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Biomedical subjects

A Liverani

Publications and source records attributed to A Liverani.

17 recordsLinked to original sources
PubMed1998

[Mannhein index in the prognosis and treatment of acute peritonitis].

BACKGROUND: Early prognostic evaluation of patients affected by acute peritonitis is really desirable to program a correct therapeutic plan, selecting high-risk patients for more aggressive therapeutic procedures. The Mannheim peritonitis index is reliable and easy to apply, so its use is possible without the need of intensive care units. METHODS: Between 1991 and 1995 a total of 235 patients were operated on for acute peritonitis. A retrospective study on this group of patients was performed in order to estimate prognostic reliability of Mannheim peritonitis index. RESULTS: The overall mortality was 8.1%; for patients with a score less than 26 the mean mortality rate was 2% and for score greater than 26, 40.5%. This score is the threshold over which the therapeutic approach have to be more aggressive; planned multiple laparotomies or the open abdomen technique could be the best options to explore and clean up the peritoneal cavity from septic debris. In personal experience, all patients who died had residual sepsis in peritoneal cavity.

Adolescent↗
PubMed1994

[Is surgery duration really a complication factor?].

Of the numerous factors which may cause postoperative complications, some authors sustain that the durations of surgery plays a fundamentally important role. On the basis of a retrospective survey and analysis of cases operated, the authors observe that this factor, if considered alone, does not appear to cause a significant increase in septic complications, anastomotic dehiscence or mean postoperative hospital stay. Four homogeneous groups of patients were examined. Two groups included 100 who had undergone abdominal surgery which had not contaminated the peritoneal cavity. The other two groups included 150 patients who had undergone partially polluting colorectal surgery. The general preparation of patients was similar, with the exception of antibiotic prophylaxis. The mean time was calculated by analysing anesthesiological records. From an analysis of the most recent data, which are characterized by the absence of anastomotic dehiscence and operative mortality, it can be seen that the incidence of sepsis has fallen to 4% even if mean operating time was long. Mean postoperative hospital stay was also reduced from 17.3 days to 13 days. The prolongation of operating times does not depend on the complexity of surgery, intraoperative complications or the surgeon's inexperience, but may be the result of the meticulous implementation of procedures and steps taken to prevent complications which, given that they require extreme care and attention, necessarily contribute to increasing the duration of surgery. With regard to antibiotic prophylaxis and the duration of surgery, it was observed that if antibiotic prophylaxis preceded the operation by more than one hour, the incidence of sepsis was about 20%. If treatment coincided with the induction of anesthesia or the start of surgery, then the incidence of sepsis fell to 13%.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1992

["Multiorgan failure" in surgery: its physiopathology, prevention and treatment. A review of the literature].

At present multiorgan failure (MOF) is the complication with the highest mortality after emergency or elective general surgery. The syndrome seems to find its pathogenesis out of the very complex interactions of endogenous and exogenous mediators; instead the physiopathology seems to depend on cellular oxygen deficiency. The authors refer the common criteria defining organ and/or system damage during MOF and analyse the available possibilities for their treatment. In this regard they stress the role of prevention, which relies on the opportune treatment of earlier stage of shock, constantly preceding the syndrome, and on the intensive organ/systems functions monitoring to obtain an early and rational correction of the alterations taken away.

Emergencies↗
PubMed1990

[Use of ultrasonography to estimate fetal weight in premature infants. Development of a new mathematical formula].

In 73 pregnant patients at a gestational age under 36 weeks, who gave birth within 72 hours from the last US examination, mathematical equations were elaborated. The equations were aimed at predicting fetal weight by measuring the main US biometric parameters; the results were compared to the actual birth weight. A statistical analysis was performed using the "backward elimination" method. The linear equation that has provided with the best estimation of fetal weight is the following: fetal weight = 12.9875 BPD +29.5642 AD +28.8023 FL -3496.1265. According to this equation, about 95.22% of the variability of the unknown quantity (i.e. birth weight) can be ascribed to its correlation to the variables: biparietal diameter (BPD), abdominal diameter (AD) and femur length (FL). Estimated fetal weight by US, as calculated on the basis of biparietal diameter, abdominal diameter and femur length measurements, showed, in our study, a standard error of 143 g (9.02%) (R = 0.95).

Body Weight↗
PubMed1989

HLA-alloimmunization in pregnancy.

The authors analyzed the correlations between the presence of anti-HLA antibodies and fetal neonatal problems. There are specific data in the literature on the protective effect of anti-HLA antibodies against abortion. Nevertheless our study shows a significant correlation between their presence and perinatal problems.

Abortion, Habitual↗
PubMed1987

[Computerized management in the surveillance of nosocomial infections].

A personal computerised system was developed for the on-going assessment and monitoring of hospital infections. The system involves the computer processing of clinical analyses. It also selects and statistically processes the data from microbiological tests conducted on hospital patients and staff. The system makes it possible to monitor the microbiological situation of the hospital environment with particular reference to the air, surfaces, instruments and material. In this way it is possible to identify the outbreak of minor hospital epidemics and to monitor their evolution and spread.

Air Microbiology↗
PubMed1984

[Automated management of information in the microbiology department of a hospital analysis laboratory. Practical evaluations and operational proposals].

The computer has now an important role in analysis laboratory. Particularly the microbiological sector may receive a considerable support by the computer. In fact it's possible to form an effective epidemiologic hospital observatory, by making a systematic and continuous control of bacterial ecology in hospital wards, through the statistical results elaborated by computer. This is the object of the microbiological sector in the hospital's laboratory in Pistoia Town.

Electronic Data Processing↗
PubMedDate not supplied

Intraoperative ultrasonography for pancreatic insulinomas.

BACKGROUND/AIMS: Islet cell adenomas of the pancreas are both single and benign tumors in more than 90% of the cases. Even with the use of increasingly innovative diagnostic techniques, a percentage of tumors are not located in the preoperative or, sometimes, even intraoperative phase. This study compares the results of various diagnostic techniques and provides a brief review of the literature. MATERIALS AND METHODS: Between January 1978 and December 1994, 15 patients (11 females and 4 males) averaging 49 years of age (range 27-70) affected by pancreatic insulinoma underwent surgery at the Department of General Surgery of the "R. Silvestrini" Hospital. RESULTS: In 8 cases the tumor intrapancreatic position was indicated in the preoperative stage. On the contrary, intraoperative ultrasonography allowed the correct location in all the cases, but one. Surgery allows for the complete cure from the diseases when the removal of adenoma is complete. All of our patients underwent surgery which involved enucleation or resection of the distal portion of the pancreas. CONCLUSION: The choice of the type of operation to perform, as well as the consequential morbidity and mortality, seems to depend essentially on the size and position of the insulinoma. All of the patients, except for one who died because of a pancreatic fistula, are alive and normoglycaemic.

Adult↗