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1.
J Wound Care ; 25(8): 428-37, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27523654

ABSTRACT

OBJECTIVE: There are no well-defined criteria for assessing the efficacy and quality of wound dressings, and evaluation is often simplistic and based on the subjective opinion of the health-care professional. The aim of this study was to identify specific parameters suitable for measuring dressings' performance, and to recommend laboratory tests able to evaluate these specific criteria in an objective manner. METHOD: After reviewing all tests currently used in Italy and examining the criteria for evaluating the quality of dressings, the authors selected 12 clinically significant parameters. These parameters were measured using standard and non-standard tests, and in some cases, these tests were modified and improved to simulate real-life conditions more accurately. RESULTS: Most of the tests used were able to discriminate well between dressings belonging to different brands, with some tests being more suitable than others for the assessment of specific dressings. CONCLUSION: These results highlighted some issues in the standard testing procedures, such as the need of a suitable fluid that mimics the real exudate, and the importance of standard temperature and humidity conditions during testing. Our study paves the way for a larger project aimed at a systematic evaluation of dressing quality able to assess every wound dressing on the market.


Subject(s)
Bandages, Hydrocolloid/standards , Wound Healing/physiology , Wounds and Injuries/therapy , Evaluation Studies as Topic , Humans , Italy , Reference Standards
2.
Q J Nucl Med Mol Imaging ; 59(4): 446-54, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26416036

ABSTRACT

AIM: The role of fluorodeoxyglucose positron emission tomography (FDG-PET) as an additional investigation to computer tomography for pulmonary carcinoid tumors remains controversial. The aim of this study was to assess the role of FDG-PET for the diagnosis and staging of pulmonary carcinoid tumors. METHODS: We performed a retrospective mono-institutional analysis of data from 97 patients with pathologically confirmed pulmonary carcinoid tumor who had been operated on between July 1998 and April 2009 and had had a preoperative FDG-PET scan performed. RESULTS: Sixty-five (67%) of the 97 tumors were typical (TC) and 32 (33%) atypical (AC) carcinoid tumors. Overall FDG-PET sensitivity was 67% being lower for TC (60%) than for AC (81%) (P=0.04). FDG-PET negative tumors were smaller than FDG-PET positive tumors, with a respective median size of 15 and 17 mm (P=0.02). Median SUVmax for FDG-PET-positive tumors was 4.0 (2.8-5.1) with no difference between TC and AC tumors. Median Ki-67 expression was respectively 4.7% and 3.1% for FDG-PET positive and FDG-PET negative tumors (P=0.05). During a median follow-up of 49 months (interquartile range 30-63 months), 9 patients (4TC, 5AC) developed recurrent disease. Neither SUVmax nor Ki-67 expression resulted associated with disease-free survival. CONCLUSION: With an overall sensitivity of 67%, FDG-PET has shown to be useful in the preoperative work-up of patients with suspect lung carcinoid tumors. In particular it could have a role in larger tumors. These results warrant a prospective evaluation of FDG-PET in the staging of lung carcinoid tumor.


Subject(s)
Carcinoid Tumor/diagnostic imaging , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Positron-Emission Tomography , Adolescent , Adult , Aged , Carcinoid Tumor/metabolism , Carcinoid Tumor/pathology , Carcinoid Tumor/surgery , Female , Follow-Up Studies , Gene Expression Regulation, Neoplastic , Humans , Ki-67 Antigen/metabolism , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Middle Aged , Neoplasm Staging , Preoperative Period , Prognosis , Retrospective Studies , Sensitivity and Specificity , Young Adult
3.
Lung Cancer ; 82(3): 426-30, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24099665

ABSTRACT

INTRODUCTION: It is unclear how long low-dose computed tomographic (LDCT) screening should continue in populations at high risk of lung cancer. We assessed outcomes and the predictive ability of the COSMOS prediction model in volunteers screened for 10 years. MATERIALS AND METHODS: Smokers and former smokers (>20 pack-years), >50 years, were enrolled over one year (2000-2001), receiving annual LDCT for 10 years. The frequency of screening-detected lung cancers was compared with COSMOS and Bach risk model estimates. RESULTS: Among 1035 recruited volunteers (71% men, mean age 58 years) compliance was 65% at study end. Seventy-one (6.95%) lung cancers were diagnosed, 12 at baseline. Disease stage was: IA in 48 (66.6%); IB in 6; IIA in 5; IIB in 2; IIIA in 5; IIIB in 1; IV in 5; and limited small cell cancer in 3. Five- and ten-year survival were 64% and 57%, respectively, 84% and 65% for stage I. Ten (12.1%) received surgery for a benign lesion. The number of lung cancers detected during the first two screening rounds was close to that predicted by the COSMOS model, while the Bach model accurately predicted frequency from the third year on. CONCLUSIONS: Neither cancer frequency nor proportion at stage I decreased over 10 years, indicating that screening should not be discontinued. Most cancers were early stage, and overall survival was high. Only a limited number of invasive procedures for benign disease were performed. The Bach model - designed to predict symptomatic cancers - accurately predicted cancer frequency from the third year, suggesting that overdiagnosis is a minor problem in lung cancer screening. The COSMOS model - designed to estimate screening-detected lung cancers - accurately predicted cancer frequency at baseline and second screening round.


Subject(s)
Adenocarcinoma/diagnosis , Computer Simulation , Early Detection of Cancer/methods , Lung Neoplasms/diagnosis , Smoking , Adenocarcinoma/mortality , Female , Follow-Up Studies , Humans , Lung Neoplasms/mortality , Male , Middle Aged , Neoplasm Staging , Predictive Value of Tests , Prognosis , Reproducibility of Results , Risk , Survival Analysis , Time Factors , Tomography, X-Ray Computed
4.
Ecancermedicalscience ; 4: 186, 2010.
Article in English | MEDLINE | ID: mdl-22276037

ABSTRACT

BACKGROUND: Low-dose computed tomography (CT) screening can detect early stage lung cancer in high-risk populations. However, no data on repeated annual screening over more than 5 years are available, and the impact of screening on lung cancer mortality is controversial. METHODS: We analysed outcomes in high-risk asymptomatic volunteers (smokers and former smokers, >50 years) enrolled in a pilot study over 1 year from June 2000, who received annual low-dose CT for 7 years. Cumulative lung cancer incidence and survival were represented by Kaplan-Meier curves. Standardized incidence and mortality ratios were used to estimate risks relative to the general Italian and US population. RESULTS: Compliance was 86% at the end of the seventh year in 1035 recruited volunteers (71% men, mean age 58 years). Lung cancer was diagnosed in 54 (5.3%); radical surgery was possible in 48/54 (87%); 39/54 (72%) had stage I disease. Five-year survival was 63% overall, 89% for stage I cases. During 6308 person-years of observation, 47 participants had died versus 75 expected in the Italian general population standardised for age and sex. Fourteen lung cancer deaths were registered versus 27 expected in a standardised US smoker population. CONCLUSIONS: Seventy percent of screening-diagnosed patients had stage I disease, and the survival of screen-detected cancer patients was high. Lung cancer mortality was favourable compared to age- and sex-matched population of US smokers, suggesting that mortality can be lowered by screening, although larger trials with longer follow-up are necessary to confirm these findings.

5.
Minerva Chir ; 64(6): 669-71, 2009 Dec.
Article in English | MEDLINE | ID: mdl-20029363

ABSTRACT

Solitary fibrous tumors of the pleura (SFTP) are rare mesenchymal neoplasms usually originating from the visceral pleura, but sometimes found in other sites like the orbit, dura, paranasal sinus, upper respiratory tract, thyroid, sublingual gland, lung, periosteum, cauda equina, ovary, scrotum and testicular tunica vaginalis. Solitary fibrous tumor of the kidney is extremely rare with fewer than 15 reported cases in modern English literature. To the best of our knowledge, this report describes the first known case of synchronous SFTP in the left parietal pleura and left kidney. The SFTP of the pleura, widely compressing and displacing the left lower lung lobe, was resected via left thoracotomy, whereas the renal SFTP, diagnosed by echo-guided histological biopsy, was closely monitored by computed tomography scan and ultrasound. After a one-year follow-up no recurrence was detected in the left hemithorax and the renal lesion remained stable.


Subject(s)
Kidney Neoplasms/diagnosis , Neoplasms, Multiple Primary/diagnosis , Solitary Fibrous Tumor, Pleural/diagnosis , Solitary Fibrous Tumors/diagnosis , Female , Humans , Middle Aged
6.
Thorac Cardiovasc Surg ; 57(3): 185-6, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19330764

ABSTRACT

We report the case of a 42-year-old woman with a double vascular catheter mimicking a false persistent left superior vena cava on a chest X-ray. Physicians should be aware of the correct course of these catheters in order to avoid serious clinical consequences.


Subject(s)
Catheterization, Central Venous/instrumentation , Catheters, Indwelling , Vascular Malformations/diagnosis , Vena Cava, Superior/abnormalities , Adult , Diagnosis, Differential , Female , Humans , Radiography, Thoracic , Tomography, X-Ray Computed , Vascular Malformations/diagnostic imaging , Vena Cava, Superior/diagnostic imaging
8.
J Cardiovasc Surg (Torino) ; 48(3): 385-7, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17505445

ABSTRACT

We report a case of a 62-year-old man affected by Pancoast's tumor who developed pneumocephalus 17 days after right upper lobectomy with en bloc resection of the first three ribs and C8-D1 branches of the brachial plexus. The patient complained of aphasia, disorientation and sphincterial release. A chest and brain-CT scan showed a right apical pneumothorax associated with a massive pneumocephalus of the ventricles and of the subarachnoidal spaces. A pneumoperitoneum was also seen. The patient was treated using pleural drainages, Trendelenburg's position and antibiotic therapy. Clinical and radiological remission was achieved after 12 days of additional hospital stay.


Subject(s)
Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/surgery , Pancoast Syndrome/surgery , Pneumocephalus/etiology , Pneumonectomy/adverse effects , Anti-Bacterial Agents/therapeutic use , Carcinoma, Non-Small-Cell Lung/pathology , Drainage/methods , Head-Down Tilt , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Pancoast Syndrome/pathology , Pneumocephalus/pathology , Pneumocephalus/physiopathology , Pneumocephalus/therapy , Pneumonectomy/methods , Tomography, X-Ray Computed , Treatment Outcome
9.
Minerva Chir ; 62(2): 137-9, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17353857

ABSTRACT

Bronchopleural fistula (BPF) is a well recognized and potentially fatal complication of major thoracic surgery and several strategies regarding its prevention and subsequent management have been described. An immediate BPF occurring intraoperatively after bronchial closure is a rare event and is usually treated by bronchial stump reamputation and/or hand-suture reinforcement by mattress suture, or myoplasty. We report a simple and successful technique, using azygous vein flaps, to repair an intraoperative BPF associated to a small bronchial dehiscence occurred after a right pneumonectomy in a 70-year-old diabetic man receiving induction chemotherapy treatment.


Subject(s)
Amputation Stumps , Bronchial Fistula/surgery , Pleural Diseases/surgery , Pneumonectomy/adverse effects , Postoperative Complications/surgery , Aged , Bronchial Fistula/etiology , Carcinoma, Squamous Cell/surgery , Humans , Lung Neoplasms/surgery , Male , Pleural Diseases/etiology , Postoperative Complications/etiology , Treatment Outcome
10.
Minerva Chir ; 61(4): 307-13, 2006 Aug.
Article in Italian | MEDLINE | ID: mdl-17122763

ABSTRACT

AIM: The aim of this study was to evaluate the safety of continuous nonabsorbable (3/0 polypropylene) sutures for sleeve lobectomy, and the influence of induction chemotherapy on postoperative outcome in patients with lung malignancies. METHODS: A review of a prospective database of a single surgeon identified 41 consecutive patients who underwent sleeve lobectomy from May 1998 to July 2003. Bronchial reconstruction was done placing two 3/0 polypropylene sutures at the far side of the cartilaginous wall and subsequently fixed. Afterwards, two running sutures were performed in order to obtain a telescopic anastomosis. RESULTS: Twenty-four patients (59%) underwent induction chemotherapy. There were 31 right upper, 3 left lower ''reverse'', and 7 left upper sleeve lobectomies with radical lymph node dissection. Eight patients underwent reconstruction of the pulmonary artery. There were 34 non-small cell lung cancers, 3 limited small cell lung cancers, 1 neuroendocrine large cell carcinoma, and 3 bronchial carcinoid tumors. N2, N1, and N0 diseases were found in 13, 12 and 16 patients, respectively. Post-operative morbidity and mortality were 14.5% (n=6) and 4.8% (n=2) (1 patient, 4%, after induction chemotherapy). The rate of postoperative anastomotic complications was 2.4% (n=1). Late bronchial stenosis developed in 3 cases, but all were successfully medically treated. Twenty-nine patients are still alive, 27 without evidence of disease. The overall 2-year probability of survival (Kaplan-Meier) was 59%. Induction chemotherapy did not influence postoperative morbidity/mortality (chi2 test: P=0.64/P=0.56). CONCLUSIONS: Continuous nonabsorbable suture for sleeve lobectomy is quick and technical easy to perform, with low postoperative morbidity/mortality; induction chemotherapy does not influence postoperative outcome in these patients.


Subject(s)
Bronchi/surgery , Lung Neoplasms/surgery , Pneumonectomy/methods , Suture Techniques , Adult , Aged , Aged, 80 and over , Anastomosis, Surgical , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Humans , Lung Neoplasms/mortality , Lung Neoplasms/therapy , Male , Middle Aged , Polypropylenes , Prospective Studies , Retrospective Studies , Survival Analysis
11.
Minerva Chir ; 61(4): 353-5, 2006 Aug.
Article in English | MEDLINE | ID: mdl-17122767

ABSTRACT

Complete anastomotic dehiscence after sleeve resection is a dramatic and often fatal event requiring an extremely aggressive and risky treatment; completion pneumonectomy represents the sole effective therapeutic option to rescue the patient, but postoperative mortality after this procedure is high. We report a case successfully treated by extended redo carinal sleeve resection after full bronchial dehiscence. This option should be taken into account in such a complication, mainly in patient with compromised respiratory function.


Subject(s)
Bronchi/surgery , Pneumonectomy/adverse effects , Surgical Wound Dehiscence/surgery , Bronchial Neoplasms/surgery , Carcinoma, Non-Small-Cell Lung/surgery , Humans , Male , Middle Aged , Reoperation , Surgical Wound Dehiscence/etiology , Treatment Outcome
17.
Eur J Cardiothorac Surg ; 24(1): 168-70, 2003 Jul.
Article in English | MEDLINE | ID: mdl-12853064

ABSTRACT

Primary retroperitoneal carcinoma is a rare but highly aggressive tumour often resulting in infiltration of abdominal organs and diaphragm. We describe a case of retroperitoneal carcinoma infiltrating the diaphragm, the lower lobe of the left lung and ribs IX and X, but sparing the abdominal organs. After thoracoabdominal access, our patient underwent resection of the retroperitoneal carcinoma, left hemidiaphragm and ribs IX and X with wedge resection of the left lower lobe. Haematogenous lung metastasis from retroperitoneal carcinoma is well known; on the contrary, direct transdiaphragmatic lung invasion is very rare and requires thoracoabdominal access for a one step operation, representing one of the most stimulating challenges for thoracic surgeons.


Subject(s)
Adenocarcinoma/surgery , Retroperitoneal Neoplasms/surgery , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/radiotherapy , Diaphragm/diagnostic imaging , Diaphragm/surgery , Humans , Lung/diagnostic imaging , Lung/surgery , Male , Middle Aged , Radiotherapy, Adjuvant , Retroperitoneal Neoplasms/diagnostic imaging , Retroperitoneal Neoplasms/radiotherapy , Thoracic Wall/diagnostic imaging , Thoracic Wall/surgery , Tomography, X-Ray Computed
19.
Eur J Cardiothorac Surg ; 22(6): 1008-10, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12467830

ABSTRACT

Leiomyoma is the most common benign tumour found in the esophagus but it is, however, a rare neoplasm; in fact of all esophageal tumours, benign tumours account for fewer than 10%, of which 4% are leiomyomas. Leiomyomas should be removed when diagnosed, even if asymptomatic, because malignancy cannot otherwise be excluded and symptoms are likely to develop if treatment is delayed or omitted. Enucleation of esophageal leiomyoma is a safe and effective procedure. We report a case of symptomatic giant anular leiomyoma of the distal esophagus, compressing the trachea and the descending aorta, resected after right thoracotomy.


Subject(s)
Esophageal Neoplasms/surgery , Leiomyoma/surgery , Adult , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/pathology , Humans , Leiomyoma/diagnostic imaging , Leiomyoma/pathology , Male , Thoracotomy/methods , Tomography, X-Ray Computed
20.
Chemosphere ; 49(6): 545-57, 2002 Nov.
Article in English | MEDLINE | ID: mdl-12430642

ABSTRACT

The distribution and speciation of heavy metals in five agricultural soils of Piedmont Region (north-western Italy) were investigated. Ten metals, namely Al, Cd, Cr, Cu, Fe, Mn, Ni, Pb, Ti and Zn were considered. Analytical determinations were performed by atomic emission or atomic absorption spectroscopy after microwave sample dissolution in acid solution. Total metal concentrations fit in the typical concentration ranges for unpolluted soils, with the exception of cadmium and lead content in some horizons. The effect of sampling depth on concentrations was discussed. Speciation studies were carried out by applying Tessier's procedure, which allows to subdivide the total metal content into five fractions, representing portions bound to different components of the soil. Moreover, the element labilities in two soils were evaluated by extraction with EDTA. Correlations among the variables and/or similarities among the sampling points were identified by principal component analysis and hierarchical cluster analysis.


Subject(s)
Metals, Heavy/chemistry , Soil Pollutants , Agriculture , Chemical Fractionation , Edetic Acid/chemistry , Hydrogen-Ion Concentration , Italy , Metals, Heavy/analysis , Microwaves , Particle Size , Solubility , Spectrophotometry, Atomic/methods
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