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Biomedical subjects

G Rosso

Publications and source records attributed to G Rosso.

At least 19 recordsLinked to original sources

Chronic kidney disease is still present after renal transplantation with excellent function.

According to a k/DOQI work group, chronic kidney disease (CKD) can be present also in subjects with glomerular filtration rate (GFR) >90 mL/min or a serum creatinine (sCr) below 1.3 mg/dL. The aim of this study was to document the prevalence of clinical or biologic abnormalities among 190 cadaveric renal transplant patients with excellent and stable renal function at 6 months after transplantation as well as 5 years later. The recipients were 82 women and 108 men of mean age at transplantation of 44.56 +/- 11.73 years. All patients were on Neoral-based immunosuppression with at least 5-year follow-up. Mean sCr was 1.18 +/- 0.2 mg/dL. Mean GFR was 78.57 +/- 27.06 mL/min. Systolic blood pressure was >130 mm Hg in 56.6%, although 78.3% of patients were on antihypertensive therapy; 34.3% were anemic; 75.4% had serum cholesterol >200 mg/dL; 62.2% had serum triglyceride levels >170 mg/dL. Serum intact parathyroid hormone >100 pg/mL was observed in 38% of patients and 43% were on vitamin D supplementation, and 11.4% had developed posttransplant diabetes mellitus. With respect to controls, von Willebrand factor was higher in 81.2% (P < .0001; RR = 11); serum homocysteine levels in 75% (P < 0.001; RR = 7.61); PAI-1 in 37.5% (P = .0009; RR = 4). At 5 years posttransplantation we observed an overall improvement in these abnormalities. The vast majority of renal transplant patients with excellent graft function belong to stage 1 of CKD being affected by hypertension, dyslipidemia, anemia, and residual hyperparathyroidism. Markers of endothelial dysfunction were largely abnormal, a condition that could predispose to cardiovascular events.

Adult↗

Systemic lupus erythematosus: mortality and survival in Argentina. A multicenter study.

OBJECTIVE: To analyze the factors associated with mortality, survival and causes of death in patients with systemic lupus erythematosus (SLE) in Argentina. PATIENTS AND METHOD: A series of 366 patients with SLE (45 men and 321 women), mean age 29 y (range 11-70 y) and mean disease duration 6 y, was evaluated from 1990 to 1998. A total of 57 clinical, serological and therapeutic variables were studied. RESULTS: Five- and 10-year survival was 91% and 85% respectively. Forty four patients died (12%): 54% due to sepsis and 32% due to active SLE. Mortality risk factors included heart involvement CRR 3.82), hyperlipidemia (RR 2.72), renal damage (RR 2. 62), infections (RR 2.44), lung disease (RR 2.20) and myositis (RR 2. 07). High-dose prednisone (RR 3.4) or cyclophosphamide (RR 9.19) treatments increased the risk of sepsis (P=0.003) as a cause of death. However, corticosteroids, antimalarial agents and accumulated cyclophosphamide doses proved to be protective factors in overall mortality figures (RR <1). CONCLUSIONS: The main risk factors of death in SLE were heart involvement, hyperlipidemia and renal damage. Treatment with steroids, antimalarial agents and cyclophosphamide improved survival. High-dose corticosteroids and cyclophosphamide were associated with sepsis as a cause of death.

Adolescent↗

[Breast carcinoma in men. The surgical treatment of a case under our observation].

A case of male breast carcinoma in a very young subject (seventeen years old) is described. Breast carcinoma in male is infrequent, and at a so young age it is really rare. The patient was subjected to "Patey" mastectomy with removing the lymph nodes of the breast with the tumor, and subcutaneous mastectomy at the opposite side breast. As agreed with the oncologist other therapy was carried out.

Adolescent↗

Biliopancreatic diversion: clinical experience.

BACKGROUND: Biliopancreatic diversion (BPD), by ad hoc stomach resection (AHS-BPD) has been accepted as an effective surgical treatment for morbid obesity. METHODS: Between 1.1.1992 and 31.7.1996, 59 patients (54 females, five males, mean age 40.3 years, range 23-61 years) underwent AHS-BPD. Mean preoperative body-weight was 121.2 kg (range 94-160), with a mean body mass index of 48.6 (range 35-64). Three of these patients were converted from a previous vertical banded gastroplasty to AHS-BPD (one patient with stomach preservation). After at least 36 months follow-up, seven patients underwent abdominal dermolipectomy (five with associated incisional hernia repair, one with thigh dermolipectomy). RESULTS: Mean post-operative hospital stay was 13 days (range 10-30 days). Follow-up is currently in progress in all patients. Excess body weight-loss was 78% in 33 patients with 24 months follow-up, with excellent long-term weight loss maintenance. Protein deficiency was the main specific complication, encountered in two patients (3.4%). Mortality was one patient (1.7%), due to pulmonary embolus. CONCLUSIONS: This clinical experience supports the effectiveness and safety of AHS-BPD, despite some criticism. This procedure appears to be suitable for patients with clinically severe obesity who will poorly tolerate food intake restriction but will accept long-term follow-up. Careful preoperative clinical assessment and selection of patients who will be reliable in long-term follow-up are the keys to success with AHS-BPD, both in terms of weight loss and reduction of specific metabolic complications.

Adult↗

[Our experience in the use of somatostatin in upper digestive hemorrhages].

The paper illustrates the Authors' personal experience of the use of somatostatin in high digestive hemorrhages. Endoscopy continues to be the principal method for hemorrhage diagnosis and therapy and the additional use of somatostatin undoubtedly accelerates recovery by blocking gastric and pancreatic secretions and blood flow at the splanchnic level.

Adult↗

[Primary neoplasms of the gallbladder. Remarks on a case series].

Data relating to a series of 22 patients suffering from primary gallbladder cancer are reported. In 8 cases the condition was benign, in 14 malignant. In 21 cases, concomitant presence of gallbladder calculosis was encountered. Survival in patients with gallbladder carcinoma was poor and significant in only 2 cases in which the tumour was observed at a non-advanced stage.

Adult↗

[The role of cytology by needle aspiration in the diagnosis of thyroid nodules. Examination of 179 cases].

Since May 1981, fine needle biopsies have been used for cytological examination of thyroid nodules that were barely or not recorded by scintiphotography. By February 1984, a total of 179 patients had been examined. The biopsies were repeated on 12 patients where the first sample produced no diagnostic material. In 57 cases, a histological control existed in the form of material removed surgically by enucleoresections, partial and total thyroidectomies. Histological examination confirmed the cytological diagnosis in 7 out of 8 cases (88%) of malignant neoplasias with varying degrees of differentiation. A cytological diagnosis of adenoma was reached in 80% of cases, and of nodular struma in 82% of cases. Microscopic aspects of the cases are described together with the consequent cytological diagnostic criteria, while the characteristics and importance of the technique are also discussed.

Adenoma↗

[Usefulness of sequential isotopic cholangiography in biliary surgery follow-up].

Personal experience in the follow-up of 39 patients subjected to bile duct surgery is reported. The results indicated that sequential isotopic cholangiography is less effective as a supplementary examination in the postoperative period by comparison with its use in preoperative diagnosis. It does, in fact, constitute the only possibility of visualising the main biliary pathway in subjects who have been operated for biliodigestive anastomosis, with the exception of invasive methods, such as PTC, itself out of the question in the execution of periodic postoperative controls.

Adult↗

[Our experience with cysts of the pancreas].

The Authors produced their series of pancreatic cysts and pseudocysts. In order to a correct surgical therapy they deem it essential to do the Wirsungraphia or the cysto-wirsungraphia to recognize the "communicating cyst" and the "non communicating cyst". The simple resection and the cystoparenchimal resection are the operations of choice but the cystoanastomosis provides suitable and definitive results in the same way. Whereas the marsupialization and the external drainage are operations to reserve for the high risk patients, for the hazard of the pancreatic fistula particularly in the "communicating cyst".

Humans↗

[Emergency or deferred treatment of perforated and bleeding gastroduodenal ulcer].

The treatment of perforated peptic ulcer, according to the experience of the Authors (327 cases), must be very pressing and always surgical. The closure of the perforation, the simplest treatment, seems the most suitable and the least dangerous for the survival of the patient, even though 68% of these patients will have to undergo surgery again in the course of 10 years. The radical treatment of resection, is reserved to few and carefully chosen cases, because it is loaded with sufficient risk. Acute bleeding peptic ulcer (86 cases) requires the operation: immediate or delayed according to the importance of the hemorrage: very serious, serious, moderate.

Emergencies↗

[Value of thermography in the postoperative control in direct arterial surgery].

21 patients suffering from arteriopathy of the lower extremities and treated with a variety of surgical techniques and arterial recanalization have been studied by means of pre- and post-operative angiography and thermography. After analysing the results, the value of thermography, particularly as regards assessment of the surgical results and subsequent long-term controls, is confirmed.

Arterial Occlusive Diseases↗