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Biomedical subjects

P Ronca

Publications and source records attributed to P Ronca.

At least 19 recordsLinked to original sources
PubMed1998

Accuracy of CLOtest after Helicobacter pylori therapy.

BACKGROUND: The accuracy of rapid urease testing after Helicobacter pylori therapy has not been widely studied and might be diminished because of decreased numbers of organisms. We assessed CLOtest results after therapy in two randomized, double-blind trials. METHODS: A total of 233 patients (in two separate studies) with true-positive baseline CLOtests (by histology or culture) received 2 weeks of omeprazole/amoxicillin, omeprazole, or amoxicillin. In study 1, patients received an additional 2 weeks of omeprazole therapy (20 mg/day) or placebo; no additional therapy was given in study 2. Endoscopy was repeated 4 weeks after completion of therapy in both studies. A diagnosis of cure required at least two negative endoscopic biopsy tests (histology, culture, CLOtest) and no positive tests. RESULTS: After therapy, 178 patients (76%) remained positive for H. pylori by histology and/or culture for both studies combined. Post-therapy CLOtest sensitivity was 86% and specificity was 95%. Sensitivity was poorer in patients after dual therapy than after monotherapy in both study 1 (68% vs. 89%; p = 0.03) and study 2 (75% vs. 94%; p = 0.03). CONCLUSIONS: CLOtest sensitivity after therapy was lower than expected in our large group of patients with baseline true-positive CLOtests. In addition, sensitivity was lower after the use of more effective therapy (i.e., dual therapy as compared with monotherapy). Although most patients with unsuccessful treatment will be identified with the CLOtest alone, a negative result should not be taken as diagnostic of eradication.

Amoxicillin↗
PubMed1998

US double-blind, controlled trials of omeprazole and amoxycillin for treatment of Helicobacter pylori.

BACKGROUND: Widely variable Helicobacter pylori eradication rates have been reported with omeprazole/amoxycillin dual therapy. We present the first US double-blind, controlled trials of this dual therapy. METHODS: Three separate studies were performed: Studies 1 and 2 included patients with an active duodenal ulcer and Study 3 included patients with a documented history of duodenal ulcer. H. pylori eradication regimens in all studies were omeprazole plus amoxycillin vs. omeprazole vs. amoxycillin for 2 weeks. Doses in Study 1 were omeprazole 40 mg b.d. and amoxycillin 500 mg t.d.s., and in Studies 2 and 3 they were omeprazole 20 mg b.d. and amoxycillin 1 g t.d.s. Endoscopic biopsy tests were used for H. pylori diagnosis, and testing for H. pylori eradication was done at least 4 weeks after the completion of therapy. Amoxycillin sensitivities were performed in Study 2. RESULTS: Intention-to-treat (ITT) and per protocol (PP) analyses showed that eradication rates with omeprazole/amoxycillin [ITT: 39%, 40%, 46% (n = 72, 62, 48); PP: 50%, 46%, 54% (n = 54, 52, 37)] were significantly greater than monotherapy with either omeprazole (ITT: 0-4%); PP: 0-5%) or amoxycillin (ITT: 2-5%; PP: 0-11%). No patients taking the dual therapy discontinued therapy due to adverse events. Amoxycillin resistance was not seen at baseline (n = 76) or after amoxycillin therapy (n = 56). CONCLUSIONS: Omeprazole/amoxycillin dual therapy is well tolerated but the eradication rate which can be expected in the USA is at best about 50%.

Administration, Oral↗
PubMed1994

[Locoregional complications of stomas. Therapeutic approach].

Principal local complications of ostomies are examined. Etiologic factors and possibilities of treatment are analyzed. These pathologies are often extremely troublesome and their resolution very difficult, unless appropriate therapy is established and, when possible, causal factors removed. However, because of the particular problems of these patients it would be better for them to be assisted by a specialized staff, in qualified centers.

Adult↗
PubMed1994

[Functional and esthetic results of surgery of leg varices].

An experience of 1240 patients suffering from varicose veins of the lower limbs and operated from December 1987 to October 1992, is reported. In order to obtain an objective valuation of functional and aesthetic results, a table with subjective symptoms and clinical and instrumental signs was filled in, before the surgical operation. The correction of anatomic and functional defects and the results so obtained were evaluated by filling in another table after the operation and comparing the postoperative to the preoperative situation. We gave different scores to each parameter considered according to the results obtained and the overall result was obtained by adding up all the different scores for each parameter. In 73.6% of the patients we registered the maximum score, 15 (excellent result), in 1.9% of the patients the score obtained was 10 (sufficient result) and in the remaining 24.5% of the patients the score was variable from 14 to 11 (good result).

Adult↗
PubMed1994

[Varicocele and infertility: clinical framework and therapeutic approach].

A diagnostic-therapeutic protocol which can be used in patients affected with varicocele, in order to obtain a complete clinical study of them and try to improve functional results of therapy, is described. The aims of this protocol are: precise diagnosis of venous refluxes, examination of testicular functionality, detection of possible associated pathologies which can cause infertility, establishment of correct indication to hormonal postoperative therapy. The rapid surgical correction of venous stasis, the treatment of prostatic phlogosis, often concomitant, and, in selected patients, the use of hormonal therapy, can improve functional results in the treatment of this pathology.

Adolescent↗
PubMed1994

[Systems of cerebral monitoring and protection in extracranial carotid surgery].

The main methods for cerebral monitoring and protection during surgical operations of extracranial carotid are examined, analyzing for everyone advantages and limits. Particularly, the authors discuss benefits and disadvantages of cerebral monitoring using somato-sensorial evoked potentials (EP) associated with the measurement of the stump pressure in patients in which general anaesthesia was performed, comparing this method to the monitoring of patients operated using locoregional anaesthesia. The results obtained allow us to say that EP are a very good method for cerebral monitoring and that, if they are not pathological, also with stump pressure values lower than 40 mmHg, a shunt is not necessary.

Aged↗
PubMed1993

[Surgical alternatives in the treatment of perforated duodenal ulcer].

The therapy of perforated gastroduodenal ulcer is still discussed, especially today that good drugs and new surgical devices are available for the treatment of this disease. The authors try to establish a valid protocol for the diagnosis and the therapy of patients affected with this disease.

Clinical Protocols↗
PubMed1993

[Acute cholecystitis in videolaparoscopy].

The authors describe their experience in 15 cases of acute cholecystitis treated with laparoscopic cholecystectomy in emergency. Only in one patient, affected with an abscess of the upper right abdominal space, a laparotomy was performed. The results were excellent. The 14 patients treated with laparoscopic cholecystectomy were quickly discharged from the hospital (on an average 4 days after the surgical treatment) and the convalescence period was very short (range 10-15 days). In the patient treated with laparotomic cholecystectomy the postoperatory period was regular.

Acute Disease↗
PubMed1993

Therapeutic strategies in the surgical management of pancreatic neoplasms in the elderly.

The clinical records of all consecutive patients aged 65 and older undergoing surgical treatment for pancreatic neoplasms between January 1980 and January 1992 were reviewed in order to establish a clinical trial based on the morbidity and mortality rates related to the different surgical procedures. In early diagnosed neoplasms, in patients in good general condition, even in the geriatric age a radical surgical procedure is preferred. In other cases, a palliative surgical procedure has to be performed if possible, namely a bilio-digestive anastomosis, associated if necessary with a gastro-enteric anastomosis.

Aged↗
PubMed1993

[Varicose veins in pregnancy: physiopathology and therapeutic approach].

The Authors examine the endocrinological, mechanical and constitutional factors which are involved in the pathogenesis of varicose veins in pregnancy. Discussing the results of their experience (328 pregnant patients observed, 158 of which affected with various degrees of varicose veins) they suggest a protocol of treatment in the different situations in order to obtain an improvement of the clinical conditions and, if necessary, postpone a surgical operation after delivery, so avoiding useless risks during the pregnancy.

Adult↗
PubMed1993

[Surgical staplers in surgical emergencies. Our experience].

This study describes the use of staplers during surgical treatment performed in emergency from January 1980 to December 1991. For the different, possible operations, some technical notes are examined and results reported. The advantages and risks related to the use of these devices are analysed.

Colectomy↗
PubMed1993

[Giant ovarian dermoid cyst in prepubertal age. Report of a case].

We report a case of a very large (size cm 33 x 41) dermoid cyst in the right ovary in a 11 year old child, causing a complete atrophy of the remaining right ovarian parenchyma and ipsilateral salpinx. Sonography and CT allowed us to diagnose this disease and also showed an associated ureterohydronephrosis. The patient underwent a surgical operation during which a right ovarosalpingectomy was performed. A rapid regression of the ureterohydronephrosis was observed and the patient was discharged from the hospital six days after operation.

Abdomen↗
PubMed1993

The anastomotic aneurysms.

The authors describe their experience of anastomotic aneurysm diagnosis and treatment. They are classed into two groups: slowly growing anastomotic aneurysms, which are the most common; and rapidly growing anastomotic aneurysms, which are more infrequent. A follow-up is proposed in order to detect this involvement early, in election. Urgent diagnostic timing is also proposed. Moreover an analysis is made of criteria to follow in their therapy and indications to surgical treatment. In the period from January 1988 to October 1992 we observed 413 patients and 876 anastomosis or arterial sutures in election, discovering 27 anastomotic aneurysms whereas in 6 cases we had patients who were affected with rapidly growing anastomotic aneurysms. These were urgently operated, whereas of the 27 patients with slowly growing anastomotic aneurysms, 22 were operated and in 5 cases we preferred to check them by a close follow-up.

Anastomosis, Surgical↗
PubMed1993

[Surgery vs PTA in sub-inguinal atherosclerosis].

The authors describe their experience in the treatment of arterial occlusive disease of the lower limbs in the femoro-popliteal and tibioperoneal districts, by surgery (proximal or distal femoro-popliteal by-pass or segment by-pass) and Percutaneous Transluminal Angioplasty (PTA), analyzing indications, advantages, limits and complications of the two methods. Immediate and after one and three year results of surgical by-pass and PTA are compared. On the whole, in the patients in which we performed a surgical by-pass, we obtained slightly better results. Anyway, in the second stage of the arterial occlusive disease and in patients affected with short arterial stenosis and/or obstructions, PTA represents the best treatment.

Aged↗
PubMed1993

[Role of the second look in ovarian neoplasia].

The indications for the execution of a second look in patients affected with ovarian cancers and the possible benefits of this procedure, related to the stage of the neoplastic disease, are examined. The second look, at first largely used in patients in which had been performed adjuvant chemotherapy with drugs containing platinum and with no evidence of residual disease, has been later strongly criticized and the effective usefulness of this invasive procedure discussed. At the moment, we think that the indications for its execution are still large because with the second look it is also possible to put into the abdomen a catheter which can be used for locoregional chemotherapy and there is now the opportunity to perform this procedure also in video-laparoscopy.

Adnexa Uteri↗
PubMed1990

Comparison of the effects of lovastatin and gemfibrozil on lipids and glucose control in non-insulin-dependent diabetes mellitus.

Patients with non-insulin dependent diabetes mellitus have an increased incidence of coronary artery disease which may, in part, be associated with abnormalities in plasma lipids. In a double-blind, parallel, randomized study, lovastatin and gemfibrozil were compared in 102 diabetic patients with primary hypercholesterolemia; two-thirds of the patients were treated with oral hypoglycemic agents and one-third received diet therapy alone for their diabetes. Mean pretreatment total and low-density lipoprotein (LDL) cholesterol values were 273 and 193 mg/dl, respectively. Lovastatin significantly reduced total, LDL and very low density lipoprotein cholesterol (20, 26 and 28%, respectively) and raised high-density lipoprotein (HDL) cholesterol (14%). Gemfibrozil significantly reduced triglycerides and very low density lipoprotein cholesterol (36 and 41%, respectively) and, to a lesser extent, total cholesterol (9%); it also increased HDL cholesterol (21%). Lovastatin therapy was not associated with a significant change in triglycerides, and gemfibrozil did not significantly lower LDL cholesterol. The decrease in the ratio of total to HDL cholesterol tended to be greater with lovastatin than with gemfibrozil (26.5 and 20.4%, respectively; p = 0.053). Changes in lipid profiles with both agents were of a degree similar to those reported in nondiabetic patients. Neither agent had a clinically important effect on fasting glucose or hemoglobin A1c. Both drugs were well tolerated with the exception of 2 patients treated with gemfibrozil who developed symptoms of cholecystitis.

Adult↗