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Biomedical subjects

G Tiberio

Publications and source records attributed to G Tiberio.

At least 19 recordsLinked to original sources
PubMed2005

Clinical outcome of patients with venous thromboembolism and recent major bleeding: findings from a prospective registry (RIETE).

BACKGROUND: Patients who have experienced a recent major bleeding episode are usually excluded from clinical studies of venous thromboembolism (VTE) treatment. Therefore, recommendations based on evidence from clinical trials may not be suitable for these patients. The Registro Informatizado de la Enfermedad TromboEmbolica (RIETE) is a multicenter, observational registry designed to gather and analyze data on VTE treatment practices and clinical outcomes in patients with acute VTE. OBJECTIVES: The aim of this analysis was to study outcomes of patients with VTE who had experienced recent major bleeding (< 30 days prior to VTE diagnosis). METHODS: Patients with objectively confirmed symptomatic acute VTE are consecutively enrolled into the RIETE registry. Patient characteristics, details of antithrombotic therapy, and clinical outcomes at 3 months were recorded. RESULTS: Of 6361 patients enrolled up to January 2004, 170 (2.7%) had experienced recent major bleeding: 69 (40.6%) gastrointestinal tract, 60 (35.3%) intracranial, 41 (24.1%) other. The incidences of major bleeding (4.1%) and recurrent pulmonary embolism (PE) (2.4%) were significantly higher in patients with recent major bleeding. Among them, patients with cancer had an increased incidence of major bleeding [odds ratio (OR) 10.0, 95% confidence interval (CI) 2.3, 50; P < 0.001] and fatal PE (OR 4.1, 95% CI 0.98, 17; P < 0.05). CONCLUSIONS: Patients with VTE and recent major bleeding prior to VTE diagnosis (2.7% of total enrolled patients) had poorer clinical outcomes compared with those who had not experienced recent major bleeding. In patients who had recent major bleeding prior to enrollment, those with cancer had a poorer clinical outcome than those without cancer.

Adult↗
PubMed2005

[Registry of occupational respiratory diseases in Navarre].

BACKGROUND: In January 2002 an occupational respiratory diseases record was established in Navarre so that the number and characteristics of the occupational respiratory pathology could be analysed. METHODS: The cases reported by doctors who collaborated in 2002, 2003 and 2004, were entered in a database for subsequently analysis. This database has several variables: gender, age, tobacco habit, hospital department and notifying doctor, diagnosis, job and causal agent. RESULTS: 125 cases were reported. 97 males (77.6%) and 28 females (22.4%). Average age was 55,4 years old. Eighty-eight were non-smokers (70.4%) and 37 were smokers (29.6%). Pneumology reported 84 cases (67.2%) and Allergology 41 (32.8%). The diagnoses were: 50 bronchial asthma (40%), 31 benign pleural disease (24.8%), 8 extrinsic allergic alveolitis (6.4%), 8 mesothelioma (6.4%), 7 bronchopulmonary cancer (5.6%), 5 acute inhalations (4%), 3 amianthinopsy (2.4%), 2 rhinitis (1.6%), 1 RADS (0.8%) and 1 COPD (0.8%). The most reported jobs were: 13 painting and varnishing (10.4%), 12 spinning asbestos yarn (9.6%) and 8 bakery and confectionery (6.4%). The main causal agents were: 49 cases of asbestos (39.2%), 15 isocyanates (12%) and 8 silica (6.4%). CONCLUSIONS: The most frequent pathology was bronchial asthma, followed by benign pleural disease. The most reported job was painting and varnishing and secondly spinning asbestos yarn. Asbestos was the first substance involved and the second was isocyanates. Most of the patients were males and non-smokers. The Pneumology Service of the Virgen del Camino Hospital reported most of the cases. Ratio contrast analysis showed a certain tendency towards a statistical significance in rhinitis, occupational asthma and amianthinopsy.

Adult↗
PubMed2004

[Hepatitis A seroprevalence in Navarra].

BACKGROUND: Determine the hepatitis A seroprevalence in Navarra. Because of the improvement in the hygienic-sanitary conditions, we hope to find a decline of the total prevalence. METHODS: Population and random sample of Navarra, obtained by stratified sampling with proportional allocation of sex, age, and area of health care: 1,440 individuals over 15 years of age. Detection of total antibodies by enzyme immunoassay of microparticles. RESULTS: Global seroprevalence: 79.24%. By age: 9.09% (16-19 years), 35.32% (20-29 years), 77.78% (30-39 years), 97.31% (40-49 years), 98.58% (50-59 years), 97.51% (60-69 years), 99.33% (70-79 years) and 100% (>79 years). By gender: 78.76% in men and 79.7% in women. Rural area 82.04% and urban area 75.77%. Areas of health care: Tafalla, 89.06%; Estella, 87.91%; Tudela, 82.88%; northern, 77.22%; Pamplona, 75.05%, and eastern, 70.97%. CONCLUSIONS: The global prevalence is 79.24% and increasing progressively with the age. Greater seroprevalence in rural areas and in people in contact with livestock. Characteristics of the persons with seroprevalence for HAV in Navarra: inhabitant of the average area, of rural area, with average age and in contact with livestock.

Adolescent↗
PubMed2001

Obstructing colonic cancer: failure and survival patterns over a ten-year follow-up after one-stage curative surgery.

BACKGROUND: Large-bowel cancers that present as obstructing lesions have a poor prognosis. However, little is known of the reasons for the dismal survival and of failure patterns after potentially curative treatment. METHOD: An observational study and multivariate analysis were conducted to identify determinants of survival and to compare recurrence patterns between obstructing and nonobstructing tumors after primary resection and anastomosis as curative treatment. RESULTS: Over a period of ten years (1980-1989), 528 patients with colonic cancer were treated at one institution. The cancer was obstructing in 179 cases and nonobstructing in 349. One-stage primary resection and anastomosis as curative treatment were performed in 107 obstructed and 256 nonobstructed patients. Three hundred thirty-six potentially cured survivors (94 in the former group and 242 in the latter) were followed for a median of 55 months. During follow-up, local recurrence occurred in 37 patients (12 obstructed (12.8 percent) and 25 nonobstructed (10.4 percent), P = 0.44) and metastatic disease in 68 (25 obstructed (27.6 percent) and 43 nonobstructed (17.8 percent), P = 0.029). Multivariate analysis of survival showed that age over 70 years, Dukes stage, histologic grade, and recurrence were the only prognostic factors. No statistically significant determinant turned out for local recurrence, whereas at multivariate analysis for metastatic and overall relapse, Dukes stage, positive nodes, and obstruction remained independent prognostic factors. CONCLUSIONS: After one-stage emergency curative treatment, patients presenting with obstructing tumors of the colon have a smaller survival probability than that of patients with nonobstructing lesions. Local recurrence pattern is similar between groups. Conversely, obstruction, along with pathologic stage and positive nodes, carries a significantly higher risk of metastatic tumor recurrence and death.

Aged↗
PubMed2001

Mesenteric and renal oxygen transport during hemorrhage and reperfusion: evaluation of optimal goals for resuscitation.

BACKGROUND: Changes in flow to the gut and the kidney during hemorrhage and resuscitation contribute to organ dysfunction and outcome. We evaluated regional and splanchnic oxygen (O2) flow distribution and calculated oxygen supply distribution during hemorrhage and reperfusion and compared them with global measures. METHODS: Seven anesthetized pigs were instrumented to evaluate global hemodynamics, visceral blood flow, and oxygen transport. Tonometric pH probes were positioned in the stomach and jejunum. Animals were bled to 45 mm Hg for 1 hour. Crystalloids and blood were infused during the following 2 hours to normalize blood pressure, heart rate, urine output, and hemo- globin. RESULTS: During hemorrhage, mesenteric flow and O2 consumption were significantly decreased, whereas systemic consumption remained normal. Renal flow was reduced, but renal O2 consumption remained normal. After resuscitation, despite normal hemodynamics, neither systemic, mesenteric, nor renal O2 delivery returned to baseline. Lactate remained significantly increased. Arterial pH, base excess, and gastric and jejunal pH were all decreased. CONCLUSION: During hemorrhage, the gut is more prone than other regions to O2 consumption supply dependency. After resuscitation, standard clinical parameters do not detect residual O2 debt. Lactate, arterial pH, base excess, and intramucosal gut pH are all markers of residual tissue hypoperfusion.

Acid-Base Equilibrium↗
PubMed2001

Coeliac disease in Williams syndrome.

BACKGROUND: Coeliac disease (CD) has been reported in several patients affected by chromosomal disorders, including Down syndrome (DS) and Turner syndrome (TS). CD has also been found in sporadic Williams syndrome (WS) patients. In this study, CD was evaluated in a consecutive series of patients with WS, in order to estimate if the prevalence of CD in WS patients is higher than in the general population. METHODS AND RESULTS: A consecutive series of 63 Italian patients with WS was studied by analysing the dosage of antigliadin antibodies (AGA) IgA and antiendomisium antibodies (AEA). In patients with positive AGA and AEA, small bowel biopsy was performed. The prevalence of CD in our WS population was compared with that estimated in a published series of 17 201 Italian students. Seven WS patients were found to be positive for AGA IgA and AEA. Six of them underwent small bowel biopsy, which invariably disclosed villous atrophy consistent with CD. The prevalence of CD in the present series of WS patients was 9.5% (6/63), compared to 0.54% (1/184) in the Italian students (p<0.001). CONCLUSION: The present results suggest that the prevalence of CD in WS is higher than in the general population and is comparable to that reported in DS and TS. AGA and AEA screening is recommended in patients with WS.

Adolescent↗
PubMed2001

Neurofibromatosis-1 and ampullary gangliocytic paraganglioma causing biliary and pancreatic obstruction.

Gangliocytic paragangliomas (GPs) are exceedingly rare tumors that arise in close proximity of the papilla of Vater. Nevertheless, jaundice is an uncommon presenting symptom, reported in only 3 of 125 cases described in the literature to date, with gastrointestinal bleeding being more common. Association between GPs and neurofibromatosis 1 (NF-1), described in two patients, may be more than casual, being the frequency in normal population 1:3,000. We report an additional case of this association, presenting for the first time with simultaneous obstruction of the common biliary duct, and of the main pancreatic duct. Previous cases of GPs with jaundice and/or NF-1 are reviewed, and updating of the histogenesis presented.

Ampulla of Vater↗
PubMed2000

Obesity and WAGR syndrome.

We describe a 15-year-old boy with WAGR syndrome and obesity and suggest that obesity should be added to the WAGR spectrum. It is also suggested that a putative gene for obesity might be located within the 11p13 band.

Adolescent↗
PubMed2000

Intraluminal duodenal diverticulum causing acute pancreatitis: CT scan diagnosis and review of the literature.

BACKGROUND: Intraluminal duodenal diverticulum is a rare congenital anomaly. First described by Boyd in 1845, no more than 100 cases have been reported up to now: only 17 are associated with acute pancreatitis. METHODS: A new case of intraluminal duodenal diverticulum with acute pancreatitis is reported and the literature about this association reviewed. RESULTS: The diagnosis was made by helical CT scan. The pathogenesis of pancreatitis was possibly due to a pure duodenal content reflux through the papilla of Vater. The patient was successfully treated by surgery. CONCLUSIONS: Intraluminal duodenal diverticulum is a rare but curable cause of pancreatitis, usually affecting young people. We describe, for the first time, its unusual helical CT imaging with two-dimensional reformations.

Acute Disease↗
PubMed1998

Outcome of large-bowel perforation in patients with colorectal cancer.

PURPOSE: Perforation of the colon is seldom associated with malignant disease. Operative mortality varies widely in published studies and little is known about patterns of failure and long-term outcome. An observational study was undertaken to assess the outcome of colorectal cancer complicated by perforation. METHOD: We reviewed a series of 83 consecutive patients treated during a 14-year period at one institution. RESULTS: Fifty-four (65 percent) patients had perforation of the tumor itself, and 29 (35 percent) had diastatic perforation proximal to an obstructing tumor. Twenty-six (31.5 percent) patients had metastatic disease at laparotomy. Primary resection of the diseased segment was performed in 47 (87 percent) patients with perforation of the tumor itself and in 21 (72.4 percent) patients with diastatic perforation proximal to an obstructing tumor. However, only 57 patients (39 (72.2 percent) with perforation of the tumor itself; 18 (62 percent) with diastatic perforation proximal to an obstructing tumor; P = not significant) were potentially cured. Operative mortality was 16.7 and 48.3 percent, respectively (P < 0.01) and correlated significantly with Hinchey's stage (P < 0.001) and advanced disease (P = 0.023). At a mean follow-up of 43 (median 31) months, 21 (46 percent) of the 46 potentially cured survivors were alive. The local recurrence rate was 22.9 percent in patients with perforation of the tumor itself and 18.2 percent in patients with diastatic perforation proximal to an obstructing tumor (P = not significant). Peritoneal seeding occurred in 17 and 0 percent (P = not significant); the mean disease-free interval was 33.9 and 49.9 months (P = not significant); and five-year cumulative disease-related survival probability was 0.51 and 0.90 (P = 0.049), respectively. CONCLUSIONS: Diastatic perforation proximal to an obstructing tumor is associated with higher operative mortality and better cancer-related survival than a tumor perforating through the bowel wall. Early diagnosis in diastatic perforation and aggressive management of sepsis associated with radical surgical resection is recommended.

Aged↗