Biomedical subjects

R Bertelli

Publications and source records attributed to R Bertelli.

66 records · Page 4Linked to original sources

PubMedDate not supplied

Kidney transplantation from elderly donors: a prospective randomized study comparing celsior and UW solutions.

AIM: The aim of present study was to assess the effect of Celsior as compared with University of Wisconsin (UW) solution on immediate and long-term function of kidney transplants harvested from elderly donors. METHODS: A prospective multicenter randomized study was designed to evaluate the efficacy of Celsior versus UW solution for the clinical preservation of the kidney. Fifty renal transplants were performed from donors over 60 years old. Twenty-five kidneys were stored in Celsior and 25 in UW solution. The groups were comparable with regard to donor and recipient characteristics. Renal function outcomes were compared by evaluating delayed graft function rates, daily urinary output, as well as the evolution of mean serum creatinine at 1, 3, 5, 7, and 15 days. RESULTS: The warm ischemia time was 42.4 +/- 11 minutes among Celsior vs 46.9 +/- 17.9 minutes in the UW cohort (P = NS). The cold ischemia time was 18 +/- 4.5 hours in Celsior and 19 +/- 6.5 hours in UW (P = NS). Delayed graft function occurred in 48% of the Celsior group and in 52% of the UW group (P = NS). Mean serum creatinine levels and mean daily urinary output were also similar. One- and 5-year graft survivals of kidneys preserved with Celsior were 91.8% and 79.3% compared with 96% and 87.4% for UW without any significant statistical difference. CONCLUSIONS: Our data show that the preservation of kidneys from elderly donors in Celsior solution is equivalent to that of UW solution.

Adenosine↗

PubMedDate not supplied

Urological complications in kidney transplantation: ureterocystostomy versus uretero-ureterostomy.

In our initial experience of kidney transplantation, we performed an extravesical uretero-cystostomy (U-C), but in 1997 we shifted to a uretero-ureterostomy (U-U) with the aim of reducing early and late urological complications. A data base was constructed to compare the incidence, donor and recipient risk factors, treatments, and outcomes of urological complications with the two techniques. From 1990 to the end of July 2004, 894 kidney transplants included 43 from living donors and 851 from cadaveric donors with 804 first and 47 second transplants. We observed 48 urinary fistulas (5.4%): 45 were successfully repaired and three were treated with a ureteral stent with two good results; and one failed at a late operation. We had 26 early stenoses (2.9%), all of which were successfully treated: 16 with surgery and 10 with a stent. Donor and recipient risk factors for fistula and early stenosis did not reach statistical significance, confirming the technical etiology of these complications. There were only six cases of late ureteral stenosis in patients operated after 1990, and in eight cases of U-C we observed vesico ureteral reflux. There were 88 urological complications, with only one kidney lost. The shift from U-C to U-U did not change the incidence of urological complications, but with U-U we observed a significant decrease in the number of postoperative urinary infections, an easier possibility to resolve ureteral stenosis with endourology and no reflux. It is now our first choice with a normal ureter.

Cystostomy↗

PubMedDate not supplied

Portal vein arterialization: a new surgical option against acute liver failure?

Survival rates of patients with acute liver failure (ALF) without transplantation are poor. Supporting these patients until an organ becomes available or until their own liver is able to regenerate itself, avoiding transplantation, is a major goal in the treatment of ALF. We report our clinical experience of portal vein arterialization in one case of massive liver necrosis after liver transplantation and in two patients with ALF caused by idiosyncratic drug reaction and mushroom intoxication. Portal vein arterialization, at least in two cases, was a turning point in the course of the disease since a close temporal association between surgery and clinical improvement was clearly evident. We believe that this novel approach, which should promote liver regeneration by providing an additional oxygen supply to the liver, may disclose a new possibility in the treatment of ALF and prompt new clinical and experimental research.

Adult↗

PubMedDate not supplied

[Multimodal treatment of gastric MALT lymphoma: our experience].

Primary gastric lymphoma (PGL) is rare, but its incidence is increasing. It represents 52% of all extranodal GI tract lymphomas. The majority of PGLs are B cell non-Hodgkin's lymphomas or a high grade, diffuse, large cell lymphoma. The development of gastric mucosa associated lymphoid tissue is dependent on Helicobacter pylori infection. From January 2000 to February 2004, 10 patients were observed in the Unit of Surgical Oncology at Morgagni-Pierantoni Hospital in Forlì (6 F, 4 M), mean age was 68.3 (range, 45-86). Diagnosis was made in all patients by endoscopy and biopsies of gastric mucosa, US endoscopy and TC-PET. According to the Ann-Arbor classification modified by Musshoff, 6 patients were stage IE(1), 1 IE(2), 1 IIIE. 2 IV. Four and two patients underwent distal or total gastrectomy. respectively. Chemotherapy was performed in three patients, RT in one patient. Complete remission was observed in patients submitted to surgery and chemotherapy alone. No mortality and morbidity were observed. The treatment of LGP is not standardized yet. The role of surgery in the treatment of primary gastric lymphoma has been recently re-evaluated. Traditionally surgical treatment was aggressive, more recently radical gastrectomy is disputed and considered unnecessary. Conservative surgery and combined treatment is considered more appropriate for localized gastric lymphoma.

Aged↗

PubMedDate not supplied

[The psychiatric education of professional nurses. What education for which nurses?].

On the basis of a structured interview of 27 professional nurses who have recently started their practice in the psychiatric services of the USSL 34 Ferrara, the authors analyze the difficulties met in the working place. Three main findings deserve underlining: strong perception of the inadequacy of the basic training provided in schools, the need of reference persons, even if reliance on "old" behavioral models may represent an obstacle to change, the extreme degree of disaffection with respect to the working environment which leads to a passive acceptance of the present state of things.

Adult↗

PubMedDate not supplied