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Biomedical subjects

L Romano

Publications and source records attributed to L Romano.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

[Personal experience in 71 consecutive patients with acute cholecystitis].

PURPOSE: Acute cholecystitis is one of the most frequent abdominal inflammatory processes. If untreated or misdiagnosed it can result in severe complications such as gallbladder rupture, abscesses, or peritonitis. We retrospectively reviewed a series of 71 consecutive patients with surgical confirmation of acute cholecystitis and now compare the results of the diagnostic techniques we used preoperatively. MATERIAL AND METHODS: Over 16 months, 71 consecutive patients (42 women and 29 men; age range: 34-84 years, mean: 58) with acute abdominal pain were operated on for acute cholecystitis at Cardarelli Hospital, Naples. Abdominal plain film was performed in 65 of 71 cases, abdominal US in 69 and abdominal CT in 6. On abdominal plain films, we retrospectively searched the following signs: densities projected over the gallbladder, linear calcifications in gallbladder walls, gallbladder enlargement, focal gas collections within the gallbladder, and air-fluid levels in the gallbladder lumen. On US images we looked for: gallbladder wall thickening (> 3 mm), intraluminal content in the gallbladder, pericholecystic fluid, US Murphy's sign, and gallbladder distension. On CT images, we investigated: gallbladder distension, wall thickening, intraluminal content, pericholecystic fluid, and inflammatory changes in pericholecystic fat. Associated complications of cholecystitis were also searched on all images. RESULTS: On plain abdominal films we found densities projected over the gallbladder (16.9%) and linear calcifications in the gallbladder wall (4.6%). Abdominal US demonstrated gallbladder wall thickening (56.5%), one or more gallstone(s) (85.5%), pericholecystic fluid (14.5%), gallbladder distension (46.4%), and US Murphy's sign (39.1%). Abdominal CT showed gallbladder wall thickening (83.3%), gallbladder distension (66.6%), pericholecystic fluid (66.6%), gallstones (50%), inflammatory changes in pericholecystic fat (33.3%), and increased bile density (> 20 HU) (33.3%). CONCLUSIONS: US appears to be the most useful imaging technique in patients with suspected acute cholecystitis, for both screening and final diagnosis. CT plays a limited role in the early assessment of these patients, but can be a useful tool in diagnosing acute cholecystitis in patients with questionable physical findings or in investigating related complications.

Acute Disease↗
PubMedDate not supplied

[Spiral computed tomography in the assessment of vascular lesions of the pelvis due to blunt trauma].

PURPOSE: We investigated the role of Helical Computed Tomography (CT) in the evaluation of low or high flow vascular injuries in patients with blunt pelvic trauma. MATERIAL AND METHODS: From May 1998 to December 1999, forty-nine patients (32 men and 17 women, ranging in age 14-59 years) with acute symptoms from blunt pelvic trauma were submitted to Computed Tomography (CT). A conventional radiography of the pelvis had been performed in all cases. CT was performed with a helical unit (thickness 8 mm, reconstruction interval 8 mm, pitch 1.5) after intravenous contrast agent (150-180 mL) rapid infusion (4-5 mL/s, 60 s acquisition delay from bolus starting) and using a power injector. A second spiral acquisition was performed in all cases from the iliac roofs to the inferior border of the pubic symphysis. Vascular hemorrhage was considered as low flow when the hematoma appeared as a focal homogeneous density area and as high flow when associated with contrast agent extravasation. Moreover, traumatic assessment included evaluation of the hematoma, of the leakage site and of the involved vessel. RESULTS: Radiologic examination of the pelvis revealed fractures in 35/49 patients (71.4%). Helical CT allowed us to identify low flow hemorrhage in 37 patients, affected with hematomas from fracture of the iliac wing or of the sacrum (14 cases), tear of the pelvic (3 cases) or extrapelvic (4 cases) muscular structures, or injury of the venous plexus (20 cases). In four patients two vascular injuries were detected. High flow hemorrhage was seen in 12 patients, who had Helical CT findings of contrast agent extravasation along the common iliac vein (3 cases), external iliac artery (3 cases), internal iliac artery (4 cases), internal pudendal artery (1 case), obturator artery (1 case), inferior epigastric artery (2 cases), superior gluteal artery (2 cases), inferior gluteal artery (1 case), cremasteric artery (1 case). In 6 patients with high flow hemorrhage, two vascular injuries were shown. In all these patients, an extraperitoneal hematoma was associated with the contrast agent extravasation. DISCUSSION AND CONCLUSIONS: Fractures of the pelvic ring generally result from severe trauma. Management of these injuries must include not only treatment of the skeletal trauma but also of the associated shock and complications. Major blood loss usually occurs as a result of bleeding from the branches of the internal iliac artery. With respect to pelvic plain radiography, CT provides superior detailing of fractures, position of fracture fragments and extent of diastasis of the sacroiliac joints and pubic symphysis. Moreover CT provides diagnostic information regarding the presence or absence of pelvic bleeding and can identify the site of bleeding. In our experience, Helical CT allows us to distinguish high flow hemorrhage, where vascular injuries must be treated first, from low flow hemorrhage which can be managed differently.

Adolescent↗
PubMedDate not supplied

[Small bowell volvulus - combined radiological findings].

PURPOSE: We retrospectively evaluated the radiological findings observed at plain abdominal film, abdominal sonography and abdominal CT performed in 66 patients with surgically proven small bowel volvulus. MATERIAL AND METHODS: Sixty-six patients (35 women and 31 men, ranging in age 38-77 years) with surgically proven small bowel volvulus were submitted to plain film, sonography and CT of the abdomen. Abdominal plain film was performed in the upright position (postero-anterior view) in 46 cases, and in the supine position in 20 cases. On plain abdominal film we evaluated the following findings: bowel loops dilatation, air-fluid levels and site of obstruction. At abdominal US, performed with 3.5 e 7.5 MHz probes, we retrospectively searched for: bowel loop dilatation, bowel wall thickening, peristalsis alteration, extraluminal fluid. CT was performed with a helical unit (thickness 4 mm, reconstruction interval 4 mm, pitch 1.5), after intravenous contrast agent (120 ml) infusion (3 ml/s, 55 s acquisition delay from bolus starting) and using a power injector. The following CT findings were searched for: whirl sign, beak sign, extraluminal fluid, bowel loop dilatation, bowel wall thickening, bowel wall or mesenteric alterations. RESULTS: Plain abdominal film showed the following findings: air-fluid levels (92.4% of cases), bowel loops dilatation (71.2%), site of obstruction (42.4%). Abdominal sonography demonstrated bowel loop dilatation (48.5%), extraluminal fluid (48.5%), peristalsis alteration (27.3%), bowel wall thickening (27.3%). The most frequent CT findings were: bowel loop dilatation (95.5%), bowel wall thickening (78.8%), beak sign (69.7%), mesenteric alterations (66.7%), extraluminal fluid (54.5%), whirl sign (13.6%). CONCLUSIONS: Air-fluid levels and bowel loop dilatation were the most frequent radiological findings in our series. Plain abdominal film allowed us to identify signs of obstruction, whereas signs of bowel wall necrosis were accurately shown by abdominal CT.

Adult↗
PubMedDate not supplied

[Helical CT as preferred imaging modality in the diagnosis of pulmonary embolism].

PURPOSE: We investigated the role of Helical Computed Tomography (CT) as primary screening imaging modality in the diagnosis of pulmonary embolic disease. MATERIAL AND METHODS: We retrospectively reviewed the CT examinations, resulted positive for pulmonary embolism, performed in 134 patients (69 men and 65 women, ranging in age 23-83 years) from June 1998 to June 1999. CT was performed with a helical unit (thickness 3 mm, reconstruction interval 2 mm, pitch 1.5) after intravenous contrast agent (120 mL) rapid infusion (4 mL/s, 15s acquisition delay from bolus starting) and using a power injector. The spiral acquisition was performed from the apex of the pulmonary trunk to the diaphragm. Pulmonary embolism was considered as complete when a filling defect was present in a main pulmonary artery, as moderate when a filling defect was observed in an interlobar pulmonary artery and as very small when a filling defect was identified in a segmental pulmonary artery. RESULTS: Helical CT allowed us to identify the presence of a filling defect in the main pulmonary artery in 60.4% of cases (complete pulmonary embolism), in an interlobar pulmonary artery in 27.6% of cases (moderate pulmonary embolism) and in a segmental pulmonary artery in 11.9% of cases (very small pulmonary embolism). At helical CT study, pulmonary embolus was identified as complete filling defect (92.5% of cases), thromboembolic mass floating freely in the lumen (28.3%) and partial filling defect (19.4%). Pleural effusion and pulmonary infarction were associated in 46.2% and 20.1% respectively. DISCUSSION AND CONCLUSIONS: Pulmonary embolic disease continues to be a major cause of morbidity and mortality. The clinical diagnosis of pulmonary embolism remains an important challenge: among the different imaging modalities, contrast-enhanced helical CT can be used as primary screening imaging modality in the diagnosis of pulmonary embolism, allowing us to detect the presence of pulmonary embolus in the main, lobar and segmental artery, as demonstrated in our experience.

Adult↗
PubMedDate not supplied

[Microbial etiology of subclinical bovine mastitis in the Santa Fe dairy basin].

A study of 320 samples of mammary quarters from cows in 40 dairy farms around Santa Fe city during 1977-1978 was made. The samples were selected based on clinical examination and California Mastitis Test (GMT). High percentage of subclinical mastitis was found. The etiological agents most frequently isolated were Staphylococcus aureus (54,1%), Streptococcus agalactiae (23.4%) and Pseudomonas aeruginosa (13,2%). A winter increment of S. aureus (48,1%) and P. aeruginosa (3,7% and 22,5%) was observed. But S. agalactiae did not experiment considerable variation (26,8% and 20% throughout the year. The sensitivity to antibiotics of some strains decreased in winter specially in S. aureus and P. aeruginosa (61,5% and 38,9%), and some biochemical properties related with their virulence increased. Penicillin in milk was not detected, but the levels of contamination by non specific inhibitory substances were very high (40%). Besides it was found a great contamination with aerobic sporeforming bacteria in these samples, being Bacillus coagulans (59,1%), B. polymyxa (26,1%) and B. sphaericus (9,5%) the most frequent.

Animals↗
PubMedDate not supplied

MR findings in a case of exogastric stromal tumor of the stomach.

A case of gastrointestinal stromal tumor of stomach investigated with US, CT, and MRI is reported. On imaging, the neoplasm arises from the wall of the gastric fundus and appears well circumscribed and sharply demarcated from the adjacent structures. MRI provides an excellent means of evaluating the site and extension of this neoplasm and enables accurate surgical planning. The authors stress that there has been recently widespread scientific and clinical interest in GIST (gastrointestinal stromal tumor) because its principal pathogenetic defect has been identified and a specific molecular inhibitor of GIST has been developed.

Aged↗
PubMedDate not supplied

[Proposal of health care program for workers of Large Organized Distribution].

The whole of trading enterprises with many average/big saling-centres forms what is today commonly known as Large Organized Distribution (LOD). The main risks regarding the people working in the LOD are: MM, repetitive motion of upper limbs, fixed postures, unfavourable microclimatic conditions and, moreover, the probability of labour accidents. In order to analyse the risks due to MM and false postures, we have used the ergonomic software "Classic Jack" distributed by EAI-UGS, which has been very helpful to find out the most dangerous labour operations (e.g. charging and discharging of goods, fragmentation and reassembling of manufactures, goods-shelving, branding and labelling). We have, then, suggested a programme of health surveillance that includes a medical examination, eventual x-ray exams, specialized examination and a posturologic visit. This posturologic visit has got an olistic diagnostics approach, whose research after the causes that could be responsible for the checked diseases concerns not only the damaged area, but also other parts of the body (ocular system, auditive system, podalic system, masticatory apparatus).

Accidents, Occupational↗
PubMedDate not supplied

[Thymidine kinase as a biological marker in neoplasms of the lung and mediastinum].

Thymidine kinase (TK) is a biological marker recently used in diagnosis and monitoring of pulmonary and mediastinal malignant neoplasms. Authors report more recent clinical evidences of literature and, in the meanwhile, they report their personal experiences about a 20 patients group suffering of lung cancer and Hodgkin disease. Their study demonstrates a good sensitivity of TK as biological marker of SCLC and a lower sensitivity in case of NSCLC and Hodgkin disease. It has been possible to contribute to establishment of normal range values, on account of 10 healthy volunteer group blood sample assays.

Aged↗
PubMedDate not supplied

[Tumor markers in lung neoplasms].

The authors studied the variations of the markers isolated or in differently associations, in pulmonary pathology. The results from linear multivaried analysis, applied to CER, TPA, Ca 125, Ca 15.3 and calcitonin, are particularly interesting in diagnosis.

Adult↗
PubMedDate not supplied

Nutritional and hormonal effects of biosynthetic human growth hormone in surgical patients on total parenteral nutrition.

The anabolic effects of biosynthetic human growth hormone (BHGH) were tested on 30 patients, aged 37-68 yr, divided into four groups: group 1 received surgery plus total parenteral nutrition (TPN) plus BHGH, group 2 received just surgery and TPN, Group 3 received TPN and BHGH, and group 4 received just TPN. TPN was given as an all-in-one formula (glucose 4.7 g.kg.-1day-1, amino acids 1.2 g.kg-1.day-1, lipids 0.7 g.kg-1.day-1, electrolytes and trace elements. BHGH (0.25 IU.kg-1.day-1) or placebo were administered subcutaneously at 0800 for 10 days. Nitrogen and phosphorous balance, as well as the common plasma nutritional markers (transferrin, albumin, prealbumin), triglycerides, apolipoprotein B, insulin, and cortisol were evaluated daily. Urinary creatinine loss was evaluated on days 3, 7, and 10. Cumulative nitrogen balance was better in group 1 (-16.1 +/- 3.2 g N2) than in group 2 (-33.7 +/- 4.6 g N2) (P less than 0.01), whereas the difference was nonsignificant in groups 3 and 4. Phosphorous balance and creatinine excretion paralleled nitrogen balance. Plasma markers were not significantly improved in group 1 compared with group 2; however, they were significantly better in group 3 than in group 4. Lipids were better metabolized in the BHGH-treated groups. Insulin was increased in both groups 1 and 3, whereas cortisol did not rise after surgical stress, probably because of BHGH administration. A positive effect of BHGH on nutritional status and hormonal background is suggested by these data.

Adult↗
PubMedDate not supplied

Subclinical hypothyroidism and hyperprolactinemia.

The authors have studied 25 women aged 22 to 26 years with a diagnosis of prolactinemia moderately increased in primary sterility. Among 25 women under observation, 7 (28%) showed a hormone picture of subclinic hypothyroidism. In fact the evaluation of TSH after stimulation with TRH showed a curve typical of the subclinic hypothyroidism. In 8 women (32%) the authors have found an increase of the thyroid gland, and in 3 patients (12%) galactorrhea. The increase of volume of the thyroid gland was constant in all the women with subclinic hypothyroidism. Considering the results obtained by this study, the authors point out a correlation between subclinic hypothyroidism-hyperprolactinemia and sterility. The data obtained are in accordance with that has been reported in literature.

Adult↗
PubMedDate not supplied

[Computerized tomography in pulmonary cystic fibrosis].

This study was aimed at evaluating CT sensitivity in identifying the signs of pulmonary cystic fibrosis (CF). The chests of 39 patients (16 males and 23 females, mean age 19.1 years) were examined by CT: all patients had been given a clinical score according to Schwachman and Kulckzycki criteria. Thickened bronchial walls were observed in all cases, which are typical of peribronchitis. Bronchiectases were present in 87% of cases; their extent, pattern and localization were exactly shown on CT scans. Bronchoceles were seen on CT scans in 64% of patients; less frequent was the finding of atelectases and subpleural bullous emphysema. In a great number of patients (64% and 82%, respectively) pleural thickening and hilar adenopathy were demonstrated on CT scans. In conclusion, our results confirm CT as a more sensitive method than conventional radiography to identify and locate the signs of pulmonary CF. The early identification of the lesions is of high prognostic value, since the early detection and treatment of bronchoceles may prevent permanent bronchiectasis.

Adolescent↗
PubMedDate not supplied

Laparoscopic findings and hormonal patterns in the treatment of endometriosis by danazol.

The authors have studied, in 120 women with sterility, the incidence of endometriosis in the laparoscopic diagnostics, the development of pathology after the treatment by Danazol alone (600 mg/daily/6 months) or preoperative Danazol and subsequent conservative surgery, the sera RIA levels of FSH, LH, PRL, 17 beta-oestradiol and progesterone during therapy, the pelvic findings in the laparoscopic second look and the pregnancy rates after the treatment. On the findings of the obtained results, which agree with the most recent studies, the authors point out the significance of laparoscopy in the diagnosis and staging of endometriosis; the correlation between staging and different therapies; the peculiarity of the laparoscopic second look in monitoring endometriosis evolution after therapy and at last the deep correlations, not yet well explained, among the mild endometriosis and alterations as the luteal phase defect and the anovulatory both in the acute fitness of the pathology and after treatment by Danazol alone or preoperative Danazol with subsequent conservative surgery as shown by persistence of sterility or of infertility, although without other well-known reasons which could explain the subsequent pregnancy failures.

Adult↗