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Biomedical subjects

D Fontana

Publications and source records attributed to D Fontana.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Perforated diverticulum of the cecum: conservative therapy or resection?].

The diverticulum of the right colon is a rare disease in Western Countries but is very common in Eastern races. The etiology is usually congenital in the lesions limited to the cecum (true diverticulum). The diagnosis is rarely made preoperatively. The most useful help is from CT and US. Because the clinical features suggest an acute appendicitis, in most cases of appendicectomized patients the intervention is made without any other investigations. At laparotomy, when the diverticulum is surely identified, a conservative treatment is recommended (diverticulectomy or invagination). If there are some doubts an ileo-colic resection is more opportune. After recovery it is useful to study the colon with an Rx clisma.

Cecal Diseases↗
PubMed1994

[Treatment of voluminous renal cysts with drainage and repeated percutaneous administration of alcohol. Our experience].

The Authors report their experience on the treatment of simple voluminous renal cysts with an echo-guided puncture followed by a sclerosis, that is repeated thrice, with an endocavitary injection of pure alcohol. Since the fair results (94% of success) that were obtained after a mean follow-up of 16 months, the low invasivity of the method and the benignity of the disease, should propose the method itself as the first approach for the treatment of voluminous but not complicated renal cysts.

Combined Modality Therapy↗
PubMed1994

[The pharmaco-erection test].

Intracavernous administration of vasoactive drugs induces an erection in absence of erotic stimuli; we can use this property in the study of impotent patients, inducing the appearance on an erection to examine it in all its phases (FIC Test). In case of the appearance of a good erection, the test should rule out the presence of a penile arterial disease or of a corpora-veno-occlusive deficiency. When the administration of the drug does not cause complete tumescence, it is very probable that the erectile dysfunction is caused by arterial vascular alterations or by organic disorders of veno-occlusion mechanism, but we cannot exclude for a certainty a psychogenic dysfunction. In fact an excessive noradrenergic autonomic control, as during stress condition, may limit FIC Test response. Therefore we hope that more efficacious molecules will be available in a near future. Nevertheless, we consider the opportunity of enclosing tests in the diagnostic algorithm of impotent patients to reveal an excessive adrenergic tone, such as, for example, psychological tests, study of cavernous potential, or intracavernous catecholamine dosage.

Alprostadil↗
PubMed1994

[Psychological problems related to the sexual stimulation video (SSV) test in the diagnosis of erectile disorders].

The Authors analyze scientific community's attitude towards VSS test. Related psychological problems are examined: the doctor's fear to be accused of voyeurism, the doctor's inadequacy in "invading" patient's field of intimacy, the doctor's relationship with his own erotic fantasies and with pornography, the "castrating" aspects in hospital environment and so on.

Diagnosis, Differential↗
PubMed1994

[Carcinoma of the gastric stump. Our experience].

The authors have examined eight patients operated at the Department of Surgery "B" of the G. Bosco Hospital (Torino) from 1980 to 1992 for gastric stump cancer. All patients were male of about 72 years who were subjected to resection: 5 for gastric ulcer and 3 for duodenal ulcer. During the first operation they used the same recanalization technique after gastric resection: the semi-oral distal gastric jejunal anastomosis created by Hofmeister-Finsterer. The second operation was the subtotal gastric resection made on 6 patients, total gastrectomy in 1 case and explorative laparotomy in an inoperable case. The average of free time from disease was 32 years while it is 24 years in literature. The mean survival was 40 months. The 5-year survival was about 33%. The authors conclude that carcinoma of the gastric stump has a worst prognosis then carcinoma in normal stomach. The subtotal resection has the same results as in total gastrectomy.

Aged↗
PubMed1994

[The effects of plasma cholesterol reduction on vasoconstriction due to sympathetic activation in patients with moderate primary hypercholesterolemia].

Recent studies have demonstrated that hypercholesterolemia is one of the major factor involved in the progression of coronary heart disease and that the reduction in plasma cholesterol reduces mortality for cardiovascular events. Indeed, recent experimental studies have demonstrated alterations in vascular reactivity in atherosclerosis. The aim of this study was to evaluate in patients with primary hypercholesterolemia the consequences of an effective of chronic treatment with inhibitor of HMG-CoA reductase on vascular responsiveness to cold pressure test. We observed a significant reduction in total plasma cholesterol during the study that was accompanied by a significant decrease in the response of peripheral vascular resistances to cold pressure test (55 +/- 4% vs 73 +/- 5% p < 0.01). There was also a significant relationship between the reduction of total cholesterol and the response of vascular resistance to the cold pressure test (r = 0.853, p < 0.05). Our results demonstrate that the reduction in total plasma cholesterol may influence the haemodynamic response induced by the activation of the sympathetic system.

Adult↗
PubMed1993

[Current surgical approach in the treatment of pancreatic pseudocysts].

INTRODUCTION: The paper evaluates the role of surgery in the treatment of pancreatic pseudocysts in the light of current knowledge. The authors underline the important part played by ultrasonography and CT in monitoring the evolution of pseudocysts: ETG on account of its high levels of sensitivity and specificity and CT due to its diagnostic accuracy which is equivalent to almost 100%; these methods allow the surgeon to decide if and when to operate. MATERIALS AND METHODS: A series of operations were carried out by the authors' division in 15 patients suffering from pancreatic pseudocysts. Emphasis is placed on the high percentage of emergency operations, 40%, due to complicated pseudocysts. External drainage was always used in emergency surgery, whereas in elective surgery it was preferred to use cystojejunostomy with a Roux-en-Y loop, followed by cystogastrostomy; cystoduodenostomy was only chosen in one case. The operative mortality rate was 20%. DISCUSSION: In elective surgery the operation which currently gives the best results is cystojejunostomy with a Roux-en-Y loop, but cystogastrostomy should not be overlooked due to the ease with which it is performed. A recent acquisition is the use of needle aspiration and CT- or ETG-guided percutaneous drainage in the treatment of post-necrotic pseudocysts, therefore after 4-8 weeks' maturity, both in a rapid-growth from and in the event of suppuration. Pancreatic resection is indicated for multiple atypical pseudocysts caused by retention, and this also serves to treat the underlying pancreopathy. Duodenocephalopancreatectomy is now considered to be excessive by the majority of authors. In emergency surgery, drainage of the pseudocysts is the method of choice using either a surgical or percutaneous method.

Female↗
PubMed1993

A reversal theory approach to the causes and treatment of stress in professional life.

An interactive model, which takes into account both situation and individual, is likely to be most useful in understanding the occurrence of stress in professional life. Reversal theory, when applied in the way detailed in the present paper, yields just such a model. It also, in the way discussed, provides a number of practical strategies for helping professionals identify and develop ways of coping with stress, particularly when employed within the context of the stress management workshop.

Adaptation, Psychological↗
PubMed1993

Stress levels, gender and personality factors in teachers.

The study reports an investigation of stress levels, gender and personality dimensions in a sample of school teachers. The Professional Life Stress Scale (PLSS) was used to assess teachers' stress levels and the Eysenck Personality Questionnaire (EPQ) was used to define their personality dimensions (Extroversion-Introversion, Neuroticism-High Psychoticism-Low Psychoticism). The study sample consisted of 95 teachers, 51 females and 44 males. Results revealed that the majority of teachers sampled, 72.6 per cent, were experiencing moderate levels of stress, and 23.2 per cent serious levels. T-test results showed no significant difference between male and female teachers in stress levels. Correlation analysis between stress level and personality dimensions revealed significant positive correlation between stress and psychoticism. A significant negative correlation emerged between stress and extroversion, and a significant positive correlation between stress and neuroticism. A multiple regression analysis revealed that extroversion and neuroticism were the best predictors of stress levels. Overall, the results therefore indicated that personality dimensions appear to contribute more to stress levels than do the variables of either age or gender.

Adult↗
PubMed1993

[Palliative endoscopic treatment of esophageal neoplastic stenosis].

The authors examined a series of 231 patients suffering from unoperable neoplastic dysphagia of the esophagus and treated using prevalently palliative endoscopic methods (photocoagulation and/or intubation) during the period 1980-1991. They draw the following conclusions: a) endoscopic methods are better than surgical techniques; b) there are a greater number of indications for endoscopic intubation than for photocoagulation (approximately 2 to 1); c) some situation which are indicated for photocoagulation are not contraindicated for intubation; d) the sole contraindication for intubation is stenosis in which the proximal limit is less than 2 cm from the upper esophageal sphincter; e) contraindications for photocoagulation are long stenoses and/or those of the infiltrating type, and/or involving the upper third of the esophagus; f) sometimes the two methods may be complementary in the sense that intubation may be preceded by a few photocoagulation sessions in order to necrotize the vegetating portion of an infiltrating tumour; g) it is best to choose intubation wherever possible since this technique is less expensive and the quality of remaining life better, even if the percentage of severe and generally fatal complications (perforation) is still too high; h) the possible introduction of expandable metal prostheses might increase indications for intubation and reduce the number of severe complication.

Esophageal Neoplasms↗
PubMed1993

[Transvaginal ultrasonography in the diagnosis of urethral diverticula].

The authors report their experience on transvaginal ultrasound in the diagnosis of urethral diverticula, using a high frequency linear probe, that is generally employed for transrectal prostate sonography. This non invasive method seems to be more reliable than voiding cystourethrography. This investigation may be recommended in women who have symptoms of lower urinary tract infection, urethral pain, dyspareunia, palpable mass of the anterior vaginal wall.

Diverticulum↗
PubMed1993

[Dose-response study of bunazosin in the treatment of light-to-moderate arterial hypertension].

INTRODUCTION: The antagonists of alpha-adrenergic receptors were introduced in the therapy of arterial hypertension in 1950, but have had limited use due to the poor efficacy and safety of some drugs belonging to this pharmacological class. A recent molecule from this class, bunazosin, is a highly selective alpha 1-antagonist, whose long half-life allows a single daily administration. The aim of this study was to identify the minimum effective dose of bunazosin in the treatment of mild-moderate arterial hypertension. MATERIALS AND METHODS: Patients of both sexes, aged over eighteen years, suffering from mild/moderate essential arterial hypertension were admitted to the study. The experimental design was controlled between patients; and the study was carried out in accordance with the principles of Helsinki anf Tokyo. Dosage was of 3 and 6 mg/day per os; after 2 weeks' treatment, if DBP in clinostatism > or = 95 mmHg, the dose was doubled. Treatment lasted four weeks. RESULTS: At the end of treatment, in the group of patients initially treated with 3 mg/day, SBP, in clinostatism fell by 10.0% and DBP by 8.4% (p < 0.01 between times); in the group of patients initially treated with 6 mg/day, the reductions were of 9.2% and 6.5% respectively (p < 0.01 between times). Heart rate, electrocardiograph traces and laboratory parameters showed no clinically significant modifications. The safety profile of the treatment was excellent in 80% of the patients treated overall. DISCUSSION: This study allowed the minimum effective dose of bunazosin, equal to 3-6 mg/day, to be identified, as well as confirming the antihypertensive efficacy of the drug and its ample safety margin. In fact, this range of daily dosage led to a fall in pressure values, without causing clinically significant alterations of heart rate, electrocardiograph traces and laboratory parameters. CONCLUSIONS: In conclusions, in mild/moderate arterial hypertension, bunazosin in monotherapy at the dosage of 3-6 mg/day, is an effective and safe treatment.

Adrenergic alpha-Antagonists↗
PubMed1993

[Anatomo-functional changes in the cavernous body in the elderly].

The main histological alteration that happens to the structure of the corpora cavernosa as years go by, is the progressive increase of collagen fibers compared to the decrease of both smooth muscle and elastic fibers. This phenomenon is held responsible of consequences on the hemodynamic events occurring during the erection.

Aged↗
PubMed1992

Monoclonal antibody Ki-67 in the study of the proliferative activity of bladder carcinoma.

We studied the proliferative activity of bladder carcinoma using monoclonal antibody Ki-67, which is able to stain a nuclear antigen exclusively present in cells in the cell cycle, that is with activated deoxyribonucleic acid (DNA). We used this immunohistochemical technique on neoplastic tissue removed by transurethral resection from 101 patients. A significant correlation was observed (p less than 0.003) between cells with activated DNA and histological grading, even though within the context of each grade we observed tumors with a different proliferation index. Furthermore, we studied the location of the activated cells in the context of the tumor. In invasive tumors (stages T1 to T4) cells with activated DNA were always present at the base of implant of the tumor and in the neoplastic tissue that infiltrates the bladder wall. In regard to noninvasive tumors (stage Ta), in 57% of the cases most cells with activated DNA were present in the vegetative portion of the tumor and there were no recurrences at followup, while in 43% of the cases such cells were present also or especially at the base of implant of the tumor, near the lamina propria. In the latter patients we observed a 94% recurrence rate. These results suggest that the immunohistochemical assessment of the proliferative activity of transitional tumors of the bladder, using monoclonal antibody Ki-67, and the evaluation of the location of stained neoplastic cells provide a more reliable estimate of biological aggressiveness than that obtained with histopathological patterns alone.

Antibodies, Monoclonal↗