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M Cesari

Publications and source records attributed to M Cesari.

At least 55 records · Page 3Linked to original sources
PubMed1997

Neoadjuvant chemotherapy for osseous malignant fibrous histiocytoma of the extremity: results in 18 cases and comparison with 112 contemporary osteosarcoma patients treated with the same chemotherapy regimen.

Eighteen patients with high grade malignant fibrous histiocytoma (MFH) of bone and 112 patients with high grade osteosarcoma (OS) of the extremity were treated with neoadjuvant chemotherapy comprised of methotrexate, cisplatinum, doxorubicin and ifosfamide. For the 18 patients with MFH, surgery involved amputation in 2 cases and limb salvage in 16 (89%); the 112 osteosarcoma patients had amputation in 8 cases and limb salvage procedure in 104 cases (93%). The rate of good histologic response to preoperative chemotherapy (90% or more tumor necrosis) was significantly higher in patients with osteosarcoma than in patients with MFH (74% vs 28%; p < 0.003). However, at a median follow-up of 38 months (range 25-61), the 3-year event-free survival (EFS) did not differ in the two groups (MFH 77.8%, OS 70.5%; p = ns). In patients with MFH, no local recurrences were registered, whereas in the osteosarcoma group there were 6 local relapses (5.%). The effectiveness of neoadjuvant chemotherapy in the treatment of osteosarcoma has been assessed during the last 15 years. The results of the present study seem to indicate that, in spite of a usually poor histologic response to preoperative treatment, neoadjuvant chemotherapy is very effective also in MFH of bone.

Adolescent↗
PubMed1996

Endothelin-1: a scientist's curiosity, or a real player in ischemic heart disease?

Endothelin-1, the most potent endothelium-derived vasoconstrictor peptide identified so far, exerts multiple biologic effects that are potentially relevant for the pathogenesis of coronary atherosclerosis and ischemic heart disease. Since the discovery of the peptide, a good deal of experimental and clinical data have been accumulated to support an important role of endothelin-1 in ischemic heart disease. In experimental animals, exogenous endothelin-1 was found to cause coronary vasoconstriction and, at higher doses, ventricular fibrillation and death. Endothelin receptor subtypes have been demonstrated and pharmacologically characterized in the coronary vascular bed. The plasma levels of immunoreactive endothelin-1 were found to be increased in patients with coronary atherosclerosis, acute myocardial infarction, and angina. Given its growth-promoting and mitogenic action, endothelin-1 has also been suspected to participate in the mechanism of restenosis after PTCA. The purpose of this study was to critically review the experimental and clinical data supporting the involvement of endothelin-1 in ischemic heart disease and the results of more recent studies on the effects of endothelin-1 blockade on experimental myocardial necrosis and restenosis after PTCA.

Angioplasty, Balloon, Coronary↗
PubMed1995

Expression of the endothelin-converting enzyme gene in human tissues.

Based on the cDNA sequence of the human and bovine endothelin converting enzyme (ECE-1) we have developed a novel reverse transcription polymerase chain reaction to investigate the tissue expression of this gene. We were able to specifically detect the gene mRNA starting from very limited amount of tissue in all human as well as bovine tissues examined. Thus, our results confirm a widespread expression of the ECE-1 gene in human tissues, in keeping with the findings in other species, and suggest a major biological role of ECE-1.

Adrenal Gland Neoplasms↗
PubMed1994

[Three-way tube for lavage and active aspiration for prevention and treatment of colorectal disunion and for surgery of acute necrosis of the pancreas].

We conceived and used from 1985 to 1992 a three-way trans-anastomotic tube for 183 left colectomies in order to prevent the disunion of colorectal anastomoses, and also to actively contribute to their treatment. The three-way lavage and aspiration tube was positioned during the suture of the anastomosis. One hundred and nine pre-tube anastomoses served as controls. Major intra-sub or entirely sub-peritoneal resections were performed in 94.61% of the cases. The number of disunions decreased from 4.85% to 1.09% including two cases with very low anastomosis with defective sutures. From July 1988 to 31 December 1992 there were no disunions in the 137 last anastomoses. The number of abdomino-perineal amputations was reduced from 81/109 resections in the pre-tube period to 37/183 in the with-tube period, i.e. from 42.63% to 16.81%. All of the disunions healed within 12-18 days. The length of hospitalization declined from 19-20 days to 11.6 days (11 days in the last 137 cases). We also used a three-way tube in 9 cases of acute necrosis of the pancreas. These cases require surgery as soon as possible. With or without sequestrectomy. All nine of our cases were discharged after successful treatment between day 14 and 39, and all returned to normal activities, with the exception of persistent diabetes in one. Secondary operations were never required.

Acute Disease↗
PubMed1991

[Diverticula of the duodenum. Our experience in 27 cases].

After the colon, the duodenum is the most common site of diverticula. The Authors describe their experience of the surgical treatment of 27 patients suffering from duodenal diverticulosis. Treatment of diverticula was associated with therapy for more severe underlying pathologies in 23 cases. Four cases underwent elective treatment for symptomatic diverticulosis. No major complications or increase in the average time spent in hospital were observed in either group.

Adult↗
PubMed1990

[A case of supernumerary spleen in the left pleural cavity].

An extremely rare case of supernumerary spleen contained in the left pleural cavity is reported. Only one other case of this type is known. The anomaly, which was discovered by accident, may be explained by the probable delayed fusion of the mesenchymal tissue islands which form the spleen bud at the embryonic stage. One of these islands was imprisoned in the chest by the diaphragm, which was also in the final stages of development, thus creating the supernumerary spleen.

Diaphragm↗
PubMed1989

[Biliary ileus. Our experience].

Personal surgical experience of 7 cases of typical gallstone ileus and 2 cases of Bouveret's syndrome secondary to spontaneous bilio-digestive fistula of lithiasic aetiology are reported. After analysing the problems inherent in the clinical picture and the diagnostic protocol, stress is laid on the therapeutic strategies employable in the event of typical gallstone ileus. It is concluded that single stage correction of the bilio-digestive occlusion and fistula is always preferable except in patients whose general condition is very poor. Patients should initially be submitted to treatment of intestinal occlusion alone.

Aged↗
PubMed1989

[Spontaneous bilio-digestive fistula of lithiasic etiology. Experience of 41 cases].

Spontaneous biliary-digestive fistulas represent a rare pathology, but an important one given the diagnostic difficulties and high operative mortality that still characterise the obstructive forms in particular. Personal experience of 41 cases is reported with a discussion of the symptoms, diagnostic procedures and surgical indications. The complete clinical aspecificity of the fistulas and their frequent association with choledocholithiasis and stricturing odditis are emphasised.

Adult↗
PubMedDate not supplied

Pain management in frail, community-living elderly patients.

BACKGROUND: Pain is a common problem among older people living in different community settings. As indicated by the World Health Organization (WHO), pain can be relieved using pharmacologic agents. However, pain continues to be addressed inadequately. OBJECTIVES: To describe the prevalence of pain in frail elderly people living in the community and to evaluate the adequacy of pain management. METHODS: We analyzed data from a large collaborative observational study group, the Italian Silver Network Home Care project, that collected data on patients admitted to home health care programs. Twelve home health care agencies participated in the project evaluating the implementation of the Minimum Data Set for Home Care instrument. We enrolled 3046 patients, 65 years and older, in the present study. The main outcome measures were the prevalence of daily pain and analgesic treatment. RESULTS: A total of 1341 individuals (39%, 49%, and 41% of those aged 65-74, 75-84, and > or = 85 years, respectively) reported daily pain. Of patients with daily pain, 25% received a WHO level 1 drug; 6%, a WHO level 2 drug; and 3%, a WHO level 3 drug (eg, morphine sulfate). Patients 85 years or older were less likely to receive analgesics compared with the younger patients (univariate odds ratio, 0.73; 95% confidence interval [CI], 0.60-0.89). Another independent predictor of failing to receive any analgesic was low cognitive performance (adjusted odds ratio, 0.80; 95% CI, 0.69-0.93). CONCLUSIONS: Daily pain is prevalent among frail elderly patients living in the community and is often untreated, particularly among older and demented patients.

Aged↗