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G Mangiante

Publications and source records attributed to G Mangiante.

66 records · Page 4Linked to original sources
PubMedDate not supplied

[Biomechanical-clinical interpretation of firearm wounds. General problems. X. Propedeutic ABC of terminal ballistics].

Any discussion of firearms which failed to take due account of the complex interaction between the weapon and its user would be missing the point. This interaction takes on a major role, particularly in the case of military ordinance weapons; their "optimal" use demands the maximum control of this interaction, which is of the utmost importance for the tactical role of the soldier-weapon system. The use of the latest long-barrelled ordinance firearms is more acceptable precisely because of their smaller calibre (which also means reduced interaction with the user). Today the traditional primacy of the long-barrelled weapon (now getting progressively shorter) is threatened by the short-barrelled gun cartridge, which we have seen used on an extensively scale in recent militia warfare. Paradoxically, it is precisely this cartridge, whose main shortcoming is its low propellant content (and thus reduced kinetic energy) which is expected to provide the kind of killing performance capable of snuffing out even "the dead man's last five seconds".

Biomechanical Phenomena↗
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[Biomechanical-clinical interpretation of firearm wounds. General problems. XI. Propedeutic ABC of terminal ballistics].

The pathogenetic potentiality of firearms differs in relation to whether we are dealing with rifled long-barrelled weapons, handguns, or smooth-bore long-barrelled guns. Up until a few years ago, the tissue-damaging effect, at least in the modern warfare context, of short-barrelled or smooth-bore long-barrelled firearms, was thoroughly negligible; today, however, their impact, as causes of wounds and death, is steadily increasing, and for the first time small bullets designed for low-cost military training are also coming to play a primary role on the battlefield. At the same time short-gun bullets are appearing which, which in the name of "stopping power" seem to contradict the very definition of a handgun. The smooth-bore long-barrelled gun, in turn, is casting off the anti-humanitarian image of the trench gun to play the more suggestive ordinance role of the grenadiercumhunter.

Biomechanical Phenomena↗
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[Terminal ballistics. 1].

We have chosen to conceive of terminal ballistics as a violent and extremely rapid confrontation between two forms of resistance before the final state of rest is reached. This definition, which cannot help but don the admittedly loud and outlandish garb of physics, is the most promising for the purposes of biological interpretation. The main characters on this stage are two, but only one of these really plays the lead, namely the human target, which acts out the basic roles inherent in its physical make-up; the other, the bullet, remains a background figure, frozen in its walk-on part, and ready for the next performance. This modus operandi, which is no simplification, but rather an academic necessity, enables us to focus on images which stand out more clearly as a result of an intensive macroscopic spotlight which brings out the features of the individual phenomena, broken down into a succession of close-ups, and subtracts them from the cold physical nature of this or that form of inert matter, which here is merely an occasional, disagreeable witness, or even more, a standing from time to time for but one of the infinite facets of the biological composite being. Here, then, faced with a kind of exploded macrophotograph of a complex kaleidoscope, we see the animal universe, of which we capture so far the plasticity, the subdivisibility, the anisotropy and the cavitation.

Animals↗
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[Terminal ballistics. 2. (The skin)].

It goes without saying that, at first glance, it is the velocity with which the fired bullet pierces the solid target and perhaps even penetrates it that bears witness to the efficiency of a firearm. Prior to the advent of ceramic and composite materials, iron and its clone, steel, provided the most satisfactory and most coveted evidence as a test material in both the positive and negative senses. It the biological field, wood and deal in particular were for decades the only witnesses, alongside tests in cadavers, which, despite obvious reservations, provided us with a wealth of data, much of which is still regarded today as among the mainstays of forensic didactics. Prominent among these, in terms of clinical importance, in that they mark the start of the bullet wound, are the velocity and energy thresholds per presentation area. The bullet, after overcoming the barrier of the skin, continues on its course through the soft tissues, and there leaves its most authentic and singular mark as a bullet wound.

Biomechanical Phenomena↗
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[Terminal ballistics. 3].

This brief chapter, focusing essentially on a single topic, has been written in homage to Emile Theodor Kocker, a masterful exponent of the art of surgery and founder of the culture of terminal ballistics. For most of the literature we are indebted to Fackler and Dougherty, who, with the particular grasp, and fair of historians, act as guides on a trial which is only apparently retrograde, but which actually bears eloquent witness to the fact that even in the most physically tangible of arts, namely the art of surgery, inspired curiosity may help us to go well beyond the limits of our day and age. This chapter is also dedicated to the memory of another great surgeon, Vittorio Pettinari, who for one of the authors was an incomparable mentor and past-master of such curiosity.

Animals↗
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[Propedeutic to general problems of the hypothesis of a new "open" interpretation of firearm wounds of soft tissues].

On the basis of a review of the literature and their own personal knowledge and experience, the authors define the state of the art regarding a point of considerable importance, namely the leaky gut hypothesis. Taking gunshot wounds in soft tissues as their starting point, they believe that such lesions are among the most suitable for illustrating the chain of events which translates an entirely local pathology--admittedly serious--into a systemic pathology carrying a very severe prognosis, if the physician is unable to interrupt this clinical course.

Endotoxins↗
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[Treatment of pain in advanced-stage intra-abdominal neoplasms].

Different types of pain are present in far advanced intra-abdominal cancer, sometimes in the same site too. An accurate semeiological analysis of pain is important because different types of pain often differently respond to the available therapeutical tools. In this paper the results and the complications of the most important methods of pain management in far advanced intra-abdominal cancer are examined. Analysis of the data reveals that the association of more methods, pharmacological and non, should be a rule rather than the exception.

Abdominal Neoplasms↗
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[Biomechanical and clinical interpretation of firearm wounds. General problems. VI. Propedeutic ABC of terminal ballistics].

Any lengthy and properly structured propedeutic ABC of terminal ballistics must necessarily embrace a comparison between the two main protagonists of gunshot wounds. It is almost a specular, yet distorted image of the ritual act consumed by the larger mammals, not proud of their mutual aggression, but the conformation between mechanics and biology, or between kilogram-metres and life. The two types of physical entity brought together through the unique agency of a new language--both biological and mechanical, but necessarily halting and inadequate--stand out like two parallel lines opposite one another, displaying their respective profiles and most intimate structures. One can take this as far as the biological paradox of the clash between the dimension of power and the chance quality of life.

Biomechanical Phenomena↗
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[Diagnosis and treatment of traumatic diaphragmatic hernia with delayed presentation].

AIM: To evaluate the clinical picture, diagnostic techniques and most appropriate treatment in traumatic diaphragmatic hernia with delayed presentation on the basis of personal experience and in the light of other published studies. EXPERIMENTAL DESIGN: Review of cases treated. SETTING: Patients treated in University General Surgery wards. PATIENTS: Those patients in whom diagnosis was made some time after trauma and after the acute event were selected from a group of patients with traumatic diaphragmatic hernia. SURGERY: All patients underwent surgery to reduce hernia and repair the diaphragmatic lesion. MEASUREMENTS: All clinical findings were examined together with the tests performed and the type of treatment carried out. RESULTS: The diagnosis was made between 3 months and 3 years after the injury. Three patients presented manifest symptoms of high intestinal occlusion on entry. Radiological alterations were present in standard chest X-rays in all patients and digestive tract contrast radiography was positive for the diagnosis of hernia in 3 out of 4 cases in which it was performed; a preoperative diagnosis of hernia was obtained in 4 cases. Patients were operated using a thoracotomy (3 cases) or combined laparothoracotomy access (2 cases); the diaphragmatic lesion, localised in all cases in the cupula of the left hemidiaphragm, was repaired using separate sutures in non-reabsorbable material without the use of grafts. One patient died postoperatively owing to septic complications. CONCLUSIONS: traumatic diaphragmatic hernia with delayed presentation involves severe complications that increase morbidity and operating mortality.

Adolescent↗
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[Rupture of the diaphragm caused by closed trauma. Case contributions and review of the literature].

AIM: Retrospective evaluation of 19 diaphragmatic ruptures due to blunt trauma. MATERIALS AND METHODS: We collected all patients with thoracic and/or abdominal blunt trauma who were admitted to the department of surgery (Clinica Chirurgica and Chirurgia generale C) from 1970 to 1995. We selected patients with ascertained diaphragmatic rupture. RESULTS: We considered 17 cases of TDR (15 males and 4 females). Mean age was 38 years (range 16-67). Radiologic findings were consistent with TDR in 10 cases out of 17 (58.8%). Right hemidiaphragm was injured in 6 cases (31.6%). 10 patients (52.6%) presented at operation with intrathoracic visceral herniation. 8 patients underwent laparotomy, 7 both laparotomy and thoracotomy, 4 thoracotomy alone. Perioperative mortality was 15.7% (3 patients). DISCUSSION AND CONCLUSIONS: The clinical features were complicated by a large number of associated lesions; radiologic diagnosis is comparatively easy if visceral herniation into the thorax is present, repeated radiologic examinations facilitate diagnosis. The surgical access is determined by concomitant associated injuries which may require urgent operation.

Adolescent↗
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[Reconstruction technique after pancreaticoduodenectomy].

The many techniques proposed for the reconstruction of the digestive path after pancreaticoduodenectomy show the continuous research of the most anatomical and safest way to achieve the best results. Most of the technical variations concern the treatment of the pancreatic stump and are directed to prevent the pancreatic fistula that is the most frequent cause of postoperative mortality and morbidity. None of the pancreatico-digestive reconstruction ways is absolutely better than the others and we think neither the total obstruction of the Wirsung duct is the solution of the problem of the pancreatic fistula. The accuracy and technical precision, the availability to modify the technique in relationship to different anatomy and functional conditions of the pancreatic stump are essential to improve the results. To achieve this goal is decisive the experience and patients volume of the surgeon and of the institutional team.

Digestive System Surgical Procedures↗