HIV- and HCV-specific markers and echocardiographic pulmonary artery systolic pressure among United States veterans.

Hepatitis C virus (HCV) may increase pulmonary hypertension (PH) risk among people living with HIV (PLWH). Prior studies on this topic have been relatively small and examined selected populations. We determine whether HIV/HCV coinfection is associated with higher pulmonary artery systolic pressure (PASP) and prevalent echocardiographic PH.

Increased Echocardiographic Pulmonary Pressure in HIV-infected and -uninfected Individuals in the Veterans Aging Cohort Study.

Rationale: The epidemiology and prognostic impact of increased pulmonary pressure among HIV-infected individuals in the antiretroviral therapy era is not well described.

Objectives: To examine the prevalence, clinical features, and outcomes of increased echocardiographic pulmonary pressure in HIV-infected and -uninfected individuals.

Methods: This study evaluated 8,296 veterans referred for echocardiography with reported pulmonary artery systolic pressure (PASP) estimates from the Veterans Aging Cohort study, an observational cohort of HIV-infected and -uninfected veterans matched by age, sex, race/ethnicity, and clinical site.

Blocking both type A and B endothelin receptors in the kidney attenuates renal injury and prolongs survival in rats with remnant kidney.

Renal disease progression in the rat is associated with a time-dependent upregulation of renal endothelin-1 (ET-1) gene expression and synthesis. We have previously demonstrated that endothelin A receptor subtype (ETA) blockade in rats with remnant kidney reduced signs of disease activity, suggesting that ET-1 exerts part of its deleterious effects on the kidney through ETA. No data are available so far on the role of ETB receptor in progressive renal injury.

[Popliteal aneurysm].

The authors describe their experience of the aneurysm popliteal artery. They analyze the symptomatology, the diagnostic way and the therapy of such disease.

Abdominal aortic coarctation inducing aortic occlusion and renovascular hypertension.

Abdominal aortic coarctation is a rare, non-atherosclerotic disease. It is a functionally significant at an early age when associated with aortic branch stenosis and renovascular hypertension. The pathogenesis of aortic constrictive lesions remains unknown, but may be related to developmental error or aortic growth arrest and various hypotheses have been reported.

[Diverticulitis of the cecum].

Cecal diverticulitis, is not a common disease, frequently congenital, becoming clinically evident between the second and the fourth decade. The diagnosis of cecal diverticulitis is often controversial since the signs and symptoms simulate an acute appendicitis or an appendicular abscess. Moreover, during surgery, sometimes it appears like carcinoma of the cecum.

[Computerized management of a surgical department: preliminary report].

The authors deal with the problem of the computerized management of the Department, using a TRS 80 microprocessor, with a RAM memory of 48 Kbyte. They are working for the creation of a data bank which will store the basic information of the patient hospital record in variable format, together with some specific files for a number of diseases in fixed format. The main advantages in the use of the so-called "department's microprocessor" are the great saving of time in the management of the patient's data and the more accurate analysis of the same which allows a prompt diagnostic and therapeutic feedback.

[Malignant neoplasms of the extrahepatic bile ducts and Vater's papilla: clinico-therapeutic study].

No changes in prognosis of extrahepatic bile ducts malignant tumors was observed in the last years, in spite of modern tomographic procedures: only occasionally an early diagnosis resulting possible. Jaundice is the presentation sign of the disease, allowing in most cases when the site of tumor is the papilla of Vater or distal common bile duct a radical surgery but only palliative procedures when the tumor arises in the gallbladder or at the hepatic duct junction. Survival data from literature and personal experience indicate limited late results for radical surgery together with high operatory mortality.

[Traumatic perforations of the esophagus].

The Authors describe 6 patients with esophageal jatrogenic of foreign body perforation treatment during the last 5 years. The early recognition and immediate direct suture of the lesion proved a simple and efficient treatment. At the contrary a delayed diagnosis represent the cause of morbidity and mortality (one case on the six described) being impossible a direct suture of the lesion as consequence of local and general infective complication leading to very long postoperative causes with possible iterative surgery.

[Cancer of the kidney. Natural history and therapeutic problems].

Radical nephrectomy with initial ligation of the renal artery and removal en bloc of the perirenal fat and lumboaortic lymphadenectomy was carried out according to the technique of Robson (1969) in 10 cases at the University of Parma 1st Surgical Clinic between 1976 and 1978. The usefulness and superiority of the technique were demonstrated in this albeit small series, which included four stage I, two stage II, one stage III, and four stage IV patients, according to the classification of Flocks et al. Supplementary antiblastic and/or hormonal treatment was given, except in stage I cases.

[The use of selective amino acid solutions in the pre- and post-operative treatment of cirrhotics. Preliminary observations].

The use in cirrhosis of so-called selective amino acid solutions, i.e. solutions rich in branched and poor in aromatic acids, is readily explained by the proven alteration of the basal amino acid picture in this disease.

[Primary carcinoma of the gallbladder: report of 41 cases (author's transl)].

The Authors described their experience in 41 patients operated on because of gallbladder cancer. The overall mortality was 20%. Four cases suitables for a "radical" wide resection showed an average survival of 8 months, while 2 on 3 patients with in "situ" carcinoma treated by simple cholecystectomy are still alive at more than 3 years, the other dying after five years because of disease not related to the gallbladder cancer.

[Surgical treatment of cancer of the pancreas].

A series of 145 patients with cancer of the pancreas is presented. Radical surgery was performed in 23 cases. An assessment is made of anatomical and clinical factors likely to interfere with the results of surgery, particularly radical surgery.

[Transduodenal papillosphincterotomy in treatment of biliary lithiasis].

The Authors report 180 cases of transdudenal papillosphincterotomy. Medium follow-up at 5 years revealed a complete recovery in 87 of 100 controlled patients. Nine cases revealed persistence of some degree of dyspepsia, while a second operation was necessary for the remaining patients to remove recurrent calculi in 2 cases and because of Oddi's stenosis in other two cases.

[Dedo and Fishman technique for laryngeal release in cervical tracheal reconstruction (author's transl)].

The Authors report two cases of tracheal tumor operated with laryngeal release and tracheal mobilization following Dedo and Fishman. They discuss the indications and describe this technical procedure which has proved successful in obtaining a suture without traction also for 4 cm sleeve resection of trachea.

[Emergency colectomy in ulcerative colitis (author's transl)].

During the last 12 years 7 patients with ulcerative colitis were treated because of an acute complication consisting in 2 cases of colonic perforation, 3 cases of toxic megacolon (two of them perforated) and 2 cases of massive enterorragia. In all patients an emergency total colectomy was performed resulting a mortality of 3 cases, two of which had required the removal in a second time of the rectal stump. In 3 or 4 recovered patients we performed in a period of 7-15 months an ileo-proctostomy once confirmed the healing of the ulcerative lesions in the residual rectum.