[Totally implantable central venous systems in neoplastic patients]. / I sistemi venosi centrali totalmente impiantabili nei pazienti neoplastici.

Long-term chemotherapeutic drugs administration in cancer patients requires the use of special devices such as TIS (Totally Implantable Systems) for central venous access without complications such as thrombosis and sepsis. From January 91 to January 95, 42 TIS were implanted in the same number of oncology patients at the Institute of Surgical Pathology of the University of Chieti. The catheters were inserted by surgical incannulation of the cephalic vein in 36 cases, of the external jugular vein in 5 cases and of the internal jugular vein in 1 case. Four complications occurred consisting of 3 cases of haematoma, which were resolved by wound revision and 1 case of port dislocation treated by repositioning without removing the system. It is concluded that TIS are currently the best technological solution in long-term central venous catheterization because of the very low rate of complications and the easier nursing management and significant improvement in the quality of life for these patients.

[Surgical treatment of hyperthyroidism]. / Trattamento chirurgico dell'ipertiroidismo.

The most important problems of hyperthyroidism surgery are: the correct indication of operation, the choice of the best moment for operation and at last the extension of the resection. The authors experience include 365 patients with hyperthyroidism; 201 of them had monolateral autonomous nodules, 82 had diffuse multinodular goitre and 79 had Graves disease. In the first group of patients surgical treatment was total extracapsular isthmo-lobectomy, in the second group was performed subtotal thyroidectomy and in the third group was almost performed near-total thyroidectomy. Three relapses were found: two of that regarded patients with autonomous function nodule and one in patient with Graves disease. In 201 patients with toxic monolateral hyperfunction of the node, an extracapsular isthmo-lobectomy was performed. In the greater part of the 82 multinodular goiter cases a sub-total thyroidectomy was performed, as well as in 79 patients with Graves disease. Among the 3 recidive cases of hyperthyroidism (0.8%) one was recorded in a patient with Graves disease, (after subtotal thyroidectomy) and two in patients with hyperfunction of the node, (after isthmo-lobectomy). The authors justify the low incidence of recurrence by the choice of large extension of resection without a great number of complications.

[Ocular hypertension in radiologists and radiology technicians]. / Ipertono oculare in medici e tecnici radiologi.

Ionizing radiations (IR) produce changes in the eye and, above all, in the lens. Several studies on radiotherapy in neoplastic diseases and dangerous nuclear accidents like Chernobyl have indicated the percentage and the exposure level at which the eye becomes the target organ of IR. The aim of the study was to establish the association between ocular tension and low-level IR exposure. The incidence of ocular hypertension in the general population is about 1-2% in persons aged 30-40 years and 10% in the 70-80 years age group; the frequency of glaucoma is 0.2-0.5% in persons aged 50-55 years and 2% in those aged 70 years and over; after 15 years of disease, conversion from ocular hypertension to glaucoma is observed in 40% of the cases. We examined 128 subjects occupationally exposed to IR (42 radiologists and 86 radiology technicians) and 130 non-exposed. For each subject we recorded age, length of employment, job titles, dosimetry, ocular tension, refraction and motility impairments. The data obtained from a complete ophthalmologic test was analyzed by the t-Student test, Chi-square and Pearson's test. The ocular tension of 33 occupationally exposed subjects and 2 non-occupationally exposed subjects was higher than the cut-off value of 18 mmHg. There was no analogy between age distribution of ocular hypertension in the groups under study and the general population. There seems to have been a relationship between ocular tension and job titles since a higher incidence was observed among the radiology technicians than among the radiologists and also in the 30-40 years age class.(ABSTRACT TRUNCATED AT 250 WORDS)