[Hepatic abscesses: how to recognize and treat them today].
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Anti-Bacterial Agents↗
Biomedical subjects
S Lazzara
Publications and source records attributed to S Lazzara.
[Sequential therapy with antiestrogens and progestational drugs in carcinoma of the breast in an advanced stage].
After discussing the mechanism of action of antioestrogens and medroxy-progesterone-acetate, the authors report on their experience with the sequential use of these two hormones in a group of patients with advanced cancer of the breast. After illustrating the results of their study, the authors conclude by stressing that the sequential use of these drugs appears to improve the quality of life of the patients with a significant increase in rates of complete or partial remission of the neoplastic disease.
Adult↗
[Use of tumor markers in monitoring thyroid carcinoma].
The authors report on their experience regarding the use of tumours markers for the pre-operative monitoring and subsequent follow-up of patients suffering from thyroid carcinoma. All patients were subjected to radio-immuno-assay for circulating thyroglobulin, a valuable indicator of residual and metastatic thyroid tissue. The patients suffering from medullary carcinoma of the thyroid and their immediate families were also monitored by periodic thyrocalcitonin assay. A further tumour marker assayed was CEA, levels of which are raised in the presence of thyroid neoplasms at an advanced or metastasizing stage. The authors conclude by presenting the results obtained and confirm the usefulness of these tumour markers in the study and follow-up of patients with thyroid carcinoma.
Adenocarcinoma↗
[Evaluation of long-term results of the Duhamel intervention in the treatment of congenital megacolon in the adult].
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Adult↗
[Principles of rehabilitation of colostomy patients].
The authors, after pointing out the number of enterostomized patients in the last years was more and more increasing, study all the repercussions of metabolic, functional and psychologic nature which are arising in the patients subjected to ultimate colostomy. Then, they describe the principles of a correct rehabilitative program for such patients, consisting in performing a correct colostimy and rigidly following hygienicodietetic rules. At last the authors, as a conclusion, affirm the rehabilitation, through the creation of proper centers with specialized staff, should also aim at the resolution of the remarkable psychologic problems affecting such patients, so as to have them reinserted in the social context they are coming from.
Colostomy↗
[Clinico-statistical features on the operative risk in old age].
The authors, after reporting the data concerning the increase of the average length of life and the increment of the population in geriatric age, studied the different aspects of the surgical risk. They consider the age, the existence or absence of associated diseases, the situation of the different organs or apparatuses, and the possibility to correct, in preoperative stage, the different functional unbalances remarked. At last, after confirming the conception whereby age for itself does not represent a specific factor of risk, they emphasize the importance of a multidisciplinary cooperation in the assistance to old patients, both during intervention and in the postoperative course.
Age Factors↗
Human blood oscillating axially in a tube.
Experiments were performed to study the rheological response of human blood at hematocrit ratios of 0 to 0.45 in axial oscillatory flow in a tube of uniform bore. Three principal regimes of flow were identified, depending on the amplitude of oscillation. At the highest amplitudes (and therefore the largest range of shear rates in the blood) there was turbulent motion and the friction coefficient increased in proportion to the square of the hematocrit. At small amplitudes the friction decreased with increase in amplitude, the rate of decrease increasing with hematocrit. At intermediate amplitudes the friction increased in proportion to the square of the hematocrit. Glutaraldehyde fixation of the red cells caused increase in the friction, and reduced the rate of decrease of friction with amplitude at small amplitudes. With a stenosis of very modest degree and span the friction in normal blood increased disproportionately, and a small blind hole in the lumen of the stenosis caused additional and disproportionate increase in friction.
Blood Physiological Phenomena↗
[Treatment of occlusions caused by carcinoma of the left colon in the aged].
The Authors, after pointing out that, in geriatric age, the incidence of left colon carcinoma has significantly increased, and this, in a high quantity of cases, goes unnoticed in precocious stage, but appears "d'emblée" pith an occlusive situation, state their experience concerning the surgical treatment of occlusions due to left colon carcinoma in patients aged over sixty. From the evaluation of the results they obtained, the Authors assert that, if the operation is performed after a correct appraisal of the patient's general conditions and after an adequate counterbalancing of the metabolic and functional alterations, often present in old people, the operative mortality, the postoperative complications and the indices of survival are not so significantly different from those remarked in the young subjects.
Aged↗
[Iatrogenic lesions of the femoral artery during hernioplasty].
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Adult↗
Pre and intra-operative methods of staging gastric cancer.
The aim of this paper was to examine the indications and limits of pre- and intra-operative instrumental diagnosis of gastric cancer. In order to achieve this effectively, the authors emphasized the importance of proper staging methods and obtained a detailed description of tumor diffusion. The most important diagnostic instruments considered were magnetic resonance, endosonography, intra-operative echography, pre- and intra-operative immunoscintography and a cytological examination of peritoneal lavage fluid. The authors concluded that pre- and intra-operative staging of gastric cancer is important for two major reasons: it results in the most accurate definition possible of disease evolution, enabling a proper therapeutic program; and it involves a combination of three complementary metasurgical treatments.
Cytodiagnosis↗
[Surgical problems in the aged patients].
Authors, considering the increasing of the middle duration of life and the increasing of geriatric population, examine various surgical problems in the elderly. They took in consideration not only the age, but all the other markers of surgical risk related to the surgical illness, to the associate illness and to the type of operation. After reporting their experience in the treatment of geriatric patients, they conclude that a scrupulous surgical preparation, a correct indication to the operation and an accurate overseeing after surgery are necessary to do that the elderly patient faces surgical intervention with the same capability of success of the young.
Age Factors↗
[Miles operation in rectal carcinoma: history and current status].
The Authors confirm how the advent of mechanical suture has directed the management of rectal carcinoma to an increasingly conservative attitude. In reporting their experience--which consists of about twenty years (222 patients) they specify how not only an increased incidence of recurrence has not appeared, but they have also observed a reduction of theirs (-5.2%). They then attempt to outline basic moments which have characterized the history of rectal carcinoma surgery and they state how today, 80 years since it was conceived, Miles' intervention maintains its validity, even if with more restrictive indications.
Digestive System Surgical Procedures↗
[The use of synthetic prosthesis in the treatment of hernia].
The authors report their experience on synthetic prosthesis used in 36 patients with abdominal hernias. Thirty six cases of incisional hernias have been analyzed by Institute of General Surgery of Messina University from 1992 to 1998. Among the 33 cases with median parietal defect, in 7 cases concerning great incisional hernias group a PTEF-e prosthesis, which was positioned in an intraperitoneal site, was employed. In 21 cases of medium size incisional hernias they used a polypropylene prosthesis, which was positioned in an intraparietal or preperitoneal site. In 5 cases of small size incisional hernias, polypropylene prosthesis was placed in a superfascial site. In the 3 cases of medium size lateral laparocele++, polypropylene prosthesis was positioned in a intraparietal site. There was no operative mortality. Among postoperative complications, 4 seromas, 1 parietal and 1 subcutaneous haematoma and 2 haematomas in retroperitoneal site appeared. Clinical-instrumental controls, which have continued until two or three years after the operation were performed which pointed out a recurrence in just one case where the prosthesis was positioned in a superfascial site. To conclude, we consider that nowadays the use of synthetic prosthesis lets us face and solve problems concerning surgical treatment of incisional hernias with confidence.
Adult↗
[Aorto-esophageal fistula caused by foreign body].
Aortoesophageal fistula is a rare but fatal cause of upper gastrointestinal bleeding. AEF develop progressively from the esophageal perforation caused by foreign body. Clinically, there is a medial chest pain, followed by hematemesis and finally terminal exsanguination. Diagnosis must be achieved during the free intervals in this triad of often rapidly succeeding signs.
Aorta, Thoracic↗
[Endoscopy in non-neoplastic cholestasis].
The role of endoscopic treatment of cholestasis is well codified as an alternative or adjuvant therapy to surgery, particularly in those cases where non malignant cause has been identified. Non-neoplastic cholestasis therefore benefits very substantially from endoscopic treatment in a context where the traditional surgical approach presents limitations in terms of morbidity and mortality. It should be borne in mind, however, that the two approaches are strictly complementary for the correct management of these patients.
Cholestasis↗
[Intraperitoneal neoplastic dissemination of incidental gallbladder carcinoma after laparoscopic surgery].
BACKGROUND: Several laboratory and clinical studies have raised the concern that laparoscopic procedures might worsen the prognosis of patient with malignant disease due to premature intraperitoneal cancer cell dissemination. The aim of the study was to examine the risk of the dissemination in patients with unsuspected gallbladder cancer diagnosed after laparoscopic cholecystectomy (LC). METHODS: A retrospective clinicopathologic study was performed on 5 patients with unsuspected gallbladder cancer without preoperatively diagnosis among 1280 patients that underwent LC in the period 1993-2002. The possible neoplastic dissemination was compared to that reported in 8 patients affected from unsuspected gallbladder cancer diagnosed after open cholecystectomy. RESULTS: Two patients with unsuspected gallbladder cancer (T1a-T2) presented a port-site recurrence after respectively six and four months. There was not statistically significant difference between types of cholecystectomy (LC or OC). Survival rate did not change according to whether the operation was carried out using LC or OC. CONCLUSION: After an accurate checking of the factors indicated to explain the early neoplastic dissemination frequently observed in the patients undergone LC and an analysis of their own experience the Authors conclude that LC does not worsen the prognosis of unsuspected gallbladder cancer.
Aged↗
[Malignant melanoma of the skin: current diagnostic and therapeutic approaches].
The Authors claim that the treatment of malignant melanosis of the skin is a problem of undiminished topical interest owing to its highly aggressive characteristics. Risk factors and pre-neoplastic lesions are reviewed, and the signs of malignant transformation are described along with the appropriate treatment. The Authors stress the importance, for therapeutic and prognostic purposes, of accurate clinical staging and macro- and microscopic study of the primary tumour. They also describe their own therapeutic approach, which involves the use of a CO2 laser for resecting the primary tumour. They present their patient population and conclude by observing that the progress achieved over the past decade is due both to earlier diagnosis and to improvements in the various therapeutic means available.
Adult↗