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Biomedical subjects

G Vadalà

Publications and source records attributed to G Vadalà.

At least 19 recordsLinked to original sources

[Ogilvie's syndrome].

"Ogilvie's syndrome" or the idiopathic dilatation of the colon is an infrequent pathology whose underlying physiopathology is not yet well known. On the basis of their experience and having reviewed the literature, the authors affirm that this syndrome is caused by the inhibition of gastrointestinal hormones which, under the control of the neurohypophysis, contribute to colon motility. This supposition is backed up by the fact that medical treatment with somatostatin or octreotide leads to the resolution of the disorder.

Adolescent

[An update in the diagnosis and treatment of tumors of the hepatic portal].

BACKGROUND: Cholangiocarcinoma affecting the cross of the bile ducts is a tumour which has, although treatments, a high rate of mortality. METHODS: Between January 1986 and January 1996 six patients affected by Klatskin's tumor were studied; three of them underwent operation and were treated with insertion of a T tube (Kerr), whereas the other three were managed endoscopically with trans-tumoral stenting. RESULTS: The survival rate was about seven months for patients who underwent operation and fifteen months for patients managed with endoscopic stenting. CONCLUSIONS: After a review of the literature and according to personal experience, it is underlined that only an early diagnosis can achieve best results, since the latest knowledge about hepatic anatomy derived from transplants allows more extensive resections.

Aged

[Treatment of stage IV breast carcinoma].

The authors report a study carried out in 4 patients with stage 4 breast cancer. The treatment protocol was selected according to age and the general conditions of patients. Two out of four patients were treated with adjuvant chemotherapy associated with cyclophosphamide, adriblastin, 5-fluorouracil and folic acid; one patient received neoadjuvant chemotherapy with the same treatment protocol, while the fourth patient was treated with hormone and immunotherapy. Results were satisfying given that survival was considerably increased in 3 patients together with an improvement in general conditions.

Breast Neoplasms

[Laparoscopic appendectomy].

The authors report their experience of 6 cases of appendicectomy using a laparoscopic route of which 5 were performed under local anesthesia and 1 under general anesthesia. The results indicate that this new technique is easy to perform and as rapid and safe as the traditional operation. The possibility of using local anesthesia, the lack of complications when operating on obese patients, the lower incidence of wound infections and rapid postoperative mobilisation all argue in favour of this alternative approach to conventional open surgery.

Adolescent

[Complications of ileal lymphoma].

Non-Hodgkin lymphoma of the ileum accounts for some 3% of all extranodal onset lymphoma and 20% of gastrointestinal lymphoma given that the ileum is more frequently affected than the jejunum and duodenum. The large majority of primary extranodal lymphomas present a diffuse histological structure and in particular involve the cervico-fascial and gastrointestinal regions. Moreover, it is not uncommon to find an association between gastroenteric involvement and Waldeyer's ring (cervico-fascial region). Primary intestinal involvement may not present specific symptoms and remain silent for some time. It is manifested by the onset of complications caused by occlusion and perforation. Two cases of ileal lymphoma were treated at the Institute of Emergency Surgery of Catania University between 1992 and 1993. They were complicated by intestinal perforation and occlusion respectively. Both patients underwent emergency intestinal resection. Surgery represents the elective treatment for primary forms, followed by polychemotherapy and radiotherapy. Prognosis depends on the spread of disease and the hystotype. The administration of NTP and somatopstatin resulted in a shorter postoperative period with fewer surgical complications.

Combined Modality Therapy

[Synchronous tumors of the colon].

Although rare, synchronous tumors of the colon represent an important clinical manifestation of cancer of the colon. The paper reports a study carried out in 437 patients with the aim of evaluating the incidence of synchronous tumours and identifying the most useful diagnostic tools for diagnosis. On the basis of the results obtained the authors conclude that the incidence of synchronous tumours of the colon ranges between 1-3% and that in comparison to other methods pancolonoscopy enables a complete diagnosis for a prophylactic approach to multiple tumours.

Adenocarcinoma

[Spontaneous hematoma of the rectus muscle].

The possibility of heart surgery and vascular surgery and the increased number of dialyzed patients receiving dicourmarin and heparin treatment raises the question of the probable rupture of the abdominal muscles, in particular the rectus muscles, following the onset of lancing abdominal pain. The authors report a clinical case referred to them in emergency conditions. They examine the possible etiopathogenetic causes and underline the symptoms of acute abdomen in patients being treated with anti-coagulating drugs.

Hematoma

[Simultaneous bilateral primary lymphomatous tumors of the testis].

Among the malignant tumours of the gonads, primary lymphoma of the testis represents a rare pathology. It is even more rare to observe this pathology in a bilateral localisation. After a careful evaluation of the cases described in the literature, the authors report a case or primary synchronous and bilateral lymphoma of the testis in a 68-year-old patient; they examine the clinical data and diagnostic methods and analyse the surgical treatment. In conclusion the authors affirm that primary synchronous bilateral lymphoma of the testis represents a rare form of tumour which is burdened by a high mortality rate.

Adult

[An update on surgical laparoscopy].

It is reported a 15-year research experience in the laparoscopic field. General and emergency surgery have been improved by new methods. Further scientific innovations, such as video-laparoscopes, fibrin glues, instruments for the performance of hemostasis, led to carry out real surgical operations, so that laparoscopy may be considered as an alternative method compared with traditional surgery.

Emergencies

[Congenital diaphragmatic hernias].

Based on their personal experience the authors affirm that if treated early congenital diaphragmatic hernia may be resolved provided no congenital anomalies are present. Pulmonary hypoplasia is secondary to the presence of viscera in the thorax, but excellent results can be obtained if early surgery is performed and provided negative-pressure thoracic drainage and correct anesthesia are ensured. Mortality is due to associated visceral malformations.

Diaphragm

[Current etiopathogenic guides in pulmonary embolism].

Pulmonary embolism is still a dangerous postoperative complication in spite of antithrombotic prophylaxis. The paper examines the etiopathogenetic stages of the disease and stresses the relevance of Wircov's triad today, even in the light of recent acquisitions which highlight the role of endothelium as a modulator of the fibrinolytic process.

Adenocarcinoma

[Nonparasitic hepatic cysts].

Serous cyst of the liver are a rare pathology which are often diagnosed during surgery. The paper reports 12 cases which were diagnosed during laparoscopy and discusses the etiopathogenesis of the disease, the latest diagnostic tools and the possible use of surgery. In conclusion, the Authors affirm that surgical laparoscopy represents an alternative form of treatment in some cases, such as polycystic liver.

Adult

[Acute thyroiditis].

Acute suppurating thyroiditis is now an uncommon pathology which is rarely found, although it was frequent before the introduction of antibiotics. Having observed a case, the Authors were prompted to study the subject in greater depth, in particular to assess whether the disease is easier to diagnose using modern techniques diagnosis, and whether there are changes in the therapy. In conclusion, the paper affirms that in spite of the fact that the diagnostic evolution has thrown further light on the clinical aspects of the disease, biopsy still remains the most reliable instrument of diagnosis, whereas surgery is the most effective form of therapy.

Acute Disease

[The diabetic foot].

The rise in the mean age and the increase in diabetes have frawn the surgeon's attention to gangrene of the lower limb which requires a multidisciplinary approach (doctor, surgeon, prosthesis specialist). Contrary to the concept of high thigh amputation, the possibility of carrying out a lumbar sympathectomy has encouraged the idea of a more distal amputation with conservation of physiological joints and an early recovery of function thus enabling patients who would otherwise have been condemned to permanent invalidity to return to social life.

Diabetic Angiopathies