Biomedical subjects
Publications and source records attributed to M Pittaluga.
The aim of this article was to review the main indications of laparoscopic colostomy. A series of 9 patients is reported, stressing the technical steps of laparoscopic colostomy. The laparoscopic approach in patients with unresectable colorectal cancer permit to avoidance mayor laparotomy. In conclusion this technique appears safe, feasible and effective.
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The association between physical activity and a decreased risk of age-correlated diseases appears to be well established. Nevertheless, the relation between past life style and current health in the elderly is likely to be affected by interactions of environmental and genetic factors in mediating the effects of exercise on disease prevention. As a contribution to this general issue, a retrospective twin study was undertaken so as to take advantage of the classical twin method in assessing genetic influences on health status in the elderly. A more specific aim was to possibly identify and compare genetically identical elderly twins with substantial differences in previous exposure to physical activity, but otherwise similar life style factors and events, thereby allowing the application of the co-twin case-control method, a powerful experimental approach in which even a few cases may prove significant. The study involved the assessment of general health status (based on structured interviews, clinical examination and several functional and laboratory analyses) and life style in 27 male twin pairs, aged 71.0 +/- 2.6 and classified (through DNA analysis) as 13 monozygotic and 14 dizygotic pairs. Past and present physical activity were evaluated through the Modified Baecke Questionnaire for Older Adults. In general, higher intrapair correlations in monozygotic than dizygotic pairs for almost all clinical variables were found, thereby confirming the relevance of genetic effects. More specifically, five monozygotic pairs discordant for past physical activity were found: contrary to expectations and, notwithstanding this major difference, they did not appear to be less similar than other pairs with respect to general health status. More data are clearly needed, and the implications of these findings, if confirmed, may leave room for complex interpretations. Tentatively, however, one might be led to conclude that whatever protective role physical activity and other life style variables clearly play in general health, this may in the end be unable to offset strong genetic dispositions, particularly so when it comes to major risk factors, which, after all, is perhaps only reasonable.
The Authors present a case of an insidious onset of Crohn Disease (CD) in an elderly patient. Diagnosis complicated by extraintestinal manifestation properly of old age could be delayed and often made after surgery on the histological specimen as in our case. CD is uncommon as primary manifestation in old age, often unsuspected, incorrectly diagnosed and in many case the clinical features may lead to late diagnosis. Differential diagnosis of CD in elder people with fever, diarrhoea and abdominal pain is difficult and other symptoms affecting intestinal tract can closely mimic CD symptoms, although the pattern of clinical presentation in older patient resemble those in younger.
An Olympic gold medalist in a 20 km competitive walking race and his identical twin brother, also an Olympic athlete in the same event but with inferior performance, were tested in order to obtain some further insight into the relative importance of genetic factors in modulating athletic excellence. Both twins had undergone the same strenuous, long-term training for 19 years since the age of 15 under the guidance of the same coach. An assessment of their bio-behavioural profiles at 40 years of age, i. e. 7 years after they ceased training, revealed that intrapair differences were negligible in physiological attributes but divergent in personality traits measured. Respective values for the Olympic winner and his identical counterpart were as follows: Body mass index 23.2 and 22.7, cardiac mass index 85.4 and 84.4 g x m2, squatjumping 25.3 and 27.3 cm, VO2 at running speed 9 km x h(-1) 33.1 and 33.6 ml x kg(-1) x min(-1), VO2 max 57.1 and 58.6 ml x kg(-1) x min(-1) (72.5ml x kg(-1) x min(-1) for the Olympic winner at age 22 yrs), reaction to anger 97 and 9 and anger expression 2 and 76 in percentile of the State-Trait Anger Expression Inventory. Findings suggest that although genetic constitution and years of physical training are prerequisites for making an Olympic athlete, success may be largely influenced by personality traits.
Adenocarcinoma of the jejunum is a rare tumor. The diagnosis is often difficult and not early. The Authors report a case recently observed in their clinical practice and successfully operated, reporting also what's in the literature about.
Angioneurosis, together with bones and joints disorders, represents the most frequent clinical syndrome due to vibrating instruments. The authors report a general presentation of the disease, particularly focused on indications, usefulness and methods of plethysmography and Doppler C.W., as noninvasive diagnostic procedures.
Streptococcus pneumoniae causes lobar pneumonitis but primary peritonitis can occur in cyrrotic adults as well as in children affected by nephrosis and immunopathies. In young females peritonitis can be the consequence of infection localized at genital organs. Pneumococcal sepsis is becoming rare with the antibiotic era but resistance to penicillin is actually frequent and is becoming a problem for elderly. We report a case of a young woman affected by spontaneous primary peritonitis and pneumococcal sepsis. The prevalent symptoms were gastrointestinal: diarrhea and emesis. No infectious foci could be detected on imaging studies and during surgery.
Familial Mediterranean fever is an autosomal recessive hereditary disease characterised by recurrent fever, poliserositis, chest and/or abdominal pain. Up to date diagnosis is based on clinical symptoms, familial anamnesis and response to colchicine. It is an inflammatory reaction affecting serosal tissues but until recently different hypotheses have been suggested to explain the greatly increased chemotactic activity of the polymorfonuclear leucocytes. Identification of the function of the MEFV gene on chromosome 16 and its protein allows us to understand the pathogenesis of familial Mediterranean fever as well as provides a new diagnostic test and therapeutic measures. We describe a case of an young patient and review the literature.
A renal mass with not typical instrumental characteristic in patient in follow-up for ovarian neoplasia sets to the surgeon serious doubts about proper surgical strategy. Achieve of the conservative renal surgery assisted by the intraoperative use of the radiofrequency energy has allowed to preserve the renal function and the diagnosis of unknown angiomyolipoma.
Appendiceal mucocele is an uncommon disorder caused by accumulation of mucus within the appendiceal lumen. Mucoceles represent a heterogeneous group comprising various histopathologic lesions including mucosal hyperplasia, cystoadenomas, and cystoadenocarcinomas and prognosis is related to these subtypes. The most common symptom is pain or a palpable mass in the right lower quadrant on physical examination. The preoperative diagnosis is performed with abdominal U.S. and confirmed with CT scan; typical CT scan image is a capsulated cystic mass with calcification of the wall while U.S. pattern shows cystic lesion with the onion skin sign considered a specific sonographic marker for appendiceal mucocele. In conclusion a cystic mass sonographically detected with onion skin sign, in the presence of normal female reproductive organs, suggest the diagnosis of appendiceal mucocele.