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1.
Minerva Gastroenterol Dietol ; 43(3): 163-5, 1997 Sep.
Article in Italian | MEDLINE | ID: mdl-16501487

ABSTRACT

The authors propose the conservative treatment of ischemic colitis using slow-release mesalazine and enema. The excellent tolerability of the treatment and the good level of therapeutic efficacy was confirmed in 13 cases treated without signs of recurrence of disease.

2.
Minerva Chir ; 52(9): 1069-75, 1997 Sep.
Article in Italian | MEDLINE | ID: mdl-9432581

ABSTRACT

335 inguino-femoral hernias were repaired with polypropylene mesh from December 1991 through December 1995. Eleven patients underwent mesh reinforced Bassini, 167 modified Lichtenstein's technique and 108 Trabucco's repair. Forty-three patients were treated under regional anesthesia. Bilateral hernia was diagnosed in 33 patients and in 20 out of 33 the surgical procedure was entirely performed under regional anesthesia. Early complications referred were 32 scrotal hematomas which spontaneously healed. Two patients showed a recidive hernia and were retreated with and additional mesh; plug rejection (early experience) was referred in one patient who was reoperated on employing a mesh. The indications for the more suitable technique were directly deducted from Nyhus' hernia classification. The authors finally point out the: 1) importance of regional inguinal anesthesia; 2) correct cutting and application of the mesh in the inguinal canal; 3) internal inguinal ring repair; 4) bilateral hernia repair under regional anesthesia.


Subject(s)
Hernia, Femoral/surgery , Hernia, Inguinal/surgery , Surgical Mesh , Adolescent , Adult , Aged , Aged, 80 and over , Anesthesia, Conduction , Anesthesia, Local , Female , Hernia, Femoral/complications , Hernia, Inguinal/complications , Humans , Male , Middle Aged , Polypropylenes , Recurrence , Reoperation
3.
Minerva Gastroenterol Dietol ; 42(4): 191-3, 1996 Dec.
Article in English | MEDLINE | ID: mdl-17912209

ABSTRACT

Following numerous reports confirming the role of erosive chronic gastritis and ulcer, several treatment protocols have been used with the aim of eradicating this microorganism. Elimination was initially achieved using polychemotherapeutic associationsbismuth salts+metronidazole+amoxycillin and/or tetracyclineswhich proved relatively efficacious in therapeutic terms, but often led to side effects, the onset of bacterial resistance and scarse patient compliance. The authors consider that these limits can be overcome by using a new association of homeprazole+azithromycin, whose effica-cy in the eradication of Helicobacter pylo-ri has been shown to be of about 85% of cases treated for a relatively short period (4 weeks).

4.
Minerva Chir ; 50(3): 247-52, 1995 Mar.
Article in Italian | MEDLINE | ID: mdl-7659259

ABSTRACT

The authors examine 192 consecutive cases of upper gastrointestinal hemorrhage; the series included 133 males and 59 females with a mean age of 55.78 years (SD +/- 17.88) and range of 18-97. All patients underwent emergency esophagogastroduodenoscopy within 6-12 hours of hospitalisation. Adequate infusion and; when necessary, transfusion therapy associated with protection using anti H2 (ranitidine 200 mg/24 h) and octreotide (0.2 mg x 3/day sc), proportionately scaled over the following 72 hours, were used in all patients. Nasogastric aspiration (nasogastric probe or Sengstaken-Blakemore probe) were used for at most 48 h after endoscopy. Patients were then subdivided into 2 age groups: under (104 cases) and over (88 cases) 60 years. Statistical relations were studied (Chi-square test), assuming the reference value to be p = 5%, between age and diagnosis, sex, symptoms on presentation, hemotransfusion, Forrest's classification, the onset of renewed bleeding and lastly the evolution of each case. Hemorrhage was more frequent in males aged < 60 years and in females aged > 60 (p < 0.004), hemorrhagic shock, the presence of Forrest 1a and 1b and death were significant in elderly subjects (p < 0.004; p < 0.01; p < 0.01). The latter finding included patients with esophageal varices, group which was significantly correlated with mortality independent of age. The overlap of statistical results in hemorrhage not related to varices suggests, on the one hand, that appropriate early treatment has a greater influence on the prognosis rather than the type of pathology, and on the other that being aged over 60 does not correspond to an increased biological risk.


Subject(s)
Gastrointestinal Hemorrhage/diagnosis , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Emergencies , Endoscopy, Digestive System , Female , Humans , Male , Middle Aged , Prognosis
5.
Minerva Chir ; 49(12): 1317-23, 1994 Dec.
Article in Italian | MEDLINE | ID: mdl-7746455

ABSTRACT

The authors examine eight cases of acute pseudo-obstruction of the colon and point out that these may be inserted in the wider context of intestinal pseudo-obstructions. These comments raise questions concerning Ogilvie's syndrome since the dilatations observed do not only affect the colon, according to the classic definition, but also the ileo-jejunal tract, in spite of the fact that the main target continues to be the colon. The term Ogilvie's syndrome is still significant in the clinical identification of colic dilatation, in particular the right colon in which possible complications are more severe. The authors identify colonoscopy as the best instrumental test owing to the possibilities its offers, including therapeutic, and also underline that there does not appear to be a real risk of iatrogenic lesions if an appropriate technique is used.


Subject(s)
Colonic Pseudo-Obstruction/diagnosis , Aged , Aged, 80 and over , Colon/pathology , Colon/surgery , Colonic Pseudo-Obstruction/pathology , Colonic Pseudo-Obstruction/surgery , Colonoscopy , Fatal Outcome , Female , Humans , Laparotomy , Male , Middle Aged , Retrospective Studies , Terminology as Topic
6.
Minerva Chir ; 49(11): 1133-5, 1994 Nov.
Article in Italian | MEDLINE | ID: mdl-7708237

ABSTRACT

The authors report three cases of acute epiploitis diagnosed intraoperatively and discuss the etiopathogenetic hypotheses. They suggest a relationship between acute epiploitis and mesenteric lymphadenitis, as well as their common origin.


Subject(s)
Mesenteric Lymphadenitis/surgery , Omentum , Adolescent , Aged , Cefotaxime/therapeutic use , Ceftriaxone/therapeutic use , Child , Female , Humans , Inflammation , Mesenteric Lymphadenitis/diagnosis , Mesenteric Lymphadenitis/pathology , Omentum/pathology , Peritoneal Diseases/diagnosis , Peritoneal Diseases/pathology , Peritoneal Diseases/surgery , Premedication
7.
Med Pediatr Oncol ; 21(4): 259-64, 1993.
Article in English | MEDLINE | ID: mdl-8469220

ABSTRACT

Ninety patients with biopsy-proven Langerhans cell histiocytosis (LCH) were enrolled from June, 1983, to December, 1988, in the multicenter AIEOP-CNR-H.X. '83 study. They were divided into two groups: poor prognosis (PP), comprising 11 children with organ dysfunction (OD), and good prognosis (GP), made up of 79 patients without OD. Eighty-four patients were evaluable for treatment results. Among GP patients, 16 with a single lesion received only local treatment, while 59 entered a clinical trial of immunotherapy and/or monochemotherapy with vinblastine (VBL). Nonresponders, sequentially received doxorubicin (ADM) and then etoposide (VP16). PP patients were treated with 4 week cycles of vincristine, ADM, cyclophosphamide, and prednisone for nine courses. The overall survival was 92.8% (100% for GP patients and 45.5% for PP patients) at 48 months. The complete response (CR) rates for immunotherapy, VBL, ADM, and VP16 were 10%, 62.9%, 42.8%, and 88.2%, respectively. Two of the 11 PP patients had a CR (18.2%), while six died and three are still alive with recurrent disease. The overall incidence of disease-related disabilities was 47.7%, while that of diabetes insipidus was 20%. Monochemotherapy is probably adequate in GP patients, while more effective treatments are needed for PP patients.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Histiocytosis, Langerhans-Cell/therapy , Adolescent , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Child , Child, Preschool , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Doxorubicin/adverse effects , Doxorubicin/therapeutic use , Etoposide/adverse effects , Etoposide/therapeutic use , Female , Humans , Immunotherapy , Infant , Infant, Newborn , Italy , Male , Prednisone/administration & dosage , Prognosis , Prospective Studies , Treatment Outcome , Vinblastine/adverse effects , Vinblastine/therapeutic use , Vincristine/administration & dosage
8.
Minerva Chir ; 47(19): 1521-7, 1992 Oct 15.
Article in Italian | MEDLINE | ID: mdl-1470405

ABSTRACT

Acute intestinal ischemia is a pathology which is relatively often encountered in elderly patients where the concomitance of other diseases make its prognosis more severe, especially since diagnosis is usually late. Laboratory tests and imaging techniques are not of great value to diagnosis since they do not provide pathognomonic data, but together with a careful anamnesis they contribute a series of findings which, taken as a whole, lead to the diagnosis of intestinal ischemia. The sole therapy is surgery--when still possible and the best results are obtained when surgery is performed at an early stage. The authors report a series of 12 cases of acute intestinal ischemia and underline the difficulty of diagnosing this subtle pathology and the advantages of aggressive surgical techniques.


Subject(s)
Intestines/blood supply , Ischemia/diagnosis , Abdomen/diagnostic imaging , Acute Disease , Aged , Aged, 80 and over , Female , Humans , Infarction/diagnosis , Infarction/surgery , Intestines/surgery , Ischemia/surgery , Male , Middle Aged , Radiography, Abdominal , Time Factors , Ultrasonography
9.
J Med Eng Technol ; 16(4): 149-56, 1992.
Article in English | MEDLINE | ID: mdl-1433245

ABSTRACT

In spite of many clinical and experimental applications, the technique of transcranial magnetic stimulation still presents obscure aspects. This especially concerns safety parameters and the exact characterization of the current induced by a single magnetic pulse. The model proposed consists of an equivalent electric network derived by Maxwell's equations and applied to discretized magnetic resonance imaging of a normal subject. This model allows accurate prediction of current distribution, charge per phase and dissipated energy.


Subject(s)
Cerebral Cortex/physiology , Computer Simulation , Electromagnetic Fields , Models, Biological , Cerebral Cortex/anatomy & histology , Electric Impedance , Electric Stimulation/adverse effects , Humans , Magnetic Resonance Imaging , Reference Values
10.
Sci Total Environ ; 114: 47-57, 1992 Apr.
Article in English | MEDLINE | ID: mdl-1594923

ABSTRACT

The same sampling and analytical methods were used to compare atmospheric pollution due to polycyclic aromatic hydrocarbons (PAHs) and heavy metals (Tl, Pb, Mn, Fe, Cr, V, Zr, Ni Cd) in two towns in Italy, Genoa and La Spezia, whose populations are 746, 785 and 112,602 respectively. Knowledge of the organic and inorganic composition of airborne particulates permits a reliable identification of the main sources of pollution which is required in order to identify populations at risk. In the urban area of Genoa and in La Spezia, traffic appears to provide a diffuse source of carcinogenic and toxic compounds in the atmosphere producing high and constant exposures to PAHs and lead along busy streets. In Genoa approximately 70,00 people (10% of residents) are considered to be exposed to the highest concentrations of toxic and cancerogenic pollutants emitted from this source. The highest daily PAH concentrations were found in the industrial areas; in Genoa, coke ovens were identified as the main localised sources of these compounds. According to meteorlogical and orographic characteristics for this area, for approximately 25,00 people (3% of the general population) may be exposed to pollutants emitted from this source over a maximum period equivalent to approximately 3 months each year. The highest individual doses of PAHs due to urban pollution inhaled by the population of Genoa and La Spezia were comparable to those produced by high exposure to passive smoke; the exposure to carcinogenic metals (Cr, NI, Cd) was relatively low. The mean concentrations of the analysed pollutants appeared to depend strictly on urban characteristics; no correlations were found with the size of the town.


Subject(s)
Air Pollutants, Occupational/analysis , Air Pollutants/analysis , Metals/analysis , Polycyclic Compounds/analysis , Urban Health , Geography , Italy
12.
Minerva Chir ; 46(7): 319-26, 1991 Apr 15.
Article in Italian | MEDLINE | ID: mdl-1866039

ABSTRACT

Personal experience in the management of head injury in a General Surgery Department is reported and a series of 352 patients analysed with a view to identifying variations in the epidemiological profile of this pathology over the last decade and in order to establish indications for admission and the transfer of the patient to specialist departments.


Subject(s)
Craniocerebral Trauma/epidemiology , Surgery Department, Hospital , Age Factors , Brain Injuries/epidemiology , Humans , Incidence , Italy/epidemiology , Retrospective Studies , Sex Factors , Skull Fractures/epidemiology , Surgery Department, Hospital/statistics & numerical data
16.
Minerva Chir ; 45(12): 911-3, 1990 Jun 30.
Article in Italian | MEDLINE | ID: mdl-2250790

ABSTRACT

A case of intestinal occlusion is reported caused by volvulus of Meckel's diverticulum. The etiological and clinical aspects are discussed together with their implications in terms of suitable surgical therapy.


Subject(s)
Ileal Diseases , Intestinal Obstruction , Meckel Diverticulum , Adult , Emergencies , Humans , Ileal Diseases/surgery , Intestinal Obstruction/surgery , Male , Meckel Diverticulum/surgery
18.
Minerva Chir ; 45(13-14): 933-4, 1990.
Article in Italian | MEDLINE | ID: mdl-1703287

ABSTRACT

The paper illustrates a personal technique used in palliative surgery of extensive tumours of the head of the pancreas. An omega loop is prepared into which both the VBP and digestive tract are diverted, thus reducing the number of anastomoses to be performed and the length of the operation.


Subject(s)
Pancreatic Neoplasms/surgery , Cholecystectomy , Common Bile Duct/surgery , Humans , Jejunum/surgery , Palliative Care , Stomach/surgery
19.
Minerva Chir ; 44(18): 1989-94, 1989 Sep 30.
Article in Italian | MEDLINE | ID: mdl-2694008

ABSTRACT

Intraoperative cholangiography continues to be the principal investigation in the intraoperative diagnosis of biliary disease. Cholangiography and preoperative echography, the clinical aspect are not sufficient to exclude the possibility of choledochal lithiasis in operations carried out for straightforward cholelithiasis. Personal experience in a series of 248 bile lithiasis operations is examined: intraoperative diagnosis was based on 244 cholangiographies, 41 echographies and 22 choledochoscopies. Choledochoscopy proved decisive for evidencing residual choledochal calculi after seemingly accurate choledocholithotomy operations and also after trans-Kehr intraoperative cholangiography. Intraoperative echography, in the light of rather limited experience, would seem to add nothing to the two previous associated intraoperative instrumental investigations; it may prove useful in certain special cases.


Subject(s)
Cholelithiasis/diagnosis , Cholangiography , Cholelithiasis/surgery , Humans , Intraoperative Period , Ultrasonography
20.
Minerva Chir ; 44(18): 1995-2000, 1989 Sep 30.
Article in Italian | MEDLINE | ID: mdl-2616001

ABSTRACT

Perforated diverticulitis of the large bowel is a frequent observation in surgical practice. There is, however, no standard attitude to the procedures to be adopted: the only fixed point is the abandonment of straightforward colostomy and drainage. A series of 16 cases of perforated diverticulitis of the large bowel operated on in emergency and treated with various procedures, i.e. 8 Hartmann resections, 6 Paul-Mikulicz operations, 2 ideal colectomies, 2 colostomies and drainage. The observations made permit a number of considerations: 1) "ideal colectomy" is undoubtedly the best intervention providing the patient presents an early NPT and a temporary colostomy has been made to protect the anastomosis; 2) the rupture of a single diverticulum suggests the Paul-Mikulicz operation and it can be treated at a later stage by straightforward closure; 3) rupture of a diverticulum within the framework of extended diverticular involvement suggests Hartmann's resection; 4) colostomy and drainage should be abolished for its poor results and can be kept for patients in very serious condition.


Subject(s)
Diverticulitis, Colonic/surgery , Intestinal Perforation/surgery , Aged , Aged, 80 and over , Diverticulitis, Colonic/diagnosis , Female , Humans , Intestinal Perforation/diagnosis , Male , Methods , Middle Aged
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