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Biomedical subjects

R Ruggiero

Publications and source records attributed to R Ruggiero.

At least 55 records · Page 3Linked to original sources

Surgical management of severe liver trauma: a role for liver transplantation.

Severe devascularizing liver injuries continue to carry a high mortality. Rapid operative intervention to achieve hemostasis and debride devitalized tissue remains essential to salvaging these patients. For those with unsalvageable liver injuries liver transplantation can be employed. Careful support of the patient in the anhepatic state, reversal of coagulopathy, and use of venous bypass intraoperatively permit successful transplantation.

Adolescent↗

[Intestinal gases and digestive pathology: clinical syndromes and their treatment].

A number of annoying and frequent disturbances caused by an increase in intestinal meteorism have aroused the interest of students since the last century. Aerophagy, abdominal distension, flatulence represent the commonest aspects of this frequent gastroenterological pathology. The new diagnostic approaches have made it possible to classify the principal mechanisms involved in the production and elimination of intestinal gases. It has thus been possible to study with greater precision the composition of gaseous content and the origin and removal of intestinal gases. It is possible to demonstrate an increase in intestinal gas in various conditions, not only in relation to concomitant organic factors but also following surgery and disease situations triggered by functional or reflex mechanisms. Basic diagnosis is important because if correctly classified these pathological conditions can be resolved with simple therapeutic aids.

Aerophagy↗

Medulloblastoma: a critical approach to the management on the basis of 12 years of experience.

Medulloblastoma constituted 28% of brain neoplasms among children referred to the Santobono Children's Hospital of Naples from 1973 through October 1984. The authors summarize their experience with 68 cases of medulloblastoma, which were managed with a multimodal institutional protocol involving surgery, chemotherapy and radiation therapy. The evolution of modern management is discussed, and particular attention is directed to the factors affecting the prognosis.

Adolescent↗

Iopamidol for intrathecal use in pediatric neuroradiology.

A clinical trial using iopamidol, a non-ionic contrast medium, in various iodine concentrations (300, 200 and 150 mg I/ml), was carried out in 947 children, aged between 1 day and 14 years, who underwent various neuroradiologic procedures: computed tomography (CT) cisternography (n = 307), CT ventriculography (n = 203), CT myelography (n = 153), and conventional myelography (n = 284). No significant variation in vital signs and neurologic status was recorded during and up to 72 hours after the examination. Psychic agitation was the major effect registered, being clearly related to the type of procedure used. A significant reduction of untoward side effects (about 50%) was observed using the lower concentrations of the medium. Iopamidol 150 mg and 200 mg represented the optimal concentration for CT enhancement, these concentrations reducing artifacts; the 300 mg I/ml concentration gave best results in conventional radiology. It seems that the lower concentrations of iopamidol (200 and 150 mg I/ml) can be usefully employed in pediatric neuroradiology, with preserved contrast and dramatically reduced untoward reactions.

Adolescent↗

Acute aperistaltic megaesophagus as a complication of Nissen fundoplication: a case report.

A case of acute aperistaltic megaesophagus which arose after Nissen fundoplication for sliding hiatal hernia, is reported. The resolution of the clinical and instrumental picture with cholinergic drugs leads to the conclusion that the phenomenon observed is of vagal origin. This may be an extreme picture of the mild esophageal dilatation and transitory dysphagia that sometimes occur after Nissen fundoplication.

Esophageal Achalasia↗

Ureteral obstruction secondary to acute sigmoid diverticulitis.

Genitourinary manifestations and complications of sigmoid diverticulitis are well recognized. These consist mainly of bladder symptoms or fistula formation. Ureteral obstruction secondary to acute sigmoid diverticulitis is rare with only 3 cases documented and reported up to the present. All 3 cases were of left ureteral obstruction. Two patients are presented with acute sigmoid diverticulitis complicated by ureteral obstruction -- one of which was obstructed bilaterally. Both patients were admitted with left lower abdominal pain and tenderness and showed elevated temperatures with leukocytosis. Neither had a significant past history of gastrointestinal or urologic disorders. Ureteral obstruction in both patients was documented preoperatively by intravenous pyelography, and postoperative resolution was documented following definitive treatment of the diverticulitis. The proximity of the sigmoid colon to the left ureter should cause more instances of this complication than is reported.

Acute Disease↗

High resolution CT spinal scanning with Acta 0200 FS.

The diagnostic features of CT images of the spine are constantly influenced by some limitations of the method because of the peculiar configuration of the human spine. Recent generations of CT scanners greatly improve the results but with the second generation (Acta 0200 FS Pfizer Scanner) we have been able to develop a modified scan reconstruction method to maintain the quality of our spinal images, thanks to the very flexible software of our CT scanner.

Humans↗

[Extracranial angioma with dural participation].

Extracranial congenital arteriovenous malformations are often associated with dural and/or cerebral malformations. One case is presented. The angiography of the common carotid artery revealed no evidence of abnormal vessels into the internal or external carotid territory. The injection of contrast medium into an enlarged epicranial vein showed the extracranial malformation, well opacified; the phlebography revealed also a small dural malformation draining in the superior sagittal sinus. The Authors outline the importance of complete angiographic study in all the cases of extracranial vascular malformations even if the carotid angiography is apparently normal.

Angiography↗

[Direct experience in the treatment of unusual, primary, and secondary malignant tumors of the stomach].

The reduced incidence of gastric cancer, due to a better patients surveillance and more accurate understanding of prophylactic measure, has allowed a detection of early stages as well as cancers with different origin cells. Either the difficulty of differential diagnosis or the various surgical and integrated approaches, make these neoplasm hard to enroll in standard treatment protocols. Our experience consists of 5 clinical cases with four different histology: lymphoma, leiomioma, carcinoid and gastrinoma. A rare case of secondary involvement of the stomach by an adrenal adenocarcinoma is also described. Lymphomas benefit of the surgical therapy only in early stages (IE, IIE), eventually associated to chemio- and radiotherapy, in relationship with local diffusion of the disease; gastric resection is more supported than gastrectomy. Polychemotherapy, with or without radiotherapy, is used for advanced stages (IIIE and IVE), leaving to surgery the role of controlling hemorrhagic or occlusion compliances. GIST have a different therapeutic approach: surgery represents the only choice since chemio- and radiotherapy have no benefits for the biological characteristics of such neoplasm. Surgery is the ideal choice for the carcinoids with some indications for chemio radiotherapy in the palliative surgery or in the relapsing. We emphasize the rarity of the secondary gastric neoplasm coming from the suprarenal glands. We analyze our diagnostic and therapeutic protocols, comparing them with the current literature.

Adenocarcinoma↗

[Septic complications of gallbladder lacerations during laparoscopic cholecystectomy].

The iatrogenic gallbladder perforation with bile and, eventually, gallstones loss in the peritoneal cavity happens in the laparoscopic cholecystectomies more frequently than in the laparotomic ones. The authors have reviewed their experience and recent bibliography with the aim to clarify factors that increase risks for this adverse effect; 579 patients subjected to laparoscopic cholecistectomy: in 81 cases (13.98%) the intra-peritoneal perforation of the gallbladder wall has happened, in 26 associated to gallstones loss; 12 of these last have developed abdominal wall infections. No case of intra-peritoneal abscess was observed. The Authors believe to be proper to select patients with the clinical and instrumental evaluation. They identify emergency and flogosis as risk factors for the perforations, as well the systemic illnesses for sepsis. They emphasize the role of antibiotic prophylaxis in the high risk subjects.

Adult↗

[Sarcoma of the breast. Two clinical cases and review of the literature].

BACKGROUND: Sarcomas of the breast are rare neoplasm. Wide discordances exist about prognostic factors, therapy and life expectancy. METHODS: Two women affected by sarcoma of the breast; prognostic aspects and therapy are analyzed. RESULTS: After radical mastectomy one patient, with neoplasm of 4.5 cm in diameter, is still alive one year after the surgical procedure. CONCLUSIONS: Diagnosis of the sarcomas of the breast is very difficult with the common radiological imaging, specially in the early phases when the sarcomas often can simulate absolutely benign lesions. Prognostic factors are histological type and degree, mytosis number for field and, probably, dimensions of the neoplasm. Sarcomas less than 3 cm in diameter can be admitted to conservative surgical procedure, but radical mastectomy is unavoidable when dimensions exceed this limit.

Aged↗