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Biomedical subjects

G Maria

Publications and source records attributed to G Maria.

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

Clinical picture and pelvic floor physiology in the solitary rectal ulcer syndrome.

Clinical examination, proctosigmoidoscopy, rectal biopsies, barium enema and pelvic floor physiology studies were performed in four patients with solitary rectal ulcer syndrome. All patients had chronic constipation and rectal bleeding. Resting tone and voluntary contraction were found to be decreased at anal manometry in two patients (maximal squeeze pressures were ten and 35 mm Hg, respectively). Balloon proctogram showed an increased rectoanal angle in these two patients (90 degrees and 93 degrees at rest, unchanged on squeezing) with a poor striated sphincter function at EMG; their deficient anal reflex, slight fecal incontinence and perineal descent seemed consistent with pudendal neuropathy. Fibromuscular obliteration of the lamina propria was found at histology. All subjects had successful conservative treatment, including topical corticosteroids in one patient; normalization of bowel habit was the most effective therapy for the disease. The present study seems to confirm the role of chronic constipation and abnormal pelvic floor physiology in the pathogenesis of the syndrome.

Adult↗
PubMedDate not supplied

Site, emergency, and duration of symptoms in the prognosis of colorectal cancer.

Four prognostic factors, i.e., site of the tumors, mode of presentation, duration of symptoms, and pathologic staging, were correlated to the results of surgical treatment, i.e., curative resectability, postoperative complications and mortality, and five-year survival, in 161 patients operated upon for colorectal cancer. Only 31 (19 per cent) of the growths were right-sided; 71 patients (44 per cent) had symptoms less than six months. Fifty-four of them had a localized cancer; a radical procedure was performed in 114 (71 per cent), and postoperative complications occurred in 42 cases (26 per cent). The overall crude five-year survival was 38 per cent (53 of the 140 followed-up patients). The length of the clinical history did not correlate with the pathologic staging, which greatly influenced curability and survival. A statistically significant power prognosis was observed in patients with left-sided tumors, with an emergency presentation and with a duration of symptoms shorter than six months. A better prognosis can be achieved by means of a presymptomatic diagnosis.

Adult↗
PubMedDate not supplied

Evaluation of prognostic factors in patients with acute pancreatitis.

BACKGROUND/AIMS: The severity of acute pancreatitis is variable and does not always correlate with structural and functional changes in the pancreas. More precise predictors of severity are necessary to enable intensive therapy to be targeted at patients with severe attacks, and to judge efficacy of treatment, to help in the early detection of complications, and to facilitate comparison of patients from different centers. METHODOLOGY: On admission, clinical criteria, biochemical and hematological parameters and multiple prognostic scores (Ranson, Imrie and APACHE-II scores) were collected from patients with acute pancreatitis. RESULTS: Two hundred and twenty-seven patients were seen during the study period. The overall mortality rate was 11.4%. A significantly higher mortality was found in patients with severe pancreatitis (25.8%) than in those with mild disease (1.5%, p=0.00001). Mortality was related to the presence of fever at admission (16.5% vs. 5.0%, p=0.006), and not to age, sex, etiological associations, or concomitant medical or surgical diseases. Of the biochemical and hematological parameters tested, ten factors (plasma glucose, BUN, serum creatinine, serum calcium, serum lactate dehydrogenase, serum albumin, red cell count, white cell count, hematocrit, and lymphocytes count) were found to be statistically significant, and four factors (serum potassium, alkaline phosphatase, total bilirubin, and hemoglobin) were marginally significant. In high-risk patients (Ranson and Imrie scores > or = 3, APACHE-II score > or = 10) mortality rates were higher (22.5%, 23.0%, and 22.5%, respectively) than in low-risk patients (2.4%, 2.3%, and 0.8%, respectively, p=0.00001). APACHE-II scores may be especially useful for monitoring the progress of patients with pancreatic necrosis and secondary pancreatic necrosis. CONCLUSIONS: Acute pancreatitis still represents a condition of variable severity. The adoption of multiparametric criteria proposed together with morphological evaluation consents the formulation of a discreetly reliable prognosis on the evolution of the disease a few days from onset, even though this still appears insufficient to plan a varied and timely therapeutic program.

APACHE↗
PubMedDate not supplied

Value of extended lymph node dissection in the treatment of gastric cancer.

Regional lymph node metastasis is a critical prognostic factor in gastric cancer, and extended lymph node dissection and routine microscopic examination of all resected nodes could potentially provide accurate information regarding lymph node status. On the other hand, the therapeutic value of extended lymph node dissection is controversial. While retrospective and prospective non-randomised comparative studies have shown that extended lymph node dissection significantly improves the survival rate, prospective randomised trials have failed to demonstrate the efficacy of extended dissection, although the number of patients in these studies was limited. The present review of the literature therefore considers the prognostic significance of regional lymph node metastases and the therapeutic efficacy of lymph node dissection performed for gastric cancer.

Clinical Trials as Topic↗