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Biomedical subjects

A De Medici

Publications and source records attributed to A De Medici.

At least 19 recordsLinked to original sources
PubMed1996

[Gastric injury by caustics: a case report].

The authors get the idea from the observation of a case of ingestion of muriatic acid, recently happened by Clinical Surgery II of the IRCCS Polyclinic "San Matteo" of Pavia in order to examine carefully the matter. The rareness of the shown case is given by the whole involvement of only the stomach, without damages for the oropharynx and the esophagus. The total gastrectomy executed 6 months after the ingestion of the acid has given to the patient the whole recovery. The follow-up checked for a periodical time of 6 months for a period of about five years, permits to observe the normal intestinal canalization without stenitical symptoms or zonas with degenerative risk.

Adult↗
PubMed1995

[Cervico-mediastinal goiters. Clinical aspects].

Among 660 cases of thyroid pathology diagnosed by the 2nd Institute of Clinical Surgery, Policlinico San Matteo, IRCCS, Pavia, during the period 1984 to 1993, 34 cases of cervical-mediastinal goiter were observed with an incidence of 5%. After a careful analysis of the main contributions to the study of cervical-mediastinal goiters, paying special attention to their classification, pathogenesis, methods of growth, and unique symptomatic manifestations, the authors focus on current radiological and instrumental studies, which are widely regarded as being useful for the diagnosis of the site and nature of this disease. They review the routes for aggressive surgery and appropriate techniques for the exeresis of the mediastinal mass. Having empasised the absolute indication for surgery the authors recommend quasi-total or total thyroidectomy as the elective form of surgery.

Adolescent↗
PubMed1994

[10 years of neoplastic pathology of the thyroid].

Here the authors have reported case studies made over a ten year period from 1982 to 1991 at the Surgical Semeiology Institutes of the Surgical Pathology, and Surgery Clinic II of the IRCCS San Matteo General Hospital, Pavia. It considered 28 cases of thyroid carcinomas (18 papillary, 6 follicular, 3 anaplastic and 1 medullary). Firstly an in depth examination using the most up to date diagnostic methods available today was made with particular attention paid to cytological examination by needle suction showing the rarity of the affliction. Then the histological variables the various biological aggressiveness, the multicentric and bilateral nature of certain neoplastic forms were recorded. Finally particular attention was paid to the therapeutic problem. In agreement with the great majority of authors, they believe that the best therapy is as follows. For differentiated tumours, a total thyroidectomy and when there is a more conservative surgical choice, the isthmolobectomy should be modified by prognostic indicators (age, sex, six of the tumour, single or multi location histotype). Furthermore lymphadenectomy should not be carried out automatically, but after a careful evaluation of the lymph node areas for a simple suspicion of metastasis.

Adenocarcinoma, Follicular↗
PubMed1993

[Sigmoid volvulus].

The authors report a retrospective study of four patients treated for sigmoid volvulus at the Clinica Chirurgica II of IRCCS Policlinico S. Matteo of Pavia between April 1974 and June 1989. They are collected from a series of 74 consecutive operations for colonic obstruction not related to hernias of the inguinal-crural region (incidence 5.4%). One patient died. The authors review the incidence, epidemiology, etiopathogenetic hypothesis, clinical patterns, nonoperative and operative therapeutic options of the affection. They emphasize the poor prognosis because the sigmoid volvulus usually occurs in elderly ill patients.

Adult↗
PubMed1993

[Traumatic lesions of the colon].

Four patients operated on at the Clinica Chirurgica II of IRCCS--Policlinico San Matteo of Pavia for trauma involving the colon were reviewed. All were males and their ages ranged from 14 to 84 years (mean 43.5 years). Injuries of the colon were found on 9 per cent of all patients operated on for abdominal penetrating injuries and on 6 per cent of patients with blunt injuries. The authors recall the pathogenetic mechanisms, clinical patterns, some grading systems proposed for quantifying the severity of the lesion. Our experience has shown that in blunt trauma the prognosis is worse because there were many associated organ injuries. These condition the early mortality for shock and exsanguination.

Abdominal Injuries↗
PubMed1992

[A department of general surgery using the Diagnosis Related Groups (DRGs) system. Evaluation of the case series].

DRGs system allows the grouping in a single grad-bag code of a number of similar surgical procedures carried out in patients homogeneous for age, physical status, complication and so on with similar costs. Therefore this grouping method is useful for payment to hospitals. The Authors have coded with DRGs the surgical activity of a general surgery staff during a year to verify the image that DRGs bears. Seven hundred diagnoses of dismission were related to operated on patients while one hundred twenty seven were related to patients treated with medical therapy. The DRGs more numerous were 290, 258, 198, 162, related with thyroidectomy, mastectomy, cholecystectomy and herniorrhaphy.

Diagnosis-Related Groups↗
PubMed1992

[Epithelial cysts of the spleen].

The Authors report a case of epithelial cyst of the spleen-observed in a 25 years old woman. After remembering the nomenclature and pathogenetic hypothesis, they consider clinical patterns of this rare disease of the spleen which is usually found in children and young adults. The Authors discuss pathological findings, diagnostic aids, especially non-invasive imaging. They also suggest considering the cysts in diagnosis of the diseases of the spleen and splenectomy as a treatment of choice.

Adult↗
PubMed1992

[A rare case of massive digestive hemorrhage. Carcinoid of the small intestine].

The authors reports a case of massive digestive hemorrhage produce by a carcinoid of the small intestine. Having reviewed the most frequent causes of primary hemorrhage of the mesenteric small intestine, attention is focused on the difficulties o making an etiological and topographical diagnosis, in spite of using the most advanced instrumental research methods. The paper concludes that explorative laparotomy is the sole method for making a precise diagnosis and performing appropriate surgical treatment.

Acute Disease↗
PubMed1992

Nodular sclerosing Hodgkin's disease and large cell lymphoma. Immunophenotypic characterization of a composite case.

Composite lymphomas have rarely been reported in Hodgkin's disease (HD), except in the lymphocyte predominance sub-type, and immunohistochemical investigations have been performed in only few cases. We describe the histological and immunophenotypical findings in a case of composite nodular sclerosing HD and high-grade, large cell non-Hodgkin's lymphoma (NHL). In our case HD and NHL cells displayed striking morphological and immunophenotypical divergence, suggesting a lack of correlation between the two neoplasms.

Adult↗
PubMed1992

[A case of primary carcinoma of the duodenum with subampullar localization].

The authors illustrate a case of previous duodenal adenocarcinoma with subvaterian localization and, after revising the literature and some general remarks, they explain their practice. They come to the conclusion that in some well selected cases, duodenal segmental resection can be correctly applied. They remember that the most important factor of the improvement of the prognosis is early diagnosis: it is indispensable for radical exerectical therapy.

Adenocarcinoma↗
PubMed1990

Oral administration of loxiglumide (CCK antagonist) inhibits postprandial gallbladder contraction without affecting gastric emptying.

The effect of a single oral dose of loxiglumide, a cholecystokinin antagonist, on postprandial gallbladder contraction and on gastric emptying was evaluated in humans. Following a 12-hr fasting period, two tablets of loxiglumide (400 mg each) or placebo was administered on different days, in random order and in a double-blind fashion to 10 healthy volunteers 15 min before the ingestion of a 1050-kcal standard meal. Gallbladder and antral volumes were measured by real-time ultrasonography in basal conditions and at fixed time intervals after the meal. Oral loxiglumide administration was followed by a total inhibition of the gallbladder contraction for 60 min after the end of the meal ingestion. Thereafter, up to the end of the study period, gallbladder volume was larger than that of the placebo study (at 300 min after the meal 2.7 +/- 1.6 ml after placebo and 8.2 +/- 3.5 ml after loxiglumide; P less than 0.008). No difference between placebo and loxiglumide was found in the antral volumes at any time interval (postprandial 63.5 +/- 16.5 ml after placebo and 59.4 +/- 24 ml after loxiglumide; at 300 min after the meal 20.8 +/- 13.3 ml after placebo and 18.9 +/- 9.5 ml after loxiglumide). In conclusion, a single oral dose of loxiglumide at the dose of 800 mg can inhibit postprandial gallbladder contraction without affecting gastric emptying. It would therefore appear that in man endogenous CCK, released after a solid-liquid, caloric, nutrient-balanced meal, plays a major role in the contraction of the gallbladder but does not affect gastric emptying.

Administration, Oral↗
PubMed1989

Rectal sensitivity in chronic constipation.

Rectal sensitivity is often reduced in patients affected by chronic constipation, but it is not known whether this alteration differs according to the severity and the site(s) of the slowing of gastrointestinal transit. Moreover, it is not known whether alteration precedes or follows bowel complaints. In this study, perception of intrarectal distension was evaluated in 28 healthy controls, in 20 patients complaining of constipation and with a normal gastrointestinal transit time (less than 96 hr), and in 44 patients complaining of constipation and with a prolonged gastrointestinal transit time (greater than 96 hr). Within the latter group, perception to intrarectal distension was analyzed in patients with slowing of transit in the rectum only, in the colon only, and in both the rectum and the colon. In a subgroup of 22 patients, rectal sensitivity was evaluated before and after treatment. Rectal sensitivity was found to be reduced significantly in constipated patients; it was more severely reduced in patients with objective evidence of prolonged gastrointestinal transit time and with slow transit in the rectum. Rectal sensitivity improved in patients who responded to treatment and did not vary significantly in nonresponders.

Adolescent↗