From 1978 to 1993, 220 patients were admitted at the Cl. Chirurgica III of the University of Bologna because of acute colonic diverticulitis. During the same period 108 patients (58 females and 50 males; mean age 65 years) were operated on for complications of the disease; 21 acute diverticulitis, 10 pericolic or pelvic abscess, 30 purulent peritonitis, 7 fecal peritonitis, 19 obstruction, 14 hemorrhage and 7 fistula. Surgical techniques were: resection and primary anastomosis (n. = 46), two or three stage procedure (n. = 49), Hartmann's resection (n. = 13). Mortality rate was 15%, 14,2% and 7,6% respectively. The advantages or disadvantages of the various surgical approaches in relation to the type of complications were evaluated. In conclusion appropriate segmental resection of the colon with or without primary anastomosis is recommended.

Acute Disease↗

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Preceptor development. An opportunity to stimulate critical thinking.

In this article, the authors describe a preceptor development program with several unique features. The program provides preceptors with strategies to promote critical thinking and has expanded content on feedback and evaluation processes. Ongoing professional development is continued through follow-up seminars. These seminars provided preceptors with an opportunity to share their experiences, which led to identification of important issues for further exploration. For example, preceptors need assistance developing teaching strategies to meet the needs of the middle-aged new graduate nurse.

Education, Nursing, Continuing↗

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[Device for intraarterial access for locoregional chemotherapy in hepatic metastasis from colorectal neoplasms (technical note)].

Metastasis are the most common malignant lesions of the liver. Liver is the most common site of visceral metastasis from colo-rectal carcinoma. Only in few patients are the lesions surgically resectable for cure and standard intravenous chemotherapy produces a low response rate. An intrahepatic arterial device for regional chemotherapy is an effective and safe alternative for unresectable liver metastasis from colorectal carcinoma, with a significant improvement on response rates compared with conventional i.v. chemotherapy; a longer survival is also reported in patients receiving intrahepatic therapy, even if the difference is not statistically significant. The catheter is inserted through the gastro-duodenal artery and the reservoir is placed in a subcutaneous pocket on the anterior thoracic wall. The Authors discuss indications, implantation technique and complications. Intra-arterial chemotherapy is administered in ambulatorial regimen and scintigraphic scanning and/or epatic ultrasonography are performed every three months to evaluate response rate. Median survival is variable from 12 to 17 months in the different series with response rates (disappeared metastases or tumor-mass reduction over 50%) of 48%-62%. The increased tumor responses reported together with a lower systemic toxicity (compared with systemic therapy) suggest that intra-arterial chemotherapy is a reliable and well tolerated treatment.

Antineoplastic Agents↗

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Amplification of eosinophilia by melatonin during the immunotherapy of cancer with interleukin-2.

Eosinophilia, which occurs during IL-2 immunotherapy, has appeared to be due to an enhanced secretion of IL-5 and to be associated with a clinical response. Since our previous experimental studies showed that the pineal hormone MLT potentiates IL-2 efficacy, a study was started to evaluate the influence of a concomitant MLT administration on IL-2-induced eosinophilia. The study included 30 advanced solid tumor patients, 16 of whom received IL-2 alone (6 million IU/day) and the other 14 IL-2 plus MLT (10 mg/day orally at 8.00 P.M.). Eosinophil mean number was significantly enhanced during both treatments, but its increase in patients receiving IL-2 plus MLT was significantly higher than that seen in patients treated with IL-2 alone. These results show that MLT may enhance IL-2-induced eosinophilia, by suggesting that T helper lymphocyte- type 2, which is the source of IL-5, may be the target cell for MLT action.

Adult↗

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[An anomalous vena cava inferior with azygos continuation: a clinical case report].

We report a case of azygos continuation of inferior vena cava. The diagnosis is confirmed by C.T. scans. We also report possible diagnosis among other pathologies which substain similar radiographic pictures bat which are connected with silent clinic evolution.

Azygos Vein↗

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Measurement of catecholamines in mouse bone marrow by means of HPLC with electrochemical detection.

BACKGROUND AND OBJECTIVE: Noradrenergic innervation is present in the bone marrow and adrenergic agents can modulate hematopoiesis. However, since no data are available concerning endogenous catecholamines at this level, we investigated their presence and origin. METHODS: Using a high performance liquid chromatographic method, we have and measured endogenous catecholamines in bone marrow from normal, 6-OHDA-treated and pargyline-treated mice. RESULTS: Noradrenaline, adrenaline and dopamine levels were, respectively, 2806.74 +/- 408.85, 803.37 +/- 87.66 and 274.47 +/- 51.54 pg/g of tissue. Noradrenaline levels were lower after 6-OHDA (1130.47 +/- 142.73 pg/g of tissue, p < 0.01 vs. control values) and higher after pargyline (4122.62 +/- 509.54 pg/g of tissue, p < 0.05). None of these treatments significantly affected adrenaline or dopamine content. INTERPRETATION AND CONCLUSIONS: Noradrenaline in the bone marrow originates mainly from sympathetic nerve endings and is metabolized through specific enzymatic pathways. Adrenaline and dopamine may originate from other sources, such as the systemic circulation.

Adrenergic Agents↗