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Biomedical subjects

A Ginardi

Publications and source records attributed to A Ginardi.

18 recordsLinked to original sources
PubMed2000

[Incidence of complications of thyroid surgery].

BACKGROUND: Thyroid surgery presents a low incidence of complications. Death is certainly a rare, or even exceptional event. Hypoparathyroidism, above all if definitive, is the main complication of total thyroidectomy with percentages that very between 0 and 10% in the literature (average 2%). METHODS: The incidence of recurrent lesions varies between an improbable 0% to 8%, whereas lesions to the superior laryngeal nerve are relatively frequent, but often undervalued. Dysphagia, although always transient, presents a high risk of pneumonia ab ingestis and severe dehydration. Hemorrhage has an incidence of 0.1-3.8% and infection is reported in approximately 1% of cases. The permanent and recurrence nature of thyroid pathology in literature is between 5 and 11%, resulting from inadequate or sometimes useless surgery. Hypothyroidism is the logical consequence of total thyroidectomy. In the light of these data we have re-examined 300 operations involving thyroid pathology performed by the same team using the same method over the past 4 years (82% females, 18% males). 33% of the cases presented benign euthyroid nodular pathology, 27% hyperfunctioning benign nodular pathology, 2.6% Flajani-Basedow-Graves disease, 9% were adenomas, 7% were differentiated carcinomas, 2% anaplastic carcinomas and 0.7% medullary carcinomas. 99 extracapsular total loboisthmectomies, 135 total extracapsular thyroidectomies and 66 subtotal thyroidectomies were performed. RESULTS: The following complications were observed: 31/300 symptomatic hypocalcemias of which 25 were transient and 6 (2%) were definitive but easily controlled with treatment; 9 recurrent monoplegias out of 501 isolated recurrent forms of which 4 (0.8%) was permanent; 5/300 (1.7%) postoperative dysphagias associated with recurrent monoplegia in 4 cases. Damage to the external branch of the superior laryngeal nerve was suspected in 11/300 cases (3.7%). Postoperative hemorrhage occurred with an incidence of 1.3%, whereas the incidence of wound infection and serous collection was 1.7%. Moreover, persistent hyperthyroidism after subtotal bilateral thyroidectomy was observed secondary to toxic plurinodular struma. A case of paralysis of the right ulnar nerve, when the arm was adducted, was observed on the operating table, but regressed after about 4 months. Mortality was zero. CONCLUSIONS: Thyroid surgery is still hampered by a relatively low percentage of complications, which are probably still the result of various technical limitations, and it appears difficult to reduce these, let alone eliminate them completely.

Adolescent↗
PubMed1997

[The surgical treatment of nonpalpable breast lesions].

Non-palpable breast lesions may be defined as suspected lesions for "occult" tumours and diagnosed during the course of screening or, occasionally, in asymptomatic women. Mammography is the main diagnostic instrument owing to its high sensitivity and specificity, although an increasingly important complementary role is played by ultrasound scan. The comparison of findings obtained provides elements for further evaluation. Moreover, mammography can be used to make a dynamic study of the breast over time in order to evaluate doubtful lesions that might change, especially in women of a child-bearing age and during the various phases of the menstrual cycle. The use of the metal repere allows the lesion to be identified and surgically removed. A total of 135 operations for breast pathologies were examined from 1 January 1994 to 30 April 1996, subdivided into 26 operations for benign pathologies and 109 for malignant pathologies. Of the latter 52 (47.7%) were modified radical mastectomies, 50 (45.9%) were quadrantectomies with axillary lymphadenectomy, 1 (0.9%) quadrantectomy, and 5 (5.5%) simple mastectomies. A total of 16 needle biopsies were performed of which 8 were benign and 8 malignant. The latter were treated using 2 modified radical mastectomies owing to the presence of an extensive intraductal component, 5 quadrantectomies with lymphadenectomy, and 1 simple quadrantectomy for a lobular carcinoma in situ. Kopans needle was also used as a repere and the stiffening cannula was used for an accurate, effective but economical exeresis. One of the 8 benign cases was complicated by an hematoma (12.5%). Neither the mammary gland nor the subcutis were sutured to avoid unsightly scars and uncertain images at later mammographic controls.

Biopsy, Needle↗
PubMed1997

[Inguinale hernia: alloplasty with polypropylene surgical mesh].

INTRODUCTION: Alloplasty with prosthetic graft (marlex net, dacron, mersilene, etc.) represents an undoubted progress in the surgical treatment of inguinal hernia. Having completed the isolation and possible resection of the hernial sac, the posterior wall of the inguinal canal is no longer reconstructed using musculo-aponeurotic plastic surgery (Bassini, Postemski, etc.), but by encouraging a granulomatous reaction using a prosthetic graft which provides a solid posterior wall to the inguinal canal. METHODS: A total of 447 cases were examined of patients undergoing alloplastic surgery with the use of a prosthetic polypropylene graft who were controlled at one week, one month and one year after surgery. RESULTS: Mortality was zero whereas morbidity was 21 cases: 7 hematoma, 5 funicular edema, 8 seroma. A total of 9 recidivations were recorded (2%).

Adult↗
PubMed1997

[Our experience with pediatric pH-metry].

INTRODUCTION AND METHODS: The authors present their experience of pH monitoring in children performed in patients in the Pediatric Division selected on the basis of the following criteria: endoscopic evidence of incontinent cardia with or without oesophagitis, presence of pyrosis/epigastralgia even in the absence of objective endoscopic findings, dry cough without bronchopulmonary findings, vomit with apparent endoscopic causes, presence of anti-helicobacter antibodies with clinical symptoms. RESULTS: The authors report their findings and discuss them in comparison to the literature. CONCLUSIONS: They conclude by affirming that pH monitoring is a well tolerated and easily performed test in children. It may provide indications and useful clarifications regarding a number of pathologies often over- or undervalued by the doctors in charge or parents, leading to the start of correct treatment with excellent clinical results.

Adolescent↗
PubMed1996

[Traumatic lumbar hernia of the Petit's triangle. A clinical case].

Lumbar hernias are very rare and no more than 300 are reported in literature. They can be classified as congenital and acquired. The latter are in turn subdivided into primary and secondary. Secondary traumatic lumbar hernias account for 25% of all cases. The site of the formation of this hernia is mainly Grynfelt's triangle and, to a lesser extent, Petit's triangle. Traumatic lumbar hernia have very moderate symptoms and may be corrected surgically relatively easily, in particular with the use of Marlex nets. Recidivations can be easily identified owing to the lack of aponeurotic support structures in this anatomic site. Owing to their traumatic etiopathogenesis these hernias are of particular medicolegal importance for the purposes of indemnity. The case reported refers to a 46-years-old man involved in a road accident who sustained an injury caused by the explosion of hollow viscera in the abdomen and the subsequent onset of a hernia swelling through Petit's triangle in the right lumbar region. Owing to the width of the breach, plastic surgery was carried out using a Marlex graft. A large recidivation was observed around one year later.

Accidents, Traffic↗
PubMed1994

[Rare venous pathology: Mondor's disease].

A case of Mondor's disease is described. They remark etiopathogenesis and clinical signs of this rare disease that affects thoraco-epigastric vein or one of its confluents. They point to the benignity of the disease that tends to evolve to a spontaneous healing in a few weeks. Authors confirm the advisability of performing appropriate exams to exclude malignancies of the breast.

Adult↗
PubMed1994

[Extraosseus plasma cell lymphoma with ileal localization].

The paper reports a case of extraosseous plasmacytic lymphoma in an ileal localisation in a patient with multiple myeloma. After having underlined the relative rarity of tumours of the small intestine and their diagnostic and clinical characteristics, the paper describes the case in question. The unique nature of the case depends on the extreme rarity of cases of isolated secondary forms in patients with active systemic pathologies reported in the literature.

Aged↗