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G Ronga

Publications and source records attributed to G Ronga.

30 records · Page 2Linked to original sources
PubMed1989

Postoperative recurrence of simple goiter and replacement therapy. Study of 210 patients.

The incidence of recurrent goiter after different surgical procedures for colloid-cystic goiter has been studied in 210 patients. The results of the study confirm the high incidence of recurrence (35.7%). This incidence was shown to be higher in patients undergoing more conservative surgery. Furthermore, the incidence resulted also higher in younger patients, while it was lower after postoperative replacement therapy.

Adolescent↗
PubMed1988

Prevalence of parathyroid insufficiency after thyroidectomy: study of 1037 cases.

In 1037 patients undergoing total (827 cases) or partial thyroidectomy (52 cases of subtotal thyroidectomy, 108 of hemithyroidectomy, 50 of enucleation and resection) for each study group the incidence of hypoparathyroidism, its possible causes and technical factors favouring the onset, were examined. In this series postoperative prevalence of hypoparathyroidism was 16.6%. It seems to be directly proportional to the extent of surgery thus confirming the necessity to locate and preserve the parathyroid glands during surgery. This should be as conservative as possible according to the prognosis of the thyroid disease.

Cross-Sectional Studies↗
PubMed1986

Complementary role of whole body scan and serum thyroglobulin determination in the follow-up of differentiated thyroid carcinoma.

In 233 patients with differentiated thyroid carcinoma previously treated by total thyroidectomy supplemented, when necessary, with a therapeutic dose of 131I, serum thyroglobulin determinations and whole body scans were simultaneously performed. 82 of the 233 showed local or distant metastases: they were detected by both tests only in 36 cases. In 43 patients thyroglobulin was positive but without pathological concentrations of 131I at whole body scan were observed. The remaining 3 cases were detected on the basis of the positive whole body scan only, without increase in the circulating thyroglobulin. These results suggest that caution should be taken when considering thyroglobulin determination as possible substitutive test of whole body scan in the follow-up of differentiated thyroid carcinoma. However, for optimal sensitivity and reliability the complementary role of the two tests is stressed.

Adenocarcinoma↗
PubMed1983

TRH test in the follow-up of operated simple goiter: a study of recurrence.

The study was carried out on 46 patients operated for simple goiter. The statistical analysis of data of TRH test on a sample of 57 healthy volunteers has permitted an evaluation of the upper limits of the normal thyrotropin response; the secretory area (As) was shown to be more discriminating. The patients were divided on the basis of response to TRH (evaluated by As) and incidence of recurrence in the group of patients with an abnormal curve with respect to patients with a normal curve was shown to be highly significant (77% v.s. 33%; p less than 0.01). The study underlines the limits of conventional methods of follow-up which should avoid the appearance of recurrence and suggests the validity of TRH test in the screening of subjects to be treated by opotherapy for prevention of recurrence.

Adolescent↗
PubMedDate not supplied

[Restoration of digestive continuity after subtotal gastrectomy: comparison of the methods of Billroth I, Billroth II and roux en Y. Randomized prospective study].

UNLABELLED: The aim of this study was to evaluate functional results after Billroth I, Billroth II and Roux en Y reconstruction in subtotal gastrectomy. MATERIAL AND METHODS: 45 patients were randomised between 1990 and 1995 and stratified in 3 different groups: 15 BI, 15 BII and 15 Roux. They were investigated by EGDS with multiple biopsies and upper gastro-intestinal scintiscanning, to evaluate gastro-esophageal reflux (GER) and dynamics of gastric emptying. Besides they answered a questionnaire: "Gastrointestinal Quality of Life Index" (GIQLI). RESULTS: A reflux esophagitis was found in 5 BI, in 7 BII and in 2 Roux (p < 0.001). No gastric lesions were found in 6 BI, in 5 BII and in 12 Roux, (BI vs. Y, p < 0.05; BII vs. Y, p < 0.001). Chronic superficial gastritis was present in 9 BI, in 4 BII and in 3 Roux (BI vs. Y, p < 0.05). Dynamic scintiscan demonstrated the presence of GER in 5 BI and gastric emptying was fast (37' < T 1/2 < 86'), but incomplete (60' residual activity: 49-62%). GER was evident in 7 BII with slow (28' < T 1/2 < 143') and incomplete (60' residual activity: 48-72%) gastric emptying. GER was detected in 2 Roux and radioactive bolus progression in the Roux limb was fast (24' < T 1/2 < 53') and complete (60 residual activity: 42-52%) (BI vs. Y; BII vs. Y, p < 0,001). There was not statistical significance between GIQLI score in the 3 groups. CONCLUSION: The authors affirm the Roux en Y is the technique of choice in subtotal gastrectomy, if compared with BI and BII.

Adult↗
PubMedDate not supplied

[Hyperthyroidism in the elderly].

UNLABELLED: Hyperthyroidism in elderly patients is not to be under-evaluated, since it is characterized in such age range by particular clinical and prognostic features. Based upon literature survey and their clinical experience, the authors discuss in the present paper clinical, diagnostic and therapeutic problems of hyperthyroidism in geriatric patients. MATERIAL AND METHOD: In the period between 1978-2003 out of 1804 patients surgically treated for thyroid disease (non neoplastic in 1470 pts.), 180 subjects presented hyperthyroidism (17%). 36 were in geriatric age-range (mean age 76 yr.; 29 females and 7 males). 26 presented a Multinodular Toxic Goiter (72.2%), whereas 9 patients complained of Plummer Adenoma (25%); only 1 patient showed Basedow disease (2.7%). RESULTS: As far as ASA classification, there were 7 ASA I, 27 ASA II and 2 ASA III. Compression of digestive tract and/or respiratory airway represented a surgical indication in 15 patients (41.6%). 12 (33.4%) were operated due to predominant cardiac symptoms (tachycardia, atrial fibrillation). The remaining 9 patients (25%) were treated for the concomitance of atypical symptoms of hyperthyroidism. We performed 15 total thyroidectomy, 7 "near totally", 8 sub-total, 6 hemithyroidectomy in case of Plummer adenoma. Postoperative mortality was nihil; p.o. morbidity was 5.5% for medical conditions (pneumonia) and surgery-related (1 laryngeal recurrent paralysis and 1 hypoparathyroidism) in 5.5%. Post-operative follow-up, conducted at 6 and 12 months from the operation, showed regression of hyperthyroidism and regression or improvement of all clinical symptoms complained by the patient. CONCLUSION: Surgical treatment seems to be the only immediate and definitive cure for hyperthyroidism. Geriatric age does not seem to be a surgical contraindication.

Aged↗
PubMedDate not supplied

Thyroid carcinoma with biphasic clinical course and evolution in medullary carcinoma-follicular variant. A case report and an immunocytochemical demonstration of calcitonin and thyroglobulin in the same neoplastic cells.

The authors present an unusual case of thyroid neoplasia firstly diagnosed as an anaplastic carcinoma with no rise in plasma thyroglobulin (Tg) and treated with total thyroidectomy and radioiodine administration. After 18 months regional lymph node metastases were present with a rise in plasma calcitonin (Ct) (8000-14000 pg/ml); lymphectomy and external radiation were performed and histology revealed a metastasis from thyroid medullary carcinoma. After 3 years, mediastinal and right supraclavicular masses were present with a concomitant rise in plasma calcitonin (from 700 to 3400 pg/ml); all neoplastic lesions showed radioiodine uptake and plasma Tg was 8.9 ng/ml. A biopsy of the supraclavicular region was taken and 131I therapy was attempted, but the patient died after 6 months. Immunocytochemistry of the biopsy revealed the presence of a medullary carcinoma-follicular variant: the neoplastic cells were variably reacting with anti-Ct and anti Tg, and, moreover, the two antigens were sometimes observed in the same cell bodies. The metabolic pattern and the clinical course of this tumour are discussed, and the authors propose that Ct and Tg plasma levels be evaluated and a total body scan (WBS) with radioiodine be performed in all cases of medullary or poorly differentiated thyroid carcinomas.

Adenocarcinoma↗
PubMedDate not supplied

[Organotherapy treatment in the course of normofunctional goiter. Long-term results in 104 patients].

Results of therapy with thyroid hormones (LT4 and/or LT3) were evaluated in 104 patients (95 females and 9 males) with simple diffuse or nodular goiter. The mean interval of observation was 7.2 years. The reported results were analysed in relation to patient's age at the onset of the pathology, time elapsed since its appearance, place of origin and sex of the patient, results of laboratory studies, and clinical signs.

Adolescent↗
PubMedDate not supplied

In vivo measurement of immunoglobulin accumulation in the pancreas of recent onset type 1 diabetic patients.

OBJECTIVE: The possibility to quantify in vivo the severity of the inflammatory process in the pancreas of patients with recent onset insulin dependent diabetes mellitus (IDDM) could be of great relevance for follow-up studies involving immunotherapy. Scintigraphy with radiolabelled human polyclonal immunoglobulins (99mTc-HIG) is currently used for the diagnosis and follow-up of several acute and chronic inflammatory diseases. In this longitudinal study we have investigated to what extent 99mTc-HIG accumulate in the pancreas of patients with recent onset IDDM and in subjects at risk to develop IDDM. METHODS: Combined computerised tomography and gamma camera imaging were used to measure the radioactivity in the pancreatic region, as the pancreas/bone radioactivity ratio (P/B). Patients with IDDM (n = 15) were investigated at the time of diagnosis and after 1 year. Five pre-diabetic ICA+ve subjects and 8 age and sex matched normal subjects were also investigated. RESULTS: Eight out of 15 newly diagnosed IDDM patients and 2/5 ICA+ve subjects showed a significant accumulation of radiolabelled HIG in the pancreas (P/B higher than the upper 1st centile of normal subjects). One year after the diagnosis a significant accumulation of immunoglobulins was still detectable in the pancreas of IDDM patients positive who were positive at diagnosis. CONCLUSIONS: These results suggest that immunoglobulins home and bind to the pancreas of patients with recent onset IDDM and also in some ICA+ve individuals. This may reflect an increased vascular permeability of pancreatic capillaries as a consequence of the inflammatory process involving the islets. Thus, this technique may be useful for monitoring the efficacy of immune intervention at diagnosis.

Adolescent↗