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Biomedical subjects

M B Speranzini

Publications and source records attributed to M B Speranzini.

At least 19 recordsLinked to original sources
PubMed1999

Perianal diseases in HIV-positive patients compared with a seronegative population.

PURPOSE: The aim of this report was to present our cases showing the prevalence and cause of perianal diseases in human immunodeficiency virus-positive patients. METHODS: We compared 1,860 human immunodeficiency virus-positive patients to 1,350 human immunodeficiency virus-negative outpatients with perianal diseases, examined from January 1989 to December 1996, and the results obtained with the treatment methods for seropositive patients. Among them, 88.7 percent were males, mostly in the age range from 30 to 50 years old. RESULTS: Condylomas, ulcers, hemorrhoids, fistulas, fissures, abscesses, and tumors were the most frequently diagnosed diseases. Two or more anal diseases occurred in 16.7 percent of patients. Among the human immunodeficiency virus-negative patients we noticed the same incidence of gender, and most were in the age range of 40 to 60 years old. Hemorrhoids, fistulas, skin tags, and fissures were diagnosed. CONCLUSIONS: From statistical analysis we may conclude that human immunodeficiency virus-positive patients have more condylomas, ulcers, tumors, fistulas, and abscesses than human immunodeficiency virus-negative patients, who have more hemorrhoids. Incidence of fissures was similar in the two groups.

Adult↗
PubMed1998

Healing after anal fistulotomy: comparative study between HIV+ and HIV- patients.

PURPOSE: The aim of this work was to compare wound-healing after anal fistulotomy in human immunodeficiency virus (HIV)+ and HIV- patients and to recognize healing parameters in HIV+ patients. METHODS: Sixty patients were treated with fistulotomy for intersphincteric anal fistula. For each patient, we evaluated white blood cell count values, T CD4 counts, Centers for Disease Control and Prevention classification, and healing duration. There were 31 HIV+ patients (7 A2; 1 A3; 7 C1; 6 C2; 10 C3). RESULTS: Seven C3 patients had incomplete healing. Statistically, there was no difference in the healing duration in HIV+ A2, C1, C2, and HIV-negative patients. C3 patients who did heal took longer than other HIV+ patients. T CD4 counts were similar to healed and not healed C3 patients, although healed C3 values of white blood cell counts were higher than not healed C3 values (4,450 and 2,380/mm3). CONCLUSION: After anal fistulotomy, HIV+ C3 patients either had retarded healing or no healing at all. Therefore, we feel that surgery should be done only in emergency cases of anorectal diseases or in patients with more than 3,000 white blood cells/mm3.

Adult↗
PubMed1998

The bilobed island flap in nasal ala reconstruction.

A bilobed island flap with an extended subcutaneous pedicle including part of the transverse portion of the elevator muscle of the nasal ala is described. This flap was employed for nasal ala reconstruction in 21 patients following excision of malignancy. The series includes 12 females and 9 males ranging in age from 25 to 83 years. In 19 patients, the reconstruction spared the mucosa layer and in two a skin graft was used under the flap to reconstruct the lining. The flap was viable in all cases and the aesthetic outcome satisfactory. The rotation fold dog ear is eliminated. In planning the BIF the length of its lobes (proximal and distal), should be equal to the defect; the width of the proximal lobe, compared to the defect, and the distal lobe compared to the proximal lobe should be progressively narrower.

Adult↗
PubMed1994

Total reconstruction of the auricle after traumatic amputation.

We report a technique of auricular replantation used in a case of traumatic amputation. The principal difficulties encountered in this type of replantation are mentioned, and ways of avoiding them are suggested. All the skin of the ear was removed except for that of the anterior surface of the conch. At this site, the cartilage received small, multiple perforations to allow for nutrition of the corresponding skin. The remainder of the auricular cartilage was covered by a skin flap undermined from the mastoid region. Three months later, the retro-auricular region was freed and covered with a total skin graft taken from the right supraclavicular region. On the basis of the satisfactory results obtained, we discuss the intention and the technical details of the method and possible contraindications.

Adult↗
PubMed1991

Bacteriology of the anal wound after open hemorrhoidectomy. Qualitative and quantitative analysis.

The purpose of this study is to analyze the size of the bacterial colonies in anal wounds after open hemorrhoidectomy. Twenty patients were studied during predetermined postoperative time periods. Material was collected from the surface and from within the tissue of each patient's three open wounds, intraoperatively, on the 6th, 13th and 20th postoperative days for bacteriologic examination in aerobic, microaerophilic, and anaerobic media. The bacterium most commonly identified was Escherichia coli, followed by Staphylococcus aureus and Staphylococcus epidermidis. Pseudomonas aeruginosa, Enterococcus faecalis, Klebsiella pneumoniae, Proteus vulgaris, and Proteus mirabilis were also identified. Critical indexes of colonization were present since the intraoperative stage (greater than 10(5) bacteria/g of tissue and greater than 10(6) bacteria/ml); obligate anaerobic bacteria were not identified; neither the species nor the number of bacteria, even when critical indexes were present, prevented proper healing. The same bacteria were not necessarily present on the surface and in the tissue; the bacterial load observed among the three wounds (left lateral, right posterior, and right anterior), was the same.

Adult↗
PubMed1991

Clinical regression of infected pancreatic necrosis. Case report.

Infected pancreatic necrosis was diagnosed clinically and radiologically in a patient admitted for acute pancreatitis. As free gas in the pancreatic area was recognized, antibiotic therapy (ceftriaxone) was empirically introduced, while surgical drainage was being planned. After the second week, the patient rapidly started to improve, to the point that he could be discharged home without operation. Control CT-scans and general laboratory tests, at this phase and later on, confirmed a still enlarged gland but free of infection or ongoing inflammation. Cholelithiasis, which had been identified in an early ultrasound scan, was electively treated by cholecystectomy 2 mo after the onset of pancreatitis, in the absence of sepsis, and with uneventful recovery. This case illustrates the rare possibility of spontaneous regression of infected necrotic pancreatitis, without any type of operation or nonoperative drainage.

Acute Disease↗
PubMed1991

Lower eyelid repair utilising triangular skin flaps with subcutaneous pedicles.

Fifty-four patients were studied during the period from 1984 to 1989. The lower eyelid was repaired in 55 cases utilising a triangular flap with a subcutaneous pedicle. Repair was achieved in 39 cases with a triangular flap only and in 16 it was necessary to use a chondromucosal graft of nasal septum as well. The method is described and is feasible for repairs ranging from the simplest to the most complex in different locations of the lid.

Basal Cell Carcinoma↗