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Biomedical subjects

M Cazzaniga

Publications and source records attributed to M Cazzaniga.

83 records · Page 5Linked to original sources
PubMedDate not supplied

[Aortic-left ventricular tunnel. Long-term surgical results].

OBJECTIVE: The aim of this work is to describe the different aspects of diagnosis and postoperative follow-up in four patients after surgery for aortic-left ventricular tunnel (ALVT). The surgical techniques and results have been published, in the literature but there are no reports about the progression of aortic regurgitation. METHOD: We reviewed the clinical features of four patients operated with ALVT. The clinical information (electrocar-diograms, echocardiograms and catheterilution) was studied in the preoperative period. Surgical technique and postoperative evolution were analysed. The follow-up period ranged between 4.7 and 13 years. RESULTS: In a 14 years period, four children (2 boys and 2 girls), were operated for ALVT. The mean age at the time of diagnosis was 8.5 years (ranged between 1 month and 14 years). A continuous murmurs was present in all cases, associated to cardiac failure in the youngest patient (1 month old). The clinical diagnosis was ALVT in the four cases but only in two the echocardiographic study showed correctly the anatomic aspects of the malformation. The angiohemodynamic study was correct in three patients and the differential diagnosis was made in last one with rupture of aortic sinuses of Valsalva to the left ventricle. All cases were operated; with direct closure of the aortic orifice (two cases), or with dacron patch (two cases). In one case aortic valve replacement was also performed. There was not mortality and the mean age at the time of surgery was 9 years (1.5 months and 14 years). The mean follow-up was 8.5 years (ranged between 4.7 and 13 years), three patients showed clinically and in the echocardiogram study an aortic valvular regurgitation without ALVT deshiscence. All cases are asymptomatic. No patient was reoperated. CONCLUSION: The surgical treatment of ALVT must be done as soon as the diagnosis is made to prevent left ventricular enlargement, ventriculo-aortic floor distortion and aortic valvular lesion. A precise echocardiographic study is necessary to avoid catheterization. This study provided a clear knowledge of anatomic structure of the ALVT for both clinician and surgeons. This information is important in order to obtain an optimal surgical success, particularly to prevent the valvar aortic regurgitation.

Aortic Valve Insufficiency↗
PubMedDate not supplied

Inhibition of tumor necrosis factor-alpha secretion by pentoxifylline in advanced cancer patients with abnormally high blood levels of tumor necrosis factor-alpha.

TNF, in addition to its antitumor activity, would play an important role in the pathogenesis of cancer-related severe complications, including ARDS and DIC. Therefore, the modulation of TNF secretion could be important in the supportive care of advanced cancer patients. At present, PTX is the only drug which has been proven to be able to inhibit in vitro the release of TNF. The present study was performed to evaluate the effect of PTX on TNF blood concentrations in disseminated cancer patients with abnormally high TNF values. The study included 14 cancer patients, with initial or conclamate signs of ARDS (n = 8) or DIC (n = 6). PTX was given intravenously at a dose of 300 mg/day for 7 days. Mean serum levels of TNF significantly decreased in response to PTX therapy, and they returned to normal range in 5/14 patients. These preliminary data would suggest that PTX may be considered as a biological response modifier, capable of inhibiting TNF secretion in humans, with a following potential use in the treatment of cancer-related severe complications.

Adult↗
PubMedDate not supplied

Cytokine regulation of iron metabolism: effect of low-dose interleukin-2 subcutaneous therapy on ferritin, transferrin and iron blood concentrations in cancer patients.

It is known that the anemias of chronic diseases, which often occur in neoplastic and in systemic inflammatory disorders, are characterized by high levels of ferritin associated with generally low iron concentrations, by suggesting an iron transfer defect due to unknown factors. Since both chronic inflammatory diseases and advanced neoplasms are characterized by alterations in the endogenous production of cytokines, a possible involvement of interleukins in chronic disease-related anomalies of iron metabolism cannot at present be excluded. The present study was carried out to investigate the effect of low-dose IL-2 subcutaneous immunotherapy (3 million IU/day for 6 days/week for 4 weeks) on ferritin, transferring and iron serum levels in cancer patients. Six patients with metastatic gastrointestinal carcinomas were evaluated. Ferritin mean levels significantly decreased during IL-2 treatment, and this finding was associated with a significant increase in transferrin values. Iron mean levels increased in response to IL-2, without, however, significant differences in respect to the pretreatment concentrations. These preliminary data, by showing changes in ferritin, transferrin and iron in cancer patients during the immunotherapy with IL-2, would suggest the existence of a cytokine regulation of iron transfer from tissues to blood, perhaps by modulating the macrophage function.

Adult↗
PubMedDate not supplied

[Cholecystectomy with laparoscopy and laparotomy. Analysis of the complications].

Laparoscopic cholecystectomy (LC) has been adopted by many as the treatment of choice for uncomplicated biliary lithiasis; since an increasing number of surgeons use LC even in complicated cases, we examined our series in order to see if this is the correct procedure. We report on the results of our first 252 LC and compare them with our latest 66 open cholecystectomies, in order to evaluate number and importance of postoperative complications. Besides we compare complications in patients below and over 60 years of age to verify if age bears any significance. We found no difference in frequency of complications among patients younger or older than 60; highly significant is, on the contrary, the difference in complications between the two procedures, the incidence being much lower in the laparoscopic one. We state that LC is a safe and effective procedure and suggest it as the method of choice for the treatment of any symptomatic gallbladder stone disease.

Adolescent↗
PubMedDate not supplied

[Deep venous thrombosis and neoplastic pathology: our experience in emergencies].

Deep vein thrombosis incidence is 1/1000 per year; it is associated with many risk factors which is considered as "thrombophilic states". Its pathogenesis is complex, caused by alterations of hemostasis system. Many studies have established the relation between cancer and subsequent venous thromboembolism, confirming the relationship of neoplastic cell interaction with coagulation system. Forty-seven patients admitted to the hospital from 1987 to 1996 with symptomatic clinically proved deep vein thrombosis were included in a retrospective study. Routine examination at the time of diagnosis of deep vein thrombosis revealed an occult cancer in 8 out of 47 patients; 9 out of 47 patients were admitted in hospital with vein thrombosis and known cancer. The aim of this study is to suggest the best, first treatment of vein thromboembolism in emergency to avoid the dangerous pulmonary embolism complication. The patients affected with deep vein thrombosis and cancer were elderly (over 70 years old, in mean); the neoplasia was of digestive system (8/17) in advanced metastatic stage there was cancer familiarity in 7 out of 47 patients. The high risk of pulmonary embolism associated to deep vein thrombosis suggests the importance of early starting the anticoagulant therapy and placing caval filter.

Adolescent↗
PubMedDate not supplied

[Seveso: biological monitoring of dioxin pollution. An example of environmental medicine. Multicentric and interdisciplinary applied research].

In 1976 the population of an area including Seveso (about 30,000) affected by the fallout of a toxic cloud containing 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) started a health monitoring plan which lasted until 1985. Smaller groups were monitored until 1997. The large number of people and the different toxic effects on organs have gathered different discipline experts including informatic. This work has permitted the not easy observation both of minor and bigger effects during two decades.

Environmental Medicine↗