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Biomedical subjects

M Catani

Publications and source records attributed to M Catani.

At least 19 recordsLinked to original sources

Small bowel intussusception: what is the role of laparoscopy?

Small bowel intussusception in adults is a rare surgical disease which almost always occurs as a complication of either benign or malignant lesion of the bowel that is working as a leading point. In adults, the surgical approach consists of the resection of the bowel involved to ensure the excision of the lesion below. The authors report a case of ileocecal intussusception occurred in a young woman, 35 years old, observed for abdominal pain and signs of small bowel occlusion. She underwent surgical resection of the ileocecal segment with laparoscopic approach. The authors discuss the feasibility of the laparoscopic approach in this rare surgical disease and its benefits in terms of patient's postoperative comfort and outcome.

Journal Article↗

[Systemic Salmonella Arizona infection: description of a rare surgical case].

Salmonella arizona enteritis has been described in patients resident in the southern states of the USA and in Mexico, whereas in Europe it is rarer. The virulence of this bacillus is, however, still little known and we have few descriptions of severe systemic infections, which are all present in patients with immune system impairment. Only two cases have been reported in Italy where the infection has occurred as severe sepsis with the pathogenic agent being isolated in the blood. Here we report what is, on the basis of our knowledge, the third case in Italy of a systemic Salmonella arizona infection.

Aged↗

Dietary cellulose has no effect on the regeneration of hemoglobin in growing rats with iron deficiency anemia.

The objective of the present study was to determine the effect of cellulose on intestinal iron absorption in rats during recovery from iron deficiency anemia. Twenty-one-day-old male Wistar-EPM rats were fed an iron-free ration for two weeks to induce anemia. At 5 weeks of age, the rats were divided into two groups (both groups receiving 35 mg of elemental iron per kg diet): cellulose group (N = 12), receiving a diet containing 100 g of cellulose/kg and control (N = 12), receiving a diet containing no cellulose. The fresh weight of the feces collected over a 3-day period between the 15th and 18th day of dietary treatment was 10.7 +/- 3.5 g in the group receiving cellulose and 1.9 +/- 1.2 g in the control group (P<0.001). Total food intake was higher in the cellulose group (343.4 +/- 22.0 g) than in the control (322.1 +/- 13.1 g, P = 0.009) during the 3 weeks of dietary treatment. No significant difference was observed in weight gain (cellulose group = 132.8 +/- 19.2, control = 128.0 +/- 16.3 g), hemoglobin increment (cellulose group = 8.0 +/- 0.8, control = 8.0 +/- 1.0 g/dl), hemoglobin level (cellulose group = 12.3 +/- 1.2, control = 12.1 +/- 1.3 g/dl) or in hepatic iron levels (cellulose group = 333.6 +/- 112.4, control = 398.4 +/- 168.0 g/g dry tissue). We conclude that cellulose does not adversely affect the regeneration of hemoglobin, hepatic iron level or the growth of rats during recovery from iron deficiency anemia.

Anemia, Iron-Deficiency↗

Plasma antioxidants are similarly depleted in mild cognitive impairment and in Alzheimer's disease.

In order to assess peripheral levels and activities of a broad spectrum of non-enzymatic and enzymatic antioxidants in elderly subjects with mild cognitive impairment (MCI) and Alzheimer's disease (AD), plasma levels of water-soluble (Vitamin C and uric acid) and of lipophilic (Vitamin A, Vitamin E and carotenoids including lutein, zeaxanthin, beta-cryptoxanthin, lycopene, alpha- and beta-carotene) antioxidant micronutrients as well as activities of plasma and red blood cell (RBC) superoxide dismutase (SOD) and of plasma glutathione peroxidase (GPx) were measured in 25 patients with MCI, 63 AD patients and 53 controls. Peripheral levels and activities of antioxidants were similarly lower in MCI and AD patients as compared to controls. As MCI may represent a prodromal stage of AD, and oxidative damage appears to occur as one of the earliest pathophysiological events in AD, an increased intake of antioxidants in patients with MCI could be helpful in lowering the risk of conversion to dementia.

Aged↗

[Early laparoscopic cholecystectomy in the treatment of acute cholecystitis].

BACKGROUND: The aim of the study was to demonstrate the importance of early laparoscopic cholecystectomy for acute cholecystitis. METHODS: From 1998 to 2000, 66 patients were submitted to laparoscopic cholecystectomy. All patients were submitted to US scans preoperatively and operated on by surgeon skilled in emergency laparoscopic operative technique. RESULTS: Only one patient (1.5%) had conversion to open cholecystectomy. There was no mortality and no bile duct or major vascular injuries. The overall operative morbidity rate was 3%. The mean postoperative hospital stay was 3.1 days. CONCLUSIONS: Author's experience and results support the validity of early laparoscopic cholecystectomy in the treatment of acute cholecystitis, since it reduces the postoperative length of hospital stay and hospital costs. Early treatment is always helpful for inflamed and oedematous tissue which favours dissection.

Acute Disease↗

[Laparoscopic inguinal hernia repair "IPOM" vs "open tension free". Preliminary results of a prospective randomized study].

AIM: The authors report the preliminary results of a prospective comparison of IPOM (group A) and "open tension free" (group B) hernioplasty in 50 patients having a mono or bilateral primitive hernia. METHODS: In group A (26 patients) hernia repair was performed using "Gore-Tex DualMesh Plus biomaterial with holes Corduroy" and in group B (24 patients) using the patch and plug technique with Marlex prosthesis. RESULTS: No intraoperative complications occurred and, in group A, no conversion was necessary. Four minor complications were obser-ved in group A (10.8%): 3 seromas and 1 transient paresthesia; 5 in group B (16%): 4 hematomas and 1 wound infection (p=n.s.). In group A only 2 patients (7.6%) needed analgesics after the first 24 hours and 12 patients (50%) in group B (p<0.001). Mean resumption of normal activity was 8 days in group A and 17 days in group B (p<0.001). At a 12-month-follow-up, no recurrence was reported in both groups. CONCLUSIONS: The results of this prospective randomized study show that IPOM may be not only a feasible and effective procedure in the treatment of recurrent and bilateral hernia or when hernia repair is performed during other laparoscopic procedures, but also in particular cases of primitive hernia such as in very active young males or heavy duty workers. However it is necessary to definitely ascertain the true incidence of recurrence in non limited series and in longer follow-up and the preliminary results of this study encourage the authors to complete the randomized study.

Adult↗

[Popliteal artery entrapment syndrome. Case report].

Popliteal artery entrapment syndrome (PAES) is an uncommon pathological entity, due to segmental popliteal artery compression by the surrounding myofascial structures. Clinical symptoms may appear acutely, with temporary ischemic attacks, or chronically, with claudicatio intermittens of the involved calf and for 30% bilateral. Treatment, generally, is surgical by simple freeing of the popliteal artery from the surrounding myofascial structures or by autologous vein (saphenous v.) interposition grafting and patching, or bypass without vessel resection. The case of a 44-year female with left calf acute pain symptoms, cold skin at the thermotouch, hypo-paresthesia with fifth toe cyanosis and walking inability is reported. The surgical treatment, because of early diagnosis, consisted of simple cut of myofibrous bundle starting from the medial head of the left gastrocnemious muscle and compressing the popliteal artery, with clinical complete resolution.

Adult↗

(1)H-MR spectroscopy differentiates mild cognitive impairment from normal brain aging.

This study aimed to characterize the white matter biochemical profile of healthy elderly subjects, mild cognitive impairment (MCI) subjects, and early Alzheimer's disease (AD) patients. We used proton magnetic resonance spectroscopy ((1)H-MRS) to measure myo-inositol, creatine, N-acetylaspartate (NAA) and choline levels from a volume of interest located in the paratrigonal white matter bilaterally. A significantly higher myo-inositol/creatine ratio was found in MCI subjects and AD patients than in controls. The NAA/creatine ratio was reduced in AD patients in the left hemisphere compared to control subjects. The choline/creatine ratio was not significantly different among the three groups. These data suggest that MCI is different from normal brain aging, having a white matter biochemical pattern similar to AD.

Aged↗

[Duodenal ulcer and Helicobacter pylori].

BACKGROUND: The purpose of this study was to evaluate the relationship between duodenal ulcer (DU), Helicobacter pylori (Hp) infection and genetic and enviromental factors, and its influence on treatment and long-term RESULTS. METHOD: In the course of an epidemiological study on the prevalence of esophagogastroduodenal diseases, 1,169 volunteers underwent an endoscopy of the upper part of the gastrointestinal tract. The relationship of incidence rate and size of duodenal ulcers and several risks factors was investigated. RESULTS: A DU was observed in 240 subjects (20.5%), mostly of male gender (64.4% - p<0.0001). The Histological presence of a gastric Hp infection was confirmed in 179 cases (74.6%); it did not influenced the mean size of the ulcers and the presence of gastric intestinal metaplasia, compared to subjects without Hp infection. However, a superficial chronic gastritis was observed in 95.9% of Hp+ subjects and in 83.3% of Hp- (p<0.003), whereas a familiar history of DU was noted in 33.3% of Hp+ subjects and in 50.8% of Hp- (p<0.02). The main risk factor for DU was represented by Hp infection in 119 cases (49.6%), by infective and genetic factors in 60 cases (25%) and only by the genetic factor in 31 cases (12.9%), and was not detected in 30 cases (12.5%). Ulcer recurrence rates, after medical therapy, were 0,5% and 6.5% (p<0.03) at a 2-month follow-up, and 2.2% and 49.1% (p<0.00001) at a 12-month follow-up, among Hp+ and Hp- patients, respectively. CONCLUSIONS: The most common risk factor for DU was a gastric Hp infection, alone or associated to the genetic factor. Since the high incidence of recurrences at a 12-month follow-up, patients affected with a DU but Hp- represented an important therapeutic concern.

Adolescent↗

[Acute cholecystitis in patients over 70 years old].

BACKGROUND: Gallstone disease is the most common surgical indication in the elderly. Post-operative prognosis is severe in elderly with acute cholecystitis. Aim of this paper is to investigate the factors responsible for the severe prognosis and to detect how it could be improved. METHODS: One hundred fifty-seven patients, aged between 70 and 85 years (average 82 years), undergoing cholecystectomy between the years 1990 and 2000 have been studied; 65 patients (group A) had acute cholecystitis; 92 (group B) had uncomplicated gallbladder stones. RESULTS: Acute cholecystitis was the first symptom of gallstone disease in 69.2%. Laparocholecystectomy was performed in 31 cases (47.6%) of group A and in 58 cases (63.7%) of group B. In those cases with acute cholecystitis the postoperative morbidity (18.4%) was higher than in group B (1.0%), (A vs B: chi(2)=15.3; p<0.001). Similarly, postoperative mortality was higher (6.1% vs 1.0%; chi(2)=3.2; p<0.05) The severe postoperative prognosis was correlated significantly to index ASA (ASA II vs IV: chi(2)=7.0; p<0.001) but not to the technique adopted for cholecystectomy (VLC vs open: (chi)2=0.01; p=n.s.). The results obtained seem to confirm that the high incidence of postoperative complications in acute cholecystitis is due to the presence of associated diseases in elderly patients accompanied by the septic state. CONCLUSIONS: Early colecystectomy, in those cases with symptomatic, uncomplicated gallstone disease, might avoid severe postoperative prognosis in the elderly.

Acute Disease↗

[Laparoscopy in emergency: treatment of choice in acute abdomen].

From 1992 to November 1999, 225 consecutive cases of acute abdomen were observed: 163 suspicious acute appendicitis, 7 ovarian cysts with suspect torsion, 4 intestinal occlusions, 1 digestive hemorrhage due GIST (Gastro-Intestinal Stromal Tumor), 1 case of hemoperitoneum after laparoscopic appendectomy and 49 cases of acute cholecystitis. In the 225 cases of emergency laparoscopic operations for acute abdomen the diagnostic accuracy has been of 99.5%, with only one case of conversion in to laparotomy for diagnosis. The conversion from laparoscopic to laparatomic surgical technique was registers in 2 cases (1%). The realimentation started in all the cases with a liquid diet as soon as 6 hours after the operation and with solid foods the following morning. The Authors haven't registered wound contaminations. The patients of working age rehabilitated in 8 days (between 7 and 21 days). In the athletic patients the average rehabilitation time was 15 days. On the base of the results obtained with their video-laparoscopy experience in acute abdomen emergency surgery, the Authors confirm that this technique can be advised as Emergency Surgery's first choice treatment.

Abdomen, Acute↗

[Reflux oesophagitis and risk factors. Results of a population study].

BACKGROUND: To evaluate the prevalence and endoscopic grade of reflux oesophagitis (RO) and to correlate them to symptoms and to a list of risk factors including age, sex, weight, smoking, alcohol, work, hiatus hernia. METHODS: This study was carried out in Roccacorga (LT), a little town of 3435 inhabitants in central Italy. The sample totalled 1084 volunteers, aged over 18 years old and enlisted in opened cohort. After filling in the questionnaire, all the patients were subjected to esophagogastroduodenoscopy without eating for at least six hours and diazepam pretreated (10 mg ev). Three biopsies were routine performed on the 3 biopsies on distal esophagous wall. The RO range was evaluated according to the Savary-Miller classification. RESULTS: The RO was found in 443 patients (188 M, 42%; 255 F, 58%) (p<0.0002), a large number of asymptomatic patients (39%). The prevalence of hiatus hernia was 7.2%, RO associated in 60.3% (p<0005). The prevalence of associated gastroduodenal injuries was pointed out (p<0.03). Patients affected only by RO were mostly female (p<0.02). Precancerous esophagous were 0,37%. CONCLUSIONS: According to this study the RO diagnosed through endoscopy is much more prevalent than supposed, especially among females and it affects a younger age than reported (31-50 years). Smoking and alcohol are among male risk factors, while, in female, agricultural works, weight and hormonal state could have a leading role (p=NS).

English Abstract↗

[Current therapeutic orientation toward testicular germ cell tumors].

Personal experience in a case of primary germinal tumor of the testis in advanced state is described. The initial treatment was chemioterapy: the patient received four complete cycles of cisplatin-based chemoterapy (PEB scheme). A surgical treatment consisted of a radical inguinal orchiectomy with high ligation of the spermatic cord at the deep inguinal ring associated with interaortocaval lymphonodes dissection. Actually, after two years from the beginning of treatment, the patient is well, without signs of neoplasm disease.

Adult↗

[A rare case of epidermoid carcinoma of the breast].

A case of a 76-year-old woman who seemed to suffer from Paget's disease of the breast, is reported. The patient was submitted to surgical of the breast, is reported. The patient was submitted to surgical treatment of the lesion and histological examination of the specimen showed a rare case of epidermoid carcinoma of the breast.

Aged↗

[VIPoma: surgical treatment].

This paper reports a case of pancreatic VIPoma with widespread hepatic metastasis which was treated for approximately 2 years with a synthetic somatostatin analog (SMS 201/995). The treatment of choice in cases in which the tumour was fully removable is surgical resection. This occurred rarely since approximately 80% of VIPomas are malignant and are operated late when local infiltration is already widespread; in addition, 50% of cases are already metastasised at diagnosis. In this case, due to the infiltration of the superior mesenteric artery by the primary tumour it was necessary to carry out a left pancreasectomy which included two-thirds of the neoplastic mass. This was justified by slow tumour growth and also facilitated control of diarrhea and ensured a greater efficacy of possible postoperative chemotherapy. The use of synthetic somatostatin analog (SMS 201/995) enabled diarrhea to be satisfactorily controlled and is therefore specifically indicated for this type of tumour. NSE serum assay (neuron specific enolase) allowed the evolution of disease to be monitored during follow-up.

Female↗

[Locoregional staging of cancer of the rectum with transrectal echography].

Accurate preoperative staging of rectal cancer is very important for both prognosis and the choice of surgical approach. The authors report the results obtained by means of endorectal US in the locoregional staging of medium-low rectal neoplasms. The TNM UICC 1988 classification was considered as reference. US findings were compared with histologic results. Thirty-seven patients with rectal cancer were studied with endorectal US; they had been selected on the basis of rectal examination findings, of combined endoscopy and biopsy, and barium enema results. US was performed only when the lesion was confined within 13 cm from the anal edge. US and histologic findings were compared in 32 of 37 patients; in 2 cases surgery could not be performed, and 3 patients could not undergo US due to the presence of a tight rectal stenosis. Overall US sensitivity was 87.5%. T1 (2 cases) and T4 (2 cases) staging was always correct; 2 of 16 patients were understaged as T2 (T3), while 2 of 12 were overstaged as T3 (T2). In conclusion, endorectal US appears to be an accurate method for the locoregional staging of rectal cancer.

Adult↗

[What happened to Zollinger-Ellison syndrome?].

Three Zollinger-Ellison syndrome patients were treated during the period January 1977 to June 1978. The first patient is in good health 11 years 3 months after a total gastrectomy as is the second patient, 11 year after the enucleation of a cephalo-pancreatic gastrinoma. However the third patient died from malignancy 5 years after a total gastrectomy and enucleation of a cephalo-pancreatic gastrinoma followed by therapeutic cycles with streptozotocin and 5-fluorouracil. The decline in the Zollinger-Ellison syndrome over the last ten years is examined and the type of surgical treatment is discussed. Total gastrectomy once advocated as the preferred treatment, is now reappraised because of the effectiveness of medical therapy in controlling ulcers and because of the frequent malignancy of pancreatic gastrinomas.

Adult↗