111 research outputs found
Risk of awareness can be increased during thiopental induction as compared to propofol : a bispectral index study
No full textRetrospective analysis of the effect of interferon therapy on hepatocellular carcinoma (HCC) development in cirrhosis
No full textThiopenthal can increase risk of awareness during anesthesia induction : a bispectral index study
No full textRetrospective analysis of the effect of interferon therapy on clinical course of disease and on hepatocellular carcinoma (HCC) development in cirrhosis
No full textLaparoscopic and laparotomic second look surgery for ovarian cancer:a report of 49 consecutive patients.
No full textLaparoscopy and laparotomic second look surgery for ovarian cancer: a report of 49 consecutive patients
Prevalence and incidence of cholecystolithiasis in cirrhosis and relation to the etiology of liver disease
No full textTo assess prevalence and incidence of cholecystolithiasis in cirrhosis, 356 consecutive cirrhotics and 247 consecutive cases of chronic hepatitis without cirrhosis were studied by ultrasonography. Cholecystolithiasis was significantly more frequent in cirrhotics than in patients with chronic hepatitis (p lt 0.001) after stratification for age and for alcohol abuse, and its prevalence in the former was affected by Child's class (p lt 0.001) and duration (p lt 0.001) of cirrhosis and was higher in HBsAg-negative as compared with HBsAg-positive cases (36.2 vs. 11.9%) and in patients with previous alcohol abuse (41.5 vs. 28.3%), while no difference was noted in relation to sex. By multivariate analysis, duration and Child's class of cirrhosis and HBsAg-negative status were statistically associated with cholecystolithiasis. One hundred and eighty-two of the 356 cirrhotic patients without gallstones at inclusion were followed prospectively, and 21 (11.5%) of them developed cholecystolithiasis, and duration of cirrhosis and past alcohol abuse were found to be independent risk factors for gallstone development by multivariate analysis. Cirrhosis is a significant risk factor for cholecystolithiasis, except for HBsAg-positive patients who have prevalence and incidence similar to noncirrhotics. Severity and duration of cirrhosis and previous alcohol abuse are associated with an increased risk of gallstone formation
Concurrent hepatitis B and C virus infection and risk of hepatocellular carcinoma in cirrhosis. A prospective study
No full textBACKGROUND. Patients with cirrhosis have a high risk of hepatocellular carcinoma (HCC) but it is unclear how the etiology of liver disease influences tumor development. The authors evaluated hepatitis B and C virus (HBV, HCV) infection in cirrhosis in relation to the risk of HCC. METHODS. Two hundred and ninety consecutive cirrhotic patients were followed prospectively with periodic ultrasound examination. At entry, patients were tested for markers of HBV and HCV to assess relation to tumor development during follow-up. RESULTS. Twenty and five-tenths percent of patients were hepatitis B surface antigen (HBsAg) positive and 68.9% were positive for HCV antibodies. Previous alcohol abuse was present in 26.2%. During follow-up (46.3 +/- 21.4 months), HCC developed in 32 patients (11.0%) (annual incidence approximately 3%) including 19.6% of HBsAg-positive patients, 12.2% of HCV antibody positive patients and 14.4% of patients with a history of alcohol abuse. The highest rate of HCC was in patients with dual HBsAg and anti-HCV positivity with or without previous alcohol abuse, whereas the lowest incidence (0%) was in cases without risk factors. By univariate analysis, age older than 59 years (P < 0.005), longer duration of cirrhosis (P < 0.005), serum alpha-fetoprotein levels higher than 20 ng/ml (P < 0.05), and dual HBsAg and HCV positivity (P < 0.02) appeared to be associated with HCC. By multivariate analysis, age (P < 0.01), positivity for HBsAg and HCV antibodies (P < 0.05), male sex (P < 0.05), and previous alcohol abuse (P < 0.08) were independently related to tumor appearance. CONCLUSIONS. These results, although confirming that male sex and previous alcohol abuse are risk factors for hepatocellular carcinoma in cirrhosis, indicate that concurrent hepatitis B and C virus infection determines the highest risk of developing hepatocellular carcinoma
Ruolo della laparoscopia in chirurgia ginecologica oncologica. Corso di addestramento teorico e pratico.
No full textNegli ultimi anni è stato dimostrato come sia possibile in molti casi utilizzare la laparoscopia per gli stessi interventi fino ad oggi effettuati con le tecniche chirurgiche classiche, riducendo molto gli effetti collaterali legati all’intervento chirurgico e consentendo una ripresa post operatoria molto più rapida, nonché un danno estetico e funzionale minore. Questi vantaggi sono particolarmente evidenti nei casi in cui è possibile conservare la funzione riproduttiva ed è proponibile sia nel caso di tumori dell’ovaio che dell’utero. Va dunque assolutamente rivista l’idea che identificava la chirurgia oncologica come estremamente aggressiva, demolitiva e spesso mutilante.Con la laparoscopia l'accesso chirurgico è minimo, la cicatrice poco evidente, la visione delle strutture anatomiche è ingrandita e ciò permette una notevole precisione senza ridurre la radicalità chirurgica ove necessaria.Tutto ciò porta ad una riduzione dei tempi di ricovero, un decorso post-operatorio più favorevole, una migliore compliance della paziente
Ruolo della laparoscopia nella Malattia Infiammatoria Pelvica
No full textLa laparoscopia trova nella chirurgia ginecologica odierna sempre più indicazioni.La maggior parte delle patologie che in passato venivano trattate con la chirurgia tradizionale, oggi possono essere affrontate per via laparoscopica, ad esempio la PID (malattia infiammatoria pelvica). Nella maggior parte dei casi di PID il quadro clinico è incerto comportando un gran numero di falsi negativi, pertanto, visto anche l'importante rischio di sterilità associata a questa patologia, la laparoscopia diagnostica rappresenta un efficace ausilio per i medici ginecologi. La laparoscopia permette infatti di affermare la diagnosi di PID, consente di eseguire prelievi endopelvici per una valutazione microbiologica e di definire il grado di gravità di questa malattia per poi procedere con il trattamento più idoneo a seconda dei casi
Retrospective analysis of the effect of interferon therapy on the clinical outcome of patients with viral cirrhosis
No full textBACKGROUND. Recent data suggest that interferon therapy (IFN) can reduce the risk of progression to hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related cirrhosis. METHODS. A cohort of 189 patients with Child's Stage A cirrhosis of viral etiology followed prospectively were analyzed retrospectively to assess the effects of IFN on the clinical course and development of HCC. RESULTS. During a mean follow-up of 71.5 +/- 23.6 months, 7.9% of 88 treated and 21.8% of 101 untreated patients showed worsening of the Child's disease stage (P < 0.01); 5.6% of treated and 26.7% of untreated patients developed HCC (P < 0.001); and 3.4% of treated and 19.8% of untreated patients died of liver disease or underwent orthotopic liver transplantation (OLT) (P < 0.005). Using Cox's regression analysis, no treatment with IFN, high bilirubin and alkaline phosphatase (ALP) levels, and low leukocyte counts and prothrombin activity (PT) were associated significantly with worsening of Child's disease stage; no treatment with IFN, long term disease, low albumin and PT, and high gamma-glutamyl transpeptidase (GGT) were related significantly to HCC development; and no treatment with IFN, low albumin and PT, and high GGT and ALP were associated significantly with reduced survival. After adjustment for independent risk factors identified by multivariate analysis, the estimated cumulative probability of worsening of cirrhosis (P < 0.05), development of HCC (P < 0.001), and death or OLT (P < 0.006) was significantly lower in IFN-treated patients compared with untreated patients. This beneficial effect of therapy was statistically evident only in HCV positive patients. CONCLUSIONS. These results support the hypothesis that IFN improves clinical outcomes and reduces progression to HCC in patients with HCV-related cirrhosis. These conclusions, based on retrospective data, should be confirmed prospective
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