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Biomedical subjects

P Bernardini

Publications and source records attributed to P Bernardini.

At least 19 recordsLinked to original sources
PubMed2002

Effect of acute load of grapefruit juice on urinary excretion of citrate and urinary risk factors for renal stone formation.

The effect of citrus fruit juice ingestion on the risk of calcium oxalate stone formation is still debated. The present study was undertaken to investigate changes in urinary stone risk factors after administration of a soft drink containing grapefruit juice. Seven healthy subjects, with no history of kidney stones, were submitted to an acute oral load (20 ml/kg body weight over 60 min) of a soft drink containing grapefruit juice diluted (10%) in mineral water. After a 7-day wash-out period, each subject underwent an oral load with mineral water alone under the same conditions. Urine specimens were collected before (for 120 min) and after each oral fluid load (for 180 min). Urinary flow was significantly increased after both grapefruit juice (46+/-26 vs 186+/-109 ml/h, p = 0.01) and mineral water (42+/-16 vs 230+/-72 ml/h, p=0.001) compared to baseline. Compared to mineral water, grapefruit juice significantly (p=0.021) increased urinary excretion of citrate (25.8+/-9.3 vs 18.7+/-6.2 mg/h), calcium (6.7+/-4.3 vs 3.3+/-2.3 mg/h, p=0.015) and magnesium (2.9+/-1.5 vs 1.0+/-0.7 mg/h, p=0.003). Citrus fruit juices could represent a natural alternative to potassium citrate in the management of nephrolithiasis, because they could be better tolerated and cost-effective than pharmacological calcium treatment. However, in order to obtain a beneficial effect in the prevention of calcium renal stones a reduced sugar content is desirable to avoid the increase of urinary calcium due to the effect of sugar supplementation.

Adult↗
PubMed2001

The Legnano radiology picture archiving and communication system/radiology information system project implementation.

The necessity to meet the ever-increasing diagnostic and interventional demands in the most cost-effective and efficient way led to the decision to turn the Department of Radiology at Legnano City Hospital nearly filmless. Crucial for the implementation of this challenging project was the development of a sophisticated and efficient digital architecture along with a nearly global renovation of the whole department, connecting it in the meantime to the hospital asynchronous transfer mode (ATM) backbone. The highlights and drawbacks faced in the implementation of the project are described and discussed.

Computer Systems↗
PubMed2001

[Epidemiology and physiopathology of urinary incontinence after radical prostatectomy].

Beginning in the 1980s, a series of anatomical discoveries were introduced to modify the classic retropubic radical prostatectomy proposed by Millin in 1942 in an effort to reduce intra and postoperative complications such as intraoperative bleeding and postoperative erectile dysfunction and incontinence. Urinary incontinence post retropubic "anatomical" radical prostatectomy remains a distressing problem for the patient and the physician rating from 6 to 20% even in the hands of experienced surgeons from high volume Academic Centers. The reason for the discrepancy in results is unclear and should be searched in surgical experience of the surgeon, volume of surgical activity of the Center, and selection of the patients undergoing the radical retropubic procedure. In the Literature we identified methodological factors which can bias the data on post radical retropubic prostatectomy such as 1) Consensus is lacking on definition of continence and/or incontinence following radical retropubic prostatectomy 2) Different surgical techniques are compared: sphincter damaging, versus repairing, versus preserving; bladder neck sparing versus non sparing; nerve sparing versus non sparing 3) Patients with preoperative urinary incontinence are included in the series and the preoperative continence status is not known. 4) Different timing in registration of incontinence. 5) Different methods in data collection. This latter seems to be the most important reason for discrepancy in the collection of the data. Self administered questionnaires oriented to evaluate incontinence analyzed by a third party seem to be the most powerful and objective tool for post prostatectomy incontinence rating. Post prostatectomy incontinence may be attributed to sphincter dysfunction as a result of surgical injury during prostatic surgery and/or to bladder dysfunction including detrusor instability and decreased compliance resulting in stress or urge or mixed stress/urge postoperative incontinence. In the Literature bladder dysfunction is considered to be responsible or jointly responsible for post RRP incontinence in a rate as high as 93%. More recently, a major role is considered to be played in post RRP incontinence pathophysiology by intrinsic sphincter insufficiency. Rarely bladder dysfunction is an isolated cause of incontinence. Moreover the symptom of stress incontinence accurately predicts the finding of intrinsic sphincter deficiency. The apical dissection and the preservation of the intrinsic sphincter remain the most complex parts of RRP and the keys to the maintenance of postoperative urinary continence.

Humans↗
PubMed1999

Photoadaptation of two members of the Chlorophyta (Scenedesmus and Chlorella) in laboratory and outdoor cultures: changes in chlorophyll fluorescence quenching and the xanthophyll cycle.

The role of the xanthophyll cycle in the adaptation of two chlorococcal algae Scenedesmus quadricauda and Chlorella sorokiniana to high irradiance was studied under laboratory and outdoor conditions. We wished to elucidate whether the xanthophyll cycle plays a key role in dissipating the excesses of absorbed light, as in higher plants, and to characterise the relationship between chlorophyll fluorescence parameters and the content of xanthophyll-cycle pigments. The xanthophyll cycle was found to be operative in both species; however, its contribution to overall non-photochemical quenching (NPQ) could only be distinguished in Scenedesmus (15-20% of total NPQ). The Scenedesmus cultures showed a larger pool of xanthophyll-cycle pigments than Chlorella, and lower sensitivity to photoinhibition as judged from the reduction of maximum quantum yield of photosystem II. In general, both algae had a larger xanthophyll-cycle pool when grown outdoors than in laboratory cultures. Comparing the two species, Scenedesmus exhibited a higher capacity to adapt to high irradiance, due to an effective quenching mechanism and high photosynthetic capacity; in contrast, Chlorella represents a species with a larger antennae system, less-efficient quenching and lower photosynthetic performance. Non-photochemical quenching (NPQ) induced through the xanthophyll cycle can, to a limited extent, represent a regulatory factor in diluted algal cultures grown in outdoor solar photobioreactors, as well as in natural algal phytoplankton populations exposed transiently to high irradiance. However, it does not play an appreciable role in dense, well-mixed microalgal suspensions.

Adaptation, Physiological↗
PubMed1999

[Interstitial cystitis: epidemiology].

The epidemiological assessment of intestitial cystitis (IC) is not definitive as no diagnostic criteria, such as endoscopy or biochemical and anatomopathological examination, exist. The diagnosis is solely based on symptoms like urgency, frequency and pelvic pain. The first studies on the population date back from 20 years ago and show a percentage of 10 cases every 100 thousand inhabitants. There is weak link between genetic factors, immunological diseases, previous cystitis or eating habits and intestitial cystitis. Epidemiological studies have highlight the frequency of this disease, and stressed the importance of stricted behavioural rules for the first stages of intestitial cystitis.

Cystitis, Interstitial↗
PubMed1999

[Interstitial cystitis: surgical treatment].

Surgical therapy of interstitial cystitis must never be considered a first option but must be reserved for cases, less than 10%, in which conservative therapy has proven ineffectual. Surgical therapy includes a variety that started at the turn of the century. Neurosurgical denervation and perivesical denervation like cysto-cystoplasty and cystolysis, manipulate the innervation to reduce the bladder's hypersensitivity. This surgical approach may be considered in patients in whom bladder capacity is normal. The results are uncertain and the complications like neurogenic bladder relevant. Enterocystoplasty is much more widespread because interstitial cystitis is a benign disease that rarely required radical surgery. Augmentation cystoplasty and substitution cystoplasty are two variants but only the later has a rationale as it involves the resection of the detrusor which is the source of the pain. Detubularization drastically reduced urinary incontinence. The resection of the detrusor can be supratrigonal, subtrigonal or at the proximal urethra like in the orthotopic neobladder. If urinary diversion is chosen, the bladder must be removed. Before recommending surgical therapy each patient should undergo tests for the localization of the pain; moreover psychological and gynaecological evaluations should be made. If the bladder capacity exceeds 400 cc surgical operation is not advisable. If, on the other hand, the bladder capacity is lower than 400 cc substitution cystoplasty is first choice. If the patient suffers from trigonal cystitis or urethral hypersensitivity, urinary diversion is a better therapy. According to the questionnaires send to the Urologic Departments in Lombardy in 1998, the most widespread type of operation seems to be supratrigonal cystectomy + enterocystoplasty and augmentation cystoplasty. Subtrigonal cystectomy or urinary diversion are only occasionally chosen; continent pouch is the least frequent therapy at all.

Adult↗
PubMed1996

[pT1G3 bladder carcinoma: our experience].

Approximately 6 to 23% of the patients with transitional cell carcinoma confined to the superficial mucosa of the bladder suffer for a pT1G3 tumor. Between 1984 and 1994, 12 patients were treated for high grade stage T1 tumores. Trans-urethral resection of the bladder cancer was performed in 8 patients, supported in two cases by immunotherapy with B.C.G. and in one case by endovesical chemotherapy. Radical cystectomy was carried out in 4 patients. Our results are similar to what reported by other Authors, but we didn't have any progression in all 8 patients treated with conservative therapy.

Antibiotics, Antineoplastic↗
PubMed1996

[Stents in the treatment of stenosis of the entero-urethral junction in continent diversion: case reports].

Strictures of entero-urethral anastomosis in orthotopic neobladder and of the catheterizable conduit in continent diversion after cystectomy are seldom encountered; they are usually treated with dilation, TUR or cold incision. 3 cases that came to our observation are presented. The first was treated with TUR after neo-bladder neck stricture in orthotopic neobladder; total incontinence occurred after this procedure. The patient at present is waiting for AS800 artificial sphincter implant. The second patient had similar features. After repeat TUR a prostacoil removable stent was placed through the stricture and removed after 5 months. At 12 months from removal the patient is continent and doesn't present clinical evidence of restriction. The third patient underwent cystectomy with Indiana continent pouch. After 4 months increasing problems in self catheterization occurred due to stricture of the catheterization conduit (appendix). He was treated twice with cold incision with early recurrence of the stricture. A permanent Memotherm stent (indicated for urethral strictures) was placed inside the appendix. After one month self catheterization was started again. At a 2 months follow up there is no evidence of stricture. In our experience, even if anecdotal, we have verified that treatment of this kind of strictures with TUR can cause incontinence or expose to further recurrences. 2 of the cases presented were treated with different kind of stents; the outcome is good even if the follow up is still short. We believe that this kind of treatment can be considered in selected cases.

Aged↗
PubMed1994

[Echo-guided retropneumoperitoneum in laparoscopic renal surgery].

Laparoscopic surgery admits the retroperitoneal approach: the main restriction is the tight manoeuvring space that can be obtained with insufflation. The use of a dilatator balloon in the retroperitoneal cavity offers a solution to this problem. A cutaneous access and a dull parietal path is created, with blind positioning of the apex of the dihedron between the inferior renal pole and the ureter. Peroperative ultrasound control makes it possible to identify the inferior renal pole, to control the position of the apex of the catheter with the balloon and the movements of the retroperitoneal organs in real time. The possibility of following the procedure by ultrasonography have proven usefull in our experience.

Humans↗
PubMed1992

[Complications of hepatic hydatidosis].

Fifty cases of complicated hydatid cyst of the liver on a total of 250 cases of hydatid cyst observed were analyzed. The Authors describe the several complications observed (compression, infection, rupture into biliary tract or into the thorax or into the peritoneal cavity, the diagnostic and therapeutic procedures. Total mortality was about 7.6% (3 cases) 2 patient died for intraperitoneal rupture and one for rupture in the biliary tract. Surgical treatment should be as radical as possible performing total or subtotal pericystectomy, hepatic resection is reserved to selected cases. Drainage by Kehr tube of biliary tract is necessary of rupture of the cyst in the biliary tract, while we limit the indication for a papillostomy to the sphincter duct stenosis.

Adult↗
PubMed1990

[Perforation of the colon].

The paper reports personal observations relating to 111 cases of colonic perforation. Etiopathogenesis and different surgical approaches are discussed and results are compared. Hartmann's operation is identified as the best solution in cases of colonic perforation with diffuse peritonitis. In cases of localized peritonitis, excellent results may be obtained by operating immediately.

Adolescent↗