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V Ziparo

Publications and source records attributed to V Ziparo.

At least 37 records · Page 2Linked to original sources
PubMed1998

[An appendiceal-vesical fistula in a patient with cystic fibrosis].

Cystic fibrosis is an hereditary disease in which abnormally viscous secretion of exocrine glands causes chronic pulmonary infections and gastrointestinal disorders. The authors report the case of a patient with cystic fibrosis and appendicitis complicated by appendico-vesical fistula. The appendico-vesical fistula has been described during appendicitis; its association with the cystic fibrosis however has never been reported in the literature.

Adult↗
PubMed1996

[Caroli's disease: 2 case reports and review of the literature].

The most appropriate management of Caroli's disease is still controversial: in fact many surgical modalities have been proposed for patients exhibiting cholangitis or intrahepatic lithiasis, but these approaches have been seldom performed on asymptomatic or oligosymptomatic patients. However, this figure, due to the surgical risk related with a bilio-enteric anastomosis or with an hepatic resection, should be always compared with the possible development of a cholangiocarcinoma within the enlarged biliary tree (7%), as clearly shown in the 2 cases herein reported.

Adult↗
PubMed1994

[Gastric angiodysplasia: a rare cause of bleeding from the upper digestive tract].

Two cases of bleeding gastric angiodysplasia treated with a different approach, on the basis of the endoscopic features, are reported. Arteriovenous malformations may arise from any site of the digestive tract: gastric angiodysplasia represents one of the less frequent localizations, causing 2-5% of upper gastrointestinal bleeding. Several diagnostic tools are currently available and the choice of the most appropriate therapeutic strategy depends on many features: site and number of the lesions, patient's hemodynamic conditions, endoscopic skill. Surgery is preferred only when multiple and disseminated lesions within the gastric wall occur or when endoscopic approach fails.

Angiodysplasia↗
PubMed1994

[Papillomatous lesions of the biliary tract].

Biliary papillomatosis is a rare entity, characterized by single or multiple lesions arising from the biliary epithelium, leading to relapsing attacks of obstructive jaundice and cholangitis. Usually considered a benign disease, progression to malignancy has though been reported. In this paper the case of a 72 year old patient, with a single papilloma of the left hepatic duct treated by left hepatectomy, is discussed. The main histological, clinical and therapeutic aspects of this unusual pathology are then examined, with a complete review of the Literature.

Aged↗
PubMed1994

[Ectopic pancreas with gastric localization: a clinical case and review of the literature].

Heterotopic pancreatic tissue localized in the upper gastrointestinal (UGI) tract rarely presents with symptoms unless it is complicated by bleeding or mucosal ulceration. The case of a 26 year old man who presented with a one year history of epigastric pain, dyspepsia and several episodes of vomiting, without signs of bleeding or ulceration is reported. Work-up, which included upper gastrointestinal endoscopy, abdominal ultrasound and UGI series, revealed an intramural mass on the lesser curvature of the stomach, with normal overlying mucosa. The patient underwent surgical excision of the lesion and histologic examination showed normal pancreatic tissue. Postoperatively the patient did well with marked clinical improvement. In reviewing the literature on aberrant pancreatic lesions of the stomach the Authors discuss the varying clinical presentation and differential diagnosis as well as treatment options: when the lesions present with disabling symptoms, surgical excision should always be performed.

Adult↗
PubMed1991

Short-term oral zinc supplementation does not improve chronic hepatic encephalopathy. Results of a double-blind crossover trial.

The effect of short-term oral zinc supplementation (zinc sulfate 600 mg/day) on hepatic encephalopathy, was assessed in a double-blind, crossover trial. Fifteen cirrhotic patients with stable, chronic hepatic encephalopathy were randomized to receive either oral zinc or a placebo for 10 days. Following a two-week washout period, these were crossed over to the alternate treatment. Conn's index, which comprises the evaluation of the mental state, asterixis, number connection test, EEG record, and plasma ammonia, was used to score the degree of hepatic encephalopathy, both at the beginning and end of each treatment period. Serum zinc was significantly raised after oral zinc administration and reached the levels observed in cirrhotics without hepatic encephalopathy. Despite this, however, no modification in the parameters included in Conn's index were observed. In conclusion, this study failed to confirm that short-term oral zinc supplementation improves chronic hepatic encephalopathy.

Administration, Oral↗
PubMed1991

[The echographic aspects of the splenoportal axis in patients with esophageal varices].

In the present study the A. try to assess the usefulness of ultrasound in detecting blending risk in portal hypertension. Endoscopic and sonographic findings of 35 cirrhotic patients with esophageal varices were compared to a control group of 27 hepatopathy patients without portal hypertension, observed in the same department and in the same interval. The medium caliber of portal vein was 14.64 +/- 2.59 and 11.8 +/- 1.33 mm, respectively in the study and in the control group (p less than 0.01). Statistic correlations were also found in subgroups of patients with varices of different degrees. A portal vein greater than 16 mm was found in 10 of 11 patients with large varices; this pattern provides a sensitivity of 71.4% and a specificity of 94.1%. In our experience this echographic finding should represents a clear indication for close endoscopic follow-up, even in patients without previous bleeding from esophageal varices.

Adult↗
PubMed1990

[Indications and limitations of the surgical treatment of portal hypertension].

The authors report a review of the literature and describe their personal experience with treating esophageal varices; all types of surgical approaches (selective and total shunts, esophageal transection) are examined and compared to the results obtained with non surgical treatment (particularly endoscopic sclerotherapy). Indications and results of surgical treatment are discussed from three definitive viewpoints: prevention of first bleeding or prophylactic treatment, control of acute bleeding or emergency treatment and prevention of rebleeding or elective treatment.

Esophageal and Gastric Varices↗
PubMed1990

Lactitol in the treatment of chronic hepatic encephalopathy--a randomized cross-over comparison with lactulose.

The effect of lactitol, a new non-absorbable disaccharide, in the treatment of chronic hepatic encephalopathy was assessed in 14 cirrhotic patients with non-selective portosystemic anastomosis in a randomized, cross-over study. At the time of inclusion, all patients showed alterations in mental state, and/or psychometric performance, and in the electroencephalogram. Moreover, 10 out of 14 patients suffered from recurrent episodes of hepatic encephalopathy in the 12 months prior to the study. Patients were randomly treated for two consecutive periods of six months with either lactitol or lactulose. The PSE index was calculated to quantify the neuro-psychiatric impairment. Twelve patients completed the study. The patients required a daily dose of 38.2 g +/- 19 of lactulose or 36.3 g +/- 5 of lactitol to produce two semi-soft stools per day. No deterioration in the mental state or in the other neuro-psychiatric parameters were observed, neither during lactitol nor during lactulose therapy. During the study, mild episodes of recurrent encephalopathy occurred in 60% of the patients taking lactulose, and in 25% of the patients taking lactitol, the difference not being significant (X = 1.54, p = 0.21). Flatulence, the major side-effect noted during the study, was present in 7 of the 12 patients during lactulose treatment, and in 2 patients during lactitol treatment; one patient on lactitol complained of nausea. The side effects which occurred during lactitol of the dosage, while those occurring during lactitol appeared when the dosage was higher than 40 g. Lactitol may be considered at least as effective as lactulose in the treatment of chronic hepatic encephalopathy.

Adult↗
PubMed1989

[Changes in the lymphocyte subpopulations in a patient with orthotopic transplant of the liver].

Earlier experimental studies have shown that the cyclosporin immunosuppressive effect (CsA) can be modulated by drug timing as well as dose. More specifically treatment during the night was constantly associated with a statistically significant improvement in the prevention or delay of allograft rejection. The present study reports on the circadian variations in T-lymphocyte subpopulations in the peripheral blood of a patient given an orthotopic liver allograft and treated with CsA and steroids. In particular, a statistically significant circadian rhythm (p = 0.012) was observed for the T-helper (OKT4) subset with a peak time (acrophase) occurring during the night at 4:27 A.M. In this patient, CsA treatment was, therefore, adapted to the T-helper cycle with the aim of marching CsA blood level variations to that curve. The results suggest that CsA timing can provide a tool for daily dose reduction and then improve the success rate of drug treatment.

Antigens, Surface↗
PubMed1989

Lactitol in prevention of recurrent episodes of hepatic encephalopathy in cirrhotic patients with portal-systemic shunt.

Recurrent episodes of hepatic encephalopathy (HE) frequently occur in surgically shunted cirrhotic patients. The prevention of these episodes is based mainly on the long-term use of lactulose. Recently, lactitol, a nonabsorbable disaccharide similar to lactulose, has been proposed as an alternative in the management of HE. It has the advantage of being better tolerated and producing a more predictable catharsis. The effects of the two agents were compared in a controlled randomized study lasting six months involving 31 cirrhotic patients with portal-systemic shunt, of whom 40% experienced HE. The PSE index (mental state, EEG, asterixis, Raitan test, and ammonia) was assessed in each patient on entry to the study and every three months during treatment. Episodes of HE, side effects, and the patients' comments on efficacy, tolerability, and palatability were recorded. The dose required to induce two bowel movements per day was 48 +/- 25 ml of lactulose syrup and 36 +/- 7 g of lactitol. During the study, the number of patients who had an episode of HE and the PSE index was similar in both groups. The patients judged lactitol better from the point of view of palatability. Meteorism and flatulence, experienced by patients treated with lactulose, was not reported by the lactitol group. We concluded that lactitol is as effective as lactulose in the long-term prevention of episodes of HE in cirrhotics with portal-systemic shunt and may be better tolerated.

Adolescent↗
PubMed1989

Management of esophageal varices in the Western world--the state of the art.

The treatment by Western countries of bleeding from esophageal varices was reviewed from three definite viewpoints: prevention of first bleeding or prophylactic treatment, control of acute bleeding or emergency treatment, and prevention of rebleeding or elective treatment. Even though prophylactic surgery has been abandoned on the basis of several randomized studies, some authors still perform esophageal transection and report encouraging results. In emergency situations, the role of surgery has been limited by the prohibitive hospital mortality and by the introduction of vasoactive drugs and endoscopic sclerotherapy. Nevertheless, good immediate and long term results have been obtained in specialized centers in which bleeding patients undergo surgery no later than 8 hours after their admission. As regards the prevention of rebleeding, non selective portal decompression gives adequate protection against rebleeding, however, hepatoencephalopathy follows in considerable incidence. In order to avoid this complication, direct operations on varices have been performed, largely with good results. The Warren shunt offers results showing advantage over the non-selective shunt in the first postoperative period but later on, it behaves hemodynamically as a total shunt and the advantage is then cancelled. We report herein a review of the literature and also describe our personal experience with treating bleeding esophageal varices.

Clinical Trials as Topic↗
PubMed1985

Role of delayed cutaneous hypersensitivity reaction in classifying patients with bronchial carcinoma.

Cell-mediated immune response was evaluated in 150 patients with histologically confirmed bronchopulmonary carcinoma using bacterial and fungal recall antigens injected intradermally (PPD, candida, trichophyton). In the study group negative skin test reaction was found in 51 of 150 patients (34.0%), whereas in the control population it was found in 5 of 33 cases (15.1%) (p less than 0.05). Histologic cell type and stage of disease were defined for each patient. It was possible to calculate the growth rate of the primary tumor only in 68 of 150 patients, and it was recorded as doubling time. Evaluation of the skin test reaction in each prognostic subgroup showed no statistically significant differences. The only statistically significant differences were found when each prognostic subgroup was compared with the control population according to the frequency of a negative response to the skin test, particularly in stage III M1 (p less than 0.05) and stage III M0 (p less than 0.02). The delayed cutaneous hypersensitivity studied with recall antigen stimulation was mainly correlated with the stage of disease, and it should not be considered as an independent prognostic factor.

Candida↗
PubMed1984

Spontaneous motor activity increases after portacaval anastomosis in rats.

Spontaneous motor activity was monitored in rats at various times, up to 14 weeks, after portacaval anastomosis (PCA) or sham operation. Total 24 hour activity scores rose significantly after PCA and remained significantly higher than those of sham operated rats for twelve weeks. After PCA, activity during the twelve hour lighted period was greatly increased, whereas dark period activity was unchanged. Increased activity in the light period was found to be well correlated with the degree of elevation in brain concentrations of tryptophan, tyrosine, phenylalanine and glutamine. These results are consistent with previously reported EEG studies and suggest that motor-activity measurement may facilitate the correlation of biochemical changes with behaviour in rats with portal systemic shunting.

Amino Acids↗
PubMed1981

Exaggerated glucagon secretion in diabetic and non-diabetic subjects with surgical porto-caval anastomosis.

Pancreatic glucagon (IRG) levels in the postabsorptive (fasting) state and in response to arginine test (ATT), have been investigated in 17 subjects with porto-caval anastomosis (PCA). Out of these, seven subjects were insulin-treated diabetics, 5 were untreated diabetics, and 5 had no evidence of clinical diabetes. Basal and stimulated IRG values in the overall group of PCA subjects were significantly increased in comparison to 14 normal controls. No significant difference was found between the three groups of patients in respect to IRG values. The mean fasting IRG levels, grouped in relation to the age of shunt, were significantly raised six months after surgery. In addition no significant difference in IRG values (fasting or stimulated) was observed in relation to the entity of the liver disease (child degree) or to the type of surgical shunt. Finally, when PCA patients with or without encephalopathy were considered, fasting and peak IRG values were significantly increased in those patients with encephalopathy.

Arginine↗