[Use of a chronomulticorticoid in the therapy of ulcerous rectocolitis].
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Biomedical subjects
Publications and source records attributed to M Cavallero.
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Peritonitis encapsulans is a clinical interest on account of its rarity and the diagnostic difficulties caused by its aspecific symptomatology. A personal case is presented and its ambiguous clinical and instrumental picture is discussed. Diagnosis was finally obtained intraoperatively, after repeated episodes of mechanical ileus had made surgery mandatory.
1654 cases of tumour of the digestive tube operated on in the Department of General Clinical Surgery and Surgical Therapy of the University of Pavia, during the period 2nd half 1964--1st half 1977, have been considered. Four primary tumours (1 leiomyoma, 2 adenocarcinomas, 1 reticulosarcoma) and one secondary tumour (metastases of retroperitoneal sarcoma) occurred in the jejunum and their pathology is examined from the etiopathogenetic and anatomoclinical viewpoints.
75% of duodenal diverticula occur in the second or descending portion where, in 60% of cases, a juxta-Oddian site is involved. In about 10% of cases, juxta-Oddian forms may be responsible for symptoms due to their own effects or those induced in the biliary and pancreatic area. Two cases in female patients are presented and the subject is examined from all aspects in the light of 85 cases from the literature. Exact preoperative diagnosis is difficult. Radiological examination of the digestive tract and bile ducts, though by no means conclusive, is the only effective instrumental aid. When the symptoms are clear or indicative, surgery is necessary to prevent complications. In the two reported cases, an unevenful course and complete recovery were observed after diverticulectomy combined with papillosphincteroplasty.
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Fasting and after meals serum gastrin levels were determined in healthy subjects and patients with different gastroenterological diseases (duodenal and gastric ulcer, hiatal hernia with gastroesophageal reflux, Billroth II gastric resection, atrophic gastritis, Zollinger-Ellison, Ménétrier, chronic calcifying pancreatitis, gastric carcinoma and lymphoma). The results pointed to the usefulness of evaluating both fasting levels and "gastrin curve" after meals as an expression of the rapidity of response of hormone-secreting gastric cells. Calculation of the I.G.O. (Integrated Gastrin Output) must also be carried out to provide a parameter from which the overall ability of G cells to secrete in response to feeding can be assessed.
On the basis of some experimental observations of hypergastrinemia in animals chronically intoxicated with ethanol, both fasting and after meals serum gastrin were determined in patients affected by chronic alcoholic pancreatitis. A significant increase in serum gastrin levels was observed in patients with chronic pancreatitis compared with controls, both in basal conditions and following food stimulation. The physiopathological hypotheses and possible aetiopathogenetic implications suggested by such gastrin behaviour are discussed.
The physiopathological premises for various methods of hepatic revascularisation are described and results wiht splenohepatoplasty in 40 rats are presented. This operation involves insertion of the upper pole of decapsulated spleen in the left hepatic lobe to create a new parenchymal supply and regenerate the liver cell. The clinical, functional and anatomopathological data are discussed. The experimental value of the procedure is asserted, though it is felt that no sure demonstration can be given of the establishment of newly formed vascular connections between the two organs.
The results of protein deficiency in major burn cases are examined. They include diminished organ resistance, deleyed wound haeling, proneness to infection, and increased sensitivity to liver-toxic substances, leading to the protracted course of the patient's conditions. Since his caloric intake also needs to be increased, the importance of protein replacement is apparent. A standardised 15-day treatment with daily administrations of 1000 cc of a 7.5% natural amino acid solution was experimented during the period following shock, to prevent loss of amino acids through the vessel walls, since permeability is high in this periodo. Marked improvement in blood proteins was noted, with normalisation in some instances. No chagens in blood chemistry attributable to the treatment were noted.
Serum GOT, GPT, LDH, CHE, MDH, SDH, PK, GLDM, LAP and amylase levels and serum ammonia were determined in 49 major burn cases with 2nd and 3rd degree lesions covering 25% to 80% of the body surface. GOT, GPT, LDH, CHE and gamma-GT have above normal in all cases. Limited and inconsistent movements were noted for the remaining enzymes. Blood ammonia was constantly increased and it is felt that the enzyme picture may be of considerable prognostic value in major burn cases.
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Different diagnostic techniques for massive active lower gastrointestinal hemorrhage are reviewed. According to data in the literature and personal experience in 409 emergency endoscopic examinations of the large bowel, emergency colonoscopy is a valuable diagnostic tool in cases of massive colorectal bleeding.
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Cytologic evidence of candidiasis was sought on endoscopic oesophageal brushings from 116 patients with acquired immune deficiency syndrome (AIDS) to determine the reliability of oesophagoscopy and the possibility of predicting Candida spp. oesophagitis from concomitant oral candidiasis or oesophageal symptoms. Oesophageal candidiasis was present in 42 patients and constituted the first opportunistic infection in 19 patients. Sensitivity and specificity were, respectively, 98% and 96% for oesophagoscopy, 69% and 42% for oral candidiasis, 52% and 74% for oesophageal symptoms, and 83% and 35% for the presence of at least one of these last two parameters. Endoscopy also proved to be the examination of choice for diagnosis, and cytology was needed only when it was negative. Oral candidiasis and oesophageal symptoms were not sufficient to predict oesophageal candidiasis. Endoscopy would seem to be indispensable to the diagnosis of oesophageal candidiasis and its differentiation from other forms, thus preventing any empirical resort to unwarranted forms of treatment. It is also indicated for staging purposes in asymptomatic patients, since oesophageal candidiasis is one indicator of the transition to full-blown AIDS.