PubMed Health⌕ Search

Biomedical subjects

C Militello

Publications and source records attributed to C Militello.

45 records · Page 3Linked to original sources
PubMedDate not supplied

[Usefulness of chromogranin A determination in the diagnosis of neuroendocrine neoplasia].

Neuroendocrine gastroenteropancreatic tumor diagnosis is a very difficult and expensive procedure. This study compared Chromogranin A (CgA) to Neuron-specific enolase (NSE) in 55 patients affected by neuroendocrine tumors. Advanced local or metastatic neoplasia was found in 43 patients. Radical operation was performed in 12 patients. Seventeen cases of lung microcystoma, 23 cases of other intestinal tumors and 19 patients affected by irritable bowel syndrome were used as controls. CgA sampling demonstrated sensitivity of 73% and specificity of 66%, a positive predictive value of 77% and a negative predictive value of 61% while NSE sampling showed sensitivity of 100%, specificity of 36%, a positive predictive value of 15% and a negative predictive value of 100%. CgA values demonstrated a statistically significant difference between patients with neuroendocrine tumors and tumor-free resected patients (p = 0.0015), microcystoma patients (p = 0.0087), other types of neoplasia (p = 0.01) and irritable bowel syndrome patients (p = 0.0004). No significant difference was found among the same groups when NSE values were analyzed. The high diagnostic accuracy of CgA sampling renders it very useful in early neoplastic detection, even in cases of nonfunctioning neoplasms or absence of liver metastases. In addition, CgA sampling may be an effective screening test in patients with irritable bowel syndrome or with liver or lung metastases when there is no evidence of the primitive tumor.

Adult↗
PubMedDate not supplied

[Surgical risk in the elderly].

In our Country 16% of population is over 65 years old and on 2010 a quarter of people will be over 70 years old. More over the percentage of patients over 70 years admitted in surgical departments is triple than 10 years ago and the percentage of octgenarian patients is ten times. In the last years new methods of diagnosis and care have been introduced to reduce morbility and mortality; the preoperative evaluation to define the risk factors is complex. The surgeon should respect some primary points: the patient interest, true surgical treatments, multimodal management, valid pain therapy, discharge as soon as possible, ambulatory or day hospital management, expecting and quality of life.

Adult↗
PubMedDate not supplied

[Intestinal infarction in the elderly].

The bowel infarction is till affected by high mortality in spite of new diagnostic methods and therapy. In our experience was observed about 45 patients with bowel infarction by different etiology; fast diagnosis and therapy are necessary for a good prognosis. The arteriography, at the light of this experience, is the gold standard but it is still performed in a low number of patients. The laparoscopy, in the advanced pathologies, is able to avoid an ineffectual laparotomy and permits a better diagnosis in borderline cases.

Age Factors↗
PubMedDate not supplied

[Septic shock: surgical and medical problems in the elderly].

The sepsis is a bacterial invasion of the organism producing many manifestations which are able to amplify themselves. In the United States of America there are 100,000 death per year and the incidence is among 300,000-500,000 cases. The major surgery in the elder (especially if it is in emergency) has a great percental of risk because the preoperative study isn't often complete. Fever, agitation, panting, bullation, abdominal splinting, enteroplegia, are signals of evolving inflammatory situation. Moreover there are disorders of biochemical values: leukocytosis, thrombocytopenia, increased levels of VES, PCR, amylase and biliribinaemia. The more common radiological examinations are the straight radiography of abdomen and horax, abdomen ultrasonography, CT or MRI. In the last years pro-calcitonin, interleukin-6 , C-reactive protein, and nitric oxide from endothelial and muscularis cells have been evaluated as prognostic factors in the septic shock.

Aged↗
PubMedDate not supplied

[Treatment of the early form of rectal carcinoma in the elderly].

The early rectal cancer which needs conservative surgical treatment should present some pathological characters: intramucosal site without muscularis invasion (pT1), high or moderate differentiated grading (GI-G2), no lymph node metastasis or vascular invasion. Total mesorectal excision is the gold standard for these neoplasms and permits very low resection or colo-anal anastomosis with sphincter function preserving. However, this type of surgery has still a high percentage of postoperative morbidity and mortality (some authors report respectively 40% and 5%). Therefore the local excision in selected cases is able to preserve the sphincter function and to reduce the postoperative complications with high probability of recovery.

Aged↗
PubMedDate not supplied

[Therapeutic strategy in neoplasia of the pancreas and ampulla].

The major symptoms of periampullary neoplasia are jaundice, lowering of weight, abdominal pain extending behind; diabetes, pancreatitis or exocrine pancreatic failure are uncommon. In the last years, surgery has been considered as the gold standard of the therapy because new technologies are able to reduce morbility and mortality. In the too advanced neoplasia, palliative surgical care permits better survival and quality of life. The duodenopancreatectomy today has a low perioperative mortality (0-3%) and an acceptable survival (15.25%). Good results were found for palliative surgery in unresectable neoplasms while in the inoperable patients we consider endoscopic and radiological treatments better than chemotherapy because they are able to correct the jaundice, improving quality of life (but not survival).

Aged↗
PubMedDate not supplied

Androgen profile in patients with pancreatic carcinoma.

Serum testosterone, free testosterone and androstenedione levels were measured in 28 male patients with pancreatic cancer and compared with the values obtained from 28 male patients with chronic pancreatitis, 29 with gastrointestinal malignancies and 41 healthy controls. Mean total testosterone values were significantly lower in the pancreatic cancer group when compared to chronic pancreatitis and healthy controls. Total testosterone concentrations were also significantly lower in patients with gastrointestinal malignancies when compared to healthy controls. No difference was found in free testosterone and androstenedione levels in the four groups of patients. Total testosterone serum levels correlated significantly with poor nutritional status. This study confirms low testosterone levels in patients with pancreatic cancer, but provides no evidence to support a direct relationship between pancreatic cancer and testosterone metabolism.

Adult↗
PubMedDate not supplied

[Bleeding gastric lymphoma: report of two cases].

We report two cases of bleeding gastric lymphoma. The stomach is the most common site of primary extranodal Non-Hodgkins Lymphomas. The best treatment for primary gastric lymphoma has not yet been defined. For many years the treatment of choice has been the gastric resection. Helicobacter pylori (H. pylori) has been associated with many gastric pathologies, including gastric lymphoma. Eradication of H. pylori is now considered essential for the treatment of this pathology, and usually consists of antibiotic therapy, combined with acid suppression by a proton pump inhibitor. This simple treatment in patients with low grade histology and tumor confined to the stomach can often obviate the need for surgical intervention. Surgery is a necessary treatment, independently of the grading and the staging of lymphoma, in the bleeding complication as the cases we showed.

Aged↗