Fusidic acid vs ofloxacin prophylaxis before cataract surgery.

PURPOSE: To evaluate the safety and efficacy of two self-administrated antibiotics in eliminating conjunctival microbial flora. METHODS: A total of 133 patients operated for cataract surgery were divided into three groups. The first group (A), 55 patients, received fusidic acid drops (1%) two times per day during the 3 days before the surgery; a second group (B), 55 patients, received ofloxacin (0.3%) four times per day during the 3 days before the surgery; and the third group (C), 23 patients, did not receive any topical antibiotic before the surgery. On the day of the surgery, cultures were taken from the lower fornix. RESULTS: In Group A, 28 cultures (50.9%) were sterile, and 27 (49.1%) were positive for the presence of microbial agents. In Group B, 25 cultures (45.4%) were sterile, and 30 (54.5%) were positive for the presence of microbial agents. In Group C, 5 cultures (21.7%) were sterile, and 18 (78.2%) were not. Staphylococcus epidermidis was the most common micro-organism isolated in all the groups. Statistical analysis does not reveal a significant difference between Groups A and B for the sterile cultures (p=0.7) (chi-square test), but a statistically significant difference is present between the treated and not treated patients (p= 0.05) (chi-square test). CONCLUSIONS: A preoperative prophylaxis is useful in eliminating conjunctival micro-organism, and both antibiotics (fusidic acid and ofloxacin) are efficient.

Optical coherence tomography findings in a case of acute multifocal posterior placoid pigment epitheliopathy (AMPPPE).

PURPOSE: To report the optical coherence tomography (OCT) findings in a case of acute multifocal posterior placoid pigment epitheliopathy (AMPPPE). DESIGN: Case report. METHODS: A 26-year-old woman was seen for a mild loss of visual acuity in both eyes. The fundus examination revealed yellow-white placoid lesions in the posterior pole suggesting AMPPPE. Fluorescein and indocyanine green (ICG) angiography and optical coherence tomography (OCT) were performed 2 days, 9 days, and 1 month after the first examination. RESULTS: In the acute phases the OCT revealed a mild hyperreflective area above the retinal pigmented epithelium (RPE) in the photoreceptor layer. In the later phases the OCT scan revealed a nodular hyperreflective lesion on the plane of the RPE with mild underlying backscattering. CONCLUSIONS: In AMPPPE, the OCT demonstrates hyperreflective lesions that may indicate inflammatory tissue and inflammatory cells or the presence of ischemic edema in the outer retinal layers.

Optical coherence tomography findings in a case of an acute multifocal posterior placoid pigment epitheliopathy (AMPP).

PURPOSE: To report the optical coherence tomography (OCT) findings in a case of acute multifocal posterior placoid pigment epitheliopathy (AMPPPE). METHODS: A 26-year-old woman was seen for a mild loss of visual acuity in both eyes. The fundus examination revealed yellow-white placoid lesions in the posterior pole suggesting AMPPPE. Fluorescein and indocyanine green (ICG) angiography and optical coherence tomography (OCT) were performed 2 days, 9 days, and 1 month after the first examination. RESULTS: In the acute phases the OCT revealed a mild hyperreflective area above the retinal pigmented epithelium (RPE) in the photoreceptor layer. In the later phases the OCT scan revealed a nodular hyperreflective lesion on the plane of the RPE with mild underlying backscattering. CONCLUSIONS: In AMPPPE, the OCT demonstrates hyperreflective lesions that may indicate inflammatory tissue and inflammatory cells or the presence of ischemic edema in the outer retinal layers. (Eur J Ophthalmol 2005; 15: 143-7).

Fusidic acid vs ofloxacin prophylaxis before cataract surgery.

PURPOSE: To evaluate the safety and efficacy of two self-administrated antibiotics in eliminating conjunctival microbial flora. METHODS: A total of 133 patients operated for cataract surgery were divided into three groups. The first group (A), 55 patients, received fusidic acid drops (1%) two times per day during the 3 days before the surgery; a second group (B), 55 patients, received ofloxacin (0.3%) four times per day during the 3 days before the surgery; and the third group (C), 23 patients, did not receive any topical antibiotic before the surgery. On the day of the surgery, cultures were taken from the lower fornix. RESULTS: In Group A, 28 cultures (50.9%) were sterile, and 27 (49.1%) were positive for the presence of microbial agents. In Group B, 25 cultures (45.4%) were sterile, and 30 (54.5%) were positive for the presence of microbial agents. In Group C, 5 cultures (21.7%) were sterile, and 18 (78.2%) were not. Staphylococcus epidermidis was the most common micro-organism isolated in all the groups. Statistical analysis does not reveal a significant difference between Groups A and B for the sterile cultures (p=0.7) (chi-square test), but a statistically significant difference is present between the treated and not treated patients (p= 0.05) (chi-square test). CONCLUSIONS: A preoperative prophylaxis is useful in eliminating conjunctival micro-organism, and both antibiotics (fusidic acid and ofloxacin) are efficient.

[The immunohistochemical demonstration of intracytoplasmic estradiol in colorectal neoplasms]. / Evidenziazione immunoistochimica dell'estradiolo intracitoplasmatico nelle neoplasie del colon-retto.

Intracytoplasmic estradiol content was studied retrospectively using immunohistochemical procedures in tissue samples from subjects suffering from colorectal cancer. The results obtained reveal the presence of intracytoplasmic estradiol in cancer tissue. In precancerous lesions this presence is rarer and inconstant. Estradiol was not detected in the healthy tissue examined. These data suggest that such tumours may depend to some degree on endocrine factors.

Effect of lovastatin on serum lipids in patients with nonfamilial primary hypercholesterolemia.

The effect of lovastatin on serum lipids and its tolerability in patients with non-familial primary hypercholesterolemia (type II-A and type II-B) during a six-month period were evaluated in this open-label study. Thirty-eight patients were enrolled in the study; tolerability was assessed in all 38 patients. Thirty patients completed the study, and the effect of lovastatin on serum lipids in these patients was assessed. Some patients had been treated for hypercholesterolemia with long-term dietary and other non-pharmacologic means before entry into the study. All patients were unresponsive to a six-week program of intensive dietary therapy and other nonpharmacologic treatment to lower their blood cholesterol levels before receiving lovastatin. While maintaining intensive dietary therapy, administration of lovastatin was instituted at a dosage of 20 mg/day, which was increased by 20-mg increments monthly, as necessary, to a maximum of 80 mg/day. In an effort to achieve goal levels of low-density lipoprotein cholesterol (LDL-C), ten patients received a daily dosage of 20 mg, 12 patients received 40 mg, seven patients 60 mg, and one patient 80 mg. Twenty-nine of the 30 patients achieved significant lowering of serum levels of total cholesterol (TC), LDL-C, and apolipoprotein (apo) B-I; this was demonstrated after the first month of therapy with lovastatin and was maintained throughout the six-month treatment period. One patient failed to demonstrate lowering of these serum lipids, despite receiving the maximum recommended dosage of lovastatin of 80 mg/day. Comparative measurements of serum lipids during dietary therapy alone and after six months of diet plus lovastatin therapy were as follows: TC, 289 +/- 5 versus 216 +/- 9 mg/dl (P less than 0.0005); LDL-C, 206 +/- 4 versus 141 +/- 5 mg/dl (P less than 0.0005); and apo B-I, 112 +/- 3 versus 89 +/- 2 mg/dl (P less than 0.0005). Serum levels of very-low-density lipoprotein cholesterol (VLDL-C) and triglycerides decreased slightly during lovastatin therapy, but the changes were not statistically significant. There were slight but statistically insignificant increases in serum levels of high-density lipoprotein cholesterol (HDL-C), apo A-I, and apo A-II.(ABSTRACT TRUNCATED AT 400 WORDS)

[Care and rehabilitation of colostomized patients]. / L'assistenza e la riabilitazione del colostomizzato.

The enterostomies represent the result of a surgical operation that we have been carrying out more frequently in the last few years both on account of the neoplastic and inflammatory pathology of the large bowel; in fact about 40,000 colostomies are effectuated in Italy every year. On the basis of what has been said, the problem of assistance and of rehabilitation of the patients with colostomy assumes great importance. Therefore the authors have examined the various phases of the assistance (pre, intra and post-operatory) and they have underlined the rehabilitation of such patients. They conclude by affirming that it is indispensable to have a multidisciplinary collaboration to insure a correct assistance and rehabilitation, which involves the surgeon, the radiotherapist, the enterostomist, the psychologist and the oncologist; only in this way will they be able to restore to society these patients capable of living the rest of their lives if not happy at least serenely.

[Prostaglandins and gastric cancer: a preliminary study]. / Prostaglandine e cancro gastrico: studio preliminare.

As high levels of Prostaglandins E2 were observed in several gastric diseases, the Authors determined the PGE2 levels in gastric cancer patients without recurrences, in pre and post-operative period. PGE levels were correlated with cancer progression and their significance as tumoral markers was also assessed.

[Retroperitoneal neurilemmoma (anatomo-pathologic and clinical considerations)]. / Il neurilemmoma retroperitoneale (considerazioni anatomo-patologiche e cliniche).

After extensively reviewing the literature on primary retroperitoneal tumours, the authors present a case of retroperitoneal neurilemmoma. They stress the rareness of this disease and go on to discuss the related epidemiological, histogenetic and anatomo-pathological problems. Finally, they deal at some length with the symptoms of the disease and the diagnostic strategy they adopt, emphasizing the usefulness of CT and ultrasonic tomography in the study of the retroperitoneal region.

[Liver scintigraphy using 99mTc-HIDA in the study of biliary-digestive anastomosis]. / La scintigrafia epato-funzionale con 99mTc-HIDA nello studio delle anastomosi bilio-digestive.

Surgical operations characterised by the creation of a bilio-intestinal anastomosis are becoming an increasingly frequent procedure in bile tract surgery. Just as frequent and well known are the immediate and longer-term postoperative sequelae. Thus, one of the problems which has always interested surgeons and investigators is how best to monitor the functional efficiency of the anastomosis. Traditional x-ray methods, including highly invasive examinations such as PTC and ERCP, as well as the harmless ultrasound procedures do not provide an adequate picture of the functional efficiency of such anastomoses, the only wholly valid and efficacious method being sequential scintigraphy with 99mTc-Hida. On the basis of these principles, the authors describe their experience in this field, stressing the validity of the method, which enables surgeons to study the morphology and, above all, the functional efficiency of bilio-intestinal anastomoses.

[A case of intestinal occlusion caused by a Meckel' diverticulum (etiopathogenetic, diagnostic and clinical considerations)]. / Su di un caso di occlusione intestinale da diverticolo di Meckel (Considerazioni etiopatogenetiche, diagnostiche e cliniche).

The authors show a case of acute intestinal stoppage due to Meckel's diverticulum. After some notices about embryogenesis, pathological anatomy and symptomatology of Meckel's diverticula, they point out the difficulty to reach the diagnosis of such disease, which almost always is only done subsequent to the appearance of complications, such as: intestinal stoppage, inflammation, ulceration, perforation, neoplasms, bleeding. In fact, the diagnosis of Meckel's diverticulum is exceptionally preoperative and difficult on the basis of the symptomatology only, for which the disease can be responsible, whereas it can be more easily placed thanks to the contribution of instrumental methods, such as: barium meal, opaque enema, scintigraphy with 99mNa pertechnetate, selective arteriography of upper mesenterial artery. The diagnosis is more frequently interoperative, in course of explorative laparotomy or performed for other indications. Then the Authors state their orientation about the treatment, which is surgical in all the complex cases of Meckel's diverticulum, with a mention of the different operative techniques, and, as a conclusion, confirm the necessity for the systematic research of the asymptomatic diverticulum, the removal of which represents the only prophylactic measure against a permanent possibility and dreadful complicative evolution of same.

[Clinical considerations on diverticula of the duodenum]. / Considerazioni cliniche sui diverticoli del duodeno.

The authors, in the light of the data supplied by the literature, and through a careful analysis of their recent casuistry, based upon the observation of 48 cases of duodenal diverticula, propose a modern reviewing of the topic. After illustrating the etiopathogenetic, anatomo-pathological and clinical features of such disease, the Authors dwell upon the diagnostic and therapeutical problems involved, and point out the importance of a correct diagnostic iter and a consequent exact surgical indication. As a conclusion, they affirm the surgical treatment of duodenal diverticula, not exempt from risks, should be only reserved to cases rebellious to the medical treatment or severely complicate.