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Biomedical subjects

I A Grillo

Publications and source records attributed to I A Grillo.

At least 19 recordsLinked to original sources
PubMed1995

Management of neglected embolic occlusions in lower-limb arteries using arterial lavage.

Fourteen patients (seven males and seven females aged between 8 months and 100 years) with embolic lower-limb arterial occlusions of 1 to 6 days' duration were treated at Assir Central Hospital, Abha, Saudi Arabia over a 27-month period. On admission, the limbs were ischaemic up to mid-thigh and peripheral pulses were absent. Doppler studies showed absence of blood flow. The anatomical block was localized by angiography and ultrasonography. Fogarty catheter embolectomy was performed in all patients followed by rapid positive-pressure lavage of the vascular tree with 4-61 Ringer's lactate solution containing mannitol in an attempt to remove free radicals. Three patients died; one transmetatarsal amputation was performed. The remaining 11 limbs were salvaged and these patients remain ambulatory 21 to 42 months after surgery.

Adolescent↗
PubMed1995

Deep venous thrombosis in Assir region of Saudi Arabia. Case-control study.

In a five-year case-control study (1988 to 1993) at Assir Central Hospital (ACH), Abha (8,000 feet above sea level), Saudi Arabia, 92 of 129 patients suspected of deep venous thrombosis (DVT) were studied with ascending contrast venography (CV) (74 patients, 80.4%) or Doppler ultrasonography (DUS) (18 patients, 19.6%). Female-to-male ratio was 2.3 to 1. Age range of patients was twelve to ninety years; mean age was 44.45 yrs +/- 17.38 years. DVT hospital incidence was 18 per 10,000 admissions. The most common associated factors included immobilization due to chronic diseases (21.7%), trauma and surgery (19.6%), and pregnancy and oral contraceptives usage (16.3%). The most common symptom and sign were limb pain and tenderness (95.6%). Limb swelling was noted in 93.5% of patients. The left lower limb was more commonly affected than the right. There was a definite increase of DVT during the winter months. Altitude was not a contributory factor. Pulmonary embolism was the greatest complication.

Adolescent↗
PubMed1995

Empyema thoracis in adults in Saudi Arabia.

Empyema thoracis in adults is an uncommon disease in the Asir region of Saudi Arabia. In a period of seven years (1988 to 1994), 24 patients were treated for empyema thoracis with a hospital incidence of about 23 patients in 100,000 admissions. The community acquired empyemas are more common and less aggressive in non-Saudi patients (six males and one female) as compared to Saudi patients (11 males and 6 females) whose empyemas are mostly nosocomial with an aggressive course. The peak age in both Saudi and non-Saudi patients is 45 years and 25 years respectively, and the right pleura is more commonly affected than the left pleura in both groups. Risk factors include diabetes mellitus, pulmonary tuberculosis, post-pneumonectomy infections, trauma and pneumonia. The commonest organisms grown are Pseudomonas aeruginosa, Klebsiella species and Staphylococcus aureus, although in almost 40% of the patients the empyemas were sterile. The commonest method of treatment was closed thoracostomy tube drainage.

Adolescent↗
PubMed1994

Colo-rectal carcinoma in a tropical African population: an overview report.

Fifty-one selected cases of colo-ano-rectal carcinoma seen in a tropical African population over a period of two decades were reviewed. The patients were divided into three groups. Group A were those cases seen under the age of thirty years, Group B were the resectable rectal carcinoma because they were bulky and occupied the whole of the pelvis. This we referred to as cases with "frozen" pelvis. Our modality of treatment consists of surgical excision when possible, the use of Levamisole, the use of 5-Fluoro-Uracil either intravenously, intraperitonealy and intrarectally as the case requires and radiotherapy when available. For Group A, the average survival period is 10.6 months, for Group B, it is 17.3 months and for Group C, it is 14.5 months. Symptoms of tenesmus and ascites improved by intrarectal and intraperitoneal infusion of calculated dose of 5-Fluoro-Uracil.

Adenocarcinoma↗
PubMed1984

Developmental anomalies of the lung in Nigerian children.

Five cases of developmental lung anomalies occurring in Nigerian children are reported; three were congenital lobar emphysema while two were scimitar syndromes. The radiological features demonstrated in each case effectively excluded the common causes of pulmonary disorders. Three patients were treated surgically with successful results in two. We believe that an increased awareness in our tropical setting would result in improved detection of these treatable but rare conditions.

Female↗
PubMed1982

Suppurative diseases of the lung and pleura: a continuing challenge in developing countries.

A retrospective study of 1,150 consecutive patients with thoracic and cardiovascular diseases seen at the University College Hospital, Ibadan, Nigeria, over a five-year period (January, 1975, to December, 1979) showed that 42% (481 patients) were treated for suppurative diseases of the lung and pleura, notably empyema thoracis, lung abscess, and bronchiectasis. Of these, 336 or 70% were treated for empyema thoracis, most of whom were less than 2 years old. Seventy-five patients (16%) had lung abscess, 53 of whom were treated medically with 8 deaths, while 22 had emergency resection for massive hemoptysis with 9 deaths. Of the 70 patients with bronchiectasis, 37 were treated medically with 2 deaths, while 33 were treated surgically with 5 deaths. These data demonstrate that infectious diseases of the lung and pleura remain the greatest challenge to the thoracic surgeons in tropical, developing countries who are often handicapped by inadequate facilities, lack of drugs, illiteracy, poverty, superstitious beliefs, and poor environmental hygiene.

Adolescent↗
PubMed1981

Purulent pericarditis: a continuing surgical challenge.

This report presents a prospective series of 12 patients with a diagnosis of purulent pericarditis who were treated between April 1978 and September 1979 by the cardiothoracic surgical unit at the University College Hospital, Ibadan, Nigeria. These patients were studied to determine the adequacy of a therapeutic protocol consisting of systemic antibiotics and pericardiostomy tube drainage. All patients were in the pediatric age group with an average age of 6¾ years. Bronchopneumonia was the antecedent focus of sepsis in eight patients, with pyomyositis in four (33 percent). Two patients expired prior to surgery.No mortality or significant morbidity occurred in the ten patients who underwent pericardiostomy.The results of this series combined with the initial experience reported in 1978 by the same authors confirm the described protocol as the treatment of choice in their environment.

Anti-Bacterial Agents↗
PubMed1981

Management of tuberculous destroyed lung in Nigeria.

Between 1969 and 1979, 20 patients under-went pneumonectomy for tuberculous destroyed lungs (TDL) at the University College Hospital (UCH), Ibadan, Nigeria. Their ages ranged from 9 to 57 years, with an average age of 24 years. The left lung was involved in 16 patients (80 percent) and the right lung in four patients (20 percent). All patients had received treatment for pulmonary tuberculosis (PTB) for over three years, and all patients had negative cultures of acid-fast bacilli (AFB) at the time of operation. Pulmonary function studies were performed in 15 patients, bronchography in 18, and pulmonary angiography in four. Ninteen patients had elective resection because of mild to moderate hemoptysis without mortality. The only death occurred in a 37-year-old man who had emergency resection because of massive hemoptysis. He died intraoperatively of cardiac arrest. One patient developed bronchopleural fistula (BPF), empyema, and wound infection. The fistula closed spontaneously following prolonged chest drainage and pleural irrigation with antibiotics and antituberculous drugs. As a result of our experience with pulmonary tuberculosis in our environment, the authors now recommend elective resection for patients with TDL in order to prevent massive hemoptysis which may prove fatal.

Adolescent↗
PubMed1980

Open pulmonary valvotomy: report of the first successful open heart surgery at the University College Hospital, Ibadan, Nigeria.

Although cardiac surgery has become the standard procedure for management of intracardiac and extracardiac defects in developed countries, it is still relatively new in Africa. This report describes our first successful open heart surgery on a 16-year-old Nigerian boy who underwent open pulmonary valvotomy under cardiopulmonary bypass for congenital pulmonary stenosis at the University College Hospital, Ibadan, Nigeria, on September 18, 1979.

Adolescent↗
PubMed1980

Esophagopleural fistula: a complication of chest intubation for empyema.

This report documents the first recorded patient in the recent literature with an esophageal perforation and an esophagopleural fistula following chest intubation for empyema. It was treated successfully by conservative method with feeding gastrostomy. It is important to realize that tube thoracostomy drainage is not an innocuous procedure and to be alert to this complication, especially in the presence of empyema.

Child, Preschool↗
PubMed1980

Chronic constrictive pericarditis: hemodynamic changes following pericardiectomy.

Ten patients with chronic constrictive pericarditis underwent pericardiectomy at the University College Hospital, Ibadan, from July 1977 to May 1979. Preoperatively, right heart catheterization and angiocardiography were performed in seven patients. A significant decline in mean right atrial pressure occurred intraoperatively immediately after completion of decortication. Further measurements obtained in the immediate postoperative period identified two patient groups: one group of four patients with normal pressures and no mortality and one group of five patients with abnormal pressures and three deaths.Intraoperative pressure measurement at pericardiectomy is suggested as a useful parameter in identifying those patients with "reversible" myocardial dysfunction at risk from refractory cardiac failure in the postoperative period. Restoration of normal pressure after pericardiectomy is not dependent on the duration of disease.

Adult↗
PubMed1980

Broncho-esophageal fistula presenting as bronchiectasis in a Nigerian child.

A case is presented of a five-year-old girl with history of intermittent episodes of cough and vomiting exacerbated by eating. A diagnosis of broncho-esophageal fistula was made on barium esophagography after she failed to improve on therapy for bronchiectasis and tuberculosis over a one-year period.The diagnostic considerations and management of broncho-esophageal fistula in the Nigerian child with bronchiectasis are described.

Bronchial Fistula↗
PubMed1979

Investigation of Nigerians with diffuse radiographic pulmonary shadowing.

During a five-year period, 45 Nigerians with radiographic appearances of diffuse pulmonary infiltration with at least six sputum specimens negative on culture for tubercule bacilli were investigated at University College Hospital, Ibadan. The value of pulmonary function studies and open or closed lung biopsy in discovering the cause of diffuse lung disease was examined. Cryptogenic fibrosing alveolitis was the most common cause (13 cases). Other diagnoses included malignant disease (11 cases), sarcoidosis (three cases), progressive systemic sclerosis (three cases), miliary and non-caseating tuberculosis (three cases) and pulmonary alveolar microlithiasis (one case): this last is believed to be the first case diagnosed in Africa South of the Sahara. This study emphasizes the fact that, even in developing countries where tuberculosis is highly prevalent, there are other causes of diffuse pulmonary infiltration.

Aged↗
PubMed1979

Primary malignant melanoma of the bronchus.

A case is presented of a 55-year-old woman with fever, cough, chest pain, and hemoptysis. A chest x-ray showed a large mass in the right upper lobe of the lung. Bronchoscopy and bronchial biopsies revealed malignant melanoma of the bronchus. Careful search of all common sites for melanoma and the histological examinations of the two skin lesions failed to substantiate the possibility of an extrapulmonary origin and, thus, by deduction it can be assumed with some certainty that this lesion is primary bronchial melanoma.Total pneumonectomy, when there is no evidence of extrapulmonary extension, coupled with adjuvant chemotherapy seem to offer a chance of cure.The patient presented is the first reported case of primary malignant melanoma of the bronchus from the University College Hospital, Ibadan, and perhaps the first reported case in a Nigerian.

Bronchial Neoplasms↗