PubMed Health⌕ Search

Biomedical subjects

P Patrone

Publications and source records attributed to P Patrone.

At least 19 recordsLinked to original sources
PubMed2003

[Complications of pseudoainhum].

A 39 year old man presented with recurrent episodes of leukocytoclastic vasculitis and a large ulcer at the distal part of the stump of his right leg. Since birth the patient showed a clinical picture of pseudoainhum as part of the amniotic band syndrome (Simonart syndrome). Radiologic examination of the right foot showed only an hypoplastic talus and calcaneus which had been designated as a "stump":, which have been detected by x-ray. On both upper limbs there were missing phalanges, syndactyly and some constrictive fibrotic bands. Since the ulcer worsened with therapy, the patient underwent the amputation of the stump just below under the knee. Since then no further vasculitic lesions have been observed. We consider this case remarkable both because pseudoainhum is so rare and because of these equally unusual complications.

Adult↗
PubMed2001

Ofuji's disease: diagnostic and therapeutic problems. A report of three cases.

BACKGROUND: Ofuji's disease is an eosinophilic dermatosis affecting mostly male subjects. It is characterized by the appearance of follicular papulopustules, at times on an erytemathous base, which tend to form an annular configuration. The evolution is relapsing remitting. The histopathological examination demonstrates a dense dermal infiltrate with a prevalence of perifollicular and perivascular eosinophilia. Peripheral blood eosinophilia is observed in a high percentage of cases. The pathogenesis is unclear. METHODS: We report three cases of patients affected by Ofuji's disease with presentation on different sites. Our case reports concern three male subjects otherwise in good health and whose hematologic results were normal. Before they came to our observation, an erroneous diagnosis had been made and they had been subjected to improper treatment. RESULTS: To make a definite diagnosis it was necessary to evaluate the following features as a whole: the clinical aspect, the evolution, the result of the histological examination, the negativity of cutaneous cultures and the lack of response to previous treatments. All three patients were treated with dapsone 100 mg/day with regression of the clinical manifestations. In one case there was a relapse which was treated with isotretinoin 0.5 mg/kg/day. CONCLUSIONS: From our experience we can deduce that in cases of follicular pathologies which do not respond to conventional therapies, it is necessary to take into consideration the possibility of Ofuji's disease and, in that case, patients should be monitored because of the frequent relapses.

Adult↗
PubMed2000

Validation of flow convergence region method in the assessment of carotid artery stenoses during color-flow duplex studies.

PURPOSE: The flow convergence region (FCR) method (also known as the proximal isovelocity surface area method) is currently used in echocardiography to evaluate the flow through cardiac valves and septal defects. The FCR method is based on the characteristic alterations in flow dynamics that occur proximal to a stenotic orifice. Blood converges uniformly and radially towards an orifice that is small relative to the section of the vessel and forms concentric isovelocity hemispheric shells where velocity progressively increases and flow remains laminar. The purpose of the article is to validate the use of this principle in the detection and assessment of carotid stenoses in the course of color-flow duplex studies. METHODS: In this prospective study, 80 patients affected by unilateral or bilateral carotid artery stenoses were evaluated for the presence of the FCR from February 1997 to March 1999. The results were compared with digital subtraction angiography. RESULTS: Color-flow duplex diagnosis of carotid artery stenoses of 70% or more was confirmed in 100% of the carotid artery stenoses (40/40 patients) with angiography. The FCR was detected in 72.2% (13/18) of carotid arteries affected by stenoses greater than 80%, in 54.4% (12/22) of carotid arteries affected by stenoses 70% to 80%, and in 13.6% (6/44) of carotid arteries affected by stenoses 50% to 69% (P <.001). In 5% of cases (2/40 of stenoses) the FCR was the only detectable sign of carotid stenosis. CONCLUSION: Our data suggest that a routine search for FCR in the course of color-flow duplex study of carotid arteries may further improve the reliability of this examination in the detection of carotid artery stenoses, particularly in the presence of heavily calcified lesions.

Angiography, Digital Subtraction↗
PubMed1998

"Marsupial cava" and ruptured abdominal aortic aneurysm. A case report and review of the literature.

A patient with a ruptured abdominal aortic aneurysm underwent an emergency operation. A rare anomaly of inferior vena cava, known as "marsupial cava," was found. The iliac vein confluence crossed anteriorly (rather then posteriorly) the right common iliac artery. Even though the patient had undergone a computed tomography scan, this rare anomaly had not been detected and therefore was unexpected by the surgeon. The aim of this report is to describe the technical details required to perform the aortic reconstruction and to stress the importance of routine computed tomography scans and their careful reading in the case of stable patients before retroperitoneal operation. This is, to our knowledge, the first report of an aortic prosthetic grafting for ruptured aortic aneurysm in association with a marsupial cava.

Aged↗
PubMed1998

Angiotensin-converting enzyme gene polymorphism and reversibility of uremic left ventricular hypertrophy following long-term antihypertensive therapy.

BACKGROUND: Prolonged antihypertensive therapy might be less effective in reversing the left ventricular hypertrophy (LVH) in uremics bearing the deleted (DD) allele of the angiotensin converting enzyme (ACE) gene than in patients with the inserted (II) allele or in those heterozygous (ID) for the gene. METHODS: Thirteen DD and 17 II + ID hemodialyzed uremics were followed-up with yearly echocardiography and 24-hour blood pressure (BP) monitoring over five years while on an antihypertensive therapy that included ACE inhibitors as first line drugs. RESULTS: In the II + ID group there were significant decreases of the left ventricular mass index (LVMi) and of both systolic and diastolic BPs. These changes were less pronounced in the DD group, but the difference was not statistically significant given the wide overlap between the two groups. Further analysis of the data revealed that the only factor associated to a decreased LVMi was the decrease of the systolic BP irrespective of the ACE gene genotype of each individual patient. CONCLUSIONS: The ACE-gene genotype does not necessarily predict the extent to which LVMi will be lowered by ACE-inhibitors therapy. The LVH of hypertensive uremics is amenable by long-term antihypertensive therapy provided that it results in significantly decreased systolic blood pressure.

Adult↗
PubMed1998

Surgery and cyclosporine A in the treatment of erosive lichen planus of the feet.

Erosive lichen planus is known to be relatively unresponsive to medical treatment. Surgery could be an alternative treatment for this disease. We report the case of a 68-year-old man with a 10-year history of painful, disabling, ulcerative lesions on the soles of both feet. All previous topical and oral treatments had failed and his condition was gradually worsening. Cyclosporine A was administered twice. The first time, systemic cyclosporine A gave a marked but only temporary improvement. The second time, treatment with cyclosporine A was begun 10 days before the ulcer on his left sole was covered with a Thiersch split-skin graft. The grafting was successful, so cyclosporine A was gradually reduced to smaller maintenance doses and 10 months later it was completely withdrawn. The patient refused to undergo surgery on his right foot thus providing the opportunity to compare the results. At the present time, eighteen months following grafting and ten months after total withdrawal of cyclosporine A, the condition of the left sole is stable and free from pain while the ungrafted ulcer on his right sole is still painful and has increased in size.

Aged↗
PubMed1993

[Controversies regarding an algorithm and the type of surgical treatment in popliteal aneurysms].

Having outlined their 20-year experience in the treatment of popliteal aneurysms (PA), the authors discuss the type of therapeutic approach used. From the authors' point of view an overly aggressive approach to PA is unnecessary, and the decision to adopt a given therapy must instead be weighed up on the basis of the careful clinical evaluation of each individual case, taking into account the patient's clinical conditions at the time, the pathological anatomy of the lesion and its consequences. The authors divide primary PA into symptomatic and asymptomatic cases; in the latter surgery is definitely indicated and the possible contraindications represented by anesthesiological risk or small aneurysm diameter need not be evaluated. In the case of symptomatic PA, treatment varies depending on whether they are manifested by rupture, acute ischemia or chronic ischemia. While there are no grounds for uncertainty regarding the need for immediate surgery in the first case, in the second and third cases the authors attribute decisive importance to the evaluation and possible improvement of run-off before surgical correction. In the event of acute arterial insufficiency of the limb, the careful assessment of clinical conditions (degree of loss of sensitivity, motility and cutaneous vascularization) and anamnestic data (possible presence of signs and symptoms of previous chronic arterial insufficiency) allow the surgeon to decide whether or not to resort to immediate surgery or to obtain an improved run-off by using loco-regional fibrinolytic therapy and therefore postpone surgical treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1993

[Anastomotic pseudoaneurysms of the femoral bifurcation. Clinical experience].

The authors report their experience of the treatment of anastomotic pseudoaneurysms of the femoral tripod. The paper analyses 231 cases treated over the past 8 years by the Division of Vascular Surgery using an alloplastic prosthetic implant in correspondence with the femoral tripod. Pseudoaneurysms were observed in 23 patients (9.8%) and emergency corrective surgery was required in 10 cases (43%) and elective surgery in 13 (56.5%). A total of 6 trans-obturator by-passes, 2 femoro-femoral by-passes using the saphena vein, 2 axillo-popliteal by-passes, 8 resections and re-implants, and 5 ligatures were performed. Immediate permeability was obtained in 15 patients, whereas 5 were amputated at the thigh and the remaining patient undergoing ligature preserved the limb but with chronic ischemic symptoms; 2 patients died. In the long-term follow-up of those patients who were permeable on discharge, permeability had persisted in 5 (83%) treated with trans-obturator by-pass and in 7 (87%) who had undergone resection and re-implant. The remaining axillo-popliteal by-pass had thrombosed after 6 months but the patient had not lost the limb. The authors underline the unpredictability of this pathology and analyse the causes which may provoke the development of this complication which inevitably leads to thrombosis or hemorrhage. However, suture materials (continuing pseudoaneurysm in spite of not using silk), the infective etiology (the extreme difficulty of obtaining a positive bacteriological culture) and the inguinal region (onset of pseudoaneurysm during aorto-femoral by-pass but hardly ever during femoro-popliteal by-pass) may be contributory causes but not decisive factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed1992

Palmoplantar keratoderma with sclerodactyly (Huriez syndrome).

A syndrome characterized by palmoplantar keratoderma, sclerodactyly, and skin cancer was first described in two families by Huriez et al. The pattern of inheritance was compatible with that of an autosomal dominant disorder. We report a patient with this condition and review the literature.

Fingers↗
PubMed1991

[Traumatic lesion of the popliteal artery. Synthesis of our experience].

The Authors reported experiences from 26 traumas of popliteal artery; 2 are related to continuous microtrauma from exotosis; 2 vasospasms implied vascular intervention. Tibial artery bypasses with vein grafts have been advocated to obviate any exploration of popliteal hematoma. A multidisciplinary approach consisting of orthopedist, plastic and vascular surgeons should be employed.

Exostoses↗