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Biomedical subjects

H W Pinotti

Publications and source records attributed to H W Pinotti.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

[Barrett esophagus in the esophageal stump after subtotal esophagectomy with cervical esophagogastroplasty].

In 48 patients that suffered subtotal esophagectomy and were submitted to esophagogastroplasty a long term follow-up study was carried out. In four of these patients (8.3%) pathological changes that characterize Barrett's esophagus were found in the esophageal stump. As far as we could verify, such changes were never reported at this localization before. The Barrett's esophagus seems to be intimately linked to reflux esophagitis resulting from the action of acid-peptic and biliary secretions.

Barrett Esophagus↗
PubMedDate not supplied

[A new technique of intrahepatic cholangiodigestive shunt in the right lobe of the liver].

Intra-hepatic cholangiojejunostomy in the left liver lobe is a well standardized procedure. For the right lobe however this procedure may be tedious, difficult and followed by early and late complications. A new technique is described based on two principles: minimal sacrifice of hepatic parenchyma and establishment of latero-lateral cholangio-intestinal anastomoses. Five patients were submitted to this procedure and one of them is alive without jaundice three years after the operation. It's concluded that this technique can be indicated in cases of biliary obstruction in which the anastomoses of the left duct cannot be performed because of local changes and in cases with cholangitis.

Anastomosis, Roux-en-Y↗
PubMedDate not supplied

[Cholecystectomy in patients with sickle-cell anemia].

The surgical treatment of cholelithiasis in patients with sickle cell anemia is rather frequently followed by the operative complications. In order to study the influence of pre-operative factors and post operative complications, 31 consecutive patients distributed in two groups has been studied. In group I, all the patients have been operated by conventional procedures with 43.75% of complications. In group II, a more appropriated technique and a better metabolic control ensured a lower morbidity (6.67%). There was no pos operative death in this series. Pre operative bilirubin levels was the only condition associated with increased pos operative morbidity.

Adolescent↗
PubMedDate not supplied

[Carcinoid tumor of the duodenal papilla].

Carcinoid tumor of the duodenal papilla is very rare. The authors report the case of a 17 years old male with a carcinoid tumor at this site in whom a partial pancreatoduodenectomy was performed and who is well and asymptomatic 13 years after the surgical intervention. A review of literature of this unusual condition and a discussion about the treatment are presented.

Adolescent↗
PubMedDate not supplied

[Influence of diet composition on the late course of acute pancreatitis. Experimental study in rats].

Acute pancreatitis was induced with sodium taurocholate 1% in two lots of rats fed during 21 days with diets that differed in lipid composition. Serum amylase, pancreatic tissue enzymes (trypsinogen, chymotrypsinogen and amylase), pancreatic tissue nucleotides (RNA and DNA) and biopsies for histological study were collected in normal pair fed animals, and in the experimental lots 1, 4, 7 and 15 days after AP was induced. ANOVA and Student t-test were used for the comparison of biochemical data (p less than 0.05). They showed that acute pancreatitis aggravated progressively until the fourth day independently of the regimen. On the 15th day, the histological and biochemical parameters reached normal values. The authors concluded that high lipidic diet was not the main factor responsible for progressive injury of the pancreas.

Acute Disease↗
PubMedDate not supplied

[Leiomyosarcoma of the inferior vena cava: report of a case].

Leiomyosarcoma of the inferior vena cava is a rare tumor. The authors report a case and discuss the clinical features, diagnosis and treatment of this disease. With recent advances in radiologic and surgical procedures an early diagnosis and radical resection might be possible, leading to a better prognosis or even to the cure of the condition.

Adult↗
PubMedDate not supplied

Proximal gastric vagotomy. A comparative study between the standard technique and the extended technique associated with denervation of the greater curvature.

Forty-six patients in the postoperative period of proximal gastric vagotomy (PGV) for duodenal ulcer (DU) were studied comparatively to verify whether the dividing of the gastroepiploic nerves (Rosati's maneuver) can reduce or not the occurrence of recurrent ulcer as it was proposed. Twenty-one patients who underwent PGV associated with Rosati's maneuver (PGV-R) were compared to 25 after standard PGV (PGV-S), according to several criteria: (1) clinical evaluation; (2) pre and postoperative basal and pentagastrin-stimulated gastric acidity; (3) postoperative basal and pentagastrin-stimulated serum pepsinogen; (4) postoperative basal and sham feeding-stimulated serum gastrin; (5) postoperative endoscopy; (6) endoscopic Congo red test. Both groups were similar (P greater than 0.05) as to age, sex, levels of preoperative gastric acidity and had a 24.4 month average follow-up (12 to 58 months). There has been no significant difference between the techniques studied as to clinical, secretory, morphological or hormonal gastric tests, although PGV-R proved more effective in reducing basal gastric acidity than PGV-S (P less than 0.05). We concluded that Rosati's maneuver does not improve the results obtained with PGV, although it provided greater reduction of basal gastric acidity than PGV-S.

Adult↗
PubMedDate not supplied

[Portal thrombosis: early complication of azygo-portal disconnection in the treatment of bleeding esophageal varices].

The authors studied 30 patients with bleeding from esophageal varices due to portal hypertension. They underwent the disconnection of portal and azygos veins and splenectomy. The immediate postoperative complications were: portal thrombosis in four patients (13.3%); subphrenic abscess in two (6.6%); pulmonary embolism in one (3.3%) and esophageal perforation in one (3.3%). The manifestations of portal thrombosis were ascites, and fever (without leukocytosis). One patient with portal thrombosis who had intractable ascite was submitted to peritoneovenous shunting.

Adolescent↗
PubMedDate not supplied

[Focal nodular hyperplasia of the liver observed in a patient undergoing prolonged therapy with ketoconazole].

The authors report on a 44 year old man presenting focal nodular hyperplasia of the liver associated with prolonged ketoconazole therapy in the absence of known intake of either estrogens of androgens as well as of any factor that could cause hyperproduction of estrogens. It seems possible the existence of an etiopathogenic relationship between prolonged ketoconazole therapy and focal nodular hyperplasia of the liver since ketoconazole inhibits steroidogenesis and can also increase the estradiol-testosterone ratio (E/T). This hormonal alteration is known to play an important role in the pathogenesis of several hepatic neoplasms, including focal nodular hyperplasia.

Adult↗
PubMedDate not supplied

[Contamination of enteral diet solutions in nosocomial environment].

The gastrointestinal tract is comparatively resistant to food-born germs, but recent studies suggest that nosocomial infections may be triggered by this route. In a study with industrialized diets, prepared with aseptic technique and stored up to 24 hours, aerobic and anaerobic contaminants were searched. Samples were taken after 0.8 and 24 hours, whereas half of these last two analyses were carried out in material left at room temperature, and the other half in refrigerated diets. Initial examination revealed 50% of positive cultures, but part of this was due to non-pathogenic Bacillus germs. After 8 and 24 hours 90% of the samples grew organisms, again with a large proportion of Bacillus, but also with several Gram-negative bacteria, as well as rare Gram-positives. Diarrhea and fever were not registered in patients submitted to enteral nutrition during the study period, nor could any episodes of bacteremia or septic shock be attributed to contaminated feeding material. This lack of clinical consequences of the reported bacterial isolations is not unexpected, and suggests that low concentrations of microorganisms were probably present in the preparations, below a critical level. Nevertheless, attention will be required in the future for better quality control of enteral nutrition mixtures, specially when resistant strains of Gram-negative species are identified, and also in the management of debilitated or immunologically compromised hosts.

Bacteria, Aerobic↗
PubMedDate not supplied

[Splenic abscess: report of 8 cases and review of the literature].

Eight patients with splenic abscess are reported. Etiological factors were sepsis, mainly due to endocarditis. Diagnosis was made by ultrasonography and computed tomography scans. Splenectomy was performed in four cases, transcutaneous drainage in three and abscess puncture in one case. Mortality was 12.5% (1/8). Since the introduction of US and CT scans early diagnosis and treatment was possible by which the mortality decreased.

Abscess↗
PubMedDate not supplied

[A hyperlipidic diet and acute pancreatitis: experimental study in rats].

After acute pancreatitis was induced, the residual pancreatic tissue contents were evaluated in two series of rats fed with diets that differed in the lipidic composition: 1--high lipid and balanced protein diet; 2--balanced diet. Total protein, nucleic acids, trypsinogen, chymotrypsinogen were quantified in the pancreatic tissue; amylase activity was measured in the pancreatic tissue and serum under the following conditions: 1--in rats fed "ad libitum" (groups CB and CL); 2--in rats submitted to a fast of 30 hs (groups JB and JL) and 3--twenty-four hours after acute pancreatitis was induced (group B and L). The results obtained were statistically compared among groups with the same kind of diets, using ANOVA and the Tukey test. Student t-test was used to compare the same parameters among similar groups with different diets (p less than 0.05). In comparison with the groups under same regimen it was verified that the pancreatic enzymes content didn't change in fasting groups, but did in PA groups. It was also found that trypsin was increased in all groups, RNA/DNA decreased and total protein increased in AP group in rats fed with hyperlipidic diet. It is concluded that high lipid intake can aggravate pancreatic injury.

Acute Disease↗
PubMedDate not supplied

[Surgical treatment of ascites and pleural effusion in patients with chronic pancreatitis].

Pleural effusion and ascites are now recognized as possible complications of chronic pancreatitis. Diagnosis of these conditions can be made by the finding of high amylase levels in the pleural or ascite fluid. Out of 31 of our patients with this complications 19 had ascites, 10 pleural effusions and two both pleural effusion and ascites. In 19 patients, presenting poor clinical conditions, the treatment was external drainage. Remaining patients were treated by internal drainage or resection. Eight out of the 19 patients treated by external drainage and one of the 13 patients with internal drainage had to be reoperated. There was no mortality. Though external drainage is followed by high incidence of reoperations this technique should be used in patients with poor conditions.

Adult↗
PubMedDate not supplied

[The management of acute pancreatitis in pregnancy--the coadjuvant role of parenteral feeding].

Acute pancreatitis in pregnancy is not a frequent condition: only a few hundred cases have been published in the literature. Its diagnosis can be misguided by clinical manifestations of the pregnancy itself, and by the delay in ordering the required diagnostic tests. These facts may contribute to the serious prognosis of this disease, which in the past had a mortality of up to 20%. The treatment recommended is conservative. A surgical intervention in the event of biliary lithiasis is best to be postponed till after delivery. Parenteral alimentation can be helpful because of its effects in the promotion of pancreatic rest with simultaneous improvement of the nutritional conditions of the mother and the fetus.

Acute Disease↗
PubMedDate not supplied

Serum pepsinogen before and after proximal gastric vagotomy in duodenal ulcer treatment.

Serum pepsinogen (SP) behavior was evaluated under basal conditions and under betazole stimulation in 59 patients: 14 controls, nine unoperated duodenal ulcers (DU) and 36 DU after proximal gastric vagotomy (PGV), 14 with and 22 without recurrent ulcer. The mean follow-up of the 36 patients who underwent PGV was 38.7 months. SP was higher in unoperated DU than in the control group (p less than 0.05). After PGV in DU, there is a significant decrease of SP for both the patients with and without recurrent ulcer (p less than 0.05), being statistically similar to the control group. No difference of SP was observed between DU with and without recurrent ulcer after PGV. We concluded that SP can differentiate normal subjects from DU patients, although it is not a sensitive indicator of recurrent ulcer after PGV.

Adult↗