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Biomedical subjects

D Righi

Publications and source records attributed to D Righi.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Percutaneous transhepatic treatment of massive intrahepatic calculosis secondary to stenosis of a biliary-digestive anastomosis].

The authors describe a successful technique for the percutaneous treatment of intrahepatic gallstones from a stenotic Rouxen-Y hepaticojejunostomy. A bilioplasty of the anastomosis with wash-out of the biliary tract has been achieved through two percutaneous external biliary drainage catheters, one inserted in the right biliary ducts and the other placed in the left biliary ducts by means of an anterior approach.

Aged↗
PubMed1985

[Percutaneous correction of benign stenosis of the bile ducts and biliary-digestive anastomosis. Percutaneous transhepatic biliplasty].

The authors describe their experience in nine cases of transhepatic percutaneous dilatation of bile ducts benign stenosis by a Gruntzig catheter inflated at the stenotic level in order to stretch the sclerotic lesion. Despite the brief follow-up, the first results are satisfying; for this reason percutaneous dilatation of bile ducts benign stenosis could be a new procedure in the treatment of these lesions in selected cases.

Adult↗
PubMed1985

[Use of the one-stick introducer system set in the pyelostomy as a 1st stage of pyelo-uretero-lithotripsy (PUL)].

In the last few years there has been an increasing diffusion of endoscopic percutaneous trans-lumbar lithotripsy as a treatment for kidney stones. This technique requires an adequate pyelostomic approach. The authors at this purpose suggest the utilisation of the "One Stick Introducer System Set", that has been created for the biliary tree catheterism as this set is easy to use and rarely traumatic for the patient.

Catheterization↗
PubMed1984

A study of the semeiological reliability of dorsalis pedis artery and posterior tibial artery in the diagnosis of lower limb arterial occlusive disease.

Routine diagnosis of suspected occlusive arterial disease of the lower limbs are often based on the pulse absence at the dorsalis pedis artery. However many of these diagnoses are not confirmed after more thorough tests, and this fact arises the problem of the semeiological reliability of the above mentioned artery. Researches carried out by several authors in normal individuals on the dorsalis pedis artery yielded controversial results. Three hundred-sixty subjects free of occlusive arterial disease were then examined by means of clinical and Doppler investigation in order to assess the semeiological reliability of the dorsalis pedis artery in the diagnosis of occlusive arteriopathy of lower limbs, when compared to the posterior tibial one. The conclusion is drawn that a greater semeiological reliability must be attributed to the latter, due to its lesser "absence" incidence.

Adolescent↗
PubMed1983

Effects of calcitonin on limb blood vessels in human obstructive arterial disease.

To check the possibility of a vasoactive effect of calcitonin in man, the authors treated ten hospitalized patients (seven males and three females, mean age 66.3 +/- 3.24), suffering from obstructive arterial disease in the lower extremities, with 100 units M.R.C. i.m. daily, for a period of 15 days. Five patients presented Raynaud's phenomenon. Treatment (B) led to an improvement of subjective symptomatology and to the disappearance of Raynaud's phenomenon in comparison with symptoms before treatment (A) and after a placebo period of 15 days (C). With respect to instrumental parameters, calcitonin induced: a) a slight increase of segmental plethysmography values (height/width ratio of curves) if compared with A (p less than 0.05) and more significantly if compared with C (p less than 0.01 and less than 0.0125, from right and left sides, respectively); b) a small change in venous-occlusion plethysmography values, if compared with A and C, both in basal conditions and after the "ischaemic test"; c) a significantly lesser reduction of digital photoelectric plethysmography values (height/width ratio of curves) after the "cold test" in comparison with A (p less than 0.01, both on the second and on the third fingers of the right hand), as well as with C (p less than 0.01 and p less than 0.025, on the second and on the third fingers, respectively). The present investigation points out the vasoactive influence of calcitonin in human obstructive disease. Results show the improvement in collateral limb circulation and, above all, in the amount of cutaneous flow. Little information is available on the mechanism of this effect, for which only hypotheses can at present be advanced.

Aged↗
PubMed1982

Sensitization of mice to methylphenidate.

Mice that received five daily injection of methylphenidate HCl, 10-75 mg/kg, showed an increased running response to methylphenidate, cocaine, and amphetamine. Sensitization to methylphenidate persisted for at least 50 days. Repeated IP injections of methylphenidate into mice with unilateral striatal lesions increased ipsilateral turning in response to methylphenidate, but decreased contralateral turning after apomorphine. The climbing response to apomorphine in intact, methylphenidate-sensitized mice was also decreased. There was no change in either basal or dopamine-stimulated adenyl cyclase activity in the striata of sensitized mice, but there was a 36% increase in the specific binding of haloperidol. The rate of turnover of striatal dopamine was increased in sensitized mice. These results suggest that pretreatment with methylphenidate may alter the sensitivity of presynaptic dopamine receptors.

Adenylyl Cyclases↗
PubMed1982

Observations on changes in intermittent claudication after the administration of creatine phosphate.

A study was carried out in 13 patients with stabilized occlusive arterial disease to assess the effect of treatment with creatine phosphate (800 mg/day for 12 days) on walking distance to onset of disabling pain and on haemodynamic parameters (Winsor Index and calf arterial blood flow after ischaemia). Before treatment, patients had daily exercise for 12 days on a treadmill to plateau walking distance increase due to exercise. The results showed a further significant increase in walking distance after treatment, and a significant increase in peak reactive hyperaemia in all but 2 patients. The possible mechanisms of the effects of creatine phosphate are discussed.

Adult↗
PubMedDate not supplied

Percutaneous removal of biliary stones.

Since 1983 we have performed percutaneous treatment of biliary lithiasis in 97 patients. Previous retrograde endoscopic procedures were incomplete or infeasible in all patients. Immediate results were excellent resulting in complete resolution of lithiasis in 89 of 97 patients (92%). In 4 patients (4%) partial success was obtained (symptoms subsided although there were nonobstructing residual stones). Percutaneous treatment failed in 1 patient (1%). Three patients died. Complications occurred in 14 of 97 patients (14%) and mortality at 30 days was 3%. Long-term results were evaluated in 71 patients who had a least a 6-month follow-up (mean 31 months and range 6-78 months). Eight of 71 patients (11%) had recurrence of stones and 7 of these were successfully retreated transhepatically. Percutaneous removal of biliary stones is efficacious because it has a high cure rate, a low complication rate, and a mortality rate that compares favorably to that of surgery even though the patients are usually older and in poorer general condition.

Adult↗
PubMedDate not supplied

[Evaluation of patient doses in interventional radiology].

PURPOSE: To verify the suitability of indicative quantities to evaluate the risk related to patient exposure, in abdominal and vascular interventional radiology, by the study of correlations between dosimetric quantities and other indicators. MATERIAL AND METHODS: We performed in vivo measurements of entrance skin dose (ESD) and dose area product (DAP) during 48 procedures to evaluate the correlation among dosimetric quantities, and an estimation of spatial distribution of exposure and effective dose (E). To measure DAP we used a transmission ionization chamber and to evaluate ESD and its spatial distribution we used radiographic film packed in a single envelope and placed near the patient's skin. E was estimated by a calculation software using data from film digitalisation. RESULTS: From the data derived for measurements in 27 interventional procedures on 48 patients we obtained a DAP to E conversion factor of 0.15 mSv / Gy cm2, with an excellent correlation (r=.99). We also found a good correlation between DAP and exposure parameters such as fluoroscopy time and number of images. The greatest effective dose was evaluated for a multiple procedure in the hepatic region, with a DAP value of 425 Gy cm2. The greatest ESD was about 550 mGy. For groups of patients undergoing similar interventional procedures the correlation between ESD and DAP had conversion factors from 6 to 12 mGy Gy-1 cm-2. CONCLUSION: The evaluation of ESD and E by slow films represents a valid method for patient dosimetry in interventional radiology. The good correlation between DAP and fluoroscopy time and number of images confirm the suitability of these indicators as basic dosimetric information. All the ESD values found are lower than threshold doses for deterministic effects.

Fluoroscopy↗
PubMedDate not supplied

[Interventional radiology in the treatment of the complications from interventions on the lower urinary excretory tract].

Ureteral diversions may be complicated by strictures, hydronephrosis, pyelonephritis, lithiasis, fistulas, etc. In the last 10 years, 103 patients with 133 urological postoperative complications underwent percutaneous treatment. Most of the patients had been treated by percutaneous antegrade drainage; afterwards, stricture dilatation, ureteral stenting and stone extraction were performed. In one case a Strecker metallic stent was employed. We have successfully treated 101 of 133 complications (75.9%), with only 27 failures (20.3%). Five cases (3.8%) of lithiasis did not require percutaneous treatment. The good results obtained, the absence of major complications, the low cost and the little discomfort for the patients confirm the leading role of percutaneous treatment in complicated ureteral diversions.

Adolescent↗
PubMedDate not supplied

Femoral haemostosis with Vasoseal ES: experience in 150 patients.

PURPOSE: The aim of this study is to assess the effectiveness and safety of the use of Vasoseal ES collagen plug in heavily anticoagulated patients with high risk of complications at the vascular access site who had undergone vascular radiological intervention. MATERIALS AND METHODS: Between January 2002 and March 2003 180 consecutive transfemoral arterial accesses in 169 patients subjected to vascular radiological procedures were performed (bilateral access was performed in 11 patients): 140 percutaneous transluminal angioplasties and 40 transarterial chemoembolisations. All the patients who underwent angioplasty were given 3,000 IU of sodic heparin intravenously during the procedure and later a prolonged antiaggregant therapy was undertaken (ticlopidine 500 mg/day and aspirin 150 mg/day). The sheaths were removed at the end of the surgical manoeuvre and two cartridges of collagen were positioned on the external surface of the artery. The mean values of platelets and partial thromboplastin time were 42,000/ml and 170 s, respectively, in cirrhotic patients against 250,000/ml and 200 s in patients with peripheral arteriopathy. The next day a colour Doppler examination was performed at the puncture site. RESULTS: The technique proved successful in 89.4% of cases (161/180). In 19/180 vascular accesses placement of the haemostatic cartridges was not possible owing to the inability to compress the common femoral artery proximal to the release site (4/19), owing to a pre-existing haematoma (5/19) and owing to the limited presence of subcutaneous tissue (10/19). The mean time required for the placement of Vasoseal ES was 4 min. The mean time-to-haemostasis was 6 min. The mean time-to-mobilisation was 4 hr. Only in two patients was there an onset of a pseudoaneurysm of the right common femoral artery; the lesions were treated with ultrasonography -guided compression. In addition, 16 small local haematomas were recorded. In 4 cases early re-puncture of the femoral artery was performed (24-48 hr following the use of the device) without consequences. CONCLUSIONS: Vasoseal ES is a safe collagen closure device characterised by a high success rate. In anticoagulated patients the device can reduce the time-to-mobilisation and the incidence of complications.

Adult↗
PubMedDate not supplied

[Endoscopic therapy of giant choledochal calculosis].

The paper reports the results of conventional endoscopic treatment in 100 consecutive cases of giant lithiasis of the common bile duct. A giant calculus is one whose dimensions exceed 2 cm. Endoscopic therapy proved successful in 73% of cases, with an 8% incidence of complications. The success of endoscopic treatment is related to the anatomical conditions of the biliary tract and the diameter of calculi. Mechanical lithotripsy has proved efficacious in all cases where it was used, whereas poor results were obtained using MTBE infusion through a naso-biliary tube. ESWL provided encouraging results. Cases which were not resolved using endoscopic methods were treated using intervention radiology or surgery, or both.

Adult↗
PubMedDate not supplied

[Treatment of postoperative biliary fistulas by endoscopic papillosphincterotomy and nasobiliary drain].

Personal experience in the non-surgical treatment of postoperative biliary fistulas observed between July 1987 and October 1990 is reported. Leakage were treated with an endoscopic technique (papillosphincterotomy+nasobiliary drain) in 11 of 12 patients in an average time of 2 weeks. The 12 patient, who presented a lesion of an intrahepatic duct, needed 2 months to heal following combined endoscopic-percutaneous manoeuvres. On the basis, then, of the good results obtained, it is recommended that in these cases, non-surgical treatment should be carried out on principle, choosing endoscopy as the initial access route.

Biliary Fistula↗
PubMedDate not supplied

[CT of the operated liver].

The Authors examine retrospectively 93 CT exams performed on 60 patients submitted to hepatic surgery both for malignant and benign lesions. It is concluded that CT, if performed correctly, is helpful in recognizing both complications and recurrences.

Adult↗
PubMedDate not supplied

[Percutaneous pancreato-gastrostomy in the treatment of pancreatic pseudocysts. Presentation of 2 cases].

The authors describe a new method for the treatment of pancreatic pseudocysts using a personal technique: the percutaneous pseudocystogastrostomy. Under US and fluoroscopy guidance at first a percutaneous drainage is introduced in the pseudocyst using a transgastric approach. For seven days the drainage catheter is flushed with antibiotic solution (Rifocin), then under fluoroscopy and endoscopy guidance doubled pig-tail catheter is placed with its curlend ends in the lumen of the stomach and pseudocyst respectively. After 60 days the double pig-tail catheter is removed endoscopically. Two patients with pancreatic pseudocysts were treated successful by this method. No complications or recurrences were observed.

Acute Disease↗