[Pica in psychotic patients: an unusual cause of acute abdomen]. / Il picacismo nei pazienti psicotici: una inconsueta causa di addome acuto.

Pica is a pathologic craving for substances not commonly regarded as foods. In this study the authors report their experience about five cases presented with an acute abdomen following foreign bodies ingestion by patients mentally handicapped. Therapeutic treatment was emergency laparatomy with postoperative morbidity of 40% and mortality of 40%. It is hoped that specific drug therapy with more aggressive surgical treatment will reduce the mortality significantly.

A survival regression analysis of prognostic factors in colorectal cancer.

BACKGROUND: Many prognostic factors of colorectal cancer are known but their actual clinical validity is still uncertain. The aim of the present study was to verify, on the basis of our experience, the prognostic validy of variables for survival by using survival regression analysis. METHODS: From January 1978 to December 1986 the prognostic factors for 192 patients were analysed. These patients had undergone surgical resection for colorectal cancer. The follow up was completed in every patient by the end of December 1992, with a median follow up of 10 years (range 6-14 years). The prognostic factors considered in the statistical analysis were age, sex, size of tumour, site, grade, direct spread, node involvement and stage (according to Astler-Coller and pTNM). RESULTS: Of the prognostic factors, sex was the only one not to show any prognostic significance. In the survival regression analysis we have used an accelerated failure time model (equivalent to the Cox proportional hazard model); age, grade and stage were significant covariables. CONCLUSIONS: Although clinical pathological staging (pTNM) appears as a pre-eminent prognostic factor, and as our analysis shows, it needs a further variable (grading), which has been shown to affect the prognosis in a significant way.

[Rectal prolapse: etiopathogenetic and therapeutic problems in psychiatric patients]. / Il prolasso del retto: problematiche etiopatogenetiche e terapeutiche nel paziente psichiatrico.

Rectum prolapse is a pathological condition which has long been considered as rare but whose occurrence has been progressively increasing in the past decades. There still exists a degree of uncertainty as to the disease etiopathology: moreover the exact relationship between rectum prolapse and psychic disorders which have been found in up to 50% of the patients with prolapse has not been clarified. Neither on the therapeutic level is there a common opinion as to the ideal surgical approach and over one hundred techniques have been suggested for the surgical correction of the prolapse. A study has been carried out on 10 patients suffering from psychiatric pathology of different kinds (oligophrenia, schizophrenic psychosis), hospitalized at Istituti Ospedalieri Opera Don Uva in Bisceglie. They suffered from complete rectum prolapse and underwent surgical intervention. In this study the etiopathogenetic problems of prolapse are investigated according to recent developments, with particular reference to the very peculiar implications they have in the psychiatric patient. Finally the surgical techniques correctly used and their possible application in the psychiatric patient are examined.