Biomedical subjects

M Frazzetta

Publications and source records attributed to M Frazzetta.

25 records · Page 2Linked to original sources

PubMedDate not supplied

[Ultrasonic dissector for total thyroidectomy: results of prospective randomized study].

In the last years, the introduction and employment in surgery of the dissectors of last generation (ultrasounds, radiofrequency, etc.) have contributed to a remarkable improvement and simplification of the performances and the surgical techniques. The present study has the aim to verify, on the basis of the experience made in the last two years and through a careful comparisons with operations performed in the usual way, the advantages of employment of ultrasonic dissector in thyroid surgery and if besides such advantages it is possible to obtain real and substantial reductions of the complications. To such aim a randomized perspective study has been lead, confronting two groups of 60 patients, submitted to total thyroidectomy in Chair of General Surgery and Surgical Physiopathology of the University of Palermo-Complex Operating Unit of General Surgery. In all patients have been considered age, sex, histological diagnosis, length of the incision, time (from the incision until suture of skin), entity of the bleeding, hospital stay, post-operative consequences and total costs of thyroidectomy. The elaboration of the obtained data shows the advantages following to the use of the dissectors of last generation: reduction of the times, reduction of the complications, better tolerance of the operation by patients, better rationalization of the resources.

Adult↗

PubMedDate not supplied

[Calcitonin inhibition of insulin-stimulated gastric secretion. A possibility of selective evaluation of gastric secretory function].

There is both clinical and experimental evidence for the antigastric effect of calcitonin. A study was therefore made of gastric secretion after maximum insulin stimulation, and during its inhibition by calcitonin. Evaluation of basal acid flow and the maximum acidity peak in these two tests showed that the difference between the two peaks was related to the increase in gastrin. This was not the case during inhibition. The results show that selective evaluation of gastric secretion enables selective surgical techniques to be employed in the treatment of duodenal ulcer.

Calcitonin↗

PubMedDate not supplied

[Chlorhydropeptic inhibition with atropine during stimulation with pentagastrin. A possibility of selective evaluation of gastric secretive function].

Basal secretion and the acidity peak have been evaluated in ulcerous patients during pentagastrinic stimulation and during atropinic inhibition, on the basis of the observations of Schofield et al. and in relation to the need to achieve correct identification and quantification of hydrochloric acid gastric secretive function. The results obtained with this technique suggest the possibility of a selective evaluation of the secretive function of oxyntic cells. This is extremely interesting because it opens the way to the most suitable surgical techniques for the treatment of ulcers.

Atropine↗

PubMedDate not supplied

[Short-term and long-term surgical prophylaxis with pefloxacin].

In the present study the efficacy and safety of pefloxacin (400 mg/5 ml vial) intravenously administrated for surgical prophylaxis was assessed. Nine hundred and fifty-two patients were treated (599 M, 343 F), with a mean age of 57.9 years +/- 18.6 SD, and in all cases surgical prophylaxis was carried out according to the following scheme: short-term with 2 vials (800 mg) 1 h before the operation, repeated at 12 and 24 hours after the operation; long-term 2 vials (800 mg) 1 h before the operation repeated at 12 and 24 hours after the operation and followed by 1 vial every 12 h for other 2 days. The choice between the two schemes was conditioned by the type of operation and by the basic conditions of the patient. Pefloxacin was seen to be effective in preventing the onset of post-surgical infections (97%), also maintaining the clinical parameters considered within normal limits. Safety was also highly satisfactory, since only 22 (2.3%) cases of side effects occurred, particularly involving the gastro-intestinal system. Thus, in conclusion, the validity of pefloxacin in surgical prophylaxis, with special emphasis on its efficacy in elderly and compromised patients is asserted.

Adult↗

PubMedDate not supplied

[Complications of the laparoscopic access].

The Authors analysed the complications observed during 156 laparoscopic accesses. In 38 cases following the classic closed technique, two pneumoderma, one pneumoscrotum, one pneumoepiploon and two laparoceles were observed in the umbilical area. In 30 patients the laparascopic access was performed according to the open technique, registering a significant loss of gas during the operation though not compromising it in 4 patients, and two infections of the umbilical incision. In 88 cases the modified closed technique was used and only one infection in the umbilical trocar insertion area was observed. After discussing the incidence, the etiopathogenesis, the diagnosis and the treatment of complications related to the laparoscopic access, the Authors emphasize the fact that in patients with surgical scars near the naval or patients who have already undergone laparascopy, or those with a positive history of affections causing abdominal adherence, the laparoscopic access must be performed using the open technique.

Adolescent↗

PubMedDate not supplied

[Hypoxemia and pulmonary atelectasis after laparoscopic cholecystectomy].

The aim of this study is to evaluate, after laparoscopic (CL) or open (CO) cholecystectomy, the incidence of pulmonary atelectasis and hypoxaemia which are strictly related to the onset of pulmonary complications. Two groups of 20 consecutive patients affected by symptomatic and not complicated gallstone disease were cholecystectomized either using CO or CL. Hypoxaemia was assessed preoperatively and after operation. Postoperative determination was performed at the 4th, 8th, 12th and 24th hour and then every 12 hours until discharge from hospital. A not informed radiologist evaluated atelectasis through two X-rays, preoperatively and postoperatively at the 3rd day. Atelectasis cases were divided in micro, focal, segmental, lobar and of the entire lung. Statistic analysis was performed using the "t" Student test. No mortality or intraoperative complications occurred. The two groups were similar for age, sex, smoker percentage, obesity, preexisting pulmonary dysfunctions and anaesthesiological risk (ASA). Operative time resulted in longer in CL compared to CO patients although in an insignificant way. PO2 value resulted significatively reduced (P < 0.05) at 4th, 8th, 12th and 24th postoperative hour after CO, while subsequent measurements did not show significant differences. There was no evidence of PO2 significative reduction after CL. After operation atelectasis was found in 11 patients (55%) of CL group (P < 0.05) and in 17 patients (85%) of CO group (P < 0.001). Atelectasis observed in the group of 11 CL patients was represented by 7 micro and 4 focal types, while in the CO group 7 micro, 8 focal and 2 segmental types were found. This study suggests that CL alters the pulmonary function less than CO.

Cholecystectomy↗

PubMedDate not supplied

[Ulcerated carcinoma of the breast in an elderly woman. An unusual clinical case report].

The authors analyze the most current methods for the treatment of ulcerated breast cancer in the elderly. They describe a peculiar case recently observed, characterized by an ulcerative lesion spreading from the hemiclavicle to the foreaxilla including the axillary cavity, causing a large phlebo-lymphaedema, anaesthesia and paresis of the homoteral upper limb. After an initial treatment with tamoxifen a scapulo-humeral disarticulation and a suture of the cutaneous wide defect were performed using a myo-skin graft which included the deltoid muscle. A radiotherapeutic treatment followed by tamoxifen therapy was carried out. No distant metastases and no local relapses were registered in the one year follow up. The Authors on the basis of their experience and according to the review of the Literature suggest that age itself is not a limiting factor to the therapeutic approach of ulcerated breast cancer.

Age Factors↗