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F Bresadola

Publications and source records attributed to F Bresadola.

At least 55 records · Page 3Linked to original sources
PubMed1998

Persistent secondary hyperparathyroidism after renal transplantation.

BACKGROUND: The persistence of secondary hyperparathyroidism after renal transplantation is frequent and often complicated by overt hypercalcemia. Recent investigations have shown an effect of the different vitamin D receptor (VDR) genotypes on parathyroid hormone (PTH) secretion in both primary and secondary hyperparathyroidism. The aims of this study were (i) to assess whether persistent secondary hyperparathyroidism after renal transplantation is characterized by any change in calcium-controlled PTH secretion, and (ii) whether different VDR allelic distributions might play any role on this setting. METHODS: Eighty-one cadaveric renal transplantation recipients, followed-up for at least 12 months, were checked for PTH, other primary metabolic and clinical variables, and VDR B/b alleles (BsmI). In 22 of these the following parameters were evaluated: (a) kinetics parameters of the Ca-PTH relation curve; (b) vertebral mineral density; (c) calcitriol serum levels; (d) PTH-related peptide serum levels; and (e) urinary hydroxyproline. RESULTS: According to the stabilised PTH levels (reached by the third month), the patients were divided in two groups: group A (N = 40, PTH < 80 pg/ml) and group B (N = 41, PTH > 80 pg/ml). Group B differed from group A in that patients had higher PTH levels at the time of transplantation, were older in age, and spent more time on dialysis. Group B had increased maximal and minimal PTH levels, and higher set-point levels than Group A. The patients with the BB pattern of VDR genotype were characterized by the lowest PTH levels both at time of transplantation and after stabilization, and lower set point values than patients with Bb and bb patterns. CONCLUSIONS: Our study suggests that (i) the severity of pre-existing secondary hyperparathyroidism is the main factor determining its persistence after renal transplantation, (ii) persistent secondary hyperparathyroidism is characterized by an autonomous pattern of PTH secretion, (iii) the VDR BB genotype seems to be related to lower PTH levels.

Adolescent↗
PubMed1998

Laparoscopic versus open splenectomy in the management of splenomegaly: our preliminary experience.

BACKGROUND: Laparoscopic splenectomy for normal-sized spleens has several advantages compared with laparotomy. Only a few cases of splenomegaly done by laparoscopy are reported in the literature. The purpose of this study is to show that laparoscopy for splenomegaly is feasible and has several advantages over the open operation. METHODS: We performed retrospective chart review of 8 cases of splenomegaly managed by laparoscopy (group 1), 15 cases of open splenomegaly (group 2), and 27 cases of laparoscopic splenectomy for normal-sized spleens (group 3). Comparison has been done between groups 1 and 2 and groups 1 and 3 in terms of operative time, intraoperative estimated blood loss, need for blood transfusion, postoperative ileus, postoperative stay, and mortality and morbidity rates. RESULTS: Patients in group 1 required longer operative time and significantly less intraoperative blood transfusion compared with group 2. The postoperative course was less complicated and shorter in group 1 than in group 2. Operative time was longer in group 1 compared with group 3. No significant differences in terms of postoperative course have been found between groups 1 and 3. CONCLUSIONS: Laparoscopy for splenomegaly is a feasible, effective, and safe technique for experienced laparoscopic surgeons. This approach seems to have several advantages over the open operation. Prospective, randomized trials would be required for a proper quantitative evaluation.

Adult↗
PubMed1997

[Surgical treatment of liver metastases of breast carcinoma. Our experience].

The authors report their experience in the surgical treatment of breast cancer liver metastases. Although with a restricted number of cases (4 patients), the short-term results are satisfactory; this is in agreement with the literature. The survival of those patients treated with a loco-regional approach to metastases (chemotherapy and surgery), is longer than one obtained using systemic chemotherapy. This is still an open question requiring further experience.

Adult↗
PubMed1996

Laparoscopic splenectomy in the management of hematological diseases. Surgical technique and outcome of 17 patients.

After being successfully applied to other intraabdominal organs, the laparoscopic approach has been applied to the spleen since 1991. The experience with 17 cases of laparoscopic splenectomy performed due to immune thrombocytopenia purpura (10 instances), hereditary spherocytosis (2 cases), and Hodgkin's disease where the staging was done according to Standford (5 cases), have been reported. With the patient in anti-Trendelenburg position, and the surgeon between the patient's legs, four or five trocars are introduced into the upper abdominal quadrants and the spleen hilum is isolated. Hilar vessels are dissected and ligated with a surgical stapler. A plastic bag is introduced into the abdomen cavity and the spleen is slipped inside; it is then extracted through an umbilical incision after morcellation. Advantages of the open operation include a decrease in postoperative pain, a decrease in pulmonary sequelae, a reduced incidence of subphnic abscesses, and cosmetic advantages. The decrease of postoperative sequelae reduces hospitalization and costs, which are higher for the operation itself (materials and staff's training).

Adult↗
PubMed1996

Preemptive analgesia: intraperitoneal local anesthetic in laparoscopic cholecystectomy. A randomized, double-blind, placebo-controlled study.

BACKGROUND: A controversy exists over the effectiveness and clinical value of preemptive analgesia. Additional studies are needed to define the optimum intensity, duration, and timing of analgesia relative to incision and surgery. METHODS: One hundred twenty patients undergoing laparoscopic cholecystectomy under general anesthesia plus topical peritoneal local anesthetic or saline were studied. Local anesthetic (0.5% bupivacaine with epinephrine) or placebo solutions were given as follows: immediately after the creation of a pneumoperitoneum (blocking before surgery), and at the end of the operation (blocking after surgery). Patients were randomly assigned to one of four groups of 30 patients each. Group A (placebo) received 20 ml 0.9% saline both before and after surgery, group B received 20 ml 0.9% saline before surgery and 20 ml local anesthetic after surgery, group C received 20 ml local anesthetic both before and after surgery, group P received 20 ml local anesthetic before and 20 ml 0.9% saline after surgery. Pain was assessed using a visual analog scale and a verbal rating scale at 0, 4, 8, 12, and 24 h after surgery. Metabolic endocrine responses (blood glucose and cortisol concentrations) and analgesic requirements also were investigated. RESULTS: Pain intensity (visual analog and verbal rating scales) and analgesic requirements were significantly less in the group receiving bupivacaine after surgery compared to placebo. However, in the groups receiving bupivacaine before surgery, both pain intensity and analgesic consumption were less than in the group receiving bupivacaine only after surgery. Blood glucose and cortisol concentrations 3 h after surgery were significantly less in groups receiving bupivacaine before surgery. CONCLUSIONS: The results indicate that intraperitoneal local anesthetic blockade administered before or after surgery preempts postoperative pain relative to an untreated placebo-control condition. However, the timing of administration is also important in that postoperative pain intensity and analgesic consumption are both lower among patients treated with local anesthetic before versus after surgery.

Adult↗
PubMed1996

[Hemoperitoneum caused by lesions to the appendix epiploica. An unusual complication of colonoscopy].

A rare case of hemoperitoneum in a young man who performed a diagnostic colonoscopy is reported. The rupture of an epiploic appendix among rectum and colon sigma caused massive bleeding into the peritoneum cavity followed by haemorrhagic shock. Diagnostic and therapeutic colonoscopy has a low rate of morbility; perforation and bleeding are the most common events; hemoperitoneum following colonscopy is usually due to spleen rupture. Among other complications, ileal and cecal volvolus, incarceration of hernias and subcutaneous emphysema are reported.

Adult↗
PubMed1995

[Vascularization of the gastric stump tubule in esophagogastroplasty (EGP)].

The authors present the results of the vascular supply of tubulized gastric stump in patients who had sub-total oesophagectomy and cervical oesophago-gastroplasty (OGP) for oesophageal carcinoma, evaluating the importance of altered tubulized gastric stump's vascular supply on oesophago-gastric anastomosis efficiency. From April 1989 up today 51 patients who had OGP entered this study. Among these 2 had intestinal reconstruction by whole stomach and 49 by tubulized gastric stump. These 49 patients had celiac and upper mesenteric arterial angiography 30 days after surgery. As regards vascular patency angiography allowed us to divide the tubulized gastric stump into three parts; giving useful information above all on the distal part of the stump, considered "at risk" as concerning vascular supply. The authors thus demonstrate that the anastomosis high rate dehiscence is preferably due to the oesophageal stump vascular supply (strongly affected by cervical dissection) rather than to the poor vascular supply of the distal third of the transposed tubulized gastric stump.

Esophageal Neoplasms↗
PubMed1994

The effects of intraperitoneal local anesthetic on analgesic requirements and endocrine response after laparoscopic cholecystectomy: a randomized double-blind controlled study.

This randomized double-blind placebo-controlled study was designed to evaluate the effects on postoperative pain of the local anesthetic, 0.5% bupivacaine with epinephrine, sprayed hepatodiaphragmatically under the surgeon's direct view during laparoscopic cholecystectomy. Metabolic endocrine responses to surgery (glucose and cortisol) and nonsteroidal anti-inflammatory drug requirements were investigated, as well as the presence of nausea, vomiting, and sweating. Local anesthetics or placebo solutions were given as follows. Immediately following the creation of a pneumoperitoneum, surgeons sprayed the first 20 mL of solution (S1), and an additional 20 mL of solution (S2) was sprayed at the end of the operation. Patients were classified into three groups (14 patients per group). Group A received 20 mL of saline during both S1 and S2, group B received 20 mL of saline during S1 and 20 mL of bupivacaine during S2, and group C received 20 mL of bupivacaine during both S1 and S2. The degree of postoperative pain was assessed using the visual analogue scale (VAS) and the verbal rating scale (VRS) on arrival in the recovery room and subsequently at time intervals of 4 h, 8 h, 12 h, and 24 h. The results of this study indicate a significant decrease of postoperative pain in patients treated with local anesthetic. VAS and VRS pain scores, as well as respiratory rate and analgesic requirements, were significantly lower in group C. The postoperative plasma cortisol level in group C was significantly lower than in groups A and B.

Adult↗
PubMed1993

Chilaiditi's syndrome as a surgical and nonsurgical problem.

Hepatodiaphragmatic interposition of the intestine is a rare anomaly (0.025 to 0.28 percent of the general population) described by Chilaiditi in 1911 and often believed to be of irrelevant clinical interest. To the contrary, recent studies stated that this syndrome is a potential source of abdominal problems requiring emergency or elective operation. From a retrospective analysis of records since 1976, four instances of Chilaiditi's syndrome have been found (three males and one female). Interposition of the proximal transverse colon was found in three patients and the small intestine in one patient. The findings of plain roentgenograms of the chest were determinants for diagnosis in three patients. In one patient, a barium meal was given to obtain a better definition. Two patients were admitted for malignant neoplasms (metastatic carcinoma of the breast, carcinoma of the gastrointestinal tract and cirrhosis of the liver) and died within a few months. The other two patients complained of abdominal pain. Patient No. 4 had gastric volvulus. Chilaiditi's syndrome was diagnosed intraoperatively in that patient and a surgical treatment with hepatopexy was performed, by suturing the falciform, the coronaria ligament and the anterior margin of the liver to the diaphragm with interrupted absorbable stitches. After a two year follow-up evaluation, this patient is as well as the patient who underwent medical therapy. Volvulus of the stomach, as was found in Patient No. 4, is an unusual condition and, to our knowledge, the patient is the second reported instance.

Adult↗
PubMed1989

[Comparative scintigraphic functional study of 3 different reconstruction technics following total gastrectomy].

Esophago-jejunal reconstruction, after total gastrectomy, is best performed by one of the following three operations: interposed jejunal loop, Roux-en-Y loop and "omega" loop with Braun anastomosis. To assess the effects of the three mentioned techniques three groups of 15 patients each were examined after total gastrectomy for I, II or III stage cancer. Four to ten months after surgery all patients underwent the following tests: a) esophago-jejunal transit with labeled solid meal; b) cholangio-scintigraphy and c) absorption test of biliary acids. A group of 10 patients, without gastrointestinal pathology, was selected for comparison. The data obtained from the comparative study, in agreement with the opinions held by many Authors and our previous research, demonstrate that the interposition of jejunal loop (Mouchet) is the reconstructive technique closest to the unoperated stomach and, for this reason, is to be preferred after total gastrectomy.

Bile Acids and Salts↗
PubMed1989

[Malignant hyperthermia. A case with minimal manifestations].

A case of malignant hyperthermia is reported. The clinical symptoms arised after anesthesia and the post-operative enzymatic alterations prompted the Authors to send the patient to the University of Padua where muscle byopsy and caffeine contracture test were performed. The initial diagnosis was confirmed.

Adult↗
PubMed1989

[Effects of therapy with aminaftone on chronic venous and lymphatic stasis].

Following a short introduction on the physiopathology of the phlebo-lymphatic system, the results of a study carried out on 114 patients suffering from chronic venous insufficiency (CVI) treated at the Department of General Clinical Surgery and Surgical Therapy of the University of Ferrara are reported. These patients were subdivided into two random groups and treated with common phlebotonic drugs and aminaftone, respectively. Both groups were also subjected to those physical and medical measures that are usually adopted for the treatment of such patients. The therapeutic effects were assessed by comparing symptomatology before and after 90 days of treatment, both subjectively (patient's assessment of the symptoms by means of a scoring system) and with objective methods (measurements and echo-Doppler examinations). The differences between the two groups were statistically very significant in favour of patients who had taken aminaftone. Excellent results were obtained in the treatment of CVI as well as in lymphatic-related pathology (lymphedema).

4-Aminobenzoic Acid↗
PubMed1988

Physostigmine and metoclopramide in oesophageal peristaltic spread in man.

Simultaneous recordings of electrical and mechanical activities at different levels of the oesophagus were performed in normal men before and after physostigmine and metoclopramide injections. Various parameters of the basal oesophageal peristalsis were significantly modified following drug treatment. In particular, physostigmine injections induced a shortening of electromechanical coupling time and a reduction of the propagation velocities of the electrical and mechanical oesophageal events. Metoclopramide shortened the electromechanical coupling time but increased the electrical and mechanical propagation velocities along the oesophagus.

Electrodes↗