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Biomedical subjects

L D'Anna

Publications and source records attributed to L D'Anna.

14 recordsLinked to original sources
PubMed2003

[Solid pseudopapillary tumour of the pancreas. Report of a case].

Solid pseudopapillary pancreatic tumour is an uncommon disease including 2.7% of exocrine malignancies of the pancreas. Its low incidence is associated with an uncertain prognosis and with difficult diagnostic and therapeutic problems, despite routine use of ultrasonography, TC and RMN. A case of solid pseudopapillary pancreatic tumour in a young woman is reported: the clinicopathologic features, diagnostic imaging and surgical treatment are discussed. Surgery is the primary option. Prognosis is however not fully known. From a review of the literature it is suggested that these tumours should be regarded as potentially malignant.

Adult↗
PubMed2001

Helicobacter pylori: diseases, tests and treatment.

Gastroduodenal disease associated with Helicobacter pylori infection are reviewed as well as the diagnostic approach. Generally, there are by and large two ways in which a diagnosis of infection by Helicobacter pylori can be made: by using either an invasive or non-invasive procedure. The invasive procedures involve endoscopy and biopsy Biopsy is essential since the mucosa may often appear macroscopically normal but, nevertheless, be inflamed. Once a biopsy is obtained histological examination, culture, polymerase chain reaction, detection of the presence of urease activity can be detected. The non-invasive tests that can be used to diagnose the infection are: serology, detection of labelled metabolic products of urea hydrolysis either in the breath (13CO2, 14CO2), the urine or the blood, detection of Helicobacter pylori antigen in stool specimen. At present, no single test is sufficiently reliable to definitely detect colonisation by Helicobacter pylori, and a combination of two is recommended, if feasible. Choice of the test to be used is not straightforward and relies on a series of situations, i. e., clinical setting and local expertise and availability, that the clinician must consider to obtain the best diagnostic yeld. The challenge of Helicobacter pylori eradication is not very easy to obtain. The possible scenario and the use of a new proton pump inhibitor (esomeprazole) are reviewed and discussed.

Dyspepsia↗
PubMed2001

How valuable is the application on consensus guidelines in the management of functional gastrointestinal disorders?

When patients complain of problems, physicians are used to look for some physical or physiological abnormality ruling out infections, inflammatory or cancer. Unfortunately, when we talk about functional disorders we usually cannot observe any defects and it is only possible for us to know of them through the words of our patients. Developing criteria and guidelines is not an easy process, in particular for functional gastrointestinal diseases, when no disease-based biological markers exist. It is difficult to define a medical disorder in the absence of a biological "gold standard". The Rome II classification is based on the assumption that for each disorder there are symptom clusters. Symptoms have in common disturbances in sensory and/or motor gastrointestinal function, which sometimes may overlap across anatomic regions. Nevertheless, several studies provide evidence for site-specific syndromes.

Colonic Diseases, Functional↗
PubMed1995

Fusion and duplication variants of pancreatic duct system. Clinical and pancreatographic evaluation.

The aim of this study was to assess the incidence of fusion and duplication variants of the pancreatic duct system and their clinical significance. A total of 650 endoscopic retrograde cholangiopancreatography were reviewed; 485 cases with satisfactory imaging of the pancreatic ducts were included in the study. Anatomic variants were observed in 48 patients (9.9%), fusion variants were 54.1% of the cases (22 pancreas divisum and 4 functional divisum), and duplication variants were 45.8% (13 bifurcations of the main pancreatic duct, 4 loop, 2N-shape, 3 ring). Clinical indications to endoscopic cholangiopancreatography were idiopathic acute pancreatitis (33.3%), suspected chronic pancreatitis (18.7%), unexplained abdominal pain (14.5%), suspected pancreatic mass (10.4%), chronic hyperamylasemia (6.2%), and acute biliary pancreatitis (16.6%). Except for acute biliary pancreatitis (significantly more frequent in duplication variants), no statistical difference was observed between the groups with anatomical variants concerning clinical features.

Adolescent↗
PubMed1992

Double blind trial of colloidal bismuth subcitrate versus placebo in Helicobacter pylori positive patients with non-ulcer dyspepsia.

We have carried out a double blind placebo controlled trial to assess the effects of treatment with colloidal bismuth subcitrate in Helicobacter pylori associated non-ulcer dyspepsia. Eighty patients with dyspepsia, normal upper gastrointestinal appearances at endoscopy and H pylori associated active chronic gastritis on histology of gastric antral biopsies were included in the trial. The patients were randomised to receive colloidal bismuth subcitrate 240mg twice daily for four weeks or matching placebo and were reassessed four weeks after completing treatment. Twenty-six patients (67%) receiving colloidal bismuth subcitrate had normal histology or improved inflammation compared with five (13%) receiving placebo (p less than 0.001), and symptoms were absent or improved in 32 (82%) and two (5%) respectively (p less than 0.001). Serum IgG level was a marker of infection, and fell with successful treatment. Colloidal bismuth subcitrate is effective treatment for H pylori associated non-ulcer dyspepsia with improved gastric antral histological appearances and has a beneficial effect on symptoms.

Adult↗
PubMed1990

Endoscopy in dyspeptic patients: is gastric mucosal biopsy useful?

Should dyspeptic patients coming to endoscopy with "normal" findings also be biopsied? To assess this, we studied the sensitivity and specificity of endoscopic examination compared with histology, microscopic evidence of Helicobacter pylori, CP-TEST, culture, and serum IgG and IgA antibody titers to H. pylori to determine whether endoscopy and antral biopsies really are useful. One hundred seven consecutive dyspeptic patients (mean age 43 yr) were entered. Four antral biopsies were taken routinely for evaluation by histology, microscopy, CP-TEST, and culture. Serum IgG and IgA antibody levels were measured in all patients. Of symptoms, postprandial bloating was statistically more common in H. pylori-positive than in negative patients. Endoscopy had the poorest sensitivity (37.1%) and specificity (53.3%). Patients with normal endoscopic appearances but histologically confirmed gastritis had significantly higher IgG and IgA titers than the patients normal by both endoscopy and histology and without evidence of H. pylori. This study has shown that endoscopy is unhelpful in dyspeptic patients if endoscopic biopsies are not routinely taken.

Adult↗
PubMed1989

Endoscopic sphincterotomy in 1000 consecutive patients.

Between 1983 and 1988, endoscopic sphincterotomy was attempted on 1000 consecutive patients with a clinical diagnosis of bileduct stones in a centre with a policy to establish immediate bileduct drainage for retained stones. Endoscopic cholangiography was successful in 985 patients, of whom 782 had visible stones and 203 had a dilated bileduct but no visible stones. Endoscopic sphincterotomy was successful in 975 of these patients, with eventual bileduct clearance in 674 of 772 patients (87.3%) with visible stones; immediate bileduct drainage was achieved in 160 of the 161 patients (99%) in whom bileduct clearance failed at the first attempt. Overall, 771 of 797 patients (96.7%) with visible bileduct stones had successful bileduct clearance or drainage. Complications occurred in 6.9%, with a 30-day mortality rate of 1.2%, but procedure-related mortality was only 0.6%.

Adult↗
PubMed1989

A novel, fully automated rotometer for the study of turning behavior. Comparison of results under different experimental conditions.

The turning or circling activity of the rat is a very useful experimental model for the study of dopaminergic cerebral pathways. Quantification of turning makes it applicable to follow changes of pattern evolution in the same subject or for comparison between animals under different experimental conditions. Automated quantitative evaluation of turning has the advantage of its reliability, eliminates subjective inaccuracies and allows longer periods of observation. Therefore a fully automated rotometer aimed to accomplish these objectives was developed. It consists of a sensor box to transduce the circling movement of animals into computed information to be processed by a microprocessor and a printer for recording of results. The sensor was designed with a 16 holes perforated disc and two infrared receiver/emitter units. Pulses generated in the sensor box are computed and stored by the microprocessor. Reading of results may be made in manual or automated mode from the display or listed through the printer connected on-line. The reliability and validity of the rotometer were tested in animals submitted to different experimental conditions. Rats with unilateral chemical lesions (6-hydroxy-dopamine or kainic acid) of substantia nigra pars compacta rotated vigorously contraversive to lesion side after apomorphine injection (0.5 and 1 mg/kg, s.c.). Electrolytic lesion of the same nucleus made animals rotate ipsiversive to the lesion after apomorphine. To attain significant level of circling activity, the electrolytic lesion should be placed in the external boundaries of substantia nigra (265.8 +/- 53.4 turns/60 min for group with external placed lesion; (n = 5); 97.3 +/- 19.5 for group with internal placed lesion (n = 3); t = 2.31; p less than 0.05). Unilateral striatal lesion with ibotenic acid made animals rotate ipsilaterally with apomorphine as well as with the selective D-2 agonist bromocriptine (10 and 30 mg/kg, i.p.). Qualiquantitative differences in circling were observed between these two dopaminergic agonists. Comparison of circling activity on semispherical and flat surfaces showed a non significant trend to rotate more intensively on spherical surfaces but only in those animals turning greater than or equal to 3 turns/min. The results obtained with the automated rotometer herein described agree with those currently reported in the literature about the subject. They demonstrate also that this apparatus is adequate and reliable for the study of turning behavior under different experimental conditions. Interestingly enough, our observation on the specificity of electrolytic lesions placed in the lateral boundaries of substantia nigra to induce rotation is worth further investigation.

Animals↗
PubMed1979

Disturbances of motor reaching behavior. Clinical note.

Disturbance of motor reaching behavior was found in a patient submitted to a partial lobectomy including the posterior regions of the parietal cortex. The altered function could be objectivated by means of a battery of tests designed to detect visuo-spatial appreciation following which the subject has to point out to the center of figures with different configurations. Likewise, the damaged motor function could also be detected when the patient intended to reproduce, by copying, models of a figure as well as of straight lines of different lengths. Difficulties to reach -on first attempt- the proper point on the sheet with the point of the pencil, brought the performance of these tests to a high degree of inexactness and showed clearly the inaccuracy in production of voluntary motor responses within concretely definable visuo-spatial limits. These findings can be considered to be similar to those described in monkeys after removal of parieto-occipital cortex. It might be that a lesion in this part of the brain disrupt the high level of elaboration of different kind of stimuli (tactile, proprioceptive, visual, etc.) indispensable to attain normal reaching motor functions.

Astrocytoma↗