[Acute severe pancreatitis caused by anti-HIV drugs]. / Pancreatite acuta grave da farmaci anti-HIV.

Acute pancreatitis in patients with HIV infection is infrequent and often not recognized. Autopsies performed on patients died for different pathologies show pancreatic lesions approximately in 50% of cases. The etiological factors associated with acute pancreatitis are related to HIV infection and particularly to drugs used to treat the syndrome or to prevent opportunistic infections. We report a case in a 38 years old male patient with AIDS without risk factors for acute pancreatitis in which the disease developed while taking Stavudine, Lamivudine and Indinavir. His conditions improved with intensive medical therapy. The subsequent medical course became complicated. The patient died after 75 days for severe abdominal haemorrhage. A review of the literature reports several cases of A.P. in HIV patients mainly related to opportunistic infections. Many authors regard the medical treatment of HIV syndrome as etiological factor but a casual relationship was never demonstrated. The aim of the present paper is to underline that besides Lamivudine also Stavudine and Indinavir might be related to acute pancreatitis. Clinical and laboratory investigations in HIV patients are therefore indicated for an earlier diagnosis and treatment.

[The treatment of laparocele by means of a reticulo-laminar prosthesis (Composix Mesh). A technical note]. / Trattamento del laparocele mediano con protesi reticolo-laminare (Composix Mesh). Note di tecnica.

In this paper, the authors present a modified Rives' technique for the treatment of incisional hernias. This technique requires the use of a nonabsorbable prosthesis (Composix Mesh) made of a double-knit layer of monofilament polypropylene bonded with a single layer of low-porosity e-PTFE inserted behind the rectus muscles and fixed by metallic clips. The outer side (polypropylene) encourages complete host tissue incorporation to reduce recurrences, the inner side (e-PTFE) minimizes tissue attachment and, therefore, visceral complications.

[1,000 prosthetic hernia repairs: experience of a dedicated team]. / 1000 ernioplastiche protesiche: esperienza di un gruppo dedicato.

The authors report on their 8-year experience with inguinal prosthetic repair. Their personal experience includes 1000 hernioplasties, 639 of which performed using the "plug and patch" technique. The postoperative morbidity was 2.7% and patients were unsatisfied only in 1.8% of cases (self-evaluation test). Follow-up was carried out by means of phone enquiries supplemented by a clinical examination in selected cases and in a control group of asymptomatic patients. 85.4% of the study population and 94.8% of patients operated on in the last 38 months were contacted by phone. The recurrence rate after "plug and patch" repair was statistically adjusted according to the maximal bias test, taking into account the percentage of patients lost to follow-up. Other late complications were severe neuralgia (0.9%) and rejection of the prosthesis (0.1%). Migration of the plug was never observed. The authors confirm that the aims of inguinal hernia surgery (significant reduction of recurrences and minimal discomfort for the patient) can be best achieved in suitable facilities (hernia centres) by a dedicated team of experienced professionals.