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L Bertolaccini

Publications and source records attributed to L Bertolaccini.

8 recordsLinked to original sources
PubMed2005

Inguino-scrotal hernia of a double district ureter: case report and literature review.

Ureteral hernia is uncommon and usually misdiagnosed. From an anatomic point of view, we can distinguish between two uretero-inguinal hernias: intraperitoneal and extraperitoneal. Ureter inguinal hernias are nearly always indirect. This kind of hernia can include the ureter alone or, frequently, other abdominal sliding organs within the hernia sac (bladder, bowel tracts, etc.). Kidneys and urinary tracts present normal anatomic conformation, although renal ptosis may be found. As of July 2004, 139 cases of ureteral hernia had been described in the literature. Here we report a case of inguino-scrotal herniation of double district ureter and review the current literature to analyze the main clinical characteristics of this pathology and to establish pitfalls.

Diabetes Mellitus, Type 2↗
PubMed2003

[The role of surgery in the treatment of hepatic metastases from colorectal cancer].

Colorectal neoplasms are a common and frequently fatal illness. Presence of distance metastases from colorectal neoplasm does not preclude therapeutic treatments. Surgical resection is the standard treatment for hepatic colorectal metastasis. Some good results in hepatic metastasectomy are due to the progress of radiology which allows not only early findings of metastatic pathology but defines a surgical technique planning. Patients who are candidates for surgical resection are those with no extrahepatic pathology, resectable hepatic metastases with 1 cm of disease free margin and adequate residual parenchyma. Recurren-ces are shown in two thirds of surgical patients; this suggests that microscopic pathology persists commonly even after resection and that adjuvant therapy is critical. In recent years, many palliative techniques for hepatic cancers have been developed. Potentially useful role of these techniques is ablation of small lesions in patients with contraindications to hepatic resection, small recurrences not resectable, and not resectable neoplasms diffuse in both lobes. Accurate follow-up is essential after hepatic metastasectomy. In conclusion, patients with hepatic potentially resectable colorectal metastases should be evaluated by an expert surgeon, because better long-term outcome is derived from surgical resection.

Adenocarcinoma↗
PubMed2002

[Hereditary non polyposis colorectal cancer (HNPCC). A clinical and genetic entity].

The first description of hereditary non polyposis colorectal cancer goes back to Warthin's study in 1895. In 1966 two families with autosomal dominant predisposition to colon and endometrial cancer were found. This condition was defined initially as familial neoplasm syndrome, then Lynch syndrome, and at last hereditary non polyposis colorectal cancer (HNPCC). HNPCC is classically subdivided into Lynch syndrome I (characterized by predisposition to colorectal cancer with early age of onset, to cancer of the proximal colon, and excess of synchronous and metachronous cancer), and Lynch syndrome II (characterized by similar colic phenotype with augmented risk of extracolonic neoplasm). If all clinical characteristics are present, it is possible to suspect HNPCC: however, diagnosis is difficult. Histological and genetic features of colon cancer confirm the diagnosis of HNPCC. Surgical therapy of colic neoplasm is total colectomy. A careful screening of HNPCC family members is one of the cardinal point in prevention. Follow-up of these surgical patients is the same as for sporadic neoplasms.

Colorectal Neoplasms, Hereditary Nonpolyposis↗
PubMed2002

[The role of apoptosis in hepatic graft rejection].

In 1965, Kerr described a type of death, apoptosis, with different characteristics from necrosis. Apoptosis has an important role in the development and cell homeostasis. Excessive or insufficient apoptosis contributes to the pathogenesis of pathology like ischemia, neurodegeneration, autoimmunity, viral infection, and tumor growth or regression. Apoptosis is subdivided into four sequential phases: order of death; death of cell; phagocytosis of apoptotic bodies and degradation of apoptotic bodies. Death programs converge on sequential activation of a proteases family, caspases. Some aspects of graft rejection can be interpreted as failure of apoptosis in host immunity cells; sometimes rejection involves induction of apoptosis. Apoptotic-type lesions were found in early vascular occlusions, one of the cause of graft failure. Then, an augmented apoptosis in hepatic graft biopsy can be used like a signal of early vascular occlusion. In hepatic transplantation, apoptosis is followed by a proteolytic cascade, which causes sequential activation of caspases. Synthetic inhibitor of caspases can be used, then, in the prevention and/or treatment of pathologies with implication of apoptosis due to ischemia-reperfusion. These inhibitors are not enough for prevention of hepatic lesions, even if caspases inhibitor can be a strategy for treatment of hepatic graft rejection.

Apoptosis↗
PubMed2001

[Cancer immunotherapy. A future therapeutical choice?].

The idea that there might be an immune response to cancer has been around for many years. Immunotherapy has a long history, but is only rarely considered as the treatment of choice. Immunotherapy has encountered a number of intrinsic difficulties in cancer, such as the antigenic resemblance between the tumour and normal cells, the rapid kinetic proliferation of tumour cells and their reduced immunogenicity. There are various types of immunotherapy. Aspecific immunotherapy augments the body s immune response without targeting specific tumoral antigens. In adoptive immunotherapy, cells are administered with antitumoral reactivity to mediate neoplasm regression. Specific active immunotherapy is based on the principle that neoplasm cells contain immunogenic sites against which an antitumoral immune response can be induced in an attempt to stimulate the immune system to target specific tumoral antigens. Vaccines against cancer cells are based on a more precise identification of the tumoral antigen components. Passive immunotherapy was limited by the difficulty of obtaining high titering and specificity in early attempts using polyclonal antisera; monoclonal antibodies are currently used alone or in association with radioactive substances and cytotoxic agents. Enormous progress has been made this century in the use of immunotherapy for cancer treatment. It seems likely that the next century will see its increased afficacy, making it one of the possible therapeutic options.

Antibodies, Monoclonal↗
PubMed2000

[Treatment of pain in the oncologic patient].

Around 65-85% of cancer patients suffer from pain at advanced stages. Pain is often inadequately treated, although it can be controlled simply in the majority of cases. It is important to try and achieve a number of targets, including pain control at night, resting pain and pain during movement. Pain can be divided into somatic pain caused by the stimulation of traditional nociceptors, visceral pain and neuropathic pain caused by damaged nervous fibres. All three types may exist in the same patient. Drugs are the main method used to control oncological pain. The three main classes of drugs (FANS, opioid analgesics and adjuvant analgesics) are used individually or in combination. Given that the collateral effects of opioid analgesics may limit their value, they must be monitored to ensure careful treatment. The appropriate use of invasive treatment in patients with advanced disease who do not respond to oral therapy may alleviate cancer pain in 10-30% of cases. These adjuvant procedures are classified as blockades of autonomous nervous tissue, peripheral nerves and neuraxis. In conclusion, the ability to give an overall evaluation of a patient with pain, to ensure the component administration of analgesic drugs and to inform the patient and the family forms the basis of the treatment of pain in cancer.

Analgesics, Opioid↗
PubMedDate not supplied

[The treatment of malignant pleural effusions: the experience of a multidisciplinary thoracic endoscopy group].

More than half of neoplastic patients show in their clinical history the onset of pleural effusion. Malignant pleural effusion produces dyspnea, decreases respiratory function and quality of life in patients with advanced cancers. Optimal treatment is actually controversial. The aim of this study is to analyze the experience of malignant pleural effusion treatment of the Multidisciplinary Group of Thoracic Endoscopy. Patients are been subdivided in two group, depending on respiratory performance status and they are been submit to a Video-Assisted Thoracic Surgery (VATS) with talc pleurodesis and to positioning of a chronic indwelling pleural catheter. The treatment of malignant pleural effusion with the methods reported above allows, not only to achieve palliation of symptomatology, but also to achieve pleurodesis in patients with limited life-expectancy with good cost-beneficial ratio.

Aged↗