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L Bignardi

Publications and source records attributed to L Bignardi.

At least 19 recordsLinked to original sources
PubMed2006

Octreotide in the treatment of lymphorrhea after renal transplantation: a preliminary experience.

BACKGROUND: Lymphorrhea is a minor complication after kidney transplantation but may develop into a lymphocele and prolong hospital stay. Treatment is conservative based on percutaneous drainage until lymphatic leakage cessation. It has been reported that octreotide has beneficial effects to treat lymphorrhea after axillary node dissection and excision of lymphatic malformations. The aim of this study was to report preliminary experience about octreotide treatment in lymphorrea after kidney transplantation. MATERIALS AND METHODS: This retrospective study included 20 recipients of cadaveric kidney allografts with posttransplant lymphorrhea including 10 treated with instillation of povidone iodate solution, and the other 10 with octreotide (0.1 mg three times a day subcutaneously). We reviewed the daily amount of fluid collection, duration of lymphorrhea, complications, lymphocele formation, rejection episodes, graft outcomes, and hospital stay. RESULTS: The average duration of lymphorrhea was 8.5 (+/-4.5) and 16.3 (+/-7.3) days for the octreotide versus the povidone groups, respectively (P = .001). No complications occurred among the octreotide group, while three lymphoceles grew among patients treated with povidone solution. No differences were observed for acute rejection episodes or renal function between the groups. No octreotide-related adverse events were noted. CONCLUSION: The mean length of lymphorrhea was lower with octreotide versus iodate povidone solution treatment. There was a shorter hospital stay and minor patient discomfort. In conclusion, lymphatic leakage after kidney transplantation may be successfully managed by octreotide administration.

Adult↗
PubMed2004

Renal vein extension in right kidney transplantation.

A short right renal vein may be associated with technical problems in renal transplantation. For this reason, a vena caval extension may be useful to improve exposure of the anastomosis and graft placement. This report evaluates the safety and the effectiveness of renal vein extension, which was routinely performed in right renal transplantation. From April 1986 to December 2002, we performed 371 right kidney transplantations with 252 using the standard technique (group A) and 119 using the renal vein extension (group B). No statistical differences were found between the 2 groups in terms of renal vein thrombosis incidence, delayed graft function, morbidity, and graft loss. Indeed, mean warm ischemia time was reduced in the venoplasty group. In conclusion, renal vein extension is an easy, safe technique that reduces warm ischemia time. We suggest more extensive use of this procedure in right kidney transplantation.

Functional Laterality↗
PubMed2000

Molecular evidence of organ-related transmission of Kaposi sarcoma-associated herpesvirus or human herpesvirus-8 in transplant patients.

In transplant patients, Kaposi sarcoma (KS)-associated herpesvirus or human herpesvirus-8 (HHV-8) infection is associated with the development of KS, primary effusion lymphoma and Castleman disease. Whether HHV-8 is either reactivated in the recipient or transmitted by the donor has been investigated so far only by serologic studies. Thus, we addressed the issue of HHV-8 transmission in the transplantation setting by molecular methods. We exploited the high level variability of the orf-K1 gene and the polymorphism of the orf-73 gene of the HHV-8 genome to assess the genetic relatedness of the HHV-8 strains identified in the posttransplant KS lesions that developed, simultaneously, 20 months after transplantation, in 2 recipients of twin kidneys from the same cadaver donor. The 100% identity of nucleotide sequence of the most variable viral region and the presence of the same, single orf-73 type in both patients provides strong molecular evidence of organ-related transmission of HHV-8 in the setting of transplantation.

Base Sequence↗
PubMed1998

[Neoplasms and kidney transplantation. Case contribution].

BACKGROUND: The incidence of malignancies after transplantation is higher when compared with expected cancer in control patients, particularly skin and female genital cancer, non-Hodgkin's disease and Kaposi's sarcoma. The aim of this study is to evaluate the frequency and the efficacy of the treatment of cancer following renal transplantation. METHODS: A retrospective analysis of 404 recipients was performed and it showed the onset of 15 cancers (8 skin cancers, 3 Kaposi's sarcomas, 2 renal carcinomas, 1 urotelioma and 1 colon cancer) in 11 patients (3.7%). At the time of diagnosis, the mean period of immunosuppressive therapy (7 cases of double therapy, 4 cases of triple therapy) was 44.8 months. Skin cancer (53.3%) and Kaposi's sarcoma (20%) were the most frequent in personal experience as reported in literature. Neither lymphomas, nor female genital cancers were detected. RESULTS: All the cases were surgically treated, except patients with Kaposi's sarcoma, whose immunosuppressive therapy was reduced without alteration of renal function. Death-rate was 0.25% (1 case), the remaining patients show no signs of local recurrence or metastasis with preserved renal function except for the patient with renal carcinoma of the transplanted kidney, who underwent nephrectomy and returned in replacement therapy. CONCLUSIONS: The conclusion is drawn that the research of relationship between type of immunosuppressive therapy and cancer incidence and careful clinical and instrumental examination of transplant patients may contribute to reduce the onset of neoplastic degenerations and lead to an early diagnosis.

Antineoplastic Agents↗
PubMed1993

Functional surgery of ceruminoma of the external and/or middle ear.

The paper describes two cases of "Ceruminoma" of the external and/or middle ear, treated by conservative surgery. The authors illustrate, besides morphological and histological features of ceruminoma, the surgical treatment modulated on the basis of an exact identification of the lesions.

Adenoma, Sweat Gland↗
PubMed1991

[Diagnostic role of ultrasound in the transplanted kidney].

Among diagnostic postoperative procedures in renal cadaver transplantation echographic examination shows high sensitivity and specificity (over 80%). Urographic examination is in fact often dangerous and impossible in non-functioning grafts. Echography can reveal several liquid and solid collections such as hematomas, urinomas, abscesses, lymphatic collections and so on. Urinary obstructions caused by ureteral clots, calculi, external masses can be also detected through echographic examination. Vascular complications can be evaluated through echo and US Doppler examination showing arterial and venous complications. In most of cases acute and chronic graft rejection can be revealed through echo examination whereas in few cases diagnosis can be made only with the help of renal biopsy, laboratory findings and clinical conditions. In conclusion echography is a safe and reliable procedure in renal graft postoperative monitoring.

Follow-Up Studies↗
PubMed1987

Histopathological changes in cyclosporin-treated renal allografts biopsied at one and twelve months.

Forty-four renal allograft recipients were biopsied routinely one month and one year after transplantation. All patients received cyclosporin and prednisolone. Fifteen patients had at least one rejection episode, while 29 patients never underwent rejection. At one year there were no specific histological features that enabled these two groups to be distinguished. Between one month and one year, interstitial cellular infiltrate and vascular pathology regressed, and renal function steadily improved. Interstitial fibrosis, however, was either unchanged or mildly increased in all patients. There was no correlation between the amount of interstitial fibrosis at one year and either the total dose of cyclosporin or the mean concentration during the first 3 months. Our results suggest that trough, whole blood cyclosporin concentrations, at the upper level of the therapeutic range (800-200 ng/ml), may be safely tolerated during the first 3 months, with little evidence of chronic damage at one year. At one year maintenance doses of cyclosporin can be achieved that are associated with almost normal plasma creatinine concentrations and minimal tubular atrophy and interstitial fibrosis. We expect that such doses may be continued indefinitely.

Adolescent↗
PubMed1986

A personal experience with subtotal and conservation surgery as treatment for laryngeal cancer.

A personal technique for laryngeal cancer reconstructive surgery is presented and discussed. The functional and therapeutic purpose of this surgery is to broaden its indications and to improve functional results. In particular, our surgical technique involves removal of the soft internal part of the cricoid cartilage (mucosa, submucosa and perichondrium), which is otherwise conserved. Satisfactory functional results can be achieved by: modeling of two symmetrical pseudoarytenoids; an anterior epiglottiplasty or the use of a Hiranandani base-of-the-tongue flap to close the anterior gap (if present); muscular flap lateral-plasty avoiding a cricoidhyoidpexy.

Cricoid Cartilage↗
PubMed1986

Morphological differentiation between rejection and cyclosporin nephrotoxicity in renal allografts.

In a prospective study of renal dysfunction in 60 consecutive allograft recipients treated with cyclosporin and prednisolone routine renal biopsies at one week and one month after transplantation, as well as for all episodes of renal dysfunction, were performed. The one year graft survival of this group was 88%. In a retrospective clinical analysis of these patients 35 episodes of dysfunction due to rejection, defined by a response to antirejection treatment alone, and 30 episodes due to cyclosporin nephrotoxicity, defined by a response to reduction in cyclosporin dose alone, were identified. The morphological findings from these biopsies were compared with 20 samples from routine biopsies taken from patients with stable renal function. All patients diagnosed as having rejection had a diffuse, interstitial mononuclear cell infiltrate (32 of 35) or arteritis (19 of 35), or both. In contrast, focal mononuclear cell infiltrates were common in both patients with nephrotoxicity and those with stable function (17 of 30 and 14 of 20, respectively). There were no important differences between biopsies from those with nephrotoxicity and those with stable function, except that arteriolar hyalinosis was considerably more common in the nephrotoxic patients than in those with stable function. Many patients with stable function were, in retrospect, in a state of stable mild nephrotoxicity. In our experience rejection should only be diagnosed when there is at least a diffuse interstitial infiltrate or an arteritis. Focal mononuclear cell infiltrates do not denote rejection. The development of arteriolar lesions in the absence of rejection is indicative of nephrotoxicity.

Adolescent↗
PubMed1983

Tracheostomal recurrences after laryngectomy.

A clinicopathologic study of 681 laryngectomies performed at the Otorhinolaryngology Clinic of the University of Ferrara forms the basis here of a discussion of the etiopathogenesis of the postsurgical tracheostomal recurrence. Special attention is paid to the much debated etiopathogenetic role of preoperative tracheotomy. In all classes of material analyzed, tracheostomal recurrence was more frequent in patients with preoperative tracheotomy, though the percentages varied depending on the class. Morphological analysis of original tumor specimens from preoperatively trachetomized patients who later had tracheostomal recurrence, revealed tumors in 4 out of the 11 usable specimens. Of these, two had submucosal infiltration in a peripheral digitation of the tumor; in the other two cases, no contact was observed between the neoplastic infiltration and the outer border of the original tumor. The authors also reviewed the case histories of patients in whom conservative surgery was followed by total laryngectomy because of endolaryngeal recurrence. The high rate of tracheostomal recurrence in this category of patients suggests that the pathogenetic mechanism may be analogous in the two situations: preoperative tracheotomy/tracheostomal recurrence and inadequate conservative surgery/tracheostomal recurrence.

Humans↗
PubMed1983

Behavior of cancer at the anterior commissure of the larynx.

The present research is concerned with the behavior of the vestibular cancer with respect to the portion of the anterior commissure of the larynx which the authors have named the "x-space." The research is based on the analysis of semiseriated vertical sections showing cancers of the vestibule in stages T1 and T2 with histological gradings 1 and 2. The specimens show that, at least in the early stages of the neoplastic spread, the fibrous structures of the x-space act as a fairly effective barrier to deep diffusion of the tumor. This fact enables the surgeon to estimate macroscopically the lower borders of the tumor growth on the basis of the superficial spread of the cancer in the zone of the x-space.

Adult↗
PubMed1978

Critical appraisal of haemofiltration and ultra-filtration. The development of ultra-short dialysis: preliminary results.

The clinical experience obtained with 2 hours every other day recirculation dialysis, using 20-40 liters of dialysate, without sorbents, and standard cuprophane dialyzers of 1.0-1.5 sq.mt. is reported. So far, over 350 treatments in 8 patients have been performed. After 2 hours of treatment the removal of urea, creatinine, phosphate and uric acid, is similar to that obtained by 4-6 hours of haemofiltration. The alkalinazation of the patient through direct venous infusion of bicarbonate, makes predialysis acid-base significantly better than in standard haemodialysis and haemofiltration. Asymptomatic correction of severe fluid overload is easily obtained like in isolated ultrafiltration. The role of osmolality and vasopressors are discussed. A dry weight below the value obtained by previous dialysis treatment is achieved, and volume dependent hypertensions as in haemofiltration are corrected after 2-8 weeks. As an additional advantage, this method offers a highly semplified technical approach and a further reduction of the dialysis time.

Bicarbonates↗