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Biomedical subjects

M Vitali

Publications and source records attributed to M Vitali.

14 recordsLinked to original sources

[Unusual anatomo-clinical features of thyroid metastasis].

The authors report a case of metastatic tumor from clear cell carcinoma in the thyroid gland occurred in a patient who had his primary tumor previously treated with right nephrectomy. The time interval before the appearance of the metastasis was 6 years. The diagnosis was made preoperatively because of the peculiar biological behavior of the primary tumor. In fact, the metastasis and the primary presented with neoplastic invasion of the middle thyroid vein and the renal vein respectively. The ultrasound examination revealed the vein thrombus arising from the thyroid and reaching the internal jugular vein through the middle thyroid vein. Subsequent fine needle aspiration biopsy confirmed the diagnosis of metastasis from clear cell renal carcinoma. The low grade of malignancy of the primary from the clinical point of view and the absence of other metastatic locations influenced the therapeutic approach.

Carcinoma, Renal Cell

Total thyroidectomy for benign thyroid disease: when and why.

Surgical complications after total thyroidectomy (TT) and subtotal thyroidectomy (STT) are analysed in a series of 364 patients operated on over a 36-month period. All operations were carried out because of the following 3 groups of disease: malignant tumors, multinodular goiter and Graves' disease. The difference among the incidence of surgical complications resulted to be not statistically significant when as discriminating factors the type of surgery or disease were used, while the difference was statistically significant when the results obtained in the 2 groups of patients operated only once or undergoing reoperative surgery for recurrence, were compared. Based on these observations, the surgical approach consistent with the above mentioned types of thyroid disease is reported, and the preference for total thyroidectomy is justified to a larger extent by what has been done to-date also in case of benign thyroid disease. The choice of the type of surgery should always be made, based on a careful clinical and intraoperative assessment of each case.

Adult

[Hepatic abscesses secondary to peritonitis: puncture and ultrasonically guided transparieto-hepatic drainage].

The Authors describe one case of duplex and separated hepatic abscesses secondary to perforated appendicitis and peritonitis. A contemporary literature review confirms the actual rarity of this entity. The patient was treated by percutaneous and transhepatic puncture and drainage of abscesses under sonographic control in two different stages. Material and methods of this technique are herein reported, in particular those concerning the management of the smaller of the two abscesses, located posteriorly into the lower segment of the right lobe of the liver, having a more difficult approach. The therapeutic results were excellent: either few days later percutaneous treatment than two months later after the patient was discharged, the clinical and sonographic controls confirmed a successful recovery.

Child

[Intraluminal diverticulum of the duodenum].

A case of intraluminal duodenal diverticulum associated with partial situs inversus in a 15 year-old girl is reported. Etiopathogenicity is discussed. The pathological characteristics explain that surgery associated with upper digestive endoscopy had to be performed and why endoscopic excision was not possible in this case.

Adolescent

The incidence of Down syndrome in northern Finland with special reference to maternal age.

The incidence of live-born children with Down syndrome was found to be 1.73/1000 (1:578) in northern Finland over the years 1965 to 1979. Despite a marked reduction in the proportion of older mothers, no significant change in the incidence was observed. Instead, an age-specific rise in the incidence for mothers aged 25 to 29 years could be shown during the last five-year period in years 1975 to 1979.

Adult

[Surgical treatment of obliterating arteriopathies of the lower limbs in the aged].

The Authors review 86 cases, aged over 70, needing surgical treatment because of atherosclerotic obstructive disease of the lower limb, stage III-IV. 35 patients underwent thigh amputation with 14% mortality in the early post-operative period (30 days) and 32% in the late post-operative period, considered up to 6 months. For 38 patients who underwent a revascularisation procedure mortality resulted 8% in the 30 post-operative days and 10% at 6 months. Escluding the aorto-iliac reconstructions through a trans-peritoneal approach, the overall mortality is limited to 3,2%. A major amputation was avoided in 76% of patients who underwent a revascularisation. On the base of their results the Authors discuss the indications of direct surgery in treatment of advanced ischemic lesions in elderly patients concluding that a surgical correction should be always considered in the aim of avoiding or limiting the amputation. In these high-risk elderly patients the extra-peritoneal aorto-iliac reconstructive technique must be preferred together with extraanatomical femoro-femoral or axillo-femoral by-passes.

Aged

Post-amputation pneumatic walking aid.

A pneumatic walking training aid is described that has been developed by the Biomechanical Research and Development Unit, Roehampton, from the original design by Little. The new design has been used in the management of 87 amputations, including 44 patients over the age of 70. Ninety-four per cent of these patients were rehabilitated to walking independently on a pylon or prosthesis.

Adult

[Treatment of thyroid neoplasms and proposed therapeutic plan].

Thirty-seven patients with thyroid cancer were treated at 1a Clinica Chirurgica of Parma between 1962 and 1970. Fourty-five per cent of tumors were papillary, 24 per cent follicular, 2 per cent medullary, 9 per cent anaplastic. Surgery combined with ormonal therapy formed the commonest treatment. Eighty-five per cent of the patients with papillary carcinoma 70 per cent with follicular and 33,3 per cent with anaplastic carcinoma survived for 10 years. This present series indicates that total thiroidectomy combined with ormonal therapy influences the survival time, confirms the prognostic value of histology and shows that papillary node metastases do not prejudice survival.

Adenocarcinoma

Immediate operative fitting of upper limb prosthesis at the time of amputation.

Three patients are described--2 with an above-elbow amputation and 1 with a through-wrist amputation--in whom a temporary prosthesis was applied on the operating table and in all of whom function was rapidly established. The patients did not become one-handed, with the result that they have all continued to wear their prosthesis throughout their working hours and use their artificial hand for all everday functions. The value of this technique in making the patient accept the prosthesis and therefore to make full use of it suggests that this procedure should be more widely applied in patients who require upper limb amputation.

Adult

[Gastro-esophageal reflux in childhood. When to operate?].

Gastroesophageal reflux has been well described in children as the cause of a variety of symptoms from nutritional to respiratory problems. If the regurgitation and vomiting are very common symptoms in newborns, their persistence after the first months of life will result in pathological entity leading to complications as esophagitis, failure to thrive, respiratory problems. The purpose of this article is to point out the functional and anatomical implications maintaining gastroesophageal reflux in children and the correct indications for surgery.

Child, Preschool