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Biomedical subjects

F Rulli

Publications and source records attributed to F Rulli.

31 records · Page 2Linked to original sources
PubMed1995

Ruptured aneurysm of the superficial femoral artery.

OBJECTIVE: True isolated "arteriosclerotic" aneurysms of the superficial femoral artery are rare. One case of isolated superficial femoral artery aneurysm and review of literature is reported. DESIGN: Case report and review of the literature. SETTING: Hospitalized care. PATIENT: An 80-year old man presenting with rupture of superficial femoral artery aneurysm was observed and treated with graft interposition, which resulted in limb salvage. INTERVENTION: Removal of the aneurysm and replacing of the arterial aneurysmatic segment by interposition of a polytetrafluoroethylene prosthetic graft. MEASURES: Patency of the graft with no evidence of ischemic or embolic complication assessed with a follow-up period of 6 months. RESULTS: From the review of the literature we collected 21 isolated true arteriosclerotic superficial femoral artery aneurysms in 17 patients. These aneurysms may be discovered after the onset of complications such as rupture (33%) or thrombosis and limb ischemia (19%). Other aneurysms are frequently concomitant (69%), mostly represented by abdominal aortic aneurysms (40%). CONCLUSIONS: Ruptured arteriosclerotic aneurysm of the superficial femoral artery is very uncommon and the treatment of choice is based on replacing of the aneurysmal segment with a prosthetic graft interposition or proximal and distal artery ligation and bypass. Early diagnosis and surgical reconstruction is recommended for patients with aneurysms of the superficial femoral artery that are 2.5 cm or greater in maximum diameter and for complicated aneurysms of any size.

Aged↗
PubMed1992

Pneumonia complicating abdominal sepsis: an experimental model of hematogenous contamination of the lung.

Pulmonary infection complicating intra-abdominal sepsis is a major clinical problem. An experimental model for intra-abdominal sepsis was created with implantation of gelatin capsules, containing 3 x 10(8) cfu E. coli strain no. 2554, in the peritoneal cavity of 20 rats (10 animals received and 10 did not receive antibiotic therapy with ceftriaxone) in order to verify the role of the primary site of infection in the pathogenesis of pneumonia. Ten rats were sacrificed to determine the relative pulmonary weight and 10 were submitted to simple laparotomy and insertion of a germ-free capsule (sham-operated group). In this group of animals there was only one death (10%). All the rats that received antibiotic therapy survived until sacrifice while all the rats that did not receive ceftriaxone died, 7 within the 2nd and 3 on the 6th postoperative day. Pneumonia and peritonitis developed only in the animals that did not receive ceftriaxone. Bacteriological findings of material obtained from peritoneal and pleural cavities revealed the same strain of E. coli used for the experiment, suggesting that bacteria involved in the pleuro-pulmonary infections may originate in the primary site of infection and that antibiotic therapy started at the moment of contamination, can prevent this major complication.

Abdomen↗
PubMed1992

Scintigraphic assessment of "effort" axillary-subclavian vein thrombosis.

"Effort" axillary-subclavian vein thrombosis (Paget-Schroetter syndrome) is an uncommon deep venous thrombosis due to repetitive activity of the upper limb. Clinical suspicion is usually confirmed by contrast venography. This report describes a case where the diagnosis was made by radionuclide venography (Tc-99m DTPA). The examination was carried out in the acute phase and clearly demonstrated the presence and the site of the obstruction as well as the collateral vessels. Despite a complete clinical recovery, obtained by medical therapy, further examinations performed in the follow-up period showed persistence of the thrombotic obstruction and a rich development of collateral vessels. In the authors' opinion, radionuclide venography is worth considering as a first-choice procedure when an axillary-subclavian vein thrombosis is suspected, and contrast venography should be performed only when surgical treatment is indicated.

Adult↗
PubMed1991

Aztreonam biliary excretion in bile duct ligated jaundiced rats.

An experimental study was undertaken to assess aztreonam biliary concentrations in bile duct ligated jaundiced rats. The study proved that aztreonam biliary concentrations are sufficient to inhibit Gram-negative bacteria within the first and the second hour after antibiotic administration. The experimental model suggests that clinical conditions such as lithiasis or neoplasms of the biliary tree should not totally inhibit the antibiotic excretion.

Animals↗
PubMed1989

Urinary sodium levels related to jaundice duration in the assessment of postoperative risk of hepatorenal syndrome in elderly patients undergoing surgery for biliary obstruction.

The early diagnosis of hepatorenal syndrome (HRS) is based chiefly on biochemical alterations and in particular, the relationship between urinary sodium levels and duration of jaundice seems to offer the most reliable prognostic index. Urinary sodium levels were determined in 32 elderly patients, who underwent surgery for benign or malignant biliary obstruction, without, major organ resection; in this group 4 patients died of HRS (12.5 per cent). The diagnostic accuracy of the method reached 97 per cent.

Aged↗
PubMed1980

Buerger's disease: is it a rickettsiosis?

A serologic study using the direct seroagglutinate method described by Babudieri and Zardi was carried out in 31 patients affected by Buerger's disease, to determine the positive antibody reaction level against rickettsial disease. In 41.9% of the cases there was a positive test for R. burnetii, in 6.4% a positive test for R. mooserii, and in one a positive test for R. conorii. The results lead us to believe that these pathogenic agents are largely responsible for the development of thromboangiitis obliterans.

Adult↗
PubMedDate not supplied

Correlation of Tc-99m-red blood cell phleboscintigraphy with clinical severity of chronic venous disease.

Equilibrium red blood cell phleboscintigraphy of the lower limbs for the diagnostic management of chronic venous disease has been proposed. The aim of this study was to verify the correlation of the phleboscintigraphic assessment of chronic venous disease with the clinical grading of the severity of the disease, since other diagnostic modalities have been recently demonstrated a poor and only partial correlation. Equilibrium Tc-99m-red blood cell phleboscintigraphy was performed in 27 patients with chronic venous disease. Scintigraphic images of 52 limbs were classified according to a four-class qualitative grading of the severity of the venous disease, and a quantitative scintigraphic index (saphena /femoral ratio) was assigned to each limb. The scintigraphic qualitative grading showed a highly significant correlation with the clinical grading (Rs=0.82, p<0.01), a good interobserver and intraobserver agreement (86.5% and 92.3%, respectively) and more than 90% sensitivity and specificity to identify the categories "minimal or no chronic venous disease" or "more significant disease" (assessed according to the Bayes theorem). Sensitivity and specificity results for the quantitative assessment were not as good. Phleboscintigraphy correlates well with the clinical grading of the severity of chronic venous disease of the lower limbs and may have potential as a valuable diagnostic tool for the noninvasive assessment of chronic venous disease.

Chronic Disease↗
PubMedDate not supplied

Hyperthyroidism with concurrent thyroid cancer.

The occurrence of thyroid malignancy is considered a rare event in hyperthyroid patients. With the aim of assessing the clinical relevance of this association, we have analyzed the incidence of thyroid cancer in hyperthyroid patients treated by surgery. The incidence of thyroid cancer was retrospectively evaluated in 202 hyperthyroid patients who underwent thyroidectomy during a twenty-year period. A thyroid cancer was diagnosed in 12 cases (5.9 per cent). Histologic examination revealed the presence of papillary carcinoma in 9 cases, follicular carcinoma in 1 case and Hürthle cell carcinoma in 2 cases. The association between thyroid cancer and hyperthyroidism was more frequent in toxic adenomas (17.8 per cent) than in toxic diffuse (5.3 per cent) or multinodular goiters (1.7 per cent). In 8 patients they presented as an occult carcinoma (maximum diameter below 1 cm), but unfavourable histologic features, such as local invasiveness and multifocality, were found in 5 of them. Follow-up data indicate that all 12 patients are currently alive and apparently free of disease. Hyperthyroid patients, particularly those affected by toxic adenomas, should be carefully evaluated to exclude the presence of concurrent malignancy. A special attention should be made moreover to the presence of "occult" lesions that, in our study was characterized in a higher proportion (62.5 per cent) of cases, by unfavourable histologic features.

Adult↗
PubMedDate not supplied

Radionuclide venography and the surgical treatment of chronic venous disease of the lower extremity.

PURPOSE: The purpose of this study was to describe the use of radionuclide venography in detecting the site and the functional value of blood reflux through incompetent perforating veins of the leg of patients with chronic venous disease. METHODS: In this study we evaluated the management of 29 patients (34 lower limbs) who were admitted with chronic venous disease of the lower limbs (in 7 with ulcers refractory to conservative management), surgically treated between 1991 and 1994 on the basis of physical examination and scintigraphic detection of pathological venous refluxes. RESULTS: In 26/29 patients (31/34 legs = 91%) there was a good result with no recurrence and complete alleviation of symptoms. All the ulcers healed but in two cases recurred after 2 and 6 months respectively. Amelioration of leg tropism was achieved in all patients with a good "cosmetic" result in 27/34 legs (79%). A complete deconnection of the incompetent perforating veins was confirmed with radionuclide venography in 31/34 legs (91%). CONCLUSIONS: The authors conclude that radionuclide venography is useful in the pre-operative evaluation of patients with chronic venous disease of lower extremity.

Chronic Disease↗
PubMedDate not supplied

From Bassini to tension-free mesh hernia repair. Review of 1409 consecutive cases.

The short and long-term results of traditional and tension-free inguinal hernia repairs have been assessed in three surgical units. In order to standardise the results, hernias were classified according with Nyhus. There were 109 type I, 311 type II, 854 type III, and 125 type IV hernias. Follow-up was possible in 1201 patients (1249 hernia repairs). Postoperative course, postoperative pain, and recurrences were analysed. Recurrences ranged from 0.7% up to 9.3%. The tension-free methods of repair provided the most important advantages in term of low recurrence rate and early return to work even if, in our series, recurrences resulted mainly related to the type of hernia than to the type of repair. The Authors conclude that any hernia repair should be sized to the type of hernia defect in order to avoid over-treatment and abusive placing of a foreign body such as polypropylene mesh.

Evaluation Studies as Topic↗