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Biomedical subjects

N A Belnome

Publications and source records attributed to N A Belnome.

At least 19 recordsLinked to original sources

[Trans-anal resection of low rectal neoplasms].

BACKGROUND: The rising incidence of colorectal neoplasms, and in particular those localised in the lower rectum is stressed and the therapeutic opportunities offered by the trans-anal resection technique are underlined. METHODS: The indispensable conditions for adopting a surgical approach are pointed out. These are identified as the size of the neoplasm, which should not exceed 4 cm, the fixity, site, the polypoid and non-ulcerated nature of the lesion, and the involvement of not more than 1/4 of the circumference of the bowel. Using these inclusion criteria, the authors operated on five patients in the 4th Division of General Surgery at G. Martino Polyclinic in Messina, using trans-anal resection of low rectal neoplasm. RESULTS: No hemorrhagic complications or lesions in the visceral wall occurred. All patients underwent a follow-up of up to 36 months and to date no patient has presented long-term metastasis; local recidivation was observed in one patient after 14 months and this was treated using the trans-anal method. CONCLUSIONS: The authors affirm that trans-anal resection may be regarded as the elective treatment of patients with neoplasms confined to the visceral wall and without dissemination; it is palliative in cases where the tumour is larger than 4 cm, with lymph node involvement. But even in this case, and in more advanced situations, this method allows mortality due to occlusive complications to be reduced and ensures a better quality of residual life.

Adenocarcinoma↗

[Use of monofilament prosthesis in inguinal hernia treatment: cost-benefit ratio].

BACKGROUND: The authors aimed to demonstrate the real advantages in terms of cost and patient comfort of inguinal hernia surgery using monofilament prostheses. METHODS: A retrospective survey was carried out on two groups of patients: the first group, consisting of 1032 patients who underwent inguinal hernia surgery under general anesthetic between 1985 and 1995 at the Institute of General Surgery at the University Polyclinic of Messina, included cases of both emergency and elective surgery that did not use monofilament prosthesis. The second group, consisting of 348 patients operated under local anesthesia between 1996 and 1999 at the IV Division of General Surgery at the University Polyclinic of Messina, included cases of both emergency and elective surgery using tension-free techniques and polypropylene mesh. The numbers of recidivations and complications were compared, together with the relative costs of the methods used in both groups. CONCLUSIONS: In the light of these experimental results, it is clear that the use of biocompatible alloplastic materials in monofilament considerably reduces the risks of recidivation, without no significant increase in the number of dehiscences, infections or postoperative complications. Moreover, there was a striking reduction in costs linked not only to the shorter hospitalisation of patients and the reduced use of painkillers, but also a fall in the number of future hospital admissions owing to recidivation.

Cost-Benefit Analysis↗

[Biliary peritonitis caused hy hydatid disease].

After specifying that rupture of a hydatid cyst in the peritoneal cavity is one of the most serious and rarest complications of hepatic hydatidosis, attention is paid to the peritoneal hydatid (o chole-hydatid). The aetiopathogenetic mechanisms and the anatomo-pathological features of this type of lesion are described in brief. Finally, the personally employed diagnostic protocol and therapeutic strategy in the face of this feared complication are reported.

Chylous Ascites↗

[Conservative surgical treatment of acute hemorrhagic necrotizing pancreatitis].

The Authors though in theirs' opinion medical treatment is the primary therapeutical approach to Acute Necrotizing Haemorrhagic Pancreatitis (A.N.H.P.), state that the surgical treatment is indicated as soon as the necrotizing haemorrhagic evolution of the disease is strongly suspected. It should be conservative in type acting on the evolution of the disease and saving the anatomic integrity of the pancreas. The surgical technique adopted is described which consists in removing cellular debris as well as highly toxic necrotic pancreatic apparatus and it is completed by the endo-retroperitoneal perfusion for a continuous washing of the peritoneal cavity. In conclusion, they report their personal experience with 16 patients affected with A.N.H.P.

Acute Disease↗

[Sequential therapy with antiestrogens and progestational drugs in carcinoma of the breast in an advanced stage].

After discussing the mechanism of action of antioestrogens and medroxy-progesterone-acetate, the authors report on their experience with the sequential use of these two hormones in a group of patients with advanced cancer of the breast. After illustrating the results of their study, the authors conclude by stressing that the sequential use of these drugs appears to improve the quality of life of the patients with a significant increase in rates of complete or partial remission of the neoplastic disease.

Adult↗

[Importance and limitations of the immunological monitoring of patients with malignant tumors].

The authors, after considering the incidence of neoplastic diseases is particularly high in subjects suffering from congenital or acquired immunologic lacks, assert the importance to perform an immunologic monitoring in the patients bearing malignant neoplasms, with the purpose to identify and calculate the direrent deficits of the sheltering organism. Then, they state the method adopted for the study of the cellulo-mediate immunity (in vivo and in vitro) and the humoral one. At last, on the basis of the results they obtained, the Authors, as a conclusion, affirm there is always in neoplastic patients a certain degree of depression of tumour immunity (especially if cellulo-mediate), and it can be put in relation to the evolutive stage of neoplasm.

Adult↗

[Colo-rectal precancerous conditions: anatomo-pathologic and clinical aspects].

The authors, after emphasizing the value presently ascribed to the conception of "epithelial displasia" as initial histologic and cytologic alteration, common to all groups of patients with high risk of development of colorectal cancer, review the mani precancer lesions of large intestine. As a conclusion, they affirm the main target one presently aims at for the screening in groups with high risk is to precociously identify the stage of transformation of epithelial displasia into carcinoma, so as to be able to set up a timely treatment.

Adenoma↗

[Principles of rehabilitation of colostomy patients].

The authors, after pointing out the number of enterostomized patients in the last years was more and more increasing, study all the repercussions of metabolic, functional and psychologic nature which are arising in the patients subjected to ultimate colostomy. Then, they describe the principles of a correct rehabilitative program for such patients, consisting in performing a correct colostimy and rigidly following hygienicodietetic rules. At last the authors, as a conclusion, affirm the rehabilitation, through the creation of proper centers with specialized staff, should also aim at the resolution of the remarkable psychologic problems affecting such patients, so as to have them reinserted in the social context they are coming from.

Colostomy↗

[Clinico-statistical features of breast pathology in old age].

The authors, after discussing the incidence and etiopathogenesis of displastic and neoplastic diseases of breast in geriatric age, state their experience in the treatment of such illnesses. They emphasize the necessity for a treatment suitable for aged people, based on the selection of the patients, their preparation and the constant pre- and postoperative monitoring, and, as a conclusion, affirm the necessity for a strict interdisciplinary cooperation, pith the purpose to ecectively treat such pathology, showing a more and more increasing incidence in the population of the most advanced nations.

Aged↗

[Clinico-statistical features on the operative risk in old age].

The authors, after reporting the data concerning the increase of the average length of life and the increment of the population in geriatric age, studied the different aspects of the surgical risk. They consider the age, the existence or absence of associated diseases, the situation of the different organs or apparatuses, and the possibility to correct, in preoperative stage, the different functional unbalances remarked. At last, after confirming the conception whereby age for itself does not represent a specific factor of risk, they emphasize the importance of a multidisciplinary cooperation in the assistance to old patients, both during intervention and in the postoperative course.

Age Factors↗

[Treatment of occlusions caused by carcinoma of the left colon in the aged].

The Authors, after pointing out that, in geriatric age, the incidence of left colon carcinoma has significantly increased, and this, in a high quantity of cases, goes unnoticed in precocious stage, but appears "d'emblée" pith an occlusive situation, state their experience concerning the surgical treatment of occlusions due to left colon carcinoma in patients aged over sixty. From the evaluation of the results they obtained, the Authors assert that, if the operation is performed after a correct appraisal of the patient's general conditions and after an adequate counterbalancing of the metabolic and functional alterations, often present in old people, the operative mortality, the postoperative complications and the indices of survival are not so significantly different from those remarked in the young subjects.

Aged↗