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Biomedical subjects

S Morosini

Publications and source records attributed to S Morosini.

At least 19 recordsLinked to original sources

Inappropriate prescribing of compounded antiobesity formulas in Brazil.

Volunteers posing as patients underwent paid medical consultations at the offices of 107 Brazilian doctors (in two Brazilian cities) with the purpose of obtaining an antiobesity prescription. In 80.3% of 71 São Paulo visits, as well as in 47.2% of 36 Recife visits, compounded preparations were prescribed. Four to six active components predominated, but there were prescriptions listing as many as 17 components. All contained anorectic substances and benzodiazepines. Diuretics, thyroid agents, laxatives, medicinal plants, and a variety of other substances were often included. The prescribed doses were frequently above recommended limits, reaching amounts as much as five times the internationally defined standard doses. In some instances two anorectic substances were prescribed simultaneously. Most doctors failed to warn volunteers of the possible occurrence of adverse reactions to the prescribed substances. Furthermore, in the case of all volunteers involved, antiobesity prescriptions would be completely unnecessary, a fact that points to improper medical conduct on the part of doctors. It is concluded that the practice by some Brazilian medical doctors of prescribing manipulation formulas based on anorectic and benzodiazepine drugs is a greater hazard than a benefit to patients.

Journal Article↗

[Experimental study on hepatic encephalopathy: EEG and blood amino acid findings].

The AA. describe a method of gradual occlusion of the portal vein in the rat to induce a hepatic encephalopaty. This method allows to realise a condition of hepatic ischemia and a portal hypertensive state accompanied by spontaneous portal-systemic shunts. These two factors produce a hepatic encephalopaty like in cirrhotic state or in patients after portal systemic anastomosis. A part from similar behavior at the beginning of the encephalopaty it is possible to define two classes of animals: one showing a slow recovery and one showing a transient and slight improvement followed at the end by the death of the animal. The AA. found a definite correlation amoung the clinica, EEG's, serum aminoacids and biochemical data. Probably the different anatomical and phisiological aspects of the induced portal systemic shunts and the different ways of hepatic rivascularization may determine the two different evolutions of the animals.

Amino Acids↗

[Surgical aspects of thrombosis in the portal system (author's transl)].

The Authors present and discuss clinical and therapeutic aspects of several cases of chronic portal thrombosis, troncular and radicular, either isolated or variously associated. Splenoportography and selective arteriography do not always provide a clear-cut picture of the vascular situation, particularly in the presence of mural thrombi. Surgery may be needed as an emergency measure in cases of hemorrhage, but the best results are obtained if it can be done electively. Indications, however, must be evaluated very carefully in each individual case, especially for thrombosis not associated with cirrhosis of the liver, in which the tendency to a more favorable natural evolution may invite a more conservative approach. The choice of surgical procedures is dictated essentially by the site of obstruction in the portal system. After discussing the indications for various methods, the authors present some cases of thrombosis involving only the superior mesenteric vein, managed successfully by disobliteration and mesenterocaval anastomosis.

Adolescent↗

[Traumatic thrombosis of the peripheral arteries].

Ten cases of post-traumatic arterial thrombosis are described. The anatomopathological, diagnosis and therapeutic aspects of peripheral artery lesions of this type are examined. Surgical exploration followed by reconstruction are dictated by the presence and degree of seriousness of ischaemia; they are not subordinate to arteriography, itself not always necessary. Resection of the confused segment and reconstruction is the management of choice. Thrombectomy and thromboendarteriectomy cannot be considered as rational operations, even though they can be used in a few special cases, such as iatrogenic forms. Reconstruction is best achieved by direct anastomosis or with the aid of venous grafts. A prosthesis, on the other hand, is liable to produce less satisfactory long-term results.

Adult↗

[Correlation between histological findings and clinical behavior following surgery for portal hypertension in cirrhosis (author's transl)].

This is a retrospective study of 29 cirrhotic patients who underwent surgery for haemorrhage or ascites due to portal hypertension, carried out to look for any correlation between histological findings and clinical outcome. When Mallory's bodies and signs of activation are found, indicating that the cirrhosis is progressing, the clinical results are often discouraging. A careful choice of which cirrhosis patients are likely to gain from surgery should take account of selective histological criteria as well as full clinical and haemodynamic data.

Adult↗

[Present position of non-shunt surgery for bleeding oesophageal varices (author's transl)].

This is a critical retrospective study of a homogeneous group of 24 patients with hepatic cirrhosis and portal hypertension who underwent emergency surgery for bleeding oesophageal varices. The adopted procedure was the porta-azygos disconnection, according to Torres-Degni, with or without splenectomy. The criterion derived from the need to stop bleeding, from contraindications to a portal-systemic shunt, or from other situations which are illustrated. The difficulty of selecting in these cases the appropriate surgery and the high operative death rate (46%) is commented. In survivors, the long-term outcome depends on the progress of the underlying liver disease.

Adult↗

[Dissection-ligation of the oesophagus according to Vosschulte for bleeding varices (author's transl)].

Ligation of the oesophagus on a Vossschulte prosthesis provides interruption of the venous back-flow in gastro-oesophageal wall occurring in portal hypertension, and therefore renders more effective the disconnection techniques used for oesophageal varices when liver function is too severely impaired to permit a portal-systemic shunt. According the literature and their own initial experience, the Authors stresse the possibilities of the method in controlling active haemorrhage and preventing further bleeding, and discusse its possible complications, represented by portal thrombosis, fistulae and oesophageal stenosis. Unlike shunts, this procedure does not give rise to any worsening in hepatic function, but should nevertheless seriously considered especially if the oesophago-gastric junction is radically isolated.

Adult↗