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Biomedical subjects

C Iacono

Publications and source records attributed to C Iacono.

At least 91 records · Page 5Linked to original sources
PubMed1980

[Exocrine pancreas cancers: our experience (author's transl)].

The AA. report 136 cases of exocrine pancreas carcinomata that they have observed in 8 years in Surgical Hospital in Verona and they tackle diagnostic problems and surgical therapy. They confirmed the utility for the diagnosis of echotomography (ECO), computerizing axial tomography (T.A.C.), retrograde-endoscopic-cholangio-pancreatography (PTC). Considering the survival, at a distance of the cases that had an operation and life quality, the AA. incline, if possible, for a destroying surgical operation.

Adult↗
PubMed1980

[Pseudocystic pleural fistula documented by retrograde cholangiopancreatography].

The use of recently introduced methods such as computerised axial tomography (CAT), in addition to endoscopic retrograde cholangiopancreatography (ERCP), has in recent years led to attainment of new targets in the diagnosis of pancreatic diseases. The Authors present a clinical case of massive and recurring left pleural effusion in a patient with a pseudocyst at the level of the cauda pancreatis. They report the clinico-diagnostico-instrumental factors leading to pre-operative diagnosis of pseudocystic-pleural fistula.

Adult↗
PubMed1980

[Cystadenocarcinoma of the pancreas. Considerations on a clinical case].

A case of pancreatic cystoadenocarcinoma treated surgically four years earlier as a pancreatic pseudocyst is reported. The problems of differential diagnosis between cystic tumours (cystoadenoma and cystoadenocarcinoma) and the more common pseudocystic lesions are analysed. Stress is laid on the importance of correct intra-operative diagnosis, mainly based on multiple biopsy of the cyst wall, and the need for radical exeresis.

Cystadenocarcinoma↗
PubMed1979

[Study of the allogenic reactivity and suppression function of lymphocytes, in rheumatoid polyarthritis treated with cold salts, in mixed lymphocyte cultures].

In a group of 30 rheumatoid polyarthritis treated with gold salts, a determination of the T lymphocytes (sheep red cells) furnished in percentage normal values, and in absolute value a normal average value, with, however, a low level of T lymphocytes. In autologous lymphocyte cultures no spontaneous increase of DNA synthesis was registered. The allogenic response was normal, and in mixed culture with the addition of a third type of cells, a discrete specific suppressive activity appeared.

Adult↗
PubMedDate not supplied

Exercise capacity in young patients after total repair of Tetralogy of Fallot.

Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. Measurement of physical activity is usually performed as a routine part of the patient's cardiac evaluation. The aim of this study was to examine the exercise performance of young patients operated on for tetralogy of Fallot, assessing the possible influence of known negative prognostic factors related to the surgical repair. The study group comprised 41 consecutive patients (29 male and 12 female, ages 11.2 +/- 3.9 years, range 6-16 years) operated on for tetralogy of Fallot. Patients in the study group were divided in subgroups in relation to the age of surgical intervention (before or after 2 years of life), the surgical approach (combined transatrial/transpulmonary approach or right ventriculotomy), and the presence of aortopulmonary shunts prior to performing total correction. Their data were compared with those of 33 aged-matched asymptomatic control subjects (19 male and 14 female, ages 11.9 +/- 1.3 years, range 11-16 years). Blood pressure and heart rate measured at rest were similar between control and Fallot groups. A normal increase in systolic blood pressure was observed in response to exercise intensity for all subgroups. No significant difference between control and Fallot groups was found under conditions of mild or moderate exercise or for diastolic blood pressure at rest and in response to exercise. Lower maximal heart rate and systolic blood pressure values were recorded in all patients when compared with the control subjects. Significant differences in peak workload were detected between control and Fallot groups and between the control and each subgroup; however, no difference was found between subgroups. In conclusion, despite their very satisfactory clinical status, all patients showed a reduced peak workload, irrespective of the surgical approach, age at surgery, and aortopulmonary shunts prior to performing total correction.

Adolescent↗
PubMedDate not supplied

Does extended pancreaticoduodenectomy increase operative morbidity and mortality vs. standard pancreaticoduodenectomy?

The poor prognosis of pancreatic carcinoma after resection is related to distant metastases and local recurrence that is characterized by a strong tendency to infiltrate the retroperitoneal tissue and spread along the neural plexuses and lymph nodes. Thorough clearance of these tissues around the celiac and mesenteric axes, aorta, and inferior vena cava from the diaphragm to the inferior mesenteric artery (extended pancreaticoduodenectomy may lower the rate of local recurrence, but the procedure has been criticized for its higher morbidity and mortality. Our aim was to compare extended pancreaticoduodenectomy (EPD) with standard pancreaticoduodenectomy (SPD) in terms of postoperative morbidity and mortality. Data from 47 patients who underwent either EPD (n=24) or SPD (n=23) between November 1992 and October 1995 were retrospectively analyzed. Preoperative laboratory findings, operative risk (according to the American Society of Anesthesiologists classification), type of operation (classic Whipple vs. pylorus-preserving Whipple), operative time, intraoperative blood and plasma transfusion, postoperative morbidity and mortality, and postoperative hospital stay were scrutinized. The results showed that all of the parameters considered were similar in the EPD and SPD groups (intraoperative blood transfusion 800+/-490 ml vs. 700+/-586 ml, postoperative mortality 0% vs. 4.3%, overall morbidity 45.8% vs. 47.8%, surgical morbidity 37.5% vs. 34.7%, and postoperative hospital stay 16+/-8.1 days vs. 17+/-13.1 days. These two groups differed only in the operative time, which was significantly longer for EPD than for SPD (360+/-68.9 minutes vs. 330=66.9 minutes, P=0.02). Although the operative time is increased with EPD, there does not appear to be an increase in intraoperative complications, postoperative morbidity and mortality, or postoperative hospital stay with this procedure. However, definitive confirmation of these results can only be provided by a prospective randomized study.

Female↗
PubMedDate not supplied

Is there a place for central pancreatectomy in pancreatic surgery?

Tumors located in the neck of the pancreas that are not small and superficial enough to be enucleated are usually resected with a pancreaticoduodenectomy or left splenopancreatectomy. Such operations may cause digestive disorders, glucose intolerance, and late postsplenectomy infection. Central pancreatectomy is a segmental resection whereby the cephalic stump is sutured and the distal stump anastomosed with a Roux-en-Y jejunal loop. The purpose of this study was to evaluate whether central pancreatectomy has a place in pancreatic surgery. Thirteen patients with the following tumors underwent central pancreatectomy: five endocrine tumors, one mucinous and six serous cystadenomas, and one solid cystic-papillary tumor. Mean operative time was 250 minutes. Operative mortality was zero. Complications occurred in three patients (23%). At mean follow-up of 68 months, no recurrences were found. Postoperative oral glucose tolerance, pancreolauryl, and fecal fat excretion tests were normal in all patients. We believe that central pancreatectomy does have a place in pancreatic surgery; it is a reliable technique for benign or low-grade malignant tumors and has a surgical risk similar to that of standard operations. Its principal advantage is that it preserves pancreatic parenchyma and the anatomy of the upper gastrointestinal and biliary tract and the spleen better than pancreaticoduodenectomy or distal pancreatic and splenic resection. (J Gastrointest Surg 1998;2:509-517.)

Adult↗
PubMedDate not supplied

Atenolol and amiodarone: a comparative study of their anti-ischaemic effect.

A total of 10 patients with mixed angina were entered into a study to compare the anti-ischaemic efficacy of atenolol and amiodarone. The study was divided into three parts: (a) placebo for 2 weeks; (b) 100 mg atenolol given for 8 weeks; and (c) amiodarone given for 8 weeks, divided into week 1, 200 mg three times daily; week 2, 200 mg twice daily; weeks 3 and 4, 200 mg once daily; weeks 5-8, 200 mg once daily for 5 days a week. Clinical examination, basal and multi-stage effort electrocardiograms were performed at the end of each treatment. The number of anginal attacks and the amount of trinitrin taken by the patients were significantly reduced by both drugs with no significant difference between them. Compared with placebo, both drugs induced a significant increase in work capacity and in the time to decrease the ST-segment by 1 mm. At rest, atenolol reduced systolic blood pressure, heart rate and the systolic blood pressure--heart rate product compared with placebo. Systolic blood pressure was also reduced significantly compared with patients given amiodarone. Amiodarone did not influence these parameters. At maximum effort, amiodarone reduced heart rate and the systolic blood pressure--heart rate product compared with placebo. This reduction was greater for atenolol. The ST-segment depression was comparable between patients given either test drug. Amiodarone, therefore, exerts an anti-ischaemic effect similar to that shown by atenolol with different haemodynamics: atenolol reducing myocardial oxygen demand, amiodarone having an additive increase of coronary flow. Such an effect was obtained with a lower dose of amiodarone than is commonly used.

Amiodarone↗
PubMedDate not supplied

[Perforation of the esophagus during pneumatic dilatation in achalasia].

Esophageal perforation is a serious complication of pneumatic dilatation. We studied the cases of 4 patients (2 men and 2 women, mean age 58 years, range 56-62) who had surgical treatment for achalasia, two of which had had previous dilatation. The main symptoms were pain and dyspnea. Pneumomediastinum was present in all patients, pleural effusion in 2 and cervical emphysema in 1. Esophagographic results showed evidence of perforation in all four cases and gastric patches were surgically placed on the esophageal tear within 12 hours. Three patients received enteral nutrition for an average of 13 days. Mean hospital stay was 14 days. No post-operative complications were exhibited although one patient did develop gastroesophageal reflux 3 months later and underwent surgery to repair a hernia in the thorax 5 years later. Early and aggressive treatment is considered the best therapy and the gastric patch, in our opinion, is an effective and reliable technique for esophageal perforation repair in achalasia patients.

Dilatation↗
PubMedDate not supplied

Non ductal-adenocarcinoma neoplasms of the pancreas.

Pancreatic Non Ductal-Adenocarcinoma Neoplasms (PNDAN) represent about 20% of pancreatic and periampullary tumors and should be considered in differential diagnosis with ductal adenocarcinoma in the presence of isolated pancreatic mass. From January 1992 to December 1998, 238 patients were operated on for pancreatic and periampullary masses. Fifty-five patients had PNDAN: 24 endocrine tumors, 7 serous cystadenomas, 6 intraductal papillary-mucinous tumors, 5 acinar carcinomas, 4 mucinous cystadenomas, 3 metastatic tumors, 2 cystic papillary tumors, 2 solid cystadenocarcinomas, 1 neurilemmoma, and 1 pancreatoblastoma; 19 were benign and 36 were malignant or borderline tumors. A correct preoperative diagnosis was obtained in 58% of the cases. In all other cases, diagnosis was achieved intraoperatively. Major (18 pancreaticoduodenectomies, 17 left splenopancreatectomies, 1 total pancreatectomy) and minor resections (5 central pancreatectomy, 10 enucleations) were performed; curative surgical operations were carried out on 39/55 patients (curative resectability: 71%). Operative mortality and morbidity were 1.8% and 21.8%, respectively. Three and 5-year actuarial survival for malignant or borderline PNDANs are 65% and 40% versus 31% (3-year) for ductal adenocarcinoma of pancreatic head treated by pancreaticoduodenectomy (p-value = 0.03). We believe that pancreatic masses that are not ductal adenocarcinomas, can be aggressively resected even if large in size, resulting in a better outcome than ductal adenocarcinoma itself.

Adenocarcinoma↗
PubMedDate not supplied

Long-term results of aggressive surgical treatment of primary and recurrent retroperitoneal liposarcomas.

The aim of this study was to establish the role of surgery in the treatment of retroperitoneal liposarcomas. Data concerning 28 patients submitted to surgery for retroperitoneal liposarcoma in our department over the period from 1972 to 1999 were reviewed retrospectively and analysed. Seventy-four operations were performed; in 54% of the operations it was necessary to resect contiguous organs (kidney 60%, colon 50%, adrenal gland 35%). In 89%, grossly curative resection was achieved at the first operation; 20 patients had at least one local recurrence after first operation (median time interval: 22 months). The mean follow-up was 80 months; median survival time was 51 months and 5-year actuarial survival time 51%. Patients with low-grade liposarcoma showed a statistically significant improvement (P < 0.001) in median survival (153 months) versus those with medium- (37 months) and high-grade sarcomas (8 months). At present surgery is still the treatment of choice in the treatment of primary and recurrent liposarcoma; in the case of low-grade liposarcomas especially, an aggressive surgical approach can result in long-term survival.

Adolescent↗
PubMedDate not supplied

Necrosectomy by lavage in the surgical treatment of severe necrotizing pancreatitis. Results in 263 patients.

A conservative surgical technique for treatment of necrotizing pancreatitis is described. Standardized since 1976, the technique is based on washout mechanical necrosectomy accomplished by lavages via intraoperatively placed wide-bore drainage tubes. The overall mortality rate from necrotizing pancreatitis was thereby reduced from 61% (with resective technique) to 18%, and in 106 cases observed from the onset of the disease the mortality fell to only 6.6%. The series included also patients with fulminant acute pancreatitis and multiorgan failure.

Acute Disease↗
PubMedDate not supplied

[Treatment of pain in advanced-stage intra-abdominal neoplasms].

Different types of pain are present in far advanced intra-abdominal cancer, sometimes in the same site too. An accurate semeiological analysis of pain is important because different types of pain often differently respond to the available therapeutical tools. In this paper the results and the complications of the most important methods of pain management in far advanced intra-abdominal cancer are examined. Analysis of the data reveals that the association of more methods, pharmacological and non, should be a rule rather than the exception.

Abdominal Neoplasms↗
PubMedDate not supplied

Papillary cystic neoplasm of the pancreas: radiological findings.

We report a series of 10 papillary cystic neoplasms of the pancreas evaluated in our institution. The lesions are analyzed in retrospect to define the existence of eventual specific imaging patterns as well as to point out the existing problems of differential diagnosis versus other pancreatic tumors.

Adolescent↗