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Biomedical subjects

G Tiberio

Publications and source records attributed to G Tiberio.

At least 109 records · Page 6Linked to original sources
PubMed1978

[Proposed technic of drainage tunneling in marsupialization of hydatid cysts of the hepatic cupula].

Even though the present tendency is to make use of radical operations, such as pericystectomy, hepatic resection and lobectomy, in the surgical management of hydatidosis of the liver, marsupialisation is still the method of choince in a large and clearly defined number of cases. While usually simple, this operation may prove difficult and complex when used on cysts of the cupola, since it may often be necessary to mobilise the liver to a large extent and employ damaging approach routes. A description is offered of a particular technique for tunnelling the desinage tube which considerably simplifies marsupialisation in cases of this kind.

Drainage↗
PubMed1977

[Porto-systemic anastomosis in the treatment of portal hypertension due to intrahepatic block. Advanced surgical technics].

A physiopathological interpretation is offered of the possibilities given by recent selective or portally regulated reduction of pressure in achieving a balance between reduction of pressure and diversion. Classic demonstrations, in fact, prove effective in the prevention of haemorrhage due to rupture of oesophageal varices. On the other hand, by over-diversion of the portal flow from the liver, they may cause a further deterioration in liver performance and more imposing the greater the flow of portal blood through the liver preoperatively. Procedures aimed at de-tension of the portal system, particularly the gastro-oesophageal segment, and at ensuring an intrahepatic venous flow sufficient to obviate steal syndrome damage, are described. Some of these procedures are still at the experimental stage. The techniques involved are explained, along with the underlying principles achieved by or prospected for each of them.

Drainage↗
PubMedDate not supplied

[Influence of socio-health variables on the cognitive state of mind of the geriatric patients of a health centre].

BACKGROUND: To determine the influence of age, education, admission in nursing homes and chronic diseases (arterial hypertension, diabetes, hyperlipidaemia, anxiety and depression) on the cognitive state of the population over 65 years of age. MATERIAL AND METHODS: A study was made of a geriatric outpatient population (patients living at home or institutionalised) with chronic diseases, who showed cognitive deterioration and depressive symptoms. The cognitive mini-exam (CME) and the geriatric depression scale (Yesavage) were administered. RESULTS: One hundred and forty-seven patients participated, with an average age of 71.4 years and a similar proportion of men (74; 50.3%) and women (73; 49.7%). Thirty-four subjects (23.1%) were living in nursing homes. The most prevalent diseases were hypertension (50%), anxiety-insomnia (30%), diabetes (22%), arthrosis (22%), depression (13%) and hypercholesterolaemia (12%). Half of the patients (79; 53.7%) were following treatment with more than three medicines; 60 (40.6%) with between two and three medicines, and only 8 (5.5%) were taking no medication. The percentage of subjects living in an institution increased with age. The consumption of medicines was also higher amongst the more elderly. The scores on the cognitive scale (CME) decrease with age and were also lower amongst subjects who live in institutions (above all if they suffer from depression). The patients who took psychotropics had lower scores on the CME. Although performances on the CME are lower amongst subjects with a low level of education, the differences do not reach statistical significance. The presence of hyperlipidaemia also decreased the results of the CME. CONCLUSIONS: The socio-health factors that altered performance negatively in the cognitive mini-exam are advanced age and institutionalisation. These results are also significantly influenced by depressive disease, hyperlipidaemia and the consumption of medicines that affect the cognitive state.

Age Factors↗
PubMedDate not supplied

[Multiple symmetric lipomatosis: a case report].

We present the case of a 46 year-old man with Multiple Symmetric Lipomatosis (MSL), an infrequent disease with an unknown aetiology. MSL is characterized by multiple masses of adipose tissue and it is usually associated with alcoholism, metabolic disorders and neuropathy. We describe the clinical-morphological characteristics of the lesions it presents, the exploratory findings, cervical CAT, the analytical results and the results of subcutaneous biopsy. MSL type I disease was diagnosed. The treatment of choice, the lipectomy, was performed, making it possible to obtain a substantial disease improvement, both physical and aesthetically.

Biopsy↗
PubMedDate not supplied

Predictive value of a pathophysiological score in the surgical treatment of perforated diverticular disease.

Resection is the preferred method of perforated diverticular disease treatment compared to conservative treatment. However, the immediate or deferred timing of bowel continuity restoration for advanced degrees of peritoneal contamination is debatable. This is a retrospective study designed to identify operative mortality predictors and guidelines for safe primary anastomosis. A pathophysiological score (acute physiology and chronic health evaluation, APACHE II) was applied to 135 consecutive patients who had undergone surgery for acute inflammatory complication of diverticular disease. A multivariate analysis was used to identify prognostic factors such as age, chronic diseases, neoplastic cancer, Acute Physiology Score (APS), Hinchey's classification and APACHE II scores. Seventy patients underwent primary resection and anastomosis, 35 underwent Hartmann's procedure and 15 conservative treatment. There was a significant correlation between operative mortality and increasing disease severity based on Hinchey's classification, APS and APACHE II scores. The multivariate analysis proved APACHE II scores to be the only prognostic factor of operative mortality. Both single and multivariate analysis of variance failed to identify a factor significantly associated with surgical and/or medical postoperative complications. APACHE II scores were the best predictor for operative mortality in patients with diverticular disease complications, but none of the classification criteria used was effective in predicting postoperative complication. Patients with phlegmonous sigmoiditis can be safely treated with primary resection and anastomosis. Conservative treatment should not be considered an effective method for diverticular disease. A prospective trial comparing resection with and without colostomy should be done for local and diffuse purulent peritonitis treatment. Hartmann's procedure is seen to be the only indicator for faecal peritonitis.

APACHE↗
PubMedDate not supplied

Langer-Giedion syndrome. A patient without mental retardation and a large 8q23.2-q24.22 deletion.

Mental retardation (MR) is a typical feature of Langer-Giedion syndrome (LGS). Only 18 cases of LGS without MR have been reported. All of them either had normal karyotype or carried a deletion not exceeding the 8q24 band. Thus, it has been proposed that MR in LGS patients is associated with larger deletions. A patient with LGS and a large 8q23.2-q24.22 deletion but without MR is reported. This case suggests that there is not any particular gene which alone is responsible for MR in LGS patients, but it is the reduced expression of a large number of genes which predisposes to MR.

Child↗
PubMedDate not supplied

[Video laparoscopic cholecystectomy in a female patient with cholelithiasis in Steinert's myotonic dystrophy].

Steinert's disease (SD) is a rare (3-5/100000) myotonic myopathy responsible for chronic restrictive respiratory insufficiency and dilatative myocardiopathy. The authors report the case of a 52-years-old female patient with SD who underwent laparoscopic cholecystectomy for cholelithiasis. Postoperative course was uneventful and the patient was discharged after 4 days. Laparoscopic surgery was effective and safe in the treatment of this pathology.

Anesthesia, General↗
PubMedDate not supplied

Analysis of deaths due to injury in Milano: preliminary results.

We reviewed all trauma deaths occurring in the urban area of Milan during one year. Autopsy reports were cross-referenced with pre- and in-hospital records and the Injury Severity Score was calculated by a senior surgeon. Causes of deaths were defined as central nervous system injury (CNS), hemorrhage (HEM), combined central nervous system injury and hemorrhage (CNS + HEM), and burns (BURN). Places of death were considered the scene (DOS), during transportation (DOA), the emergency room (DER), and hospital. Two multidisciplinary commissions reviewed patient reports and deaths were judged non-preventable, possibly preventable or frankly preventable, using the unanimous decision rule. The TRISS method was used to calculate the probability of survival for in-hospital deaths. Overall trauma deaths were 255 with 78.04% blunt and 16.08% penetrating traumas. Burns accounted for 5.88%. CNS and CNS + HEM caused 171 (67.05%) deaths. DOS were 91, DOA 48, DER 34, and in-hospital deaths 33. Victims found dead (49 individuals) were excluded from further analysis. The commissions classified 56.31% of deaths as non-preventable, 32.03% as possibly preventable and 11.65% as frankly preventable. The Injury Severity Score decreased from DOS to in-hospital deaths (p < 0.05). The preventability rate was higher for in-hospital deaths (p < 0.05). The results of this study suggest that the development of a tiered trauma system in Milan is mandatory.

Adult↗