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L Poggi

Publications and source records attributed to L Poggi.

152 records · Page 9Linked to original sources
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[Splenic hydatidosis: report of 4 cases].

This report describes the clinical, diagnostic and treatment features of four patients with primary splenic hydatid disease who were treated between 1991 and 1993 in three hospitals of Lima where hydatid disease is often seen. Clinical features were not sufficient to reach a correct diagnosis in all cases. In two patients splenic cysts were found by accident. Abdominal ultrasound scanning gave erroneous or dubious results in three patients. Abdominal CAT scan was useful in locating a cyst in one of the cases. One patient harboured an infected cyst before surgery. Total splenectomy was performed in all cases with no complications up to discharge from the hospital. Splenic hydatidosis is rare but should be looked for in patients with cysts in other organs or with presumptive abdominal images suggestive of this disease.

Adult↗
PubMedDate not supplied

Drug-induced changes in ambulatory blood pressure and pulse pressure in patients with or without sustained hypertension.

We retrospectively studied 216 mild to moderate hypertensive patients receiving either an angiotensin converting enzyme inhibitor (ACEI) or a calcium antagonist (CA), as a once-a-day monotherapy; their blood pressure had been measured using both a sphygmomanometer and an ambulatory blood pressure recorder. Numerous discrepancies were found between the two methods of blood pressure measurement with respect to systolic blood pressure (SBP) and diastolic blood pressure (DBP), as well as pulse pressure (PP). Clinic blood pressure measurement did not show any significant differences between the effects of ACEI and those of CA, whereas ambulatory blood pressure measurements (ABPM) showed that in patients with normal ambulatory blood pressure (so-called 'white coat' hypertensive patients), ACEI only (but not CA) significantly lowered SBP, DBP and PP. Accordingly, a threshold of efficacy was sought: it appeared to be lower for ACEI than for CA (120/80 vs 140/85 mmHg). Furthermore, for a given degree of DBP lowering, SBP and PP were more lowered by ACEI than by CA, indicating a greater effect of ACEI on arterial compliance. Likewise, for a given level of mean blood pressure, SBP and PP were lower and DBP slightly higher in patients on ACEI than in those on CA. Our data are consistent with some recent papers, emphasizing a heightened activity of the renin-angiotensin system in 'white coat' hypertensive patients.

Adult↗
PubMedDate not supplied

[Comparison of clinical and ambulatory measurements of blood pressure with benazepril alone or combined with hydrochlorothiazide in hypertension].

The aim of this study was to analyse the respective values of clinic and ambulatory blood pressure measurements in patients with treated hypertension. Twenty-eight patients with mild to moderate hypertension were studied (clinic blood pressure > or = 160/95 mmHg), treated with benazepril alone (n = 7) or combined with hydrochlorothiazide (n = 21). A 24 h ambulatory blood pressure measurement was performed before (d0) and after 8 weeks of treatment (d56). The treatment was effective on the ambulatory blood pressure in 19 patients (Staessen criteria) and effective on clinic measurements in 20 patients (WHO criteria). The results were concordant in 25 of the 28 patients. The decrease of the ambulatory blood pressure values during the day between d0 and d56 was not significantly related to the decrease of the clinic values. The comparison of the ambulatory blood pressure values at each hour between d0 and d56 showed that the treatment was effective during 24 h. The 'white coat' effect has been evaluated at d0 and d56 by the difference between mean daytime ambulatory blood pressure and clinic values. Clinic values were higher than mean daytime ambulatory values in benazepril (14 +/- 12 mmHg and 7 +/- 7 mmHg for the systolic and diastolic pressure) and benazepril-hydrochlorothiazide group (12 +/- 12 mmHg and 0.2 +/- 9 mmHg for the systolic and diastolic pressure). This 'white coat' effect was not modified during the treatment. Previous studies have emphasized a better assessment of the cardiovascular risk with ambulatory than with clinic measurements. The differences in the assessment of the efficiency of the treatment between clinic and ambulatory measurements shown in our study prompt us to use ambulatory measurements in patients with apparently uncontrolled hypertension.

Adult↗
PubMedDate not supplied

[Bleeding in diverticular disease of the colon].

The incidence of bleeding from diverticular disease ranges from 3 to 30%. Haemorrhage is more common when the whole colon is affected; the source is more frequently in the right colon. Typically, the bleeding is massive, with 15% of the patients admitted in shock. It nearly always stops spontaneously, but recurrence rate is high. Chronic blood loss suggests alternative sources. Emergency angiography detects aetiology and site of the haemorrhage in most of the patients. Vasopressin infusion can frequently stop the bleeding. Colonoscopy is profitable only when bleeding stops, after a rapid clearing of the colon. On the other hand, intraoperative colonoscopy could be useful in emergency cases when urgent surgery is clearly indicated. Surgical treatment is requested only in few patients: segmental resections (generally right hemicolectomy) are indicated when there is evidence of the source of the blood loss. In the other cases sub-total or total colectomy are justified and provide better and safer results.

Adult↗