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Biomedical subjects

P Croce

Publications and source records attributed to P Croce.

At least 19 recordsLinked to original sources

[Ultrasonographic evaluation of timing in emergency cervical cerclage].

The aim of the present paper is to utilise endovaginal ultrasonography as an instrument for establishing the most appropriate moment for carrying out cervical cerclage after interrupting uterine contractions in a situation of near miscarriage. A patient at 20 weeks and 4 days of gestation, with contractions, integral membranes and complete dilatation, was laid in the Trendelemburg position, keeping the bladder moderately full, and given tocolytic therapy. After 14 days cerclage was carried out on a reconstituted neck. At 37 weeks and 1 day, the patient delivered a female newborn weighing 3.100 g. The Trendelemburg position, the moderately full bladder and tocolytic therapy with endovaginal ultrasonographic monitoring can move the timing of surgery forward so as to render it safer and more useful for prognostic purposes.

Adult↗

Gastric carcinoma detected by cervical cytology.

This paper is a report on a case of gastric carcinoma of diffuse type in a young female patient aged 38. The patient was still asymptomatic at hospital admission, her only pathological sign being the finding of malignant cells of indeterminate origin at a routine Pap-test examination. Subsequent investigations showed the presence of a poorly differentiated gastric carcinoma, with metastatic diffusion to uterus, ovaries and peritoneum. Only a few cases of gastric carcinomas without cervical localization, detected by Pap-test, are reported in literature. A few other cases with cervical localization have been described. The aim of this work is to point out that a Pap-test smear may reveal the presence of extragenital tumors still unappreciated.

Adenocarcinoma↗

[Cloacal exstrophy, ultrasonic diagnosis].

This study aims to underline the importance of transvaginal ultrasonography in the first three months of pregnancy. The authors report a case which was referred to their attention for preliminary tests performed prior to amniocentesis, recommended by the general physician because of the mother's age. The primapara woman and father of the fetus were healthy and the family history excluded hereditary diseases or congenital pathologies. Transvaginal ultrasonography permitted the diagnosis at the start of the fourth month of pregnancy of a polymalformed fetus with cloacal exstrophy, sacral myelomeningocele, clubfoot, single umbilical artery. In this case, the mother decided to undergo eugenic abortion in view of the severity of the pathology.

Cloaca↗

[Endometriosis of the ileum and colon complicated by intestinal obstruction. Report of two cases].

The authors report two cases of intestinal occlusion, one ileal and the other colic, caused by endometriosis. Both patients underwent surgery. Following a review of data in the literature regarding the frequency, pathogenesis, diagnosis and management, the authors conclude that pre- and intraoperative diagnosis is often impossible in these cases and must be postponed to histological analysis. Full remission was achieved after surgery.

Adult↗

[Selective episiotomy. Comparison of two suture technics].

AIMS: The study aimed to highlight any differences between the sequelae of episiorrhaphy performed using the Blair-Donatti and Guilmen-Pontonnier techniques. METHODS: A total of 202 pregnant women were recruited in the Obstetrics Ward of Codogno Civic Hospital in 1994 and 1995. Subjects were randomly divided into two groups matched for socioeconomic status, age and parity (group A: Guilmen-Pontonnier suture, group B: Blair-Donatti suture). The following parameters were evaluated: pain twenty-four hours, sixty-six hours and one, two and three months after labour, pain during sexual relations, the onset of infection, hematoma, dehiscence of the wound, and lastly the cosmetic results. RESULTS: No significant differences were found between the parameters examined in both groups, barring the improved cosmetic result in group A.

Adult↗

[A clinical study of the use of a combination of glucomannan with lactulose in the constipation of pregnancy].

RATIONALE: Constipation is a problem frequently encountered during pregnancy as is excessive weight gain. Treatments of common use to control constipation are endowed with some drawbacks and they are not active in controlling weight increase. A preparation of lactulose and glucomannan in previous studies proved very effective and well tolerated in patients affected by stypsis and evidentiated also activity both in controlling excessive food intake and in correcting some metabolic imbalances regarding lipids and urea. MATERIAL AND METHODS: 50 pregnant females affected by constipation were treated with sachets containing a preparation of glucomannan (1.45 g) and lactulose (4.2 g) in a posology of 2 (1-4) sachets a day for 1-3 months. RESULTS: Treatment induced a return to normal frequency of weekly number of evacuations (4.9-5.8/week) and a parallel control of weight gain (within 20% of initial body weight). The latter finding seems to be related to hunger control induced by glucomannan at the gastric level which prevents an excessive food intake.

Cathartics↗

The four postulates of Robert Koch.

A critical revision of the "Four postulates of Koch". The erroneousness of the 3rd and 4th postulates are justified in an historical perspective. Koch could not foresee the future progress of medicine and microbiology, but he could have imagined it; imagination is an endowment of scientific thinking. Koch considered science as a static and incontrovertible activity, but did not foresee the future development of that technological progress that soon after allowed to "see" the viruses and greatly widened the concept of infection.

Animals↗

[Hydronephrosis in pregnancy. Ultrasonographic study].

Hydronephrosis is a common pathology during pregnancy and according to some authors affects between 80 and 90% of women in the third trimester. The right side is most frequently affected. Moreover, there appears to be no relation between parity and hydronephrosis or between previous infections of the urinary tract and hydronephrosis; however its presence, especially if severe, is associated with urinary infections with a frequency which is significantly greater than in patients with a urinary tract within normal limits. There are two pathogenetic hypotheses: one identifies the inhibitory effect of progesterone and prostaglandins on muscular tone and the peristalsis of smooth ureteral muscle, with consequent dilatation and anfractuosity of the excretory tract above the pelvic brim; the other is the mechanical hypothesis based on the possible compression of the ureter caused by the pregnant womb at the level of the pelvic brim at the intersection with the ilial and ovarian vessels. One hypothesis does not exclude the other, but on the contrary they complement each other and give added plausibility to a multifactorial pathogenesis. The study of hydronephrosis in pregnancy has made considerable progress since the introduction of echotomography in image diagnosis, a low-cost method which is easy to use and does not harm the product of conception. Echographs with 3.5 MHz probes were used to carry out a prospective study by examining the kidneys and excretory tract in 370 asymptomatic pregnant women during the first, second and third trimesters of gestation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Gynecomastia].

Gynecomastia is a benign pathology due to the increased volume of the mammary glands. The various etiological factors lead to an imbalanced estrogen/androgen ratio or to a greater local receptivity to the former with consequent hypertrophy of the mammary stromal gland components. Although the majority of cases are benign and/or transient, gynecomastia must be carefully examined using thorough anamnesis, hormone assays and instrumental tests in order to exclude local or further removed pathology. At present, medical or surgical therapy is reserved for those cases in which this condition is painful and/or psychologically damaging. In this study, following a review of the literature, the Authors focus on the etiological, diagnostic and therapeutic aspects of gynecomastia and illustrate the cases they have observed.

Adolescent↗

[Intestinal volvulus in pregnancy].

Intestinal occlusion is a rare pathologic event during pregnancy occurring mostly in the second and third trimenon when increased volume of the uterus and the consequent displacement of abdominal organs cause complications of pathologies which would otherwise escape notice, such as intestinal adhesions, to become manifest. Diagnosis is difficult for a number of reasons. Vomiting during the first trimenon and mild abdominal pain during the third are often neglected or considered to be part of the normal course of pregnancy; pain is sometimes referred to atypical sites due to the displacement of abdominal organs; in other cases, the high endorphin tonus is apt to reduce the customary defence reaction. All this should not cause time to be lost, and whenever intestinal occlusion is suspected all the necessary diagnostic procedures must at once be carried out and appropriate therapy must speedily be started so as to reduce the risk of mortality and morbidity for mother and fetus. Management of ileus in pregnancy is identical to that for the non pregnant woman, except for the need to empty the uterus in cases in which it prevents treatment or if the fetus has reached a sufficient degree of pulmonary maturity. The paper describes a case of ileal volvulus and revisits the literature analyzing the diagnostic and therapeutic options suggested.

Adult↗

[Ultrasonography and ultrasound-guided biopsy in lymphomas].

The authors have reviewed the literature on imaging techniques for the diagnosis of lymphoma. Lymphography, axial computerized tomography (CT) and echotomography have been compared as to their sensitivity and specificity. Lymphography allows diagnosis of the disease even in lymph nodes of less than 0.5 cm diameter, but this technique cannot be applied to all lymphatic station. Echotomography and CT are equivalent as to the accuracy of diagnosis and are both helpful for guided needle biopsy. In view of its low cost, echotomography is considered by most workers the first-line approach to the evaluation of lymphoma patients. In spite of its advantages over other methods, echotomography must, nevertheless, be integrated by CT, lymphography, and nuclear magnetic resonance.

Biopsy↗

[Diagnosis of breast carcinoma. Comparison of clinical, mammographic, echographic and cytological aspiration diagnosis in a group of 50 patients].

The study assesses the sensitivity of clinical, mammographic, echographic and needle biopsy tests in a sample group of 50 women some of whom were examined and operated by the Surgical Division of Casalpusterlengo Hospital, whereas others were examined and operated at Crema Hospital. Data were compared with those from larger studies recently reported in the literature. Patients had a minimum age of 42 years and a mean age of 64.3 years; all were symptomatic. Clinical examination, mammography and echotomography showed an increased sensitivity in parallel with the increased size of tumour and the patient's age. The sensitivity of mammography in T1 cases was higher than that of clinical examination and ultrasound tests. Diagnosis was made on cytological grounds alone in 2% of cases, but was negative in 14% (benign/inadequate sample) in spite of the presence of a positive clinical examination and mammography. A 90.4% sensitivity rate was achieved using a combined clinical examination and mammography.

Adult↗

[Acute appendicitis in aged patients].

Over the course of 12 years (1977-1989) 40 patients aged over 50 (mean age 67 years) with acute appendicitis (Group I) were admitted to and operated in the Department of Surgery at Casalpusterlengo Hospital. Diagnosis was always confirmed by pathological examination. The following data were taken into account: the intervals between initial symptoms and admission, and between admission and surgical treatment; clinical and laboratory findings, the type of laparotomy, length of hospital stay, morbidity and mortality. Findings were also compared to two control groups composed of the same number of patients affected by acute appendicitis but aged between 1-20 years old (Group III) and between 21-50 years old (Group II). When data from all three groups were compared, it was found that there was a higher percentage (47.5%) of perforated appendices among the eldest group of patients; this may be explained by the fact that disease was more aggressive in these patients or that there was a longer interval between the appearance of symptoms and hospital admission. There was also a higher number of postoperative complications in group 1 (Group I = 27%; Group II = 7.5%; Group III = 2.5%). There was a greater incidence of complications in perforated appendicitis (Group I = 47%; Group II = 20%; Group III = 1 patient over 2) and the most common complication was wound infection (44%) followed by prolonged ileus (15%).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

[Pure and primary squamous cell carcinoma of the breast].

A case of a pure squamous cell carcinoma (SCC) of the breast is a 75 y.o. white female is reported. The cancer was discovered at the clinical exam requested by the patient for a growing mass in the left breast. Mammogram and an ultrasound exam showed a big cystic mass (4 cm x 4 cm) with a liquid content and a small polypoid mass of 0.5 cm x 0.5 cm arising from the inner surface of the cyst. A fine needle aspiration was done and the cytological report was consistent with squamous cell carcinoma. A left modified radical mastectomy was carried out. The skin was not involved and the lymph nodes were negative, and no other cutaneous tumor elsewhere was found. The stage was II (T 2a N o M o). The patient did well and was discharged 10 days post-op and now she is still doing well with no signs of recurrences or metastasis. This cancer should not be confused with a much more largely manifest metaplastic changes in a usual breast cancers. The criteria to define "pure" a squamous cell Ca of the breast are: 1) that no other neoplastic element such as ductal or mesenchymal ones are present in the tumor; 2) that the tumor is independent of adjacent cutaneous structure; 3) that no other distant epidermoid tumor exists in the patient. The origin of this tumor is controversial; it has been stated as arising from dermatoid cyst of the breast, chronic abscesses, complete metaplasia of glandular breast tissue. Despite the rarity of this neoplasia it should be kept in mind that in a cystic mass of the breast in older patient could arise a squamous cell carcinoma.

Aged↗

[Echography in the diagnosis of breast cancer].

Fifty-one patients with clinically palpable breast cancer were examined using small-parts echotomography. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of overall diagnosis were assessed in the two groups of patients: T1 (diameter less than 2 cm) and T2-T3-T4 (diameter greater than 2 cm). The frequency of the main echographic signs associated with breast cancer was also investigated. Diagnostic accuracy was found to be high in the T2-T3-T4 group (93%), but very low in the T1 group (71%). The study confirms the importance of ultrasound as an additional test in the study of breast cancer. However, this method becomes increasingly less sensitive and specific as the size of the tumour decreases.

Breast Neoplasms↗