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Biomedical subjects

V Gasbarro

Publications and source records attributed to V Gasbarro.

At least 19 recordsLinked to original sources

[Effectiveness of the combination of alpha tocopherol, rutin, melilotus, and centella asiatica in the treatment of patients with chronic venous insufficiency].

BACKGROUND: The aim of this comparative clinical study was to evaluate the efficacy of the association of alphatocopherol, rutin, melilotus officinalis, and centella asiatica with oral administration in patients with chronic venous insufficiency. METHODS: Thirty patients with chronic venous insufficiency have been randomized in two groups of fifteen subjects (control and treatment group). During the period of treatment the patients didn't wear elastocompressive stockings. The therapeutic efficacy and the clinical tolerability of this association have been valued with clinical-instrumental evaluations and by a control after 15 and 30 days. Functional bothers, cramps and the edema have been valued in function presence and of their gravity with a clinical-score between 0 and 4. RESULTS: At the end of the observation period, a significant improvement of the clinical simptomatology was obtained, characterised by a diminution of the sovrafascial edema. CONCLUSIONS: The present study confirms previous clinical experiences regarding the described treatment and suggests its application in chronic venous insufficiency.

Antioxidants↗

Endovenous management of saphenous vein reflux. Endovenous Reflux Management Study Group.

PURPOSE: This study assessed clinical outcomes of two catheter-based endovenous procedures to eliminate or greatly mitigate saphenous vein reflux. MATERIALS AND METHODS: A computer-controlled, dedicated generator and two catheter designs were used to treat 210 patients at 16 private clinic and university centers in Europe. The Closure catheter applied resistive heating over long vein lengths to cause maximum wall contraction for permanent obliteration; the Restore catheter induced a short subvalvular constriction to improve the competence of mobile but nonmeeting leaflets. RESULTS: Closure treatment caused acute obliteration in 141 (93%) of 151 limbs; Restore treatment, shrinking one or more valves, acutely reduced reflux to less than 1 second in 41 (60%) of 68 limbs. Closure treatments were associated with early recanalization (6%), paresthesias (thigh, 9%; leg, 51%; P <.001), 3 skin burns, and 3 deep-vein thrombus extensions, with 1 embolism. Restore treatments were thrombogenic (16%) despite prophylactic anticoagulation, and treated valves enlarged over 6 weeks, becoming less competent. Clinical Efficacy Assessment Project clinical class was significantly improved after both treatments, up to 1 year. At 6 months, 87% of 53 Closure patients were class 0 or 1, 75% were symptom-free, and 96% of 55 treated limbs were completely free of reflux. Fourteen of 31 Restore patients (45%) had no symptoms, but 55% were class 2 or lower and only 19% had less than 1-second reflux. CONCLUSION: Closure treatment is clinically effective, albeit with offsetting complications and early failures; these are being addressed through four procedural modifications. Restore valve shrinking, although conceptually attractive, is too problematic to be competitive with Closure treatment or saphenectomy.

Catheterization, Peripheral↗

Reparative surgery of valves in the treatment of superficial venous insufficiency. External banding valvuloplasty versus high ligation or disconnection. A prospective multicentric trial.

OBJECTIVE: A prospective study was performed in order to compare results obtained in the treatment of early and/or limited primary varicose veins of the lower limbs using two different procedures: external valvuloplasty and high ligation or disconnection of the sapheno-femoral junction. MATERIALS AND METHODS: 116 limbs (113 patients) were selected. 57 with normal cusps in dilated valves were subjected to external valvuloplasty with Silicone prosthesis under Doppler control (intraoperative angioscopy in 16 cases); 59 limbs were subjected to high ligation or disconnection of the junction; 57 limbs out of 116 were subjected to complementary procedures. Duplex and photoplethysmographic examinations were performed before and after the surgical procedures in all patients. Doppler venous pressures were measured in 36 limbs and invasive pressures in 40 limbs. Patients were postoperatively followed up every 4 months until the 12th month. RESULTS: Indications for valvuloplasty were found in 8.2% of cases and in 66.3% of the early varices. Clinical results were slightly superior in the reparative surgery group. Thrombotic occlusion of the proximal long saphenous vein was significantly higher in the ligation-disconnection group. Results from photoplethysmography and venous pressure measurements indicated that both operations are equally effective in the elimination of reflux in the junction.

Adult↗

[Surgical treatment of cervical fistula after esophagogastroplasty (EGP)].

The authors report their experience on cervical anastomosis dehiscence in patients who had total esophagectomy and esophagogastroplasty for esophageal neoplasms. They describe, accurately and step by step, the plastic reconstructive technique (by using a vascularized transposed cutaneous flap), used to treat a symptomatic cervical fistula which occurred in 3 of the 24 patients who had esophagectomy and cervical-esophagogastroplasty. This kind of treatment led to complete healing of the fistulas, without clinical and radiological signs of fistula recurrence in all the patients treated.

Anastomosis, Surgical↗

["Simulated walking" in the duplex evaluation of the venous system. The clinical and instrumental correlations].

The goals of non-invasive duplex vascular diagnosis of the venous system of the lower limbs are: 1) To make evaluation of the venous system during deambulation feasible under physiological, pathological and post-surgical or elastocompressive conditions. Moreover, any such evaluation must be achieved using a standardized, easy, highly reproducibly method which is inexpensive and utilizes the diagnostic instruments available. 2) To achieve detailed, selective localization of the valvular and parietal dysfunctions at the basis of any reflux pathology. 3) To identify and quantify venous flux and reflux during deambulation. The present work gives the results achieved over the period of one year after a new method simulating deambulation (Walk System 1 patented) was set up for several utilizations, principally correlated to the use of conventional duplex scanning in studying the venous system. The main purpose of the Walk System 1 is step simulation to uncover the location and extent of venous disease. This application test of: a pneumatic pump which compresses the calf to 100-120 mmHg in 0.3 sec thus simulating muscolar pumping during deambulation; standard 40 mmHg compression of the foot in order to rule out any hemodynamic involvement of the foot pump venous system. We can use this pump in the hemodynamic component, a part, during the step simulation, with synchronism with calf pump in TVP prophylaxis or in vascular therapy; an easy-to-use application software able to quickly pulsed Doppler data of flux and reflux by means of the flux and reflux orthodynamic indices or with measures in ml/sec. The study was performed on 80 lower limbs in normal subjects in order to define the normality range and in 380 lower pathologic limbs. The study has yielded a clinical-instrumental correlation between the hemodynamic data observed during inflation-deflation of the calf cuff, positioning the pulsed Doppler sample volume in the saphenous vein in the saphenous-femoral ostium zone and the underlying venous morphology. The results have made it possible to determine physiological S-F reflux and to establish 4 pathological classes of orthodynamic S-F reflux, each class corresponding to a specific range in the orthodynamic reflux index (class 0 = 0 < RI < 0.25; class 1 = 0.25 < RI < 2; class 2 = 2 < RI < 3.5; class 3 = 3.5 < RI < 6; class 4 = RI > 5) and to a particular morphological conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Visceral aneurysmal arterial pathology].

In this paper the Authors report their experience on diagnostic and surgical procedures with respect to aneurysms of the visceral district. The clinical review during the last ten years of surgical activity in the Istituto di Clinica Chirurgica (Università di Ferrara) regards 13 patients with different visceral aneurysms. The study reports the different percentage of localization, the diagnostic approach, the surgical procedure performed and discussion of results obtained. Patients at risk for this disease are pointed out.

Aneurysm↗

A prospective study of local recurrence after resection and low stapled anastomosis in 183 patients with rectal cancer.

Local recurrence is the most serious complication of anterior resection for rectal cancer, usually occurring during the first two years after surgery. Over a five-year period, from 1981 to 1986, 183 patients underwent anterior resection for rectal carcinoma at the Surgery Ward of the University of Ferrara. Patients were followed for two years postoperatively. All operations were performed with staplers and classified according to Dukes, with 43 cases of Dukes' A; 83 cases of Dukes' B; and 57 cases of Dukes' C. In the first 24 months after surgery, the tumor recurred locally in 44 of the 183 patients (24 percent). Dukes' stage, grading distal resection margin, and histopathologic differentiation of the distal rectal ring left in the stapler after anastomosis were assessed to determine a prognostic indicator for the recurrence of the tumor. The stage:recurrence ratio was as follows: A, 1 (2 percent); B, 21 (25 percent); and C, 22 (39 percent). The grading:recurrence ratio was: G1, 13:51 (25 percent); G2, 24:110 (22 percent); and G3, 7:22 (32 percent). The ratio between distal rectal resection margin and recurrence was: 0 to 2 cm, 15:27 (56 percent); 2 to 4 cm, 16:74 (22 percent); and over 4 cm, 13:82 (15 percent). Histopathologic examination of the distal rectal ring was negative for all patients. These data confirm the direct relationship between class and local recurrence and indicate histologic grade and distal resection margin as significant prognostic parameters only when interpreted in the light of staging.

Adult↗

[Effects of therapy with aminaftone on chronic venous and lymphatic stasis].

Following a short introduction on the physiopathology of the phlebo-lymphatic system, the results of a study carried out on 114 patients suffering from chronic venous insufficiency (CVI) treated at the Department of General Clinical Surgery and Surgical Therapy of the University of Ferrara are reported. These patients were subdivided into two random groups and treated with common phlebotonic drugs and aminaftone, respectively. Both groups were also subjected to those physical and medical measures that are usually adopted for the treatment of such patients. The therapeutic effects were assessed by comparing symptomatology before and after 90 days of treatment, both subjectively (patient's assessment of the symptoms by means of a scoring system) and with objective methods (measurements and echo-Doppler examinations). The differences between the two groups were statistically very significant in favour of patients who had taken aminaftone. Excellent results were obtained in the treatment of CVI as well as in lymphatic-related pathology (lymphedema).

4-Aminobenzoic Acid↗

[Therapy and follow-up of breast cancer. Experiences in 11 years of observation].

Out of 1260 biopsies performed on neoplasias of the breast in 11 years' surgical practice, 463 (36,7%) malignant tumours were encountered. The surgical strategy in the latter cases was based on two basic parameters: a) the histological report on the intraoperative biopsy; b) the clinical stage (TNM). After surgery oncological treatment followed the now universal standard practice: --T1, T2, T3, N+, M0 and T4 independent of N or M: multiple chemotherapy for 6-12 months then periodic check ups as in N- cases. --M1: multiple chemotherapy, hormone and radiation treatment combined in various ways. The results obtained in terms of trouble free periods and survival are in line with reports in the literature including those describing a larger number of cases.

Breast Neoplasms↗

[Our clinico-therapeutic attitude to fibrocystic mastopathy].

The authors relate their experience about Chronic Cystic Disease. They emphasize the frequency of relapses and the risks that such a pathology involves. They finally suggest a surgical treatment plan that, in their opinion, should be applied whenever the patient is a peri-menopausal aged woman who has undergone, at least twice, an operation for a Chronic Mastopathy with a histologically proved epiteliosis. The operation suggests is a total glandulectomy with simultaneous breast reconstruction by means of a prosthesis.

Adult↗

[Surgical therapy of rectal prolapse. Our clinical experience of 12 years of observations].

AA. are reporting their experience on the subject of the surgical treatment of the rectal prolapse in all his clinical forms, during 12 years of activity that has taken place in the clinical surgery of the University of Ferrara. From their casuistry it is shown that usually this pathology is joined with other morbid forms of the small pelvis which vary according to the degree of the prolapse. They emphasize the excellent results obtained and support the surgical way of laparotomy adopted in the treatment of prolapse of II type (incomplete) and III type (complete).

Adult↗

[Carcinoma of the gastric stump. Considerations on 26 observed cases].

The authors report their experience concerning 26 cases of gastric stump carcinoma after gastric resection for benign pathology, observed in about 12 years. The incidence of such disease is 9,2% as regards the gastric neoplastic pathology and 5,2% as regards the benign ulcerous pathology, observed in the same period of time. The removal of the tumour was performed in 18 cases (69,2%), in spite of the stage, in most cases advanced, of the disease. In 7 cases (38,8%) the operation was extended to other organs. In 5 cases (27,7%) the removal was performed in spite of the presence of liver metastases. The survival amounts to 3 (16,6%) patients after 2, 4,5 and 5 years, one of whom suffers from liver metastases. In spite of the better knowledge of the histologic modifications and the phenomena caused by the biliopancreatic rebux and gastric hypochlorhydria, the etiopathogenesis of that disease is still unknown; the prognosis remains still unfavourable, due to the diagnostical delay and the particular aggressiveness of the neoplasm. Therefore, the Authors confirm the necessity for a precocious diagnosis, which only is suitable to improve the immediate and remote results.

Adult↗