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Biomedical subjects

S Mosca

Publications and source records attributed to S Mosca.

82 records · Page 5Linked to original sources
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Acromegaly and intestinal neoplasms.

Acromegalic subjects show increased frequency of neoplastic lesions in the colon and rectum with respect to the general population. Recent prospective studies using colonoscopy have shown a 3 time higher prevalence of intestinal polyps and up to 4 time increased presence of colorectal cancer in acromegaly, independently of sex, age, duration of disease and clinical status of the patients. The polyps are distributed throughout the extension of the large bowel and are often multiple, showing at least two different histologic types: hyperplastic and adenomatous. Sometimes they are associated with intestinal carcinomas. Pancolonoscopy is the procedure of choice for the diagnosis of large bowel neoplasms, even though it may be difficult to complete in these subjects because of the frequent presence of an enlarged and elongated colon. It shows a higher sensitivity and specificity compared to other tests such as the barium enema, fecal occult blood test and serum levels of carcinoembryonic antigen. Therefore, it is recommended to follow up acromegalic patients using pancolonoscopy to obtain early detection of neoplastic lesions in the large bowel.

Acromegaly↗
PubMedDate not supplied

[Interventional radiology in the treatment of acute and chronic mesenteric ischemia].

Radiologic revascularization procedures--i.e., percutaneous transluminal angioplasty (PTA) and fibrinolysis--are a valuable alternative to surgery in the treatment of stenoses and occlusions of the visceral vessels, that is the celiac tripod and the superior and inferior mesenteric arteries. We treated 32 patients, 10 of them with acute mesenteric ischemia and 22 with chronic mesenteric ischemia and clinical signs of angina abdominis. Grüntzig or pre-shaped Cobra or Simmons balloons were employed (diameter: 5-7 mm, with variable length) when PTA was performed. Urokinase or rtPA was employed for fibrinolysis. In 3 cases acute mesenteric ischemia was not occlusive and could be successfully treated with papaverine infusion. In 7 cases, acute mesenteric ischemia was occlusive: in 5 of these patients it was successfully treated by PTA and/or fibrinolysis. Our results were positive in 80% of the cases, with remission of clinical signs in 4 of 5 patients treated for acute mesenteric ischemia. In 22 patients with chronic mesenteric ischemia, 26 stenotic occlusions were observed at angiography and 22 were treated with PTA, which was technically successful in 21 instances (early success rate: 85-95%). At 24 months, 10% of restenosis was observed. In our experience, PTA of the visceral district, possibly preceded by loco-regional infusion of fibrinolytic drugs, can be widely applied and yields excellent therapeutic results.

Acute Disease↗
PubMedDate not supplied

Gastric antral erosions and Helicobacter pylori infection in cirrhotic patients: a pilot controlled study of oral bismuth vs ranitidine therapy.

A controlled study was performed comparing bismuth and ranitidine oral therapy in the treatment of chronic antral erosions and chronic active gastritis and in clearing Helicobacter pylori in cirrhotic patients. Forty four patients took part in the randomized study. H pylori was present in more than 50% of the patients in the study. There was a close association between the presence of H pylori and inflammatory activity of gastritis at an antral level (p less than 0.001). CBS was significantly better than ranitidine in clearing H pylori (p less than 0.001) and reducing inflammatory activity of gastritis (p less than 0.001). This reduction was related to H pylori clearance. No action of the two medications was observed in improving endoscopic findings of erosive gastritis. H pylori clearance did not influence amelioration of endoscopic chronic erosive antral gastritis (EG) in cirrhotic patients. These findings suggest that H pylori does not seem to play a pathogenetic role in the aetiology of EG in cirrhotic patients while it represents an important factor in determining and maintaining the inflammatory activity of histologically confirmed gastritis in these patients.

Administration, Oral↗
PubMedDate not supplied

[Percutaneous transluminal angioplasty in angina abdominis].

Personal experience in the use of percutaneous transluminal angioplasty (PTA) in the treatment of atherosclerotic lesions responsible for angina abdominis is reported. The series consists of two men and two women aged 62-74, three with isolated segmentary lesions of the coeliac tripod, two stenoses and an obstruction and the fourth with associated stenoses of the coeliac tripod and the superior mesenteric artery. No significant local or systemic complications arose and angiography revealed a satisfactory outcome in all 4 cases with total disappearance of symptoms even at follow up (minimum 12 months). Apart from the possible applications of PTA in the treatment of angina abdominis, the possibility of using it in the treatment of isolated oligo-symptomatic stenoses of the coeliac tripod is discussed.

Abdomen↗
PubMedDate not supplied

[Serum gastrin in patients with nonalcoholic liver cirrhosis].

Serum gastrin before and after a low-lipid glycoprotein meal was studied in patients with viral cirrhosis (without associated alcoholism) and controls. Cirrhotics are at high risk of peptic ulceration and most authors have attributed this to their gastrin levels which in many studies are higher in cirrhotics than controls. Since such studies involved patients with cirrhosis from a variety of causes, mostly alcohol (which in itself causes a rise in gastrin levels and an increased risk of peptic ulceration), we believed it necessary to evaluate gastrin levels before and after stimulation in patients with non-alcoholic cirrhosis, i.e. in those with viral cirrhosis.

Female↗