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Biomedical subjects

T Stefanini

Publications and source records attributed to T Stefanini.

10 recordsLinked to original sources

[Surgical treatment of toxic megacolon].

After an introduction on the various aetiological factors involved in toxic megacolon, its onset, medical treatment and indications to surgery, the paper describes personal experience with seven cases. The report highlights the importance of medical treatment which is recommended as the appropriate initial therapeutic approach. Then after a review of evolving surgical techniques, it is suggested , again on the basis of personal experience, that the surgical approach should be neither excessively aggressive (total proctocolectomy with permanent ileostomy) nor excessively conservative (multistoma decompression). According to this report, the operation of choice is currently subtotal colectomy plus ileostomy and sigmoidostomy which combine modest morbidity and mortality with the possibility of future reconstruction.

Adult↗

[Echographic study of the shoulder. Clinico-echographic correlations].

US is indicated in the study of the impingement syndrome. A series of 152 shoulders was examined in a clinical-US study carried out following a standard protocol including a physical examination first and then a US examination. The study was aimed at investigating the agreement between clinical and US findings and at assessing the diagnostic reliability of US. 57% of the shoulders were positive to clinics (1 test at least) and were then divided in 4 groups. Positivity rate was high (85-87% for at least 3 or 4 tests). US findings included several different patterns. Our results demonstrate that a correct clinical-diagnostic protocol increases reliability, besides reducing the use of more complex and expensive imaging modalities--e.g., CT and MR.

Adult↗

Arthrolysis in the treatment of ankylosis and severe post traumatic stiffness of the elbow.

Between 1977 and 1989 the authors performed arthrolysis on 18 patients with ankylosis or severe post traumatic elbow stiffness. After an analysis of the cases, the operative technique is described and original parameters are proposed to evaluate the consequent results. The validity of arthrolysis as a possible alternative to arthroplasty or arthroprosthesis is confirmed by the 67% positive results.

Adolescent↗

[Diagnostic considerations in a case of pericardial effusion with anomalous distribution].

The authors report an atypical arrangement of pericardial effusion simulating an expansive mediastinal mass. Radiologic examination of the chest (standard, fluoroscopy and conventional tomography) failed to establish the correct diagnosis, its diagnostic aid was only related to demonstrate the lesion, without provided any additional anatomical and morphological features. The final and correct diagnosis was only obtained with CT and U.S. These latter imaging modalities have correctly located the lesion in pericardial space, and particularly they identified it like an loculated, completely fluid pericardial not corpusculated effusion. The authors remarked the value of CT and US techniques in the study of para and pericardial regions, especially of pericardial serosal surfaces. CT scan allow to localize the lesion, and to discriminate through densitometric values between cystic and solid masses; further more it provided information of possible extracardiac and/or mediastinal invasion. US provides the features of the fluid, its changes during systo-diastolic cycle, its mobility in different patient positions and the thickness of cardial wall. Nevertheless, at present, we consider both imaging modalities indispensable in the study of lesions occupying the cardiac-mediastinal border.

Aged↗

Stable osteosynthesis by the AO method in comminuted intra-articular fractures of the distal humerus.

The authors report their experience between 1982 and 1986 in 16 cases of comminuted supraintercondylar fractures of the elbow treated by stable osteosynthesis using the AO method with immediate or early mobilisation. They illustrate the technical possibility of obtaining stable synthesis even in fractures with numerous fragments and analyse the long-term functional results. Because of the severity of the fracture, none of the patients recovered full flexion and extension of the elbow; nonetheless in all the patients there was recovery of at least 90 degrees of movement and, most importantly, this occurred in the most useful range of movement. These results, and the time required for healing, amply justify the use of solid synthesis in fractures where the alternative would be arthroplasty.

Adolescent↗

Transposition of the 5th to the 4th ray by osteotomy of the hamate.

The authors present 5 cases of transposition of the 5th to the 4th ray according to Le Viet's method. This is indicated for the aesthetic and functional defects that follow total or subtotal amputation of the ring finger. The technique consists of radial transposition of the whole ray and intracarpal arthrodesis after cuneiform osteotomy of the hamate bone. It is easier to perform than the traditional metacarpal osteotomy and the results were uniformly good.

Adult↗