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Biomedical subjects

D Mazza

Publications and source records attributed to D Mazza.

At least 37 records · Page 2Linked to original sources
PubMed1999

STI screening.

Explore the source record for details and available documents.

Adult↗
PubMed1999

Endometriosis.

27 year old Melinda presents to you with increasingly severe dysmenorrhoea. She has been using condoms for contraception and is no longer able to control the pain with the anti inflammatory tablets you suggested at the last consultation 6 months ago. She also complains of the recent development of deep dyspareunia. She has been in her current relationship for the last 5 years. Examination illicits similar pain and tenderness to that which she feels during intercourse. A Pap smear and STD screen are normal. You refer her to a gynaecologist who undertakes a laparoscopy on Melinda. What is seen? Ovarian adhesions secondary to endometriosis (Figure 1). Classic endometriosis (Figure 2).

Adult↗
PubMed1998

Recent advances in contraception.

BACKGROUND: Advice regarding contraception, the means of fertility regulation for millions of women, is part of a general practitioner's bread and butter work. The area is however, developing at a rapid pace with the refinement of hormonal methods and the development of new and easier modes of delivery. OBJECTIVE: This article will review the results of recent studies in the area of reproductive health that better clarify the critical issues in the prescription and use of contraceptives. It will also describe contraceptive products that will soon be available in Australia. DISCUSSION: General practitioners need to convey the results of this research to patients so that they may make informed contraceptive choices based on evidence. Patients should also be made aware of all of their contraceptive options as well as the availability of emergency contraceptives.

Australia↗
PubMed1998

Hepatitis C. Issues for women and their partners.

BACKGROUND: A large proportion of injecting drug users in Australia have been found to have hepatitis C virus (HCV). Many of these are women who as a result of the disease have specific concerns related to risk of transmission to spouses and children and questions regarding what contraception they can use. OBJECTIVE: This paper reviews the literature to examine the relationship between hepatitis C and: limitations on contraceptive use; whether sexual transmission can occur between couples; whether transmission occurs within households; rates of vertical transmission; whether transmission can occur through breastfeeding. DISCUSSION: While the prevalence of hepatitis C is low in women (except where a known history of injecting drug use exists) a small risk of sexual and vertical transmission exists when viral loads are high (such as in acute phases of the disease) or when the infected person is immunocompromised. New technologies such as polymerase chain reaction (PCR) testing may allow better advice to be given about the transmissibility of disease. Hormonal contraception may worsen liver function and general practitioners need to take this into account when discussing contraceptive options with their patient.

Female↗
PubMed1997

Adult liver transplantation and abnormalities of splanchnic veins: experience in 53 patients.

The aim of this study was to analyze the influence of technical problems resulting from splanchnic venous anomalies on the outcome of orthotopic liver transplantation. From February 1984 until December 1995, 53 (16.3%) of 326 adults underwent consecutive transplantations whilst having acquired anomalies of the splanchnic veins. These consisted of portal vein thrombosis (n = 32, 9.8%), thrombosis with inflammatory venous changes (phlebitis; n = 6, 1.8%) and alterations related to portal hypertension surgery (n = 15, 4.6%). Because of major changes in surgical technique, i.e., eversion instead of blind venous thrombectomy, immediate superior mesenteric vein approach in cases of extended thrombosis, and piggyback implantation with preservation instead of removal of the inferior vena cava, patients were divided into two groups: those who underwent transplantation during the period February 1984 to December 1990 (group 1) and those transplanted between January 1991 and December 1995 (group 2). Surgical procedures to overcome the anomalies consisted of venous thrombectomy (n = 26), implantation of the donor portal vein at the splenomesenteric confluence (n = 5) or onto a splenic (n = 1) or ileal varix (n = 1), interposition of a free iliac venous graft between recipient superior mesenteric vein and donor portal vein (n = 9), and interruption of surgical portosystemic shunt (n = 13). All patients had a complete follow-up. The 1- and 5-year actuarial patient survival rates were similar in patients with (n = 53) and without (n = 273) splanchnic venous abnormalities (75.5% vs 78.1% and 64.3% vs 66.9%, respectively). Early (< 3 months) post-transplant mortality was 24.5% (13/53 patients). Mortality was highest in the portal vein thrombophlebitis group (5/6, 83.3%), followed by the portal hypertension surgery group (5/15, 33.3%) and the portal vein thrombosis group (3/32, 9.4%). Technical modifications significantly reduced mortality in group 2 (10.3%, 3/29 vs 41.7%, 10/24 patients in group 1; P < 0.05) as well as the need for re-exploration for bleeding (13.8%, 4/29 patients in group 2 vs 15/24, 62.5% in group 1; P < 0.01). Mortality directly related to bleeding was also significantly lowered (1/29, 3.4% in group 2 vs 9/ 24, 37.5% in group 1; P < 0.01). We conclude that liver transplantation can be safely performed in the presence of splanchnic vein thrombosis and previous portal hypertension surgery.

Adolescent↗
PubMed1997

Prevalence of Helicobacter pylori infection in 190 control subjects and in 236 patients with gastroesophageal reflux, erosive esophagitis or Barrett's esophagus.

A prospective study was performed in 190 control subjects and in 236 patients with different degrees of endoscopic esophagitis in order to determine the prevalence of Helicobacter pylori infection at duodenal gastric and esophageal mucosa and its correlation with histological findings. All patients with pathologic gastroesophageal reflux had 24-h pH monitoring studies confirming the presence of acid reflux into the esophagus. Besides the endoscopic findings, biopsies were taken from the duodenal bulb, gastric antrum, gastric fundus and distal esophagus or at the specialized columnar epithelium in patients with Barrett's esophagus. Patients with pathological gastroesophageal reflux were divided into three groups: 55 with absence of endoscopic esophagitis (gastroesophageal reflux), 81 patients with erosive esophagitis and 100 patients with Barrett's esophagus. There was no H. pylori infection present at duodenal or esophageal mucosa or at the specialized columnar epithelium of the distal esophagus in any case. The prevalence of H. pylori infection at gastric antrum was similar in controls and in any group of patients with reflux disease (20-25% of H. pylori infection). No differences in age and sex distribution were seen. H. pylori infection at gastric fundus was very low (less than 5%). The presence of HP infections was correlated with the finding of chronic active superficial or athrophic gastritis while, in the absence of H. pylori infection, gastric mucosa was normal. In the presence of intestinal metaplasia, no H. pylori infection occurred. Based on these findings, it seems that there is no significant evidence for an important pathogenic role for H. pylori infection in the development of pathologic chronic gastroesophageal reflux, erosive esophagitis or Barrett's esophagus, and the presence of antral gastritis in patients with Barrett's esophagus is closely related to the presence of H. pylori infection, and probably not related to an increased duodenogastric reflux.

Adolescent↗
PubMed1997

Laparoscopic fenestration of symptomatic non-parasitic cysts of the liver.

BACKGROUND: Some 5-10 per cent of patients with congenital 'solitary' liver cysts develop symptoms (pain, gastric outlet obstruction or jaundice), and require treatment. METHODS: Ten consecutive patients with symptomatic non-parasitic liver cysts have been treated by laparoscopic fenestration. RESULTS: There were no postoperative complications. During a median follow-up of 25.5 months with ultrasonographic examination there has been no recurrence of the cysts and the patients remain asymptomatic. CONCLUSION: The minimal access surgical approach by laparoscopic fenestration could become standard treatment for simple liver cysts.

Adult↗