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Biomedical subjects

L Scotti

Publications and source records attributed to L Scotti.

At least 19 recordsLinked to original sources
PubMed1990

Combined mortality and morbidity of direct surgical treatment of abdominal aortic aneurysm.

Two hundred aneurysms of the abdominal aorta were treated surgically from 1980 to 1987 by the same surgeon. There were 187 men and 13 women whose mean age was 66.1 years. Nine patients were 80-years-old or more. Eighty-seven percent of patients had preoperative risk factors, 30% of which were coronary artery disease. The operative approach was through a transverse laparotomy in 188 patients compared to 11 midline incisions and one lumbotomy. An aortoaortic tube was inserted in 87 patients, a bifurcated prosthesis in 99, and a tube bypass in 14. Five patients (2.5%) died within the 30 day perioperative period. Death was due to colonic necrosis, right heart chamber thrombosis, renal failure after repeat operation for acute lower limb ischemia, and myocardial infarction associated with renal and respiratory failure. The morbidity rate was 15.7% (31 patients) and included seven neurologic accidents, four respiratory complications, five ischemic events of the lower limbs requiring reoperation and one amputation, four cardiac complications, two renal failures, one reversible colonic ischemia, one revision for incomplete hemostasis, one phlebitis, one sliding syndrome, and five minor infections or cutaneous complications. Mean duration of hospital stay was 10.9 days. These results confirm that direct operation on aortic aneurysms can be performed in patients from all age groups and even with associated diseases. A rapid, simple technique based on a transverse approach, minimal dissection and insertion of aortoaortic tubes, whenever feasible, appears to reduce combined mortality-morbidity.

Age Factors↗
PubMed1989

Infantile seborrheic dermatitis: seven-year follow-up and some prognostic criteria.

Based on clinical features, infantile seborrheic dermatitis (ISD) can be classified as follows: true seborrheic dermatitis (SD), psoriasiform seborrheic dermatitis (Psor SD), and erythrodermic seborrheic dermatitis. We reviewed the records of 72 children who had been affected by ISD several years earlier to investigate the evolution of disease, to evaluate the patients for the presence of new skin lesions, and to study family histories with respect to these conditions. In addition, we attempted to determine if there is any connection among the initial features of ISD and the types of skin lesions, and atopy or psoriasis. On reexamination, our patients previously diagnosed as having SD showed a larger variety of new skin lesions than those who had Psor SD, and 15% had developed atopic dermatitis. Atopic dermatitis was not present at follow-up in the children with previously diagnosed Psor SD. Psoriatic lesions were present in similar percentages in both groups at the time of reevaluation. Investigation of family history was not useful in predicting later development of psoriasis or atopic dermatitis. We conclude that the initial clinical features of ISD may be of prognostic value, and that SD and Psor SD are probably two different clinical entities.

Dermatitis, Atopic↗
PubMed1989

[Congenital multiple arthrogryposis. Report of a case].

Six patients affected by arthrogriposis multiplex congenita (AMC) are studied and the detected alterations, the adopted treatment and the obtained results are described and discussed. Notwithstanding the limited number of considered cases, it is underlined that a precocious, constant and protracted treatment can considerably help these patients to gain a certain degree of self-sufficiency though it can not heal serious deformations. This result is also supported by the cases published by the literature.

Arthrogryposis↗
PubMed1988

[Combined surgery of subrenal aorta and renal arteries].

Frequency and place of renal artery surgery during reconstructive aorto-iliac operation are discussed in relation to 25 patients operated upon between 1980 and 1986, these representing 4.1% of cases undergoing aorto-iliac surgery during the same period. Aortic lesions included 6 aneurysms of infrarenal aorta and 18 stenotic and/or occlusive lesions: 16 stage II, 1 stage III and 1 stage IV. Renal artery repair was for renovascular hypertension (13 cases), for renal prophylaxis (6 cases) and for technical reasons (5 cases), and consisted of direct reimplantation (3 cases), thrombo-endarterectomy (5 cases, including 2 trans-aortic by thoracolumbar approach) or bypass (18 cases, including 11 venous grafts-3 in a same patient - and 7 prostheses). In contrast to literature data reporting an intraoperative mortality of between 6.8 and 12% no postoperative death occurred in this series. Morbidity observed was 2 asymptomatic postoperative renal thromboses, 1 stenosis of marked degree of a renal artery after trans-aortic disobstruction treated successfully by endoluminal dilatation and finally, one case of acute renal insufficiency becoming chronic. No early or late complications were related to repair surgery to aorta and to lower limbs. Long-term results were comparable with those of other series, with recovery from hypertension in 15.3% of cases, improvement in 46.1% and persistence in 38.4%. The lack of mortality in this short series has led to wide indications for combined aortic and renal surgery, but definitive conclusions cannot be drawn because of the small number of patients treated.

Adult↗
PubMed1987

Treatment of lower urinary tract infections in children: single dose fosfomycin trometamol versus pipemidic acid.

Fifty-one children suffering from symptomatic and asymptomatic recurrent urinary tract infections were treated at random in a comparative study. A single dose of 2 g fosfomycin trometamol was administered to 24 children (2 males and 22 females, mean age 6.7 +/- 3.3 yr) and two 200 mg doses of pipemidic acid (400 mg in children weighing more than 25 kg) were administered daily to 27 children (3 males and 24 females, mean age 6.6 +/- 3 yr) for 7 days. Bacteriological results showed that at the end of followup (1 month) urine was sterile in 17 out of 24 children treated with fosfomycin trometamol (70.8%) and in 19 out of the 27 children treated with pipemidic acid (70.3%). One persistant infection and six reinfections were observed in the follow-up period in the fosfomycin group and 8 reinfections in the pipemidic acid group, usually in patients with urinary complications. No side effects were reported. The microbiological study of feces showed that neither of the drugs caused the emergence of resistant bacteria.

Adolescent↗
PubMed1986

Simultaneous revascularization of the internal carotid and vertebral arteries in their distal cervical segments.

Fibrodysplasic lesions or tortuosity, involving both ipsilateral carotid and distal vertebral arteries may be treated by a one stage combined procedure of external and internal carotid artery transposition and possibly dilatation of the internal carotid artery. Indications for this technique are uncommon. Only 4 of 969 cerebrovascular reconstructions performed between January 1980 and June 1986 utilized this method. Good results were obtained in all cases. This technique is a satisfactory and simple solution for certain situations requiring vascular reconstruction.

Anastomosis, Surgical↗
PubMed1985

[Popliteal aneurysms. Our experience apropos of 119 cases].

The authors report their experience of 119 popliteal aneurysms diagnosed in 76 patients. They feel that the prevalence of such aneurysms is underestimated. In 56% of cases there were bilateral aneurysms and in 24% of cases there was an associated aortic aneurysm. In 68% of cases, the popliteal aneurysm presented with complications. Clinical examination of the popliteal fossa gave a diagnosis in 66% of cases. In 1/3 of cases, arteriography failed to provide direct visual evidence of the aneurysm. The arteriographic diagnosis was then that of a femoro-popliteal thrombosis, of stenosis or isolated popliteal thrombosis. In all these difficult cases, echotomography is essential to diagnosis. The authors feel that indications for surgery should be as wide as possible. They consider that there are three types of contraindications: an excessively precarious physical condition, absence of a distal vascular network, an asymptomatic thrombosed popliteal aneurysm.

Adult↗
PubMed1985

[Medical and surgical outcome of thigh amputation for arteritis].

Results of a minimum 4 year follow up of 87 cases of thigh amputation are discussed. Postoperative mortality was 40% and 40% of patients had survived after one year. Early mortality factors were age (mean 75 years) and the coronary lesion responsible for more than a half of postoperative deaths. Amputation stump complications were noted in 13% of cases, their onset being dependent on 3 factors: loss of femoral pulse, failure of vascular re-establishment and early amputation after this failure. The remaining limb required major amputation in 21% of cases before the end of the second year, the final major level of amputation being a factor of the lack of distal revascularization in 77% of patients.

Age Factors↗
PubMed1983

[Serum lipoproteins and coronary disease in diabetes. Changes in the lipoprotein pattern in relation to the type of antidiabetic therapy].

One hundred and fifty seven maturity-onset diabetics (77 males and 80 females) with coronary heart disease (CHD) were compared with 130 non-CHD diabetic patients (62 males and 68 females) of the same age-range. Integrated mean blood pressure, duration of diabetes, serum triglycerides, beta and prebeta-lipoproteins were significantly higher and alpha lipoproteins significantly lower in CHD than in non-CHD patients. Alpha lipoproteins, duration of diabetes and beta lipoproteins were the variables of highest weight in discriminating CHD from non-CHD patients. Alpha lipoprotein had a greater discriminating power than beta lipoprotein in man, while in women the opposite occurred. In patients on insulin and on sulfonylurea therapy, both with and without CHD, the concentration of alpha lipoproteins, but not of other lipoproteins, was higher than in the corresponding subgroups of the diet-treated patients. However, within each treatment group, patients with CHD had lower alpha lipoproteins.

Blood Pressure↗
PubMed1983

[Thoracic outlet syndrome. Apropos of 112 cases: toward a more refined tactical approach].

A total of 112 operations were performed in 87 patients with a cervicobrachial syndrome, 25 with bilateral lesions, over a period of 8 years. Surgery was reserved for severe or complicated cases. Presenting signs were complex and intricated in 53 p. cent of cases, with neurological lesions predominating. Absence of radial pulse after 90 degrees abduction of the arm, present in 87 p. cent of patients, is not a specific diagnostic test as positive results are obtained in over one-third of a normal population. Electromyography confirmed clinical lesions of the brachial plexus in only one out of 8 cases. A more precise and more sensitive procedure for electromyographic exploration of the plexus was therefore established. Dynamic arteriography of the upper limbs was not conducted routinely (70 p. cent of cases), but was reserved for arterial, neuro-arterial, and arterial and venous forms. The axillary approach was used exclusively (94 times), between 1974 and 1980. However, the frequency of postoperative complications (10 p. cent), and the high level of poor or incomplete results (19.5 p. cent) led to the reestablishment of the supraclavicular route of approach. The latter is used preferentially in neurological forms (57 p. cent of cases in this series) in cases requiring correction of an arterial lesion (aneurysm, ulcerated plaque), or when a cervical rib or apophysomegalia of the 7th cervical vertebra is associated.

Adolescent↗
PubMed1979

CT detection of intracranial aneurysms in subarachnoid hemorrhage.

Contrast enhanced computed tomography (CT) scans of 59 patients with subarachnoid hemorrhage were evaluated for intracranial aneurysms. After prospective study, the CT results were compared with angiography. Depending on the location, the CT detection rate varied from a low of 36% for the internal carotid artery complex to a high of 76% for anterior and middle cerebral artery aneurysms. It was concluded that angiography may be deferred if the causative aneurysm is demonstrated by CT.

Basilar Artery↗