[Anastomotic dehiscence and conservative therapy. Technical note].
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Biomedical subjects
Publications and source records attributed to F Esposito.
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Indoor resting Anopheles gambiae s.l. were collected in two villages near Ouagadougou, Burkina Faso, and processed to investigate the presence and distribution of Plasmodium sporozoites. Salivary glands were dissected, examined by phase contrast microscopy and further processed by IRMA in order to reveal the presence of the circumsporozoite (CS) antigen of P. falciparum. The corresponding thoraces were homogenized and processed by IRMA. In the village characterized by the higher inoculation rate more than 40% of the infected mosquitoes were not found infective since CS antigen was detected in the thorax in absence of sporozoites and CS antigen in the corresponding salivary glands.
In the course of a clinic-anamnestic study performed from November 1984 to April 1985 by the collaborators of USL 40 Maternal-Infantile Service, among the children (1569) of the first primary school, 622 children has been selected for possible, probable and verified asthma. For making deeper the diagnosis, 358 children had gone to the respiratory allergologic section of division of pneumology and respiratory allergology of Cardarelli Hospital. The control group was formed from 12 children without atopic familiarity and without asthmatic tendency. Among the 358 children, 127 were asymptomatic but with familiar anamnesis positive for atopy; 219 had or had suffered allergic symptomatology. The authors had studied all children by Prick-test with a standard battery of allergens and with by methacholine aspecific bronchial reactivity test. The familiar tendency to atopy was present in 81.1% of studied children, with prevalence of maternal tendency (41,83%) in comparison with this of ascendents and collaterals. Among the asymptomatic subjects with atopic familiarity only 27.56% was skin positive for one or more allergens, while 59.82% of symptomatic subjects was skin positive. The bronchial aspecific reactivity with methacholine was increased in the 62% of asymptomatic and in the 84.69% of symptomatic subjects. The aspecific bronchial reactivity level in mean was higher in the children with bronchial asthma but also the subjects with rhinitis and chronic cough has showed a higher level in comparison with adults affected of similar symptomatology. In 8 children the authors have studied the reproduction of PD20 methacholine which was very high.
The authors present the combined use of the Keller bunionectomy with the Austin osteotomy in select cases. Severe degenerative joint disease and metatarsus primus varus with fair to good bone stock are the major criteria. This procedure offers an alternative for the elderly patient who is not a candidate for joint salvage, implant or base osteotomy. Preoperative, intraoperative and postoperative biomechanical evaluations are essential to the success of this procedure.
The presence of a postoperative wound infection after clean podiatric surgery may predispose the patient to a prolonged, often nonambulatory, convalescent period. Although the incidence of postoperative infection after elective podiatric surgery is small, a protocol to govern the use of prophylactic antibiotics has been developed in order to achieve their maximum benefits with a minimum of risk. Indications for chemoprophylaxis have been divided into two groups: specific operative procedures that may warrant antibiotic intervention and patients who present with specific risk factors. Additionally, it has been suggested that single dose prophylaxis is preferable to multiple dose administration.
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The Authors considered the incidences of the urgencies for allergic pathology arrived at Santobon Hospital during January-December 1992. In the period of twelve months a whole of 42.702 children came to Hospital; among them 4.359 showed an allergic pathology with a clear prevalence for wheezing and asthma. In addition it was observed too that an allergic mainly affected male children.
With the aim of emphasize the characteristics of the migration of human primordial gonocytes through the mesenchyme of the dorsal mesentery towards the genital ridge, a very early human embryo, corresponding to Carnegie stage 11 (23-24 days of development) was studied together with other embryos from the 4th to the 10th week of pregnancy. The early embryo was embedded in resin, serially cut and the observations were made on semithin coronal sections, de-plasticized and stained with toluidine blue. Migrating primordial germ cells were identified in the thickness of the splanchnopleure, where they appeared as pale and round elements with a nucleolated nucleus and granular cytoplasm. The clusters of primordial gonocytes were constantly surrounded and in close relationship with smaller, polyhedral and intensely stained elements. These features suggest the hypothesis that gonocytes and dark cells join together during the process of migration and that the last can participate in the formation of the gonadal bud. The hypothesis is confirmed by the observation of dark cells, surrounding the gonocytes, in the primitive ovaries or testes, in later stages of development. Perhaps they do not participate directly in the formation of the sexual cords, but reach their periphery where they assume an elongate shape.
The dimensional changes of the muscle fibres of the active motor units generate a signal, labelled as mechanomyogram (MMG), related to the number and firing rate of the active fibres. Aim of the study was to evaluate if the root mean square (RMS) of the surface EMG, of the MMG and their relationship (electromechanical coupling efficiency, EMCE) are related to the clinical stage of patients affected by myotonic dystrophy. The EMG and the MMG were recorded during isometric contractions at 20%, 40% and 60% of the maximal voluntary contraction (MVC), in less (elbow flexors, EF) and more (finger flexors, FF) affected muscles in 10 myotonic dystrophy (DM) patients (duration of disease: 15-22 yr.; MDRS scale: 3-4) and in 10 age matched controls (C). It resulted that I) the MVC was only 30% lower in DM than in C (P > 0.05) for the EF but 74% lower (P < 0.001) for the FF; II) at the same relative force the MMG-RMS and the EMG-RMS in DM were significantly lower than in C (P < 0.05); III) the EMCE was almost the same in DM and C for EF but dramatically lower for FF. In conclusion these findings provide evidence that the EMCE changes due to the dystrophic process can be monitored by this new and non invasive technique. A good concurrence of clinical findings and experimental results was observed.
A case of acute perforation of the small bowel in a 32-year-old man with Crohn's disease not previously diagnosed is presented. The patient underwent an emergency bowel resection and anastomosis and was put on 5-ASA for the following 4 years. No clinical or endoscopic recurrences appeared during this period. In order to avoid both functional disorders and recurrences, a surgical treatment based on resection and anastomosis in minor risk cases, i.e. in patients without abscess and/or concurrent steroid therapy, and on resections limited to grossly involved segments of bowel is advocated.