Determinants of health-related quality of life in morbid obese candidates to gastric banding.

OBJECTIVE: To analyse determinants of self reported health-related quality of life (HR-QoL) in morbid obese patients candidates to laparoscopic adjustable gastric banding (LAGB). METHODS: Determinants of HR-QoL were investigated in 383 morbid obese patients (82 M and 301 F) with BMI≥40 kg/m² (BMI≥35 kg/m² if complicated obesity) and age 18-60 years. HR-QoL was determined with the SF-36 questionnaire. Determinants of the two summary measures of SF-36 (physical component and mental component) were analysed by stepwise multiple linear regression analysis with age, BMI, physical comorbidites, mental comorbidites and eating behaviour disorders as independent variables. Physical comorbities (diabetes, hypertension, hypertriglyceridemia, low HDL, sleep apnea and osteoarthritis) were coded as present or absent on the basis of simple diagnostic clinical criteria; mental comorbidities (depression) and eating behaviour disorders (binge eating, sweet eating and nibbling) on the basis of an unstructured clinical interview. RESULTS: Mean age was 38.8±10.2 years and mean BMI was 41.5±5.4 kg/m². Scores in the eight SF-36 subscales were lower in women than in men and lower than in the general Italian population. However, 18.4-43.5% of the participants had HR-QoL levels above the normative values, depending on the scale. In both genders, low scores in the mental component of the SF-36 were associated to the presence of depression and eating behaviour disorders and not to physical comorbidities or BMI levels. Low physical self-perceived well being was associated to high BMI levels in men and to depression, hypertension and hypertriglyceridemia in women. CONCLUSION: HR-QoL was poor in morbid obese candidates to LAGB, particularly in women, and was negatively affected more by mental comorbidites and eating behaviour disorders than by physical comorbidities or BMI levels.

[Aorto-mesenteric compression syndrome. Description of clinical case and critical review of the literature]. / La sindrome del compasso aorto-mesenterico. Descrizione di un caso clinico e revisione critica della letteratura.

Aorto-mesenteric duodenal compression syndrome is a rare disease in which superior mesenteric artery causes a substenosis of the duodenum. Pathogenesis of this syndrome is due to congenital or acquired factors. Symptomatology is usually non specific and intermittent. Diagnosis is given by selective superior mesenteric artery angiography. Therapy is only surgery.

[The right laparoscopic adrenalectomy of an incidentaloma]. / Surrenectomia destra laparoscopica di un incidentaloma.

The authors report a case of incidental lesion of right adrenal gland in a 56-years-old patient, followed for a liver disfunction. The lesion, with cystic and hemorrhagic histological characters, was treated with laparoscopic resection. The following case report covers the diagnostic procedures, laparoscopic technique, showing the advantages, and postoperative course in surrenal lesion without local infiltration.

Intestinal occlusion secondary to Morgagni-Larrey's herniation in an adult. Case report and analysis of the literature.

Morgagni-Larrey's hernias are congenital diaphragmatic hernias, rarely observed and generally identified accidentally due to the lack of symptoms. The authors report a case of intestinal occlusion secondary to Morgagni-Larrey herniation in an adult recently observed and underline the aetiopathogenic aspects, the diagnostic tools and the clinical pattern. They suggest to consider surgical repair as a choice of treatment, also for asymptomatic patients.

[Adenomyomatosis of the gallbladder. Our experience]. / L'adenomiomatosi della colecisti. Nostra esperienza.

Adenomyomatosis is a rare affection of the gallbladder and it's infrequently reported in the Literature. Having observed eighteen cases of adenomyomatosis of the gallbladder in the last five years and considering the difficulties in making an early diagnosis of gallbladder cancer, the authors suggest the importance of cholecystectomy in this pathology.

[Laparoscopy in iatrogenic lesions of the colon during operative endoscopy]. / La laparoscopia nelle lesioni iatrogene del colon in corso di endoscopia operativa.

Colonscopy is a standard diagnostic and therapeutic procedure that has its own morbidity. Colonic perforation is the dangerous complication of this procedure. Successful management of perforation by conservative or surgical treatment remains controversial. We report two cases, recently observed, of patients with colonic perforation occurring during therapeutic colonscopy treated with minimally invasive technique.

Determinaçäo de receptores hormonais em câncer de mama: método histoquimico / determination of hormonal receptors breast cancer: histochemical method

Em 31 biópsias de pacientes portadores de câncer de mama foram realizados diagnóstico histopatológico e avaliaçäo do status hormonal. A técnica histoquímica usada para o estudo de receptores de estrogênio e progesterona (ER e PgR) em cortes criostáticos é simples e de fluorescência alternativa. Cortes adjacentes foram corados por hematoxilina-eosina (HE) e laranja de acridina (AO) para diagnóstico e identificaçäo da populaçäo celular maligna. Achados preliminares mostram: 1) dos tumores estudados, 38,7% foram positivos, 12,9% duvidosos e 48,4% negativos. 2) Maior freqüência de ER e PgR foi encontrada nas pacientes pós-menopáusicas. 3) O carcinoma lobular infiltrante apresentou elevada positividade para ER e PgR. 4) Valores baixos de ER e PgR foram encontrados em tumores com infiltrado linfocitário intenso. 5) A populaçäo heterogênica que forma os tumores malignos de mama está constituída por células ER e PgR positivas e negativas em diversas proporçöes. Os autores também relatam observaçöes sobre a presença de receptores nucleares e dados morfológicos

Infecciones humans por Flavivirus en Tandil. / Human infections by Flavivirus in Tandil

Se analizaron 336 sueros humanos obtenidos entre el 24-4-79 y el 26-11-81, del partido de Tandil, para determinar la presencia o no en esta latitud de 3 Flavivirus conocidos para la Republica Argentina. Se pudo establecer las actividades de los virus encefalitis de San Luis e Ilheus.No ha habido actividad de fiebre amarilla a pesar de que algunos de los individuos encuestados tienen mas de 80 anos. Se admite la existencia a otro/s Flavivirus aun no identificado/s, diferente a los dos (SLE e ILH) ya constatados como endemicos

Infecciones humans por Flavivirus en Tandil. / Human infections by Flavivirus in Tandil

Se analizaron 336 sueros humanos obtenidos entre el 24-4-79 y el 26-11-81, del partido de Tandil, para determinar la presencia o no en esta latitud de 3 Flavivirus conocidos para la Republica Argentina. Se pudo establecer las actividades de los virus encefalitis de San Luis e Ilheus.No ha habido actividad de fiebre amarilla a pesar de que algunos de los individuos encuestados tienen mas de 80 anos. Se admite la existencia a otro/s Flavivirus aun no identificado/s, diferente a los dos (SLE e ILH) ya constatados como endemicos