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Biomedical subjects

O Giordano

Publications and source records attributed to O Giordano.

At least 37 records · Page 2Linked to original sources
PubMed1978

[Unusual case of urogenital anomaly].

A case of associated malformation of the urogenital apparatus, right renal aplasia associated with uterus unicornis with the second uterine duct being independent of the first and located in the corner of the right iliac vessels, in reported in a woman of 41. Three pregnancies had all terminated regularly with live foetus born from eutocic delivery. The unusual nature of the case is insisted on and it would not seem possible to include it in any of the five classes established by Musset et al.

Adult↗
PubMed1978

[Intraoperative peritoneal lavage in generalized acute peritonitis. Experience with 61 cases].

After wide preface about peritoneal anatomy, pathological, physiology and physiopatology and about the physiopatology of general acute peritonitis, a case records of 61 patients is produced. All the patients were shocked and urgently operated for general acute septic peritonitis and were abundantly washed with a polisaline solution during the operation. That washing technique is described and the authors remark its abundancy (at least 10-12 litres) and its systematicity. They also remark that the washing is the true and main moment of the reanimation and it is the most important salvage action in the general acute peritonitis. The antibiotical therapy, especially the topical one, and the drainage are only complementary elements in the treatment. Among 61 patients, with an average of 54 years, there were eight deaths (13%) in old patients, with an average of 71 years and they were all caused by cardiac and circulatory disease. No patient died for peritonitis or for toxic-infections causes. The postoperative morbility (eight patients-13%) was mainly caused by the infection of the laparotomy and it only prolonged some days the stay in hospital.

Adolescent↗
PubMed1977

[Complication of spontaneous internal biliary fistulae (experiences in 46 cases)].

Spontaneous internal biliary fistulas are complications of biliary disease and may themselves be the source of further complications. Instances of the latter observed in a series of 28 bilio-digestive and 18 bilio-biliary forms are described: angiocolitis, biliary peritonitis, cholangitic cirrhosis, diarrhoea and malabsorption syndrome, haemorrhage, biliary ileus and Bouveret syndrome. Stress is laid on the need for early diagnosis and early surgery. It is pointed out that there is no such thing as an innocuous biliary calculus.

Aged↗
PubMed1977

[Spontaneous bilio-biliary fistulae. Experience in 18 cases].

Six cholecyst-hepatic, nine cholecyst-hepatic-choledochic, and three cholecyst-choledochic spontaneous fistulae were observed in subjects (89% females) aged 28-76 (average 52) yr, forming 0.9% of a series of bile duct operands. Lithiasis is seen as the origin of these forms. A large calculus wedged in the gallbladder basis leads, due to decubitus, to symphysis between the basis and the main bile duct. Later, infection results in necrosis of the walls and gives rise to the fistula. The symptoms are not pathognomonic. Clinical diagnosis is virtually impossible and the condition is usually an unexpected surgical discovery. The only sound management consists of elimination of the fistula and calculus and reestablishment of free bilio-enteric transit. Anterograde cholecystectomy (including section of the organ in nearly every case) may or may not be accompanied by papillotomy. The fistulae is sutured or a bilio-enteric diversion is provided. Personal experience suggests that Y-diversion to the jejunal loop according to Roux is preferable to choledocho- or hepatico-duodenostomy. Very good results are usually obtained and mortality is low at 5-9%.

Adult↗
PubMed1977

[Trans-sheath laparotomy of the rectus muscle in appendectomy].

Reference to personal experience covering 2035 appendicectomies is referred to in an account of the technique of transvaginal laparotomy of the rectus muscle. Here the sheath of the rectus and the peritoneum are incised at different levels and in different directions. The outside border of the sheath is not touched and the muscle is displaced medially, without section or displacement of the muscle fibres. If required, the operation can be extended upwards or downwards into a pararectal incision without departing from the context of the sheath. The technique is easy and gives ample vision. Closure is simple, rapid and cosmetically satisfying. The resulting solidity of the wall means that laparocele does not occur.

Appendectomy↗
PubMedDate not supplied

Phytochemical study and anti-inflammatory properties of Lampaya hieronymi Schum. ex Moldenke.

The chemical study of aerial parts of Lampaya hieronymi Schum. ex Moldenke yielded oleanolic acid, epi-oleanolic acid, epi-maslinic acid, 4'7-dimethoxyapigenin, p-hydroxyacetophenone, and p-hydroxyacetophenone-beta-glucoside. In searching for natural products as potential anti-inflammatory agents, all the compounds, except 4'7-dimethoxyapigenin were evaluated in vivo for their ability to inhibit acute inflammation. Our studies demonstrated that p-hydroxyacetophenone and the triterpenes produced protective effects in carrageenan induced paw edema in mouse, at 1-3 h and 3-5 h, respectively, after the injection of carrageenan. These results indicated that their effects might correlate with the release of histamine, serotonin, kinin and prostaglandins.

Animals↗
PubMedDate not supplied

[Spontaneous bilio-digestive fistulas. Experience with 27 cases].

A series of 27 cases of biliary-digestive fistulae is presented. 26 were due to calculi and 1 to ulcer and calculi. 20 led to the duodenum, 6 to the colon, and 1 to the stomach from the gallbladder. The series constituted 1.4% of bile ducts operations. Females (mostly multiparae) formed 66%. The mean age was 64 yr. Direct fistulae (66%) had the appearance of surgical openings, whereas the indirect forms (34%) included a fistulous connection between the mucosae of the two organs. There was no distinctive symptomatology. In most cases, the fistula was formed during a serious exacerbation episode of the underlying diseases, whose symptoms, if occasional, tended to become continuous. Pre-operative diagnosis was difficult, though suspicion was present in 44% of cases. Radiological examination is essential for this purpose. Pneumoangiocholia observed during direct examination of the abdomen is virtually pathognomonic. Examination of the bile ducts with contrast medium given venously or per os proved less useful, since the fistula was very difficult to detect; at best, pneumocholecyst between the main duct and the opposing duodenum could be seen. Detection was, on the other hand, possible in over 50% of cases on examination of the digestive apparatus with contrast medium per os or rectally. Treatment consists of removal of the fistula and the disease responsible for it. Very good results were obtained, with a mortality of 3%.

Aged↗
PubMedDate not supplied

[The single-stage surgery of colorectal neoplastic occlusion. The experience of 133 cases].

BACKGROUND AND AIM: 133 cases of occluded colorectal neoplasms (14% of the entire series): 30 (23%) of the right colon, 103 (77%) of the left colon-rectum; 69 males (52%) and 64 females (48%); mean age 67.5 years old, range 33-91 years. pTNM: stage II, 28 cases (21%); stage III: 43 cases (32%); stage IV, 62 cases (47%). The aim of this study was to resolve the occlusive symptoms and to treat the neoplasm in a single operation. METHODS: In the 62 cases at stage IV, surgery was solely palliative: 49 (79%) derivations, 13 (21%) entero-enterostomies and 36 (58%) preternatural anus; 11 (18%) standard hemicolectomies, extended in two cases to hepatic resection, and 2 (3%) Hartmann's operations. In the 71 cases at stages II and III, surgery took the form of standard colic exeresis with primary ligature of the colonic vessels at source and at the outlet; 15 (21%) right colectomies, 50 (70%) left colectomies, extended in 6 cases (8%) to abdomino-perineal amputation; 6 segmentary colectomies, 3 (4%) of the transverse colon and 3 (4%) Hartmann's operations. The following aspects are essential in this single-stage surgery: urgency; massive dose antibiotic treatment limited to the pre- and perioperative stages; peritoneal cleansing using accurate, methodical, repeated and abundant lavage; perioperative colonic preparation using direct colotomic perioperative lavage or using a trans-buccoenteric access (using Grosz-Dennis tube); the peritonisation of the retroperitoneum with the omentum and the protection of the anastomosis using omental wrapping and active lavage and, for colorectal anastomosis, even using the 3-way tube, lavage and active aspiration, in a transanal trans- or sub-anastomotic position. Total parenteral feeding is useful for 6-7 days. RESULTS: In the 62 cases at stage IV, postoperative morbidity was 3 cases (6%): 3 suppurations of laparotomy, and mortality occurred in 10 cases (16%): one case of anastomotic disunion (pre-Gullino's tube), 3 cases of septic shock and 6 cardiorespiratory failures. Mean postoperative hospitalisation was 14 days. All these patients died owing to the spread of neoplasms within 1-40 months, mean 13 months. The worst results were obtained in entero-enterostomies: 1-9 months, mean 5 months. In the 71 cases at stages II and III, postoperative morbidity was 3 cases (4%): a small anastomotic filtration after right colectomy and 2 suppurations of the laparotomic incision; mortality amounted to 10 cases (14%): one case of septic shock, one of acute hepatitis, one intestinal infarction and one cardiac infarction, 3 pulmonary embolisms and 3 cardiorespiratory failures. Mean postoperative hospitalisation was 13 days, only 10 in cases of left colectomy with anastomosis protected by Gullino's tube. The long-term results were very good in these 71 patients: over 5-year survival of 50% (Kaplan-Meier). CONCLUSIONS: Using this courageous single-stage surgery, the results are optimal even at a distance, together with reduced surgical trauma and a shorter hospital stay.

Adult↗
PubMedDate not supplied

[Carcinoma of the ileo-cecal appendix].

A structurally impaired appendix observed during laparotomy in a woman of 62, suffering from gall stones with stenosis of the papilla, was removed. Histological examination showed carcinoma. Right hemicolectomy was performed later.

Adenocarcinoma, Mucinous↗