Biomedical subjects
Publications and source records attributed to F Ricci.
In the last years, the emergency endoscopic treatment has greatly reduced the number of non-variceal gastro-duodenal haemorrhages treated by surgery. The authors review the literature from 1980 to 1990 in the light of personal clinical experience and formulate a surgical protocol of the cases not healed by medical or endoscopic therapy.
Since 1982, 2911 adult AIDS cases have been officially reported in Italy up to December 31, 1988. The clinical presentation of all cases, reported to the Istituto Superiore di Sanità, Rome, and contained into the National AIDS Register, has been analyzed, with particular attention to opportunistic infections. 168 cases (mainly homosexual men) were found exclusively affected at diagnosis by Kaposi's Sarcoma (KS), while the other 2743 patients were affected by opportunistic infections and/or other pathologies. At diagnosis, 23.5% of patients had Pneumocystis carinii pneumonia (PCP), 32% esophageal or pulmonary candidiasis, and 7% cerebral toxoplasmosis. A decrease in frequency of Cytomegalovirus (CMV) diseases has been observed, as well as an increase of HIV encephalopathy from 1982 to 1988. The clinical picture of full-blown AIDS showed stability during the whole period of observation, with slight geographical variations.
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The authors shortly report on the frequency and the peculiar clinical picture in the paediatric age. The usefulness of the pharmacological control (Ranitidine i.v. 50 mg thrice for 3 days) of acute haemorrhagic compliances is discussed in reference to the patient. The same drug was continued per os for two month at a dosage of 150 mg twice daily followed by 150 once daily for 8 months; during this period no relapses were observed and an endoscopic control did show the anatomical recovery of the ulcer. The authors underline also the good compliance and the absence of side effects of the drug employed.
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The authors relate and comment on the results of admission for measles in the Hospitals of Chieti and Pescara, in the period between 1974 and 1983. The authors have studied the number of admissions and their duration; moreover, they have evaluated the relationship with the pediatric population of the considered area. They point out the importance of the complications of measles to determine the admission's length to Hospital.
The nurse's opinion and their feelings and attitudes toward the parents visits in coronary (CCU) and intensive care (ICU) units was evaluated. A questionnaire with closed questions was sent to 60 coronary care and intensive care units respectively. 50 questionnaires (41.6% were returned). Patients access to the wards is very dishomogeneous, with greater variability among ICUs. On average, patients are allowed to visit their relatives 1.35 hour/day, divided in two entry times. Only in 19% of wards (38 wards) there are exceptions to these rules. Nurses are not allowed to give any kind of information to relatives in 25% of wards, because this is considered a doctors' task. Probably the part of the limitations to the access of the relatives are due to organizative problems, but, according to the nurses, there are major opportunities for improvement.
Colectomy with ileo-rectal anastomosis (IRA) was introduced in the 'fifties as an alternative to proctocolectomy with ileostomy in patients with ulcerative colitis (UC). Seventy-four patients affected by UC and submitted to IRA were followed up with clinical, endoscopic and histological controls for a median follow-up period of 9.5 years (range: 3-25 years). The long-term outcome was assessed by evaluating the course of the proctitis, the need for medical therapy, functional results, the need for rectal excision, and mortality during the follow-up. The patients were classified in three groups according to the type of the outcome (success: low-relapsing proctitis, rare or no need for medical therapy, good functional results; partial failure: relapsing proctitis with frequent need for medical therapy and/or poor functional results; failure: necessity of proctectomy). In order to define the prognostic value the clinical characteristics at surgery (age, gender, duration of disease, rectal inflammation, and type of surgery) were compared in the three groups. The long-term outcome was judged as a success in 46 patients (62%), partial failure in 19 patients (26%) and failure in 9 patients (12%). Only one patient developed cancer in the rectal stump (incidence: 1.3%). None of the clinical parameters at surgery except rectal inflammation influenced the outcome: patients showing moderate or severe inflammation in the rectum at surgery had a higher failure rate than those with mild or no inflammation (p < 0.02). These data confirm that colectomy with IRA is a safe surgical procedure with good functional results in most cases and with a low risk of cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
Villous tumor of the duodenum is a rare disease. The authors report their personal experience from 1987 to 1993 with nine cases of duodenal villous tumors. The treatment was pancreatoduodenectomy in four cases, segmental resection of the duodenum in two cases and submucosal excision in three cases. The authors review the literature of the last 15 years in which only 241 cases of duodenal villous tumors are reported; in this review the clinical, diagnostic and therapeutic characteristics of the disease are analyzed. This malignancy presents peculiar characteristics for histologic diagnosis and pathology classification. For this reason, even surgical treatment deserves careful reflection to guarantee a curative procedure and to formulate a positive prognosis.
Patients affected by Glanzmann's thrombasthenia often require blood and platelet transfusions due to bleeding. They may develop antibodies against platelet antigens and become refractory to platelet transfusions. In this study we present our approach to platelet transfusion in a thrombasthenic patient with platelet antibodies directed against gpIIb/IIIa. We found that platelets from two HPA1b/b donors were weakly positive when matched with the patient's serum. The patient was submitted to dental surgery and platelets were transfused before and after surgery to prevent bleeding. The patient did not experience transfusion reaction and good platelet recovery was observed.