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L O Colombato

Publications and source records attributed to L O Colombato.

At least 19 recordsLinked to original sources
PubMed1996

[Analysis of patients with acute pancreatitis (AP), (1984-1994) decade. Comparison with a past series].

Between 1984-1994 records of 190 patients with acute pancreatitis (AP) were reviewed. Diagnosis was confirmed by surgery in 141, by necropsy 1 (75%), and for the remaining patients, by CT and clinical evaluation. Female 122 were female (64%), male 68 (36%), mean age 41 years (range 7-82 years). The etiologic factors were gallstones in 129 (68%) with 4 deaths (3%), alcoholic in 26 (14%) with 5 (19%) deaths, idiopathic in 24 (13%) and miscellaneous 11 (5%), the last 2 without mortality. The overall mortality was 5% (9/190). Surgical treatment was indicated in 141 (74%) and endoscopic treatment in 2 (1%), 47 patients (25%) received only medical treatment. One-hundred and fifty-four patients (81%) were mild forms with a Ranson mean score 2.2 without mortality. In this group, emergency surgery was indicated in 7 (6%), early in 3 (3%), late in 1 (0.9%) and elective in 99 (90%). In the severe group were 36 patients (19%) with a mean Ranson score of 4.2. Nine patients died (25%), 31 were surgically treated, by emergency surgery in 17 (47%), 1 (3%) early surgery and 13 (36%) late surgery. The mortality rate of this group was compared with previous series of the same hospital (1975-1984 series). The 1984-1994 group showed a significant overall mortality decrease 4.7% vs 12.7% (p = 0.0047); 3.1% vs 11.2% (p = 0.0087) for the gallstones group; without mortality in the idiopathic and miscellaneous form compared with 18.7% and 20% respectively of the previous series; no mortality was observed in the mild AP compared with 5% of the previous series. The mortality in the severe form was 25% vs 40.8% (1975-1984 group). We consider that the decreased mortality could be attributed to the improvement in the diagnosis, early recognition of the severe forms, systemic supportive care in the severe forms, the use of antibiotics with wide spectrum and deeper penetration in the pancreas and specially in the change of the surgical timing. Although, in the first period the option was the early pancreatic surgery, in the second this was indicated only in particular cases.

Acute Disease↗
PubMed1990

[Value of laboratory tests and echography in the diagnosis of biliary disease in the initial phase of acute pancreatitis].

The aim of this study was to investigate the usefulness of serum bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (APh) and real time ultrasonography (US) in distinguishing between gallstone and non gallstone related acute pancreatitis (A.P.). The second aim was to evaluate whether or nor there was biliary tract hypertension. Both aims were designed in order to evaluate them in the early stage of A.P. Two Groups of patients were studied. Group 1--gallstone related A.P., 63 pts. Group 2--Non gallstone related A.P. 21 pts. Fifty nine (93.6%) of Group 1 and 11 (52.3%) of Group 2 had surgical confirmation. In the other, the diagnosis was based on US and C.T. Blood samples were taken during the three days after admission for biochemical test and US was performed within the same period. Statistical evaluation and Student's t test were used. Biochemical test: when the cut off level was expressed by the upper limit of normal (ULN), the highest diagnostic sensibility was (table 1): ALT 85.7%, APH 80.9%. AST 71%, bilirubin 65%. When the cut off level was chosen at twice the ULN (Table 1), the sensibility was: ALT 61.9%, bilirubin and AST 47%, APh 30%, Group 2 (Table 2) values higher than the ULN were: AST 42.8%, bilirubin 33%, ALT 19%, APh 14.2%. The differences between the two Groups were statistically significant: APh and bilirubin P less than 0.001, ALT less than 0.05 m AST, NS. Ultrasonography: Group 1: gallstones were detected in 96.6% (58/60). Biliary tree was not visualized in 10 (15.8%), diagnosed as normal in 38 (60.3%) and pathologic (dilatation and/or lithiasis) in 15 (23.8%).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

The pancreatic enzymes value in the diagnosis of acute pancreatitis and acute biliary tract diseases.

UNLABELLED: The aim of this study was to investigate the usefulness of lipase and isoamylases in the diagnosis of acute pancreatitis and to determine if its use permits differential diagnosis between acute pancreatitis and acute biliary tract disease. Three groups of patients were studied. a) CONTROL: 60 patients without abdominal diseases. b) Acute pancreatitis: 60 patients, the diagnosis was made according to clinical symptoms, biochemical tests, U.S. and C.T. in 24 (40%), in the remainder 36 (60%) surgical confirmation was obtained. c) Acute biliary tract disease without macroscopic pancreatic damage, 30 patients, the diagnosis was made according to biochemical tests and U.S. in 4 (13.3%) whereas in the remainder 26 (86.6%) surgical confirmation was accomplished no later than a week of the beginning of the symptoms. Biochemical tests: serum and urine amylase, lipase, and total pancreatic and salivary isoamylases were evaluated. In the group of acute pancreatitis the highest diagnostic sensibility was: pancreatic isoamylase 95.5%, lipase 95%, total serum amylase 93.3% urine amylase 90%, serum amylase 78.3%. In acute biliary tract diseases a high number of elevated enzyme values were also found: pancreatic isoamylase 83.3%, total isoamylase 73.3%, urine amylase 66.6%, lipase 63.3%, serum amylase 53.3%. The mean enzyme values of both groups were compared statistically and showed no significant difference. We conclude that lipase and isoamylases are the best markers for the diagnosis of acute pancreatitis and the differential diagnosis with acute biliary diseases is difficult because an elevation of these enzymes is a characteristic shared by both pathologies. The diagnosis of acute pancreatitis based only in clinical symptoms and hyperamylasemia can be erroneous.

Acute Disease↗
PubMed1987

[Hepatic lesions induced by drugs. Report of 26 cases].

Two thousand six hundred and seventy one liver biopsies were reviewed from 1972 to 1985 at the Hospital A. Posadas. There were 26 patients with drug-induced liver injury; those who fulfilled the following criteria were included: contact with a drug known to produce hepatotoxicity; clinic, biologic and histologic picture corresponding to the drug studied, complete recovery after the drug was stopped and no other hepatic toxics. Fourteen patients showed estrogen-induced intrahepatic cholestasis, 5 had hepatitis-like lesions due to: alphamethyldopa (3), ketoconazole (1) and indomethacin (1). Carbon tetrachloride caused fatty degeneration in two patients and phenylbutazone a granulomatous hepatitis in one patient and cholestatic hepatitis in other. The last three cases were cholestatic lesions after the administration of chlorpromazine allopurinol and penicillin respectively. The evolution in 24 patients was excellent after the drug was withdrawn. Two patients died because of surgical complications since they were operated on with the wrong diagnosis of extrahepatic cholestasis.

Adult↗
PubMed1986

[Acute pancreatitis. Our experience].

Between the years 1975 and 1984, 228 patients with acute pancreatitis (A.P.) have been studied at the "A. Posadas Hospital". The diagnosis was confirmed in 212 patients by surgery, in the remaining 16 by clinical evaluation, increase in the activity of serum or peritoneal fluid amylase, ultra-sonography and computed tomography. The sex distribution was: female 151 (66.2%) male 77 (33.8%), the mean age in each group was 42.9 and 45 years respectively. The etiologic factors were: biliary tract disease 178 (78%) alcohol 24 (10.5%) idiopathic 16 (7%) others factors 10 (4.4%). We found mild and moderate forms of the illness in 179 (78.5%) and severe form in 49 (21.5%) patients. The mortality rate of the whole group was 29 (12.7%) and according to the etiology it was, in the biliary group 20 (11.2%) alcoholic 4 (16.6%) idiopathic 3 (18.7%). The mortality in the mild and moderate forms was 5% and 40.8% in the severe forms. The patients who underwent surgery were classified in three groups according to the opportunity of surgical treatment: elective surgery, early surgery, surgery for complications. There was no mortality in the elective surgery group. The patients operated on early period had a mortality of 18.75% (21 pts.) whereas those operated due to complications had a mortality of 42.1% (8 pts.). According to the above mentioned experience we consider that a patient with an A.P. must be classified with the known indexes in mild or severe forms, at the same time one should study the actual etiologic factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1985

[A double-blind study with misoprostol in the treatment of active duodenal ulcer].

Misoprostol (Mi, a double blind study in the treatment of active duodenal ulcer (DU). The purpose of the paper was to evaluate the effect of Mi vs. Placebo (Pl) without antacids, assessing at the same time side effects and histological alterations. Thirty five patients with active DU diagnosed by endoscopy and photography (performed on days, 0, 14 and 28) were studied. They received 4 doses/day of Mi 100 mcg, or Pl double blind. In each control, biochemical studies in blood and urine were performed. Acetaminophen, 500 mg was the only analgesic allowed. Six patients were excluded. Of the remaining 29 patients, 15 received Mi and 14 Pl. There was no difference in healing at the 14 day stage. At the 28 day stage there was complete healing of the ulcer in 66.6%, and reduction of the ulcer diameter of 89% those who received Mi. The healing rate was 28.5% and reduction of the ulcer diameter of 31% on those patients who received placebo. There were no biochemical alterations or side effects. There was no significative difference between biopsies taken from pylorus and antrum. The consumption of acetaminophen was similar to both groups. It is concluded that Mi has a healing effect similar to H2 blocking agents, accelerating the healing of active DU, without side effects and biochemical changes.

Acetaminophen↗
PubMed1984

[Chronic calcified pancreatitis. Our experience].

Forty five cases of chronic pancreatitis have been diagnosed between January 1966 to July 1983 in the Hospital A. Posadas. The diagnosis was confirmed by the presence of one or more of the following data: pancreatic calcifications positive in 35, abnormal secretin test 37, ultrasonography and computed tomography pathological findings 10. Surgical operations were carried out in 25 patients and biopsy taken in 5. Thirty nine (86.6%) were males, 6 (13.3%) females, the mean age in each group was 47.4 and 39.8 years. Chronic alcoholism was certain in 41 (91.9) patients, in the remainder 4 no other etiologic factors were found. The main clinical data were: Weight loss 38 (84.4%) diabetes 34 (75.5%) pain 33 (73.3% in 7 as acute pancreatitis) Steatorrhea 23 (51.1%) jaundice 16 (35.5%- 11 by extrahepatic biliary tree obstruction, 5 by hepatic cirrhosis) pseudocysts 12 (26.6%). The more common associated diseases were: hepatic cirrhosis 6, fatty liver 2 (17.7%) gastroduodenal ulcer 6 (13.3%) cancer 4 (8.8%--gastric 1, pancreatic 3). In order to study the frequency of the clinical data the patients were grouped according to the presence or absence of calcifications and the etiologic factor Symptoms and signs were matched and statistic analysis (coefficient association phi) was made. Only a moderate association between acute pancreatitis in no calcified group and diabetes in calcified group were found. The chronologic study of certains clinical data shows that acute pancreatitis, jaundice, pseudo-cyst and surgical operations were significative more frequent in the first five years while diabetes has little more frequency in the second five year period. Twenty six surgical operations were carried out in 25 patients; 20 (76.9%) due to complications, 6 (23.1%) secondary to pain (pancreatic resection 3, pancreatoyeyunostomy 2, exploration 1). Twenty three patients were lost to follow-up, 12 died and 10 are still alive. This last group was followed at regular period, 8 remained asymptomatic and 2 have intermittent abdominal pain related to alcoholic ingestion.

Alcohol Drinking↗
PubMed1982

[Emergency endoscopy in upper digestive tract hemorrhage].

The experience in upper G.I. tract hemorrhage accumulated during the first 30 months in the Emergency Hemorrhage Unit at the Hospital Posadas is here reported over a total of 428 endoscopies, we found 518 lesions. Ninety one (21%) presented with active bleeding, and 317 (76%) were considered as the probable cause of the bleeding. In 37 cases (8.6%) the site of bleeding was detected, but the diagnosis wasn't done. The most frequent lesions were erosive gastritis (21.2%), gastric ulcer (20%), erosive duodenitis (12.6%), duodenal ulcer (12.15%) and esophageal varices (12.12%) the diagnosis was normal 14.7% of the cases. One hundred and sixty one patients were admitted to the hospital; on 143 (88.82%) patients the original diagnosis was confirmed but it was modified in 18 patients (11.18%) by surgery or repeated endoscopy. During the last 20 months of the period the accuracy diagnostic of the endoscopy increased 95%. When compared with the first 10 months (76%) this fact shows, the importance of the experience acquired by the endoscopist. Most of the patients received medical treatment with a mortality of 9.02% and 25 patients received surgical treatment with a mortality of 28%.

Adolescent↗
PubMed1978

[Treatment of advanced digestive cancer with fluorouracil and methyl-CCNU].

We relate the experience obtained by treatment of 20 advanced digestive cancer patients, with the association of 5 fluorouracil and methyl-C.C.N.U. Objective response was found in 4 patients (20%). Toxicity consisted of leucopenia in 3 patients, allergic phenomena in 2 and diarrhea in 1 patient. Mean survival is increased in 3 months in responders, when compared with non-responders, although this difference has not statistical value.

Adult↗
PubMed1977

Biliary function studies in patients with celiac sprue.

Eleven patients with celiac sprue were studied. Biliary function in the basal state and gallbladder response to perfusion of the small intestinal mucosa with magnesium sulfate was assessed. It was shown that bilirubin output in basal conditions is decreased in these patients and that magnesium sulfate does not stimulate gallbladder contraction. In addition it was shown that in 4 of the 11 cases studied there was a complete lack of bile reaching the duodenum in the basal state as well as in 7 of 11 cases in the digestive period. That gallbladder function was intact was shown by the normal response to intravenous CCK-PZ administration, and the patency of the common bile duct was demonstrated by intravenous cholangiography. Thus the already impaired fat absorption in celiac sprue is magnified by the lack of bile delivery, and this is probably due to an alteration in the synthesis or release of endogenous CCK-PZ.

Adult↗