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Biomedical subjects

A Licata

Publications and source records attributed to A Licata.

98 records · Page 6Linked to original sources
PubMedDate not supplied

[Non recurrent laryngeal nerve. Personal experience].

PURPOSE: Damage to the recurrent laryngeal nerve (RLN) during thyroid or parathyroid surgery is the most common iatrogenic cause of vocal cord paralysis. Identification of the RLNs and meticulous surgical technique can significantly decrease the incidence of this complication. Nonrecurrent RLNs (NRRLNs) are exceedingly rare. Surgeons need to be aware of their position to avoid injuries. PATIENT AND METHODS: A retrospective review of 263 right RLN exposures (and 251 left RNL) over a 5-year period was performed. RESULTS: Two NRRLNs were encountered, for an incidence of 0.39% (0.76% only for right dissection), without anatomic anomalies on the left side. The nerve anomaly was never preoperatively diagnosed. CONCLUSION: NRRLNs are rare and is associated with a right subclavian artery arising from distal aortic arch. Awareness of their existence and correct surgical technique will prevent the surgeon from accidentally lesion of NRRLN one if it is encountered during thyroid or parathyroid surgery.

Humans↗
PubMedDate not supplied

[Campylobacter pylori (C. pylori): an occasional finding or a constant pathogenetic factor in peptic and inflammatory gastroduodenal pathology? Personal observations].

The detection of CP in the mucosa of the gastric antrum had led to the supposition of this bacterium's potential pathogenetic role in the onset and continuation of peptic ulcer and/or inflammatory gastroduodenal disease. After reviewing the literature, the Authors report the incidence rate of the presence of C.P. in the mucosa of the gastric antrum in 110 symptomatic patients. Endoscopic examination revealed a negative diagnosis, or the presence of gastric and/or duodenal ulcer, or aspecific inflammatory disease. C.P. was detected using the quick urea test and histomorphological analysis after modified Giemsa staining on bioptic endoscopic specimens. C.P. were present in 86.6% of duodenal ulcers, 94.8% of gastro-duodenal inflammation, and 29.4% of endoscopical normal patients. These results confirm that C.P. should not be considered an occasional finding but almost a constant factors. The importance of performing the quick urea test during endoscopic examination is underlined, since if positive an appropriate therapeutic protocol can be started as soon as possible.

Adult↗
PubMedDate not supplied

[Prevalence of pericardial effusion in subjects with rheumatoid arthritis: an echocardiographic study].

We used echocardiography to determine the prevalence of pericardial effusion in rheumatoid arthritis (RA) patients without cardiac systems and compared our results to those obtained in a control group of age-matched subjects. Thirty-six patients with RA (6 men, 30 women; mean age 51 +/- 11 years) were selected from a patient population in treatment at our outpatient Rheumatology Clinic. None of the patients had any symptoms of cardiac disease, and all patients with signs and/or systems of extracardiac disease were excluded from the study. The control group consisted of 60 volunteers (mean age 51 +/- 12 years) randomly selected from a larger group of subjects with neither symptoms, signs and/or clinical findings of extracardiac disease nor symptoms of cardiac disease. Standard two-dimensional and M-mode echocardiography was carried out on all subjects. In the RA patients, we found a high prevalence of pericardial involvement, especially minimal pericardial effusion. There was no statistically significant difference among subgroups of RA patients based on stage and duration of disease respectively. There was no correlation between pericardial involvement and inflammatory indexes or drug therapy. The minimal pericardial effusion found in our patients could be caused by the extra-articular inflammatory process and might be one aspect of a more complex picture characterized by silent cardiac involvement. The potential for symptomless pericardial alterations documented in our patients indicates that careful cardiac evaluation should be given high priority in the assessment and management of subjects with RA.

Adult↗
PubMedDate not supplied

[Cancer of the extrahepatic bile ducts. Clinical experience and anatomic/surgical considerations].

Cancer of the extrahepatic biliary tract is a rare disease related to a severe prognosis. The resection of the extrahepatic biliary tract is a complex procedure and the preoperative assessment of resectability is made difficult because of the malignancies. Biliary cancer resection can be curative in some patients but in some cases a liver resection has also to be performed. The authors retrospectively analyzed their recent cases closely examining some anatomical and technical aspects of biliary cancer resection. Eight patients were treated, three had distal cancer, two a central and three a proximal one (Klatskin tumor). In seven patients (87%) the cancer had spread to the liver. In one patient there was a favourable anatomical variation. All eight patients underwent laparotomy and in two (25%) the biliary cancer could be resected but curatively only in one case. Six patients underwent palliative procedures with a maximal survival of 8 months. The only curatively resected patient is well, without recurrence, 13 months after surgery. These results are similar to those reported concerning resectability and survival but a higher rate of liver metastases strongly reduced the amount of possibly curative resections. The experience shows the importance of laparotomy and of the knowledge of anatomy for a correct approach to resection and palliation of this cancer.

Aged↗
PubMedDate not supplied

[Incidentalomas of the adrenal gland].

The wider application of radiological examinations (ultrasound, computed tomography) has led to the pre-clinical discovery of "masses" in some organs, especially in adrenal gland. As these tumors are incidentally discovered, they are called "incidentalomas", and this term has been universally accepted. As soon as adrenal incidentaloma has been diagnosed it is important to establish if the patient has to undergo immediate surgical exploration or it is possible to follow the patient radiologically. Hormonally active adrenal metastatic tumors and adrenal incidentalomas greater than cm 5 should be surgically treated, while other adrenal tumors can be followed radiologically. Median anterior laparotomy or bilateral subcostal incision give a good surgical view. It is important the cooperation with endocrinologist, cardiologist and anaesthetist in order to control possible hypertensive rises during surgical operation.

Adrenal Gland Neoplasms↗