Bronchiolitis obliterans organizing pneumonia after stereotactic ablative radiation therapy for lung cancer: A case report.

Bronchiolitis obliterans organizing pneumonia is an interstitial lung disease rarely occurring after radiotherapy probably due to an activation of autoimmune processes. Most cases have been described after postoperative radiotherapy for breast cancer. Corticosteroids represent the main treatment, prognosis is generally favorable. We described a case of bronchiolitis obliterans organizing pneumonia after stereotactic ablative radiation therapy for a recurrent lung cancer. Antibiotics and steroids were administered to solve the clinical picture. After three years, a new lesion at the right lung was found and treated with stereotactic ablative radiation therapy and concomitant long course of steroids with no recurrence of bronchiolitis obliterans organizing pneumonia. Bronchiolitis obliterans organizing pneumonia is a rare event after radiotherapy with undefined risk factors. In our case, steroids played an important role in management and, maybe, in preventing bronchiolitis obliterans organizing pneumonia recurrence after second course of stereotactic ablative radiation therapy.

Salvage image-guided intensity modulated or stereotactic body reirradiation of local recurrence of prostate cancer.

OBJECTIVE: To retrospectively evaluate external beam reirradiation (re-EBRT) delivered to the prostate/prostatic bed for local recurrence, after radical or adjuvant/salvage radiotherapy (RT). METHODS: 32 patients received re-EBRT between February 2008 and October 2013. All patients had clinical/radiological local relapse in the prostate or prostatic bed and no distant metastasis. re-EBRT was delivered with selective RT technologies [stereotactic RT including CyberKnife(TM) (Accuray, Sunnyvale, CA); image-guidance and intensity-modulated RT etc.]. Toxicity was evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Biochemical control was assessed according to the Phoenix definition (NADIR + 2 ng ml(-1)). RESULTS: Acute urinary toxicity: G0, 24 patients; G1, 6 patients; G2, 2 patients. Acute rectal toxicity: G0, 28 patients; G1, 2 patients; and G2, 1 patient. Late urinary toxicity (evaluated in 30 cases): G0, 23 patients; G1, 6 patients; G2, 1 patient. Late renal toxicity: G0, 25 patients; G1, 5 patients. A mean follow-up of 21.3 months after re-EBRT showed that 13 patients were free of cancer, 3 were alive with biochemical relapse and 12 patients were alive with clinically evident disease. Four patients had died: two of disease progression and two of other causes. CONCLUSION: re-EBRT using modern technology is a feasible approach for local prostate cancer recurrence offering 2-year tumour control in about half of the patients. Toxicity of re-EBRT is low. Future studies are needed to identify the patients who would benefit most from this treatment. ADVANCES IN KNOWLEDGE: Our series, based on experience in one hospital alone, shows that re-EBRT for local relapse of prostate cancer is feasible and offers a 2-year cure in about half of the patients.

[Innovations of the Stark method for cesarean section. Comparison of techniques]. / Innovazione al metodo di stark per il taglio cesareo. Tecniche a confronto.

BACKGROUND: The evolution of surgical techniques for cesarean section have improved the neonatal outcome as well as maternal morbidity and mortality. Aim of this study is to compare the conventional technique with a personally modified Stark's technique, in order to evaluate its effectiveness. METHODS: A prospective study has been carried out on a group of patients submitted to cesarean section by two different teams. A conventional technique for cesarean section was performed by a team, while the other carried out a modified Stark's technique, at the Obstetrics and Gynecology Department of the University of Parma from May 1997 to February 1998. A total of 105 cases underwent a modified Stark's technique, while 99 were submitted to cesarean section with the conventional technique. In order to get a better reliability of results, homogeneous cases for epidemiological characteristics and indications have been enrolled in the study. Statistical analysis was performed by using Student "t"-test, chi 2 test and Wilcoxon test. The Stark's technique for cesarean section, modified by the Authors, is described. RESULTS: The parameters concerning surgical procedure, postoperative course and neonatal outcome showed statistically significant differences in favour of the modified Stark's technique. CONCLUSIONS: The conclusion is drawn that this technique leads to a remarkable reduction of blood loss and urine bacteria. Surgical drainage was never required.

Intravesicular prostaglandin E2 for the prophylaxis of urinary retention after colpohysterectomy.

The aim of this study was to assess the efficacy of PGE2 in enhancing bladder function after vaginal hysterectomy. A total of 110 women with or without urinary incontinence underwent vaginal hysterectomy and cystourethropexy surgery because of grade II or III genital prolapse. Preoperatively the patients were randomly assigned to two groups: group 1 (n = 50) received on the fourth post-operative day, before removal of the bladder catheter, an intravesicular solution of 1.50 mg PGE2 (2 x 0.75 mg); group 2 (n = 60) did not receive any prophylaxis for urinary retention. In the PGE2-treated group significantly fewer patients had urinary retention for 3 days or more (10%, P < 0.05) than in the control group (27%). The use of intravesicular PGE2 reduced the time taken to restore detrusor function.

[Term pregnancy: the review and development of fetal surveillance protocols]. / La gravidanza a termine: revisione ed evoluzione dei protocolli di sorveglianza fetale.

The authors have analyzed the reasons behind the changes in clinical and biophysical monitoring of term and post-term pregnancies. In particular, there is an assessment of the results of NST monitoring over a one-year period. Furthermore, the importance of the introduction of new methods of labour induction by means of intracervical PGE2 is also discussed and there is a reference to the results. It is clinically evident that these methods have contributed to modify the problem of term-pregnancy management. Finally, there is a presentation of the new version of up-to-date procedures based on more clinical experience and more recent statistics on the subject.

Fetal distress: role of cardiotocography.

The FHR monitoring in 320 patients with fetal distress were randomly analyzed and revised over 16 years. The aim of our study, in so long a period, was to evaluate the role of cardiotocography in order to preserve the fetus from irreversible damage. The results show a progressive improvement of neonatal outcome, due to the development of the experience with this method, and to the improvement in interpretative criteria. However, cardiotocography showed its limits, and the moment has come to seek new integrative methods to associate cardiotocography with a continuous monitoring of the fetal status.