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Biomedical subjects

G Perniciaro

Publications and source records attributed to G Perniciaro.

7 recordsLinked to original sources
PubMed1995

[Psychological assessment of patients who have ++undergone breast reconstruction using 2 different technics: autologous tissue versus prosthesis].

Breast reconstruction has become an available option for most patients undergoing mastectomy: in fact many authors agree that breast reconstruction does not interfere with possible therapies and improves the quality of life of women. The aim of the study was to evaluate the psychological adjustment of patients who had immediate or delayed reconstruction using 2 different methods: implants and autologous tissues. The study population (115 patients) was derived from patients who underwent breast reconstruction in the period January 1988-December 1991, in follow-up at the Department of Plastic and Reconstructive Surgery; no patient was undergoing psychological therapy. 58 patients underwent breast reconstruction using implants and 57 using Transverse Rectus Abdominis Myocutaneous Flap (TRAMF). Informations were gathered, including the patient's age, the number of offspring, the marital status, the scholastic education, the job and the relapse between mastectomy and reconstruction. The psychological instruments consisted in three standardized self-administered questionnaires: Psychological Distress Inventory (PDI), State Trait Anxiety Inventory form Y (STAI), Eysenk Personality Inventory (EPQ-R). These tests were chosen to gauge the psychological distress, such anxiety, anger, depression and psychosocial maladjustment. To better perform the changes of body image after breast reconstruction, women were requested to answer three more specific questions about the sexual desire, physical image and social relationships. The 102 patients assessed in this study indicate low incidence of psychological distress and adaptive coping strategies. Impairment was reported, regarding body image, by patients undergoing delayed reconstruction; in these patients higher scores in distress tests were observed.

Adaptation, Psychological↗
PubMed1995

[Reconstructive method for the repair of substantial loss of the head and neck area, following the excision of malignant melanoma].

The general increase in the incidence of malignant melanoma has caused a more massive presence at the level of special sites such as the face, posing problems of the reconstruction from a cosmetic point of view. The widespread move away from large margins of exercise (3-5 cm) towards margins of approximately 1 cm surrounding the lesion, together with the improved prognosis for this pathology on the face compared to other sites, calls for greater attention to be paid to the reconstructive techniques used. Since surgery is the only solution "quoad vitam" for the patient, it is now preferable to attempt to offer the patient both a complete exeresis of the neoplasia and a satisfactory cosmetic result. In this study the authors report four cases involving the excision of malignant melanoma in the cervico-cephalic district and their consequent reconstruction using special surgical techniques.

Adult↗
PubMed1981

[Preliminary observations on the existing relationship between plasma levels of prolactin and hypophyseal reserves of FSH and LH in the male].

PRL plasma levels and FSH and LH pituitary reserve were tested in ten apparently healthy male subjects. A good correlation was found between PRL on one hand and FSH plasma levels (p less than 0,05), LH plasma levels (p less than 0,01) and FSH pituitary reserve (p less than 0,01) on the other hand. This seems to support the current hypothesis that prolactin may cause a progressive clinically latent impairment in the spermatogenetic function of the testis. Further evidence is needed.

Adult↗
PubMed1981

[Relationship between benign breast cancer and plasma levels of prolactin].

Prolactin (PRL) plasma levels were measured in the follicular phase of the cycle in 75 normally menstruating women divided into three groups: group I was normal (n. = 39), group II showed benign breast disease (n. = 26), group III hyperandrogenism (n. = 10). PRL levels were higher (670,8 +/- 61,2 microunits/ml) in the second group than in the first (216,0 +/- 12,0 microunits/ml; p less than 0,001) and in the third group (426,0 +/- 75,2 microunits/ml; p less than 0,02). Two mechanisms are hypothesized as a possible explanation for the results: a) hyperprolactinemia primarily alters progesterone/oestradiol ratio which secondarily initiates benign breast disease, or b) relative hyperestrogenism causes an increase in PRL plasma levels, which, in turn, interact with oestradiol to give mammary gland hypertrophy. Further studies are needed in order to elucidate the problem.

Adolescent↗
PubMedDate not supplied

Can the cost affect the choice of various methods of postmastectomy breast reconstruction?

AIM AND BACKGROUND: A wide range of methodologies for breast reconstruction is now available. For immediate breast reconstruction we prefer to use implants, whereas reconstruction using autologous tissues, such as transverse rectus abdominis musculocutaneous flaps (TRAMF) and muscular latissimus dorsi flaps, is applied only in selected cases. In contrast, for delayed reconstruction the choice between prostheses and autologous tissue depends on various conditions. The different reconstructive methods can be adopted as a single procedure or as a combination of surgical procedures. Following the issue of legislation defining the new structure of the Italian Health Service, the need to accurately assess the costs incurred for the execution of surgical operations has taken on paramount importance. The aim of the study was to evaluate not only the clinical limits of each surgical technique, but also its cost, in order to optimize the choice of the same procedures, conditions being equal. METHODS: The study population included 105 patients who underwent breast reconstruction in the period 1st January 1994-30th June 1995. The reconstructive procedures included 48 immediate implants, 7 immediate TRAMF, 17 delayed implants, 30 delayed TRAMF, and 3 delayed latissimus dorsi muscular flaps. RESULTS: After data evaluation, we concluded that reconstruction using permanent expandable implants is the most convenient among implant reconstructions for its low global treatment cost. In fact, reconstructive procedures using temporary expanders, which require two surgical operations, have a higher cost than breast reconstruction using permanent expandable implants. Breast reconstruction using TRAMF is the most convenient because it limits the cost of surgical materials and because flap versatility limits the number of modifications on the contralateral breast. In contrast, breast reconstruction using latissimus dorsi flaps has high costs. CONCLUSIONS: There is no balance between price list and effective cost of the different surgical reconstructive procedures, which may be a point of departure to see whether it is impossible to improve the efficiency of the Health Care System and in any case open a debate between the Regions and hospitals to improve the service, keeping it at a good level.

Female↗
PubMedDate not supplied

[Considerations in immediate and delayed breast reconstruction].

The authors evaluate the different procedures for breast reconstruction in order to determinate the best indication of each technique. From January 1983 to June 1992, 196 reconstructions for breast cancer using implants, including 100 immediate and 96 delayed, were performed. Different types of breast implants were used in this period: in 1983-84 46 double lumen prostheses were performed, in 1985-86 34 Radovan temporary tissue expanders, from January 1986 to June 1991 115 Becker and Gibney permanent tissue expanders and 8 microstructured prostheses. Due to unavailability of silicon-gel implants, from January to June 1992 12 breast reconstructions with saline temporary tissue expanders were performed. In the patients with radical mastectomy 39 latissimus dorsi muscular flaps were carried out for implant coverage. In the same decade 204 breast reconstructions using Rectus abdominis myocutaneous (TRAM) flaps, including 201 delayed and 3 immediate were performed. It can be concluded that the implants are first choice for small or medium size breast, with light ptosis, in immediate reconstruction and when the patients refuse harder surgical procedures. On the contrary the autologous tissue, such as TRAM flap, can be used in patients with redundant abdomen, with controlateral large and ptotic breast and in delayed reconstruction.

Female↗