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Biomedical subjects

C Marchegiani

Publications and source records attributed to C Marchegiani.

At least 19 recordsLinked to original sources
PubMed1997

[2 cases of acute cholestasis caused by ticlopidine].

We report the case of two patients suffered from cholestatic jaundice occurred 3-4 weeks after starting ticlopidine therapy. In both cases the diagnosis was made by ruling out any other known cause of acute hepatitis or cholestasis. One patient underwent liver biopsy, which showed a typical intralobular cholestatic pattern and a slight lymphocytic infiltration of the portal tracts. The other patient, a 29 year-old woman, was taking ticlopidine as the sole drug, further to an ischemic stroke occurred while she was taking oral contraceptives; she presented a diffuse itchy dermatitis, fever and slight eosinophilia besides cholestasis. In both patients ticlopidine was discontinued and liver tests returned to normal values within 4-8 weeks; no rechallenge was attempted and ticlopidine was replaced with another antiplatelet drug. To the best of our knowledge 19 cases of ticlopidine-related cholestatic disease have been described so far in the literature. Its pathogenesis is still unknown, although some clinical findings and experimental results from patients with acute enteropathy or agranulocytosis induced by ticlopidine suggest that the drug may act through a toxic mechanism, perhaps mediated by prostaglandins.

Acute Disease↗
PubMed1997

[Endoscopic fragmentation of gastric phytobezoars as a valid alternative, in selected cases, to traditional surgery].

Three cases of gastrointestinal bezoar are described. Two were submitted to conventional surgery and one to endoscopic fragmentation. The natural and postoperative pathophysiologic mechanisms responsible for the formation of bezoars were studied. The condition is generally asymptomatic, the clinical presentation being similar to that of gastritis and/or duodenitis. Endoscopy is the non-invasive technique of choice in the diagnosis of gastric bezoars. Treatment of these lesions in day-endoscopy consists in removal of the bezoar if less than 3 cm in diameter and fragmentation if larger in diameter followed by extraction of any fragments over 1 cm to prevent the risk of intestinal obstruction. Long term maintenance therapy with cisapride or metoclopramide is then immediately administered for preventive purposes, and it is also used in patients submitted to traditional gastric and/or duodenal surgery.

Adult↗
PubMed1997

[Endoscopic treatment of the "cul de sac" syndrome: our experience].

The "Sump Syndrome" represents a known late complication not easily recognizable within the interventions of CDS and L-L CDS. Its incidence ranges from 0% to 9.6% according to the literature. Up to ten years ago the "Sump Syndrome" treatment was mostly surgical. Currently endoscopic treatment reduces considerably the operative risk and the number, frequency and severity of complications. The technique consists of an endoscopic papillosphincterotomy with removal of calculus, gall mud, alimentary fragments and restoration of a satisfactory flow towards the duodenum. From January 1985 to October 1993, 492 ERCP were performed in Popoli's Hospital Digestive Department with an overall success rate of 92% and a selective incannulation success rate of 87%. Endoscopic treatment was used in 56% of the cases (319 patients) with 90% of success; 271 patients (35%) with lithiasic pathology were examined and 35 (12.9%) of them presented the "Sump Syndrome". Six patients underwent operation, 2 had no treatment and 27 underwent endoscopic treatment. In 21 cases an endoscopic papillotomy was performed and in 6 cases a bile-duct washing or calculi fragmentation was assured; 21 patients recovered completely while 6 patients still refer a painful-dyspeptic symptomatology with occasional colics which could be related to phenomena of chronic pancreatitis. The clinical experience allowed us to positively evaluate the endoscopic treatment of the "Sump Syndrome" since it carries a low mortality and morbidity rate and, furthermore, it is easily repeatable.

Aged↗
PubMed1997

[Perineal surgical approach in the treatment of some disorders of the rectoanal function (fecal incontinence and obstructive constipation)].

A global experience in the surgical perineal approach to the treatment of alterations of recto-anal function (fecal incontinence and obstructed defection) is reported. Surgical techniques and results in four cases of fecal incontinence operated and surgical treatment of 14 patients suffering from obstructed defecation, due to organic obstacles (4 cases) or functional abnormalities (rectocele 10 cases) are discussed. Indications, surgical techniques as well as the obtained results are described.

Aged↗
PubMed1997

[Artificial nutrition in acute pancreatitis].

Nutritional support for acute pancreatitis is a matter of debate, clear guidelines based on objective data do not exist. We report our experience in patients with severe disease. Parenteral nutrition appears to be a safe initial therapy, but the enteral route has many practical and theoretical advantages and should be started as soon as possible.

Acute Disease↗
PubMed1996

[Apudomas: nosographic and physiopathological aspects].

The authors intend to contribute to the knowledge of this complex and in part not fully defined subject of apudomas, in particular with regard to classification criteria and physiopathological aspects. After having examined the characteristics of these neoplasias (probably common embryonal origin, similar radioimmunological, immunohistochemical and ultrastructural characteristics, the capacity to convert amine precursors into amines), the authors focus on the most significant aspect of these carcinoids which, in the light of current knowledge, possess varying but undisputed degrees of biological aggressiveness. They also highlight the importance of the gastroenteric tract as an organ with an endocrine function and lastly affirm the value of the classification which, using the pancreas as the reference organ, distinguishes endocrine neoplasias in this tract into entopic and ectotopic examples.

Apudoma↗
PubMed1989

[Gynecomastia: our experience in surgical treatment].

A group of 78 patients with gynecomastia was observed between 1974-1987. Idiopathic gynecomastia was referred in 33 cases, cirrhosis in 31 cases, prostatic hypertrophy in 2 cases, while in 12 cases gynecomastia was induced by drugs. All patients with idiopathic form and 11 patients with secondary form were surgically treated by mastectomy (20 bilaterally and 24 unilaterally). The authors emphasize that, in this pathology, is much more important restoring the masculine feature of thorax without esthetic damage than removing the hypertrophic gland.

Adolescent↗
PubMed1984

Indications, procedures and results in the surgical treatment of hyperthyroidism: a follow-up of 336 cases.

A personal experience with the surgical treatment of hyperfunctioning thyroid diseases from 1970 throughout 1982 is reported. Data on 336 controlled cases are analyzed. The series reported is homogeneous as for indications, surgical procedures, pre and postoperative management. Total lobectomy has proved to be the therapy of choice for uninodular lesions: all followed patients (208) are euthyroid. Subtotal or "near-total" thyroidectomy was curative in 71,8% of multinodular and basedowified goiters, as well as in Graves' disease. For the latter, indications of total thyroidectomy in selected cases are being evaluated. Further studies to complete the follow-up of the series are in progress.

Calcium↗
PubMed1984

Thyrotoxicosis and thyroid cancer: a report on eight operated cases.

Eight cases of hyperthyroidism and thyroid cancer, representing 0.96% of overall hyperfunctioning thyroid diseases (835), surgically treated are reported. Clinical and pathological data, and type of treatment are summarized. The etiopathogenic hypotheses about possible relations between thyrotoxicosis and thyroid cancer are discussed. In the presence of thyrotoxicosis, preoperative diagnosis of thyroid cancer is rather difficult, but awareness of the potential association and careful examination of any suspect nodularity make it possible to recognize minimal malignant foci and adequately treat them with total thyroidectomy and, when required, modified neck dissection.

Adolescent↗
PubMed1978

[Diagnostic and therapeutic role of so-called laparosplenectomy in Hodgkin's disease].

Results obtained with laparosplenectomy in the diagnosis and treatment of Hodgkin's disease are reported. The soundness of this method is asserted with regard to establishment of the anatomopathological stage, the improved tolerance of subsequent antiblastic management and the virtual absence of post-operative complications. The long-term progression of the disease, however, cannot be examined, since reliable data are not available. It will the tasks of the haematologists to follow these patients and record the clinical events observed.

Adolescent↗