Biomedical subjects

M Cappuccio

Publications and source records attributed to M Cappuccio.

6 recordsLinked to original sources

PubMed2001

Three years experience with the new intragastric balloon, and a preoperative test for success with restrictive surgery.

BACKGROUND: The BioEnterics Intragastric Balloon (BIB) is a smooth, spherical, saline-filled, silicone elastomer with a black radiopaque filling valve, intended to induce weight loss by limiting food consumption. This can be considered a "restrictive" procedure, and by using this balloon, we can assess the patient's eligibility for a restrictive surgical procedure (the BIB-Test). METHODS: From May 1997 to May 2000, 87 BIB were inserted in 77 moderately to severely obese patients (4 BIB in 1 patient, 2 BIB in 7 patients). 64 patients completed the treatment. Out of these, 18 (16 female, 2 male) underwent laparoscopic gastric banding after BIB removal. RESULTS: After the treatment (3-6 months), weight loss results were as follows: WL 14.3 kg, %EWL 23.5 and loss in BMI 5.3. 12 patients after the preliminary BIB, have been followed > or = 6 months after gastric banding, and have significant further weight loss. CONCLUSIONS: BIB appears to have good results. A supervised nutritional and behavioral regimen is mandatory. The balloon may be indicated to: 1) induce weight loss in patients whose obesity is not severe enough to warrant surgery; 2) reduce the surgical risk in those who are massively obese; 3) select patients for gastric restrictive surgery if they lose weight with the balloon. The data showed that patients who had good results with the BIB (positive BIB-Test) are still losing weight after subsequent gastric banding.

Adult↗

PubMed2000

Solitary necrotic nodule of the liver misinterpreted as malignant lesion: considerations on two cases.

In our experience, we document 2 cases of a rare and non-tumoral lesion of the liver misinterpreted as necrotic tumor: necrotic solitary nodule. In the first clinical case, ultrasound (US) showed a polylobated lesion (35 x 35 x 38 mm) at segment 8. Color-doppler identified a compression of celiac axis (Dunbar syndrome). Arteriography revealed a subtotal stenosis of celiac tripod soon after the emergence of the left gastric artery. FNAB-CT showed a highly cellulated tissue with a necrotic core surrounded by a fibersclerotic tissue. The patient underwent surgery: cholecystectomy and correction of Dunbar syndrome. US follow-up showed a progressive reduction in diameter of the lesion (24 x 25 x 25 mm at 24 months), suggesting in this case the role of ischemic injury in the pathogenesis of the lesion. In the second clinical case, a hypoechoic lesion (32 x 32 x 30 mm) of segment 6 as occasional US finding during the staging for prostate cancer was shown. FNAC-CT showed a positive result for necrotic cells. Surgical treatment consisted in a wide excision of the lesion. Histologically the lesion was solitary necrotic nodule. The diagnosis of this rare lesion is accidental. In accordance with the literature (50% of cases), we founded an associated tumor. Radiology doesn't differentiate solitary necrotic nodule and other solid lesions. Diagnosis is histological (in our second case, FNAC-CT misinterpreted the tumor as a malignant lesion, while histology showed the real nature of it).

Adult↗

PubMedDate not supplied

Symptomatic vertebral hemangioma: the treatment of 23 cases and a review of the literature.

It is the purpose of this study to analyze a group of 23 patients affected with hemangioma in one or more metameres of the vertebral column. On the basis of clinical examination and instrumental testing in time (minimum follow-up 12 months, maximum 217 months) the following treatment options are discussed: medical treatment and clinical monitoring closer in time; palliative surgical treatment whether or not associated with embolization of vascular afferences of the lesion and adjuvant treatment; intralesional surgical treatment whether or not associated with embolization of the vascular afferences of the lesion and adjuvant treatment. Skeletal hemangioma is a hamartomatous proliferation of vascular tissue, more precisely of endothelial tissue. This is demonstrated by its anatomical identity with other tissues and the existence of exceptional skeletal and multiple tissue hemangiomatosis that begin during childhood. Hemangioma is the benign tumor that is most frequently localized in the spine, involving about 10% of the world population, as reported in the literature on autoptic studies. It is often a solitary lesion, usually localized in the vertebral body, although it may extend to the posterior arch. There is predilection for the thoracic region of the spine, while it less frequently occurs in the cervical and lumbar spines. Generally, it remains asymptomatic throughout the entire life of the subject, so much so that it is often difficult to establish the onset of the lesion. Symptomatic hemangiomas (less than 1% of all hemangiomas) are those that are accidentally discovered via radiograms; they are most often observed during adult age. The most common treatment used for vertebral hemangioma associated with pain is radiotherapy, even if clinical observation represents a reasonable choice. Surgical treatment, preceded when possible by embolization of the vascular afferences of the lesion, is often associated with radiation therapy in cases where there is neurologic compression in addition to pain. It was the purpose of this study to analyze the long-term results obtained in a group of 23 patients affected with symptomatic vertebral hemangioma.

Adolescent↗

PubMedDate not supplied

Spinal metastases: treatment evaluation algorithm.

Spinal metastases are only apparently similar lesions, considering the large varieties of istotypes and the spread of the primary tumor. These metastases develop early and are not terminal events, they have to be considered as severe complications because, when possible, surgical treatment can improve the history of the patient in terms of life expectancy and quality of life. The approach to these lesions should be multidisciplinary in collaboration with oncologists and radiotherapists, in fact the average of survival of these patients has increased in recent years. The evolution of anesthaesiological techniques that permit surgical treatments that were once considered prohibitive. The application of new adjuvant therapy increases the effectiveness for surgical treatment. Controversy exist over the most appropriate treatment for patients with metastatic disease of the vertebral column. The purpose of this article was to determine the best sequential process to arrive at the most appropriate treatment considering the individual general conditions and the parameters of the metastases. We review 269 cases in 182 patients suffering from spinal metastases from a solid tumour treated between 1996 and 2002. As the number of treatment options for metastatic spinal disease has grown, it has become clear that effective implementation of these treatments can only be achieved by multidisciplinary approach.

Adolescent↗

PubMedDate not supplied

Giant cell tumor of the upper cervical spine: transmandibular-translingual access. Clinical case.

The authors describe the clinical case of a patient aged 18 years affected with giant cell tumor (GCT) at C3 who came to the surgical unit of Orthopaedics and Traumatology at the Ospedale Maggiore in Bologna after being treated by surgery elsewhere. Particular attention is paid to surgical access by means of median transmandibuloglossotomy used in order to obtain a sufficiently wide surgical field that can adequately expose the vertebral segment affected by neoplastic disease. In particular, possible complications that may be observed postsurgery can be compared to other surgical approaches to the upper cervical spine and above all that there are no permanent clinical sequelae.

Adolescent↗

PubMedDate not supplied

Solitary plasmacytoma of the spine: a 22 years follow-up case report.

BACKGROUND AND OBJECTIVES: Plasmacytoma is a systemic malignancy and it is the most frequent primary tumor affecting the skeleton. Progression from solitary plasmacytoma to systemic diffusion is reported to be 65-100% in 15 years. A case report of a rare 22-year follow-up of a thoracic solitary plasmacytoma is here presented. MATERIAL AND METHODS: Clinical case analysis, radiographs, magnetic resonance images and histological sections of the lesion are discussed. Repeated surgical interventions were required due to progression and local recurrence of disease. RESULTS: Although the inadequate surgical treatment, low response to chemotherapy and radiation therapy, and many local recurrences, no systemic diffusion of the disease was observed in 22 years. DISCUSSION: Aggressive surgery may be indicated in young patients with isolated lesion and good prognostic factors. Palliative surgery remains necessary in order to decompress the cord and to stabilize the spine.

Adult↗