[Advantages of obstetrico-pediatric collaboration in hemolytic disease of the newborn].
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Biomedical subjects
Publications and source records attributed to C Pani.
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Differentiated thyroid cancer is peculiar for its prognosis often excellent. The Authors report their experience about 78 patients affected with differentiated thyroid carcinoma, operated between 1976-1999 at the Institute of Surgical Pathology and Surgical Clinic of Cagliari University. 70 (89.7%) patients underwent total thyroidectomy, 6 (7.5%) subtotal thyroidectomy and 2 (2.5%) thyroid lobectomy. In 11 patients total thyroidectomy was performed in two times within 60 days after initial lobectomy. Tumor was found in 2 (18%) of 11 of the reoperations. Lymphadenectomy was performed only in presence of cervical lymph nodal metastases. Following 70 total thyroidectomy the incidence of recurrent nerve palsy was 4.2% and permanent hypoparathyroidism 11.4%. 79% patients received adjuvant postoperative radioiodine therapy to ablate residual functioning tissue or distant suspected metastases. After a mean follow up period of 5.8 years, recurrences developed in 10.2%. Any local recurrences, 5 (6.4%) cervical nodal recurrences, 3 (3.8%) distant metastases were encountered. Two (2.5%) of the three patients with recurrence distant metastases died from thyroid carcinoma. The Authors identify total thyroidectomy as the minimal procedure. Surgical management of the cervical nodes is recommended only in the presence of metastatic lymph-nodes. Post surgical ablation with I131 of microscopic remnants optimize detection and treatment of the recurrence and distant metastases.
The Authors examine their experience about clinical implications and therapeutic strategies on Papillary MicroCarcinoma (PMC) of the thyroid gland. Clinical charts of 412 patients, who underwent thyroid surgery, were analyzed. The Authors stress "incidental diagnosis", benign associated lesions and frequency of population presentation; they conclude that the total thyroidectomy is the procedure of choice with oncology validity.
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Cholelithiasis as cause of jaundice in newborn is rare. Usually is associated with known predisposing factors as hemolysis, congenital anomalies of biliary tree, total parenteral nutrition, prolonged fasting. However there are recent signals in literature about idiopathic neonatal cholelithiasis, that seems to be more common than previously suspected. We describe a case of idiopathic neonatal choledochal lithiasis with spontaneous resolution in few days from jaundice beginning. The importance of ultrasonographic investigation for diagnosis and follow-up is confirmed. However, because it is often a self limiting phenomenon, an aggressive approach is not warranted in the asymptomatic infant.
The authors review the differential diagnosis in the acute and recurrent abdominal pain and the classification of ovarian cysts in prepuberal girls. They report the description of three cases of ovarian cysts in prepuberal girls and the role of ultrasonography in their diagnosis in a paediatric department.