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Biomedical subjects

P Tonelli

Publications and source records attributed to P Tonelli.

45 records · Page 3Linked to original sources
PubMedDate not supplied

[Pharmacological support in dental treatment of hemophiliac patients].

The hemophilic syndrome (hemophilia A, B, C) represent about the 90-95% of all the congenital coagulopathy; in order to avoid immediate or belated hemorrhagic complications it is necessary to give these patients all the care they need. When the hemophiliacs have to be submitted to oral surgery operations we can use various therapies according to the seriousness and to the type of the disease. We have also taken into consideration the ways to grant a local hemostatic control.

Blood Coagulation Disorders↗
PubMedDate not supplied

[Ectopic salivary tissue in the mandibular region].

The presence of salivary tissue into the mandible represents often the submaxillary gland dislocation into the maxillary bones. Together with a literature revision, we have analysed the histogenetic hypothesis of this eterotopia and its prognostic implication. At last it has been described a clinical case treated in our Institute.

Adult↗
PubMedDate not supplied

Intra-arterial hepatic chemotherapy with 5-fluorouracil and 5-methyltetrahydrofolate in the treatment of unresectable liver metastases from colorectal cancer.

Treatment of patients with hepatic metastases from colorectal cancer using hepatic artery fluorodeoxyuridine (FUDR) has been reported to induce high remission rates but also a high incidence of limiting hepatobiliary toxicity. In an attempt to obviate the limiting FUDR toxic effects, a phase I-II study was undertaken to establish the efficacy and tolerability of intra-hepatic 5-fluorouracil (5-FU) when given in combination with 5-methyltetrahydrofolate. Patients with colorectal liver metastases (n = 17) received escalating doses of 5-FU as a 1 h infusion with a fixed dose (100 mg/m2) of intra-hepatic 5-methyltetrahydrofolate (4 h infusion) once a week. Dose limiting toxicity was hepatic and gastrointestinal (diarrhea) and occurred at doses > or = 350 mg/m2 5-FU. Other adverse effects included nausea/vomiting and cutaneous toxicity. One patient achieved a complete response and 2 a partial response (mean duration = 9 months) while 11 had stable disease. Patients with complete or partial responses had a mean survival of 17 months, while patients with stable disease survived 13 months and those with disease progression 5.5 months on average. These results suggest that this is a well tolerated regimen although with efficacy at the lower level of the range observed with fluoropyrimidines.

Adult↗
PubMedDate not supplied

[Perforation in Crohn's ileitis and its impact on the natural history of the disease. Note 1. Pathogenic process of the event, its relationship with intestinal obstruction, and its immediate consequences].

The pathogenesis and consequences of perforation in Crohn's disease were studied in 175 patients submitted to surgery. Perforation occurred in 40 (23%) patients with ileitis or ileocolitis, always in the terminal ileum; so-called "free" perforation occurred in 1 patient, "limited" perforation in all the others. Perforation is always a consequence of a chronic intestinal obstruction caused by the stricture of the terminal ileum, which becomes absolute because of the blocking by solid intestinal content. It occurs in the borderline between the stricture and proximal dilated loop, where the fissures (typical of Crohn's ileitis) are stretched to the utmost and dilated by the hyperpressure and distension of the wall following ileal stenosis. Perforation in the peritoneal cavity is always free; its consequence is usually not a diffuse septic peritonitis but an abscess, because only a small amount of intestinal content leaks out. This happens because in the proximal occluded bowel, pressure decreases abruptly following the spilling of intestinal content, particularly of gas. The abscess fed by intestinal content enlarges and finally opens into a hollow organ or onto the skin, causing a fistula (internal or external). The rational therapeutic approach to perforation and its consequences (the infrequent diffuse septic peritonitis, or the more common abscesses and fistulas) is always and only ileal stenosis removal.

Crohn Disease↗
PubMedDate not supplied

[Perforation in Crohn's ileitis and its consequences in the natural history of disease. 2. Consequences of perforation in the peritoneal cavity: diffuse septic peritonitis, abscesses, external and internal fistulas].

Perforation of Crohn's ileitis occurring in the peritoneal cavity is always free perforation, but it causes usually a localized peritonitis, i.e. an abscess, and only in rare cases a diffuse septic peritonitis for the reasons expounded in the Part 1. Diffuse septic peritonitis has the common features of all perforative peritonitis; its surgical treatment must be ileocolic resection, simple suture of perforation being a serious mistake. Abscesses develop: as regards the ileum, about 30-45 cm from the ileo-caecal valve; as regards the abdominal cavity, in the right iliac fossa or in the pelvis, at a site where the ileum, weighed down by its chronic inflammation, rests. These abscesses have a wall like that of all abscesses, with no specific crohnian features. On operation, if technical considerations so require, part of the abscess wall may be left in place with no fear of recurrences or fistulas. Nowadays, most abscesses of the right iliac fossa are opened surgically; an enterocutaneous fistula follows. Most abscesses of the pelvis still open spontaneously into a hollow organ (sigma-rectum, urinary bladder), and rarely into the vagina or onto the perineum after penetrating through the levator any muscle and causing suppuration of the ischiorectal fossa.

Abdominal Abscess↗
PubMedDate not supplied

[Perforations in Crohn's ileitis and their consequences in the natural history of the disease].

Not all Crohn's ileitis perforations occur in the peritoneal cavity; a proportion of them, which may be theoretically calculated as about 8%, occurs between the two leaves of the mesentery. These mesenteric perforations (which perhaps may be called more properly "penetrations") produce their pathological consequences in three consecutive anatomical compartments: 1) between the two leaves of the mesentery, causing mesenteric abscesses which are very dangerous, especially because of their embolisation into portal vessels (pylephlebitis, hepatic abscesses); 2) in the lower right quadrant of the retroperitoneum, causing what we call "Mesenteric Insertion Retroperitoneal Syndrome" (MIRS), consisting of a collection producing genito-femoral neuralgia, psoitis, obstructive uropathy and iliofemoral thrombophlebitis; 3) out from the pelvis, causing collections which in their spreading recall the cold abscesses of Pott's disease and which, diffusing along muscles and nerves, reach Scarpa's triangle, or the buttock and popliteal space.

Algorithms↗