ABSTRACT
The association between chemotherapy and hypertermia produces a synergic effect. In this study the Authors present their experience, by the analysis of the results. From 1993 to 2000, 17 patients have been treated with surgery associated with hypertermic chemotherapy for peritoneal carcinomatosis. For the management of these patients a constant cooperation among surgeon, cardiologist and anaesthetist is very important.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma/secondary , Cardiovascular Diseases/etiology , Hyperthermia, Induced/adverse effects , Peritoneal Neoplasms/secondary , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Appendiceal Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoid Tumor/secondary , Carcinoma/drug therapy , Carcinoma/surgery , Carcinoma/therapy , Carcinoma, Ductal, Breast/surgery , Cardiovascular Diseases/physiopathology , Cisplatin/administration & dosage , Cisplatin/adverse effects , Colonic Neoplasms/pathology , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Neoplasm Seeding , Neoplasms, Second Primary , Ovarian Neoplasms/pathology , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/surgery , Peritoneal Neoplasms/therapy , Retrospective Studies , Stomach Neoplasms/pathology , Treatment OutcomeABSTRACT
Bile duct carcinomas are known to be difficult to cure, due to frequent locoregional recurrence even after radical resection. The Authors analyze their experience in a study about 53 patients treated between October 1991-January 2002.
Subject(s)
Adenocarcinoma/surgery , Common Bile Duct Neoplasms/surgery , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Adenocarcinoma/epidemiology , Aged , Aged, 80 and over , Anastomosis, Roux-en-Y , Cholangiopancreatography, Endoscopic Retrograde , Cholecystitis/complications , Common Bile Duct Neoplasms/complications , Common Bile Duct Neoplasms/diagnosis , Common Bile Duct Neoplasms/epidemiology , Drainage , Duodenostomy , Female , Humans , Italy/epidemiology , Jejunum/surgery , Laparotomy , Liver/surgery , Male , Middle Aged , Palliative Care , Pancreaticoduodenectomy , Retrospective Studies , Stomach/surgery , Treatment OutcomeABSTRACT
A 3-year-old girl with 52% TBSA scalds, mostly partial thickness, was treated topically with 5% mafenide acetate solution and 1% silver sulfadiazine cream. All blood cultures and wound swabs were negative for the first 5 days. On day 6 gram-negative bacteria and yeast forms were isolated from her wounds. High fever and leukocytosis were present and the child was treated with intravenous ampicillin and gentamicin according to sensitivity bacteriogram. The bacteria were identified as Pseudomonas aeruginosa and the yeast was Candida tropicalis. On day 7, Escherichia coli was identified in blood cultures and intravenous cefixime was added. Amphotericin B was added on day 9 when blood cultures grew Candida tropicalis and Burkholderia cepacia. On day 13 dark pigmentation foci developed on some areas of partial-thickness burns in the back, resembling invasive wound infection. White blood cell count was 14,300 cells/mm3, and her body temperature reached 39.7 degrees C. Cultures from the pigmented areas were negative, and biopsies revealed deposits of silver. Most of the areas healed uneventfully, and only about 8% TBSA needed grafting, including some of the pigmented areas. No residual pigmentation remained on discharge.
Subject(s)
Anti-Infective Agents, Local/adverse effects , Burns/drug therapy , Cicatrix/etiology , Pigmentation Disorders/chemically induced , Pigmentation Disorders/diagnosis , Silver Sulfadiazine/adverse effects , Anti-Infective Agents, Local/administration & dosage , Burkholderia cepacia/isolation & purification , Burns/microbiology , Candida tropicalis/isolation & purification , Candidiasis/drug therapy , Candidiasis/prevention & control , Child, Preschool , Cicatrix/pathology , Diagnosis, Differential , Escherichia coli/isolation & purification , Female , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/prevention & control , Humans , Pigmentation Disorders/pathology , Pseudomonas aeruginosa/isolation & purification , Silver Sulfadiazine/administration & dosage , Time Factors , Treatment Outcome , Wound Infection/diagnosis , Wound Infection/microbiologyABSTRACT
Cystic lymphangioma is a benign tumor of uncertain etiology characterized by a slow growth; in 2-8% of cases it is localized in the mesentery. Symptomatology is aspecific and preoperative diagnosis is often difficult. The Authors report the case of a mesenteric cystic lymphangioma in a patient who had undergone subtotal colectomy eight years earlier for an adenocarcinoma occluding the sigmoid colon. The patient was hospitalized for intestinal occlusion.
