[Current guidelines in the diagnosis and treatment of a villous tumor of the colon].
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Adenoma↗
Biomedical subjects
L Marra
Publications and source records attributed to L Marra.
Grading scores and survivorship functions in liver cirrhosis: a comparative statistical analysis of various predictive models.
In a group of followed-up liver cirrhotics we evaluated the reliability of prognostic estimates predicted on the basis of a previously described multivariate statistical model (MSM). In the same subjects we also compared theoretical survival estimates obtained by fitting some other liver cirrhosis grading scores (Child-Turcotte's, McCormick's and Orrego's) to prognostic purposes. No statistical difference between actual and MSM-estimated survivorship functions was found (employing a life-table method with Logrank test), thus confirming the prognostic reliability of this multivariate classification model. Such a global and prognosis-correlated index may be recommendable both for comparing different groups of patients, and for assessing treatment effectiveness. Or results also substantially confirm the other investigated classificative methods such as reliable liver cirrhosis severity indexes, although their use for prognostic purposes seems to be less suitable.
Actuarial Analysis↗
[Serum bile acids in cirrhosis: correlation with liver function parameters and with the severity of the disease].
The aim of this paper is to evaluate the relationships among the increase of serum bile acids (SBA) and other common liver function tests in subjects with liver cirrhosis. Our results show that SBA levels are well-correlated with the seriousness of the disease (classified according to Child's criteria), and with the presence of ascites, of oesophageal varices, of hepatic encephalopathy and with the gamma-globulin level. SBA also appear to be well-correlated with total bilirubinemia, and, at a lower extent, with cholesterolemia and albuminemia; no significant linear correlation was found among SBA and cholestasis (alkaline phosphatase, gamma-glutamyl-transpeptidase) or cytolysis (transaminases) indexes. In conclusion, the SBA increase in liver cirrhosis without evidence of cholestasis (as in our patients) seems to be related to liver cell reuptake disturbances and to the presence of porto-systemic shunts, with consequent alterations in entero-hepatic bile salt recirculation.
Adult↗
[Changes in the parameters of hepatic function in biliary lithiasis].
Our study investigates liver involvement serum parameters in 71 subjects with cholelithiasis and choledocholithiasis, without primary liver diseases. As a control group 118 healthy subjects were studied. All patients have been examined for serum transaminases, alkaline phosphatase and gamma-glutamyl-transpeptidase, total bilirubin and for liver enlargement. The results point out the presence of increased alkaline phosphatase and gamma-glutamyl-transpeptidase levels in more than half examined patients, and in nearly half of those without hyperbilirubinemia. This fact confirms that the existence of biliary lithiasis itself (even if limited to gall-bladder, in absence of jaundice) may account for the occurrence of a subclinical cholestatic liver impairment, that should be carefully considered in long-term prognosis of these patients.
Adult↗
Liver function in drug addicts: hepatitis B markers and cell-mediated immunity.
Liver function tests, hepatitis B virus (HBV) markers and cell-mediated immunity were evaluated in 100 drug addicts and in 54 healthy controls. Liver damage prevalence was much higher in the drug group, both in HBV marker-positive and in marker-negative subjects. Moreover HBV marker distribution was different among addicts in comparison with controls, in which the patterns of infection overcoming were more frequent. Cell-mediated immunity assessment showed a deep depression in the addict group. These data suggest that liver damage in addicts may be due mainly to the immunologic defect, which would have a negative influence on the action of HBV and of other viral and non-viral agents.
Adolescent↗
[Clinico-statistical observations in hepatic cirrhosis].
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Adolescent↗
Prognostic significance of clinical and laboratory parameters in liver cirrhosis. A multivariate statistical approach.
Successive clinical and laboratory data of 73 cirrhotics, who died during a follow-up period, were evaluated. The relationships between the actual survival time and 22 potentially prognostic variables were studied by means of the log-rank test and the likelihood ratio test. Seven variables (presence of ascites, hepatic encephalopathy and oesophageal varices; serum albumin, total bilirubin, gamma-globulin percentage and cholesterol) showed a strict correlation with survival time, and were included in a multiple regression model in order to compute the specific "prognostic weight" of each parameter. Results show that the parameters directly related to liver cell biosynthesis or indicating a structural liver damage should be considered more reliable for predicting theoretical survival in patients with liver cirrhosis.
Female↗
Iatrogenic ankylosis of the temporomandibular joint. Report of a case.
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Adult↗
Laboratory parameters in the natural history of liver cirrhosis.
The aim of the present study was to evaluate the changes of common laboratory parameters in the natural evolution of liver cirrhosis, as well as their relationships with the occurrence of ascites onset and death. Routine laboratory findings of 458 patients suffering from liver cirrhosis admitted to a 9-year follow-up period were retrospectively investigated, but only data of the 138 subjects (95 males and 43 females) who died within the follow-up period were considered. Data were grouped into different classes according to the months elapsed before ascites onset or death. The statistical differences among the various groups were evaluated employing analysis of variance and Turkey's test. No laboratory parameter showed statistically significant changes before or at the time of ascites onset, while significant modifications occurred in four liver indexes (albumin, total bilirubin, platelet count and gammaglobulin percentage) during the course of the illness, thus confirming the reliable prognostic value of these laboratory parameters in liver cirrhosis.
Adult↗
[Role of crural inguinal lymphadenectomy and dynamic sentinel lymph node biopsy in lymph node staging in squamous-cell carcinoma of the penis. Our experience].
PURPOSE: We determine the value of dynamic sentinel node biopsy for staging squamous cell carcinoma of the penis. MATERIALS AND METHODS: During a period of 2 years 17 patients with penile cancer was performed after lymphoscintigraphy pre and intraoperatively with gamma ray detection probe at biopsy of the sentinel node with the aid of perilesional administered patent blue dye. After 20 days regional lymph node dissection was performed in all patients. RESULTS: Sentinel node metastasis was found in 5 patients; in one case lymphoscintigraphy not visualized sentinel node. All negative node biopsy was confirmed with the regional lymph node dissection. No major complication did occur after sentinel node biopsy. CONCLUSIONS: Occult lymph node metastases can be detected by dynamic sentinel node biopsy including preoperative lymphoscintigraphy, vital dye and gamma ray detection probe with a sensitivity of 78%, predictive negative value of 100% and with low morbidity.
Aged↗
[Hypereosinophilic syndrome and renal insufficiency].
Hypereosinophilic syndrome is a pathological condition whose etiology is still unclear. Having been introduced for the first time Hardy and Anderson in 1968, the term is used to indicate hypereosinophilia which does not accompany those pathologies with which it is more commonly associated. This paper reports the case of a patient affected by hypereosinophilic syndrome associated with kidney insufficiency. This association with a clinical picture of eosinophilic interstitial nephritis has rarely been described in the past. The Authors discuss the possibility of a possible evolution towards renal insufficiency, probably caused by the successive appearance of arteriolar glomerulitis with vasculitis, leading to the dysfunction of a growing number of nephrons.
Eosinophilia↗
[Nitrate derivatives in heart failure: physiopathological, clinical, and prognostic features].
The authors make a review about the indications and benefits of the use of nitrates in the treatment of acute and chronic cardiac failure, considering their use for a short and a long period. The advantages are reported, showing the reduction of pulmonary capillary wedge pressure and the increase of systolic output and consequently of the cardiac eject. This effect may be traceable both to the benefic effect on the mitral valve (perhaps incontinent), that in the pericadic "contraist". The reduction of the filling pressures increases the tolerance to the effort, delays the choice of the time for cardiac transplant and prolongs the survival with amelioration.
Heart Failure↗