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Biomedical subjects

P Fenderico

Publications and source records attributed to P Fenderico.

3 recordsLinked to original sources

Campylobacter jejuni enterocolitis presenting as inflammatory bowel disease.

We report a case of Campylobacter jejuni enterocolitis presenting as inflammatory bowel disease in a 19-year old woman. After a useless course of corticosteroids, ceftazidime and metronidazole, she was successfully treated with erythromicin. Campylobacter species represent an important cause of gastroenteritis in children and adults. The rate of Campylobacter isolation is 5-6 per 100,000 persons. This rate, however, grossly understimates the actual number of Campylobacter infections. In most cases, Campylobacter enteritis is a self-limiting disease, rarely associated with severe complications. Our case demonstrates the difficulty in distinguishing inflammatory bowel disease (Crohn's disease or ulcerative colitis) at onset from atypical infectious colitis. Unfortunately, corticosteroids (necessary for the treatment of inflammatory bowel disease) may exacerbate infectious etiologies. Campylobacter jejuni should be ruled out when assessing inflammatory bowel diseases at onset (as during flare-ups), especially if corticosteroids or immunosuppressive therapies are required.

Adult↗

Evaluation of the vascular pattern of hepatocellular carcinoma with dynamic computed tomography and its use in identifying optimal temporal windows for helical computed tomography.

The aim of this work was to study the vascularization of hepatocellular carcinoma (HCC) by means of dynamic CT and to demonstrate the existence of optimal temporal windows for visualization of HCC in order to develop new protocols for helical CT of the liver. We studied, by means of dynamic CT, 42 histologically proved HCCs in 30 patients after injecting contrast medium (100 ml, 3 ml/s). We performed a time-density analysis of the aorta, liver, portal vein, spleen and lesion. We identified three temporal curves of attenuation of the neoplastic tissue. Curve 1 was three-phasic: hyperattenuation, isoattenuation and hypoattenuation; curve 2 was two-phasic: hyperattenuation and isoattenuation; curve 3 was two-phasic: isoattenuation and hypoattenuation. Thirty-two lesions were homogeneous (curve 1 in 22 cases, 68.7 %; curve 2 in 7 cases, 21.8 %; curve 3 in 3 cases, 9.4 %), whereas 10 lesions were non-homogeneous. Two optimal temporal windows were identified: the first, with predominantly hyperattenuating lesions (range 29-65 s, 90.4 % sensitivity); the second, with predominantly hypoattenuating lesions (range 132.1-360 s, 76.1 %). There is an interposed time range of reduced visualization (range 62-127 s, 54.7 %) in which lesions are isoattenuating. Combined CT study during the first and second temporal windows improves the detection of HCCs especially for homogeneous and small lesions. The intermediate isoattenuation time range does not increase lesion detection rate.

Aged↗

Electrogastrography.

Electrogastrography (EGG) is the recording and the interpretation of gastric electrical activity. Recordings can be made from the gastrointestinal mucosa, serosa, or skin surface. Because of its ease of use, cutaneous EGG has gained wide acceptance. Many technical problems have been solved to obtain a good graph. The EGG is usually evaluated in terms of changes in the EGG waves amplitude and frequency. Deviations from the normal frequency of 3 cycles per minute may be referred to as brachy- or tachyarrhythmia. The clinical use of EGG has been most widely evaluated in patients with gastroparesis and functional dyspepsia. Scintigraphic gastric emptying is considered the gold standard test for evaluating gastroparesis and 13C-octanoate breath test an ideal alternative because does not use ionizing radiation. While gastric emptying evaluates the efficiency of gastric emptying, EGG focuses on the underlying myoelectrical activity. Using both EGG and 13C-octanoate breath test will be possible to detect many subset of dyspeptic patients and to understand the underlying problem.

Breath Tests↗