Free and Cued Selective Reminding Test: an Italian normative study.

The presence of episodic memory impairment is required for the diagnosis of Alzheimer's dementia by all current diagnostic criteria. The new research criteria proposed by Dubois et al. (Lancet Neurol 6:734-746, 2007) require that the impairment should not improve significantly with cueing, recognition testing nor after the control of effective encoding. This is considered to be the core deficit of "prodromal Alzheimer's disease". The Free and Cued Selective Reminding Test (FCSRT) is a memory test that allows in assessing these specific features of memory impairment. Here, we report normative data for an Italian version of the FCSRT. The test is based on the 12 pictorial stimuli, 6 belonging to the living domain, and 6 to the non-living domain. Six scores were derived from the performance of 227 healthy Italian adults, with age, sex and education homogenously distributed across subgroups: immediate free recall (IFR), immediate total recall (ITR), delayed-free recall (DFR), delayed total recall (DTR), Index of Sensitivity of Cueing (ISC), number of intrusions. In multiple regression analyses, age emerged as an influencing factor for both IFR and DFR, with older people obtaining lower scores. Education and gender appear to influence only IFR, with better performance by more educated subjects and females. Adjusted scores were used to determine inferential cutoff scores and to compute equivalent scores.

[Laparoscopic cholecystectomy. A clinical case series]. / Colecistectomia laparoscopica. Casistica clinica.

Laparoscopic cholecystectomy is a minimally invasive and highly effective technique for gallstone disease. The authors report their experience of laparoscopic cholecystectomy. Between September 1992 and December 1994 we performed laparoscopic operations on 212 patients with gallstone disease. Our series included 149 female and 63 male patients; 29 patients was converted intraoperatively to the open procedure. Laparoscopic cholecystectomy is the best surgical approach for the treatment of cholelithiasis: it reduces postoperative pain and hospital stay, has cosmetical and financial benefits.

[Duodenal adenocarcinoma]. / Adenocarcinoma del duodeno.

The authors report 4 cases of primitive malignant duodenal tumors. Adenocarcinoma of the duodenum is a rare tumor and its clinical symptoms are various and not specific. The most common picture is the occlusive stenotical one, where complications are numerous and frequent. The radiographical pictures are represented either by a short neoplastic stenosis or by lacunose aspects or by strictures of the lumen between two normal segments. Endoscopy allows biopsy and therefore helps to secure histological diagnosis. The prognosis of duodenal cancer is severe as diagnosis is late. The possible therapy is surgical and consists either in palliative interventions (digestive and biliary derivations) or in the radical ones (duodenocephalus-pancreasectomy or segmentary duodenectomy). In order to improve patients survival, which is rare and till 5 years maximum, early diagnosis is necessary.

[Splenic pregnancy. Apropos of a case]. / Grossesse splénique. A propos d'un cas.

Still nowadays the extrauterine pregnancy causes the 10% of maternal deaths, also in the most developed countries. The splenic localization is really exceptional. The authors of this article describe a case they have studied, by drawing the attention on the criteria followed in order to obtain an early and correct diagnosis for a reduced mortality rate.

[Deep vein thrombosis in surgery]. / La trombosi venosa profonda in chirurgia.

Deep vein thrombosis is still an underestimated and often unrecognised diseases both in Italy and abroad despite being far from rare and in spite of its severe complications and often disabilitating sequelae. It is a disease which is becoming more frequent due to increased life expectation, the larger number of operations on elderly patients, and the increased frequency of limb injuries. General and specialised surgery is often hampered by this complication. This has raised interest in a more detailed knowledge of the mechanisms leading to DVT, and the correct employment of the latest equipment which enable diagnosis to be made and daily monitoring of the disease during its evolution. But the greatest efforts must be reserved for preventive measures in order to achieve a statistically significant reduction in the incidence of the disease in operated patients. It is to be hoped that a greater awareness of thromboembolic diseases will allow this to be achieved in the future.

[Non-epithelial benign gastric neoplasms]. / Neoplasie gastriche benigne non-epiteliali.

The Authors report five cases of benign neoplasm of the stomach: 2 leiomyoblastomas, 2 leiomyomas and 1 ganglioneuroblastoma, underlining its rarity. After a review of the literature, the anatomo-pathological, clinical and therapeutical findings are described. The difficulty of early diagnosis is underline and the need for surgical therapy states.

[Ultrasonic diagnosis of the central hyperechogenic area in lymph nodes. A sign of benign lymphadenopathy]. / Identificazione ecotomografica di area iperecogena centrale nei linfonodi. Segno di linfoadenopatia benigna.

When identifying superficial lymphadenopathies by means of echotomography, the only accepted criterium of evaluation is still dimension. Only lymph nodes with a diameter longer than 0.5 cm are considered as potentially pathological, irrespective of their morphological characteristics. In the past two years an echotomographic study of the surface regions was carried out on 300 patients. Some suffered from unspecific solitary lymphadenopathies; most of the others were affected by stationary neoplasias, mainly situated in the cervical region. In many cases it has been possible to correlate the echotomographic and the histological results. Sixty-nine out of the 300 examined patients had lymph nodes with a central hyperechogenic area. Histology showed these lymph nodes to be the site of reactive hyperplasia. This characteristic has never been found in neoplastic lymph nodes. It has been hypothesized that this spot corresponds to the hilus of the lymph node and that, through its identification, it may be possible to distinguish benign from neoplastic lymph nodes.

[Radiation-induced intestinal injuries]. / Lesioni intestinali da raggi.

Postoperative radiation after the removal of radiosensitive tumours may cause acute or chronic intestinal lesions. In some cases severe complications requiring one or more operations may arise even years later and unfortunately the morbidity and mortality rates are high. The paper presents a discussion of the clinical onset of these pictures as well as diagnostic and therapeutic possibilities in the light of personal experience and information obtained from the literature.

[Preoperative ultrasonic diagnosis of metastasis to the cervical lymph nodes from otorhinolaryngeal neoplasms]. / Valutazione ecotomografica preoperatoria delle metastasi ai linfonodi cervicali da neoplasie di pertinenza otorinolaringoiatrica.

The results of a study on 30 patients with ear, nose and throat cancers are discussed; a comparison of clinical, ultrasound and histological findings for the preoperatory evaluation of the cervical lymph nodes has been carried out. Ultrasound technique is an excellent method of investigation for the staging "N" of such neoplasms; its contribution is very important for the following therapeutic program.

[Therapeutic effects of ribostamycin in postoperative antibiotic treatment. Comparisons and results]. / Effetti terapeutici della ribostamicina nel trattamento antibiotico post-operatorio. Confronti e risultati.

20 patients have been treated, 10 with ribostamycin sulphate, 5 with gentamycin and 5 with sodium cephalotin. Patients were selected at random from those who had undergone abdominal, thoracic or cervical operations. Doses were 1000-2000 mg i.m. for ribostamycin, 4-8 g i.v. for cephalotin, and 160-240 mg i.m. for gentamycin. Mean treatment time was 12.5 days. Indices of therapeutic activity, parameters of liver and renal function and otovestibular function are indicated. The therapeutic activity of ribostamycin was very good and no side-effects were observed.

[Study of the antispastic activity of prifinium bromide in motor dysfunction of the esophagus]. / Studio dell'attività antispastica del prifinio bromuro nelle disfunzioni motorie dell'esofago.

Motor disturbances of the oesophagus are attributable to hypermotility or hypomotility, or to peristaltic uncoordination of the upper or lower sphincter, or of the corpus. Endoesophageal manometry has enabled considerable progress to be made in the study of oesophageal dysfunction by allowing the spasm to be quantified. Treatment is poorly effective and its results are uncertain, save in the very few cases where surgery leads to resolution. For this reason, the efficacy of a new drug with marked antispastic properties, prifinium bromide, was investigated in 12 cases of megaoesophagus, of hiatal hernia, 6 of diverticulum, and 4 of dyskinesia in the light of the manometric values observed before and after its administration. The drug relieved spasm of the sphincters and corpus.

[Upward extension of esophago-gastric resection in carcinoma of the cardia: our current trend in the light of experience in 52 cases]. / Estensione verso l'alto della resezione esofago-gastrica nel carcinoma del cardias: nostro attuale orientamento alla luce della esperienza maturata su 52 casi.

A first lot of patients (18 cases) operated for carcinoma of the cardias, with oesophageal resection performed at a distance of 4-5 cm. from the neoplasia, evidenced high mortality (7 cases) within the first twelve months. In a second lot of patients (17 cases), a study of the oesophageal section was made and showed invasion in 7 cases; this led to the level of the oesophageal resection being extended to a distance of 8-10 cm. from the tumour; in 17 cases thus operated (third lot) only one case of invaded oesophageal section was found. Systematic extension of the oeophageal resection, in cases of cancers of the cardias, to the level of the inferior pulmonary vein is therefore proposed in order to obtain a radical surgical result.