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Biomedical subjects

G Menardi

Publications and source records attributed to G Menardi.

88 records · Page 5Linked to original sources
PubMed1979

[Asplenia and DIC (author's transl)].

3 cases of severe septic shock are described; a 5 month old girl with congenital hyposplenia, a 2 3/12 year old boy splenectomized because of microspherozytosis and a 11 6/12 year old boy splenectomized because of Hodgkin's disease. In 2 cases pneumococci were found in the blood cultures. In all 3 cases the coagulation analysis showed a consumption coagulopathy. Intravenous streptokinase treatment was applied in addition to general treatment for shock and antibiotic therapy. 2 patients survived and made a complete recovery, whereas the 2 year old boy died. The histological findings showed a severe DIC. In the Department of Surgery, Innsbruck, 44 children have been splenectomized during the last 6 years, 38 of whom we were able to follow up on for an average of 3.3 years. After an average of 1.2 years following splenectomy, 4 patients (including the 3 cases mentioned above) contracted acute septicaemia; a further patient also incurring a probable sepsis with DIC. 3 of these 5 children died, representing a morbidity rate of 13% and a mortality rate of 8%. The mortality rate is thus as high as that caused by the primary disease, indicating the urgency of prophylaxis for infections of this kind. 3 prophylactic forms of treatment are suggested: protection with penicillin, active immunization with polyvalent pneumococcal antigen and spleen preservation whenever possible.

Bacterial Infections↗
PubMed1979

[Intestinal obstruction following necrotizing enterocolitis (author's transl)].

The increase in survival from necrotizing enterocolitis results in an increased rate of late sequelae. We would like to take the opportunity to emphasize these new complications by a review of our patient material. 11 (23.9%) patients from a total number of 46 showed signs and symptoms of intestinal obstruction at different points in the course of the disease. In two surviving patients out of this group of 11, a resection of postinflammatory gut stenosis had to be performed within the first year. In the 9 children who died, particular emphasis is being paid in the autopsy reports to obstructive lesions in the gastrointestinal tract. Due to this rather frequent event (23.9%) of postinflammatory formation of strictures and stenoses in the recovery from NEC a functional radiographic study of the intestinal patency seems mandatory before discharge of any patient with NEC with operative or conservative treatment.

Enterocolitis, Pseudomembranous↗
PubMed1978

[Technique for removal of anaesthetic vapours from the operation theater. CO2-concentrations in the Jackson Rees system using a removal unit (author's transl)].

The Jackson Rees system was used for short operations in 50 infants combined with or without a system for removal of excess anaesthetic vapours developed by the authors. The CO2-concentration in the system was measured directly before the upper airway of the patients. No statistically significance difference between the CO2-concentration with or without the use of the removal system. A variable power of suction up to 61/min is thought to be sufficient and harmless.

Air↗
PubMedDate not supplied

HLA-DR5 antigen. A genetic factor influencing the outcome of hepatitis C virus infection?

BACKGROUND: Prognosis may be quite different among individuals infected with hepatitis C virus (HCV): a chronic liver disease is believed to occur in half the patients while in the other half there are no signs of histologic progression of liver damage. The host immune response might play an important role in such different outcomes. A relationship has been shown between HLA genes and immune response to viral hepatitis B, but to our knowledge, no evidence of an association with HCV has been reported so far. We investigated whether HLA class II alleles might influence the outcome of HCV infection. METHODS: Eighty-seven individuals, positive for anti-HCV by second-generation enzyme-linked immunosorbent assay and recombinant immunoblot assay tests, enrolled from May 1, 1991, to June 31, 1992, were evaluated. Thirty-six were symptom-free subjects found to have HCV antibodies when screened for blood donation: they all had normal results of liver function tests, normal results of physical examination, and normal hepatobiliary ultrasonography. Fifty-one were patients diagnosed as having a chronic liver disease by percutaneous liver biopsy specimen; histologic assessment was chronic persistent hepatitis in 15, chronic active hepatitis in 28, and liver cirrhosis in eight. A group of 231 donors of platelets and bone marrow, negative for anti-HCV, was used as a control population. All participants were typed for HLA class II antigens (DR and DQ) using National Institutes of Health recommended microlymphocytotoxicity test and were followed up by means of alanine aminotransferase and HCV testing for at least 1 year. RESULTS: Frequency of HLA-DR5 antigen was higher in symptom-free anti-HCV-positive individuals (52.8%) than among HCV-related patients with chronic liver disease (13.7%). The difference was statistically significant (corrected P value = .005; 95% confidence interval, 19.6% to 58.6%); between DR5 and long-term evolution of hepatitis C, there was a negative association (relative risk = 0.142). Moreover, frequency of HLA-DR5-positive subjects appeared to be inversely proportional to severity of liver disease (52.8% in symptom-free patients, 26.6% in patients with chronic persistent hepatitis, 10.7% in patients with chronic active hepatitis, and 0% in patients with liver cirrhosis, P < .001). CONCLUSIONS: Our results point to a strict relationship between HLA haplotype and ability of immune response to influence the outcome of HCV infection. Presence of HLA-DR5 antigen appears as a protective factor against a severe outcome of chronic infection, being correlated with a benign evolution of the infection, often asymptomatic, or a less severe chronic liver disease.

Adult↗
PubMedDate not supplied

Twenty-three years of follow-up in patients with total colonic aganglionosis.

The main purpose of our study was to evaluate the outcome of patients with total colonic aganglionosis diagnosed and treated in our hospital. Seven of our twelve patients died within 6 month after birth due to infectious complications or underlying other diseases. 5 patients are alive after subtotal colectomy and ileo-rectal anastomosis, and were investigated for late complications, social integration, stool behavior, local status and laboratory parameters 12 and 23 years after surgery. All patients developed almost normally and were socially and professionally integrated. Although all had an accelerated passage of stools, no signs of malnutrition were found. One patient developed a recto-sacral fistulae and sacral osteomyelitis eight years after surgery and needed an ileostomy. After ileo-rectostomy all patients were continent with a grown rectal stump, had no strictures and a normal appearance of the mucosa.

Adolescent↗