Search PubMed⌕ Search

Biomedical subjects

Andy Petroianu

Publications and source records attributed to Andy Petroianu.

29 records · Page 2Linked to original sources
PubMed2003

Subtotal splenectomy for the treatment of chronic lymphocytic leukemia.

Although splenectomy is helpful in the management of selected patients with chronic lymphocytic leukemia (CLL), in most cases this procedure is accompanied by a greater morbidity and mortality, mainly due to sepsis. Thus, it may be proposed that a conservative procedure that reduces the spleen size may have an effect similar to that of total spleen ablation for the treatment of CLL. The present paper describes our experience with an 81-year-old patient submitted to subtotal splenectomy for treatment of CLL. Indications for surgery were uncontrolled leukemic activity and intense abdominal discomfort due to the huge spleen. The good results obtained with subtotal splenectomy in the present case indicate that this procedure may be a new alternative for the treatment of CLL when removal of the spleen is indicated.

Aged↗
PubMed2003

[Quantitative parameters to evaluate the publication of scientific papers].

BACKGROUND: The assessment of the publication of scientific works is a hard challenge when it is necessary to classify a curriculum vitae or even to verify the performance of an institution, such as a medical school, a postgraduate program or a research department. Most of time, the evaluation is based on personal feelings and experience, without established standard pattern. OBJECTIVE: To present a guideline to evaluate the publications of scientific papers, without foreign influence. METHODS: The guideline to assess the value of each publication is based on the multiplication of three factors. The first factor is the value of the author corresponding to his place among the authors in the authorship of the work. The second factor is the classification of the type of publication. Finally, the product of these two factors is multiplied by ten times the "impact factor" of the journal. When the "impact factor" is zero, 0.1 should substitute it. RESULTS: This method has been used by us since 1994, with good results and without any problem related to the judgment. CONCLUSION: This criterion prevents subjective interference. Conflicts of interest are avoided when clearly presented from the beginning of the judgment process.

Authorship↗
PubMed2003

[Surgical treatment of portal hypertension in schistosomiasis mansoni].

Portal hypertension is defined by an hepatic venous pressure gradient greater than 5mmHg. It is usually caused by an increase in resistance in the portal-hepatic vascular bed due to obstruction to flow. The severe forms of schistosomiasis usually evolve with portal hypertension, esophageal, intraabdominal, retroperitoneal and abdominal wall varices. Massive bleeding due to esophageal or gastric variceal rupture is the major complication of portal hypertension in schistosomiasis. In regard to treatment, clinical (propranolol, somatostain, octreotide), endoscopic (sclerotherapy, clips and ligature of varices), vascular (TIPS - transjugular intrahepatic portosystemic shunt) and surgical (portosystemic shunts and portovariceal disconnection) approaches have been tried to decrease portal hypertension and prevent bleeding. In the present review the author discusses the subject emphasizing the surgical procedures.

Endoscopy, Gastrointestinal↗
PubMed2003

Functions of the splenic remnant after subtotal splenectomy for treatment of severe splenic injuries.

BACKGROUND: To evaluate the clinical and laboratory characteristics of patients submitted to subtotal splenectomy during the immediate and late postoperative period. METHODS: The study was conducted on 34 patients, 25 of whom were submitted to subtotal splenectomy (group I), and 9 to total splenectomy without preservation of splenic tissue (group II), and on 22 patients with intact spleens (group III, control). The immediate and late postoperative complications were investigated. Hematological examinations were performed during the late postoperative period (red cell count, hemoglobin, platelets, total and segmented leukocytes, lymphocytes, and Howell-Jolly bodies). Immunoglobulins (IgA, IgM, and IgG) and total T lymphocytes (TTL), active T lymphocytes (ATL), and B lymphocytes were also determined. Splenic scintigraphy with (99m)Tc colloidal sulfur was performed. RESULTS: Groups I and III did not presented abnormal blood bodies and their hematological and immunological pattern were normal. None of the groups showed leukocytosis or thrombocytosis. Howell-Jolly bodies were observed only in group II, which also showed reduced IgM levels. Scintigraphy showed filtering splenic tissue in group I. CONCLUSIONS: We conclude that subtotal splenectomy is a good surgical alternative for serious distal spleen lesion or when the main splenic pedicle is injured.

Adolescent↗
PubMed2002

Autotransplantation for treatment of severe splenic lesions.

The aim of the study was to evaluate clinical and laboratory variables in patients undergoing spleen autotransplantation. We studied 29 patients with severe trauma of the spleen and its pedicle. Of these, 20 underwent autotransplantation (group I) and 9 underwent total splenectomy without preservation of splenic tissue (group II). Twenty-two additional subjects with an intact spleen were used as controls (group III). Immediate and late postoperative complications were investigated. Laboratory counts were performed during the late postoperative period (red blood cells, hemoglobin, white blood cells, platelets, and Howell-Jolly bodies). To investigate the immunological profiles of patients we performed B- and T-lymphocyte counts and determined IgA, IgG, and IgM levels. All patients underwent splenic scintigraphy with technetium 99m sulfur colloid. Groups I and III did not present abnormal blood bodies, and their hematological and immunological patterns were normal. Group II showed increased numbers of Howell-Jolly bodies and low IgM levels. Splenic scintigraphy indicated the viability and filtering function of the splenic remnant in group I. Autotransplantation is a good option to maintain splenic function when total splenectomy is necessary.

Journal Article↗
PubMed2002

Bacterial clearance after total splenectomy and splenic autotransplantation in rats.

Wistar rats submitted to isolated total splenectomy or total splenectomy combined with splenic autotransplantation were inoculated with 99mtechnetium-labeled Escherichia coli. Measurement of isotope uptake in the organs of the mononuclear phagocytic system showed a greater bacterial bloodstream clearance in rats with splenic autotransplantation. Although uptake of bacteria in the spleen was higher in the control group, the number of bacteria remaining in the bloodstream did not differ between groups. These results indicate that splenic autotransplantation preserves the phagocytic function of the spleen.

Animals↗
PubMedDate not supplied

Hypersplenism in schistosomatic portal hypertension.

BACKGROUND: For many years, the hematologic changes occurring in hepatosplenic Manson's schistosomiasis have been defined as hypersplenism. Initially, the belief was that removal of the spleen would normalize the hematologic values. However, hematimetric normalization was observed in surgeries for the treatment of portal hypertension in which the spleen was preserved. In view of these findings, it is necessary to verify the clinical and laboratory profile of these patients in order to define the real presence of hypersplenism. METHODS: This study was conducted on 51 patients with schistosomatic portal hypertension divided into five groups: group 1, non-operated patients under clinical control; group 2, patients submitted to distal splenorenal shunt; group 3, patients with subtotal splenectomy and central splenorenal shunt; group 4, patients with total splenectomy and central splenorenal shunt; and group 5, patients with total splenectomy and portal-variceal disconnection. Clinical signs of hypersplenism were assessed in all patients. Hematologic values of the pre- and postoperative period were compared. Immunoglobulin counts of the patients were verified in the late postoperative period. RESULTS: In all operated groups, hematimetric values, leukocyte counts, platelet number and prothrombin time were higher during the postoperative period. With respect to the immunoglobulins, the postoperative values of IgM, IgG and IgA were normal. CONCLUSIONS: Patients with schistosomatic portal hypertension and peripheral cytopenia cannot be classified as having hypersplenism but rather as having pancytopenia due to splenomegaly caused by difficulty on portal blood drainage.

Adolescent↗
PubMedDate not supplied

[Influence of blood transfusion on development of infection in patients with malignant neoplasms of the digestive system].

BACKGROUND: Anemia affects up to 90% of cancer patients, with more than 60% requiring blood transfusion during or after treatment. AIM: To determine the influence of the allogeneic blood transfusion as a possible related factor to infection in patients with malignant neoplasms of the gastrointestinal system. PATIENTS AND METHOD: Charts of 400 oncological patients were randomly selected and divided into two groups: group 1 (n = 200)--patients submitted to allogeneic blood transfusion and group 2 (n = 200)--non transfused patients. Both groups were evaluated and compared according to the presence and type of infection and a possible association with age, sex, types of tumors and therapeutics approach. RESULTS: The relation between infection and blood transfusion, as well as age, sex, management and type of presented tumors were not significant. There was no difference in the incidence of infection between the non transfused patients (28) and those submitted to allogeneic blood transfusion (31). CONCLUSIONS: In the present investigation allogeneic blood transfusion was apparently not related to development of infection in patients with malignant gastrointestinal tumors.

Adolescent↗
PubMedDate not supplied

[Functions of the splenic remnant after subtotal splenectomy for treatment of severe splenic injuries].

PURPOSE: To evaluate clinical and laboratory variables in patients submitted to subtotal splenectomy. METHODS: 34 patients with severe trauma of the spleen and its pedicle were studied: 25 patients were submitted to subtotal splenectomy, preserving only the upper pole of the spleen (Group I), 9 were submitted to total splenectomy (Group II), and other 22 people with intact spleen were the control (Group III). Immediate and late postoperative complications were investigated. Laboratory exams were performed in the late postoperative period (red blood cells, hemoglobin, white blood cells, platelets and Howell-Jolly bodies). We studied the B- and T-lymphocyte counts and the immunoglobulins A, G and M (IgA, IgG and IgM) levels. Splenic scintigraphy with technetium 99mTc sulfur colloid was carried out on all patients. RESULTS: Group II presented Howell-Jolly bodies increased and low level of immunoglobulin M. The splenic scintigraphy demonstrated the viability and the filtering function of the splenic remnant in Group I. CONCLUSIONS: Subtotal splenectomy is a surgical alternative technique for treatment of severe distal injuries of the spleen or when its main vessels are damaged.

Adult↗