[Evalutation of neoplasms prevalence as a consequence of stressful events in the occupational and non-occupational field]. / Valutazione della prevalenza di neoplasie in seguito ad eventi stressanti in ambito lavorativo ed extralavorativo.

Starting from the hypothesis that stressful events, badly elaborated by individuals, can bring a decreasing activity of immunitary system and represent a co-factor in development of breast cancer, analyzing which events are more stressful and as a consequence, which are the ones causing a decreasing of immunitary defence. This study considers the breast cancer in large increasing amongst women. 60 women compiled the Events of Life Questionnaire (Qav) and they have been divided into two groups: 30 elements affected by breast cancer (experimental group) and 30 without evident pathologies (control group). Their age was included between the 25 and 75 years old, they came from the same social class, cultural extraction, instruction level. Throughout every single interview, each one lasting about an a hour with hospitalized patients, we potentially find a depressive personality. The statistic analysis gives extremely interesting results regarding negative events of the affective life: underlining a strong dependence among negative events of affective life relating to the development of the breast cancer This interest start from the evident limit in the medical practice, considering organic problems as the only for disease development, excluding emotional and psychological factors which are part of human being's life. Anyway, today is possible to find especially in onchological medicine, the consciousness that the medical or surgical intervention is not the only duty but is also important to underline, in a more complete view, that the patient's care also depends from the ability of questioning about patient's conditions in every day life; as shown in this study which underlines the necessity of psychotherapeutic intervention for patients affected by breast cancer, specially in pre and post operating phases.

[The relationship between mobbing and depression syndrome in the female working population of service industry: the problem statement and the prevention strategies in Sicilian environment]. / Rapporto tra mobbing e sindrome depressiva nella popolazione lavorativa femminile del terziario avanzato: dimensione del problema e strategie di prevenzione nella realtà Siciliana.

The concept of "work" and the social interactions in the workplace contribute to develop the working satisfaction and the social and personal identity of the adult. The aim of the survey is that of checking up on the presence of a statistically significant relation between The Depression Syndrome and The Mobbing Phenomenon. It is necessary to understand and value if and how some of the employer's behaviours could have a heavy influence on the worker's psychophysical condition, up to causing a state of anxiety and depression. It has been used the now famous "LIPT" (Leymann Inventory of Psychological Terror), elaborated by Leymann at the beginning of the 90's. It is a short anonymous questionnaire recognized all over Europe as a standard to confirm the Mobbing existence in organizational contexts. The current version of the questionnaire is called "LIPT EGE", a more suitable tool to check the seven parameters of the Mobbing determination, as well as the quantification of the consequent harm. Some scales for depressive symptoms evaluation have been added to the Mobbing questionnaire: The Self Rating Depression Scale (SDS) and The Depression Status Inventory (DSI) of Zung. The questionnaires are administered to 500 workers women in public and private corporation in Sicily, exactly in Siracusa and Catania provinces. 206 women aged 34-50 have answered the questionnaires. In addition to the age and the sex, the distinction variables of the examined people are the position in the firm, nationality, vocational qualification, and the yearly gross income. The research has begun in july and has continued on august 2006. Attention has been focused only on the administrative sectors. Through the chi2 test and the exact Fisher test, the dependence between the changeable presence of depression in the two questionnaires (Zung 1 and Zung 2) and every single variable of the questionnaire on the Mobbing has been pointed out. In particular, the results establish a connection between the presence of depression and systematic isolation, and depression and the changes in the working tasks. The survey has pointed out the working conditions that may lead to Mobbing situations and to psychological frustration; it follows that the Mobbing prevention is a key element if you want to better working life and avoid social emargination.

Valsalva leak point pressure: how to chose the best method.

Urinary continence is ensured as long as the urethral closure pressure remains greater than the intravesical pressure, in the presence of adequate support to the bladder and the proximal urethra. In order to select the appropriate surgical treatment, a correct diagnosis must be made; recently urodynamic evaluation has assumed a central role. In particular, the introduction of a new urodynamic parameter, the Valsalva Leak Point Pressure (VLPP), has provided new impetus to research in this area, even if different technical approaches have limited universal acceptance. The aim of the work is to describe the reasons why the authors have been led to prefer double measurement, both at partial filling and at maximum cystometric capacity, considering that this does not involve any additional economic burden. The authors underline the promising potential of the method, once standardized, in the urodynamic evaluation of urinary incontinence.

Unilateral testicular microlithiasis.

Testicular microlithiasis is a rare pathology which usually affects both testicles (less than 100 cases have been described in the literature), histologically characterized by numerous calcified deposits situated inside the seminiferous tubules, the diameter of which does not usually exceed 2 mm. The pathogenesis of the phenomenon is not completely clear; it has however been noted that there is a higher incidence in patients affected by cryptorchidism, subfertility, Klinefelter's syndrome and in particular those with testicular neoplasms, although the reason for this remains obscure. The case reported seems atypical in that there is no association with the conditions mentioned above and the finding is monolateral, something which is unusual in the literature reviewed.

[Therapy of vasomotor syndrome in the treatment of advanced prostatic cancer: apropos of 37 cases]. / Terapia della sindrome vasomotoria nel trattamento del cancro prostatico avanzato: a proposito di 37 casi.

Castration, whether surgical (orchiectomy) or pharmacological (androgen blockade), used in the management of advanced prostatic carcinoma, induces as a secondary effect, immediately following impotence, the onset of a vasomotor syndrome characterized by hot flushes and sweating. This syndrome which may present with such intensity and frequency as to severely affect the quality of life and even the psychological equilibrium of the patient. Treatment with progestinic agents leads to the release of opioid peptides at hypothalamic level, thus decreasing the level of catecholamines responsible for the vasomotor syndrome. In the 37 cases treated with progestogens, a therapeutic efficacy of 80% was observed following cyproterone acetate and of 70% following medroxyprogesterone acetate.

The ice-water test in the diagnosis and treatment of the neurogenic bladder.

OBJECTIVE: To determine the usefulness of the ice-water test (IWT) in the diagnosis and treatment of neurological bladder disease. PATIENTS AND METHODS: The IWT was carried out in 148 patients with neuropathic bladder dysfunction resulting from a traumatic lesion, to assist in their diagnosis and treatment, and in 130 patients with neuropathic bladder dysfunction and multiple pathogenic disorders; the results of the IWT were used to classify those patients with hyperactive bladders. RESULTS: The IWT was positive in 95% of patients affected by complete and in 86% of patients with incomplete medullary lesions. The IWT in patients with lower motor neuron medullary lesions was always negative. The test was used diagnostically in all patients with lower and in 43% of those with upper motor neuron lesions. In the latter, it was used in 48% of patients as a rehabilitation method during the medullary-shock phase to accelerate the appearance of the micturition reflex. In 9% of patients it was used to induce micturition during cystography. CONCLUSION: Because it is simple to perform, the IWT is a useful complement to urodynamic examinations in patients with neurological bladder disease and in patients with micturitional disorders that are otherwise difficult to interpret.

[Inguinal-scrotal hernia of a bladder diverticulum]. / Hernie inguino-scrotale d'un diverticule vésical.

Bladder diverticula may be involved in inguinal hernias usually in the form of a sliding hernia. We studied three patients with scrotal herniation of bladder diverticulum, one of them having a neurogenic bladder. All our patients have had the diagnosis before undergoing hernia repair--so iatrogenic lesions of the bladder during surgical manipulations could be avoided. Methods for an early diagnosis of this rare occurrence are discussed along with aspects of surgical approach.

[Diagnostic and therapeutic update on primary duodenogastric reflux]. / Attualità diagnostiche e terapeutiche nella patologia da reflusso duodenogastrico primitivo.

The authors, after some remarks on the pathophysiology of primary alkaline gastritis, analyze the main methods, available at present, for diagnosis; they particularly consider the importance of endoscopy and histology, gastroesophageal 24-hours pH-metry and 99mTc HIDA scintigraphy. Successively, they present the criteria for the identification of patients who will predictably benefit from surgical treatment, and examine advantages and limits of the two main corrective surgical techniques for the duodenogastric reflux in patients not previously operated on the gastrointestinal tract: duodenal extramucosal myotomy according to Mattioli, relatively easy to perform, and the "duodenal switch" according to De Meester, technically more complex, but pathophysiologically more acceptable, completely eliminating the duodenogastric reflux.

Lack of gastric adverse effects of erdosteine in rats and men.

Erdosteine is a thiol derivative endowed with mucolytic, mucomodulator and free radical scavenging properties. Studies were performed in rats and men with the aim to assess its safety on gastric mucous barrier. Two experiments were performed in rats by comparing the effects of erdosteine, homocysteine thiolactone (HTL), carbocysteine, tiopronin and placebo on a) macroscopic appearance of G. I. ulcer, total HCl, pH and volume of gastric juice 4 and 6 hours after, respectively, pylorus ligation in Shay rats and drug oral treatment, and on b) macroscopic appearance of G. I. ulcer in fasting rats for 50 hours, during which the animals received 4 oral doses of each compound. In both conditions erdosteine was completely inactive in the dose-range of 500-1000 mg/kg p.o. while HTL, carbocysteine and tiopronin were ulcerogenic already at the dose of 500 mg/kg p.o. Accordingly, 15 human beings, undergoing gastroscopy, well tolerated erdosteine at the oral dose of 300 mg TID for 9-13 days. In this open study the patients neither revealed worsening of their pre-existing gastric complains, nor indicated new subjective symptoms, nor manifested macroscopic and histological alterations concerning the parietal tonus, the status of epithelial mucosa and of gastric content (including: volume, total acidity and total, bound and free sialic acid).

[A modified Hill's procedure in the surgical treatment of hiatal hernia]. / L'intervento di Hill modificato nel trattamento chirurgico dell'ernia jatale.

After an introduction on the problems regarding indications and surgical management of gastro-oesophageal reflux disease, the Authors describe the technique they use, which is a modification of Hill's posterior gastropexy, involving the placement of suture through the median arcuate ligament, without exposing the celiac axis. The preliminary results of a prospective randomized clinical trial, conducted at the Surgical Clinic Department of Catholic University, Rome, are described. The trial evaluated early and late results of Hill's modified technique versus a control group, in which a Dor technique has been used. Intraoperative oesophageal manometry has been performed in both groups, to set the cardioplasty more properly. Ninety-one patients out of 132 have been studied; 65 had a good response to medical therapy and 26 have been operated upon. In 9 cases (6 Dor and 3 Hill) intraoperative manometry was performed. All patients have been studied pre-operatively with upper g.i. series, endoscopy with biopsies, oesophageal manometry and 24-h pH monitoring; this protocol has been repeated after 3 to 6 months postoperatively, to evaluate the results more accurately. The preliminary data, although statistically non significant because of the small study group, seem to favour the Hill modified technique, both for complication and reflux control. Further data are needed to confirm them.

Kininase I, kininase II and aminopeptidase levels in patients with gastrointestinal tumors.

Some indices of the kallikrein kinin system, namely kininase I (KI), kininase II or angiotensin converting enzyme (KII-ACE) and phenylalanine-arginine aminopeptidase (AP) were analyzed, to detect their levels in ten selected normal subjects and in 20 selected patients with colonic (n = 8) and gastric adenocarcinoma (n = 12). While AP and KI levels did not show differences in the groups under analysis, KII values showed a significant difference (P +/- 0.01), present since the early stages of the diseases and unrelated to the normal laboratory indices.

[Use of pirenzepine in prevention of stress ulcers in high-risk surgical patients]. / Impiego della pirenzepina nella prevenzione delle lesioni da stress nel paziente chirurgico ad alto rischio.

In an endoscopic controlled trial the effectiveness of pirenzepine in preventing stress ulcer in high risk patients for surgical operation was studied. 40 patients of both sexes aged between 19-72 were at random distributed to pirenzepine treatment (10 mg e.v./8 hours, starting the day before surgery to 10th day after it), or to "void" period (without specific therapy). Endoscopic findings was performed before and after treatment and every patient was daily monitored for: dyspepsia, defecation, residual intragastric volume, intestinal peristalsis, beginning oral food intake, haemodynamic and metabolic parameters. The results obtained showed the gastric and duodenal cyto-protective effect and the better post-operative clinical course, when pirenzepine was administered by parenteral infusion.