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Biomedical subjects

M A Bianco

Publications and source records attributed to M A Bianco.

18 recordsLinked to original sources
PubMed1998

Prospective comparison of argon plasma coagulator and heater probe in the endoscopic treatment of major peptic ulcer bleeding.

BACKGROUND: Argon plasma coagulator was prospectively compared with heater probe in patients with bleeding peptic ulcers. METHODS: Forty-one patients with major stigmata of ulcer hemorrhage were randomly assigned to receive either heater probe (n = 20) or argon plasma coagulation (n = 21) treatment; 40% had active bleeding and 60% had a nonbleeding visible vessel in the ulcer crater. The two groups were similar with respect to all background variables. Episodes of recurrent bleeding were retreated with the same modality as used previously. Patients in whom treatment or retreatment failed underwent emergency surgery. RESULTS: Initial hemostasis (95% vs. 95.2%), recurrent bleeding (21% vs. 15%), 30-day mortality (5% vs. 4.7%), and emergency surgery (15% vs. 9.5%) were comparable in the heater probe and argon plasma coagulation groups, respectively. Argon plasma coagulation provided faster hemostasis (mean 60 +/- 19 vs. 115 +/- 28 seconds, p < 0.05). CONCLUSIONS: Argon plasma coagulation is safe and effective. Larger studies in patients with bleeding peptic ulcers are needed to confirm these promising results.

Aged↗
PubMed1998

Emergency endoscopic ligation of actively bleeding gastric varices with a detachable snare.

BACKGROUND: Bleeding gastric varices (BGV) is a challenging condition whose management remains controversial and often empirical. METHODS: Over the past 6 months, emergency ligation of BGV was performed in seven cirrhotic patients (five men, two women; age range 47 to 70 years) using a detachable snare. Child's grade was B in two and C in five patients. Two patients had a concurrent hepatocellular carcinoma. Three patients had been previously treated with either balloon tamponade or injection sclerotherapy for bleeding esophageal varices. RESULTS: Hemostasis was achieved in all patients. Morbidity consisted of fever in one case. Six snares passed spontaneously, one was removed from the stomach on follow-up examination. Post-ligation ulcers were detected in all patients after treatment (mean diameter 7.4+/-2.1 mm) with no stigmata of recurrent hemorrhage. No early rebleeding was observed during hospital stay. On a mean follow-up of 3.8 months (range 2 to 6 months), no digestive hemorrhage was recorded. Ligated gastric varices were significantly 'reduced in size in four patients. CONCLUSIONS: Emergency ligation with detachable snare is feasible and may be an alternative life-saving method of endoscopic hemostasis in BGV.

Aged↗
PubMed1997

Endoscopic retrieval of a surgical gauze from the common bile duct.

Non-parasitic foreign bodies in the common bile duct are rare and usually require laparotomy. We report the successful removal by endoscopy of a surgical gauze seven years after a simple cholecystectomy. The foreign body had been cholangiographically misdiagnosed as a large stone. The possibility of a foreign body that has migrated into the common bile duct should be considered in patients with cholangitis. Endoscopic sphincterotomy is the procedure of choice, though other extraction techniques may occasionally be necessary.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1997

Endoscopic mechanical lithotripsy of difficult common bile duct stones.

BACKGROUND: Mechanical lithotripsy for the management of difficult common bile duct stones has sometimes yielded conflicting results. METHODS: A series of 162 consecutive patients who underwent mechanical lithotripsy was evaluated retrospectively and a large number of variables tested for their association with successful outcome. RESULTS: The procedure was safe (morbidity rate 1.8 per cent) and effective (84.0 per cent stone clearance rate). Univariate and multivariate analysis showed that stone size was the only outcome predictor (mean(s.d.) diameter of grasped versus non-grasped stones 21.7 (6.7) versus 28.3(10.4) mm; F = 10.72, 98 d.f., P = 0.002). The cumulative probability of bile duct clearance ranged from over 90 per cent for stones with a diameter less than 10 mm to 68 per cent for those greater than 28 mm in diameter (P < 0.02). CONCLUSION: Patients at high risk of lithotripsy failure (stone diameter of 28 mm or more) might more wisely undergo surgery or other non-surgical procedures, such as extracorporeal shock-wave lithotripsy or long-term biliary stenting.

Adult↗
PubMed1992

Geographic risk factors for viral hepatitis and cytomegalovirus infection among United States Armed Forces blood donors.

In an effort to determine whether residence in a foreign country increases the risk of hepatitis B and C and cytomegalovirus (CMV) infection in United States (US) Armed Forces blood donors, 5719 volunteer donors at four US Navy blood banks were evaluated. Most participants were repeat donors (68%) and were young (mean age, 25 years), male (88%), and white (80%), black (10%), or Hispanic (7%). Birth outside of the United States was reported by 6 percent of subjects, and 34 percent had lived in a foreign country for more than 3 months. Twenty (0.3%) subjects had hepatitis B surface antigen (HBsAg), and 100 (1.7%) had antibody to hepatitis B core antigen (anti-HBc). Thirty-four (0.6%) were repeatably reactive in enzyme-linked immunosorbent assay for antibody to hepatitis C virus (anti-HCV); 11 (0.2%) had anti-HCV in immumoblot assay. Of the 3484 donors tested for anti-CMV, 1117 (32.1%) were positive. When demographic characteristics were controlled for both anti-HBc and anti-CMV seropositivies were independently associated in male blood donors with residence in the Philippines. Geographic factors were not associated with HBsAg and anti-HCV positivity. These findings indicate that the prevalence of serologic markers for viral hepatitis is low in military blood donors, but that residence in the Western Pacific is a risk factor for hepatitis B and CMV infection.

Adult↗
PubMed1991

In vitro activity of phenyl-O,N,N-azoxycyanide towards Candida spp. and Torulopsis spp.

Antifungal activity in vitro of phenyl-0,N,N-azoxycyanide has been tested against some strains of Candida spp. and Torulopsis spp. freshly isolated from humans. The results indicate good activity versus all yeasts tested. These data suggest that the azoxycyanide function could be used to obtain derivatives with potent anticandidal action, if conveniently vehicled by lypophylic compounds.

Antifungal Agents↗
PubMedDate not supplied

Prophylactic sclerotherapy of high-risk esophageal varices: results of a multicentric prospective controlled trial.

In this prospective, multicenter trial, 140 cirrhotic patients with no previous upper gastrointestinal bleeding and with esophageal varices endoscopically judged to be at high risk of hemorrhage were randomized to receive either sclerotherapy or conservative treatment for the prevention of first variceal bleeding. The end-points of the study were bleeding and death. Life table curves showed that prophylactic sclerotherapy significantly diminished the incidence of variceal hemorrhage (p less than 0.001) and overall mortality (p less than 0.01). Two-year cumulative bleeding rate was 18% in the sclerosis group (95% confidence interval = 10 and 31) and 57% (95% confidence interval = 40 and 72) in the control group. Two-year cumulative mortality rate was 30% (95% confidence interval = 19 and 45) in the sclerotherapy group and 56% (95% confidence interval = 39 and 72) in the controls. One patient died after hemorrhage from an ulcer secondary to sclerotherapy. Analysis by the Cox model of the factors potentially confounding or interacting with the effect of sclerotherapy suggested that sclerotherapy was more efficient in preventing first bleeding in patients with decompensated disease (Child B and C) than in those in good condition (Child A). However, the 2-year cumulative bleeding rate of untreated Child A patients was only 19%, showing how in this group the endoscopic findings were unreliable in selecting high-risk varices and explaining why after a 2-year follow-up prophylactic sclerosis did not show any benefit in such patients. We conclude that sclerotherapy can decrease the incidence of first variceal bleeding and death for a period of 2 years in cirrhotic patients with high-risk varices.

Adult↗
PubMedDate not supplied

Woodworkers' exposure to tannins.

The tannin concentration of hard- and soft-wood dust was determined in dust powder and in samples on filters. It varied from 1.6 +/- 0.3 mg g-1 (+/- SD) for fir, which is a soft wood, to 80 +/- 30 mg g-1 (+/- SD) for oak, which is a hard wood. The low detection limit of the spectrophotometric method (1.5 micrograms per sample) made the analysis possible with no interference from cellulose ester filters. In five woodworking shops the concentrations of the total dust varied from 0.2 to 20 mg m-3, while those of tannins varied from 2 to 341 micrograms m-3. As hard woods like oak or mahogany have a higher tannin concentration than soft woods, tannin concentration analysis in wood dust can be used as an indicator of exposure to hard-wood dust.

Air Pollutants, Occupational↗
PubMedDate not supplied

Presence of helper or suppressor factors to IgE synthesis in the serum of atopic and non atopic individuals.

IgE synthesis was studied in cultures of human blood mononuclear cells. A technical procedure described by Gleich and further modified by Buckley was applied. Cells from atopic and non atopic individuals were cultured in the presence of either fetal calf serum, homologous serum or autologous serum. Timothy pollen antigen extract to which the atopic individuals were shown to be highly sensitive was also added in aliquot cultures. The results are as follows: Cells from atopic patients were shown to produce more IgE in vitro following contact with their corresponding serum, as compared to fetal calf serum. In those cell populations, the culture in the presence of serum from non-atopic individuals dramatically reduced the amount of newly formed IgE. To a lesser extent, the reverse could be observed, i.e. an increased amount of IgE was produced by cells from non-atopic individuals in the presence of serum from atopics. The addition of the specific antigen failed to quantitatively modify the IgE production capacity of cells from atopics. There was no quantitative correlation between the RAST tests and the amount of newly produced IgE in the supernatants. These results suggest the presence of enhancing and suppressing factors modulating the IgE synthesis in vitro in serum from atopic and non-atopic individuals.

Animals↗