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Biomedical subjects

G Noya

Publications and source records attributed to G Noya.

At least 37 records · Page 2Linked to original sources
PubMed1997

Simultaneous ileal intussusception and volvulus after jejunoileal bypass for morbid obesity.

OBJECTIVE: The aim of this work is to consider the mechanical complications of jejunoileal bypass for morbid obesity which can have a serious outcome because of the occult nature of the symptoms. DESIGN: The mechanical complications of jejunoileal bypass are mainly intussusception of the bypassed ileal segment, internal herniation of the ileal loops through the mesenteric defects and laparocele. SETTING AND PATIENTS: A recent case is reported in which, most unusually, intussusception and volvulus were both present, with ischaemia and necrosis of the bypassed segment. Moreover, the general health of the patient remains normal despite the severity of the complication. MAIN OUTCOME MEASURES: Examination of blind loop with CT scan which showed an abdominal mass of uncertain interpretation. INTERVENTION: A laparotomy revealed a volvulus of bypassed ileal loops, probably caused by a simultaneous ileal intussusception and an adhesion. On account of the extensive nature of the process and the degree of advanced ischaemia and gangrene patches in the folds of the ileum, resection of the entire bypassed segment as far as the previous jejunoileal anastomosis was necessary. CONCLUSION: The authors point out the occult nature of the manifestations of this type of complication: aspecific abdominal pains in all quadrants, fever, non vomiting, normal passing of faeces and gas and suggested that simultaneous diverticulitis of the colon (frequently found in the obese) can further complicate and delay diagnosis.

Female↗
PubMed1997

A case of relapsing polychondritis presenting as mediastinal syndrome, diagnosed by CT scans of the trachea and head.

OBJECTIVE: The aim of this study is to evaluate the significance of CT scans of the trachea and head in the diagnosis of Relapsing Polychondritis (RP). DESIGN: Relapsing polychondritis is a disease involving cartilaginous structures, particularly those of the ears, nose and trachea. Diagnosis is based on specific clinical features and immuno-histopathological evaluation of the cartilages involved. SETTING AND PATIENTS: We describe a case of RP in which the most evident clinical signs (cough, dyspnoea, vertigo, tinnitus, headache, oedema of the face and shoulders and fever), led us first to suspect a mediastinal compression syndrome. INTERVENTION: A CT scan of the trachea and head revealed details which established the correct diagnosis, supported by other typical RP symptoms and by histopathological examination of the cartilage. MAIN OUTCOME MEASURES: Evaluation by CT scan of the chest, the mediastinum, the head and the pinnae. RESULTS: CT scanning revealed thickening and calcification of the anterolateral tracheal wall and main bronchi besides marked narrowing of the trachea. CT of the head showed calcification also of the external auditory meatus and part of the pinnae. CONCLUSION: We consider that CT scan of the trachea and head is helpful in evaluating the bronchial tree, the auditory meatus and pinnae as well as being a valid tool for the final diagnosis and in following the course of the disease.

Diagnosis, Differential↗
PubMed1996

A new approach to the problem of surgical wound infections in clean operations.

A study was made of the risk factors causing a high incidence of surgical wound infections in clean operations. Identification of these factors in the preoperative stage allows the patients to be divided into two categories: a high risk (about 10% of patients for surgery) and low risk. By giving antibiotic prophylaxis only to patients at high risk, the incidence of postoperative infections can be reduced, decreasing the number of extra days in hospital and consequently lowering costs. This is a new approach to the problem of surgical wound infections since not only is it based on the usual classification of operations into clean, clean-contaminated, contaminated and dirty, but it also takes into account the defensive capacity of the target of the infection: the patient.

Humans↗
PubMed1995

[Mammary secretion: retrospective study of diagnostic and therapeutic problems].

Nipple secretion is an important clinical symptom in the context of breast pathology second only, in terms of incidence and diagnostic role, to the presence of a mammary nodule. Its importance derives from its possible association with cancer (from 3% to 47%) of which it may be the earliest sign, even if it is most often in relation to a benign pathology. The authors report their experience from 1988 to the present in 60 cases of mammary secretion out of 1200 patients attending the clinic.

Adult↗
PubMed1994

[Treatment of early colorectal carcinoma: surgery or endoscopy?].

This retrospective study analyses the value of endoscopic polypectomy as the operation of choice in cases of early invasive colorectal carcinoma located on the adenomatous polyp. Under these conditions the authors outline their therapeutic strategy, based not only on the histological characteristics of lesions, but also on the evaluation of the risk/benefit ratio established in relation to the characteristics of each individual patient.

Adenomatous Polyps↗
PubMed1994

[Chronic pancreatitis: notes on diagnosis and surgical therapy].

The authors analyse their experience of 30 cases of which 25 underwent surgery. In addition to the onset of complications, indications for surgery were based on the presence of severe painful symptoms which did not respond to medical treatment. Over the past few years the latter have represented one of the main indications with a success rate of between 80-90% of cases. The type of surgery must be personalized to the characteristics of each individual patient on the basis of morphological alterations of the gland, which are easily defined during a preoperative study using CPRE, ultrasonography and CT. Of these, CPRE has been found to be the most reliable in diagnostic terms, since it can detect structural alterations at a relatively early phase and is of considerable value in differential diagnosis, which is at times extremely difficult, with pancreatic carcinoma.

Aged↗
PubMed1991

Surgical treatment of hydatidosis.

Hydatidosis is particularly widespread in some geographic areas. Among these Sardinia presents one of the highest incidences. The authors examine the results obtained of 382 patients submitted to surgery between 1973 and 1989. The average age was 38.9 years. Liver involvement was observed in 215 cases, lung involvement in 167 cases, while localizations in other organs were rare. Forty liver cysts and 54 lung cysts were complicated preoperatively. The patients were submitted predominantly to total or subtotal cysto-pericystectomy (270 cases), parenchymal resection (75 cases), simple cystectomy (40 cases). Total postoperative mortality was 2.35%. Postoperative time was significantly shorter after cysto-pericystectomy and after parenchymal resection than after simple cystectomy. Patients suffering from multiple or complicated cysts were given supplementary chemotherapy.

Adolescent↗
PubMed1990

[Trans-mesenteric hernia. Presentation of a clinical case and review of the literature].

Trans-mesenteric hernia is a rare case of intestinal obstruction. A peculiar characteristic of this form of hernia is the absence of a sack and recess; in the majority of cases, hernia is due to congenital defects of the mesentery. In clinical terms, hernia is manifested by signs of intestinal occlusion in patients of any age. Occasionally, hernias may be found during surgery or autopsy.

Hernia↗
PubMed1990

[Early gastric cancer: radiologic, endoscopic or combined diagnosis?].

Having underlined the importance of an extremely early diagnosis of gastric cancer, the paper focuses on the diagnostic capacities of endoscopy and bone x-ray using a dual-contrast technique. From an analysis of published reports and on the basis of their own experience, the authors prefer, whenever possible, to combine the two methods, since this is the only way of revealing minimum neoplastic stomach lesions in almost 100% of cases.

Adult↗
PubMed1989

[Popliteal artery entrapment syndrome in our experience].

Six cases of popliteal entrapment syndrome are presented with emphasis on the diagnostic difficulties related to this disease in its initial functional phase. The utility of Doppler ultrasonography associated with dynamic angiography is underlined. Normally surgical treatment of the disease is problem-free. The important determining factor seems to be medial gemellus hypertrophy. In this case the procedure of choice is thought to be vascular reconstruction associated with the disinsertion of this muscle followed by its reimplantation in a lower and medial position on the semi-membranous tendon muscle in order to avoid any secondary arterial compression.

Adult↗
PubMed1989

[Revascularization of the distal arteries of the lower limbs with "in situ" saphenous vein].

Over a 3-year period 21 patients underwent "in situ" saphenous vein by-pass graft for lower extremity arterial occlusive disease, all of them with critical ischemia for limb salvage. The proximal anastomosis was performed in all patients end to end to the first segment of the previously endarterectomized superficial femoral artery. The distal graft was taken to the popliteal artery below the knee in 8 cases, to the tibial-peroneal trunk in 4, to the posterior tibial artery in 3, to the peroneal artery in 3, to the anterior tibial artery in 2 and last a sequential posterior tibial-peroneal by-pass graft was performed. The perioperative mortality was nil. The immediate patency rate was 90.5%, while the cumulative patency rate at 36 months was 71.4% overall, 87.5% for the popliteal grafts and 61.1% for the infrapopliteal ones. If we consider that was successful for limb salvage in more than 80% and if the encouraging preliminary results of this technique will be confirmed at a longer follow-up, we believe that this technique could become the procedure of choice for limb salvage even in the high risk patients group.

Adult↗