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Biomedical subjects

A Paolucci

Publications and source records attributed to A Paolucci.

11 recordsLinked to original sources
PubMed1996

[Deep venous thrombosis in pregnancy: diagnostic difficulties and therapeutic indications. Discussion of a clinical case].

Pregnancy is a risk factor for deep and superficial venous thrombosis because of hemodynamic changes and modifications of the coagulation and fibrinolitic systems. In case of a patient suffering from a congenital or acquired thrombophilia, risk of severe and recurrent thrombosis becomes much higher, with the possibility of a life threatening complication as pulmonary embolism. Recently a number of congenital thombophilic syndromes have been described, in particular congenital hereditary deficit of coagulation inhibitors. Among the acquired pathologies, the antiphospholipid syndrome has been recently object of studies. Diagnostic and therapeutic options are still controversial. The authors present a case of recurrent deep vein thrombosis in pregnancy treated with positioning of a caval filter for the prophylaxis of pulmonary embolism. Diagnostic difficulties are discussed, as the patient presented with low levels of the coagulation inhibitor protein S, and also circulating antibodies anticardiolipin.

Adult↗
PubMed1995

Ondansetron-induced headache. Our experience in gynecological cancer.

Chemotherapy-induced emesis is one of the major problems in the treatment of oncologic patients. Recently, a novel class of compounds, the selective 5HT3 receptor antagonists, has been introduced, achieving a dramatic improvement in the control of emesis. The absence of extrapyramidal side effects adds to their safety and good tolerability. The Authors herein analyse their experience on 269 cycles of chemotherapy in 47 patients treated for gynaecological and breast malignancies, with particular regard to adverse events such as headache. Their most frequent side-effects are headache and constipation, that are usually mild and self-limiting. Nevertheless, in some cases, severe, rebel headache has been reported, leading in our experience in 6.4% of cases to discontinuation of the antiemetic regimen. A previous history of recurrent or severe headache or migraine is not correlated with the occurrence of ondansetron-induced headache, as severe headache occurred after ondansetron only in 28.4% of the patients with positive anamnesis, and 70% of the patients that experienced had never suffered from severe headache before. In those patients complaining of severe headache, the Authors suggest an antiemetic association, with a loading dose of ondansetron i.v., followed by metoclopramide i.m. orally for the following days.

Breast Neoplasms↗
PubMed1995

[Gn-RH analogs in the treatment of benign gynecologic diseases: current trends].

Gn-RH analogues have been recently employed for the treatment of oestrogen-dependent benign gynaecological disorders, such as uterine myomata, endometriosis or metrorrhagia. They induce a "pharmacological castration", inducing a marked reduction of serum oestrogen levels. They proved more effective than other drugs used up to now in the medical treatment of these benign gynaecological diseases. Thus they were initially employed in every case. Later it became clear that Gn-RH analogues need a selective indication. The authors herein report their series of 70 patients with benign gynaecological disorders (45 uterine fibroids, 10 endometriosis, 15 metrorrhagia), treated with a Gn-RH analogue depot for 2-3 months preoperatively. They evaluated the efficacy of the treatment in the group with uterine fibroids in terms of disappearance of metrorrhagia, better haemoglobin level in anaemic patients, reduction of fibroids size allowing for a simpler and less extensive surgery (vaginal surgery, myomectomy, hysteroscopic resection). The authors discuss those cases when preoperative treatment with Gn-RH analogues is not indicated, or should be employed only under careful surveillance (in the preparation of multiple myomectomies, big submucosal myomas). In the group of 10 patients with endometriosis we observed the disappearance of pelvic pain and dyspareunia, whereas the size of endometriomas was only minimally reduced. The authors discuss the usefulness of this treatment in case of patients with endometriosis grade I or II (minimal or mild), with desire of children. In the group of 15 perimenopausal patients with metrorrhagia, 10 became amenorrhoic after termination of treatment, thus avoiding surgery. The major benefit for the other 5 patients was a better haemoglobin level at the time of surgery.

Endometriosis↗
PubMed1994

Pre-operative staging of endometrial carcinoma: magnetic resonance imaging versus ultrasounds and hysteroscopy.

Ultrasound, hysteroscopy and magnetic resonance imaging has been considerated to assess the loco-regional or extrapelvic extension of the endometrial carcinoma. Sonography has demonstrated a certain inaccuracy in predicting myometrial invasion or the involvement of the canal. Hysteroscopy allows us to characterize neoplasia and to assess its extension in the cervical canal. MR imaging is more helpful in the diagnosis of channel invasion. The assessment of ovarian metastasis requires ultrasonography or coronal planes RM imaging. As regards the involvement of the pelvic and extrapelvic lymph nodes MR is more accurate than ultrasound scan.

Adenocarcinoma↗
PubMed1994

Complications in the surgical treatment of carcinoma of the endometrium.

The authors report their experience in medical and surgical complications after surgical treatment of endometrial carcinoma, from January 1976 to December 1992, 301 cases of adenocarcinoma were operated by abdominal or vaginal route. From 1980 onwards abdominal route was the most frequent (radical hysterectomy with bilateral adnexectomy Rutledge type II-III with pelvic and/or aortic lymphadenectomy). No lesion occurred either during surgery or later, in the urinary or intestinal apparatus or to the great abdomino-pelvic vessels. The only medical complication observed was one episode of cerebral ictus three days after operation. Two cases of adynamic ileus and five of ventral hernia occurred.

Adenocarcinoma↗
PubMed1992

Intracystic carcinoma of the breast. Our experience.

Malignant tumours of the breast occurring as cysts present an incidence from 0.3% to 0.7%. The Authors report their experience during 15 years in 470 patients with carcinoma of the breast. Endocystic carcinoma appeared in 0.6% of patients: the diagnosis is not always possible with cytology, but ultrasound scans make possible to identiphy cysts which have to undergo biopsy because solid areas within the cystic cavity have been detected. In this case surgery is advised even if the cytological examination has been negative.

Adult↗
PubMed1981

[Electrocardiographic changes in acute abdomen].

We have examined the electrocardiograms of 516 patients hospitalized for acute abdomen. We have excluded from this research the younger patients than 14 years, those with shock, those with clinical signs of cardiopathy, those with electrolytic alterations and those executing anti-arythmic or anti-depressing therapy. We have found changes of repolarization and of rhythm. The changes of regularization consisted in flottening-inversion of T wave in the precordial and/or limb leads associated sometimes at negative deflection of the ST tract in the same leads. The changes of rhythm consisted in atrial or ventricular extrasystoles, paroxismal atrial tachycardia, paroxysmal atrial fibrillation. Sometimes the changes of repolarization and rhythm were associated. We have discussed the possible pathogenetic mechanisms answerable for these changes; sympathetic adrenergic activation mediate or no from a parasympathetic reflex, reduction of intra-cellular potassium, activation of enzymatic systems, reabsorption of toxic substaces. The Authors have underlined the benignity of these ECG changes, disappearing after resolution of abdominal disease, and the necessity of a correct interpretation of those, to avoid the arising of a iatrogenic disease.

Abdomen, Acute↗
PubMedDate not supplied

[Metastatic syndrome involving multiple cranial nerves on the right].

Reported is a patient who has shown, over a period of five months, a progressive involvement of the V, VI, VII; IX, X, XI, cranial nerves of the right side. Radiologically, an osteolithic lesion of the right petrous pyramid, attributed to a metastasis of prostatic carcinoma, has been demonstrated. The main syndromes of the base of the skull involving the pertinent cranial nerves are revised, and it is concluded that the patient realizes a combination of the syndromes of Gradenigo and Vernet.

Abducens Nerve↗
PubMedDate not supplied

[Breast scintigraphy with 99mTc-MIBI in the study of breast cancer].

BACKGROUND: The literature latest data point out the 99mTc-MIBI scintimammography role as a mammography diagnostic complement for a better nosologic definition of the breast nodular pathology. The object of this study is to evaluate the device sensibility and specificity with reference to the several dimensions of the neoplastic nodule. METHODS: A group of 50 patients, with breast nodule has been studied comparing scintimammography, mammography, echography and istological examination of the removed nodule. RESULTS: 38 nodules out of 50 were carcinomas, 22 were T1 and 16 T2. As far as scintimammography is concerned, the sensibility is 86% in T1 grade and 100% in T2 grade. The specificity is 91.6%. CONCLUSIONS: Since the mammography often need integration with invasive examinations, (aspiration biopsy, and biopsy) scintigraphy-mammography, global specificity 92%, is suggested as a second level examination in the mammary nodule diagnosis, for the simple performance and for the little risk for the patient.

Biopsy↗