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V Pugliese

Publications and source records attributed to V Pugliese.

At least 19 recordsLinked to original sources
PubMed1996

Bacteria involved in the blockage of biliary stents and their susceptibility to antibacterial agents.

Endoscopically inserted stents are used for the palliation of obstructive jaundice, but infections and blockage of these stents by biliary sludge and bacterial biofilm may develop, presenting major complications. To analyze which bacteria are involved in this process, 25 biliary stents were examined. Eighty-one microorganisms were isolated: 59 gram-negative bacteria (54 Enterobacteriaceae and 5 Pseudomonas aeruginosa), 19 gram-positive bacteria (all Enterococcus spp.), and 3 Candida albicans. The Enterobacteriaceae were sensitive to netilmicin (100%), imipenem (98%), ciprofloxacin (96%), cefotaxime (69%), and piperacillin (57%), whereas Enterococcus spp. were sensitive to imipenem (79%), piperacillin (75%), ciprofloxacin (63%), and ampicillin (58%). The unpredictable aetiology and high rates of antibiotic resistance suggest that bacteriological monitoring is mandatory to avoid treatment failures in these patients.

Adult↗
PubMed1995

Splenic abscess.

Explore the source record for details and available documents.

Abdominal Abscess↗
PubMed1995

Mixed pleomorphic-osteoclast-like tumor of the pancreas. Light microscopical, immunohistochemical, and molecular biological studies.

The morphological, immunohistochemical, and molecular biological features of a case of giant cell tumor of the pancreas are described. This neoplasm showed mononuclear and multinucleated tumor giant cells as well as numerous osteoclast-like cells with multiple foci of osteoid-osseous metaplasia. The pleomorphic and osteoclastic giant cells displayed extensive homologies in their immunohistochemical profiles. Neither the pleomorphic nor osteoclast-like portion of the tumor showed neither c-Ki-ras nor p53 mutation and did not express the mutated p53 protein. The results suggest that the pleomorphic and osteoclast-like components are histogenetically related and that this rare neoplasm originates from a precursor cell capable of differentiating along divergent cell type.

Aged↗
PubMed1995

No standard treatment is available for advanced pancreatic cancer.

All randomised trials, published from 1980 to 1993, of treatments in advanced and locally unresectable exocrine pancreatic carcinoma were critically reviewed to identify the most effective therapeutic strategy for use as a control arm in randomised trials for such patients. All the published randomised trials on patients with pancreatic cancer were identified, and the treatment results summarised by means of published methodological guidelines. Twenty-seven reports, including 21 on hormonal or chemotherapy and six on radio/chemotherapy were identified. Very different treatment programmes were used in the trials, without a rationale sequence for testing hypotheses. Furthermore, several methodological drawbacks undermined both the internal and the external validity of these studies. Therefore, no meta-analysis can be conducted, combining the results of the randomised controlled trials in pancreatic cancer published from 1990 to 1993; no standard treatment is currently available for patients with advanced pancreatic cancer; future studies should screen new drugs or new combinations; and an untreated control group should be included in future comparative studies until real advantages in terms of better quality of life or improved survival are demonstrated.

Aged↗
PubMed1995

Endoscopic retrograde forceps biopsy and brush cytology of biliary strictures: a prospective study.

BACKGROUND: Nonsurgical pathologic confirmation of malignant bile duct strictures is desirable for defining subsequent treatment and prognosis. Endoscopic retrograde cholangiopancreatography is frequently performed in patients suspected of having pancreaticobiliary obstruction, but there exists no standardized method for defining the nature of obstructing lesions by ERCP. METHODS: We prospectively evaluated the yields of endoscopic retrograde brush cytology and biopsy for the diagnosis of malignant bile duct strictures. Fluoroscopically guided endobiliary biopsy and brush cytology (52) or cytology alone (42) were performed during endoscopic retrograde cholangiopancreatography in 94 consecutive patients, 64 with malignant strictures and 30 with benign strictures. A single cytopathologist classified the results of these studies as positive or negative for malignancy. RESULTS: The sensitivities of the two procedures were identical (53%) and the gain achieved by combining the two techniques (61%) was small. Specificity proved excellent for both methods. One major complication that occurred was perforation of the common hepatic duct with leakage of bile, which was managed by surgical oversewing. This complication was ascribed to biopsy and untimely removal of the nasobiliary drain by the patient herself. CONCLUSIONS: This study indicates that endoscopic retrograde brush cytology alone may be sufficient in daily practice, at least in centers that have access to experienced cytopathologists. We recommend use of forceps biopsy in selected cases where brush cytology is negative.

Adult↗
PubMed1995

Evaluation of cellular immune responses and soluble mediators in patients with chronic hepatitis C virus (cHCV) infection.

In 54 patients with cHCV infection, peripheral immune responsiveness and soluble mediator release were evaluated. Results demonstrate that in these patients phagocytosis and killing capacities exerted by polymorphonuclear cells and monocytes were profoundly depressed. At the same time, absolute numbers of CD3+, CD8+ and CD16+ cells were reduced, while the CD4(+)-CD8+ dependent antibacterial activity was also impaired. With special reference to soluble mediators, elevated amounts of both soluble interleukin-2 receptor and soluble intercellular adhesion molecule-1 were detected in sera of patients. By contrast, serum levels of tumor necrosis factor-alpha were within normal ranges, whereas interferon-gamma serum concentrations were decreased. Of note, in 18.5% of cHCV patients circulating levels of bacterial lipopolysaccharides (LPS) were detected by means of Limulus assay. In the Limulus+subset of patients, absolute numbers of CD14+ cells were reduced in a significant manner, this implying a putative monocyte-LPS interaction. In conclusion, the overall results indicate a condition of peripheral immune depression in cHCV patients with an exaggerated shedding of various mediators endowed with noxious effects for the host.

Adult↗
PubMed1995

Nodular form of local hepatic tuberculosis: case report.

The nodular form of hepatic tuberculosis (TB) is a very uncommon disease characterized by coalescing tubercles to form tumour-like tuberculomas or abscesses without evidence of extrahepatic tuberculosis. Since 1950, 23 cases of isolated nodular TB in the liver have been reported in the world literature. In 19 of these cases laparotomy was performed and the correct diagnosis was obtained only on histologic examination. We report one additional case of multiple tuberculous abscesses which were initially diagnosed as hepatic abscesses and at intraoperative evaluation were thought to be a liver tumour. The diagnosis was made by histological examination with identification of acid-fast bacili.

Diagnosis, Differential↗
PubMed1993

DNA aneuploidy is an independent factor of poor prognosis in pancreatic and peripancreatic cancer.

The purpose of this study was to investigate the clinical significance of DNA ploidy, as assessed by flow cytometry, for pancreatic and peripancreatic cancers. Between 1988 and 1990, we examined fresh/frozen samples from 49 patients who had histologically confirmed adenocarcinomas of the bilio-pancreatic carrefour: They had 23 cancers of the pancreas, 21 of the Vater's papilla, and 5 of the common bile duct. All patients were selected among a cohort of subjects who underwent Endoscopic Retrograde Cholangio Pancreatography (ERCP) and/or surgery. No prognostic impact of age, sex, stage, and surgical treatment on survival was observed by univariate analysis. When the affected organ was considered, a statistically significant difference in survival was observed: At 88 wk, survival was 0% for pancreatic and common bile duct cancer patients, and 18.2% at 175 wk for Vater's papilla cancer patients (p = 0.04). In addition, we found, irrespective of affected organ, that the patients with DNA diploid tumors had a statistically significant survival advantage as compared to those with DNA aneuploidy (p = 0.02). Furthermore, the statistically significant prognostic power of DNA ploidy was confirmed when patients with tumors of the pancreas and those with tumors of the Vater's papilla were separately analyzed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1992

[Diagnostic usefulness of BAEPs. A clinical case].

We report the clinical case of a patient operated for a right extracerebral haematoma. In the immediate post-operative period, although no clinical signs were present, a BAEP examination (showing the lack of the V) warned of a pathological condition which was ascertained by CT. A second haematoma was observed, contralateral to the first, and immediately removed. In this case, therapy was based on the neuroelectrophysiological findings.

Adult↗
PubMed1989

Endoscopic papillosphincterotomy and surgical sphincteroplasty for the treatment of bile duct stones: a comparative analysis.

UNLABELLED: One hundred and ten subjects with cholelithiasis entered this retrospective study. Early and late results of 73 patients treated by endoscopic papillosphincterotomy (EPST) were compared to those of 37 patients who had surgical transduodenal papillo-sphincteroplasty (SST). The comparative analysis was made in terms of clinical, biochemical and ultrasonographic findings. The follow-up period ranged from 1 to 5 years in the first group and from 1 to 15 years in the second group. EPST and SST proved to be comparable in regard to operative mortality and morbidity. EPST failed in removing large or impacted bile duct stones in 47% of cases, while SST was uniformly successful. Long-term results were good in most patients, either when treated by EPST or SST. The 5-year failure rate was 8% after EPST and 0% after SST. In the surgical group, the 15-year failure rate was 5%. Serum alkaline phosphatase levels were higher after EPST than after SST, suggesting the persistence of some degree of biliary stasis in endoscopically managed patients. Pneumobilia was detected more often in surgical patients, indicating that SST does create a wide and permanent communication between the duodenum and the biliary system. IN CONCLUSION: 1) EPST may achieve acceptable success rates with low mortality and morbidity, even in high risk patients; 2) the high number of long-term good clinical results seems to indicate that sphincter re-stenosis after EPST is rare, at least for the first 5 years from operation; 3) SST is an effective and safe procedure, ensuring excellent long-term results, provided that the technique of and the indication for are correct (including Wirsung assessment); 4) the wide and permanent stoma created by SST is not associated with recurrent cholangitis, if bile duct re-stenosis does not occur.

Ampulla of Vater↗
PubMed1988

CA 19-9 and CA 50 in benign and malignant pancreatic and biliary diseases.

Serum concentrations of the CA 19-9 and CA 50 antigens were determined in 129 patients with malignant and benign biliary and pancreatic diseases. Values for the two markers were highly correlated (P less than 0.001). The concentrations of CA 19-9 and CA 50 were positive in 84.6% and 80.7% of patients with pancreatic cancer, respectively. The overall specificity of CA 19-9 (92.4%) was slightly higher than that of CA 50 (88.5%). The sensitivity of CA 50 (91.3%) was greater than that of CA 19-9 (73.9%) in patients with diseases of the biliary tract. Elevated concentrations of CA 19-9 (12.9%) and CA 50 (35.2%) were also found in a number of cases with benign disease, especially in patients with obstructive jaundice. These data suggest that both CA 19-9 and CA 50 can be useful markers of pancreatic cancer in nonjaundiced patients. The joint use of the two markers does not yield a better diagnostic resolution than the use of either one alone.

Adenocarcinoma↗