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Biomedical subjects

M Negri

Publications and source records attributed to M Negri.

At least 37 records · Page 2Linked to original sources
PubMed1996

The laparoscopic second look for ischemic bowel disease.

BACKGROUND: Survival after acute vascular ischemia depends on a second look laparotomy to detect extending bowel compromise and to verify the integrity of the anastomosis. In a series of five consecutive patients with acute ischemic bowel disease, we used laparoscopic technique to determine if a formal laparotomy could be avoided. METHODS: following the resection of ischemic bowel in five consecutive patients, two laparoscopic trocars were inserted in the lower abdominal quadrants and covered by sterile gloves. Forty-eight to 72 h following the primary operation, the abdomen was inflated via a trocar and secondary assessment done by laparoscopy. RESULTS: In all patients, the integrity of the anastomosis and viability of the remaining bowel was accurately assessed by laparoscopy. CONCLUSIONS: Using minimally invasive techniques, a second look laparotomy was avoided in 5 patients with ischemic bowel disease.

Aged↗
PubMed1996

The effect of metformin on liver blood flow in vivo in normal subjects and patients with non insulin dependent diabetes.

We previously reported that metformin improves insulin-mediated glucose liver metabolism in patients with non insulin dependent diabetes (NIDDM). It is not clear whether this is a direct effect of metformin on liver metabolism or mediated by other mechanisms such as increased liver blood flow. In this respect it has recently been reported that metformin increases hepatic blood flow (HBF) in diabetic rats. The aim of this study was to evaluate whether the administration of metformin is associated with modifications in HBF in humans. Patients affected by NIDDM (n = 11) and normal subjects (n = 6) were studied. In the first protocol HBF was investigated in six overweight (BMI 27 +/- 2 Kg/m2) NIDDM patients and six normal subjects (age and BMI matched) already on metformin treatment before and 2 h after the administration of 500 mg metformin. In the second protocol HBF was investigated in obese (BMI 32 +/- 1 Kg/m2) NIDDM patients (n = 5) in good metabolic control before and after 15 days of metformin at the dose of 1 g daily. HBF was measured by intravenous injection of 3 mCi 99mTc-phytate. In both protocols no significant changes in HBF were observed following metformin administration either in NIDDM patients or normal subjects. No significant differences were observed in HBF between diabetic patients and normal subjects. These data indicate that metformin has no effect on HBF in man. The previously reported improvement of insulin mediated liver metabolism induced by metformin is likely to be a consequence of the direct effect of the drug at hepatocyte level which is independent of HBF modifications.

Adult↗
PubMed1996

How does infected bile affect the postoperative course of patients undergoing laparoscopic cholecystectomy?

OBJECTIVES: To assess the rate of infected bile in patients undergoing laparoscopic cholecystectomy (LC) and to study the influence on the postoperative infective complications in this group of patients. METHODS: Bile samples of 247 patients undergoing LC were collected and cultured for aerobic and anaerobic bacteria. All patients were given prophylactic antibiotics. RESULTS: The overall rate of infected bile was 12.8% (56 positive cultures); of these, 54 were aerobic and 2 anaerobic bacteria. Only 2 patients developed infection at the umbilical site, and in both, the bile was sterile. None of the patients with positive bile cultures developed any signs of infection during a mean follow-up period of 26 months. CONCLUSION: The overall rate of septic complications following LC is extremely low, and at least in our study no correlation was found between infected bile and septic complications.

Adolescent↗
PubMed1996

Plasma met-enkephalin levels in diabetic patients: influence of autonomic neuropathy.

The presence of opioid peptides within pancreatic islets in several animal species and in humans suggests that these peptides could play a role in pancreatic endocrine secretion, influencing glucose metabolism. We measured plasma met-enkephalin (met-Enk) levels in eight neuropathic (four with insulin-dependent diabetes mellitus [IDDM] and four with non-insulin-dependent diabetes mellitus [NIDDM]) and eight nonneuropathic (four IDDM and four NIDDM) diabetic patients to study met-Enk secretion in diabetic patients with asymptomatic autonomic neuropathy. Plasma met-Enk levels were significantly lower in neuropathic compared with nonneuropathic patients both in the IDDM group (28.7 +/- 4.8 v 61.6 +/- 4.1 pg/mL, P < .0025) and in the NIDDM group (26.5 +/- 3.6 v 44.3 +/- 4.6 pg/mL, P < .0125). This study suggests that the presence of neuropathy in diabetic patients, even if asymptomatic, is associated with a significant decrease of plasma met-Enk levels, thus contributing to a worsening of metabolic control under stress conditions.

Adult↗
PubMed1996

Gastric Emptying Half-time Following Silastic Ring Vertical Gastroplasty: A Scintigraphic Study (Preliminary Results).

BACKGROUND: The mechanism for weight loss following gastroplasty surgery is unknown. A few studies have checked gastric emptying patterns following gastroplasty, but none have analyzed their pattern over time. METHODS: Gastric emptying half-time of Tc-99 phytate-labeled semi-solid meal was studied in 23 obese non-diabetic and one diabetic patient (BMI 34.6-55.7). Gastric emptying was measured by gamma scintigraphy before Silastic Ring Vertical Gastroplasty (SRVG) and 1, 3 and 6 months following surgery. RESULTS: Gastric emptying half-times were maximal in all areas of the stomach 1 month after operation, declined to base-line 3 months following the procedure, and showed statistically significant delay in the upper area of the stomach 6 months after the operation. No correlation was found between the delay in food passage following surgery and loss of weight. CONCLUSIONS: Prolongation of gastric emptying half-time following surgery may be a result of two separate mechanisms: asymptomatic or early inflammatory processes in the ring area and pouch distention as a result of partial denervation.

Journal Article↗
PubMed1996

A 5-year (1989-1993) prospective study of the incidence of IDDM in Rome and the Lazio region in the age-group 0-14 years.

OBJECTIVE: To provide data on the incidence of IDDM in Rome and the Lazio region evaluated prospectively from 1989 to 1993 for a total of > 5 million subjects younger than 15 years. RESEARCH DESIGN AND METHODS: All patients with newly discovered IDDM diagnosed between 1 January 1989 and 31 December 1993 among residents in Rome and its region were recorded. Primary ascertainment was based in diabetes clinics and specialized hospitals in the region, whereas the secondary independent source was taken from the archives of the region where patients are registered to obtain exemption from paying for medications. RESULTS: We identified 330 new patients with a degree of ascertainment of 85%. Overall the incidence rate of the disease was 7.9 per 100,000 per year (95% CI 7.1-8.8). The incidence was higher in the 5- to 9-year-old age-group (10.4 per 100,000) and in winter (36.2%). The cumulative risk for the disease is on the order of 1.18 per 1,000 subjects < 15 years of age. No significant differences in incidence were observed between boys and girls. There were 14 instances of coma at diagnosis (4.3%), but hyperglycemia without ketonuria was diagnosed in 35% of patients, suggesting an early diagnosis. DISCUSSION: Compared with the other continental Italian regions for which data are available for a single year, the IDDM incidence rate in Rome is similar. We conclude that the IDDM incidence rate in Rome and its region is comparable to that in other Southern European countries and remained stable over the 5-year observation period.

Adolescent↗
PubMed1996

[Electrocochleography by extra- and transtympanic methods: the results in a group of normal subjects].

Electrocochleography (ECoG) is an electrophysiologic approach to the study of hearing. In ECoG, electrical activity that originates within the cochlea or the auditory nerve is recorded. ECoG represents an evoked or stimulus dependent measure. The electrical potentials which can be analyzed in ECoG are: the cochlear microphonic potential (CM), the summating potential (SP) and the acoustic nerve potential (AP). Two major types of electrocochleography electrodes can be used, transtympanic and extratympanic. Transtympanic ECoG is performed by inserting a long needle electrode, placed through the tympanic membrane onto the promontory. Extratympanic ECoG is recorded by using electrodes placed within the external meatus near the tympanic membrane. At the ENT Department of the University of Parma, ECoG was performed in 10 normal hearing subjects (4 males and 6 females. Their ages ranged from 21 to 29 years (mean 26 years). All subjects underwent ECoG recording simultaneously with extratympanic and transtympanic technique.

Adult↗
PubMed1996

[Brainstem auditory evoked potentials in neonatology: the method and results in a group of normal newborns].

Brainstem evoked responses audiometry was performed on 10 newborn infants. They ranged in postnatal age from 19 hours to 5 days and in estimated gestational age from 39 to 42 weeks. Clicks of 0.1 msec duration were presented at a rate of 11.4 per second. Measurements were made at 50, 80 and 100 dB. Wave V latencies were evaluated at 50, 80 and 100 dB HL in order to measure the auditory threshold. The latency of wave V is the datum of interest. Wave V responses were obtained bilaterally at 50 dB HL. Waves I and III latencies were measured at 100 dB HL.

Acoustic Stimulation↗
PubMed1995

Comparison of serum C-reactive protein concentrations for laparoscopic versus open cholecystectomy.

In an attempt to quantify the difference in tissue damage between open cholecystectomy (OC) and laparoscopic cholecystectomy (LC), we have compared in a prospective manner the pre- and post-operative concentrations of serum C-reactive protein (CRP) in 17 patients undergoing LC and 13 patients undergoing OC. In addition, we measured the pre- and postoperative white blood cell counts (WBC), the postoperative body temperature, and the postoperative duration of hospitalization. There were no differences in the preoperative serum CRP concentrations--5.9 +/- 2.62 mg/l (mean +/- SD) for the LC group and 6.12 +/- 2.38 mg/l for the OC group. Serum CRP rose markedly following OC compared to that of patients who underwent LC (128.6 +/- 45.1 mg/l vs 26.8 +/- 10.5 mg/l) (P < 0.001). There were also significant differences in the postoperative WBC count (14,000 +/- 2,900 cells for the OC group vs 10,600 +/- 3,000 cells for the LC group), the postoperative body temperature (37.5 +/- 0.3 degrees C vs 37.0 +/- 0.3 degrees C), and the postoperative hospital stay (5.5 +/- 1.5 days vs 1.9 +/- 0.9 days). There was no correlation between serum CRP concentrations and the other postoperative parameters. These results provide us with biochemical evidence supporting the clinical observation that LC is far less traumatic to the patient than OC.

Adult↗
PubMed1995

The fate of long-standing intraperitoneal gallstone in the rat.

Gallstones are occasionally spilled into the peritoneal cavity during open and laparoscopic cholecystectomy. Using the rat model, we investigated the long term effect of such retained intraperitoneal gallstones. During a follow-up period of one year, no systemic deleterious outcome could be attributed to the presence of the implanted gallstones except for mild local effects. Based on the rat model we conclude that reasonable effort should be made in order to retrieve an escaped gallstone, but there is no justification whatsoever for a conversion of the laparoscopic procedure to an open laparotomy only for the purpose of retrieving a lost stone.

Animals↗
PubMed1995

Gastric Mucosal Changes following Gastroplasty: A Comparative Study Between Vertical Banded Gastroplasty and Silastic Ring Vertical Gastroplasty.

BACKGROUND: Long-term changes of gastric mucosa following surgery for morbid obesity have never been studied, to the best of our knowledge. As 31 patients in our series presented with various gastrointestinal complaints following surgery, we used this opportunity to study mucosal changes. METHODS: Thirty-seven gastroscopies were performed on 31 patients, 20 patients following Vertical Banded Gastroplasty (VBG) and 11 patients following Silastic Ring Vertical Gastroplasty (SRVG) with various gastrointestinal complaints. Macroscopic appearance of the gastric mucosa was examined and biopsies taken from the proximal gastric pouch, the transitional zone and distal stomach. RESULTS: In most patients, macroscopic appearance of the proximal and distal pouches was normal. Pathological findings were mainly located in the transitional zone and were found mainly in the VBG group. CONCLUSIONS: This study indicates that damage to the gastric mucosa is related to the surgical technique, and mainly to the strip of mesh used in the VBG patients. Since hyperplasia and metaplasia were among the microscopic findings, a question is raised about the possibility of malignant transformation. We suggest that routine post-operative gastroscopies be considered, especially following VBG.

Journal Article↗
PubMed1995

Beta-endorphin in silent duodenal ulcer.

OBJECTIVE: To investigate whether duodenal ulcer patients with painful active peptic ulcer and those with silent active ulceration have different plasma beta-endorphin levels. PATIENTS: Forty-five patients (28 men and 17 women), aged 38-50 years, with at least a 5-year history of duodenal ulceration. Twenty-two patients had painful symptoms, while 23 had silent active duodenal ulcer. METHODS: Beta-endorphin plasma levels (pmol/l) were measured during an acute episode of duodenal ulcer, before and after antisecretory therapy with omeprazole. In three patients we measured the concentration of beta-endorphin in gastric juice before and after pentagastric (6 micrograms/kg subcutaneous) stimulation. RESULTS: The basal values of beta-endorphin in both patients with asymptomatic and those with symptomatic duodenal ulcer showed no difference before or after 30 days of antisecretory treatment. Plasma beta-endorphin levels (median values in the normal range < 12 pmol/l) were significantly higher (Student's t-test, P < 0.005) in the asymptomatic than in symptomatic patients, both before (9.07 +/- 4.8 versus 5.6 +/- 2.5 pmol/l) and after (8.7 +/- 4.1 versus 5.7 +/- 2.4 pmol/l) omeprazole treatment. The highest levels of beta-endorphin were found in four patients with a negative history for any pain symptom (visual analogue scale score 0). CONCLUSIONS: Our data suggest that the opioid system, particularly beta-endorphin, is involved in the perception of pain in duodenal ulcer disease, which explains the silent clinical characteristics of some peptic ulcers. In addition, the concentration of beta-endorphin found in gastric juice indicates a possible peripheral effect of this opiate.

Adult↗
PubMed1995

[Laryngeal tuberculosis: a case report].

Laryngeal tuberculosis is considered by now a rare disease after the introduction and use of chemotherapeutic drugs the incidence of laryngeal tuberculosis an increase in the world population, including industrialized countries; this is partly due to the pandemy of the Acquired Immuno-Deficiency Syndrome (AIDS). The authors report a case of miliary laryngeal tuberculosis.

Humans↗
PubMed1994

[Surgery for acute arterial emboli to the arm].

During a 5-year period (1987-1992) we removed under local anesthesia 20 emboli and 2 thrombi from the arms of 18 patients aged 60-90 using a Fogarty catheter. 18 of the emboli (90%) were of cardiac origin. 1 patient had thrombosis of the axillary artery (2 episodes). The occlusions were brachial in 14 (70%), axillary in 5 (25%), and radial in 1. From 1.5 hours to 1 week elapsed between onset of symptoms and operation. 9 patients underwent arteriography. Surgery was successful in 19 (95%). Limb necrosis developed in a patient operated on 1 week after onset of symptoms. Necrosis progressed despite a palpable radial pulse. 33 patients (15%) died of causes unrelated to the operation: 2 had terminal cardiac disease and the third concomitant occlusion of the superior mesenteric artery. Early surgical exploration is advocated for acute arterial embolism of the upper extremity. Ischemic changes may be reversible even later than 24 hours from onset of symptoms. Routine arteriography is not needed before surgical exploration of these cases.

Aged↗
PubMed1994

Continuous esophageal pH monitoring during laparoscopic cholecystectomy.

Gastro-esophageal regurgitation (GER) and eventual aspiration is considered a major risk during general anesthesia. High intraperitoneal pressure produced during laparoscopic cholecystectomy (LC) is a possible source of increased GER. We investigated the incidence of GER using continuous esophageal pH monitoring in 14 patients undergoing elective LC. Only two brief episodes of acid reflux (pH < 4) occurred during LC. Apparently the high intraperitoneal pressure during LC carries no increased risk of regurgitation and aspiration.

Adult↗