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N Mozzillo

Publications and source records attributed to N Mozzillo.

At least 37 records · Page 2Linked to original sources
PubMed1997

Post-operative complications after completion thyroidectomy for differentiated thyroid cancer.

The surgical approach to differentiated thyroid carcinoma is still controversial, as many authors consider it necessary to remove the whole gland. Therefore, when definitive histological diagnosis is made following limited resection, reoperation and completion thyroidectomy (CT) is sometimes recommended. The main indications are for follicular cancer or for patients with a carcinoma of > or = 1 cm previously treated with lobectomy or limited resection (early CT), or for local recurrence after previous treatment (late CT). Several authors, however, draw attention to the high rate of complications following completion thyroidectomy and advocate its use in more limited circumstances. The aim of the study was to evaluate the results of our experience with CT in the National Cancer Institute in Naples. Of 131 patients treated for thyroid cancer 35 (26.7%) underwent a CT. Re-operation was performed within 6 months in 26 cases (74.3%) and later in the remaining nine cases (25.7%): carcinoma in the residual gland was found in six cases (23%) of early CT, and in four cases (45%) in the late CT group with an overall incidence of 28.5%. Post-operative complications were: transient hypoparathyroidism, two cases (5.6%), permanent in one (2.8%). Transient recurrent laryngeal nerve palsy occurred in three patients (8.5%) and became permanent in one case (2.8%). Completion thyroidectomy can therefore be considered a safe procedure.

Adenocarcinoma, Follicular↗
PubMed1997

Fotemustine and dacarbazine plus recombinant interferon alpha 2a in thetreatment of advanced melanoma.

Forty-three consecutive patients with advanced melanoma not previously treated with cytotoxic drugs (22 of them had already received adjuvant recombinant interferon alpha 2a (rIFN alpha 2a)) were given a combination of intravenous (i.v.) fotemustine (FM), 100 mg/m2 on day 1, and dacarbazine (DTIC), 250 mg/m2 i.v. on days 2-5, every 3 weeks. rIFN alpha 2a was administered at the dosage of 3 MIU subcutaneously 3 times a week until progression. Four complete and 13 partial responses were registered, for an overall response rate of 40% (95% CI, 25-56%). Activity of this regimen was similar in patients with mainly visceral (10/22, 45%) or soft tissue (6/13, 46%) involvement. The median duration of responses was 24 weeks. Median survival time was 40 weeks, with a 13% 2 year survival rate. Neutropenia and thrombocytopenia affected 67% and 51% of patients, but were of WHO grade 4 in only 2% and 5% of them, respectively. Side-effects attributable to rIFN alpha 2a were mild and manageable. In conclusion, the combination of FM + DTIC and rIFN alpha 2a seemed well tolerated and relatively active in patients with advanced melanoma. However, the role of rIFN alpha 2a in affecting the long-term outcome of patients is still questionable.

Adult↗
PubMed1990

To assess the efficacy of prophylaxis in digestive tract surgery using a predictive model of complication risk.

One hundred and ninety-one patients, all candidates for major clean-contaminated surgery, were classified according to the risk of developing postoperative wound infection, using clinical and nutritional factors. A widely validated nutritional assessment model, the Prognostic Nutritional Index (PNI), was used preoperatively to evaluate the risk and probability of post-operative septic complications. Based on the predicted outcome, patients were assigned to either a poor or a good risk group for statistical comparison. A prospective, double-blind, randomized trial was performed to compare the effectiveness of the monocyclic beta-lactam, aztreonam, with gentamicin for short-term perioperative prophylaxis. In the poor risk group (PNI greater than 40), aztreonam prophylaxis significantly reduced postoperative septic complications (p less than 0.05). The use of an objective scoring system to assess the risk of postoperative sepsis is recommended for future studies on antibiotic prophylaxis as it offers a realistic assessment basis.

Aztreonam↗
PubMed1989

Multicenter study of aztreonam in the prophylaxis of colorectal, gynecologic and urologic surgery.

The preliminary results of four multicenter, comparative protocols on the efficacy and safety of aztreonam are discussed. This monobactam antibiotic was used as short-term prophylaxis in patients undergoing colorectal, gynecologic or urologic surgery. When compared with gentamicin in a group of 295 patients undergoing colorectal surgery, aztreonam significantly reduced the incidence of abdominal wound infection (p less than 0.025); it also reduced the incidence of perineal wound and intra-abdominal infections, although these differences were not statistically significant. In patients undergoing abdominal and vaginal hysterectomy, aztreonam was compared with cefotaxime (both combined with clindamycin) in 170 and 142 patients, respectively. No difference in the incidence of infection was found between the two treatment regimens. In the 175 patients undergoing transurethral resection of the prostate, aztreonam was compared with placebo. The prophylactic regimen significantly reduced the number of urinary tract infections (p less than or equal to 0.0001). Its efficacy was particularly evident during the first 10 postoperative days. Side effects experienced by patients taking aztreonam were minor and similar in all three treatment groups studied. Aztreonam (alone or combined with clindamycin) offers a new and efficacious alternative to the standard antibiotic regimens currently used prophylactically in the high-risk postoperative patient.

Abdomen↗
PubMed1989

Comparative multicenter study on efficacy and safety of aztreonam and gentamicin in prophylaxis of high-risk colorectal surgery.

The usefulness of antibiotic prophylaxis in reducing the incidence of postoperative infections following colorectal surgery has been defined in many clinical studies. Since a single antibiotic agent covering all the potential pathogens (i.e. Gram-negative aerobes and anaerobes) is not currently available, a combination therapy is usually administered. The present study reports the preliminary results on comparative efficacy and safety of aztreonam and gentamicin (both combined with clindamycin) as short-term prophylaxis in colorectal surgery. Four hundred and fifty-four patients, out of 495 enrolled, were considered evaluable. Incidence of abdominal wound infections was significantly lower in the aztreonam-treated group (5.8% vs 12.5% - p less than or equal to .025). The incidence of perineal wound and abdominal infections, of fever, of need for postoperative antibiotics and the length of postoperative stay were lower in the monobactam group, even if none of these differences were statistically significant. Gram-negative aerobic microorganisms were more often isolated in infected patients from the gentamicin group. Side effects were minor and similar in the two groups. From these preliminary data, the aztreonam-clindamycin combination can be considered a major candidate to replace many of the presently available oral and parenteral regimens.

Adult↗
PubMed1988

Chemoprophylaxis in the surgical ward: results of a national survey in Italy.

As part of a national program for the control of hospital acquired infections, a survey on the use of antibiotic chemoprophylaxis was conducted in 1050 public hospitals in Italy (95% of the total number of hospitals in the country). In each hospital, the chief of the general surgery ward was interviewed by means of a standard mail questionnaire. Answers were obtained from 479 surgeons (45.6%) after two mailings. More than 60% of these reported that they used chemoprophylaxis in clean surgery (mastectomy, splenectomy, hernioplasty). More than 80% used antibiotic prophylaxis in surgery in which antimicrobial prophylaxis is facultative (i.e. elective cholecystectomy, gastric resection), and 97.1% used antibiotic prophylaxis in large bowel surgery. The authors recorded starting times and duration of chemoprophylaxis. Cephalosporins were found to be the most commonly used antibiotics followed by penicillin.

Anti-Bacterial Agents↗
PubMed1987

Chemoprophylaxis in clean-contaminated surgery.

Prophylaxis should be restricted to operations for which its benefit has been established. These are mainly operations in which a viscus colonized by bacteria is opened and in which bacterial contamination is unavoidable. The most important principle is to ensure adequate blood levels of antibiotic at the time of surgery. The choice of antibiotic should be based on knowledge of bacteria likely to cause infection.

Administration, Oral↗
PubMed1984

First full blown syndrome of acute zinc deficiency in course of long term total parenteral nutrition: a clinical case.

The case of a surgical patient with a full blown syndrome of zinc deficiency is presented and the various implications related to a deficiency of this trace mineral are discussed. The symptomatology involved mental depression, visual disturbances, glucose intolerance, decreased serum alkaline phosphatase levels, wound healing impairment, eczematoid dermatitis and reduced humoral and cellular immune defences. Oral supplementation with zinc sulphate dramatically reversed the signs and symptoms of the syndrome and resulted in rapid wound healing. This case seems to have exhibited most of the different signs and symptoms reported from time to time in the literature. Awareness of zinc deficiency is being brought to light in many medical and surgical conditions. Total parenteral nutrition (T.P.N.) can exacerbate the lack of this trace metal and supplementation with fresh blood derivate are, as demonstrated, useless in these cases. Zinc, as component of various metalloenzymes, accounts for the clinical manifestations of its deficiency.

Alkaline Phosphatase↗