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Biomedical subjects

L Belli

Publications and source records attributed to L Belli.

At least 109 records · Page 6Linked to original sources
PubMed1981

Distal splenorenal shunt. Hemodynamic advantage over total shunt and influence on clinical status, hepatic function and hypersplenism.

Clinical status, hepatic function and hypersplenism were investigated in 20 patients who underwent distal splenorenal shunt between January 1970 and June 1978. The operative morality rate was 5 percent, and encephalopathy of varying degrees affected 30 percent of the patients. There was no recurrence of bleeding, and the 3 to 5 year actuarial survival rate was 78 percent. Hypersplenism was significantly ameliorated in 17 patients (p less than 0.01). Serum glutamic improved and pyruvic transaminase significantly improved postoperatively and bilirubin significantly worsened, whereas other tests of liver function remained unchanged. Our results confirm the efficacy of this procedure in controlling recurrence of bleeding from esophageal varices. Moreover, severe hypersplenism is not an absolute contraindication to the shunt, which is preferable to total shunts since hepatopetal flow is preserved, thus avoiding early hepatic decompensation as demonstrated by the substantial stabilization of the liver function tests in the short run.

Adult↗
PubMed1980

[Is hypersplenism a contraindication of distal splenorenal shunt?].

The effect of the distal spleno-renal shunt on hypersplenism has been investigated on 19 out of 20 patients undergoing this procedure at the 2nd Department of Surgery Pizzamiglio, Niguarda Hospital of Milan. 6 patients had an hypersplenism of high degree (platelet count less than 50;000/mm3), 11 of moderate degree (platelet count greater than or equal to 50,000 and less than 100,000/mm3) and 2 of low degree (platelet count greater than 100,000 and less than 100,000/mm3). Platelet count significantly improved after the operation (p less than 0.01) and hypersplenism resulted cured or ameliorated in 17 out of 19 patients under study. After briefly discussing the pathogenesis of hypersplenism in patients bearing portal hypertension, the A. conclude that hypersplenism also severe is not "per se" a contraindication to Warren shunt.

Adult↗
PubMed1980

Fixed combination mezlocillin/oxacillin injected intramuscularly. Comparative study of local tolerability compared with ampicillin and determination of effectiveness and tolerability in the treatment of surgical and urinary tract infections.

The results of two studies on tolerability and efficacy of mezlocillin/oxacillin are reported. The pain caused by i.m. injection of 1 g (20% solution) of the fixed antibiotics combination mezlocillin/oxacillin is compared with that caused by 1 g ampicillin. The injection volume was 5 ml. The statistical analysis of the patients' statements indicates a better tolerance of the fixed antibiotics combination mezlocillin/oxacillin than of ampicillin. The second study was determined the clinical efficacy and tolerability of mezlocillin/oxacillin in the treatment of wound infections, biliary tract infections, urinary tract infections, appendicitis and peritonitis. 19/20 patients were clinically cured after about 7 days o treatment with i.m. injections of 1.5 g mezlocillin/oxacillin in 6 ml of a 25% aqueous solution t.i.d. Treatment had to be discontinued after 3 days in one case because of a generalized exanthema. No other side effects were reported. These studies show that both the i.m. injection o the 20% solution of 1 g mezlocillin/oxacillin combination and the 25% solution of 1.5 g of this combination are tolerated without problems.

Adolescent↗
PubMed1979

Effect of portasystemic shunt on hypersplenism: clinical study in 129 patients with cirrhosis.

The effect of portasystemic shunts on hypersplenism has been evaluated in 129 patients who were operated upon. Correction of hypersplenism was obtained in 79 per cent of patients with shunting procedures without splenectomy and 90 per cent of those with splenectomy. The improvement was significant and lasting. These results confirm the beneficial effect of splenic decompression on hypersplenism after simple portasystemic shunt. On the basis of these data, we feel that a difficult splenectomy can also be avoided in patients who have cirrhosis with striking hypersplenism.

Blood Cell Count↗
PubMed1979

Local tolerance of i.m. mezlocillin injection.

To evaluate the intensity of the localized pain caused by intramuscular administration of 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido]-penicillanic acid sodium salt (mezlocillin, Baypen), the pain was compared to that caused by ampicillin in a blind test. Ampicillin served as reference because of its extensive use. 50 patients were given 1 g of mezlocillin and 1 g of ampicillin successively, in both gluteal regions. Ampicillin is significantly more painful than mezlocillin. However, substantial pain is produced by both drugs. In a second study, to reduce the pain, 50 patients were given 1 g of mezlocillin twice, one injection was given in a period of 5-7 s, and the other in a 12-15 s period. The slower injection is significantly less painful than the faster one. In conclusion, i.m. administration of mezlocillin is less painful than that of ampicillin, and the slow injection reduces the pain of mezlocillin administration.

Ampicillin↗
PubMedDate not supplied

Incidence of anti-hepatitis C virus antibodies in non-A, non-B post-transfusion hepatitis in an area of northern Italy.

A total of 210 patients consecutively submitted to heart surgery at the Parma University Hospital and transfused with 1,898 units of blood were followed after transfusion in order to evaluate both the incidence of anti-hepatitis C virus (HCV) seroconversion in non-A, non-B post-transfusion hepatitis (PTH-NANB) cases and the usefulness of the screening for anti-HCV in comparison with that for serum glutamic pyruvic transaminase (SGPT) values in preventing PTH-NANB transmission. Fifteen recipients developed PTH-NANB (group A); ten of them (66.6%) showed anti-HCV seroconversion within 3-12 months. Eight of the ten anti-HCV positive patients developed chronic hepatitis, but none of the five PTH-NANB anti-HCV negative did. None of the 15 controls (group B) randomly chosen among the patient population showed anti-HCV seroconversion. A close correlation with the transmission of PTH was showed by anti-HCV positivity but not by SGPT elevation in blood donors. Eleven of 172 blood products transfused to group A but none of 139 products transfused to group B were anti-HCV positive. The incidence of elevated SGPT values was similar between the two groups of the transfused blood products. Nevertheless, the correlation observed between anti-HCV positivity and SGPT levels in the blood products involved in PTH confirms the need to exclude blood donors with abnormal SGPT values. On the whole, anti-HCV screening of donors showed a predictive value higher than that of SGPT (100% vs. 53.3%), allowing a minor blood donation exclusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine Transaminase↗
PubMedDate not supplied

Alternative use of the interposition Dacron grafts in the treatment of portal hypertension. Clinical experience with 28 cases.

Twenty-eight patients suffering from esophageal bleeding due to portal hypertension were submitted to an "H" type shunt utilizing a 12 mm. wide knitted Dacron prosthesis. The series consists of 8 meso-caval, 12 porto-caval 8 spleno-renal shunts. Thrombosis of the spleno-portal axis was the main indication for the mesocaval shunt, while side-to-side porto-caval and spleno-renal "H" anastomoses were carried out in patients in whom enlarged lymphatics, edema of the porta hepatis or a too large gap between the two veins precluded the use of a direct shunt. The overall mortality rate was 7% including one operative and one late death. The long-term follow-up study included 26 patients and ranged from 6 to 34 months. In all patients patency of the shunt was evaluated by barium swallow x-ray and esophagogastroscopy. Four of them were further investigated by angiography. A good patency of the shunt was demonstrated in all cases. There was no recurrence of the variceal bleeding either in the post-operative period nor in the long-term follow-up. On the basis of our results we feel that the use of Dacron grafts as "H" type shunts is an effective alternative method in relieving portal hypertension in patients in whom it is difficult or impossible to perform a direct anastomosis and further this procedure can be extended with encouraging results to side-to-side spleno-renal shunts.

Adult↗
PubMedDate not supplied

[Differential diagnosis of hematoma, pulsating hematoma and pseudoaneurysm of the femoral artery using color Doppler].

Color Doppler and Duplex Doppler US were employed on 4 patients with clinically suspected pseudoaneurysms as a complication of femoral artery puncture after cardiac catheterization. Pseudoaneurysms were identified with Color Doppler US and their typical appearance was confirmed. The grey-scale findings did not allow an adequate differentiation between hematoma and pulsed hematoma without fibrous encapsulation: only Color Doppler US easily detected the track between damaged artery and blood collection and allowed a sample to be obtained for pulsed Doppler examination. Color Doppler US allowed an accurate and non-invasive diagnosis of groin masses after femoral artery catheterization.

Aneurysm↗