Gerardo Sarno - Academia.edu (original) (raw)

Papers by Gerardo Sarno

Advances in medical sciences, Jan 12, 2018

Human leukocyte antigen (HLA)-G is a non-classic major histocompatibility complex HLA class I mol... more Human leukocyte antigen (HLA)-G is a non-classic major histocompatibility complex HLA class I molecule. HLA-G may have tolerogenic properties which are linked to epigenetic-sensitive pathways. There is a correlation of sHLA-G levels and graft acceptance in transplantation studies. There are previous data on correlation of sHLA-G with graft rejection as well as with viral infections such as hepatitis C virus (HCV) in kidney transplanted patients. Here, we report the sHLA-G expression in patients on the waiting list for kidney transplantation, with and without anti-HCV compared to a control group. Serum of 67 patients on the waiting list for kidney transplantation (n = 43 with anti-HCV and n = 24 without anti-HCV) was analyzed. Among these patients, n = 39 were on the waiting list for the first transplantation, while n = 28 were patients who returned in the list. The control group included n = 23 blood donors with anti-HCV (n = 13) and without anti-HCV (n = 10). The expression of sHLA...

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Jan 26, 2017

A 62-year-old male patient with diabetes underwent deceased-donor kidney transplant at our transp... more A 62-year-old male patient with diabetes underwent deceased-donor kidney transplant at our transplant unit. At reperfusion, a small and clinically not significant subcapsular hematoma was noted. The patient's postoperative course was characterized by delayed graft function since the beginning but was further complicated on postoperative day 6 by evidence (shown at daily Doppler ultrasonography) of a wide increase of the hematoma. The hematoma, which was just visible before, was now leading to graft compression because it covered up to two-thirds of the cortical surface. The patient showed no hemo-dynamic instability and showed no significant drop in hemoglobin values. Capsulotomy was not performed because it was deemed too risky. The patient was given strict follow-up with Doppler ultrasonography and high-resolution imaging techniques (magnetic resonance imaging and computed tomography scan). In the following days, spontaneous resolution of the hematoma and progressive improveme...

International Journal of Surgery Open

Reviews in endocrine & metabolic disorders, Sep 9, 2017

Kidney transplant is the treatment of choice for end-stage chronic kidney disease. Kidneys genera... more Kidney transplant is the treatment of choice for end-stage chronic kidney disease. Kidneys generate 1,25-dihydroxyvitamin D (calcitriol) from 25-hydroxyvitamin D (calcidiol) for circulation in the blood to regulate calcium levels. Transplant patients with low calcidiol levels have an increased risk of metabolic and endocrine problems, cardiovascular disease, type 2 diabetes mellitus, poor graft survival, bone disorders, cancer, and mortality rate. The recommended calcidiol level after transplant is at least 30 ng/mL (75 nmol/L), which could require 1000-3000 IU/d vitamin D3 to achieve. Vitamin D3 supplementation studies have found improved endothelial function and acute rejection episodes. However, since kidney function may still be impaired, raising calcidiol levels may not lead to normal calcitriol levels. Thus, supplementation with calcitriol or an analog, alfacalcidiol, is often employed. Some beneficial effects found include possible improved bone health and reduced risk of chr...

American journal of surgery, Jul 1, 2017

Nutrition, Jan 11, 2008

External lymphatic fistula or chyloperitoneum after intra-abdominal lymphadenectomy may present c... more External lymphatic fistula or chyloperitoneum after intra-abdominal lymphadenectomy may present challenging problems. In the absence of definite guidelines the choice of treatment is often empirical, with unpredictable effectiveness, and the reporting of new cases may broaden the available experience. Methods: We describe two cases. One patient had high-output external fistula (1300 mL/d) after para-aortic lymphadenectomy for metastatic lymph nodes. The fistula became fully evident at postoperative day 4, with resumption of an oral diet, on the basis of a 1300-mL/d output of white milky fluid from an abdominal drainage. Oral feeding was interrupted and total parenteral nutrition was started; this was transiently associated with octreotide administration, subsequently replaced by somatostatin. The second patient had a low-output fistula (350 mL/d) after liver resection and lymphadenectomy for cholangiocarcinoma and underwent treatment with total parenteral nutrition and somatostatin. Results: In the first case the lymphatic fistula healed in just less than 3 wk, with the patient constantly remaining in very good condition, without secondary complications. In the second case the low-output fistula healed more rapidly. Conclusion: Interruption of oral feeding with total parenteral nutrition and continuous somatostatin infusion was an effective treatment in both patients with an intra-abdominal lymphatic leak.

Critical reviews in food science and nutrition, Jan 31, 2016

Increasing evidence suggests that vitamin D exerts multiple effects beyond bone and calcium metab... more Increasing evidence suggests that vitamin D exerts multiple effects beyond bone and calcium metabolism. Vitamin D seems to play a role in pancreatic disease, including type 1 and type 2 diabetes mellitus as well as pancreatic cancer. Vitamin D's immune-modulatory action suggests that it could help prevent type 1 diabetes. In type 2 diabetes, vitamin D may influence β-cell function, insulin sensitivity, and systematic inflammation-all characteristic pathways of that disease. Data from observational studies correlated vitamin D deficiency with risk of type 1 and type 2 diabetes. Prospective and ecological studies of pancreatic cancer incidence generally support a beneficial effect of higher 25-hydroxyvitamin D concentration as well as inverse correlations between UVB dose or exposure and incidence and/or mortality rate of pancreatic cancer. This review discusses the literature regarding vitamin D's role in risk of diabetes and pancreatic cancer. The results to date generally s...

Hepato Gastroenterology, 2009

Renal cell carcinoma is an aggressive tumor which is often advanced at the time of diagnosis; its... more Renal cell carcinoma is an aggressive tumor which is often advanced at the time of diagnosis; its distant spread can take a lymphatic route or, more often, a vascular route (renal vein and inferior vena cava), but tumor thrombosis of left portal vein extending into the round ligament (the umbilical vein) coming from this tumor, to our knowledge, has never been described. We report the case of a metastatic thrombosis of left portal vein and of the umbilical vein from renal cell carcinoma, developed 13 years after nephrectomy, which was successfully treated with left hepatectomy. The experience with hepatectomy for metastatic renal cell carcinoma has been rarely reported. Nevertheless radical hepatectomy is considered to be the only opportunity for curative treatment for selected patients with metastatic renal cell carcinoma.

Surgical Management of Hepatobiliary and Pancreatic Disorders, Second Edition, 2010

BMJ case reports, 2009

Leyomiosarcomas arising from the portal/mesenteric venous system are very rare tumours, and only ... more Leyomiosarcomas arising from the portal/mesenteric venous system are very rare tumours, and only a few cases have been reported in the global literature. As the other leyomiosarcomas of vascular origin, they are associated with a poor prognosis. The present report describes the case of a 66-year-old woman with a leyomiosarcoma of the inferior mesenteric vein, unexpectedly found during a CT scan performed for another indication. A brief review of the literature is also given. The patient underwent radical surgical excision and enjoys a good health, without radiological signs of recurrence, 24 months after surgery. In this case, an early incidental diagnosis determined an early treatment and, probably, a favourable prognosis. This is the second case of leyomiosarcoma of the inferior mesenteric vein reported in the literature.

Chirurgia

AB Multiple symmetric lipomatosis (Madelung's disease) is a very rare syndrome characterized ... more AB Multiple symmetric lipomatosis (Madelung's disease) is a very rare syndrome characterized by multiple and symmetrical subcutaneous fatty masses that usually involve the upper third of the body. Etiology and pathogenesis of this disease remain unclear, even if a strong association with chronic alcohol abuse has been observed. Growth of the lipomatous lesions is slowly progressive and may lead to huge symptomatic masses. Interruption of alcohol abuse and surgical excision are the only effective treatments. We report the case of a 54-years-old man with Madelung's disease. The patient presented multiple asymptomatic fatty masses in the neck and upper trunk and a huge recurrent lipoma in the posterior cervical region limiting his neck movements. He underwent surgical excision of this latter mass with an uneventful post-operative course and good functional and aesthetic results. The patient is well fit 36 months after surgery, with no signs of local recurrence. Therefore we con...

Osp Ital …, 2008

Page 1. LA COLECISTECTOMIA LAPAROSCOPICA 20 ANNI DOPO COMPLICANZE DELLA VLC Osp Ital Chir 2008; 1... more Page 1. LA COLECISTECTOMIA LAPAROSCOPICA 20 ANNI DOPO COMPLICANZE DELLA VLC Osp Ital Chir 2008; 14: 126-36 Complicanze biliari della colecistectomia: la gestione della fase acuta delle lesioni iatrogene della via biliare principale ...

The American Journal of Surgery, 2008

A 34-year-old woman presented with epigastric pain, nausea, and dyspepsia. Contrastenhanced compu... more A 34-year-old woman presented with epigastric pain, nausea, and dyspepsia. Contrastenhanced computerized tomography revealed a small mass in the duodenal wall mimicking a periampullary neoplasm and, at endoscopic examination, a periampullary submucosal tumor was suspected. The diagnosis of intramural duodenal diverticulum (IDD) was made by an x-ray barium meal that showed a finger-like sac filled with barium, the so-called "windsock sign." IDD is a rare congenital abnormality caused by an anomalous process of recanalization of the primitive foregut. The intermittent filling and emptying of the IDD is responsible for epigastric pain, nausea, and vomiting. When IDD is symptomatic, surgical or endoscopic treatment is recommended.

Journal of Surgical Oncology, 2006

ABSTRACT

International Journal of Surgery, 2013

European Journal of Surgical Oncology (EJSO), 2010

British Journal of Surgery, 2012

Background Combined vasculobiliary injury is a serious complication of cholecystectomy. This stud... more Background Combined vasculobiliary injury is a serious complication of cholecystectomy. This study examined medium- to long-term outcomes after such injury. Methods Patients referred to this institution with Strasberg type E bile duct injuries were identified from a prospectively maintained database (1990–2010). Long-term outcomes were evaluated by chart review. Results Sixty-three patients were referred with bile duct injury alone (45 patients) or vasculobiliary injury (18). Thirty patients (48 per cent) had septic complications before transfer. Twenty-six patients (41 per cent) had long-term biliary complications over a median follow-up of 96 (range 12–245) months. Nine patients (3 with bile duct injury, 6 with vasculobiliary injury) required further interventions after a median of 22 (8–38) months; five required biliary surgical revision and four percutaneous dilatation of biliary strictures. Vasculobiliary injury and injury-related sepsis were independent risk factors for treatm...