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Biomedical subjects

A De Medici

Publications and source records attributed to A De Medici.

At least 19 recordsLinked to original sources

[Cystic tumours of the pancreas].

The authors illustrate 2 cases of cystic pancreatic neoplasms recently observed at the 2nd Surgical Clinic of IRCCS Policlinico San Matteo in Pavia. Having emphasised the rarity of this pathology, they describe the specific nature of the clinical condition and symptoms which may remain unchanged for a long period. They then highlight the most significant radiological aspects, paying special attention to differential diagnosis. Surgery is indicated as the treatment of election, correlated to the topography of the lesion, the anatomic and histological nature of the disease, especially mucinous, and the patient s general conditions.

Adult↗

[Medullary thyroid carcinoma].

The authors report a case of medullary carcinoma of the thyroid diagnosed at the 2nd Surgery Clinic of IRCCS Policlinico "San Matteo" in Pavia in a series of 600 cases of thyroid pathology. Having emphasised the rarity of this pathology, the authors report the characteristic pathological aspects. They also outline the clinical signs leading to suspected diagnosis, illustrate the diagnostic techniques used to achieve an early diagnosis and underline the importance of the tumour markers CT and CEA. They identify radical surgery, total thyroidectomy with MND lymphadenectomy, as the therapy of choice, followed by accurate and careful monitoring with a view to ensuring an early diagnosis of renewed disease or recidivation.

Aged↗

[Prevalence and features of peptic ulcers in the elderly: a retrospective study on a not hospitalized population aged 65 or over].

BACKGROUND: The prevalence of peptic ulcer increases with aging. Data relative to peptic ulcer in the elderly are around 5.2% to 9.9%. The aim of the present study was to evaluate the prevalence and the features of peptic ulcer in a non hospitalized population aged 65 or over. METHODS: We performed, for the first time, EGDS on 706 patients with symptoms related to the superior gastroenteric tract. We considered the following risk factors: familiarity for peptic disease, habits, eventual use of FANS, infection of Hp. RESULTS: Our data show that peptic ulcer increases with aging and with physiopathological age-related changes. 114 (16.1%) patients were affected by DU; 84 (11.9%) patients were affected by GU Symptoms thereafter were not clear: epigastralgy was present in 46.4% of patients affected by GU; pyrosis, belchings, swellings, epigastric headness were present in 37.7% of patients with DU. Several times PU may arise with some complications: melena was present in 14.9% of patients with DU vs 11.9% of patients with GU, hematemesis was present in 1.7% of patients with DU vs 5.9% of patients with G.U. The most important risk factor was the infection of Hp, at was present in 71.9% patients with GU and 81.6% patients with DU FANS assumption, often with high dose, was present in 30.9% of patients with GU and 18.4% of patients with DU.

English Abstract↗

[Malignant fibrous histiocytoma of the breast. A clinical case].

The authors report a personal, observed case of relapsing malignant fibrous histiocytoma of the breast. After recalling the anatomopathologic aspects and the clinical characteristics of the affection, the authors dwell upon the utility of correct diagnosis and point to the right therapeutic way consisting of a radical surgical treatment.

Aged↗

[Primary osteogenic sarcoma of the breast. Clinical contribution].

A case of primary osteogenic sarcoma of the breast is reported. All its clinical, radiological, gross and histological characteristics are analyzed, nevertheless the diagnosis is difficult. The authors dwell upon the utility of fine-needle aspiration and upon the importance of histologic and immunohistochemical studies. After emphasizing the difficulty both in an adequate local control and of metastasis, the authors point to the right therapeutic ways, still debated for the rarity of the tumor, which precludes every prospective trial.

Aged↗

[Gastric injury by caustics: a case report].

The authors get the idea from the observation of a case of ingestion of muriatic acid, recently happened by Clinical Surgery II of the IRCCS Polyclinic "San Matteo" of Pavia in order to examine carefully the matter. The rareness of the shown case is given by the whole involvement of only the stomach, without damages for the oropharynx and the esophagus. The total gastrectomy executed 6 months after the ingestion of the acid has given to the patient the whole recovery. The follow-up checked for a periodical time of 6 months for a period of about five years, permits to observe the normal intestinal canalization without stenitical symptoms or zonas with degenerative risk.

Adult↗

[Intestinal occlusion caused by actinic ileitis].

During the 5-year period from 1988 to 1992, 6 patients underwent operation for radiation-induced small bowel obstruction at the General Surgery II, IRCCS Policlinico S. Matteo of Pavia. Based on this experience and reports in the literature, physiopathology, pathologic findings, and operative technics are discussed.

Aged↗

[Cervico-mediastinal goiters. Clinical aspects].

Among 660 cases of thyroid pathology diagnosed by the 2nd Institute of Clinical Surgery, Policlinico San Matteo, IRCCS, Pavia, during the period 1984 to 1993, 34 cases of cervical-mediastinal goiter were observed with an incidence of 5%. After a careful analysis of the main contributions to the study of cervical-mediastinal goiters, paying special attention to their classification, pathogenesis, methods of growth, and unique symptomatic manifestations, the authors focus on current radiological and instrumental studies, which are widely regarded as being useful for the diagnosis of the site and nature of this disease. They review the routes for aggressive surgery and appropriate techniques for the exeresis of the mediastinal mass. Having empasised the absolute indication for surgery the authors recommend quasi-total or total thyroidectomy as the elective form of surgery.

Adolescent↗

[10 years of neoplastic pathology of the thyroid].

Here the authors have reported case studies made over a ten year period from 1982 to 1991 at the Surgical Semeiology Institutes of the Surgical Pathology, and Surgery Clinic II of the IRCCS San Matteo General Hospital, Pavia. It considered 28 cases of thyroid carcinomas (18 papillary, 6 follicular, 3 anaplastic and 1 medullary). Firstly an in depth examination using the most up to date diagnostic methods available today was made with particular attention paid to cytological examination by needle suction showing the rarity of the affliction. Then the histological variables the various biological aggressiveness, the multicentric and bilateral nature of certain neoplastic forms were recorded. Finally particular attention was paid to the therapeutic problem. In agreement with the great majority of authors, they believe that the best therapy is as follows. For differentiated tumours, a total thyroidectomy and when there is a more conservative surgical choice, the isthmolobectomy should be modified by prognostic indicators (age, sex, six of the tumour, single or multi location histotype). Furthermore lymphadenectomy should not be carried out automatically, but after a careful evaluation of the lymph node areas for a simple suspicion of metastasis.

Adenocarcinoma, Follicular↗

[Sigmoid volvulus].

The authors report a retrospective study of four patients treated for sigmoid volvulus at the Clinica Chirurgica II of IRCCS Policlinico S. Matteo of Pavia between April 1974 and June 1989. They are collected from a series of 74 consecutive operations for colonic obstruction not related to hernias of the inguinal-crural region (incidence 5.4%). One patient died. The authors review the incidence, epidemiology, etiopathogenetic hypothesis, clinical patterns, nonoperative and operative therapeutic options of the affection. They emphasize the poor prognosis because the sigmoid volvulus usually occurs in elderly ill patients.

Adult↗

[Traumatic lesions of the colon].

Four patients operated on at the Clinica Chirurgica II of IRCCS--Policlinico San Matteo of Pavia for trauma involving the colon were reviewed. All were males and their ages ranged from 14 to 84 years (mean 43.5 years). Injuries of the colon were found on 9 per cent of all patients operated on for abdominal penetrating injuries and on 6 per cent of patients with blunt injuries. The authors recall the pathogenetic mechanisms, clinical patterns, some grading systems proposed for quantifying the severity of the lesion. Our experience has shown that in blunt trauma the prognosis is worse because there were many associated organ injuries. These condition the early mortality for shock and exsanguination.

Abdominal Injuries↗

[A department of general surgery using the Diagnosis Related Groups (DRGs) system. Evaluation of the case series].

DRGs system allows the grouping in a single grad-bag code of a number of similar surgical procedures carried out in patients homogeneous for age, physical status, complication and so on with similar costs. Therefore this grouping method is useful for payment to hospitals. The Authors have coded with DRGs the surgical activity of a general surgery staff during a year to verify the image that DRGs bears. Seven hundred diagnoses of dismission were related to operated on patients while one hundred twenty seven were related to patients treated with medical therapy. The DRGs more numerous were 290, 258, 198, 162, related with thyroidectomy, mastectomy, cholecystectomy and herniorrhaphy.

Diagnosis-Related Groups↗

[Epithelial cysts of the spleen].

The Authors report a case of epithelial cyst of the spleen-observed in a 25 years old woman. After remembering the nomenclature and pathogenetic hypothesis, they consider clinical patterns of this rare disease of the spleen which is usually found in children and young adults. The Authors discuss pathological findings, diagnostic aids, especially non-invasive imaging. They also suggest considering the cysts in diagnosis of the diseases of the spleen and splenectomy as a treatment of choice.

Adult↗

[A rare case of massive digestive hemorrhage. Carcinoid of the small intestine].

The authors reports a case of massive digestive hemorrhage produce by a carcinoid of the small intestine. Having reviewed the most frequent causes of primary hemorrhage of the mesenteric small intestine, attention is focused on the difficulties o making an etiological and topographical diagnosis, in spite of using the most advanced instrumental research methods. The paper concludes that explorative laparotomy is the sole method for making a precise diagnosis and performing appropriate surgical treatment.

Acute Disease↗