Dextran/aspirin versus heparin/dihydroergotamine in preventing thrombosis after hip fractures.

In a randomised trial we compared the effects of two different antithrombotic regimens on the incidence of venographically established deep venous thrombosis (DVT) in 83 patients undergoing surgery for fracture of the femoral neck. Group A received dextran 40 peroperatively plus 0.5 g aspirin a day beginning before operation and continuing for 10 days after. Group B received heparin calcium 5000 iu subcutaneously plus dihydroergotamine (DHE) 0.5 mg intramuscularly, given 8-hourly, beginning before operation and continuing for 10 days after. Two patients in Group A and three in Group B developed proximal DVT, while the incidence of all DVT was 33% in Group A and 29% in Group B, a difference which was not significant. Haemorrhagic complications were much more common in the dextran/aspirin group: the volume of drainage fluid, the number of patients transfused and quantity of blood transfused, and the drop in haemoglobin level were all significantly greater in Group A. We conclude that the DHE/heparin regime is preferable to dextran/aspirin because it is safer and no less effective.

[Advantages and disadvantages of peripheral anesthesia (subarachnoid and peridural) in urological surgery]. / Vantaggi e svantaggi delle anestesie periferiche (subaracnoidea e peridurale) in chirurgia urologica.

The pros and cons of spinal anesthesia for urological surgery are discussed and the technical details described of both subarachnoidal and peridural blocks, as they are routinely performed in the author's experience. An evaluation and a comparison on the two techniques give place to the following remarks: spinal anesthesia, not higher than L4-L5, is suitable for surgery on the lower urinary tract and male genitalia, as far as reach and level are concerned; it ensure lesser blood losses because of its know effects on vascular regulation; the awakeness of the patients ensures a quicker recognition of possible complications; peridural, as compared with subarachnoidal block, affords better bleeding control, lesser side effects, a more prolonged anesthesia.

Serial CEA levels in colorectal carcinoma on adjuvant immuno (chemo) therapy.

Serial CEA levels have been studied preoperatively, and one day, 10--15 days, four months, and eight months after surgery in a group of colon cancer patients who started soon after surgery a protocol of adjuvant immuno(chemo)therapy with Levamisole R and BCG R. Results showed a decrease of mean values of plasma CEA levels from preoperatively to four months after surgery, while eight months after surgery a slight increase was noted. Some of the patients in whom disease recurred showed persistent high levels of CEA, while one patient was consistently a false-negative notwithstanding a bone recurrence. While the prognostic value of serial CEA determinations is confirmed, the possibility of restarting (or intensifying) a protocol of adjuvant immunochemotherapy given high CEA levels and a negative clinical picture is discussed.

[Frequency of lung asbestos bodies in autopsy material at Udine]. / Frequenza dei corpi dell'asbesto polmonari nel materiale autoptico a Udine

Following chemical digestion of the pulmonary tissue, asbestos bodies were sought in 50 random necropsies carried out at Udine. The age of the subjects examined, 24 men and 26 women, was between 23 and 90, and 43 cases were older than 50. A positive finding was observed in 44 cases (88%).