Biomedical subjects

A Sadighi

Publications and source records attributed to A Sadighi.

9 recordsLinked to original sources

PubMed2005

[Much ado about nothing].

The professional routine often allows us to forget over time not only the name, but often also the pathology for which a patient has recovered from and treated for with much "love and dedication". However some cases contribute to the baggage of a good doctor's experience and become nearly "proverbial" in nature. A 50 year old woman, affected by chronic cholecystitis and under suspicion of neoplasia of the cholecyst, came studied and subordinated to cholecystectomy approximately a year ago. As per William Shakespeare's comedy "Much Ado About Nothing", also in this case numerous resources have been inefficiently used and precious diagnostic tools, instead of clearing our doubts and confirming the diagnosis, perhaps due to the lack of experience and also for the fear of the medical-legal reactions, they assumed otherwise. Now, thinking about this case, makes us smile. We shouldn't forget that, in accordance with what we remember from our Masters, often the most probable pathology is also that most frequent one.

Cholecystitis↗

PubMed2004

[The surgical treatment of gastric carcinoma. Evolution in surgical technique and staging in a series of 194 patients].

AIM: Surgery is, at present, the only potentially curative treatment for gastric carcinoma. The curability depends upon the extension and localization of the tumor and, particularly, the lymphatic involvement and the presence of distant metastases. The aim of this paper is to describe the personal experience during the last 2 decades and analyze the results of the surgical approach which has changed over the time. METHODS: One-hundred and ninety-four consecutive patients have been reported (127 male and 67 female, with a median age of 65.8 years), affected by gastric carcinoma and subjected to surgical procedures from 1987 to 2000. Because of the wide period of time which it refers to, this study is overlapped by a radical change in the staging rules of gastric carcinoma, according to the publication, in 1997, of the 5th edition of the TNM. This has made necessary to divide the series into 2 different groups. The 1st group is composed of 123 patients (63.4%), staged according to TNM-1987; the 2(nd) group is composed of 71 patients (36.6%) staged according to the TNM-1997. A D1 lymphadenectomy was used as treatment protocol until 1995. Subsequently, a D2 lymphadenectomy was performed in the most part of potentially curable patients. The reconstruction after total gastrectomy was carried out in all cases with Roux technique. In distal gastrectomies a Billroth 2 technique was performed in 89.3% of the cases and a Billroth 1 technique in 10.7% of the cases. RESULTS: The operative mortality observed on the total of patients was 1.5% (3 cases). With a median follow-up of 83 months (minimal 24, maximum 180 months), 134 patients were died, 50 are alive and 10 have been lost. The total median survival, in the 2 groups, was 24 months. We have observed a trend to improvement of survival for patients with carcinoma in stage II and III operated after 1997. CONCLUSION: The treatment of unresectable gastric cancer, i.e. palliative surgery, is the best choice when possible in comparison to other surgical procedures (gastroenteronastomosis, jejunostomy), endoscopic procedures (dilatation, endoprosthesis, laser, percutaneous endoscopic gastrostomy) and medical therapies. In order to choose the best palliative treatment, a careful evaluation of the non-curability signs is necessary to avoid high risk surgical interventions in patients with a low expectation of life.

Adult↗

PubMed1997

[Ambulatory phlebectomy. Literature review and personal experience].

Outpatient varicose veins surgery, "Phlébectomie Ambulatoire" (FA) introduced by R. Muller in 1966, is now a widespread technique; modified by many authors with personal tips, FA enables most lower limb varicosities to be treated on an outpatient basis and under local anaesthesia. To achieve good functional results, an accurate preoperative diagnostic examination is mandatory; the authors present a review of the indications of FA and their personal experience. Precision in performing micro-incisions, accurate dissection of the varicosities in the subcutaneous tissue and an adequate postoperative elastic bandage guarantee good aesthetic results. At present the treatment of Saphena magna with FA is debated, but some authors have already reported encouraging results.

Adult↗

PubMed1997

[The surgery of laparoceles. The postoperative complications].

The use of prosthetic meshes in incisional hernias repairs is now very attractive, particularly for wide fascial defects; nevertheless the presence of a foreign body and placement technique may be responsible for complications sometimes leading to failure. To evaluate technical problems and complications in incisional hernia surgery the authors reviewed their 5 year experience in 70 patients; 39 mesh repairs and 31 direct sutures of the abdominal wall were performed. Local complications (fistulas, wound hematoma or infections) were more frequent in the former group; PTFE meshes showed a lower resistance to infections, particularly in diabetics, and in three patients partial or total removal was mandatory. Prosthetic meshes showed a marked reduction of recurrences in incisional hernia surgery, but their use leads to more local complications than direct repair; the authors believe that mesh placement must be evaluated for every single patient and not used as a routine procedure.

Emergencies↗

PubMed1995

[Abdominal carcinoid: various locations and clinical course].

Carcinoid tumours are rare neoplasms and their behaviour seems to change with the localization; in fact, appendiceal and rectal carcinoids show a better long-term survival than the more aggressive ileal and colonic analogues. The Authors report their experience in the surgical treatment of 13 G.I. carcinoid neoplasms, in which the clinical course was sometimes unpredictable suggesting there is much to discover about the behaviour of these particular tumours.

Adolescent↗

PubMed1985

Transgastric drainage of pancreatic fluid collections.

Eight pancreatic fluid collections in seven patients were successfully drained percutaneously through a transgastric approach. The drainage catheters were left in place for 3-6 weeks to promote the formation of a fistulous tract between the stomach and the pancreatic collection. Computed tomography (CT) was used for diagnosis and for planning of the access route. Combined sonography and fluoroscopy were used for guidance. Radiologic follow-up examinations (CT and sinograms) have shown no recurrences (3-12 months). No complications were encountered.

Drainage↗

PubMed1975

Resolution and reconstitution of Rhodospirillum rubrum pyridine dinucleotide transhydrogenase. Proteolytic and thermal inactivation of the membrane component.

Pyridine dinucleotide transhydrogenase of the Rhodospirillum rubrum chromatophore membrane was readily resolved by a washing procedure into two inactive components, a soluble transhydrogenase factor protein and an insoluble membrane-bound factor. Transhydrogenation was reconstituted on reassociation of these components. The capacity of the membrane factor to reconstitute enzymatic activity was lost after proteolysis of soluble transhydrogenase factor-depleted membranes with trypsin. NADP+ or NADPH, but neither NAD+ nor NADH, stimulated by several fold the rate of trypsin-dependent inactivation of the membrane factor. Substantial protection of the membrane factor from proteolytic inactivation was observed in the presence of Mg2+ ions, an inhibitor of transhydrogenation, or when the soluble transhydrogenase factor was bound to the membrane. Coincident with the loss of enzymatic reconstitutive capacity of the membrane factor was a loss in the ability of the membranes to bind the soluble transhydrogenase factor in a stable complex. The membrane component was inactivated by preincubating soluble transhydrogenase factor-depleted membranes at temperatures above 45 degrees. NADP+, NADPH, or Mg2+ ions, but neither NAD+ nor NADH, protected against inactivation. These studies indicate that (a) the binding of NADP+ or NADPH to the membrane factor promotes a conformational alteration in the protein such that its themostability and susceptibility to proteolysis are increased, and (b) the inhibitory Mg2+ ion-binding site resides in the membrane component.

Bacterial Chromatophores↗

PubMedDate not supplied

[Middle lobectomy for bronchiectasis: clinical case and review of the literature].

Over the past few years bronchiectasis, among the chronic lung diseases, has been the second most important after tuberculosis in terms of frequency and mortality. Although the incidence of the disease has been decreasing in recent years, the illness is currently of great surgical interest because of an upsurge of cases among people considered to be below the bread line. The authors present the clinical case and surgical treatment of a young adult with middle lobe bronchiectasis, with a 10-year primary IgG deficiency and severe bronchopneumonia requiring hospitalisation. Medical treatment, long regarded as the treatment of choice in this condition, has reduced the short-term morbidity of patients suffering from the disease, without affecting its ultimate mortality which is still very high today. The policy in the past to reserve surgery only for the most complicated cases or for patients not responding to medical treatment can now be considered obsolete, due to the reduced surgical risks (less than 1%) and to faster patient recovery. Further surgical indications are mono- or bilaterally located forms of the disease and failure to respond to medical treatment for more than 2 years. A review of the literature enables the authors to affirm that in the absence of randomised trials on the effectiveness of surgical vs medical treatment, it seems clear that surgical therapy is the best option, being curative and safe, with a high percentage of complete remission of disease and very low operative risks and mortality. It can therefore guarantee good quality of life, radically changing the prognosis which otherwise is fatal in 1/3 of patients suffering from this orphan disease.

Adult↗

PubMedDate not supplied

[Pica and intestinal occlusion: a clinical case].

Accidental or voluntary foreign bodies ingestion is a frequent reported event in emergency departments. Complication, foreign body shape related are not often observed and, once occurred, just few a cases need an open surgery approach, about 1%. The Authors report the case of a young woman with pica admitted to their Department in an emergency setting for acute intestinal obstruction due to the ingestion of not specified amount of elastics, which required an open surgery operation.

Adolescent↗