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Biomedical subjects

S Ricci

Publications and source records attributed to S Ricci.

232 records · Page 13Linked to original sources
PubMedDate not supplied

[Transcatheter embolization of expansive masses of the sacrum].

The authors report their 4-year (1984-1988) experience with TCE in the treatment of primary sacral benign/malignant and vascular bone tumors, after similar preliminary studies on aneurysmal bone cysts. Eleven patients were treated, for a total of 21 procedures: in 85% of the eight cases of palliative embolization, multiple instrumental approaches were needed for late revascularization, up to four consecutive embolizations in the same patients. Severe complications were observed in 19% of the procedures, due to arterial catheterization and/or instrumental maneuvers, but in none of them was surgery required. Technical results--i.e. devascularization of the mass--were optimal/suboptimal in all cases at the end of multiple procedures in the same patient: in 7/8 patients treated for palliation, however, the treatment was repeated, the late venous DSA angiographic control showing recanalization of the great vessels surrounding the lesion and/or revascularization through collateral channels. The analysis of morphological and clinical results (with reference to pain relief, dimension of the mass, and calcification at CT follow up) showed a complete pain relief in 100% of the patients treated preoperatively for palliation. The dimension of the mass was reduced in 12.5% of the cases treated for palliation, and recalcification was demonstrated on CT in 12.5% of cases. In 25.5% the mass had increased in size and in 62.5% its dimensions were unchanged. Effective pain relief was always obtained in the cases treated preoperatively. Thus, in our experience TCE of expansive lesions of the sacral bone can be considered as an effective therapeutical choice, with special reference to pain relief, for use in all inoperable cases, and as a preoperative treatment to minimize blood loss at surgery. Still, embolization materials are not completely satisfying: many of them are expensive, difficult to use and cannot be trusted to permanently occlude the vessels, which forces to intervene more than once to obtain optimal clinicomorphological results. As for malignant lesions, chemo-embolization with cytostatic substances should be used to improve the efficacy of the method. However, even through such negative judgements can be expressed on TCE, both technical and clinical results have been, in our experience, quite satisfactory, which calls for optimization of the methodology.

Angiography↗
PubMedDate not supplied

[Lipiodol UltraFluid in the imaging diagnosis of hepatocarcinoma with cirrhosis].

Fifty patients with HCC associated with hepatic cirrhosis underwent intra-arterial injection of Lipiodol UltraFluid (LUF) during diagnostic DSA of liver parenchyma, 42 of them for a complete chemotherapeutic treatment, 8 for an isolated diagnostic control. LUF is known to be specifically captured by HCC neoplastic tissue, with long-term persistence in the lesion if injected in the arterial hepatic tree; this is not the case with other focal hepatic masses. Therefore LUF opacification can be used to demonstrate small daughter tumors not shown by CT or US in cases with evidence of HCC, or to diagnosis HCC in clinically positive patients with no evidence of tumor at non-invasive screening. In our series of patients, accumulation of LUF in the HCC was observed in 100% of the cases, with no false negatives. Two false positives (4%) were observed, due to CT being performed too early (it should be performed not sooner than 10 days after the injection). Overall DSA accuracy was 78%, with 22% false negatives. In 14% of the cases DSA was positive for HCC in patients with aspecific noninvasive screening. CT, performed 10 days after LUF injection, demonstrated HCC daughter tumors not depicted by US, conventional CT, and angiography, in 34% of the cases, and in 9% of the patients only CT/LUF was able to show HCC in clinically positive cases with no evidence of tumor on other imaging techniques. Specificity, sensitivity and over-all accuracy were thus 100% in our series; LUF was well tolerated by the patients, and no technical complications were observed. In our opinion, the diagnostic DSA and CT/LUF is justified only for the typification of suspected focal nodules unsuitable for biopsy: in other instances, especially in case of HCC with positive biopsy/clinical findings and focal nodular mass, the technique should be directly employed as a therapeutic approach, with the injection of lipiodolized agents to treat both primary and daughter nodules after surgery in operable patients, and to begin chemoembolization treatment in patients with intrahepatic polyfocal diffusion. DSA and LUF are therefore of primary importance in the diagnosis and therapeutic flow-chart of HCC associated with hepatic cirrhosis.

Angiotensin II↗
PubMedDate not supplied

[Parkinson's disease and am-otrophic lateral sclerosis (case report) (author's transl)].

A 68 years old man affected by parkinson's disease for four years suddenly developed symptoms of a motor neuron disease. He also had a defect of his visual-spatial ability with an intra cerebral calcifications in right parieto-temporo-occipital region. The AA. discuss the nosological aspects of this case and do not accept the possibility of a chance occurrence of the two systemic degenerative diseases and favour a unification of nuerological abiotrophic diseases.

Aged↗
PubMedDate not supplied

[Combination of oxybutynin chloride (Ditropan) with intermittent catheterization in the treatment of neurogenic bladder in childhood: results on continence].

Nowadays Intermittent Catheterization (I.C.) is considered the treatment of choice in patients with neurogenic bladder dysfunction, because of its easy handling and good results. Renal function preservation, urinary tract infections prevention and continence can be achieved by this method. In particular, I.C. per sè improves continence quality in many cases, but, in the majority of them the best results can be obtained by drug therapy addition, having in mind a more direct action on to detrusor compliance and/or bladder neck tone. Oxybutynin Chloride (Ditropan)(-) is the first choice drug, even in childhood, in cases of neurogenic bladder dysfunction, for its anticholinergic, antispastic and analgesic properties. From 1978, 48 children with neurogenic bladder have been treated by I.C. Out of them, 27 have had drug therapy (Oxybutynin Chloride-Ditropan) in addition to I.C., according to indications of clinical, radiologic and urodynamics findings. Results on continence are discussed.

Adolescent↗
PubMedDate not supplied

[Measuring venous pressure with the Doppler technic statistical data].

With reference to the measuring method suggested, we report the pressure indices noted in surgery, in order to compare them with those of non-surgical methods, using the Doppler. We also define some parameters for recording the measurements; failure to observe these might result in inaccuracy of the instrumental findings. We have to consider the index of maximum pressure to be attained using the pneumatic cuff, the lenght of time of compression, and the place at which the measurement is taken.

Female↗
PubMedDate not supplied

[Catheterization of the ureter after anti-reflux reimplantation using the Cohen technic].

Cohen's ureteroneocystostomy is largely employed by many pediatric urologists, the only substantial criticism being the impossibility of endoscopic ureteral catheterization after this procedure. A method is described, based on the use of a catheter needle introduced on the filled bladder suprapubically, in a lateral position, opposite to the side of the ureter concerned. Adequate ureteral catheter is introduced on the venous catheter, using a common endoscopic rubber tip to maintain water tightness. Under endoscopic vision the ureteral catheter is easily inserted in the ureteral meatus and introduced in the ureter.

Child, Preschool↗
PubMedDate not supplied

[Plasma levels and noninvasive hemodynamic profile of slow release verapamil (240 mg). A multicenter study].

Aim of this study was to evaluate the antihypertensive efficacy, tolerability, drug plasma levels and hemodynamic effects after long-term treatment with the slow release (SR) formulation of verapamil (240 mg od). After a wash-out period of two weeks, 96 subjects (39 M, 57 F; mean age: 55 +/- 8.4 years; recruited in 9 centers) with mild to moderate, uncomplicated hypertension received verapamil 240 mg SR od for 24 weeks. The following parameters were considered: systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), ECG, echocardiogram, routine blood and urine chemistries, drug plasma levels. In addition, hemodynamic parameters were assessed in 30 subjects. A significant decrease in SBP and DBP (p < 0.01) was observed already after 1 week of treatment and was evident during all the study. HR was significantly reduced after 4 weeks (p < 0.01). No changes of ECG and echocardiographic parameters occurred. A significant increase in drug plasma levels was measured after 12 and 24 weeks of treatment (p < 0.05), when compared to the values recorded after 1 week. After 24 weeks drug levels were slightly decreases, even if not significantly, when compared to the values observed at the 12th week. No significant changes of cardiac output (CO), cardiac index (CI), stroke volume (SV) were evident. Total vascular resistances (TVR) decreases significantly (p < 0.001) 80 subjects completed the study. These results confirm the antihypertensive efficacy and tolerability of SR formulation of verapamil and suggest that the effective mechanism by which it reduces blood pressure is the progressive reduction of TVR without a sympathetic reflex stimulation. This hemodynamic effect is achieved by small drug concentrations. In conclusion, SR formulation of verapamil allows a good therapeutic control in hypertensive subjects when it is administered od and, therefore, it can be considered a drug of first choice in the treatment of arterial hypertension.

Delayed-Action Preparations↗
PubMedDate not supplied

Stroke scoring systems.

Explore the source record for details and available documents.

Cerebral Hemorrhage↗
PubMedDate not supplied

A pilot study with cisplatin, ifosfamide and weekly administration of vinorelbine as an outpatient combination chemotherapy for advanced non small cell lung cancer.

The combination of cisplatin and ifosfamide on day 1 plus vinorelbine on day 1 and 8, every 3 weeks, has demostrated a high response rate and acceptable toxicities in advanced NSCLC patients. The present study was designed to analyse the feasibility and toxicity of a similar regimen in which vinorelbine was administered on a weekly basis in advanced NSCLC patients. The scheme consisted of cisplatin 80 mg/sqm, Ifosfamide 3 gr/sqm on day 1, Vinorelbine 25 mg/sqm on days 1,8,15, every 21 days. The dose of vinorelbine on day 8 and 15 was modified according to the absolute neutrophil count. Patients who experienced grade 3-4 neutropenia received G-CSF (300 micrograms total dose subcutaneously) from days 10 to 13 and from 17 to 20 of each subsequent course. Twelve patients were treated and forty-six courses were evaluable for toxicity. Grade 3-4 neutropenia was observed in 63% of the courses; 3 episodes of febrile neutropenia were recorded. Vinorelbine on day 15 was omitted in 52% of the courses and was given at 75% and 50% of the planned dose in 11% and 4.3% respectively; G-CSF was administered in 65.2% of the courses. This scheme is not feasible because of the high incidence of grade 3-4 neutropenia. In spite of G-CSF, the dose of vinorelbine on day 15 was omitted or reduced in the majority of the cycles.

Aged↗
PubMedDate not supplied

[Protein-losing gastroenteropathy (Ménétrier's disease) in childhood: a report of 3 cases].

So far, Ménétrier's disease has been thought to be an uncommon disorder in children. It is characterized by hypertrophic gastritis, protein-losing enteropathy, hypoproteinemia and edema. During childhood, the main features of this condition include an abrupt onset and a spontaneous recovery. In this paper we describe three children, aging between 3 months and 3 years, who presented with protracted vomiting, generalized edema, colitis (one case) and elevated serum aminotransferases (one case). The diagnosis of Ménétrier's disease was made by finding the typical endoscopic and histological picture of the gastric mucosa (two cases) or by the radiological findings (one case). The fecal alpha-1-antitrypsin excretion, which is a marker of the protein-losing enteropathy, was high in all patients. Two cases showed evidences for a primary CMV infection as the possible cause of Ménétrier's disease, due to the presence of cytomegalic inclusions in the gastric mucosa and the IgM class anti-CMV antibodies positivity. All 3 cases, who received only a support treatment (plasma and albumin intravenous infusions), completely recovered in a 2-3 weeks time. In conclusion, it is confirmed that in children a protein-losing gastroenteropathy may be caused by a primary infection with CMV.

Biopsy↗