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Biomedical subjects

V Violi

Publications and source records attributed to V Violi.

69 records · Page 4Linked to original sources
PubMed1980

[Biliary lithiasis in patients aged over 70 years: considerations on 125 operations].

An experience with 125 over 70 aged patients, undergone surgery for biliary lithiasis, is here reported. These operations represent 17 percent on the whole performed ones for non malignant biliary tract diseases in Institute of Surgical Pathology of the University of Parma. As the age gets elder, we can see a percent increase of complications of lithiasis, and particularly of acute cholecystitis, of common bile duct diseases and generally of emergencies. Mortality rate was 5,6%. After cholecystectomy for uncomplicated gallstones mortality rate was zero. After operations for complications of cholelithiasis it was 9.3% (6,8% in elective, 18,7% in emergent surgery). According to the Authors, these results suggest that surgical elective indications in the aged patients have to be extensive, in order to reduce the risk of worse and often unavoidable complications.

Acute Disease↗
PubMed1978

[Surgical aspects of thrombosis in the portal system (author's transl)].

The Authors present and discuss clinical and therapeutic aspects of several cases of chronic portal thrombosis, troncular and radicular, either isolated or variously associated. Splenoportography and selective arteriography do not always provide a clear-cut picture of the vascular situation, particularly in the presence of mural thrombi. Surgery may be needed as an emergency measure in cases of hemorrhage, but the best results are obtained if it can be done electively. Indications, however, must be evaluated very carefully in each individual case, especially for thrombosis not associated with cirrhosis of the liver, in which the tendency to a more favorable natural evolution may invite a more conservative approach. The choice of surgical procedures is dictated essentially by the site of obstruction in the portal system. After discussing the indications for various methods, the authors present some cases of thrombosis involving only the superior mesenteric vein, managed successfully by disobliteration and mesenterocaval anastomosis.

Adolescent↗
PubMed1978

[Blind pouch after choledochoduodenostomy (author's transl)].

In order to define the role of the blind pouch as causal factor of late complications after lateral choledochoduodenostomy ("sump" syndrome), the Authors have reviewed 37 patients previously operated on for common duct stones and/or benign papillary stenosis. In 19 patients, clinical and laboratory data have been associated to cholangiography, barium meal and 99mTc HIDA hepatobiliary scanning. Although we considered a few cases, the results were satisfactory. Slight symptoms noticed in some patients do not derive from "sump syndrome", as proved by the lack of correlations between clinical results and roentgenologic and radioisotopic data.

Adult↗
PubMedDate not supplied

[Long term follow-up after radical mastectomy for breast cancer (author's transl)].

110 of 126 patients treated with Halsted mastectomy and postoperative loco-regional radiotherapy, during period 1961-1969 have been controlled. Overall 5 years survival resulted as following: Columbia Clinical Classification stage A 90,6%, stage B 66,6%, stage C 28,5%, stage D 33,3%; 10 years survival in patients operated on in the period 1961-64 was: stage A 69,2%, stage B 53,3%, stage C 40%, stage D 0%. On the basis of the satisfing results obtained the authors conclude that it appears by now unjustified to modify this method in treating stage A and B breast cancer either utilizing less extended resections, or renoncing to the postoperative irradiation.

Breast Neoplasms↗
PubMedDate not supplied

[Correlation between histological findings and clinical behavior following surgery for portal hypertension in cirrhosis (author's transl)].

This is a retrospective study of 29 cirrhotic patients who underwent surgery for haemorrhage or ascites due to portal hypertension, carried out to look for any correlation between histological findings and clinical outcome. When Mallory's bodies and signs of activation are found, indicating that the cirrhosis is progressing, the clinical results are often discouraging. A careful choice of which cirrhosis patients are likely to gain from surgery should take account of selective histological criteria as well as full clinical and haemodynamic data.

Adult↗
PubMedDate not supplied

Diverticulitis of the caecum and ascending colon: an unavoidable diagnostic pitfall?

PURPOSE: The infrequency of right-sided colonic diverticulitis prompted this presentation of our experiences, with emphasis on the diagnostic aspects. PATIENTS AND METHODS: Charts and documentation regarding 20 patients who underwent surgery for diverticulitis of the caecum and/or ascending colon over 22 years were reviewed. RESULTS: Eleven patients underwent pre-operative instrumental examinations: right-sided diverticulitis was recognized in five patients (two by barium enema, two by both ultrasonography and computerized tomography, one by all three examinations) and was suspected in another four. All diagnoses on merely clinical grounds--acute appendicitis in 10 patients and perforated peptic ulcer in one--were erroneous. Surgery consisted of 13 right standard or limited hemicolectomies, six conservative procedures and one Mickulicz' operation and subsequent right hemicolectomy. No operative deaths or long-term failures were reported. CONCLUSIONS: In the presence of clinical features atypical of acute appendicitis, right-sided colonic diverticulitis should be taken into account; pre-operative instrumental examinations might increase diagnostic accuracy, thereby leading to a more correct therapeutic approach.

Adult↗
PubMedDate not supplied

[Interposition meso-caval shunt for haemorrhage or ascites in hepatic cirrhosis. Report of twenty-eight cases (author's transl)].

The results are set out of emergency or electiver surgery for bleeding oesophageal carices or for intractable ascites in hepatic cirrhosis. The procedure adopted, a meso-caval shunt with prothesis interposition, led to a low percentage of thrombosis, markedly lowered portal pressure, and gave effective clinical results. Although angiography indicated that the portal flow to the liver had dropped considerably, or even ceased altogether, the bad effect on liver function and the incidence of encephalopathy seemed reduced than generally reported after porta-cava shunts. No deaths occurred among the patients for who surgery had been planned, but the rate was still high in emergency cases. This indicates that although well tolerated, the interposition meso-cava shunt is best performed after careful pre-operative selection and preparation.

Adult↗
PubMedDate not supplied

[Gastric carcinoma in the elderly (clinical findings and results)].

On the basis of a series of 643 patients operated on for gastric cancer, the Authors seek to establish whether this disease presents clinical differences with advancing age of such a nature as to have a significant effect on therapeutic management. The series is divided into two groups, the first consisting of patients aged below 70 and the second of patients aged over 70. The following aspects were evaluated: sex, tumour site, oncological stage, type of surgery performed, operative mortality, postoperative survival, as assessed in overall terms and also differentiated in relation to curative or palliative surgery and oncological stage. Analysis of the data confirms that, apart from certain particular aspects, carcinoma of the stomach in the elderly benefits from the same sort of indications and techniques as those proposed for younger patients, with comparable postoperative survival rates, but with a higher operative mortality. To achieve better operative results, what is needed, in addition to correction of metabolic and functional abnormalities, is thorough assessment of risk factors. In patients with tumours at advanced stages, usually characterized by very poor postoperative results, the presence of major risk factors may raise serious doubts as to the actual advisability of the surgical indication itself.

Actuarial Analysis↗
PubMedDate not supplied

[Treatment of hemorrhagic syndrome caused by peritoneovenous shunt with a flow regulation device].

A case of severe coagulopathy after peritoneovenous shunting for intractable ascites and hepatorenal syndrome in a cirrhotic patient is reported. It was controlled and solved without removal of the shunt, using a vascular tourniquet which allowed a regulation of the ascitic flow. The method seems susceptible of improvement and could be routinely used in risk patients.

Ascites↗
PubMedDate not supplied

[Design criteria for a computerized clinical database].

The techniques of data management constitute a principal field in medical informatics, both for systems oriented to sole information retrieval, and basic-systems for more sophisticated applications. The operative utility of a data base depends on a careful planning based on foreseen requirements, and on the observance of some methodological rules. Such as, a precised preliminary study for the selection of clinical data to include in the data base, the choice of better tools and methodologies for the data collection and the right programming of software for the management of the archives. The knowledge of these problems allows, in many cases, the programming of computerized data base to use efficiently in the management of clinical information and in the planning of research. These problems, which do not depend on the hardware used, are commonly found in these applications. However, they have to be solved either for the use of large data base in hospital, which run on mainframe, or for the archives of the department, which can be built by every clinician on his own personal computer.

Humans↗
PubMedDate not supplied

Changes in nutritional and immunologic parameters after preparation for colonic surgery.

In 15 patients about to undergo colorectal resection for cancer (group I), body weight, lymphocytes, albumin, prealbumin, complement components C3 and C4 and total hemolytic complement activity (TC) were evaluated on admission to hospital and after preroperative preparation which involved dietary restrictions for 5-9 days (450 calories, 25 g protein daily). The same parameters were evaluated in 15 patients admitted for other major surgery not requiring colonic preparation (group II). Statistically significant reduction in prealbumin, C3, C4 and TC were found only in group I. The observations suggest a relationship between immunonutritional status and preparation for large-bowel surgery, reproducing a state of acute malnutrition.

Adult↗
PubMedDate not supplied

[Multimodal treatment of intrahepatic lithiasis with traditional surgery, endoscopy, and extracorporeal lithotripsy. Report of a clinical case].

A patient with residual intra-/extra-hepatic bile duct stones, previously admitted in emergency for acute necrotic pancreatitis and cholangitis, underwent the following procedures: 1) endoscopic sphincterotomy and naso-biliary tube drainage; 2) surgical operation (choledocholithotomy, operative choledochoscopy and T-tube external biliary drainage); 3) extracorporeal shock-wave lithotripsy; 4) endoscopic sessions of fragmented stones removal. The above mentioned multimodal treatment, which resolved the intrahepatic lithiasis as shown 12 months later by endoscopic retrograde cholangiography, is therefore suitable in order to avoid, at least initially, invasive radiologic or surgical procedures, i.e. transparenchymal approaches, intrahepatic derivations and hepatic resections.

Bile Ducts, Intrahepatic↗