Low doses of ciclosporin in renal transplantation. A single center experience.
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Cadaver↗
Biomedical subjects
L Belli
Publications and source records attributed to L Belli.
Effects of low flux-low pressure cardiopulmonary bypass on intracellular acid-base and water metabolism.
In eight patients undergoing open heart surgery for elective myocardial revascularization, extra-intracellular acid-base and water metabolism parameters were studied before and after cardiopulmonary bypass procedures. All patients presented a different degree of metabolic acidosis related to plasma lactate increase. Intracellular acid-base indexes did not change significantly, though all but one patient showed an intracellular buffers consumption. Both total muscle and extracellular water increased, while intracellular water did not change. It was concluded that low flux-low pressure perfusion CPB was related to a substantial preservation of cell integrity.
Acidosis↗
Improved results with pericystectomy in normothermic ischemia for hepatic hydatidosis.
Pericystectomy is an excellent surgical procedure for the treatment of hepatic hydatidosis. However, until now, it was not a widely accepted procedure among surgeons because of the lack of literature regarding the details of the surgical technique. During the past years, hepatic hydatidosis has been treated by a majority of surgeons by marsupialization. Only recently, more surgeons have stopped using external drainage procedures in favor of hepatic resection and pericystectomy. In a previous study, we defined some of the criteria for resection of the liver and treatment of hepatic hydatidosis, analyzing the risks and benefits for this procedure. In the present study, we have defined the indications for pericystectomy and discussed the advantages and disadvantages. In a group of 31 patients, a total of 49 cysts were removed by pericystectomy. Some of the major problems related to surgical technique are described and discussed in detail with particular reference to the use of the Pringle maneuver. Clamping of the hepatic ileum, that in our experience never exceeded 20 minutes, has allowed good results--most of all in terms of decreased intraoperative bleeding, postoperative complications and operating time.
Constriction↗
Reflex control of blood pressure and heart rate by arterial baroreceptors and by cardiopulmonary receptors in the unanaesthetized cat.
Studies in unanaesthetized animals have reported that section of the carotid sinus and aortic nerves is accompanied by an increased blood pressure variability but not by a sustained blood pressure rise, thus questioning the role of arterial baroreceptors in the long term control of mean blood pressure values. However, sino-aortic denervation (SAD) does not produce denervation of all baroreceptor areas, and it has been suggested that aortic baroreceptor fibres in the vagus and cardiopulmonary vagal afferents that restrain sympathetic vasoconstrictor tone prevent blood pressure from permanently rising. In unanaesthetized cats we recorded blood pressure intra-arterially for 8-12 h when baroreflexes were intact, 7 days after SAD and 1-2 days additional bilateral cervical vagotomy. Blood pressure signals were analysed by computer to provide means and coefficients of variation (CV, variabilities) for each recording period. In intact cats, mean blood pressure was 99 +/- 7 mmHg (average +/- s.e.) and CV 6 +/- 1%. SAD did not alter mean blood pressure but markedly increased CV (12 +/- 2%; P less than 0.01). Additional vagotomy did not alter mean blood pressure (104 +/- 6 mmHg), nor did it alter the increased CV observed after SAD alone. Vagotomy failed to affect mean blood pressure and CV even when performed in cats with intact carotid and aortic nerves. The lack of effect of vagotomy did not depend on simultaneous section of afferent and efferent fibres, because selective blockade of the latter by atropine also failed to affect mean blood pressure and CV.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Bronchoplastic procedures and pulmonary artery reconstruction in the treatment of bronchogenic cancer.
Nineteen patients with primary bronchogenic carcinoma underwent bronchoplastic procedures (six wedge and 13 sleeve resections) between 1970 and 1982. In six of them lobectomy was combined with sleeve resection and reconstruction of the pulmonary artery: In one a synthetic prosthesis was inserted. Twelve patients had squamous cell carcinoma, five adenocarcinoma, and two large cell carcinoma. No operative deaths were observed, and the 5 year survival rate is 28.1%. One patient had an early bronchial fistula and two patients had bronchial stenosis (one suture granulation and one local recurrence). No patient with resection of the pulmonary artery had vascular complications. Survival rates on the basis of nodal involvement indicate 50% survival at 5 years without nodal metastasis (11 cases) versus 9.7% with nodal involvement (eight cases) (p less than 0.05). Bronchoplastic procedures, even if accompanied by segmental resection of the pulmonary artery, can be performed safely with long-term results comparable to those following major pulmonary resections.
Adenocarcinoma↗
Influence of technical factors and different immunosuppressive regimens on kidney graft survival. Retrospective analysis on 300 kidney transplants.
300 patients underwent kidney transplantation. Uretero-neocystostomy was performed by means of the Politano-Leadbetter technique in the first 185 patients and direct ureterovesical anastomosis in the other 115 patients. Immunosuppression included conventional therapy (steroids, antilymphocyte globulins, azathioprine) and the association cyclosporine A and steroids. Retrospective analysis on these 300 patients indicates that the improved 1 year graft survival rate (85% vs 64%) we observed in the latest years has depended to the same extent, on improved surgical technique and on advent of cyclosporine A in our therapeutic protocols. Cyclosporine A at low starting doses immediately adjusted on whole blood trough levels (200-400 ng/ml) proved to be superior to other therapeutic schedules reported in this study (1-year graft survival rate: 94% vs 84%-73%). Direct ureterovesical anastomosis was characterized by a net reduction of urologic complications (2.5% vs 9.7%).
Antilymphocyte Serum↗
Treatment of superficial candidiasis with bifonazole 1% gel.
Sixty-one patients with superficial candidiasis, confirmed on entry by clinical examination and mycological culture, were treated with a single daily application of a 1% bifonazole gel over a period of 4 weeks. Patients were seen every week during treatment and then followed-up for 2 weeks. An overall assessment of response to treatment, based on the clinical and mycological culture findings at the 14-day follow-up visit, showed that the results were very good in 49 and moderate in 9 patients, with only 3 patients being considered as failing to respond. Local tolerance was very good, but burning was reported by 1 patient, burning and itching by 1, and ardor and irritation by one. All these side-effects occurred at the start of treatment and they subsided without interruption of bifonazole treatment.
Adolescent↗
Treatment of tinea corporis or tinea cruris with bifonazole 1% gel: an open, multicentre study.
An open, multicentre study was carried out in 103 patients with confirmed dermatophyte infections (tinea cruris or tinea corporis). The fungi isolated were Tr. rubrum (45), Tr. mentagrophytes (11), Ep. floccosum (26) and M. canis (21). All patients were treated with a single daily application of bifonazole (1% gel) and the duration of treatment was 3 weeks. Weekly clinical controls were performed during the therapeutic period and at least two clinical and mycological examinations were given after the end of treatment. Treatment was evaluated according to the clinical and mycological findings at the 14th post-therapeutic day. The results obtained were classified as very good in 80 patients, good in 11, moderate in 11 and failure in 1 patient. Local tolerance was very good and no side-effects were observed in any patients.
Adolescent↗
An open, multicentre assessment of the effectiveness of bifonazole in the treatment of tinea (pityriasis) versicolor.
One hundred and twenty-one patients with tinea (pityriasis) versicolor, confirmed by pretherapeutic clinical and mycological examination, were treated with a single daily application of bifonazole (BAY h 4502) 1% gel for 2 weeks. Weekly clinical controls were performed during the treatment period and at least two clinical and mycological post-therapeutic controls were given. Overall results were very good in 98 patients, good in 15, moderate in 7 and failure in 1 patient. Local tolerance was very good; only 1 patient presented with slight erythema and pruritus during the treatment.
Adolescent↗
Preliminary report of a kindred affected from MEN IIa.
Preliminary data of a kindred with multiple endocrine neoplasia type IIa (MEN IIa) are presented. The study concerns 20 subjects belonging to 4 generations. The first is a man, previously adrenalectomized for pheochromocytoma, suffering from thyroid node with high serum calcitonin (CT) and normal tests for parathyroid function, who underwent total thyroidectomy, removal of a grossly enlarged parathyroid and subsequent autotransplantation, because the other glands seemed to be macroscopically uninvolved. In 4 further patients total thyroidectomy and removal of the parathyroid glands with autotransplantation were performed. In all patients, despite biochemical tests had disclosed parathyroid hyperfunction in only one, one or more enlarged parathyroid glands were found, subsequently diagnosed as adenomatous or with focal areas of "chief-cell" hyperplasia. In 3 out of 4 patients, a single test among those performed to detect the presence of a pheochromocytoma was positive. However, because of the lack of a clear correlation among data from biochemistry, stimulation tests and morphological investigations, adrenalectomy has not been performed. Nevertheless these patients will be closely followed up, in order to promptly state when andrenalectomy has to be performed.
Adolescent↗
Treatment of tinea pedis interdigitalis with bifonazole, 1% gel.
329 adult patients with tinea pedis interdigitalis, which clinical diagnosis was confirmed by positive direct microscopic examinations and cultures of organisms from the lesions, were enrolled in this open and multicentric study. Informed consent was requested and obtained in each case. The bifonazole, 1% gel, tested was applied topically once daily for 3 weeks. Weekly clinical controls were performed during the treatment period and, at least, two clinical mycological posttreatment assessments were carried out. The evaluation criteria were based on the clinical and mycological findings at the end of the second posttreatment week. According to these criteria, the results obtained were: very good (clinical cure, negative mycology) 276 (84.0%); good (clinical improvement, negative mycology) 32 (9.5%); moderate (clinical improvement, positive mycology) 20 (6.0%), and failure (no clinical and mycological changes) 1 (0.5%). Tolerance was excellent, side effects were not observed in any case.
Adolescent↗
Prophylaxis of tinea pedis interdigitalis with bifonazole, 1% powder.
With the objectives of determining the effectiveness of bifonazole 1% powder in the prophylactic treatment of tinea pedis interdigitalis and its local tolerance, 200 patients who achieved clinical and mycological cure in another previous trial with bifonazole 1% gel, and who were also reliable in the compliance of the treatment, were included in this study. Informed consent was requested and obtained in each case. This was a multicenter, double-blind, controlled and comparative study of one group (100 patients) treated with bifonazole verum against another group (100 patients) treated with bifonazole placebo. The allocation to each group was performed by randomization. Bifonazole was applied once daily in the morning on both feet, after showering, and inside shoes; patients applied it again when changing shoes or socks during the day. Treatment lasted up to 6 months. During the treatment, patients were clinically and mycologically assessed once a month and, if it was necessary, when signs and/or symptoms of infection reappeared. The evaluation criteria were based on the reinfection, clinically and mycologically demonstrable, during the treatment. 29 patients abandoned the treatment. Reinfection was observed in 57 out of the 171 patients who finished the treatment, 47 reinfections occurred in the placebo group and the remaining 10 in the verum group. Tolerance was excellent, no side effects were observed in any patient.
Adult↗
Clinical experience with sublobar liver resections.
106 liver resections have been performed at the Department of Surgery. 42 of these were liver segmentectomies and other minor liver resections. Such kinds of resective procedure have been adopted in 40 patients affected by benign or malignant lesions in whom the normal liver parenchyma had to be preserved. Indications and technical aspects of hepatic tissue preservation in liver resection are discussed. Liver segmentectomy required a transparenchymal approach, by means of finger fracture technique, through scissural planes to the deeply located segmental pedicle. It should be noted that blood loss and complication rate may be minimized when the technical procedure is carefully performed. A satisfactory survival rate in patients with hepatic involvement from colonic cancer is reported.
Humans↗
[Prevention of aspiration bronchopneumonia in the comatose patient].
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Adult↗
Resection versus pericystectomy in the treatment of hydatidosis of the liver.
The surgical treatment of 87 hepatic cysts from Echinococcus granulosus in 42 patients has been presented. The importance of determining the features of the cysts in each patient (age, number, location, and relation with vasculobiliary structures) in order to carry out the most appropriate treatment was stressed. Radical surgery was preferred because marsupialization, a conservative technique still widely used, has a high complication rate (60 percent in this study) and a prolonged recovery time. Arguments for and against cystopericystectomy and hepatic resections have been discussed. It is noteworthy that excellent results have been observed after hepatic resection when it was performed in selected patients.
Adolescent↗
Acute gonococcal urethritis: treatment with a single dose of rifampicin.
A total of 103 patients with acute gonococcal urethritis were treated with a single 1,200 mg dose of rifampicin. A 91 . 3% cure rate was obtained, as proved by the negative bacteriological controls effected on the 7th and 14th days after the initiation of therapy. Three pharyngeal infections and one ano-rectal infection responded successfully to the treatment. No signs of drug intolerance were detected with the stated dose. Reactivity to the VDRL test was not impaired during the duration of the study and three reactive cases were discovered. In previous studies of gonorrhoea we had observed a significant discrepancy between urine cultures and the urethral smears and, in view of this, it was decided to adopt the latter alone as a routine procedure. The proposed dose does not originate resistance to rifampicin in either the Hansen or Koch bacilli.
Drug Evaluation↗
[Description of a new method of heterotopic heart transplant with left ventricular assistance function].
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Animals↗
Acute gonorrhea treated with a single intramuscular dose of mezlocillin.
151 patients with acute gonorrhea were included in the study. There were 137 cases of urethritis, seven cases of vulvovaginitis, six cases of pharyngitis and one case of proctitis. Five patients were given two i. m. injections of 1 g mezlocillin at an interval of 24 hours. The clinical symptoms had disappeared 24 hours after the first dose. 146 patients were then given single doses of mezlocillin intramuscularly (106 received 1 g, 40 received 2 g). The therapeutic results were confirmed by clinical and bacteriological examinations (urine culture, culture from swab exudate) after 96 hours and 30 days. The first control showed a cure rate of 100%. Thirteen of 133 patients had a reinfection at the second control. The mezlocillin infections were tolerated very well, both locally and generally.
Acute Disease↗