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Biomedical subjects

M Pagani

Publications and source records attributed to M Pagani.

221 records · Page 13Linked to original sources
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[Prophylactic cholecystectomy for gallbladder calculosis].

Asymptomatic gallstones are defined as stones that have not caused biliary colics or other biliary symptoms. Some cross-sectional epidemiological screening studies have shown that as many as 66% to 77% of patients with gallstones are asymptomatic. Studies of natural history suggest that the cumulative probability of developing biliary colics after ten years ranges from 15% to 25%. None of the variables considered as possible modifiers of natural history, were found to be associated with an increased risk of incidence of biliary colics. Cholecystectomy is a vary safe treatment and is being performed with near zero mortality. Two are the possible strategies compared: prophylactic cholecystectomy with expectant management for silent gallstone disease. Consideration of survival and monetary costs disfavors prophylactic cholecystectomy. The results of laparoscopic cholecystectomy compare favorably with those of open cholecystectomy with respect to mortality, complications, length of hospital stay, cosmetically satisfactory and financial benefits. Patients with asymptomatic stones in the gallbladder require neither surgical nor medical treatment. Consideration of monetary costs disfavors prophylactic cholecystectomy: a waiting attitude has the advantage of lowering the sanitary costs also for the high incidence of silent gallstones in our population.

Cholecystectomy↗
PubMedDate not supplied

Neurovegetative regulation and cardiovascular diseases.

Heart period and arterial pressure short term variabilities contain rhythmic oscillations which might provide information on neural mechanisms regulating cardiovascular function. Continuous electrocardiographic and/or arterial pressure signals, after appropriate analogue to digital conversion, furnish the time series which constitute the basis for spectral analysis of their variabilities. Under stationary conditions, this methodology can be utilized to assess both total variability and the power and center frequency of each rhythmic component. Human physiological and animal studies support the hypothesis that the low frequency (LF) component, around 0.1 Hz, is a marker of sympathetic modulation of both R-R and arterial pressure variabilities, while the high frequency (HF) component, around 0.25 Hz, is a marker of vagal modulation of R-R variability. LF/HF ratio of R-R variability is a marker of sympatho-vagal balance. Spectral components when assessed for a 24-hour period evidence marked circadian rhythmicity with sympathetic predominance during the day and vagal predominance at night. Various pathophysiological conditions including arterial hypertension, ischemic heart disease, cardiac transplantation, congestive heart failure, Chagas' disease and diabetic neuropathy have been explored with this methodology, and a new quantitative evaluation of the alterations in sympatho-vagal balance which seem to characterize these abnormal states has been obtained. The study of cardiovascular rhythmicity, i.e. an analysis performed in the frequency domain, although based on indirect spectral markers, seems to offer a new clinical tool for the exploration of cardiovascular neural control in health and disease.

Cardiovascular Diseases↗