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R Parravicini

Publications and source records attributed to R Parravicini.

At least 19 recordsLinked to original sources
PubMed1989

Diagnostic accuracy of sialic acid in the diagnosis of malignant ascites.

The authors evaluated the diagnostic accuracy of sialic acid and its lipid-bound fraction in ascites and compared these tests with others (fibronectin, cholesterol) recently claimed as valuable in the differential diagnosis of ascites. Fibronectin yielded the best diagnostic accuracy (85%) with no false-positive and 37% of false-negative (10/27). The authors also found higher concentration of sialic acid in malignant ascites than in nonmalignant ascites (P less than 0.001) and, taking 300 mg/l as the cutoff value, the false-positive rate was 10% (four of 40), the false-negative rate 30% (eight of 27), and the overall diagnostic accuracy 82%, comparable to that of the fibronectin. The authors conclude that both fibronectin and sialic acid determinations in ascites may be regarded as accurate markers of neoplastic involvement of the peritoneum, although no test is useful in the ascites with hepatocellular carcinoma and cirrhosis of the liver.

Ascites↗
PubMed1988

Disposition of a flow-limited drug (lidocaine) and a metabolic capacity-limited drug (theophylline) in liver cirrhosis.

The plasma clearance after oral administration of a completely absorbed drug that is metabolized by the liver depends on its intrinsic clearance. In cirrhosis the bioavailability of a flow-dependent drug increases because of both portosystemic shunting and hepatocyte dysfunction. A drug with a high extraction ratio, lidocaine, and a drug with a low extraction ratio, theophylline, were administered to 27 patients with cirrhosis and 16 control subjects. We found a significant impairment of both theophylline clearance (p less than 0.001) and lidocaine clearance (p less than 0.001) and an increase in the lidocaine peak concentration (p less than 0.001). The three parameters were significantly correlated with each other. The impairment of theophylline metabolism did not correlate with other indexes of disease severity, whereas lidocaine clearance was lower and lidocaine peak level higher in patients with decompensated cirrhosis and evidence of portal hypertension. Thus impairment in lidocaine disposition, which reflects both hepatocyte dysfunction and portosystemic shunting, correlated closer with the severity of liver disease than did theophylline metabolism.

Adult↗
PubMed1987

Ticlopidine-theophylline interaction.

Ticlopidine, a new antithrombotic agent, and theophylline, a widely used bronchodilator drug, are both almost completely metabolized in the liver. To evaluate an interaction between these two drugs, we studied theophylline pharmacokinetics before, after 10 days of ticlopidine administration, and 1 month later in 10 healthy volunteers. We found a highly significant increase in the theophylline elimination half-life (P less than 0.001) and a comparable reduction in its total plasma clearance (P less than 0.001) after ticlopidine treatment. Pharmacokinetic parameters returned to initial values within 30 days after ticlopidine withdrawal. Moreover, no changes in theophylline pharmacokinetic parameters were observed 3 months later, before and after 10 days of placebo administration. Our results seem to exclude direct liver toxicity and may suggest a reversible inhibition of the liver metabolic capacity of theophylline.

Adult↗
PubMed1986

Diagnostic accuracy of fibronectin in the differential diagnosis of ascites.

To evaluate the diagnostic accuracy of fibronectin levels in ascites to differentiate malignant from non-malignant ascites, the authors studied 30 patients with sterile uncomplicated ascites in chronic liver disease, 18 patients with malignant ascites and four patients with spontaneous bacterial peritonitis. Fibronectin concentration was significantly higher in malignant ascites than in sterile ascites (P less than 0.001). High values (greater than 85 mg/l) were found in four of six cases of hepatocellular carcinoma in liver cirrhosis with negative cytologic examination, and in six of seven peritoneal carcinomatoses. Low values (less than 85 mg/l) were found in four patients with liver metastases and in one patient with intrahepatic biliary duct carcinoma in cirrhosis. In four patients with infected ascites, the fibronectin level was low. Among all other parameters (total protein concentration, lactate dehydrogenase, gamma-glutamyl-transpeptidase, pH, amylase, triglycerides, leukocyte count, and cytologic examination), fibronectin yielded the best degree of discrimination (diagnostic accuracy, 79%).

Adult↗
PubMed1986

Abdominal heart transplantation: description of a new allograft extrathoracic pump.

This study describes a new kind of abdominal heart transplantation for left ventricular assistance carried out in a series of 12 experiments in pigs weighing 15-25 kg. This was achieved making three connections between the donor's left atrium, aorta and pulmonary artery with the recipient's aorta, still aorta and inferior vena cava, respectively. The hemodynamic data were satisfactory, the best survival rate with a transplanted working heart was 1 month. The low output of the recipient's left ventricle was obtained by ligation of the left anterior descending (LAD) coronary artery. In all animals, the highest peak of the pressure of the transplanted left ventricle was at least 20 mm Hg higher (ranging from 20 to 60 mm Hg) than the pressure in the recipient's left ventricle, and corresponded with the peak of the systemic arterial pressure. The cardiac output of the transplanted hearts showed a good hemodynamic response with support of the circulation after ligation of the LAD coronary artery in the recipient's heart.

Abdomen↗
PubMed1978

[Interatrial communications of the ostium secundum type in the adult (author's transl)].

On the basis of personal observations made during their first year of activity in cardiac surgery, the authors review the existing literature concerning surgical indications for interatrial communications in the adult. While they recognize that there is a strong correlation between patient age and mortality, they argue that corrective surgery for such defects can be done also in the older patients, with due regard to limiting criteria relative to pulmonary arterial pressure, pulmonary arteriolar resistance, and cardiac failure.

Adult↗
PubMed1977

[Technical variants of median sternotomy].

Various modifications of the technique of median sternotomy are described. Advantages thus obtained with respective to saving time and better haemostasis are explained.

Cardiac Surgical Procedures↗
PubMed1977

[A case of simulation of ovarian cyst in volvulus of an ectopic spleen].

A case of volvulus of ectopic spleen mistaken for twisted ovarian cyst is described. Attention is drawn to six points: 1) the rarity of the condition; 2) the persistent uncertainty concerning its aetiopathogenesis, even though over a century has passed since the first case was reported; 3) the mechanism leading to twisting of the spleen stalk; 4) the absence of specific symptoms and the consequent impossibility of preoperative diagnosis in most cases; 5) the ready confusion with ovarian cyst; 6) the reasons for supposing that the reported case was the result of congenital factors.

Adult↗
PubMed1977

[Myocardial protection during open heart operations].

The need for adequate protection of the myocardial tissue during open heart operations has proved to be of considerable importance in view of the conditioning value of the functional anatomical state of the myocardial fibre on the outcome of the surgery itself. After a review and description of the most widely used methods of protection, the Authors draw on the data in literature in order to trace a critical profile of each method, outlining its merits and defects in the light of present experience.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Thickening of the gallbladder wall in ascites.

The thickening of the gallbladder wall in patients with ascites is commonly related to hypoalbuminemia and/or portal hypertension. To evaluate the pathogenetic role of these two factors, we correlated gallbladder wall thickness (GBWT) with the albuminemia and the serum-ascites albumin gradient (SAAG), an index of portal hypertension, in 47 patients with ascites caused by cirrhosis of the liver or abdominal malignancy. We found a thickened gallbladder wall in 30/47 patients. The correlation between GBWT and SAAG was 0.64 (n = 47 p less than 0.001). No correlation was found between GBWT and albuminemia (r = 0.04). We suggest that the sonographic finding of ascites and gallbladder wall thickening should be considered a valuable sign of transudative ascites and of portal hypertension whatever its cause.

Abdominal Neoplasms↗