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Biomedical subjects

C Grimaldi

Publications and source records attributed to C Grimaldi.

At least 37 records · Page 2Linked to original sources
PubMed1994

[A case of HELLP syndrome with dramatic course successfully treated with early plasmapheresis].

A case of Hellp syndrome occurred in postpartum of a pregnancy elapsed without signs of preeclampsia is described. The evolution was particularly dramatic. Early plasmapheresis was the key treatment for a complete recovery in order to avoid Multiple Organ Dysfunction System (MODS). Emphasis on a multidisciplinary approach between Gynecologist, Anesthetist, Nephrologist and Hematologist is pointed out.

Adult↗
PubMed1993

Relationship between cystic duct diameter and the presence of cholelithiasis.

We sought to measure cystic duct diameter in patients without biliary calculi and in those with cholelithiasis or choledocholithiasis. Using endoscopic retrograde cholangiopancreatography (ERCP), we visualized the cystic duct in 168 patients referred to our unit. These patients were distributed into three groups based on findings at ERCP: Group I (N = 57), no calculi in the gallbladder or common bile duct; group II (N = 27), stones found in the gallbladder but absent from the common bile duct; and group III (N = 34), stones present in the common bile duct with or without gallbladder stones. The diameter of the cystic duct was measured at its widest and narrowest dimensions. The largest diameter measured was greater in group III (7.72 +/- 2.29 mm) than in groups I (2.63 +/- 0.67 mm) and II (4.59 +/- 1.13 mm) (P < 0.001). The same differences were found in measurement of the smallest diameter (5.00 +/- 0.99 mm, 3.10 +/- 0.62 mm, and 1.83 +/- 0.53 mm, for groups III, II, and I, respectively) (P < 0.001). Maximal and minimal cystic duct diameter show a progressive increase at each level of disease. This increase in cystic duct size may facilitate the migration of gallstone fragments after lithotripsy and facilitate the instrumentation of the cystic duct during ERCP and laparoscopic cholecystectomy.

Adult↗
PubMed1993

Cholescintigraphic study of effect of somatostatin analog, octreotide, on bile secretion and gallbladder emptying in normal subjects.

The objective of the study was to investigate the effects of a single intravenous injection of the somatostatin analog octreotide on hepatic bile secretion and gallbladder emptying with a quantitative scintigraphic technique. Twelve healthy volunteers received, in a double-blind randomized fashion, either octreotide, 100 micrograms intravenously, or placebo. Ten minutes later, [99mTc]PBIDA was administered intravenously (50 microCi/kg) (time = 0) followed, 60 min later, by the ingestion of a standardized fatty meal. In the liver area, the relative decrease per minute of tracer activity from the time of maximal activity to 60 min was significantly lower in the octreotide group (P = 0.02). In the gallbladder area, after the fatty meal, the ratio of tracer activity at 60 and 90 min (A90/A60) was significantly (P = 0.01) higher in the octreotide group. Our study demonstrates that octreotide slows down liver release of the radiopharmaceutical, probably reflecting decreased bile secretion, and inhibits postprandial gallbladder contraction.

Adult↗
PubMed1992

Does the somatostatin analogue octreotide protect against ERCP induced pancreatitis?

This study evaluates the effect of the long acting somatostatin analogue octreotide on biochemical and clinical parameters of endoscopic retrograde cholangiopancreatography (ERCP) induced pancreatitis. Altogether 245 patients were randomised to receive either octreotide or isotonic saline. Octreotide (100 micrograms) was administered intravenously five minutes before ERCP and subcutaneously 45 minutes after ERCP. There were no significant differences in the median serum amylase and lipase activities at baseline, eight, and 24 hours after ERCP. Five patients (2%) developed clinical pancreatitis--three in the octreotide and two in the placebo groups. Excluding patients who developed pancreatitis, 43 (18%) developed abdominal pain after ERCP--21 in the octreotide and 23 in the placebo groups. There were no significant differences in the median serum amylase and lipase values between the treatment groups. None of the 52 patients who had therapeutic interventions developed pancreatitis. This study suggests that octreotide may not protect against ERCP induced pancreatitis.

Amylases↗
PubMed1991

[The variability of arterial pressure measured by oscillometric methods in premature newborn infants].

The variability of blood pressure measured by oscillometry and the validity of this technique were studied in premature infants. Thirty premature babies whose postnatal age was six days or more had their blood pressure measured 11 times over a twenty-minute period for three consecutive days. Movements were found to have a very substantial influence on results that could not be reliably compared with values obtained invasively. No consistent pattern of variations of oscillometric results obtained during the eleven measurements of use for recommending a specific measurement time was found. Diastolic blood pressure fell gradually over the three-day study period. The most reliable of the eleven daily values was the lowest value for which good correlations were found between the three study days; this lowest value was not influenced by neonatal or postnatal factors.

Analysis of Variance↗
PubMed1990

[Cholecystocolic fistula: from symptoms to diagnosis].

We report 2 patients with a cholecystocolic fistula in whom diametrically opposite symptoms (isolated steator-rhea, jaundice and fever) were responsible for important clinical difficulties. These fistulae are far less common than cholecysto-duodenal fistulae. Endoscopic retrograde cholangiography was performed because of abnormal liver tests and led to diagnosis in both cases. Classical aerobilia was absent in both of our cases. Barium enema was disappointing (case n. 1), whereas technetium 99m scintiscan visualized the fistula (case n. 2). Two therapeutic approaches are possible in the case of cholecystocolic fistula. Surgery, usually combining cholecystectomy and extraction of common bile duct stones with the treatment of the fistula, may be performed systematically or in case of failure of sphincterotomy (case n. 1). On the other hand, endoscopical sphincteromy during endoscopic retrograde cholangiography, which, by reducing increased biliary pressure, may be sufficient to achieve spontaneous closure of the fistula in an elderly or high risk patient (case n. 2).

Aged↗
PubMed1988

Hepatic intraarterial lipiodol: technique, semiologic patterns, and value for hepatic tumors.

Hepatic intraarterial lipiodol (HIAL) coupled with computed tomography (CT) was used in a homogeneous series of 138 cases. All patients received 10 ml lipiodol emulsion injected by an arterial route; there were no serious complications. Four semiologic patterns were observed. Aside from nodular regenerative hyperplasia occurring in the absence of cirrhosis, HIAL gave no false-positive indications of tumor, as demonstrated by a series of 20 patients with uncomplicated cirrhosis evaluated for over 12 months. Comparison of ultrasonography, CT, angiography, and HIAL coupled with CT for exploration of hepatomas revealed the marked superiority of HIAL/CT for both tumor detection and lesion localization (search for daughter tumors).

Carcinoma, Hepatocellular↗
PubMed1988

[The value of plasma exchange during flare-ups of benign recurrent intrahepatic cholestasis].

Benign recurrent intrahepatic cholestasis (BRIC) or Summerskill's disease is a rare affection characterized by recurrent episodes of cholestasis of no apparent cause, separated by totally asymptomatic remissions. No specific treatment exists for the disease, and plasma exchange (PE) was proposed for disabling episodes affecting the general condition of two patients: one by two sessions of 4 and 13 exchanges during two episodes respectively (mass exchanged 14 and 35.5 l) and the other by 3 exchanges (total exchanged 4.5 l) during one episode. Improvement in clinical symptomatology and shortening of duration of two cholestatic episodes was noted when PE was carried out at an early stage. Bile acids were purified satisfactorily (42 to 52%), 0.15 to 1.17 mmole being extracted at each acute attack. Although difficult to assess in a rare affection such as this, PE appears to contribute to the symptomatic treatment of BRIC acute episodes if performed early enough, shortening their duration by the probable purification of circulating factors that are cholestatogenic as in primary biliary cirrhosis.

Adult↗
PubMed1986

Biofiltration in elderly uremic patients.

We treated five elderly patients with conventional hemodialysis (CH) or biofiltration (BF) to establish whether their dialytic tolerance was better. For three patients treatment time was reduced from twelve to nine hours a week; for the other two, treatment time remained unchanged (10.5-12 h/week) because of their high interdialytic weight gain. At the beginning and end of the study, clinical status, biochemical data, nutritional status and acid-base balance (ABB) were checked. Plasma levels of small molecules, potassium and phosphate were unchanged for all patients. All had a lower number of episodes or less severe hypotension and good control of ABB. No patients had metabolic alkalosis or worsened nutritional status. For all patients BF was an efficacious choice compared to CH, giving them good health.

Acid-Base Equilibrium↗
PubMed1985

[The CT scan coupled to the injection of lipiodol into the hepatic artery. Preliminary trial].

A preliminary study of CT findings for 13 malignant liver tumors evaluated after intra-arterial hepatic lipiodol injection is presented. Comparison with ultrasound, conventional CT before and after contrast material injection, and arteriography revealed the superiority of intra-arterial lipiodol injection coupled with CT examination for both the detection of hepatomas and disease extension workups, thanks to the detection of small multifocal lesions. There is no lipiodol uptake by the tumor in cases of metastases or cholangiocarcinoma. The same technique can be applied to non-surgery patients for therapeutic hepatic artery injections of an extemporaneous lipiodol emulsion, hydrosoluble contrast materials and oncostatic drugs. A review of over 100 cases in the Japanese literature emphasizes the efficacy of this therapeutic approach.

Adenoma, Bile Duct↗