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Biomedical subjects

M Rossetti

Publications and source records attributed to M Rossetti.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Distal Y-gastrectomy in complex and recurrent reflux].

The consequences of mixed esophagitis due to acid-peptic as well as biliary-pancreatic reflux are widely known today, even though they are partly accompanied by physiopathologic speculations. Much seems to indicate that the biliary component causes most pathologic modifications in the esophagus as the peptic reflux alone, such as Barrett, secondary brachyesophagus, strictures and even malignancy. In advanced cases with functional failure of the upper and lower sphincter, as well as the development of serious perifocal fibrosis in the thoraco-abdominal region or, often, in the cases with a multifactorial pathology after anti-reflux surgery, standard operations of the cardia is no longer possible. For many years resections or interpositions were proposed despite their morbidity, lethality and quality of life. The distal gastrectomy in healthy tissue with a long-Roux-Y drainage has proved to be a successful procedure. We present a study of 43 cases with an interesting pathology, as well as indications and long-term results.

Esophagitis, Peptic↗
PubMed1989

[Technical and tactical development in antireflux surgery. What is left for the surgeon?].

Clinical research, increasingly objective diagnoses, tactical and technical progress have eventually led to the modification and improvement of antireflux surgery, although this evolution has not been without errors due to misinterpretation, faulty indications and methods. Conservative management has changed to include a whole gamut of pharmacological treatments, which have consistently tended to reduce indications for surgery--often rightly so, but doggedly at times. The present paper presents a review of our methods since the first fundoplication was performed, in 1955. Further achievements and adaptation of our methods to the different types of functional and organic reflux are discussed. The efficacy of surgery with predictable risk, good results and few side effects, even in the long run, permit us to make a case for this indication in a series of situations, where surgery is the sole logical solution for a less distressing life, as well as for avoiding dangers linked with irreversible organic complications. Methods and casuistics (over 2,000 personal cases) are illustrated in the course of this presentation.

Gastric Fundus↗
PubMed1989

[Intravagal fundoplication and cardiofundal vagotomy: a technical physiologic variant in surgery of reflux].

In treating hyperacid gastro-esophageal reflux it is debatable whether or not to combine an antireflux operation with an antipeptic procedure. The problem is controversial as evidenced by the number of operative procedures and the diverse opinions in published reports. We believe that if there is an increased gastric acid secretion the combination of fundoplication and vagotomy is a logical alternative to long-term treatment with H2-receptor antagonists or with the new H+ protone blocker Omeprazol, especially when these conservative measures fail. The superselective vagotomy poses technical problems for it compromises the anchorage of the fundic wrap. On the other hand truncal vagotomy, though technically simpler, is unacceptable because of its associated side effects. As a result we have come to modify our standard technique. We combine a selective denervation of the esophago-gastric junction with a modification to our standard fundoplication procedure, whereby the fundic wrap is drawn forward between the vagal trunks and the lesser gastric curvature. In the last five years we have operated 58 patients in this combined way. We were able to carry out follow-up controls in 32 patients. All of them showed good long-term healing with improvement of reflux symptoms.

Follow-Up Studies↗
PubMed1988

[Reflux disease and cancer].

The malignant potentiality of endobrachy-oesophagus and other organic forms of reflux disease amounts to ten per cent, according to experience obtained by the author of this paper and examiners elsewhere. Two thirds of the neoplasias were found to be located in the distal part of the oesophagus and one third in the centre. Lasting reflux and gradual transition to dysphagia were recorded only from 50 per cent of all cases. The author's approach to operable cases is abdomino-thoracal. Decisions on operability and radicality are usually based on laparotomy. The stomach is mobilised and, following removal of the tumour, is moved up as high as possible to the right thoracic cavity where it is anastomosed to the proximal oesophageal stump. The author analysed his patients under all relevant aspects and summarised in tabulated form classifications, origins, operability, and results. Early surgical treatment of aggressive reflux disease (abdominal fundoplication or complementary vagotomy, depending on acid potential) may reduce but not completely eliminate the risk of malignant degeneration. Preventive removal of endobrachy-oesophagus is not justifiable for the high biological price involved.

Adenocarcinoma↗
PubMed1987

Captopril and nifedipine interactions in the treatment of essential hypertensives: a crossover study.

In order to evaluate the antihypertensive effect and the tolerability of combination therapy with an angiotensin converting enzyme inhibitor (captopril) and a dihydropyridine calcium antagonist (nifedipine) compared with monotherapy and placebo, we studied 32 uncomplicated essential hypertensives. At the end of a 1-month placebo washout period, their diastolic blood pressure was greater than 105 and less than 120 mmHg. The subjects then received, according to a double-blind randomized crossover design, captopril (50 mg twice daily), nifedipine (20 mg twice daily), captopril plus nifedipine at the same doses and the corresponding placebo, each treatment being given for 1 month. Both captopril and nifedipine significantly reduced mean blood pressure, which was further and significantly reduced by the combination of the two drugs. The decreases in mean blood pressure induced by nifedipine were significantly greater than those induced by captopril, and those induced by the combined therapy were significantly greater than those induced by either drug on monotherapy. The heart rate was significantly increased only by nifedipine, and to a similar, but not significant, extent by the combination therapy. Plasma renin activity was similarly and significantly increased and urinary aldosterone tended to decrease to a similar extent under the three active treatments. Adverse effects were mild to moderate in intensity; their incidence under captopril was lower than that under placebo, while the incidence under nifedipine and combined therapy was greater than under placebo. Ankle oedema disappeared under the combined therapy in three out of four patients who developed this side effect under nifedipine, although one additional patient developed ankle oedema under combination therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Echo-Doppler velocimetry in the diagnosis of renal artery stenosis on transplanted kidney.

Renal artery stenosis is one of the most important complications in the natural history of kidney transplantation. Particular care has to be taken in the use of angiography techniques because of the invasiveness and of the potential toxicity of radiopaque contrast material, even in the less invasive radiological tests, like endovenous sequential angiourography with image subtraction (SAU) and digital subtraction angiography (DSA). Fifty-one patients have been examined with echo-Doppler velocimetry (EDV) and also with SAU in order to verify the previous status of the artery. EDV exhibits a 100% sensitivity: all SAU detected stenosis have been formerly identified via EDV. The non-invasiveness and possibility of early repetition allows an early diagnosis capability for all transplanted patients. In this way, a surgical intervention may quite often be prevented by a precocious use of endoluminal angioplasty.

Adult↗
PubMed1985

[Acari of food storage facilities. An ecologic and immuno-allergic study].

The authors studied the commonest species of storage mites, living in granaries and in house dust. They found nine species of mites belonging to different systematic groups and were identified: Acarus siro, Tyrophagus putrescentiae, Glycyphagus domesticus, Lepidoglyphus destructor, Chortoglyphus arcuatus, Androlaelaps casalis, Cheyletus fortis, Cheyletus tenuipilis, Thyreophagus entomophagus. Skin tests were performed on 14 patients with house dust allergy, using extracts of three storage mites, most commonly found in house dust (Acarus siro, Glycyphagus domesticus, Lepidoglyphus destructor) and Euroglyphus maynei, Dermatophagoides pteronyssinus, Dermatophagoides farinae. The results of the skin tests have suggested that sensitization to storage mites may be due a degree of cross-reaction between storage species and the two Dermatophagoides.

Acari↗
PubMed1984

[Mass accident and catastrophe medicine].

Medical management of mass casualties and catastrophy are discussed and principles of treatment outlined, consisting in first aid, improvisation, sorting (triage), organised help and avoiding panic and epidemics. Preparedness and leadership, summarised under the heading "catastrophy planning" are the most important elements to counteract catastrophies.

Accidents↗