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Biomedical subjects

R Orlando

Publications and source records attributed to R Orlando.

At least 127 records · Page 7Linked to original sources
PubMed1990

Laparoscopy and liver biopsy: further evidence that the two procedures improve the diagnosis of liver cirrhosis. A retrospective study of 1,003 consecutive examinations.

We examined retrospectively 1,003 patients with chronic liver disease who underwent laparoscopy and liver biopsy. The diagnosis of cirrhosis was made in 411 patients and excluded in 570; in the remaining 22 patients, the laparoscopic/histologic diagnosis was inconclusive. When the two techniques were considered separately, a final diagnosis of cirrhosis was possible in 78.4% by laparoscopy and in 78.8% by biopsy of the total of 411 cases, whereas, doing both procedures improved the diagnostic yield to 97.7% by decreasing the percentage of false negatives for each technique. Laparoscopy can also provide important additional information by detecting intrabdominal signs of portal hypertension and so improve the macroscopic diagnosis of cirrhosis. In particular, splenomegaly seen at laparoscopy seems to be an important feature for the diagnosis and evaluation of chronic liver disease.

Adolescent↗
PubMed1990

[Antimalarial chemoprophylaxis in pregnancy].

The drugs available for malaria chemoprophylaxis in pregnancy and their posology, side-effect in pregnant women and foetus are analyzed particularly for areas of high multidrug resistance. Chloroquine and proguanil are the most used with few side-effects, while pyrimethamine is recommended only for chloroquine-resistant Plasmodium falciparum spp.

Animals↗
PubMed1989

Pharmacokinetics of miocamycin in patients with liver cirrhosis.

The pharmacokinetics of miocamycin, a new macrolide antibiotic, was studied in 6 healthy controls and 6 patients with compensated liver cirrhosis. The results indicate that in chronic liver disease the kinetics of the drug is altered. Therefore, a dosage adjustment of miocamycin is recommended when dealing with these patients.

Administration, Oral↗
PubMed1988

Ultra-high-frequency jet ventilation in a bronchopleural fistula model.

High-frequency ventilation techniques have been demonstrated to be useful in decreasing gas loss from bronchopleural fistulas. We performed the present study to evaluate the impact of a new jet ventilator design and ventilatory frequency on hemodynamics, gas exchange, and bronchialstump gas flow in an animal model of bronchopleural fistula. Ten pigs underwent a right-sided thoracotomy and right-sided upper pulmonary lobectomy with cannulation of the upper lobe bronchus for measurement of bronchial fistula flow rate. Animals underwent a random sequence of conventional ventilation (12 to 20 breaths per minute), conventional high-frequency jet ventilation (120 breaths per minute), and ultra-high-frequency jet ventilation (UHFJV; 450 breaths per minute). Hemodynamic measurements were similar in the three ventilatory modes, but oxygenation was best with UHFJV. Bronchial fistula flow was lowest with UHFJV and greatest with conventional ventilation. Ultra-high-frequency jet ventilation demonstrated superior oxygen loading, adequate carbon dioxide elimination, and the least flow through the fistula, suggesting that both ventilator design and frequency are important therapeutic variables in the management of major airway disruption.

Animals↗
PubMed1988

Smooth liver surface may conceal cirrhosis. Evidence for the late development of nodular surface of the cirrhotic liver.

A 22-year-old male student with HBs Ag + acute hepatic necrosis was admitted to our clinic for further examination. Since his liver function worsened, laparoscopy with direct vision hepatic biopsy was performed. Macroscopically, the surface of the liver did not show the characteristic nodular appearance, in contrast to histological alterations suggestive of liver cirrhosis. Eight months later, a second laparoscopic/bioptic examination was performed. The liver surface appeared nodular, while the histological picture was unchanged vis-a-vis the first examination. The discrepancy between the macroscopic findings observed at the first laparoscopy and those seen eight months later, would suggest that cirrhosis initially develops "inside" the liver and can only be detected histologically; the characteristic nodularity of the liver surface "emerges" subsequently.

Adult↗
PubMed1987

[Changes in the levels of serum zinc in chronic hepatopathy].

Serum zinc levels were investigated in patients with chronic liver diseases and in control subjects. The results shows that serum zinc was significantly decreased in patients with chronic liver diseases, in contrast to controls. Zinc deficiency seems to be related to hepatic injury and not to alcoholic intake.

Adult↗
PubMed1987

Validity of laparoscopy after abdominal surgery.

The authors carried out a retrospective study to investigate the effect of previous abdominal surgery on the validity of laparoscopy. Laparoscopy was done in 2,000 patients with liver disease, between 1976 and 1985. Of these, 250 (12.5%) had undergone abdominal operations, and all presented with intraperitoneal adhesions. The whole surface of the liver was visible in 45.3%, but only in part in 46.2% of patients with upper abdominal operations (cholecystectomy, gastric surgery). Lower abdominal surgery (appendectomy, gynaecological operations) was associated with complete visibility of the liver in 97.5% of the cases. Laparotomy was followed by the highest incidence of non-visibility of the liver (28.5%). In the other 1,750 patients without abdominal operations, adhesions were detected only in 83 (4.1%) and the liver was entirely observable in 83.1% of these. In conclusion, previous abdominal surgery does not represent an absolute contraindication to laparoscopy, since risks are not as great as one might suppose. Although the view of the liver is sometimes impaired, laparoscopy retains its role in the assessment and therapy of liver disease, and avoids complications related to blind biopsy of the liver.

Abdomen↗
PubMed1987

Management and outcome of retroperitoneal abscesses.

Retroperitoneal space abscesses are unusual clinical problems encountered by general surgeons, internists, and surgical subspecialists. An insidious, occult illness marked by diagnostic delay, inadequate drainage, and considerable morbidity and mortality is common. Anatomic reviews detailing the complex extraperitoneal spaces have been published, but less attention has been focused on diagnostic and drainage techniques useful to the practicing surgeon. In a retrospective review of 50 extraperitoneal abscesses, attention was directed to clinical presentation, diagnosis, and therapy. On the average, 12.7 days were required to establish the diagnosis; 50% of patients suffered major complications. A strikingly high mortality was associated with positive blood cultures and persistent fever within 48 hours of drainage (75% and 71%, respectively). Computed tomography has greatly enhanced the diagnosis of extraperitoneal abscesses, and radiologic drainage in selected cases appears to be a useful initial approach. A simplified anatomic classification and treatment plan is proposed to facilitate comparison between clinical series.

Abscess↗