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Biomedical subjects

M Simi

Publications and source records attributed to M Simi.

At least 55 records · Page 3Linked to original sources
PubMed1987

Raised plasma concentrations of platelet factor 4 (PF4) in Crohn's disease.

Plasma platelet factor 4 (PF4), secreted by the platelets, is an index of platelet aggregation and thromboembolic risk. The authors assessed PF4 in 20 patients with Crohn's disease (ileitis in 13 patients, ileocolitis in seven) and in 20 healthy volunteers. Disease activity was low (Crohn's Disease Activity Index less than 150) in 11 patients and high in nine. Radioimmunoassay of PF4 using Abbott's Kit was performed on one sample of plasma from each subject (nv less than or equal to 0.324 nmol/ml), (nv less than or equal to 10 ng/ml). A significantly higher concentration of PF4 was found in Crohn's disease patients: 4.625 +/- 1.1 nmol/ml (142.5 +/- 36 ng/ml) than in the control group: 0.189 +/- 0.07 nmol/ml (5.6 +/- 4.8 ng/ml) (Z = 5.396, p less than 0.0001). No correlation was present between PF4 levels and activity, the site of disease, or medical treatment with or without prednisone.

Adult↗
PubMed1986

Recurrence of Crohn's disease after resection. Are there any risk factors?

We report two studies on possible risk factors for postoperative recurrence of Crohn's disease and an extensive literature review. In our retrospective study, 90 patients who had undergone curative resection and anastomosis 1 to 22 years (average 9.3 years) previously were examined. The recurrence rate, calculated by actuarial methods, was 62.2% after 10 years and 86.4% after 15 years. The site of recurrence was clearly related to the initial location of disease (p less than 0.001). However, of the various clinical, pathological, and surgical factors studied, only the preoperative history correlated directly with recurrence (p less than 0.05). The prospective study evaluated the influence on recurrence of microscopic lesions at grossly free margins of ileocecal resection. Twenty-two consecutive patients, operated on for Crohn's disease of the terminal ileum from 6 to 34 months previously (average 24 months), were studied. From the histological grading previously established, recurrence was independent of involvement at both proximal and distal section lines. Therefore, we recommend conservative resection to obtain only grossly uninvolved margins.

Actuarial Analysis↗
PubMed1985

Exaggerated response of thyrotropin to thyrotropin-releasing hormone in patients resected for Crohn's ileitis.

We have studied the response of thyrotropin to exogenous thyrotropin-releasing hormone in 13 patients who had previous intestinal resection for Crohn's disease, and in 42 healthy controls. An exaggerated and prolonged response curve was found in eight of the patients and one control (P less than 0.01), while baseline hormone levels were normal in all. These results may be related to the state of iodine deficiency known to develop in inflammatory bowel disease, but the pathophysiology requires further elucidation.

Adult↗
PubMed1985

Cancer of the large intestine and previous cholecystectomy: does a relationship really exist?

The possible relationship between cancer of the large intestine and previous cholecystectomy has been studied both experimentally and clinically but the results are contradictory. The present study, carried out in 250 patients undergoing intestinal resection for colorectal cancer and in 200 subjects who underwent cholecystectomy more than 10 years previously (with control groups) did not evidence any statistically significant relation (p = 0.2) between cholecystectomy and cancer of the large intestine. On the basis also of data from the literature, the etiopathogenetic hypotheses of the supporters of such relationship are reviewed and the different factors potentially able to explain the discrepancy between the concordant results of experimental studies and the contrasting ones of the clinical and epidemiologic experiences are examined. From the practical point of view, it is felt that a periodic (once a year) clinical and laboratory (guaiac test) control followed, when necessary, by x-ray/and or endoscopic examination should be carried out in all the patients over the age of 40, cholecystectomized since 10 years of longer, especially if females.

Adult↗
PubMed1983

Blood coagulation alterations and thromboembolism in Crohn's disease.

The present study was undertaken in view of the higher incidence of thromboembolism in patients with Crohn's disease. The blood coagulation system was studied in 12 patients previously operated for Crohn's disease (8 cases of ileitis, 4 cases of colitis) and followed as out-patients. In 75% of cases, the disease was in an inactive stage. Eight patients showed slight lipid malabsorption. Serum levels of fibrinogen, platelets and factor V were shown to be significantly increased (p less than 0.001) as compared to controls. Prothrombin time and factors II, VII and X were shown to be decreased, while factors VIII and IX and antithrombin III were not significantly altered. Thrombocytosis and hyperfibrinogenemia, as reported in literature, seem to determine a condition of blood hypercoagulability, playing therefore a primary pathogenetic role in the genesis of thromboembolism in patients with Crohn's disease.

Blood Coagulation↗
PubMed1983

Indications, strategy and results of surgical management in 141 cases of Crohn's disease.

Of 200 cases of CD observed in the course of twenty years, 141 (70.5%) have been treated by surgery. At the time of surgery, 6 patients had duodenitis, 87 ileitis, 35 ileocolitis, 9 colitis and 8 proctocolitis. In 4 cases the duodenum and ileum were simultaneously involved. Complications of the disease and failure of medical treatment represented the indications for surgery. Elective surgery was possible in 74.5% of cases. Intestinal resection was performed in all cases except for 6 by-passes (4 for duodenal obstruction) and 3 external derivations (1 ileostomy for perforation, and 2 colostomies: one for colovesical fistula and another for a rectovaginal fistula). Surgical strategy mainly depended on the site, number and extent of lesions, together with complications arising from them. Data from preoperative absorption tests and intraoperative measurements of the small bowel were useful aids in determining whether a resection was to be "radical" or "limited". Overall p.o. mortality was 4.2%. The follow-up (from 2 to 21 years) showed a long-term mortality rate of 5.7%. The rate of recurrences was 55.2%. However surgical management undeniably improved the quality of life, that was in fact good, or fairly good, even in the great majority (81.2%) of patients with recurrences.

Adolescent↗
PubMed1982

Transduodenal papillostomy as a routine procedure in managing choledocholithiasis.

The purpose of this study was to evaluate the results of transduodenal papillostomy as a routine procedure in managing choledocholithiasis in treating common bile duct (CBD) stones. From 1973 to 1978, 117 patients underwent transduodenal papillostomy for CBD lithiasis. The operation was carried out in standard manner, and all patients had preoperative telecholangioscopy, cholangiography, and biliary manometry. The mean age of patients was 53.7 years, and women predominated in a ratio of 4.5:1.0. Papillostomy was performed together with cholecystectomy for CBD stones in 111 patients (group 1). In five patients, we had to perform a choledochotomy to remove the stones after an unsuccessful papillostomy (group 2). Eight patients who previously had cholecystectomies underwent papillostomy for retained or recurrent stones (group 3), and three patients had a choledochoduodenostomy for recurrent stones after a previous cholecystectomy and papillostomy (group 4). Complications included two deaths in group 1 (1.9%). No mortality was observed in groups 2 and 4. Moreover, the overall morbidity was due to six cases of wound infection, one case of postoperative bleeding, one case of phlebitis, and three cases of cholangitis. The mean length of hospital stay was 12.9 days, considering all the groups. Lack of confidence with this procedure may explain the different results reported in the literature for transduodenal papillostomy, which on the basis of this study has been shown to ba a valid alternative to supraduodenal choledochotomy in treating CBD stones.

Adult↗
PubMed1979

Intrahepatic lithiasis. Study of thirty-six cases and review of the literature.

In 2,700 operations for biliary tract stones, intrahepatic lithiasis (stones located proximal to the confluence of the main hepatic ducts) was discovered in 36 patients (1.3 per cent). The diagnosis of intrahepatic lithiasis was determined only via intraoperative chalangiography in thirty-two cases (88.9 er cent); in 23 per cent of our cases of intrahepatic lithiasis, jaundice was never observed. This confirms that intraoperative cholangiography should be performed routinely in every case of biliary lithiasis. The removal of stones was generally performed by an indirect approach (papillostomy and/or choledochotomy). In 16.7 per cent of our cases, a direct approach was indicated. It is extremely important, after removal of calculi, to assure ample bilioenteric flow. Our surgical approach was therefore based mostly on the caliber of the biliary tract. When the tract was dilated less that 2 cm (in 20 cases), choledochohepaticotomy with papillostomy was most often performed (12 cases, 60 per cent). When the dilatation was more that 2 cm (12 cases), Roux-en-Y hepaticojejunostomy was performed in all. There was no operative mortality, although the long-term follow-up results were poor in 9.6 per cent of the cases.

Adolescent↗
PubMed1977

Retained antral mucosa in pancreaticoduodenectomy patients.

Thirteen patients with pancreaticoduodenectomy were studied. In three patients presenting with stomal ulcer or bleeding stomitis, endoscopic biopsies showed the presence of retained antral mucosa (RAM). No disease and no RAM was present in the remaining ten patients. Bombesin (BBS) infusion augmented both gastric acid and gastrin secretion in the group with RAM, whereas no change was apparent in the remaining ten patients. The BBS infusion test is useful in detecting stomal ulcer high risk pancreaticoduodenectomy patients.

Adult↗