Body composition modification in obese patients treated with intragastric balloon.

At the Centre for the Therapy of Morbid Obesity, a multidisciplinary team attends severely obese patients in a day-care hospital setting. The patients' psychological and nutritional profiles are studied and their body composition investigated with bioelectrical impedance. After the diagnosis, several approaches are proposed; among them, the insertion of a Bioenterics Intragastric Balloon (BIB). For 6 months after insertion, patients were periodically examined and followed a strict personal regimen, behaviour schedule and physical activity programme compatible with the BIB. The results obtained from the first 20 subjects are encouraging. No severe complications have been reported, and after the BIB removal, subjects are maintaining the obtained results with some of them continuing to lose weight.

[Emergency endoscopic treatment of digestive hemorrhages of the gastroduodenal tract (Forrest 1a, 1b)]. / Trattamento endoscopico d'urgenza delle emorragie digestive del tratto gastroduodenale (Forrest 1a, 1b).

During the period January 1992 - January 1995, 110 patients affected by digestive hemorrhage of the gastroduodenal tract, at stage Forrest 1a 19 patients (17.3%) and Forrest 1b 91 patients (82.7%), were treated at the Division of Endoscopic Surgery at the "C. Forlanini" Hospital. During the same period 1584 esophagogastroduodenoscopies were performed, the impact on above-mentioned hemorrhages was of 6.95% (110 patients). All hemorrhagic patients were Italians, in 41 (37.2%) the bleeding had a gastric origin, in 69 (62.7%) the origin wa duodenal. The average age was 63 years. In 56 patients there were serious pathologies preexistent to the bleeding: serious respiratory insufficiency, cardiopathies, recent thoracic radical surgery, serious fractures, stay in hospital under intensive care. The urgent hemostasis has been performed with a retractile disposable needle through endoscopy, injecting: adrenaline solution, polidocanolo, alcohol, fibrin glue. The toilet has been made with a hydraulic pump. Relapses have been 10 (9%), more frequent in the stomach: 6 cases, surgical operation has been necessary in 7 cases: 5 cases due to duodenal hemorrhage, 2 cases due to gastric hemorrhage. No complication has been noticed during the endoscopic working. Mortality after operation has been of 57%, correlated to preexistent serious cardio-respiratory conditions. The urgent perendoscopic hemostasis has resulted definitive in 93.6% (103 patients). The reduction in the use of hemotransfusion has been considerable, after the digestive hemorrage, registered in the record of cases; the quality of period in bed, even in serious cases has improved considerably. To conclude the hemostatic method described has shown to be easy, economic, effective.

[Tuberculosis of the breast. Report of a clinical case and review of the literature]. / La tubercolosi della mammella. Presentazione di un caso clinico e revisione della letteratura.

Tuberculosis of the breast is an uncommon disease and the correct diagnosis may be established only by histologic demonstration of granulomatous inflammatory infiltrates with central caseation. In fact, preoperative examination and mammography suggest carcinoma or sometimes bacterial abscess in most instances. Tuberculous mastitis was diagnosed in a 74-year-old woman. The case history and a review of the literature are presented. The Authors emphasize the role of excision of necrotic tissue and drainage, in combination with antimicrobial therapy, in the treatment of this pathology.

Comparative study with piroxicam and ibuprofen versus placebo in the supportive treatment of minor sports injuries.

Piroxicam (20 mg o.d.), ibuprofen (200 mg t.i.d.) or placebo were added to the conventional treatment in three different groups of professional athletes with soft-tissue injuries. The piroxicam-treated group showed, with a once-a-day only administration, a statistically significant better improvement of various subjective and objective signs of functional damage.