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Biomedical subjects

I Donini

Publications and source records attributed to I Donini.

At least 19 recordsLinked to original sources
PubMed1999

Lymphatic mapping for the dissection of the sentinel node in the treatment of breast carcinoma.

The Authors present the preliminary results of a study aimed at verifying the effectiveness of lymphatic mapping for the dissection of the sentinel lymph node in the treatment of breast carcinoma. The lymphoscintigraphy method was used in the study performed on 24 patients to evidence the sentinel lymph node. The sentinel lymph node was identified in 23/24 patients (95,8%), with 100% accuracy, negative predictions were 100% (21/21). Consistently with the low number of cases treated, our results seem to guarantee the same prognostic accuracy obtained using radical lymphadenectomy extended to the third lymph node level.

Adult↗
PubMed1997

Seasonal variations in the rupture of abdominal aortic aneurysms.

From 1982 to 1994, 54 patients (47 men; mean age 72 years) were referred to the Hospital of Ferrara, Italy for spontaneous rupture of abdominal aortic aneurysm. Sixteen died in the emergency department and 38 underwent urgent surgery. Day and month of onset of acute symptoms leading to urgent surgery were recorded. A seasonal variation with significant peaks in spring and autumn was found. These findings are likely influenced by local environmental, social and epidemiological factors, but may be relevant for the appropriate timing of the follow-up and therapeutic strategies for abdominal aortic aneurysms.

Aged↗
PubMed1997

Reparative surgery of valves in the treatment of superficial venous insufficiency. External banding valvuloplasty versus high ligation or disconnection. A prospective multicentric trial.

OBJECTIVE: A prospective study was performed in order to compare results obtained in the treatment of early and/or limited primary varicose veins of the lower limbs using two different procedures: external valvuloplasty and high ligation or disconnection of the sapheno-femoral junction. MATERIALS AND METHODS: 116 limbs (113 patients) were selected. 57 with normal cusps in dilated valves were subjected to external valvuloplasty with Silicone prosthesis under Doppler control (intraoperative angioscopy in 16 cases); 59 limbs were subjected to high ligation or disconnection of the junction; 57 limbs out of 116 were subjected to complementary procedures. Duplex and photoplethysmographic examinations were performed before and after the surgical procedures in all patients. Doppler venous pressures were measured in 36 limbs and invasive pressures in 40 limbs. Patients were postoperatively followed up every 4 months until the 12th month. RESULTS: Indications for valvuloplasty were found in 8.2% of cases and in 66.3% of the early varices. Clinical results were slightly superior in the reparative surgery group. Thrombotic occlusion of the proximal long saphenous vein was significantly higher in the ligation-disconnection group. Results from photoplethysmography and venous pressure measurements indicated that both operations are equally effective in the elimination of reflux in the junction.

Adult↗
PubMed1996

[Experimental study of postoperative lavage: standardization of the method].

Postoperative infections are an outstanding problem in a surgical department. We have been studying them from a clinical and experimental point of view has a long time. In this study we present a method standardisation of postoperative peritoneal lavage as prevention of surgical infections. Winstar mice, infected with intra peritoneal E. coli cultures, underwent peritoneal lavage with saline solution or sterile water. The results showed the right amount of solution and the exact administration of lavage according to grade of infection. Encouraged by this result we are going to test the efficacy of anti microbial agents for the postoperative peritoneal lavage.

Animals↗
PubMed1996

[Aneurysms of the popliteal artery. Our experience apropos of 37 cases].

The authors describe their experience concerning the surgical treatment of aneurysmatic pathology of the popliteal artery. This is the most frequent site for aneurysm after aortic aneurysm. Since 1979 to 1994, 26 patients, 21 men and 5 women (mean age 65.8 years), have been treated at the Institute of Clinical Surgery of the University of Ferrara for a total of 37 popliteal aneurysms. Thirteen patients had more than one aneurysm. Before the operation, all patients underwent DSA, and echo Doppler, 7 with CAT and 4 with RMN. Twenty-nine substitutions, 7 by passes and 1 ligation were performed. Twelve of the 29 substitutions were made by reversed saphenous vein. Fourteen by PTFEe, and 3 by dacron. In 4 cases it was necessary to reimplant either the anterior tibial artery (3 cases) or the posterior tibial artery (1 case) separately. The results obtained were good especially in the post-trauma patients. Only 3 amputations were necessary due to graft obstruction immediately after surgery, and in post-traumatic conditions.

Aged↗
PubMed1996

[Contribution of a combination of alpha and beta benzopyrones, flavonoids and natural terpenes in the treatment of lymphedema of the lower limbs at the 2d stage of the surgical classification].

HYPOTHESIS: To create a phlebolymphologic therapy in order: to activate venous system; to activate lymphatic system; to activate macrophagic system; to reduce the proteic lymphatic load. EXPERIMENTAL: A study was performed on the use of an ideal phlebolymphological association (Tonka Beans, Gingko Biloba, Melilotus Officinalis) as a practical standpoint in the treatment of lymphedema of lower limbs in order to create an efficacious dose of Coumarin, Benzopyrones and Ginkolidi. CLINICAL: We investigated a population of 76 patients treated in an open-label study for six-eight months with a dosage of Coumarin 60 mg/daily + Gingko Biloba 40 mg/daily + Melilotus 40 mg/daily. CONCLUSION: This trilogy induced a very significant improvement in lymphedema (centimeter-aspect) both in functional symptoms (pain heaviness in affected limbs) and physical signs (edema, episodes of infection). Tolerance of long term treatment was good and the improvement was observed from the third month of treatment.

Adolescent↗
PubMed1995

[Use of PGE1 in severe ischemia of the lower extremities. Clinical study].

Lower limb critical ischemia is a clinical condition typical of patients with severe chronic obstructive arterial disease (Fontaine's IIIb and IV degree). This condition often leads to amputation of the limb involved. The authors present to the use PGE1 in 50 patients with Fontaine's IIIb-IV degree chronic obstructive arterial disease of lower limbs in which the indication of amputation was done. All the patients, admitted to the emergency ward, complain of rest pain and distal ulcers. The administration of PG5(1) was given as follows: 40 mg/bid/e.v./20 days. A 6 months long follow-up was installed with the instrumental evaluation of: Transcutaneous oxygen pressure; Distal blood perfusion with Doppler; cardiac pulse; blood pressure. Eighteen patients became to a Fontaine's II degree during the next 2 months after therapy, 25 patients came back to a severe claudicatio: of them 18 underwent successfully vascular surgery, 7 underwent amputation of the lower limb. In 7 patients the PGE1 did not influence the natural progression of the disease. Among the side-effects of therapy we can mention: headache (4%), erythema and pain of injected vein (8%), sick (4%). All the side effects were transient and never led to interruption of therapy.

Aged↗
PubMed1995

[Video-assisted mediastinoscopy: clinical uses].

The experience with video-assisted mediastinoscopy in 16 cases examined, is reported. Initially the classic mediastinoscopic device with the aid of an operative thoracoscopy was used. Starting from April 1994 the Authors used the video-assisted mediastinoscopy which, enlarging the surgical field, allows to improve the operative performance and may be a good aid for multiple teaching.

Humans↗
PubMed1995

[Pleural drainage vs video-assisted minimally invasive surgery in the treatment of spontaneous pneumothorax. A retrospective study].

The most frequent cause of spontaneous pneumothorax is bleb's disease of the lung. Considering that, pnx s. has a remarkable bent for relapsing, we think that it's necessary an aggressive treatment to resolve it. That's because pleural drainage is useful for a symptomatic resolution, VATS for an etiologycal one. To value the real efficacy of the treatment of VATS, we have effected a retrospective research between two classes of patients suffering from pnx s. admitted in our Institute from 1987 until 1991, one treated with pleural drainage (class A, 11 patients) and the other with VATS (class B, 13 patients). 1) Patients treated with pleural drainage were nearly double compared to class B. 2) In class A, the mean value of drainages were nearly double compared to class B. 3) Class A had a number of relapses 10 times more compared to B. 4) Considering the period of hospitalization, class A had a value nearly triple compared to B. 5) We've noticed that the mean value of the cost for episode of pnx s. in class A was more than 15% compared to class B and the cost for patient in class A was nearly double than in class B. We can affirm that, for the treatment of pnx s., the method of VATS rappresents a real success. We're passed from the "symptomatological treatment" of it to an aetiological one, joined to the prophylaxis of the relapse.

Drainage↗
PubMed1994

[Treatment with immunomodulating drugs of patients with operated cancer. Long-term results].

The authors produce a new course of study in order to verify the efficacy of immunomodulatory treatment in cancer-operated patients. In the General Surgical Clinic and Surgical Therapy Institute of University of Ferrara, from July '86 to June '92, 582 cancer-operated patients were treated by immunomodulatory drugs, making use of standard of absolute random. A group (100 patients) was subjected to peroperative anticontagious immunoprophylaxis; B group (482 patients) to postoperative cyclic immunomodulation; in this last group, were codified C group (166 patients) and D group (63 patients), controlled in follow-up, making use of 3 parameters: survival, clinical-oncological restage, performance status. The results obtained confirm the efficacy of the proposed immunomodulatory treatment: a reduction of incidence both early infections and late infections, an increase of survival, falls in clinical-oncological stage to less advanced levels and, above all, an improvement of performance status.

Adjuvants, Immunologic↗
PubMed1994

["Simulated walking" in the duplex evaluation of the venous system. The clinical and instrumental correlations].

The goals of non-invasive duplex vascular diagnosis of the venous system of the lower limbs are: 1) To make evaluation of the venous system during deambulation feasible under physiological, pathological and post-surgical or elastocompressive conditions. Moreover, any such evaluation must be achieved using a standardized, easy, highly reproducibly method which is inexpensive and utilizes the diagnostic instruments available. 2) To achieve detailed, selective localization of the valvular and parietal dysfunctions at the basis of any reflux pathology. 3) To identify and quantify venous flux and reflux during deambulation. The present work gives the results achieved over the period of one year after a new method simulating deambulation (Walk System 1 patented) was set up for several utilizations, principally correlated to the use of conventional duplex scanning in studying the venous system. The main purpose of the Walk System 1 is step simulation to uncover the location and extent of venous disease. This application test of: a pneumatic pump which compresses the calf to 100-120 mmHg in 0.3 sec thus simulating muscolar pumping during deambulation; standard 40 mmHg compression of the foot in order to rule out any hemodynamic involvement of the foot pump venous system. We can use this pump in the hemodynamic component, a part, during the step simulation, with synchronism with calf pump in TVP prophylaxis or in vascular therapy; an easy-to-use application software able to quickly pulsed Doppler data of flux and reflux by means of the flux and reflux orthodynamic indices or with measures in ml/sec. The study was performed on 80 lower limbs in normal subjects in order to define the normality range and in 380 lower pathologic limbs. The study has yielded a clinical-instrumental correlation between the hemodynamic data observed during inflation-deflation of the calf cuff, positioning the pulsed Doppler sample volume in the saphenous vein in the saphenous-femoral ostium zone and the underlying venous morphology. The results have made it possible to determine physiological S-F reflux and to establish 4 pathological classes of orthodynamic S-F reflux, each class corresponding to a specific range in the orthodynamic reflux index (class 0 = 0 < RI < 0.25; class 1 = 0.25 < RI < 2; class 2 = 2 < RI < 3.5; class 3 = 3.5 < RI < 6; class 4 = RI > 5) and to a particular morphological conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Postoperative lavage. Experimental study of the use of antiseptic solutions].

The authors report their experience of surgical infections and particularly peritoneal intraoperative lavage. In a previous study they have standardized the technique. In this study they report on the lavage adding antiseptic substances in the solution. The experimental, controlled study, was carried out on Wistar rat stock, which were submitted to median laparotomy through which was injected a standard bacterial dose composed of 5 bn E. Coli. The peritoneal cavity was washed out after a few minutes with physiological solution with clorhexidine or PVPI dissolved. The main results were an increase of aderential syndrome and a less survival percent age (physiological solution = 100%, clorhexidine = 60%, iodophors = 23%). The authors concluded by pointing out that the use of antiseptic peritoneal lavage solution is a method that should be proscribed from operating rooms because it is unnecessary and detrimental to health.

Animals↗
PubMed1994

[Iatrogenic lesions of cranial nerves during endarterectomy of the carotid artery].

Cranial nerve injuries may result from carotid endarterectomy. In a retrospective study of 222 surgical procedures, from July 1982 through June 1990 only three cranial nerve injuries were documented (1.35%). In a prospective study of 79 carotid endarterectomies performed from July 1990 through June 1992, there were 11 nerve injuries (13.9%), fortunately most of them were temporary. We conclude that carotid endarterectomy is associated with a much higher incidence of local nerve injury than retrospective surveys would indicate.

Cranial Nerve Injuries↗
PubMed1992

[Myointimal hyperplasia caused by vascular suture. A case report and general considerations].

Smooth muscle cell proliferation is a step of the repair process after vascular injury. A similar process occurs after percutaneous transluminal angioplasty and can lead to intimal hyperplasia and vascular restenosis. We have recently observed this process in an anastomotic restenosis after saphenous vein by-pass in the popliteal artery. We suppose that myointimal hyperplasia can also be an aspecific response to surgical intimal injury.

Aged↗
PubMed1990

A prospective study of local recurrence after resection and low stapled anastomosis in 183 patients with rectal cancer.

Local recurrence is the most serious complication of anterior resection for rectal cancer, usually occurring during the first two years after surgery. Over a five-year period, from 1981 to 1986, 183 patients underwent anterior resection for rectal carcinoma at the Surgery Ward of the University of Ferrara. Patients were followed for two years postoperatively. All operations were performed with staplers and classified according to Dukes, with 43 cases of Dukes' A; 83 cases of Dukes' B; and 57 cases of Dukes' C. In the first 24 months after surgery, the tumor recurred locally in 44 of the 183 patients (24 percent). Dukes' stage, grading distal resection margin, and histopathologic differentiation of the distal rectal ring left in the stapler after anastomosis were assessed to determine a prognostic indicator for the recurrence of the tumor. The stage:recurrence ratio was as follows: A, 1 (2 percent); B, 21 (25 percent); and C, 22 (39 percent). The grading:recurrence ratio was: G1, 13:51 (25 percent); G2, 24:110 (22 percent); and G3, 7:22 (32 percent). The ratio between distal rectal resection margin and recurrence was: 0 to 2 cm, 15:27 (56 percent); 2 to 4 cm, 16:74 (22 percent); and over 4 cm, 13:82 (15 percent). Histopathologic examination of the distal rectal ring was negative for all patients. These data confirm the direct relationship between class and local recurrence and indicate histologic grade and distal resection margin as significant prognostic parameters only when interpreted in the light of staging.

Adult↗