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G Mura

Publications and source records attributed to G Mura.

At least 19 recordsLinked to original sources
PubMed2003

[Jeiuno-ileal diverticula complicated by perforation. Clinical case].

The diverticular disease is rarely located in the small intestine (0.1-1.4%). The most important feature is due to the lack of a typical symptomatology which may appear only on the occasion of the complications it may incur (perforation, haemorrhage and so on). It isn't also infrequent that the surgeon may observe intestinal diverticula accidentally, on the occasion of laparotomies carried out in emergency or for other pathologies. The literature on intestinal diverticula is reviewed and personal experience in a clinical case presenting as acute abdomen is described.

Abdomen, Acute↗
PubMed2003

[Day Surgery. Five years of experience and activity].

BACKGROUND: The aim of this paper is to evaluate the management of an integrated unit of Day Surgery in a General Surgery Department. METHODS: An outline of the first 5 years of activity is presented. Setting of investigation: little provincial hospital. Patients have been selected on a basis of Day Surgery specific features: a total of 1,294 patients. Pathologies treated: inguinal hernias, phlebectasias, phimosis, borsitis, arthritic cysts, tendon cysts, carpal tunnel, Dupuytren's disease ("crispatura tendinum"), lymphadenitis, mammary nodules, hemorrhoids, hydroceles, varicoceles, adipomas. Patients' selection parameters, surgical operation type and modalities, postoperative course, protected discharges from hospital, follow-up and complications have all been carefully recorded. RESULTS: The most numerous operations were related to hernial pathology (54.32%) and to adipomas (10.81%). The form of anesthesia was mainly loco-regional. Only 4 cases (0.3%) had to be hospitalized for the night after operation. COMPLICATIONS: 1 serious wound infection, needing removal of the hernial prosthesis; 1 painful "tumefaction" on the inguinal wound for hernioplastic operation; 3 "seromas" in inguinal hernioplastics. CONCLUSIONS: Advantages of Day-Surgery: cut in health costs due to the reduction of admissions to hospital; reduction in hospital infections and in surgical wounds; reduction in drug use; thinning of waiting lists; increase of available beds for other pathologies; reduction of disability days; high appreciation index.

Adolescent↗
PubMed2002

The effects of certain antibiotics on biogas production in the anaerobic digestion of pig waste slurry.

Antibiotics commonly used in the treatment of pigs - amoxicillin trihydrate, oxytetracycline hydrochloride and thiamphenicol were added at different concentrations to aliquots of pig waste slurry plus anaerobic sludge in serum bottles. The biogas production and methane concentration in the headspace were monitored to determine the effect of the antibiotics on the anaerobic process. With thiamphenicol significant differences in methane production were found for concentrations of 80 and 160 mg l(-1) slurry. Compared to the control, only minor differences in methane production were noted in the bottles to which amoxicillin (60 and 120 mg l(-1)) had been added. Methane production was about the same for the bottles with different oxytetracycline concentrations (125 and 250 mg l(-1)) and for the control.

Amoxicillin↗
PubMed2002

[Prevention of periodontopathy and oral mucositis during antineoplastic chemotherapy. Clinical study].

BACKGROUND: Oral mucositis is a common side effect of chemotherapy, with a multifactorial etiology: the direct toxicity of cancer therapy on the normal cells, reduced immunitary defences, presence of bacteria in the oral cavity. The aim of this study is to assess the clinical effectiveness of a preventive protocol of oral mucositis and periodontopathy during antineoplastic chemotherapy. METHODS: The design of the study was a longitudinal evaluation of 30 patients undergoing antineoplastic chemotherapy at the out-patients Department of Oncology of the University of Sassari. The study lasted one year and was carried out at the Dentistry Department of the University of Sassari. The patients were motivated to home oral hygiene, underwent professional oral hygiene and clorexidine rinses were prescribed. Visible plaque index (VPI) and gingival bleeding index (GBI) were taken from each patient as periodontal indices, and the state of the mucosa was evaluated according to the WHO recommendations (1975). The control group was composed by 33 patients. RESULTS: The values of the bleeding and plaque indices were considerably diminished between the first and the last visit, in nearly all the patients; the incidence of oral mucositis in the treated group was 20%, while in the control group it was 66%. 5-fluoruracil was always involved. CONCLUSIONS: According to the results observed, the conclusion is drawn that the professional and home oral hygiene and the use of clorexidine, can reduce the incidence of oral mucositis as a side effect of antineoplastic chemotherapy.

Adult↗
PubMed2001

The consequences of under-use of coronary revascularization; results of a cohort study in Northern Italy.

AIM: To assess whether under-use of coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) affects patient outcome. PATIENTS AND METHODS: A prospective observational study was performed following up a cohort of patients, candidates for a revascularization procedure (either CABG or PTCA) after an index angiogram. A total of 1258 patients, candidates -- according to explicit criteria -- for either CABG or PTCA entered the study enrolled by 16 hospitals located in a Northern Italian region (Lombardia). Information on demographic and clinical characteristics, type of care received (i.e. CABG or PTCA performed Yes/No) and vital status was obtained from revascularization laboratories, patients' hospital medical records and local census offices of the town of patients' residence. The main outcome measure was total unadjusted and adjusted mortality at a minimum follow-up of 9 months after the index cardiac angiogram. RESULTS: Patients who received CABG or PTCA (n=863) had lower mortality than those who did not (n=350) (4.8% vs 10.6%, P=0.001). This held true after adjustment for relevant risk factors between the two groups such as extent of coronary artery disease, clinical symptoms, and cardiac surgical risk index (adjusted odds ratio=0.48; 95% confidence intervals=0.30--0.77) and after performing a survival analysis (adjusted hazard ratio=0.31; 95% confidence intervals=0.19--0.50). CONCLUSIONS: Failure to perform a revascularization procedure when it was indicated led, in this study, to a significantly increased mortality showing that under-use of effective procedures may represent a significant quality of care problem even in areas where health care systems are well developed. Although the study was not specifically designed to identify determinants of under-use (i.e. reduced capacity leading to waiting lists, physicians' competence or patients' refusal to undergo a recommended procedure) our data suggest that limited capacity could have been the most important reason. Our findings also provide further evidence of the validity of the RAND method to assess the impact of under-use of coronary revascularization procedures.

Adult↗
PubMed2001

Use of sedative and analgesic drugs in the first week of ICU stay. A pharmaco-epidemiological perspective.

AIM: To assess the current practice of pharmacological sedation and analgesia in patients admitted in Italian intensive care units. METHODS DESIGN: observational, prospective, cohort study, involving all patients admitted during a one-month period to participating Centers in 1994. All patients were followed-up for vital status until discharge and evaluated for pharmacological sedation and analgesia for the first week of ICU stay. SETTING: 128 Italian, adult, general, intensive care units, approximately representing 1/3 of all Italian Units. PATIENTS: 2932 patients were analyzed. They generated 22612 patient-days of intensive care unit stay, 11221 of which were evaluated. RESULTS: A total of 31 different sedative drugs were used in 1751 patients. On 64% of sedated days only one drug was utilized, whereas two or more drugs were administered in the remaining days. Propofol was the most widely prescribed drug, followed by fentanyl and diazepam, while morphine accounted for 14.8% of sedated days. The analysis of the pattern of sedation over time revealed a trend to linearly reduce the use of this practice. CONCLUSIONS: Our results depict a relatively low prevalence of sedation in Italy, with the use of large number of different agents. We also observed a larger than expected use of some drugs, like propofol and fentanyl, that could be due to the unavailability of new sedative and analgesic drugs in Italy on 1994. In conclusion, Italian intensivists seem to be very conservative about the practice of pharmacological sedation in critically ill patients.

Adult↗
PubMed2000

Practice guidelines developed by specialty societies: the need for a critical appraisal.

BACKGROUND: There is increasing concern about the quality, reliability, and independence of practice guidelines. Because no information is available on the methodological quality of the guidelines developed by specialty societies, we undertook a survey on those published in peer-reviewed journals. METHODS: Practice guidelines produced by specialty societies and published in English between January, 1988, and July, 1998, where identified through MEDLINE. Their quality was assessed in terms of whether they reported: the type of professionals and stakeholders involved in the development process; the strategy to identify primary evidence; and an explicit grading of recommendations according to the quality of supporting evidence. FINDINGS: Overall, 431 guidelines were eligible for the study. Most did not meet the criteria: 67% did not report any description of the type of stakeholders, 88% gave no information on searches for published studies, and 82% did not give any explicit grading of the strength of recommendations. There was improvement over time for searches (from 2% to 18%, p<0.001) and explicit grading of evidence (from 6% to 27%, p<0.001). All three criteria for quality were met in only 22 (5%) guidelines. INTERPRETATION: Despite improvement over time, the quality of practice guidelines developed by specialty societies is unsatisfactory. Explicit methodological criteria for the production of guidelines shared among public agencies, scientific societies, and patients' associations need to be set up. Common standards of reporting, following the same principles that led to the CONSORT statement for randomised clinical trials, should be promoted.

Humans↗
PubMed1997

[Appropriateness of indicating aortocoronary bypass and coronary angioplasty: results of an observational prospective study in the Lombardy region. Gruppo Interdisciplinare Valutazione Appropriatezza Rivascolarizzazione Coronarica].

OBJECTIVE: Most studies on the appropriateness of cardiac revascularization procedures have been aimed at detecting "overuse" (ie when patients get a procedure without a clear indication), while little attention has been paid yet to "underuse" (when patients who could benefit from a procedure do not get it). This study was planned to assess the extent of over- and underuse of revascularization procedures in northern Italy. METHODS: A multidisciplinary panel of experts convened by the Italian Association of Hospital Cardiologists (ANMCO) rated the appropriateness of 898 "theoretical indications" for coronary artery by-pass grafting (CABG) and percutaneous transluminal angioplasty (PTCA) using the RAND Corporation methodology. Standardized information has been collected on a consecutive sample of patients in the Lombardy region and identified during performance of a coronary angiogram at one of the services belonging to the GISE (Gruppo Italiano Studi Emodinamica) network. Out of the 2718 consecutive patients undergoing a coronary angiogram during the recruitment period (February-May 1995), a total of 1821 (70%) were eligible for the appropriateness study. RESULTS: Indication for CABG were appropriate in 565 (80%) patients, uncertain in 111 (16%) and inappropriate in 25 (4%). Corresponding values for PTCA were: 40% (n = 262), 46% (n = 300) and 14% (n = 90). Among the 394 to whom a medical therapy was recommended after angiography, the indication was considered appropriated in only 14% (n = 57) and uncertain for 30% (n = 117). For the remaining 220, the indication was considered inappropriate, suggesting that according to the panel criteria, 56% of the patients should have received a revascularization procedure (either a CABG or PTCA) instead. CONCLUSIONS: These results suggest that underuse of revascularization procedures represents a substantial health care problem in Lombardy region, at least with reference to the period covered by this study. The study in itself does not make it possible to understand whether these results reflect a structural shortage of services (limited accessibility and/or unprioritized waiting lists) or a more general quality-of-care problem. The study protocol now foresees a follow-up for 9 months after the index angiogram to assess the eventual utilization pattern of CABG/PTCA.

Angioplasty, Balloon, Coronary↗
PubMed1996

The Role of Chirocephalus diaphanus in the Early Recognition of Environmental Pollution by Trace Elements

A study was undertaken to evaluate whether the fairy shrimp Chirocephalus diaphanus (Crustacea: Anostraca) could be considered as a species capable of biomonitoring environmental contamination by accumulating trace elements. This preliminary investigation aimed at assessing the levels of As, Cd, Cu, Hg, Pb, Se, and Zn in natural waters as well as in adults and cysts of fairy shrimps sampled from five different sites in central Italy. Trace elements were determined by inductively coupled plasma (ICP)-based spectrometry. In particular, ICP-mass spectrometry (ICP-MS) was resorted to in most cases due to its high detection power. Pretreatment of samples (adults and cysts) consisted basically in the HNO3-assisted microwave digestion of the material. The highest levels of trace elements were found in the anostracan cysts, with concentration ranges (μg/g) of 0.464-3.11 for As, up to 0.820 for Cd, 2.62-13.0 for Cu, 0.011-0.213 for Hg, 0.966-8.46 for Pb, 0.295-2.45 for Se, and 16.4-50.4 for Zn. On the other hand, the lowest concentrations were found in natural waters, with values close to the ICP-MS detection power for some elements. These data are probative of a bioconcentration process, the extent of which is proportional to the environmental level of each element. This may turn out to be useful in planning biological monitoring and assessing ecotoxicological consequences which might ensue from the diffusion of the exploitation of such organisms in aquaculture.

Journal Article↗
PubMed1994

MtDNA polymorphisms in a sample of Czechoslovaks and in two groups of Italians.

Mitochondrial DNA (mtDNA) variation was investigated in a group of 185 unrelated individuals (64 Czechoslovaks, 99 Northern and 28 Central Italians) using total blood DNA and the six restriction enzymes HpaI, BamHI, HaeII, MspI, AvaII and HincII. Among the 25 patterns (morphs) found, two morphs for HaeII, one for MspI and one for AvaII were new and each was represented by a single individual from Northern Italy. They account for four of the five new types encountered in this survey, being the fifth type characterized by the presence of the very rare morph HaeII-13. The populations analysed confirm the Caucasoid characteristics of certain polymorphisms. A review of the European data available so far is reported.

Czechoslovakia↗
PubMed1987

A study of several red cell enzyme markers in two samples of the Italian population. Report of new CA1 and PGD variant phenotypes.

Gene frequencies for 17 red cell enzymatic markers have been determined in two samples of the Italian population (Lombardy and Tuscany regions). A significant difference was found between the two samples for the AK1 and PGM1 systems (AK1*2 .028 and .044, PGM1*2 .254 and .301 in Lombardy and Tuscany respectively). Variant phenotypes, for PEPA, PEPB, CA2, PGM2, PGD and GPT markers, have been observed; some of these are due to new alleles occurring at the CA2 and PGD loci.

Alleles↗
PubMed1984

Population studies on human phosphoglucomutase-1 thermostability polymorphism.

The electrophoretic and thermostability polymorphisms of the PGM1 locus were examined in about 700 Czechoslovakians (Prague) and 3000 Italians. The Italian sample consisted of individuals from Pavia (Northern Italy), Viareggio and Rome (Central Italy) and Naples (Southern Italy). The eight PGM1 alleles, PGM1Str1, PGM1Sts1, PGM1Ftr1, PGM1Fts1, PGM2Str1, PGM2Sts1, PGM2Ftr1, PGM2Fts1, have been considered as combinations of mutations at three different sites, 1/2, S/F and tr/ts, within the PGM1 gene and their frequencies discussed in terms of linkage disequilibrium between these sites. All pairwise differences between the samples were significant except for Pavia-Viareggio and Viareggio-Rome. The frequencies of the PGMts1 alleles have been found to range from 0.0981 (Prague) to 0.0546 (Naples) and can be ordered according to a North-South cline.

Adult↗
PubMedDate not supplied

[Neoadjuvant radiochemotherapy of rectal carcinoma: retrospective analysis of a personal experience].

Even if surgical resection continues to be the mainstay of treatment in rectal cancer, preoperative chemoradiation may downstage locally advanced rectal cancer, in some cases with no residual tumors. Compared with surgery alone, preoperative radiotherapy and chemotherapy improves outcomes in patients with locally advanced rectal cancer. In the present review we summarize the results of preoperative chemoradiation therapy in a group of 15 patients who underwent surgical resection with total mesorectal excision (TME) for advanced mid and low rectal cancer from February 2002 to February 2004.

Aged↗
PubMedDate not supplied

Intra-arterial chemotherapy for liver metastases from colorectal cancer.

The aim was to investigate whether intra-arterial infusion of chemotherapy improves response to treatment in unresectable liver metastases from colorectal cancer. We treated 14 patients (pts) with intra-arterial chemotherapy. Arterial catheters were placed via percutaneous access. Treatment schedule was: 5-FU and mitomycin-C on day 1 every 21 days. Six pts also received from day 3 for 5 days, a continuous intra-arterial 24-hr infusion of interleukin-2 (IL-2). We had only one case of toxicity drug-related > grade 2 (neutropenia). We observed 2 partial response (PR) and 5 stable disease (SD). Median time to disease progression (TTP) and median survival (OS) were, respectively 4 and 15 months.

Adult↗
PubMedDate not supplied

[Multimodal treatment of gastric MALT lymphoma: our experience].

Primary gastric lymphoma (PGL) is rare, but its incidence is increasing. It represents 52% of all extranodal GI tract lymphomas. The majority of PGLs are B cell non-Hodgkin's lymphomas or a high grade, diffuse, large cell lymphoma. The development of gastric mucosa associated lymphoid tissue is dependent on Helicobacter pylori infection. From January 2000 to February 2004, 10 patients were observed in the Unit of Surgical Oncology at Morgagni-Pierantoni Hospital in Forlì (6 F, 4 M), mean age was 68.3 (range, 45-86). Diagnosis was made in all patients by endoscopy and biopsies of gastric mucosa, US endoscopy and TC-PET. According to the Ann-Arbor classification modified by Musshoff, 6 patients were stage IE(1), 1 IE(2), 1 IIIE. 2 IV. Four and two patients underwent distal or total gastrectomy. respectively. Chemotherapy was performed in three patients, RT in one patient. Complete remission was observed in patients submitted to surgery and chemotherapy alone. No mortality and morbidity were observed. The treatment of LGP is not standardized yet. The role of surgery in the treatment of primary gastric lymphoma has been recently re-evaluated. Traditionally surgical treatment was aggressive, more recently radical gastrectomy is disputed and considered unnecessary. Conservative surgery and combined treatment is considered more appropriate for localized gastric lymphoma.

Aged↗
PubMedDate not supplied

[Sentinel lymph nodes in early gastric cancer: preliminary feasibility study].

From January to December 2004, 8 patients with pre-operative diagnosis of early gastric cancer (EGC) and no nodal involvement were submitted to sentinel node biopsy using the dual mapping procedure with endoscopic blue dye and 99mTc radio-colloid injection. All the patients underwent standard radical gastrectomy and D2 lymphadenectomy. The resected nodes were evaluated by routine (hematoxylin-eosin) histopathological examination; the sentinel (blue or hot) nodes in addition were evaluated with immunohistochemistry for cytokeratin. The preliminary results and perspectives for feasibility of sentinel node biopsy and its accuracy in predicting the nodal status in EGC are discussed.

Aged↗
PubMedDate not supplied

[Intraperitoneal chemotherapy with oxaliplatin after complete cytoreduction for peritoneal carcinomatosis from colorectal carcinoma: preliminary experience].

Colorectal cancer with peritoneal carcinomatosis is usually considered incurable. Intraperitoneal carcinomatosis accounts for 25-35% of recurrences of colorectal cancer. Studies demonstrate that peritoneal carcinomatosis is not necessarily a terminal condition with no options for treatment or cure. Encouraging results were obtained in many studies by cytoreductive surgery followed by hyperthermic intraoperative intraperitoneal chemotherapy (HIIC). Oxaliplatin is a new agent whose clinical use with intraperitoneal administration has been pioneered by Elias et al. Eight patients with peritoneal carcinomatosis (PC) of colo-rectal origin underwent complete cytoreductive surgery from March 2004 to January 2005. Six of them were submitted to HIIC with semi-closed technique; in one patient mitomycin C (2 mg/m2/l) was used for intraperitoneal perfusion at 41.5-42 degrees for 60 minutes; in five patients IPCH was carried out for 30 minutes at 41.5-42 degrees with intraperitoneal oxaliplatin (460 mg/m2). Patients received intravenous leucovorin (10 mg/m2) and 5-fluorouracil (400 mg/m2) just before HIIC to maximize the effect of oxaliplatin. Preliminary results are reported.

Aged↗