Biomedical subjects

E Cortese

Publications and source records attributed to E Cortese.

11 recordsLinked to original sources

PubMed1998

[Trocar-induced complications in laparoscopy].

Trocar-related injury can occur if the different procedures, including distension of the abdomen, pneumoperitoneum or anesthesia, are insufficient. Such injuries can be prevented by proper handling and good angulation of the trocar on the abdomen. In case of suspected vascular injury, conversion to open laparotomy is required to explore the abdominal cavity. If abdominal adhesions are discovered after introducing the first trocar, a second trocar must be introduced at some distance from the first one to visually check the absence of any digestive injury. The degree of wound dehiscence depends on the size, site and direction of introduction of the trocar.

Humans↗

PubMed1997

[Warthin's tumor of the parotid gland].

The Authors report 6 cases of Warthin's tumor of the parotid gland recently observed. In all cases the tumor was intraglandular, single, and no noteworthy disorders or symptoms except for a 2 to 5 cms tumefaction were present. At surgery all lesions appeared well-capsulated and the exeresis followed a cleavage plane easily identifiable which enabled the preservation of the residual glandular tissue as well as the surrounding nervous and vascular structures. All the patients, up to now, are free from relapse.

Adenolymphoma↗

PubMed1997

[Laparocele after laparoscopic surgery].

The authors have reported two laparocele cases in the place of insertion of the umbilical trocar, on 156 laparoscopic accesses made by them. Both cases took place at the beginning of their experience when the navel fascial breach had not yet been stitched. The authors made an extensive review of the medical literature and have found out that such complication is rare and to prevent it, it is right to stitch the navel fascial defect, being careful for not englobing the epiploon or an intestinal loop in the suture.

Adolescent↗

PubMed1996

[The laparoscopic approach: a technical note].

The authors report their laparoscopic access technique. It has to be considered a variation of the classical closed technique, with the introduction of the Veress needle and the first trocar directly at the level of the fascia which is kept in traction by two Kochers.

Humans↗

PubMed1994

[The clinical evaluation of acetoxyethylcefuroxime in dentistry].

The study examines the use of an oral antibiotic with a wide spectrum of action tested in dentistry belonging to the cephalosporin class: acetoxyethylcefuroxime. The pharmaceutical industry has succeeded in synthesising a prodrug of parenteral cephalosporin "Metoxyrinic cefuroxime sodium", thus resolving the problems presented by earlier molecules such as: scarce bioavailability, poor palatability and collateral effects at a gastroenteric level. This is a 2nd generation cephalosporin whose mechanism of action consists in the capacity to selectively block the synthesis of the peptidoglycan, a fundamental component of the cell wall of both Gram+ and Gram- bacteria. The study, which was performed in the Division of Odontostomatology of the Mauriziano Hospital in Turin, examined 59 patients suffering from some of the most commonplace dental pathologies such as: apical periodontitis-alveolitis-odontogenic abscesses-eighth teeth in dysodontiasis-maxillary cysts. The following clinical parameters were evaluated in both outpatients and those undergoing surgery: swelling, pain, lymphoadenopathy at the start of treatment, and at days 3 and 5 of treatment. A 250 mg tablet was administered every 12 hours for 5 days. Owing to the rapid resolution of symptoms and the limited collateral effects observed, the authors conclude that the drug may be regarded as the elective form of treatment.

Adolescent↗

PubMed1994

[Paget's disease with an exclusively maxillary location. A case report].

The authors illustrate a case report of Paget's disease in an exclusively cranio-facial localisation. Paget's disease is a dystrophy of an osteo-condensing type. Excess bone remodelling activity, due primarily to hyperclastic hyperactivity, leads to accelerated resorption and excess tissue formation. This marked alteration of the metabolism causes the hypertrophy of the bones involved, with zones of greater density and increased vascularisation. Its clinical manifestations include morphological deformations and painful symptoms in the areas affected. Complications may include pathological fractures, medullary or radicular compression, heart failure (rare), sarcomatous transformation (approximately 1% of cases). The case reported here describes a 70-year-old who was admitted to the out-patient clinic of the Odontostomatological Division of the Ospedale Mauriziano in Turin for a dental check up. The patient had had 6 teeth removed during the past 2 weeks in a private clinic. At the time of the control a mucous crater was present, also involving the underlying bone, at the level of the extracted 2.6 tooth. The patient had kept the teeth which had been removed some of which showed that the roots were surrounded by alveolar bone. A dental panoramic x-ray and cranial x-ray were performed using 3 projections and showed the remodelling of the cranial theca and upper jaw. The suspicion of Paget's disease was confirmed by hematochemical tests, bone scintigraphy with calcium phosphate and by the histologic examination of the alveolar bone fragments adhering to the root surface of the extracted teeth.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMedDate not supplied

[Laparoscopic rectopexy: our experience in the treatment of complete rectal prolapse].

Surgical treatments of rectal prolapse still await a final arrangement. The aim of this work is to present Authors' experience with 12 female patients who underwent laparoscopic rectopexy. The patients, aged between 67 and 84 years, were suffering of a different degree of incontinence classified according to the Browing and Parks scale. Pneumoperitoneum was induced through the Veres needle end 5 trocars were placed. The technique used was the modified Orr-Loygue. One no death was observed and only two not serious intraoperative complications were registered, in both conversion to laparotomy was not necessary. Functional result as for incontinence has been really good (disappeared in 11 cases and improved in one). Whereas regarding the constipation, no improvement was observed in those in who in it was preexisting the operation, not appearing nevertheless, as on the contrary reported by other Authors, in those in whom it wasn't present before surgical treatment. The patients, all in follow-up (range between 10 and 36 months, average 25.08), still now experienced no relapse. In conclusion, on the base of Authors' experience, laparoscopic rectopexy is considered free of particular risks and excellent in the results even if, due to the slight number of series, any definitive judgement can be expressed.

Aged↗

PubMedDate not supplied

[Complications of the laparoscopic access].

The Authors analysed the complications observed during 156 laparoscopic accesses. In 38 cases following the classic closed technique, two pneumoderma, one pneumoscrotum, one pneumoepiploon and two laparoceles were observed in the umbilical area. In 30 patients the laparascopic access was performed according to the open technique, registering a significant loss of gas during the operation though not compromising it in 4 patients, and two infections of the umbilical incision. In 88 cases the modified closed technique was used and only one infection in the umbilical trocar insertion area was observed. After discussing the incidence, the etiopathogenesis, the diagnosis and the treatment of complications related to the laparoscopic access, the Authors emphasize the fact that in patients with surgical scars near the naval or patients who have already undergone laparascopy, or those with a positive history of affections causing abdominal adherence, the laparoscopic access must be performed using the open technique.

Adolescent↗

PubMedDate not supplied

[Hypoxemia and pulmonary atelectasis after laparoscopic cholecystectomy].

The aim of this study is to evaluate, after laparoscopic (CL) or open (CO) cholecystectomy, the incidence of pulmonary atelectasis and hypoxaemia which are strictly related to the onset of pulmonary complications. Two groups of 20 consecutive patients affected by symptomatic and not complicated gallstone disease were cholecystectomized either using CO or CL. Hypoxaemia was assessed preoperatively and after operation. Postoperative determination was performed at the 4th, 8th, 12th and 24th hour and then every 12 hours until discharge from hospital. A not informed radiologist evaluated atelectasis through two X-rays, preoperatively and postoperatively at the 3rd day. Atelectasis cases were divided in micro, focal, segmental, lobar and of the entire lung. Statistic analysis was performed using the "t" Student test. No mortality or intraoperative complications occurred. The two groups were similar for age, sex, smoker percentage, obesity, preexisting pulmonary dysfunctions and anaesthesiological risk (ASA). Operative time resulted in longer in CL compared to CO patients although in an insignificant way. PO2 value resulted significatively reduced (P < 0.05) at 4th, 8th, 12th and 24th postoperative hour after CO, while subsequent measurements did not show significant differences. There was no evidence of PO2 significative reduction after CL. After operation atelectasis was found in 11 patients (55%) of CL group (P < 0.05) and in 17 patients (85%) of CO group (P < 0.001). Atelectasis observed in the group of 11 CL patients was represented by 7 micro and 4 focal types, while in the CO group 7 micro, 8 focal and 2 segmental types were found. This study suggests that CL alters the pulmonary function less than CO.

Cholecystectomy↗

PubMedDate not supplied

[Ulcerated carcinoma of the breast in an elderly woman. An unusual clinical case report].

The authors analyze the most current methods for the treatment of ulcerated breast cancer in the elderly. They describe a peculiar case recently observed, characterized by an ulcerative lesion spreading from the hemiclavicle to the foreaxilla including the axillary cavity, causing a large phlebo-lymphaedema, anaesthesia and paresis of the homoteral upper limb. After an initial treatment with tamoxifen a scapulo-humeral disarticulation and a suture of the cutaneous wide defect were performed using a myo-skin graft which included the deltoid muscle. A radiotherapeutic treatment followed by tamoxifen therapy was carried out. No distant metastases and no local relapses were registered in the one year follow up. The Authors on the basis of their experience and according to the review of the Literature suggest that age itself is not a limiting factor to the therapeutic approach of ulcerated breast cancer.

Age Factors↗

PubMedDate not supplied

[Calcium antagonist vs diuretics. Doppler velocimetric monitoring of the carotid flow in patients with essential hypertension].

BACKGROUND: In the period from 1995 to 1996, 19 patients with a range of 180-200 mmHg and 95-110 mmHg respectively for systolic and diastolic pressure, have been examined by Doppler monitoring. METHODS: Nine patients were treated with lacidipine (4 mg/die) and 10 were treated with idroclorotiazide + amiloride (50 mg every other day). The IPP and the IDC were end points to value the arterial compliance and the remodynamic flow in common carotid. RESULTS: The humeral blood pressure was valued every morning and Doppler monitoring of common carotid 30 and 60 day after treatment. The carotid blood flow and cerebral perfusion had a significant amelioration with calcium antagonists and an increase of IDC with a decrease of IPP were found. CONCLUSIONS: This study demonstrates the role of calcium antagonists not only as antihypertensive drug, but also to prevent, to check and to improve progression of ateromatic injury. The conclusions is drawn that Doppler monitoring is a satisfactory scientific method to obtain information on features of arterial wall without excessive cost.

Adult↗