart failure secondary to alcoholic cardiomyopathy, refractory to conventional therapy. METHODS: Sixteen patients (14 males, 2 females) with heart failure and ascites affected by alcoholic cardiomyopathy were studied. All subjects were in IV class NYHA (New York Heart Association); ejection fraction (EF) was evaluated by echocardiogram and ascites by abdominal ultrasound. Patients were submitted to clinical exam, body weight, abdominal circumference, diuresis and routine biohumoral exams, electrocardiogram and chest X-ray. Subsequently they underwent intermittent nocturnal peritoneal dialysis with a changing cycle of 6-12 hours per session. After 5 days, subjects were checked through echocardiogram and abdominal ultrasound. RESULTS: The patients mean age was 56.7 +/- 3.2 years. After ultrafiltration, all subjects showed decreased body weight, abdominal circumference and urea; there was an increase of diuresis and Natriuria. Fifteen subjects entered III NYHA class without variation of EF; all of them showed clinical and echographic reduction of ascites. Mean ultrafiltration quantity was 6.084 ml with mean dialysis hours 20; 7.36% of patients had fever that disappeared within 24 hours with antibiotic therapy. All subjects referred to feel well and the mean hospitalization period was of 7 day in spite of the usual 22 days.

Aged↗
PubMed2001

Defecographic measurements of rectal intussusception and prolapse in patients and in asymptomatic subjects.

OBJECTIVE: The aim of this study was to provide measurements for the defecographic diagnosis of rectal intussusception and rectal prolapse. MATERIALS AND METHODS: Four hundred thirty-seven consecutive patients with defecation and micturition disorders and gynecologic complaints were studied by means of defecography (120 patients), colpodefecography (17 patients), or cystocolpodefecography (300 patients). As a control group, 43 asymptomatic subjects underwent defecographic examination. RESULTS: Thirty-five patients were found to have rectal intussusception and 18, to have rectal prolapse. Anterior and posterior rectal wall folding thickness, intussuscipiens diameter, intussusceptum lumen diameter, and the ratio between the intussuscipiens diameter and the intussusceptum lumen diameter were measured in all patients. The findings were compared with those obtained in 13 of 43 asymptomatic subjects with rectal outline changes mimicking intussusception. Rectal folding thickness and the ratio between the intussuscipiens diameter and the intussusceptum lumen diameter were significantly greater in subjects with rectal intussusception and rectal prolapse than in asymptomatic subjects with rectal mucosa folding. CONCLUSION: Our findings suggest that dynamic evacuation radiology contributes to making a differential diagnosis between rectal intussusception and mucosal folds in the rectum.

Case-Control Studies↗
PubMed2001

Chronobiology of non fatal pulmonary thromboembolism.

BACKGROUND: It as been demonstrated that acute myocardial infarction, sudden cardiac death, stroke, and fatal pulmonary embolism show an increased onset rate during certain periods of the day, week, or year. According to some authors, the highest risk appears to occur in the morning, on weekends and during winter. This paper, therefore, intends to examine whether a circadian, weekly, or annual rhythm in the incidence rate of deep vein thrombosis (DVT) and non-fatal pulmonary embolism (PE) in ageing patients does exists. METHODS: A survey was conducted into 212 patients affected by DVT and PE, admitted to the Second Medicine Institute of Padua, Italy, over a period of two solar years. Thromboses were diagnosed via echo-Doppler examination of the legs and pulmonary embolism via perfusive and ventilatory scintiphotographs. RESULTS: In the overall sample, a circadian variation was found, both for deep vein thrombosis (peak at 12:26 hrs, p=0.001), and pulmonary embolism (peak at 10:26 hrs, p=0.001). A weekly, rhythmic recurrence was also found for the two complaints, with a peak on Saturdays, while no significant annual rhythmic recurrence was found. There was, however, a tendency towards an increase during the winter and summer months. CONCLUSIONS: The results may have important clinical applications, both in prevention and in the timing of drug dosage.

Chronobiology Phenomena↗
PubMed1998

The effect of heparin on trinitrobenzene sulphonic acid-induced colitis in the rat.

BACKGROUND: Reduced blood coagulability seems to protect against inflammatory bowel disease; pilot studies using heparin in patients with inflammatory bowel disease have reported positive results. AIM: To evaluate the effects of heparin treatment on microangiographic and on inflammatory parameters in experimental colitis, induced by trinitrobenzene sulphonic acid (TNBS)-ethanol. METHODS: Four groups of rats: (i) controls (saline enema), TNBS-induced colitis with (ii) sham treatment (saline, s.c.), (iii) dexamethasone (0.25 mg/kg/day s.c.) and (iv) heparin (500 U/kg t.d.s., s.c.). Microangiography was performed 2 and 4 days after colitis induction. Partial thromboplastin time, colonic wet weight, macroscopic damage score and mucosal myeloperoxidase (MPO) activity were determined at day 4. RESULTS: TNBS-induced colitis caused a reduction in visible bowel wall vessels, which was prevented by heparin (P < 0.05) but not by steroids. The macroscopic damage scores and colon wet weights were similar in all colitis groups. Compared to untreated colitis the MPO activity in heparin-treated animals was of borderline significance. CONCLUSIONS: Heparin treatment improved microangiographic features and reduced inflammation to a certain degree. Steroids delayed development of colon hypoperfusion, but were ineffective on MPO activity. It remains to be determined if the observed effects are due to the antithrombotic activity of heparin or to an anti-inflammatory action.

Animals↗
PubMed1995

Microradiographic anatomy of the explanted rat colon.

The colon of 32 healthy Sprague-Dawley rats was studied microradiographically. The colonic arterial distribution of 18 rats was examined after injecting barium sulfate into the isolated aorta. The mucosal surface in 9 rats was studied using double-contrast technique after colon explantation. In 5 animals arterial and mucosal studies were carried out simultaneously. The radiographic thickness of the colonic wall was measured using a comparative microscope. The specimens were observed, photographed and examined histologically. Unlike the cecum and distal colon which, when insufflated, do not have mucosal folds, the proximal colon exhibits folds in an oblique direction corresponding to that of the arteries, and the colonic wall in this region is thicker. Comparison between arterial and mucosal microradiographic anatomy and wall thickness enables the proposition of a simple nontopographic division of the rat colon into cecum, proximal colon and distal colon.

Animals↗
PubMed1994

[The National Workshop on Defecography: anorectal deformities with a functional origin (prolapse, intussusception, rectocele)].

The nonoperative treatment--i.e., rubber band ligation and sclerotherapy--of mucous rectal prolapse, rectocele and intussusception is much less expensive than conventional surgery (Lit. 325,000 vs. 6,500,000, p < 0.0001 on the average). Symptom relief, however, has been reported in 0 to 57% of cases only, according to current literature. A possible cause is represented by improper management from misdiagnosis, relying on clinical findings only, overestimating mucous prolapse in 36.37% of cases and underestimating intussusception in 14.22% of cases (with respect to defecography). Defecography is a cost-effective method (average cost: Lit. 37,000) potentially reducing failure rate after the surgical repair of rectal prolapse.

Ambulatory Surgical Procedures↗
PubMed1993

[National working team report on defecography].

A questionnaire concerning defecography was submitted to 5 national experts in order to: 1) quantify the demand and 2) develop a consensus report. The demand is currently 2-8 exams week and the most frequent indication (70%) is obstructed defection, with/without constipation. The highest discriminatory capabilities was exhibited by the following variables: a) the anorectal angle (ARA) on straining and b) the distance from the pubococcygeal line (PCL) on squeezing (101.2 degrees +/- 15 vs. 120.6 degrees +/- 13, p < 0.05 and 27.4 mm +/- 15 vs. 2.4 mm +/- 7, p = 0.005, respectively) in chronically constipated patients (mean age: 60 years) when compared to the control group; and c) PCL on squeezing and at rest (35.5 mm +/- 20 vs. 2.4 mm +/- 7, p = 0.005 and 38.9 mm +/- 18 vs 18.4 mm +/- 17, p < 0.05, respectively) in patients with severe incontinence with respect to healthy subjects. While sensitivity and positive predictive values of the test were highest (97 and 98% respectively) for rectocele, specificity ranked first (92%) in anal gaping.

Defecation↗
PubMed1992

Adjustable silicone gastric banding for obesity.

Adjustable gastric banding is the least invasive operation for morbid obesity. Forty-eight patients underwent surgical adjustable gastric banding between March 1990 and August 1991. In 15 of these patients, radiological examination was performed in the early postoperative period because of dysphagia and vomiting, revealing stenosis of the stoma in all cases (caliber less than 0.3 cm); in all patients we easily punched, with fluoroscopically guided observation, the inflatable portion and obtained a true calibration of the gastric banding. In seven patients radiological examination was performed 2 months after surgical treatment because of a lack of weight loss. Radiological findings explain surgical failure, revealing a too wide stoma in four patients, the absence of a gastric pouch due to a too high position of the band in two, and the caudal sliding of the banding in one patient.

Adult↗
PubMed1991

[Measurement of gastric emptying with Tc 99m. Technique and reliability of the test].

Among the various methods used to measure gastric emptying time, scintigraphy is nowadays the technique of choice. Since only few data are available on the operative characteristics of the method, the authors investigated reproducibility, sensitivity, and specificity of a modified scintigraphic technique for the measurement of gastric emptying time. Three groups of subjects--healthy volunteers, patients with functional dyspepsia, and patients with upper gastrointestinal conditions--were administered liquid meals having various standard consistencies (349 tests on the whole). In both healthy volunteers and dyspeptic patients the method had high sensitivity (72%), good specificity (69%), and low intra-subject variation (25%). In all cases, the increase in meal density produced a delay in gastric emptying. Dyspeptic patients had slow gastric emptying of high-fiber meals, while in duodenal ulcer and in atrophic gastritis emptying was significantly faster. The radionuclide method proved valuable in measuring gastric emptying and was useful to confirm the pathogenesis of the various conditions. As for functional and organic pathologic conditions, it allowed treatment efficacy to be evaluated.

Adult↗
PubMed1990

Role of proctography in severe constipation.

As referred to in the literature, patients complaining of constipation may have a spastic or, in the case of chronic staining, weak pelvic floor. Twenty-two severely constipated patients who did not improve after a high fiber diet were submitted to whole gut transit time (TT), proctographic, and anorectal manometric studies. A control group consisting of five subjects for TT, five subjects for proctogram, and ten subjects for manometry was also studied. Transit time was delayed (P less than 0.001) in all patients. Manometry in the constipated group showed a high rectal threshold (64.1 vs. 17.1 ml of air, P less than 0.01), but no other significant difference. Proctograms in 10 of 22 patients (Group A) showed no differences in the anorectal angle (ARA) and in its distance from the pubococcygeal line (DLPC) in respect to the control group; 12 of 22 patients (Group B) had a paradoxical closure of the ARA at straining in respect to resting position (101.2 degrees vs. 120.1 degrees), and a higher DLPC than Group A and the control group in all positions studied. There was no difference in TT for rectal stasis of radiopaque markers between the two pathologic groups. Patients in Group B were older than patients in Group A (55.3 vs. 42.9 years, P less than 0.05). In conclusion, proctograms showed alterations of the pelvic floor, but there was no correlation between protographic data and rectal or colonic stasis of the radiopaque markers, or clinic severity of constipation, but a correlation between ages did exist.

Adolescent↗
PubMed1989

Crohn's disease of the esophagus.

Esophageal involvement in patients with Crohn's disease is uncommon. Histologic proof is rarely obtained by means of endoscopic biopsies. Moreover, the natural history of this condition and its response to therapy are largely unknown. We report a case of biopsy-proven esophageal Crohn's disease, which presented with a stricture of the distal third of the esophagus and was successfully treated by progressive endoscopic dilatation.

Adult↗
PubMed1988

Pancreatic cancer: CT scan.

The results of 72 cases of histologically confirmed pancreatic neoplasm are reviewed. By applying a semeiological scheme, which considers intra and extrapancreatic alterations, it is shown that the possibility of a pre-invasive diagnosis on CT is still limited, and requires further confirmation. CT examination is unique for demonstrating the extension of the lesion, and provides truly probative findings for a specific diagnosis, especially when signs of direct local or distant invasion appear.

False Negative Reactions↗
PubMed1988

Pancreatic carcinoma, diagnostic ERCP.

Fifty-three patients underwent endoscopic retrograde cholangiopancreatography (ERCP). Thirty-eight patients had pancreatic disease, diagnosed on the basis of surgical and/or instrumental-clinical findings, and consisted of 17 cases of carcinoma (group A), 10 cases of chronic pancreatitis with benign stenosis of the pancreatic duct (group B), and 11 cases of chronic pancreatitis without stenosis (group C). Linear discriminant analysis was employed to evaluate differential diagnosis data relative to secondary pancreatic ducts. With this method, 16/17 patients (94%) were correctly assigned to group A (high sensitivity), 7/8 patients (88%) to group B, and 7/10 patients (70%) to group C. A readily found radiological sign, such as abrupt and/or irregular stenosis of the pancreatic duct enables the correct diagnosis of carcinoma, but while this criterion is highly specific, it is poorly sensitive. If a clearly neoplastic stenosis of the main duct is not present, an analysis of the secondary ducts is determinant.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1988

[Radiologic diagnosis of anal fistulae with radio-opaque markers].

Fistulography classifies anal fistulas in low-below puborectalis muscle-, high-above puborectalis muscle-, and middle. This classification increases the scope and accuracy of radical surgery. In order to improve the diagnostic reliability of anal fistulography the authors point out the importance of radio-opaque markers for anatomical definition of the anorectal region. Thirty patients (25 males and 5 females; mean age: 47 years) were studied by anal fistulography using radiopaque markers: a Foley's 22 Fr catheter, with distal balloon filled of idrosoluble radiopaque contrast medium, was placed in the anal canal; a metal marker was fixed to the anus. In order to demonstrate the relationship between fistula and puborectalis muscle, we subdivided the anal canal in 3 equal segments: high, middle and low. The idrosoluble contrast medium for fistulography is injected through a pediatric Foley's catheter 8 Fr when external opening is large enough, and through a K7072 endovenous catheter when the opening is small. Fistulous tract was visible in all patients: internal fistulous opening in 23/90 cases, and relationship of fistulous tract to puborectalis muscle in 25/30 (83.3%). In demonstrating either secondary fistulous tracts or abscesses, fistulography with radiopaque markers was correct in 60% of cases; in 20% of patients some of the above-mentioned complications were demonstrated, and in the 20% no complications at all were detected.

Adult↗
PubMed1986

[Duodenal and colonic involvement in neoplastic pathology. Anatomical and radiological considerations].

The authors present 3 cases of duodeno-colic involvement by malignant neoplasms and analyse the main radiological features. Benign and malignant duodenocolic fistulas are discussed and colic lesions caused by an extrinsic process. Guiding radioanatomical criteria are stated namely the alterations in the site of the principal lesion first and, afterwards, the morphological changes or displacement of the bowel.

Adenocarcinoma↗
PubMed1986

[Radiologic methods in the evaluation of upper esophagoplasties].

Post-operative radiologic control of esophageal plastic surgical procedures in pathologic conditions of the cervical esophagus involves difficulties due to the poor collaboration of the patient, who swallows only small quantities of contrast medium. Contrast medium injection through esophageal-gastric probes, and its reflux toward the cervical region with the Trendelemburg position and/or straining, enables the demonstration of fistulas otherwise unrecognized.

Administration, Oral↗
PubMed1985

[Radiological and instrumental study of the colon in idiopathic constipation].

It has been demonstrated that it is not always possible to attribute to constipation a reduced colonic transit time as being evidenced by radiological studies using radiopaque markers. In fact, in constipated patients with a normal transit time, it was more reasonable to consider a recto-anal disorder as evidenced by defecography and manometry.

Anus Diseases↗