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Biomedical subjects

P Fabiani

Publications and source records attributed to P Fabiani.

At least 19 recordsLinked to original sources
PubMed1992

[Liver transplantation for hepatocellular carcinoma. Mid-term results].

The results of liver transplantation for hepatocellular carcinoma are disappointing. Thus, in 11 patients transplanted for hepatocellular carcinoma on cirrhosis, the actuarial survival rate at 3 years was 20 percent, with a postoperative mortality of 27 percent and 4 deaths caused by recurrence of the malignancy. These poor results contrast with those we obtained after liver transplantation for cirrhosis and finding of incidental hepatocellular carcinoma in the resected part of the liver. Out of 6 patients with incidental carcinoma only 1 died postoperatively (16.6 percent), and no case of recurrent malignancy was observed. These results confirm that the malignancy recurrence rate is high after transplantation for large carcinoma. On the other hand, the absence of recurrence after transplantation for incidental hepatocellular carcinoma encourages us to look for small carcinomas on cirrhosis.

Actuarial Analysis↗
PubMed1992

[Perineal gangrene. Analysis of 24 cases].

Fournier's syndrome, characterised by anaerobic necrotising cellulitis of the soft tissues situated below the diaphragm, is a serous disease with an unpredictable course. From 1978 to 1991, we treated 24 men with a mean age of 57 years (27 to 90 years). Following the diagnosis of this disease, rigorous treatment was instituted immediately, consisting of a triple antibiotic combination, repeated surgical exposure, debridement and drainage with a frequent, almost systematic indication for faecal diversion (n = 16), hyperbaric oxygen therapy and classical intensive care measures. The mean interval between the first clinical signs and the diagnosis was 7.4 days. The lesions were limited to the perineum in 11 cases and extended to the abdomen, thighs and/or loins in 13 cases. The microorganisms responsible for the infection were identified in 19 cases and blood cultures were positive in 5 cases. This infection was of coloproctological origin in 12 cases, urogenital origin in 4 cases and postoperative in 2 cases, while no aetiology could be identified in 6 patients. There were 6 deaths and 18 cures without sequelae. 1. The prognosis of this disease is better in younger subjects (under the age of 60 years) with a localised clinical form, with no deterioration in the general status, sterile blood cultures and treated by a diversion colostomy. 2. A detailed aetiological work-up must be performed, looking for local or regional infection, cancer, haematological malignancy or arterial disease.

Adult↗
PubMed1992

[Recurrence of virus B hepatitis after liver transplantation].

Thirty-three HBs antigen positive patients without signs of viral replication underwent orthotopic liver transplantation and received long term passive immunoprophylaxis with anti-HBs immunoglobulins at high doses perioperatively and then at a dose of 10,000 IU every month. All patients became negative during the first 6 months following surgery. At 34 months the survival rate was 67 percent and the actuarial recurrence rate of serum HBs antigen was 7.1 percent. Reappearance of HBs antigen was associated with evidence of HBV replication and histological alterations of the graft. In our experience, long term passive immunoprophylaxis reduces HBV reinfection of the grafted liver.

Adult↗
PubMed1992

[Orthotopic liver transplantation and hepatocellular carcinoma].

Nineteen orthotopic liver transplantations (OLT) were performed in patients with hepatocellular carcinoma, between March 1988 and December 1990, in our Department. Thirteen patients (68.4%), 10 men and 3 women, mean age 48.2 +/- 2.8 years, were clear cut neoplastic disease, six patients (31.6%), 4 men and 2 women, mean age 48.6 +/- 4.2 years, were incidental tumors. Three years survival rate was 20% in clear cut neoplastic diseases (4 patients died for neoplastic recurrence) and 66% in incidental tumors. Our results demonstrate that liver transplantation for hepatobiliary malignancy is still justified, patient selection is important in predicting outcome.

Actuarial Analysis↗
PubMed1991

[Fortuitous discoveries of digestive tract tumors during the evaluation of hepatic tumors by lipiodol intra-arterial injection. Diagnostic application in a case of pancreatic tumor].

The authors report three cases of extrahepatic lipiodol enhancement: two fortuitous discoveries of gastric and duodenal leiomyomas during the management of malignant hepatic lesion and a pancreatic surgical detection of an insulinoma which had not been detected with conventional techniques. The principles of the technique are described. The basis of its application to the pancreatic region is purposed and the future developments of pancreatic studies are discussed.

Adult↗
PubMed1991

Laparoscopic fenestration of biliary cysts.

We describe a new technique of biliary cyst fenestration using a videolaparoscopic approach. From June 1989 to October 1990, laparoscopic fenestration was performed for four symptomatic solitary cyst and one polycystic liver disease patients, without any morbidity. Mean hospital stay was short: 6.8 days (range of 3-14 days). No recurrence was observed on ultrasound controls with a mean follow-up of 6.4 months (range of 2-15 months). Laparoscopic fenestration for symptomatic biliary cysts is a simple, effective, and minimally invasive procedure.

Adult↗
PubMed1990

[Treatment of duodenal ulcer by posterior trunk vagotomy and anterior fundic seromyotomy under video-laparoscopy. Preliminary note with presentation of a film].

Posterior vagotomy associated with anterior fundic seromyotomy, as proposed by Taylor in 1979 and widely used since then, has been performed under video laparoscopic monitoring in 6 patients with inveterate chronic duodenal ulcer. The procedure described here produced no complications in the immediate postoperative period and early progress in the controlled healing of the ulcer and the reduction of acidity, which can be compared to those of the same procedure with laparotomy.

Adult↗
PubMed1986

[Intravenous theophylline: adaptation of dosage to blood theophylline levels at admission and to clearance].

Intravenous infusions of aminophylline expose the patient to the risk of overdosage related to the narrow safety margin of the therapeutic concentrations and to the great individual variability of its excretion. The aim of this study was to evaluate a simplified protocol designed to determine the optimal dose of theophylline based on total body clearance. Forty-four patients (average age: 63 years) admitted with decompensation of chronic respiratory failure (N = 33) or with status asthmaticus (N = 11) were studied. Theophylline was administered initially at a constant rate R0 (mg/kg/h) depending on serum theophylline concentrations on admission T0 (mg/l): R0 = 0.75 - 0.75 T0/20. Serum theophylline concentrations were measured at the 6th and 12th hours (T6 and T12) for calculation of clearance (Chiou et al. J. Pharmacokinet. Biopharm., 1978, 6, 135-151) and for adjusting dosage R. After 48 hours of treatment at this infusion rate, serum theophylline was again measured (T48) to check the adjustment of the dosage and recalculate clearance. In 11 patients T0 was greater than 15 mg/l (max = 44) and T12 was 10.5 +/- 6.4 mg/l. Theophylline was withdrawn in 6 patients with initial clearances less than 5 ml/kg/h (zero in 5 cases). T48 was within therapeutic values (10-20 mg/l) in 55 p. 100 of cases (21/38). Twelve patients had T48 less than 10 mg/l due to an increase in theophylline clearance (+ 80 p. 100 on average) related to improved right ventricular function in 7 cases. In 5 patients T48 was greater than 20 mg/l (max = 27.5) due to a fall in clearance (average -47 p. 100) which could have been caused by administration of erythromycin in 1 case and by dose-dependent kinetics in 2 cases. This protocol which is simple to carry out in practice allows early adjustment of dosage to give effective serum theophylline concentrations in over 50 p. 100 of cases. No serious cases of overdosage were observed, even in patients with high T0 and/or low initial clearances. Under-dosage and overdosage are related to large individual variations in theophylline clearance.

Aged↗
PubMed1985

[Assay of acenocoumarol (Sintrom) in the plasma by liquid chromatography].

Reversed-phase liquid chromatography was performed on C18 column using a pH 4 buffered water-methanol 45:55 (v/v) mobile phase and ultraviolet detection (307 nm). Warfarin was used as internal standard and dichloro-1,2 ethane as extraction solvent. The analytical recovery was greater than 98 p. cent. The within-day coefficient of variation (CV) was 5 p. cent, while the between day CV was 6.4 p. cent. The limit of detection was 0.02 mg/l.

Acenocoumarol↗
PubMed1978

[Zinc and enzymes in the synovial fluid and blood in various types of rheumatism].

It appears that in rheumatoid arthritis and, to a lesser extent, in the other forms of inflammatory rheumatism, the level of zinc in the blood serum is lowered, whereas synovial zinc is increased. In the synovial fluid, there is a very significant correlation between enzyme activity and the concentration of zinc. Practical experiments aimed at demonstrating in vitro the action of zinc on lacticodeshydrogenase, acid phosphatase, lysozyme and beta-glucuronidase did not produce the anticipated results and do not explain the metabolic disorders of zinc seen during inflammatory rheumatisms.

Acid Phosphatase↗