[Pilonidal sinus: long term results of excision and closure technic. Review of the literature]. / Sinus pilonidalis: risultati a lungo termine del trattamento con tecnica di escissione e chiusura. Revisione della letteratura.

The Authors report their experience in the surgical management of pilonidal sinus with modified Leichtling technique. Long term results of various treatments proposed in the past are analyzed: it is not possible to identify a satisfactory procedure for the treatment of pilonidal sinus. Ideal treatment should avoid hospital admission and general anaesthesia, assure a short time of healing, a reduced number of complications, a low risk of recurrence and a minimal time off from work. Authors' variations to the original technique show good results for non recurrent pilonidal sinus and a lower number of failed primary healing. Recurrences are probably related to the patient anatomical status which may be modified only by flattening natal cleft or surgically changing follicles orientation of presacral skin, together with a meticulous hygiene and shaving of the presacral healing area as well as a dietary regimen for obese patients.

Coenzyme Q10 and colorectal neoplasms in aged patients.

Coenzyme Q10 (CoQ10), a quinone located in cellular membranes, is a compound with mitochondrial bioenergetic functions whose antioxidant activity has recently been defined. CoQ10 content in colorectal neoplasms is significantly higher than in normal colorectal mucosa. While older patients (aged over 70 years) have also a significantly higher CoQ10 content, not observed in younger patients (aged under 70 years), the normal mucosa, instead; shows constant CoQ10 levels in both groups. For the same local stage (T), an increase in lymph node involvement (N) was observed in older patients as compared to younger ones, but not in distant metastases (M) with the same 5-year survival. These results justify the same therapeutic approach for patients older or younger than 70 years.

[Urodynamic picture in high spinal cord ischemia, induced by addictive use of cocaine. Report of a case]. / Cuadro urodinámico en la isquemia medular alta, inducida por el uso adictivo de cocaína. Descripción de un caso.

The authors present a case of spinal cord ischemia at level C2 related to cocaine use. The neurologic pattern was an anterior cord hemisection syndrome. Urodynamic assessment was performed at 6 and 14 months from the neurovascular event. The ice-water test (IWT) showed an uninhibited bladder cooling reflex, despite an areflexic detrusor (at routine filling cystometry). Occult bladder hyperreflexia became overt during the following month and was registered by the second urodynamic assessment. Anatomical bases of spinal cord blood supply are discussed. The authors emphasize the role of the IWT in predicting the development of overt bladder hyperreflexia and thus, spinal shock phase resolution.