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Biomedical subjects

A Carditello

Publications and source records attributed to A Carditello.

At least 19 recordsLinked to original sources
PubMed2001

[Treatment of bleeding esophageal varices: sclerotherapy or surgery?].

To evaluate therapeutic options to improve the prognosis of haemorrhage from oesophageal varices, a study was performed on 422 patients observed from 1983 to 1998. Patients were classified according Child-Campbell method after improvement of general conditions (class A: 7%; B: 68%; C: 25%). Thirty-two patients (7.8%) died during emergently pharmacologic treatment in the first 24 hours; 182 patients (44.6%) because of persistent haemorrhage underwent endoscopic sclerotherapy. In 164 (90.1%) bleeding stopped and 14 cases (7.6%) underwent emergency surgical treatment (9 splenectomies and splenorenal shunts, 5 mesenterico-caval shunts). Teu other patients (with rebleeding 3-7 days after sclerotherapy) underwent emergency surgical treatment (7 azygos-portal thoracotomic deconnections, 3 splenectomies and spleno-renal shunts). The rates of therapeutic success were respectively 80% for surgical treatment and 90% after sclerotherapy. Factors of prognostic improvement of these emergently disease are examined. The advantages of both endoscopic and surgical treatment are outlined.

Esophageal and Gastric Varices↗
PubMed2001

[Endoscopic obstruction treatment].

The Authors reported the last year personal experience of disobstruction endoscopic therapy; they described therefore an examination of the several techniques proposed from the international literature and in particular dwell upon laser-therapy and airway stents implantation. They emphasized the treatment importance, mostly palliative, but the effective symptomatology improvement due to airway obstruction, bleeding, pain and secretions retenction. They emphasize finally the necessity of a careful and scrupulous patients selection for disobstruction endoscopic therapy.

Aged↗
PubMed2000

[Reconstruction of the thoracic wall].

The resection of the thoracic wall for cancer, traumas or results of radiotherapy could require a reconstruction of the same wall with prosthetic material of different nature to the purpose of protect the important intrathoracic structures, avoid the flail chest and maintain a ventilation adjusted with aesthetically acceptable results. Numerous and varied they have been and they are the materials used to such aim, but the more numerous experiences concern the reconstructions of the wall with the employment of nets of Marlex or the patch of Gore-Tex. In the complete two years eight patients have arrived at our observation in which a prosthetic reconstruction has been performed with heterologous material. In three of them has been used the net of Marlex, in five the patch of Gore-Tex of two millimeters of thickness. The prostheses have stayed well you bear and in all the patients the authors have gotten a good stabilization of the thoracic wall.

Adult↗
PubMed2000

[Elective and emergency minimally invasive surgery in pleural diseases].

In the last years the video-assisted thoracic surgery (V.A.T.S.) assumed an important order for the diagnosis and treatment of the pleural disease. In this particular field, the procedure allows obtaining almost the same outcomes of traditional surgery and is very safety. V.A.T.S. reduces hospital time and trauma with a fast return to the working life. The Authors describe their experience and outline the diagnostic and therapeutic indications for the treatment of choice and emergency.

Elective Surgical Procedures↗
PubMed1999

[Open-window surgery of pleural empyema].

Thoracoscopic is performed for treatment of pleuric empiema with 65% of recovery. In the old patients the Authors achieved high grade of recovery with open window (OW) procedure. In the last two years, 7 patients with pleuric empiema underwent this treatment. In two patients the origin was tuberculosis, in 4 empiema was post-pneumonitic; in one case the cause was broncho-pleuric fistula after pneumonectomy. All the operations were performed under general anesthesia. The Authors began with thoracoscopy, drainage of cavity and then they performed the resection of one or more ribs and a pleuro-cutaneous flap: 5 patients recovered without complications. OW seems to be very useful in the case in which more radical approach is impossible. Continuous irrigations of the cavity, with rapid pulmonary expansion, permits recovery without the use of myocutaneous flaps.

Aged↗
PubMed1994

[Ambulatory hemorrhoidectomy: results of 500 surgical operations].

To evaluate the results of outcome hemorrhoidectomy, 500 Ferguson-Khubchandani's operations performed between January 1989 and December 1993, were reviewed. 272 of the patients (54.4%) were males (average age 37 years). In 76.6% of patients haemorrhoids were III degree. After outcome pre-operative study, the patients were operated using local anaesthesia and discharged two hours after the operation. Telephone contact was established with patients until the 6th day after surgery and they were reviewed 7 and 14 days after operation. 320 patients were followed up for 12 months. The results were evaluated on the basis of the following criteria: grading of post-operative pain; complications and late sequelae; grading of patients satisfaction with the surgical operation. 291 patients (39.2%) reported light post-operative pain; in 61 (12.2%) the pain was high and needed multiple analgesic (ketorolac) infusions. Post-operative complications were respectively: haemorrhage (7 cases); perianal abscess (2 cases); transitory gas incontinence (3 cases). Late sequela were: II degree stenosis (2 cases) and return of haemorrhoids (3 cases). In 89.9% of patients results were well satisfactory. 2% of patients were not satisfied with the operation. This study and the literature confirm the technical improvement in hemorrhoidectomy: with the introduction of new antalgic drugs, this procedure is now well established in an ambulatory setting with good results and low cost.

Adult↗
PubMed1989

[Recent advances in surgical therapy of hepatocarcinomas. 5 questions on the exeresis of carcinomas of the cirrhotic liver].

The surgical treatment of cancers in cirrhotic liver has two main objectives: 1) to remove the cancer with low mortality and mobility rate; 2) to carry out a radical operation with a survival index of 50% three years after the operation. For this purpose, five queries may contribute to programming the most suitable surgery. 1) What patients can be operated? a) those without abdominal ascitic effusion; b) anicteric patients; c) those with fairly well preserved liver function. 2) What liver cancers can be resected? Mainly those with a single localisation. 3) What investigations offer a picture of the extent of tumoral invasion? a) ultrasonography; b) arteriography with simultaneous injection of Lipiodol and later echography; c) intraoperative echography. 4) What surgical operation should be carried out? Liver resection as "economical" as possible (cirrhotic liver) but at the same time as "radical" as possible (hepatocarcinoma). 5) What results can be expected? a) 5% mortality; b) 30% survival 3 years after operation. As the prognosis of liver cancers in cirrhotic livers is better the more limited are the dimensions of the tumour at the time of operation, only systematic screening of cirrhotic patients by repeated ultrasonography permits their treatment at an earlier stage.

Carcinoma, Hepatocellular↗
PubMed1989

[Current facts on ulcer disease].

In the second half of this century, some important changes characterized the peptic ulcer history. The overall incidence of ulcer disease markedly decreased, with some differences in the various geographic areas and according to socioeconomic development of population. Peptic ulcer seems now more frequent in women and in the elderly patients, in comparison with the past. The appearance of H2-Receptor Antagonists determined a decline of ulcer surgery, because the ulcer is become a medical disease. Pyloric stenosis also, after ten years of H2-Receptor Antagonists treatment, markedly decreased. Indeed, the problem of acute complications is still actual. The detailed analysis of patients hospitalized, shows significative decrease of acute complications in patients with chronic ulcer and a marked anamnestics. The efficacy of medical treatment in the control of acute ulcer complications, seems to be balanced with new etiopathogenetic factors, which are able to start the appearance of acute complications of the disease (increased assumption of ulcerogenic drugs; smoke and alcohol abuse; increased socio-politic engagement of women and improved resuscitations technics).

Histamine H2 Antagonists↗
PubMed1987

[Development of suture materials: from the beginning to our day].

The history of suture materials from the beginnings to the II World War is reported. In this period, catgut and silk were the most employed sutures. The appearance and successive development of synthetic materials revolutionized the field of surgical sutures. This evolution is still active, to the search of ideal suture line.

History, 17th Century↗
PubMed1987

[Treatment of acute cholecystitis, yesterday and today: the role of diagnostic research].

To evaluate the influence of both ultrasonography and cholescintiscan on the choice of the treatment and prognosis of acute cholecystitis, the authors reviewed their series of 187 patients observed between 1974 and 1985. On the basis of diagnostic investigations employed, two distinct periods are considered, 1974-79 and 1980-85. In the I period, the exact diagnosis of the disease was obtained in 31 patients (26.3 percent) and the treatment was conservative in 81.3 percent of cases and surgical in 18.7 percent. In the II period, the disease was exactly diagnosed in 95.6 percent and all patients underwent surgery. The overall mortality and complication rate was respectively 5.1 percent and 11.8 percent in the I period and 1.1 percent and 5.8 percent in the II period. Authors conclude that ultrasonography and cholescintiscan, arising rapidly to the exact diagnosis of disease, influenced markedly the choice of surgical treatment, improving the prognosis of these patients.

Acute Disease↗
PubMed1986

[Changes in the levels of reverse triiodothyronine (rT3) during and after surgery of the thyroid gland].

The thyroid activity of twenty euthyroid patients, with single or multiple "cold" nodules was investigated, with determination of seric T3, T4, reverse-T3 (rT3) and TSH. The blood-drags were performed respectively, during (with seric samples from the inferior thyroid vein ipsilateral to the affected lobe) and after (1, 3 and 7 days) surgery. The results of this study--and particularly the significative decrease of T3 and the rapid rT3 increase, either during or after operation - suggests a condition similar to the described "Low T3 syndrome", as expression of both the stress determined by surgery and the correlated thyroid metabolic "adaptation". The clinical and biochemical euthyroidism, expressed by normal levels of TSH in all the samples, confirm the persistence of normal feed-back mechanism by the diencephalon-hypophysis-thyroid axis, even in stress conditions.

Adaptation, Physiological↗
PubMed1986

[Cytologic aspiration biopsy in the diagnosis and therapy of solitary cystic nodular thyropathies].

Between January and December 1983, 36 patients with single and benign cystic thyroid nodules underwent fine needle aspiration. They received, after fine needle aspiration, medical treatment (antiinflammatory drugs and L-T4). Clinical and ultrasonographic follow-up was performed either 6 and 18 months after FNA, to evaluate the lesion evolution. The six-month follow-up demonstrated no ultrasonographic signs of cystic lesion in 11 cases (30.6%); a decreased volume in 21 (58.3%) and four recurrences (11.1%), which underwent surgical treatment (lobectomy). In 21 patients with persistent lesions at 18 month follow-up, a cystic reduction in a 79.9% rate was documented. These data suggests the diagnostic importance of FNA and the safety of this method not only to surgical selection of patients, but also to the treatment of benign thyroid cysts.

Adolescent↗