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Biomedical subjects

D Pezzola

Publications and source records attributed to D Pezzola.

13 recordsLinked to original sources
PubMed1996

[Thyroid carcinoma in hyperthyroid syndromes].

The relationship between hyperthyroidism and carcinoma of the thyroid is still uncertain. The incidence of thyroid carcinoma ranges from 0.3 to 16.6%. Between 1984 and 1994 the Authors observed 9 patients affected with thyroid cancer and toxic nodular goiter (4 patients) or Basedow disease (2 patients) or scintigraphic evidence of single hyperfunctioning nodule (3 patients). Six out of the 9 cases were diagnosed as papillary cancer, while three as follicular cancer. A carcinoma was diagnosed before operation in only one case, while in the other 8 patients, the diagnosis was obtained by histological examination of the specimen. Four patients underwent subtotal thyroidectomy, while five patients underwent radical lobectomy. All patients are alive and in good health; the average follow-up was 48 months.

Adenocarcinoma, Follicular↗
PubMed1996

[Impact of a screening program on the surgical treatment of breast carcinoma].

Results are presented concerning the first two cycles of a breast cancer screening program carried out by USSL 41 (the local social health center). 38,000 women were examined in a period ranging from 1987 to 1993 and more than 250 early stage tumors were diagnosed. Early detection by screening is confirmed by tumor size and nodal involvement. Overall, this program carried out in Brescia met requirements set by international and national scientific committees. Good results were obtained as far as quality standards are concerned. The importance of screening is evaluated concerning surgical treatment undergone by the patients. The study of surgical treatment clearly shows the gradual progression of conservative surgery deviating from more destructive operations.

Age Factors↗
PubMed1996

[Intestinal anastomosis with biodegradable ring].

The authors report their experience using biofragmentable anastomosis ring (BAR) in bowel anastomosis. Starting January 1993 to February 1994, 46 intestinal anastomoses were performed using BAR, and particularly 39 end-to-end colo-colostomies, 2 end-to-side colo-colostomies and 5 end-to-side ileo-colostomies. 35 patients were affected by colonic neoplasm, 5 patients by diverticular colonic complications- and 5 patients by several unusual bowel diseases. Four emergency operations were performed, while 42 patients had an accurate bowel preparation before surgery. In this series of patients one case of preoperative mortality is reported, due to massive pulmonary embolism. Instead several minor complications occurred in other patients, such as paroxysmal atrial fibrillation (one case), basal pleuritis (one case), hyperpyrexia (three cases), temporary subocclusion or delayed canalization (five cases). Only one patient suffered from intestinal occlusion induced by adhesions and a second laparotomy was required. Delayed canalization seems to be caused by the small size of the BAR employed (25 mm) or by inadequate intestinal preparation, that usually occurs in emergency operations. After surgery all patients were followed up and 18 of them were examined by coloscopy six months after surgery. No clinical problem connected with bowel anastomosis was reported and all anastomosis looked quite previous and resilient. No anastomotic stenosis was found. In our experience and from recent reviewed reports, BAR seems to be a rapid, effective and safe device for sutureless bowel anastomosis.

Adult↗
PubMed1996

[Solitary splenic metastasis of bladder carcinoma. Report of a clinical case].

Several authors assumed that spleen was resistant to neoplastic dissemination because of spleen metastasis are rare in relation to the incidence of metastasis in other parenchymatous organs. We report a clinical case of a symptomatic solitary spleen metastasis in cystic-looking bladder cancer; afterwards we'll examine real incidence of secondary splenic injury. In autopsy studies, the incidence of splenic metastatic spread is in contrast with the rarity of clinical manifestations of solitary metastasis. The case reported is really uncommon: a voluminous single metastasis, cystic-looking, with splenomegaly, abdominal pain and rapid onset. In the presence of a high malignancy primitive tumor, the evaluation of the effective utility of the surgical treatment carried out is premature, because of the relatively short follow-up. On the other hand, the painful symptomatology, the risk of disruption in peritoneal cavity, the impossibility to make inquiries about the nature of the cystic mass, imposed, in our opinion, a surgical treatment.

Aged↗
PubMed1995

[Cystic adenoid carcinoma of the esophagus. Description of a case and review of the literature].

The clinical and histopathologic characteristics of a case of adenoid cystic carcinoma of the esophagus are reported. The authors reviewed the literature on the matter and stressed the more aggressive behaviour of the tumor that differs from the same tumor of the salivary glands and other anatomical sites. Surgical resection is the treatment of choice, however the aggressiveness of the tumor requires, also, a chemo and radiotherapeutic approach.

Carcinoma, Adenoid Cystic↗
PubMed1994

Simultaneous catheter replacement-removal during infectious complications in peritoneal dialysis.

The aim of this study was to verify whether the replacement of the peritoneal catheter in a single operation and during infectious complications of peritoneal dialysis is effective and safe. Sixty-eight infectious complications refractory to appropriate antibiotic therapy were treated by this technique: 26 tunnel infections, 22 peritonitis-complicating tunnel infections, 12 refractory peritonitis, and 8 recurrent peritonitis. Operations were successful in all cases of tunnel infection and recurring peritonitis, and in all cases but one of peritonitis-complicating tunnel infection. Ten failures occurred among the 12 catheters removed for refractory peritonitis. Microorganisms cultured in these 10 failures were: Fungi (3 cases), Mycobacterium (2 cases), Pseudomonas (2 cases), Acinetobacter (1 case), Acinetobacter+Pseudomonas (1 case), and Enterococcus (1 case). Complications were 3 one-way obstructions and 2 external dialysate leaks. This study supports the simultaneous catheter replacement-removal procedure during infectious complications of peritoneal dialysis (PD) with the exception of refractory peritonitis; this technique spares the patient the temporary vascular access, the shift to hemodialysis, and a second operation to insert a new catheter. There are few complications.

Catheters, Indwelling↗
PubMed1991

[The diagnosis by a Doppler color echocardiographic method of an aortocaval fistula following the rupture of an aortic aneurysm into the inferior vena cava].

We describe a clinical case presenting 2 rare features. The first was a spontaneous aortocaval fistula which had developed from rupture of an atherosclerotic aortic aneurysm into the inferior vena cava. The second infrequent feature depended on the unusual method by which the diagnosis was performed. In fact, using an echo-color Doppler flow imaging (HP 77020A ultrasound system) with a 2.5 MHz echocardiographic probe abdominal examination showed an aneurysm of the descending aorta that communicated to a dilated inferior vena cava. Furthermore, flow study with color Doppler showed a continuous turbulent, mixed (arterial and venous) blood flow into the inferior vena cava.

Aortic Aneurysm↗
PubMed1987

Cisplatin, high dose folinic acid and 5-fluorouracil in squamous cell carcinoma of the esophagus. A pilot study.

We treated 20 patients with squamous cell carcinoma of the esophagus with the following regimen: cisplatin = 100 mg/m2 i.v. day 1, HDFA = 200 mg/m2 i.v. day 1 to 5, 5-fluorouracil = 370 mg/m2 i.v. day 1 to 5 repeated every 28 days. Among the 17 evaluable patients, 4 (23%) had a partial remission, 6 had stable disease while 7 progressed. The median survival for all patients was 6+ months. Grade III or IV toxicity included 2 patients with grade III leukopenia, 1 with grade III thrombocytopenia, 1 patient with grade IV and 3 patients with grade III oral mucositis, 3 patients with grade III diarrhea. The regimen did not seem particularly active in the treatment of squamous cell carcinoma of the esophagus and had manageable but substantial toxicity.

Aged↗
PubMedDate not supplied

Results of a mammographic and clinical screening in a health district (USSL) of Brescia, Italy.

AIMS AND BACKGROUND: Screening by mammography has been shown to be effective in reducing breast cancer mortality. We present the results of a mammographic and clinical screening program carried out in an Italian health district. METHODS: The first screening round started in June 1987 and ended in July 1990, and 25,100 women between the age of 50 and 60 years were invited. The second screening round invited 34,332 women between the age of 50 and 64 years and was carried out from September 1990 to September 1993. Women with positive or equivocal results at palpation or mammography were referred for immediate diagnostic assessment followed by surgery, when required. RESULTS: The attendance rate was 67.3% at the first and 62.1% at the repeat screening. At the first screening, 206 biopsies were advised and 197 were performed; 129 of the 197 were found to be malignant. At repeat screening, 248 biopsies were recommended, 208 were performed, and 125 were found to be malignant. The cancer detection rate was 7.7 per thousand at the first and 5.9 per thousand at repeat screening. Of 129 cancers, 107 (83.0%) were T1 at first screening; 6.2% were in situ carcinomas. Axillary lymph nodes were histologically positive in 24% of cases. At repeat screening, 77.6% (97/125) of cancers were T1; 11.2% were in situ carcinomas. Positive axillary lymph nodes were found in 16.8% of cases. CONCLUSIONS: The attendance to screening was satisfactory. A higher frequency of small tumors (83.0%) was found at first screening than before the introduction of screening (56.6%). A marked difference in lymph node positivity (24.0% vs 40.6% in the pre-screening era) was also observed. Such a difference was even more evident at repeat screening. Quality standards of the screening in our study proved to be higher than those currently recommended. The reported results are encouraging, also considering the greater chance for conservative treatment.

Axilla↗
PubMedDate not supplied

[The role of intraoperative parathyroid hormone assay in the surgical management of hyperparathyroidism].

Surgical management of primary hyperparathyroidism has undergone several chances in recent years and historically has required bilateral neck exploration with identification of the parathyroid adenoma together with three normal glands. The intraoperative hormone assay allows a more limited procedure by confirming complete removal of hypersecreting tissue. The Authors report surgical treatment of 24 consecutive hyperparathyroidism and conclude that evaluation of intraoperative hormone assay accurately predicts the determination of adequacy of resection and the correct outcome of surgery in patients with parathyroid adenomas.

Adenoma↗