Biomedical subjects

Stefano Miniello

Publications and source records attributed to Stefano Miniello.

5 recordsLinked to original sources

PubMedDate not supplied

Diffuse neuroendocrine tumor of the small bowel: an exceptional case with long survival and literature review.

Malignant tumors of the small intestine are uncommon. Carcinoid tumors represent 20% of all malignancies occurring in this segment. We report the case of a 53-year-old female who was treated surgically for intestinal obstruction secondary to carcinoid tumors diffuse to the small intestine. This is the first case described in the literature. Carcinoids are considered less aggressive than the more common intestinal adenocarcinomas, but because of the extensive localization of the neoplasm this case can be considered a high-grade malignancy with an aggressive pattern of growth. Surgical resection, although noncurative in this case, can provide the patient with a long survival rate and a good quality of life.

Carcinoid Tumor↗

PubMedDate not supplied

Postsplenectomy immunodepression and its implications: an underestimated problem.

The most important sequelae of splenectomy is immunity depression. This study, conducted in three phases, was aimed at confirming this clinical condition. Data from our phase 1 study clearly show that patients undergoing splenectomy for trauma are in a critical condition because of a latent immunodeficiency shown by skin tests (ST) and in vitro evaluation of the aspecific immune activity. Because the in vitro study of the unspecific immunity that we used seems to be more expensive and complicated than ST, the aim of the phase 2 study was to compare the efficacy and the limits of the two assays (ST versus in vitro study) in detecting the immunodeficiency status of the splenectomized patient. The aim of the phase 3 study was to ascertain whether postsplenectomy immunodeficiency could be a consequence of an altered equilibrium between the lymphocyte subpopulations T helper (Th)1/Th2, evaluated by serum dosage of interferon-gamma and interleukin-4.

Adolescent↗

PubMedDate not supplied

Risk factors of morbidity in thyroid surgery: analysis of the last 5 years of experience in a general surgery unit.

The aim of this retrospective study is to analyze the risk factors of morbidity in thyroid surgery. From January 1997 to December 2001, 343 patients (69 males and 280 females, mean age 46.1) who underwent surgery under general anesthesia for thyroid disease were analyzed. In 22 (6.4%) cases the operation was a second thyroidectomy. The mean post-operative stay was 2 days (range: 1-7) and the mean follow-up was 21 months (range: 1-60 months). Statistical analysis of our data was performed by chi-square test and confirmed by Fisher exact test. The statistical analysis showed the significance of malignancy and re-surgery as risk factors of hypoparathyroidism and recurrent laryngeal nerve palsy. Sex, age, and type of operation had no influence on the medical records. The completion of thyroidectomy and histological malignancy increase the morbidity of thyroid surgery.

Adolescent↗

PubMedDate not supplied

Management of retrosternal goiters: experience of a surgical unit.

The aim of this study was to retrospectively analyze 5 years' experience of cervico-mediastinal goiters (CMG) management. Twenty-five patients with cervico-mediastinal goiters underwent surgery between January 1998 and December 2002. The group consisted of 16 females and 9 males (mean age, 48.2 years; range, 42-74 years). A total thyroidectomy under general anesthesia was always performed. A no. 7 Fogarty catheter with a 5-ml balloon was employed in the seven last cases to lift the retrosternal portion of the goiter into the neck. The mean postoperative stay was 3 days (range, 1-7 days), and the mean follow-up time was 29 months (range, 1-58 months). There were no postoperative deaths; overall morbidity rate was 28.0%. One patient with a severe life-threatening hematoma required surgical re-exploration. Surgery for CMGs shows a low morbidity rate; total thyroidectomy is the treatment of choice to prevent recurrences or re-surgery for malignancy.

Adult↗

PubMedDate not supplied

[Conservative treatment of the splenic traumas].

Authors hope for a growing diffusion of conservative treatments for lien's lesions, to avoid the asplenia syndrome, and the unfavourable implications derive from, above all immunodepression that increases septic risk. They report their experience about conservative choices for spleens traumatic injures and emphasize the absolute need of select the appropriate patients for those procedure, that must require: haemodynamics stability; not geriatric age; type I and II, according to Buntain's classifications, ien's lesions, and attentive selection of the patients carriers of type III lesions; absence of preceding spleens injures, opportunity of monitor patients, in immediate postoperative, in intensive care units. Authors suggest that one of the essential condition for the correct selection and achievement of conservative treatments of traumatic lien's injures, is the team work of the surgeon, of the anesthesiologist, of the radiologist. Conclude maintain that, conservative procedure for lien's lesions, must find a growing diffusion, but mention that is appropriate to not extend those treatments indications over the encoded ones.

Aged↗