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Biomedical subjects

G Gandini

Publications and source records attributed to G Gandini.

At least 181 records · Page 10Linked to original sources
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

[Transfusional therapy of hemodialyzed patient with anti-Cartwright antibodies: case report and review of the literature].

BACKGROUND: Red cell Cartwright antigen (Yta) is very common in the general population therefore patients without red cell Cartwright antigen and with anti-Yta alloantibodies due to previous exposure to the antigen are rare. Report about clinical significance of Yta red cell alloantibodies in hemodialysis (HD) patients are scarce. CASE REPORT: We report a cirrhotic uremic patient with anti-Yta antibodies who received Yta positive red cells. No adverse reactions nor hemolysis were detected. CONCLUSIONS: We concluded that dialysis patients with anti-Yta antibodies could be safely transfused with blood from Cartwright positive donors.

Adult↗
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

Magnetic Resonance angiography of the pulmonary veins before and after radiofrequency ablation for atrial fibrillation.

PURPOSE: To study the usefulness of magnetic resonance angiography (MRA) in imaging of the pulmonary veins (PV) before and after radiofrequency ablation procedures in patients with atrial fibrillation. MATERIALS AND METHODS: Between July 2002 and April 2003, 50 patients with atrial fibrillation underwent MRA prior to ablation; 18 patients also underwent post-procedure MRA. Images were acquired with 3D-spoiled gradient echo sequences after intravenous administration of the paramagnetic contrast medium gadopentetate dimeglumine; an automatic triggering device was used to start the angiographic sequence (Smartprep, General Electric Medical Systems). Postprocessing was performed with maximum intensity projection (MIP) and virtual endoscopy (VE) software (Navigator, GEMS). RESULTS: The venoatrial junction was visualised with MRA VE in 49 of 50 patients (98.0%). Twenty-seven patients out of 49 (55.1%) had two PV ostia on both sides, 13 (26.5%) had two right ostia and a single common left ostium, 5 (10.2%) had supernumerary PV and 4 (8.2%) had both a supernumerary right PV and a single common left ostium. Flythrough navigation showed the number and spatial arrangement of second-order PV branches in 48 out of 49 patients (98.0%). In postablation examinations, mild stenosis was detected with MIP and VE in 17 out of 83 PV examined (20.5%). CONCLUSIONS: This study confirms the clinical value of magnetic resonance imaging for visualising PV ostia in patients undergoing radiofrequency ablation for atrial fibrillation. Before the ablation procedure, MRA allows an accurate evaluation of PV number, shape and size; after the procedure, MRA is useful in screening for post-ablation stenosis and describing the location and severity of stenosis when present.

Journal Article↗
PubMedDate not supplied

[Critical evaluation of preoperative instrumental staging of rectal tumors. Research on the adequate use of US, CT and MR].

Both traditional exams (rectal exploration, rectoscopy, barium enema, CEA) and advanced imaging (31 US, 40 CT and 11 MR) were performed for preoperative evaluation of rectal carcinoma in order to assess the accuracy of radiological imaging in the T and N staging. The results obtained have not been considered satisfactory and it is felt that US, CT and MR should not be employed routinely for rectal staging. Indeed accuracy of US, CT and MR is respectively 64%, 75% and 81% in the T evaluation and 64%, 70% and 64% in the N staging. In order to evaluate the effective usefulness of these three latter imaging techniques a double therapeutical choice was proposed. The first treatment option was suggested on the basis of traditional staging while a second choice was given considering US, TC and MR data also. Operatory findings subsequently allowed a definitive judgement on the influence of the different techniques on treatment selection. US has furnished useful data that could have allowed us to modify treatment in one case while in 5 other cases diagnostic error would have influenced treatment negatively. CT was useful in 5 cases while in 7 cases it would have influenced treatment choice negatively. MR would have been useful in one case and harmful in another. It is concluded that only patients with large neoplasms (stages T3 and T4) benefit from CT and MR staging with the exception of those cases that have tumors above the peritoneal fold or in strict relation with the sphincter structures. US was useful only in evaluating relations of neoplasms of the anterior rectal wall with nearby pelvic structures.

Adult↗
PubMedDate not supplied

Plasma osteocalcin levels in liver cirrhosis.

Osteocalcin, a recently identified protein, is produced by osteoblasts in the bone tissue. Its plasma level is a good marker of bone metabolism and is reduced in the presence of 'osteodystrophia', commonly found in cholostatic liver diseases. We assayed plasma osteocalcin levels in 20 cirrhotic patients and compared the values with those of 22 healthy controls. In the same patients we also measured the liver function, clotting and mineral metabolism indexes and calcitonin plasma levels. Osteocalcin levels were significantly lower in liver disease patients than in controls (5.53 ng/ml S.D. 2.57 vs 7.79 ng/ml S.D. 2.23; p less than 0.01) and calcitonin plasma levels were much higher in cirrhotics (130.18 pg/ml S.D. 212.30 vs 28.9 pg/ml S.D. 13.09; p less than 0.05). We think that the low osteocalcin levels observed in cirrhotics may be a consequence of "hepatic osteodystrophy" due to low vitamin D and calcium plasma levels.

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↗