Biomedical subjects

L Greco

Publications and source records attributed to L Greco.

At least 127 records · Page 7Linked to original sources

PubMed1985

Renal perfusion in chronic liver diseases: evaluation by radiotechnetium renography.

Twenty-four patients with chronic liver diseases and seven normal controls were studied using renal and hepatic radiotechnetium angiography. The time-activity histograms generated were employed to calculate both the renal perfusion index (RPI) and the hepatic perfusion index (HPI). Renal perfusion proved to be reduced not only in cirrhotic patients but also in patients with aggressive chronic hepatitis, as well as in those with persistent chronic hepatitis. The HPI, which is to be considered as being strictly dependent on portal flow, only fell significantly in the group of cirrhotic patients. In all patients groups, the correlation coefficient between the HPI and RPI (mean of the two kidneys) was low (r = 0.275) and not significant (P greater than 0.05). After Warren's splenorenal derivation, renal perfusion did not improve but worsened, particularly in the left kidney where derivation anastomosis probably caused a venous overload.

Adolescent↗

PubMed1985

Inefficacy of immunosuppressive treatment in HBSAg-positive, delta-negative, moderate chronic active hepatitis in children.

The efficacy of immunosuppressive treatment was evaluated in a group of 15 children (aged 2-10 years) affected by clinically asymptomatic, biochemically mild, HBSAg-positive, delta-antibody-negative, histologically moderate, chronic active hepatitis (CAH). Clinical, biochemical, serological, and histological features of chronic hepatitis B virus (HBV) infection were studied during a follow-up of 2 years. Eight of 15 patients received immunosuppressive treatment (prednisone plus azathioprine); seven received a placebo. No significant differences were found among treated and untreated patients, an overall improvement of nearly all parameters of disease (aminotransferases, albumin, prothrombin time, immunoglobulins, bromsulphalein at 45 min, and bile acid serum levels) being found in both groups. Treated patients showed an improvement in aminotransferase levels only at the first 3-month checkup. This finding, however, was not statistically significant in our study and disappeared at subsequent follow-up examinations. A high incidence of HBeAg was noted at entry into the study (10 of 15 patients checked). HBeAg seroconversion was observed in two of the six HBeAg-positive treated patients and in two of the four HBeAg-positive untreated patients. Finally, the histological picture showed similar patterns in both groups of patients studied. Our data suggest that no benefit from immunosuppressive therapy can be proven at this time in asymptomatic, moderately active, HBsAg-positive, delta-negative CAH in children.

Azathioprine↗

PubMed1985

The effect of early feeding on the onset of symptoms in celiac disease.

The appearance of celiac disease in infancy has often been related to the time when gluten is introduced into the diet, and more recently, to the kind of milk received in the early months. This retrospective study attempts to clarify the relation between breast-feeding and gluten introduction to the onset of symptoms of the disease. One hundred forty-six children with celiac disease, aged from 4 months to 11 years, were studied. The timing and types of feeds were recorded as well as the presenting symptoms of the disease. Data were analyzed by nonparametric statistical methods, as well as by parametric analysis after appropriate transformation. Children breast-fed for 3 months or more showed a marked delay in the onset of the disease and a longer latency time from gluten introduction to onset of disease, when compared with bottle-fed children. This relationship was present for both statistical analyses and was unrelated to the age at gluten introduction into the diet. Onset of disease was positively correlated to the duration of breast-feeding and not related to the age at gluten introduction.

Breast Feeding↗

PubMed1985

10-year follow-up of patients with intraventricular conduction defects associated with myocardial infarction: the meaning of QRS duration.

The 10-year survival rate of 66 patients discharged after an acute myocardial infarction associated with intraventricular conduction delay is reported. The whole population under study consisted of 321 patients followed for 10 years or until death. In 46 patients (69.7%) the conduction delay was a definite complication of infarction, in 15 (22.7%) it preceded the acute event and in 5 (7.5%) the time of onset was undetermined. Mortality in the presence of a conduction delay was 74.2% in 10 years vs 39.2% in its absence (p less than .001). Death was sudden in 41.6% of fatalities when a conduction defect was present and 28% in its absence (p less than .01). The 10-year survival was 55% in patients with conduction defects and QRS less than .12 sec duration, 23.8% if QRS was between .12 and .14 sec, and 4% when QRS duration was greater than .14 sec. 72% of patients of this latter group was in NYHA class 3 or 4, whereas 70% of patients with QRS less than .12 sec and 47% of patients with QRS .12 to .14 sec were in class 1 or 2. These data show that long-term prognosis of conduction delay associated to myocardial infarction is poor and stratification of risk of death is possible among these patients on the basis of QRS duration.

Death, Sudden↗

PubMed1985

[Long-term (10 years) predictive value of the exercise test after myocardial infarct and significance of the longitudinal repetition of the test during follow-up].

Our follow-up after myocardial infarction consists of 321 patients followed for 10 years or until death. 147 patients, free of clinical features associated with high risk of subsequent events, underwent a late exercise test at cycloergometer 6 to 17 months after infarction. Ten year mortality was 48.3% and 10.3% in patients with a positive or a negative test respectively (p less than 0.0001). Incidence of nonfatal reinfarction was 4.6% and 33.3% respectively (p less than 0.001). 108 patients underwent a second test later in the follow-up (2.8 +/- .9 years): in 27 patients who were positive at first test the second test was also positive and mortality was 33.3%. Sixteen out of 81 patients with a former negative test resulted positive at a repeat test and mortality was 37.5% vs a 3% mortality rate among 65 patients who were negative at both tests. Thus long-term prognostic significance of exercise stress testing after acute myocardial infarction is confirmed and extended, despite limitation of a late test. Moreover, the second test along the follow-up allows further stratification. In conclusion, patients with a negative test and without clinical features predictive of poor prognosis constitute a very low risk group who need not undergo invasive testing, whereas patients with a positive result or who become positive at following test deserve further evaluation and may become bypass candidates in the ensuing years.

Evaluation Studies as Topic↗

PubMed1984

[10-year survival after myocardial infarction. Longitudinal study of a hospital population].

In this study, 321 patients discharged from hospital after an acute myocardial infarction were followed for 10 years or until death. Death rate was 46.4% and 30.8% of all fatalities was sudden. In over 80% of the cases death was from cardiac causes and frequently occurred out of hospital. Univariate analysis showed that age, female sex, previous infarction, diabetes, heart failure during hospitalization, heart murmur, NYHA class III or IV, post-infarction angina, intraventricular conduction defects, cardiomegaly, ST displacement, were all associated with an increased death rate. A positive exercise test 6-17 months after infarction, was associated with a 4-fold mortality increase. Bypass played a minor role in this series since only 6.8% of the patients underwent this operation. A nonfatal infarction recurred in 71 patients (22.1%) with an annual rate of 2.2%. Annual death rate after the first 2 years of follow-up was 3.9%, as in most recent reports on survival after myocardial infarction.

Aged↗

PubMed1983

Technical problems in pancreatoduodenectomy.

This paper reports on technical problems involved in pancreatoduodenectomy. Twenty cases of periampullary carcinoma underwent pancreatoduodenectomy. Pancreatic fistula developed in five cases: three of these patients recovered using simple drainage and TPN; one underwent a second operation in which a new pancreatico-jejunostomy was performed and another patient died (5% of the series) from sepsis and liver failure. After reviewing various techniques used in performing pancreatico-jejunostomy, it is concluded that the most suitable management of the pancreatic stump seems to be the duct-to mucosa anastomosis. But in cases in which this type of reconstruction is impossible, invagination yields satisfactory results.

Adult↗

PubMed1981