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Biomedical subjects

R Russo

Publications and source records attributed to R Russo.

At least 163 records · Page 9Linked to original sources
PubMed1994

Laparoscopic posterior truncal vagotomy and anterior proximal gastric vagotomy.

Simplified parietal cell vagotomies (Taylor's and Hill-Barker's procedures) were proposed more than a decade ago to make the operation easier and faster. Efficacy and safety have proven to be as good as with proximal gastric vagotomy. The Hill-Barker operation is particularly simplified by the laparoscopic approach, which enables the procedure to be performed very precisely. The limited trauma of minimally invasive vagotomy has increased the interest in peptic ulcer surgery, especially for patients with chronic duodenal ulcer disease who cannot or do not want to take long-term continuous medication, or who are resistant to it. We describe our technique of performing the laparoscopic Hill-Barker procedure. Our initial results with eleven patients show no operative mortality and minimal morbidity with early discharge and ulcer of all patients. Of the 9 cases which are evaluable, 8 are pain-free and one had an ulcer recurrence after incomplete vagotomy.

Duodenal Ulcer↗
PubMed1994

[Correct nutrition of pregnant women for a good fetal-neonatal development].

Food quantity and quality has been studied in a group of 197 pregnant women during their last quarter of pregnancy. The results were that nourishment was both in quantity and in quality enough close to the LARN advices, with a slight reduction of calories per day (about 300) and a slight lipa excess (+5%) to the depriment of the carbohydrates. Correct was the number of meals per day (4-5) while the "mediterranean diet" has been kept by the 53% of the subjects. Fish consumption was scanty (18%) of the cases.

Adult↗
PubMed1994

Liposomal amphotericin B (AmBisome) in Mediterranean visceral leishmaniasis: a multi-centre trial.

Thirty-one patients with visceral leishmaniasis (VL) caused by Leishmania infantum received liposomal amphotericin B (AmBisome) in a multi-centre study. Ten immunocompetent patients (six children) received 1-1.38 mg/kg/day for 21 days, and ten (nine children) received 3 mg/kg/day for 10 days. All were cured without significant adverse events and without relapse during 12-24 months of follow-up. Eleven immunocompromised adults, including seven co-infected with HIV (four with AIDS) received 100 mg (1.38-1.85 mg/kg) daily for 21 days. All were initially considered cured, but eight relapsed clinically and parasitologically at 3-22 months. Liposomal amphotericin B is a new, safe and effective drug for the treatment of VL.

AIDS-Related Opportunistic Infections↗
PubMed1993

Limb body wall complex: a critical review and a nosological proposal.

The analysis of the literature on limb body wall complex reveals a varied and rather confused spectrum of cases. However, we noticed the presence of at least 2 clearly distinguishable phenotypes. The first phenotype shows craniofacial defects and amniotic bands and/or adhesion; the second--without craniofacial defects--presents urogenital anomalies, anal atresia, and abdominal placental attachment, together with a persistence of the extra-embryonic coelom. We think these 2 phenotypes are the consequence of different pathogenetic mechanisms. The pathogenesis of the first type can be related to an early vascular disruption, while the pathogenesis of the second one is attributable to an intrinsic embryonal maldevelopment. Eight cases of the second phenotype were identified and the pathological findings proving this maldevelopmental origin are described.

Abnormalities, Multiple↗
PubMed1993

On the origin of functional differences in recollective experience.

Subjects studied target words that were repeated either immediately (lag0) or after six intervening items (lag6). At retention testing, subjects were required to discriminate targets from distractors and, contingent on a 'yes' response, to classify each identified item as one that evoked either a 'remember' (R) response or a 'know' (K) response. An R response indicated recognition based on conscious recollection, and K, recognition without conscious recollection. R responses were significantly greater in lag6 than lag0 whereas the reverse was found for K responses. The data are interpreted as showing that R responses depend on the probability of a target stimulus engaging conscious effortful processing, whereas K responses are increased in the absence of conscious involvement at learning.

Adult↗
PubMed1993

Dietary salt excess unmasks blunted aldosterone suppression and sodium retention in the stroke-prone phenotype of the spontaneously hypertensive rat.

OBJECTIVE: The mechanisms underlying the accelerating effect of high salt intake on the development of vascular injury in the stroke-prone phenotype of spontaneously hypertensive rats (SHRSP) are still not clear. The aim of the present study was to determine whether young SHRSP can excrete a dietary excess of sodium and to characterize the associated hormonal responses. METHODS: Sodium balance and hormonal parameters were studied during a 1-week high-salt diet (4% NaCl) in 6-week-old SHRSP (n = 84), in age-matched spontaneously hypertensive rats (SHR; n = 73) and in normotensive Wistar-Kyoto (WKY) rats (n = 52). RESULTS: Baseline systolic blood pressure (SBP) was similar in SHR and SHRSP and did not change significantly during the high-salt diet. SBP also remained unchanged in WKY rats during the high-salt diet. Despite similar daily sodium intakes in the three groups during the diet, the response of urinary sodium excretion to sodium loading was reduced significantly in SHRSP compared with SHR or WKY rats (F = 4.09, P < 0.001). Plasma renin activity was suppressed significantly by high salt intake in each group to a comparable extent. Plasma aldosterone concentrations were also reduced significantly by sodium loading in all strains. However, a lesser degree of aldosterone suppression was observed in the SHRSP than in both SHR and WKY rats (F = 3.01, P < 0.01). CONCLUSIONS: Young SHRSP show a blunted suppression of plasma aldosterone and a defective sodium excretion during high salt intake.

Administration, Oral↗
PubMed1993

Pneumocystis carinii pleural effusion. Pathogenesis and pleural fluid analysis.

We present three new cases of Pneumocystis carinii in pleural effusions of patients with AIDS, bringing the total number of reported cases to six. In our patients, diagnosis was made by visualization of Pneumocystis in pleural fluid stained with Gomori methenamine silver. LDH was greater than 400, and pleural fluid to serum LDH ratio was greater than 1.0 in all cases at time of presentation. All six reported patients have been associated with aerosolized pentamidine, and five of the six had documented underlying Pneumocystis pneumonia. The sixth patient, which we report, presented with primary pleural infection with Pneumocystis. Although we could not document underlying pneumonia, we suspect it was present. Pneumocystis pleural disease appears to be an anatomic extension of smoldering subpleural Pneumocystis pneumonia, and prognosis is not worse than with pneumonia alone.

AIDS-Related Opportunistic Infections↗
PubMed1993

Influence of hypercholesterolemia on adrenal steroid metabolism and electrolyte balance in spontaneously hypertensive rats.

Hypercholesterolemia and hypertension are frequently associated risk factors for cardiovascular diseases. The interactions between hypercholesterolemia and the regulatory mechanisms of blood pressure are poorly understood. In this study we investigated the effects of hypercholesterolemia on salt metabolism and its hormonal control mechanisms in spontaneously hypertensive rats (SHR). Six-week-old SHR were randomly assigned to either a high (1%) cholesterol diet or a matched regular diet for 6 weeks, followed by a 2-week dietary washout. A group of normotensive Wistar-Kyoto rats received the high cholesterol diet and was used as a control. Plasma cholesterol increased significantly (P < 0.001) in both cholesterol-fed SHR and Wistar-Kyoto rats. Blood pressure was unaffected by 6 weeks of a high cholesterol diet. Hypercholesterolemia caused a significant increase in aldosterone (by analysis of variance: F = 8.40; P < 0.01) associated with a significant decrease in corticosterone (F = 4.64; P < 0.05) in the SHR, but not in the normotensive rats. In addition, in the cholesterol-fed SHR, urinary sodium excretion was reduced (P < 0.01), and the urinary potassium/sodium ratio was increased (P < 0.01) compared to those in the remaining groups of rats. The hormonal and urinary differences between the hypertensive subgroups were not detectable after withdrawal of cholesterol. These results demonstrate that diet-induced hypercholesterolemia specifically promotes reversible mineralocorticoid accumulation and sodium retention in SHR.

Adrenal Cortex Hormones↗
PubMed1993

Age differences in implicit memory: more apparent than real.

Elderly subjects and a group of young subjects identified fragmented picture sequences under conditions of focused attention. Two other groups of young subjects carried out this task under divided-attention conditions. Implicit memory, as measured by item-specific savings, was found in all groups, but this effect was smaller in the elderly group. The young subjects, but not elderly subjects, performed better on new items. The divided-attention conditions equated recall and recognition by the young and the elderly, but only the young subjects showed greater savings for recalled items. The elderly subjects' reduced implicit memory therefore stemmed from their inability to facilitate implicit memory with explicit memory. A second experiment, involving only young subjects tested after delay, produced findings similar to those for the young divided-attention subjects. Implicit memory, as measured by savings in picture completion, does not show an age-related change when the role of explicit memory is considered. Age does, however, reduce skill learning.

Adult↗
PubMed1993

Early and late results of laparoscopic choledochotomy without biliary drainage.

On account of dissatisfaction with the two-staged approach to stones in the common bile duct, and the risks associated with endoscopic papillotomy, one-stage laparoscopic duct exploration was commenced. The initial experienced with 20 cases is presented. In 13 cases the transcystic approach to the main duct was not successful, so a choledochotomy was performed, and closed without biliary drainage. The postoperative course was similar to laparoscopic cholecystectomy and was uncomplicated in all patients. The follow-up examination of 12 patients demonstrated a mild stenosis of the main duct in our first case; however, this resolved spontaneously within six months. When indicated, the laparoscopic "ideal" choledochotomy with fibroscopic exploration gives very good early and long term results.

Adult↗
PubMed1993

[Cutaneous microcirculation in systemic sclerosis. Morpho-functional research using capillaroscopy and laser-Doppler].

Our previous researches proved that, in patients affected by Raynaud disease, microcirculatory alterations were greater in those cases in which the small vessels showed evocative appearances of a sclerodermatous connectivopathy. In this study we evaluated cutaneous microvasculature in 18 patients suffering from clear systemic sclerosis, compared with a group of 16 subjects affected by primitive Raynaud disease and a group of healthy subjects. We used videocapillaroscopy and laser-Doppler fluxmetry for morphological and functional study respectively. In patients affected by systemic sclerosis the rest flow was clearly reduced and morphological pattern of cutaneous small vessels deranged. The response to ischemic test allowed us to subdivide the skin-bounds in two subgroups: "no responders" 8 subjects (44%), in which reactive hyperaemia was completely absent, "responders" 10 patients (56%) in which the hyperaemia was completely overlapped with that of the two other groups, but with longer reaction times. In skinbounds the capillaroscopic pattern was clearly severe in comparison with other two groups (18.8 +/- 5.7 vs 5.7 +/- 2.3 and 3.6 +/- 1). Thus, in advanced stage of the pathology, is microangiopathy (in its tromboischemic and inflammatory aspects) that plays a very important role in the development of organ damage. Therefore, all those clinical and instrumental tests which may allow a differential early diagnosis between a primitive and a secondary Raynaud phenomenon be done, for its prognostic value in connection with the appearance of systemic sclerosis.

Adult↗
PubMed1993

Urological laparoscopy: our preliminary results.

From the beginning of urological applications of laparoscopy, this technique has found many clinical indications. In our center, after an experimental training in animals, we performed 48 operations using laparoscopy: 18 pelvic lymphadenectomies (15 for prostate cancer, 2 for bladder tumor and 1 for penis carcinoma), 11 ligatures of the spermatic vein (3 bilateral), 4 orchidopexies, 10 excisions of renal cysts, 4 nephrectomies and 1 adrenalectomy. For cryptorchidism, laparoscopy is a less invasive alternative to surgical exploration; in case of prostate cancer, laparoscopic pelvic node dissection has a lower incidence of complications and requires few days of hospitalisation. The excision of renal cysts by laparoscopy, in case of large symptomatic pathology, is an efficacious operation with low morbidity. In case of nephrectomy for small wrinkled kidneys or severe hydronephrosis, long execution time makes cost/benefit ratio somewhat debatable; adrenalectomy, instead, is easier than nephrectomy and offers many advantages in comparison with traditional surgical approach. All indications will be better evaluated at a later date, with the indispensable learning period and the continuous progress of technical equipment.

Genital Diseases, Male↗
PubMed1993

Effects of sympathetic stimulation on microcirculatory dynamics in patients with essential acrocyanosis. A study using mental stress.

With the aim of examining possible alterations of the neurogenic regulation of microvascular hemodynamics, the cutaneous microcirculation in 21 patients with essential acrocyanosis was studied using a laser-Doppler method both in basal conditions and during mental stress using an arithmetic test. The analysis of results showed a significant reduction in basal flow (p < 0.02) in patients with acrocyanosis in comparison to control subjects. In 15 out the 21 patients studied it was found that there was an increase in the flowmetric curve during mental stress, whereas the test caused a diminished flow in normal subjects. The altered response to sympathetic stimulus might be the result of microcirculatory stasis which would provoke an alteration in the neurogenic regulation mechanisms of microvascular dynamics.

Adolescent↗
PubMed1993

[Arthrography in the diagnosis and treatment of idiopathic adhesive capsulitis].

The painful shoulder--i.e., adhesive capsulitis--present two basic symptoms: painful and impaired motion. Clinics allow the diagnosis to be made, but treatment is difficult. In our opinion, shoulder arthrography is very useful to distinguish idiopathic from secondary capsulitis involving bones and joints: moreover, in the patients with adhesive capsulitis, arthrography is useful when removing adhesions by repeated forceful distensions of the joint capsule. January 1990 through December 1991, forty-five patients with adhesive capsulitis were studied with shoulder arthrography; 19 patients with primary adhesive capsulitis underwent forceful distension with lidocain and contrast medium and the intraarticular injection of 40 mg of triamcinolone enantate to eliminate local adhesions. Arthrographic brisement yielded good results: improved motion was observed in all patients, lasting 2 to 7 months. Forceful joint capsule distension is easy to perform and complication-free and yields valuable results; all of the above make the procedure advisable as a good alternative to surgery in primary adhesive capsulitis patients.

Arthrography↗
PubMed1993

[Echography and echo-Doppler in the study of thoracic outlet syndrome. Correlation with angiographic data].

This study was aimed at assessing the clinical utility of conventional and color duplex-Doppler US in the diagnosis of thoracic outlet syndrome. Conventional US and Doppler examinations were performed in a prospective study. The results were correlated with angiographic findings. Thirteen patients affected with thoracic outlet syndrome were studied by means of both conventional US and spectral Doppler flow imaging. Five cases (5/13) had neurovascular symptoms in the right upper limbs, 7/13 in the left upper limbs and 1/13 in both upper limbs. An accessory cervical rib was demonstrated in 2/13 cases (associated with muscular hypertrophy in one case and bilateral in the other), by means of plain films of the spine. Conventional US depicted muscular hypertrophy in 7/13 cases--bilateral in one case and monolateral in 6/13 cases, with marked muscular asymmetry. In 5/13 cases, no bone/muscle anomalies were demonstrated. The patients with an accessory cervical rib and scalenus muscle hypertrophy were seen to exhibit two types of hemodynamic alterations in the subclavian artery--i.e., turbulence and changes in the systolic window with no increase in peak systolic velocity in 5/13 cases with mild stenosis, normal or reduced peak systolic velocity with changes in the reversed flow in 3/13 cases with mild/medium-grade stenosis, either during indifferent position or after dynamic tests. In 2/13 patients with no bone/muscle alterations, turbulence was demonstrated in the subclavian artery. However, in 3/13 cases Doppler US revealed no arterial flow abnormalities--3/13 false negatives relative to mild vascular compression. Selective arteriography demonstrated vascular alterations in the subclavian artery in all cases, with or without Doppler anomalies; while angiography was often positive during hyperabduction maneuvers color duplex Doppler demonstrated hemodynamic alterations at rest with indifferent position of the upper limb. In conclusion, conventional US allowed the evaluation of the thickness of both anterior and middle scalene muscles and of possible muscular asymmetries. Color duplex Doppler US demonstrated primary and secondary alterations in the subclavian artery or vein. Therefore, conventional US, duplex and color Doppler prove to be valuable non-invasive tools in the patients with neurovascular symptoms in the upper limbs and could allow the selection of the cases to submit to arteriography.

Adult↗
PubMed1993

Peripheral metabolism of branched-chain keto acids in patients with chronic renal failure.

Peripheral tissue metabolism of branched-chain amino acids (BCAA) and branched-chain keto acids (BCKA) in the postabsorptive state was evaluated in 8 patients with chronic renal failure (CRF) and 7 controls by measuring the arterial-deep forearm venous differences for BCAA and BCKA. Arterial whole blood levels of BCAA and BCKA were also measured in an additional 7 patients and 11 controls. In CRF, total BCKA levels are reduced owing to a decrease in ketoisocaproic acid (KICA) and ketoisovaleric acid (KIVA) levels, parallel to changes in BCAA levels, whereas levels of ketomethylvaleric acid (KMVA) are not different from controls. Both in normal conditions and in patients, arterial levels of individual BCAA are directly correlated with arterial levels of the corresponding BCKA. However, in CRF, the ratios of leucine to KICA and of isoleucine to KMVA are increased. A direct correlation between KICA and HCO3- levels is observed. In CRF, the release of leucine and valine as well as of KICA and KMVA from peripheral tissues is reduced, whereas KIVA is neither released nor taken up by the forearm. The lack of KICA release from peripheral tissues likely accounts for its low circulating levels. The depressed peripheral release of leucine associated with the lack of KICA release suggests an increased degradation of leucine which proceeds beyond the transamination step.

Adult↗