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Biomedical subjects

M Mauro

Publications and source records attributed to M Mauro.

32 records · Page 2Linked to original sources
PubMed1990

Biliary diversion for pancreatic carcinoma: matching the methods and the patient.

Two hundred eleven patients with adenocarcinoma of the pancreas were reviewed. Seventy had surgically constructed biliary-enteric anastomoses. Forty-two had percutaneous/endoscopic placement of biliary diversion catheters. Surgical biliary diversion was associated with discharge at 7 +/- 2 days postoperatively. Only five patients required subsequent reoperations for anastomotic failure secondary to continued tumor growth. Sixty-one percent of percutaneous/endoscopic catheters were associated with septicemia, and 27% occluded (average life span 36 days). Hospital days averaged 20 days of an average 64-day patient life span. After evaluation of computed tomographic scans and surgical findings, patients' diseases were arbitrarily divided into (A) local, (B) regional, and (C) distant spread. Survival was 417,300, and 53 days, respectively. In view of the morbidity associated with the percutaneous/endoscopic catheter, we recommend that its use be restricted to Group C patients.

Adenocarcinoma↗
PubMed1986

Antihypertensive and renal effects of tertatolol, a new beta-blocking agent, in hypertensive patients.

Tertatolol, a new nonselective beta-adrenoceptor blocker, was administered to 11 hypertensive patients in a short-term study. Systolic and diastolic blood pressure and heart rate were significantly decreased when compared to the placebo period: in spite of that glomerular filtration rate and renal plasma flow were unchanged. The administration of metoclopramide (a dopaminergic receptor antagonist) caused a significant reduction of renal plasma flow and a significant rise of renal vascular resistances during placebo, but no change during tertatolol therapy. A possible interference of tertatolol on dopaminergic receptors is discussed as the mechanism responsible for the unmodified renal plasma flow despite the significant blood pressure lowering with tertatolol.

Adrenergic beta-Antagonists↗
PubMed1986

CT features of intraabdominal abscesses: prediction of successful percutaneous drainage.

Fifty-three patients with 71 intraabdominal abscesses identified on computed tomography (CT) and treated with percutaneous abscess drainage were evaluated for the possible predictive value of any particular CT feature in relation to the outcome of percutaneous drainage. Features analyzed included the presence of a "rind," sharp exterior margin, air-fluid level, scattered internal gas bubbles, and internal septations, as well as size, site, and the presence or absence of fistulas as determined by sinography. Statistical analysis revealed that only site has predictive value; liver and subphrenic abscesses were more likely to have a successful outcome than abscesses in other locations (84% vs 47% complete cure). The presence of a long air-fluid level denoted communication with the gastrointestinal tract, which led to significantly longer drainage times and larger drainage volumes. Since there are no CT features that can strongly predict a poor outcome, all intraabdominal abscesses should be considered candidates for percutaneous drainage.

Abdomen↗
PubMedDate not supplied

[Collaborative study on peritoneal dialysis (PD) as first dialysis treatment in an Italian region: 1994-2000].

BACKGROUND: In Lazio, only about 5% of uremic patients are on peritoneal dialysis (PD). The present study focuses on the parameters of PD selection, the treatment schedules, and the clinical outcomes of PD patients in the nine public facilities offering a PD program. A cohort of 249 first-time PD patients, from July 1, 1994 to December 31, 2000, was retrospectively considered. METHODS: For the enrollment of the patients, the Regional Dialysis Registry databank was consulted. On December 31, 2000, a systematic review of patient charts was performed to extract the reasons for the PD choice, details of PD schedule, peritonitis episodes, reasons for drop-out, and patient survival rates. In regard to technique success-defined as the probability of having a patient alive on PD-change of modality and death were considered as final events. In regard to patient survival, only death, even in the first 2 months after a shift to hemodialysis, was considered the end point. RESULT: The main PD selection reasons were patient and/or nephrologist preference in 90% of cases. One-hundred eighty-nine patients (76%) had been started on CAPD. During the follow-up, 38.2% dialysis schedules had been modified at least once. At the end of follow-up, 41.2% patients were on APD. The peritonitis rate was one episode per 30 patient-months (1 per 27 patient-months in CAPD; 1 per 37 patient-months in APD; p = 0.08). The technique success rate was 66.3% after 2 years and 49.8% after 3 years. The patient survival rate was 81.1% after 2 years and 68.7% after 3 years. CONCLUSIONS: Patients chose PD as a first dialysis treatment mainly because of reasons unrelated to their clinical status. The technique's success, patient mortality rates, and the peritonitis rate do not explain the low PD diffusion in the region. The peritonitis rate meets the target criteria for excellence recommended by the Italian Society of Nephrology. The observed outcomes may have been favored by the selection of motivated patients and by the increased use of APD.

Adult↗
PubMedDate not supplied

[Postoperative course after laparoscopic surgery of the upper abdomen].

Laparoscopic techniques in general surgery have become a widely accepted method, especially for treatment of symptomatic gallstone disease. Many reports have investigated the indications, contraindications, equipment, techniques and outcome of laparoscopic procedures. However, as yet, relatively few studies have discussed the problems concerning patient's monitoring and care during the postoperative course. In the present paper, the authors review the pertinent literature analyzing the management of the postoperative period after laparoscopic surgery of the upper abdomen. Obviously, most data have regarded cholecystectomy, that is the most frequent procedure. Surgical laparoscopists have utilized knowledge deriving from gynecological experience, but these procedures are generally short and performed on young, otherwise healthy female patients. On the contrary, laparoscopic digestive surgery shows both gastrointestinal and peculiar general problems. These procedures are frequently performed on older patients who may have pre-existing diseases and require longer periods of peritoneal insufflation. During surgery of the upper abdomen, the pneumoperitoneum and the patient's operative position produce haemodynamic and respiratory changes coupled with acid-base disturbances. Intraabdominal hypertension causes a venous stasis along the inferior vena caval territory that can lead to a decrease in cardiac preload and in cardiac output. Usually, a compensatory increase in peripheral vascular resistance ensures normal or mildly high values of arterial tension. Furthermore, a hypercapnia and a mild mixed acidosis can develop as a result of the concomitance of different pathogenetic factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗