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Biomedical subjects

F Cosentino

Publications and source records attributed to F Cosentino.

At least 73 records · Page 4Linked to original sources

Distal splenorenal shunt versus endoscopic sclerotherapy in the prevention of variceal rebleeding. First stage of a randomized, controlled trial.

In 1984 we started a prospective controlled trial comparing endoscopic sclerotherapy (ES) with the distal splenorenal shunt (DSRS) in the elective treatment of variceal hemorrhage in cirrhotic patients. The study population included 40 patients with cirrhosis and portal hypertension referred to our department from October 1984 to March 1988. These patients were drawn from a pool of 173 patients who underwent either elective surgery or endoscopic sclerotherapy during this time. Patients were assigned to one of the two groups according to a random-number table: 20 to DSRS and 20 to ES. During the postoperative period, no DSRS patient died, while one ES patient died of uncontrolled hemorrhage. One DSRS patient had mild recurrent variceal hemorrhage despite an angiographically patent DSRS. Four ES patients suffered at least one episode of gastrointestinal bleeding: two from varices and two from esophageal ulcerations. Five ES patients developed transitory dysphagia. Long-term follow-up was complete in all patients. Two-year survival rates for shunt (95%) and ES (90%) groups were similar. One DSRS patient rebled from duodenal ulcer, while three ES patients had recurrent bleeding from esophagogastric sources (two from varices and one from hypertensive gastropathy). One DSRS and two ES patients have evolved a mild chronic encephalopathy; four DSRS and two ES patients suffered at least one episode of acute encephalopathy. Two ES patients had esophageal stenoses, which were successfully dilated. Preliminary data from this trial seem to indicate that DSRS, in a subgroup of patients with good liver function and a correct portal-azygos disconnection, more effectively prevents variceal rebleeding than ES. However no significant difference in the survival of the two treatment groups was noted.

Adult↗

The safety of cumulative doses of labetalol in perioperative hypertension.

Intravenous labetalol is commonly used in the management of hypertensive emergencies or urgencies as well as postoperative hypertension. The maximum recommended dose in any clinical setting is 300 mg in 24 hours. The safety of administering high doses of intravenous labetalol (greater than 300 mg in 24 hours) was evaluated in neurosurgical patients (n = 9). During 15 distinct periods of 24 hours or less, the mean dose of labetalol given was 623 +/- 86 mg. Adverse hemodynamic and biochemical effects were minor and easily reversible. Intravenous labetalol can safely be used in doses exceeding 300 mg per 24 hours in neurosurgical patients.

Adult↗

[Evaluation of heart rate changes in the aged. An ambulatory electrocardiography study. Arrhythmias in the aged].

The Holter examinations of 111 subjects aged more than 65 who then underwent dynamic ecg were investigated in order to assess the clinical significance of cardiac arrhythmias in geriatric age. Group A was formed of 53 patients with no clinical signs of cardiovascular diseases. Thirty-two patients with clinical evidence of ischaemic cardiopathy made up Group B and 26 with arterial hypertension formed Group C. The Holter examinations were evaluated in accordance with current guidelines, considering the basic rhythm, heart rate, pulse formation and conduction disturbances and supraventricular and ventricular hyperkinetic arrhythmias. Sinus base rhythm was present in most cases whereas atrial fibrillation was noted in a similar percentage in the three groups, whether or not cardiovascular disease was present. Supraventricular and ventricular hyperkinetic arrhythmias were extremely common in the elderly and made no discrimination between patients with ischaemic cardiopathy or hypertension and the clinically healthy; for example, ventricular tachycardia was observed in 10.6% of Group A subjects, in 7.1% of Group B and 8.6% of Group C. To conclude, the clinical significance of heart rhythm changes in the elderly remains obscure because in most subjects they are not related to the presence of cardiovascular disease.

Age Factors↗

Association between intracranial aneurysms and pituitary adenomas. AEtiopathogenetic hypotheses.

Of 144 cases of pituitary adenoma operated on in the period 1981-1985, 53 underwent angiography and two of these had an associated intracranial aneurysm. The aetiological hypotheses are viewed in the light of these two cases and of the 60 published cases of this association. The most convincing hypotheses involve mechanical, microcirculatory and hormonal factors. On the hormonal front, GH seems to have a predisposing influence on intracranial aneurysm formation.

Adenoma, Acidophil↗

Vital staining in fiberoptic bronchoscopy.

The authors report on the results obtained using vital staining in fiberoptic bronchoscopic investigations. Vital staining is performed during normal fiberoptic bronchoscopic investigations under local anesthesia. The method has proved very sensitive for cancerous and precancerous lesions of the bronchial mucosa.

Bronchi↗