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Biomedical subjects

R Grossi

Publications and source records attributed to R Grossi.

9 recordsLinked to original sources
PubMed2004

Treatment of severe chronic venous insufficiency using the subfascial endoscopic perforator vein procedure.

BACKGROUND: Before 1985, corrective surgical procedures for patients with chronic venous insufficiency and venous ulcers were performed using long incisions through diseased skin and subcutaneous tissues. The procedure, involving ligation of incompetent perforator veins, known as "the Linton operation," often was complicated by wound infections and poor healing. This changed in 1985 when G. Hauer demonstrated a new surgical technique for direct visual identification of the incompetent perforator veins using an endoscope in the subfascial space. This seminal contribution marked the advent of subfascial endoscopic perforator vein surgery (SEPS). METHODS: From 1996 to 2004, the authors group prospectively collected data on 110 patients with chronic venous insufficiency who underwent a SEPS procedure. Preoperative assessment of the limb's vascular status consisted of color-flow duplex ultrasound imaging and ascending and descending phlebography to locate vein valve incompetence, along with venous mapping. The ages of the patients ranged from 42 to 82 years (mean, 60 years). A total of 128 limbs underwent the SEPS procedure in the cohort of 110 patients. According to CEAP classification for venous limb disease, 60 limbs belonged to group C5 (skin changes, pigmentation, venous eczema, lipodermatosclerosis, healed ulcer) and 68limbs to group C6 (skin changes and active ulceration). RESULTS: The 110 patients underwent 128 SEPS procedures without significant morbidity. Of the 68 limbs in class C6, 54 showed ulcer healing within the follow-up period of 12 weeks. The remaining 14 limbs in class C6 achieved ulcer healing within 24 weeks. In this latter group, 10 patients had venous ulcers larger than 4 cm in diameter. These patients underwent a split-thickness skin graft at the time the SEPS procedure was performed. The grafts remained healed during a 2-year follow-up period. CONCLUSIONS: This study demonstrated the effectiveness of the SEPS procedure when incorporated into the overall treatment strategy for patients with chronic venous insufficiency. Minimal postoperative complications accompanied by ulcer healing and relief of lower extremity symptoms were achieved for all the patients, underscoring the important role of incompetent perforator veins in the formation of chronic venous insufficiency.

Adult↗
PubMed2001

Inflammatory aneurysms of the abdominal aorta involving the ureters: is combined treatment really necessary?

PURPOSE: Peri-aneurysmal fibrosis complicating inflammatory aneurysm of the abdominal aorta may involve the ureters, causing urological complications. We assessed patient anatomical and clinical outcomes after conservative ureteral management. MATERIALS AND METHODS: From the operative records of 1,271 consecutive patients who underwent surgical repair of abdominal aortic aneurysms from 1980 to 1999 we identified 77 (6%) who had inflammatory aneurysms, which were complicated in 19 (24.6%) by dense peri-aneurysmal and ureteral fibrosis. Of these 19 patients 15 (78.9%) had coexisting monolateral hydronephrosis, 3 (15.7%) had bilateral hydronephrosis and 1 (5.2%) had renal atrophy. In 14 cases (73.6%) the fibrotic reaction severely impaired renal function. Only 1 patient underwent an emergency operation, while the others underwent elective repair. Only 2 patients (10.5%) underwent a specific urological procedure, including bilateral nephrostomy in 1 and ureterolysis plus ureterolithotomy in 1. Most ureteral complications were treated conservatively by aneurysmectomy only. RESULTS: Immediate postoperative mortality was 7% (1 of 14 cases). Median followup was 48 months. In 1 of the 13 cases (7.7%) a ureteral stent was placed during followup. After aneurysmectomy in 9 of the 12 patients (75%) with renal dysfunction periaortic fibrosis disappeared or decreased as well as associated hydronephrosis. In 11 of the remaining 12 patients (91%) of the 14 with renal failure preoperatively kidney function returned to normal or improved. In the 2 patients who underwent a specific urological procedure renal function improved but did not return to normal. CONCLUSIONS: Inflammatory abdominal aortic aneurysms involving the ureters and compressing the urinary structures respond well to aneurysmal resection only without a urological procedure.

Aged↗
PubMed1998

Outcome after early treatment of popliteal artery aneurysms.

BACKGROUND: Aneurysms of the popliteal artery are rare events with an estimated incidence of 0.1-2.8%. Their clinical importance depends on their propensity to cause thromboembolic complications or to rupture (18 to 31% of cases). This study was designed to assess the advantages of elective treatment of asymptomatic popliteal artery aneurysms so as to avoid the severe clinical manifestations that eventually arise if they remain untreated. METHODS: From 1980 to 1995, in our department we treated 28 popliteal aneurysms in 23 patients (19 elective operations and 6 emergencies). Three of the aneurysms proved amenable to fibrinolytic therapy alone. Follow-up lasted a mean 48 months (range 3 months to 15 years) in 20 patients (23 revascularizations). RESULTS: Global patency was 91.3%. Two thrombosed bypasses were treated by thrombolysis; in one case it did not resolve the ischaemia and the leg was amputated. In one case only, a graft became infected but this responded to conservative therapy with drainage and antibiotics. CONCLUSIONS: These findings suggest that popliteal aneurysms with good distal run-off should be repaired electively. Completely thrombosed aneurysms with coexistent limb-threatening ischaemia should be treated initially by thrombolysis. This will usually restore run-off and in some cases offers a valid alternative to emergency surgery for limb salvage.

Aged↗
PubMed1996

Genetic damage in urban mice exposed to traffic pollution.

Wild rodents (Mus domesticus) were collected in three areas in Rome exposed to different traffic flows to ascertain a possible correlation between genetic damage and heavy metal concentration. The concentration of lead, cadmium and zinc were determined in liver, kidney and bones and two mutagenicity tests (micronucleus test and sperm abnormality assay) were employed. The results obtained showed that the contents of lead and cadmium were higher in animals collected in areas with high traffic flows than in those from control areas. A statistically significant increase of the frequency of micronucleated erythrocytes and of abnormal sperm cells was also obtained in animals collected in sites with high traffic flows. The investigation confirmed the suitability of using wild rodents as bioindicators of environmental pollution and as key-organisms in programs of pollution monitoring and environmental conservation.

Journal Article↗
PubMed1996

[Transcranial Doppler: diagnostic methodology].

The transcranial doppler is a kind of pulsed doppler (frequency 2 Mhz) which, by arrangement of the probe in particular regions of the skull (temporal, orbital, and occipital fenestra), permits the assessment of the flow velocity on the level of the main intracranial arteris, giving information about the perviety and the characteristics of the flow and about Willis polygon being functional. This non-invasive vascular diagnostic is methodology concerned, and, therefore, fundamental in the evaluation of patients suffering from cerebral-vascular insufficiency and likely to be operated by carotid-TEA.

Cerebrovascular Disorders↗
PubMed1994

[Acute alcoholic myopathy].

A case of acute alcoholic myopathy in a subject with a 20 year history of alcohol abuse is described. The condition emerged during an episode of delirium tremens and had a quickly deadly outcome. The rapid evolution of the clinical situation accompanied by variation in the biohumoral indices (CPK, LDH, myoglobin) is stressed and although this prevented from obtaining anatomopathological samples of the rhabdomyolisis, the specific diagnosis was made with reasonable certainty. The onset of the condition was not foreseeable because of the absence of an accurate history of the subject's alcohol abuse on his admission and of significant biohumoral data indicating the existence of an alcohol correlated pathology.

Acute Disease↗
PubMed1990

[Hemicrania and food allergy in children].

Ninety-two children affected by migraine were studied, of which 49 had positive skin tests to one or more foods. Forty of those who tested positive (87%) improved after following an elimination diet for 4-6 weeks and were positive for at least one challenge test for the same types of foods which resulted in positive skin tests. Thirty-one children were cured following the elimination diet and 9 improved. At two years, despite the reintroduction of the suspected food or foods 6 to 12 months after the start of the elimination diet, these results remained unchanged.

Adolescent↗