[Longitudinal myotomy of the sigmoid].
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Colon, Sigmoid↗
Biomedical subjects
A Donati
Publications and source records attributed to A Donati.
Abdominal aortic aneurysm and horseshoe kidney.
Abdominal aortic aneurysm and horseshoe kidney is an unusual association. One case successfully operated upon is presented. Embriology, clinical pattern and diagnostic approach is also discussed.
Aorta, Abdominal↗
[Solitary rectal ulcer (a case report)].
The solitary rectal ulcer is a rare disease localized not only in the rectum but in other colonic tracts. It more frequently appears in female, the age preferred by the disease is the one between twenties and thirties. The 68% of ulcers is localized in the anterior wall of rectum and her length varies from 4 to 15 cm. The S.R.U. is a benign chronic disease that does not pass the muscularis mucosae, originated by an alteration of the mechanism of defecation with a prolapse of mucosa. Nowadays the therapy must by addressed to treat the prolapse and not the ulcer. The Authors report a case recently observed and after a review of the literature, analyze anatomo-clinic, etiopathogenetic and therapeutic aspects of the disease.
Adenocarcinoma↗
[Indications for surgical treatment of ulcerative rectocolitis].
The indications to surgical treatment of the ulcerative colitis (RCU) are a discuss argument to date, for etiopathogenetic uncertain still being. The problems of treatment are expressed by A.G. Parks and J.H. Pemberton very well, who said that "... Its treatment, both medical or surgical, is empirical", and "... The patients with chronic ulcerative colitis heal with proctocolectomy". From 1980 to 1992 we observed 65 cases of URC. 21 (32%) of these were treated by surgery. The indications to surgical treatment were: unsuccessful of medical therapy (14 cases), toxic megacolon (3 cases), severe dysplasia (2 cases), perforation (2 cases). We have submitted 5 patients to colectomy with ileostomy, 13 patients to colectomy with ileorecto-anastomosis and 3 to proctocolectomy with definitive ileostomy. Morbidity was 14.2% (anastomotic linkage, bronchopneumonia sepsis, wound sepsis). Mortality was 4.7% for a case of large bowel multiple perforations. The treatment of the URC is a difficult choice for surgeon, because he must decide the surgery timing. To different of the Crohn's disease, that is not heal with surgery, today URC allows more surgical aggressive attitude.
Adult↗
[Desmoid tumors of the abdominal wall (clinical cases)].
The authors on the basis of three cases of desmoid tumors observed, examine the etiologic factors, clinical aspects and results of medical and surgical therapy. According with the date learnt from the latest literature authors propose a surgical therapy in first instance by a large excision with clear edges. This approach guarantees the most efficacious prophylaxis of recurrence.
Abdominal Muscles↗
[Afferent loop obstruction after total gastrectomy presenting as acute pancreatitis (clinical contribution to the etiopathogenesis)].
Afferent loop obstruction presenting as acute pancreatitis is an uncommon pathology encountred after total gastrectomy or gastric resection. The authors refer about a case of afferent loop syndrom presenting as acute pancreatitis, and conclude that, since this disease is very rare, aggressive and variable, its diagnosis and therapy is still controversal.
Acute Disease↗
[Prediction of outcome in critically ill patients using haemodynamic and oxyphoretic parameters].
OBJECTIVE: To find a predictive model for short time mortality and survival of haemodinamically instable patients. DESIGN: Prospective study on two consecutive series of critically ill patients admitted to ICU. SUBJECTS: 115 critically ill patients, subdivided in two series of 83 (47 survivors and 36 non survivors after 20 days from admission) and 32 patients (19 survivors and 13 non survivors), respectively. INTERVENTIONTS: All the patients have been monitored with a Swan-Ganz catheter. MEASUREMENTS: Oxyphoretic parameters were measured at 7 different times (T): T0 (start), T1 (after 12 hours from T0, T2 (24 hrs), T3 (48 hrs), T4 (72 hrs), T5 (96 hrs) and T6 (120 hrs). A total number of 401 recorded values of the first patients' series were used to create the predictive model for outcome (0 non survivors, 1 survivors). Stepwise logistic regression was used to create the model. Model calibration and discrimination was assessed. The model was validated using data collected from the second series. RESULTS: The probability of survival after 20 days was Pr (survive) = e(logit)/1+e(logit), with "logit" = -5,106+(-6,58E-02 SVI)+(-2,76E-03 SVR)+(0,1379 LVSWI)+(0,8933 Hb)+(-3,25E-02 VO2I)+(9,09E-02 O2ER)+(-7,89E-02 SHUNT)+PAT. For medical patients PAT = -0.568; for surgical patients PAT = -1.0525 and for politrauma PAT = 1.593. Goodness-of-fit test showed a good calibration: chi 2 = 4.267, p = 0.832. The area under the ROC curve was 0.831. The model used in the validation data set, with 199 recorded values, also showed a good calibration and discrimination (Goodness-of-fit test: chi 2 = 15.65, p = 0.111; area under the curve 0.798). CONCLUSIONS: The mathematical model we found has been validated also in the second series and the discrimination capability increases with time. Using this model we can evaluate the probability of survival at every time. Its application at different times permits a better evaluation of haemodynamically instable patient trend.
APACHE↗