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Biomedical subjects

A Messineo

Publications and source records attributed to A Messineo.

34 records · Page 2Linked to original sources
PubMed1992

The balloon posterior tracheal split: a technique for managing tracheal stenosis in the premature infant.

Congenital tracheal stenosis (CTS) in the premature infant almost invariably leads to death for lack of effective reconstructive techniques. We hypothesized that the complete or near complete cartilaginous rings of CTS have a weak point in the posterior portion. Aggressive balloon dilation would result in a posterior longitudinal disruption of the trachea, and an expanded tracheal wall would be created after an appropriate period of endotracheal stenting. Three premature infants with multiple anomalies and CTS were treated with endoscopic posterior tracheal splitting, dividing the trachea as predicted. Although two died of complications of congenital heart disease 2 weeks after the procedure, the third child is alive and well at 9 months of age without airway symptoms. The posterior tracheal wall also split when we performed the procedure in a fresh cadaveric CTS patient. We believe that balloon dilation may prove to be a valuable technique in the treatment of premature infants with congenital or acquired tracheal stenosis and/or in children with such complex diseases that major surgery is precluded.

Cadaver↗
PubMed1991

Successful tracheal autotransplantation with a vascularized omental flap.

A major problem in tracheal transplantation is the restoration of an adequate vascular supply to the transplanted trachea. In 12 piglets, a segment (6 rings) of thoracic trachea was removed and the excised segment was then sutured back in place. In 9 animals (group A), a vascularized omental flap was wrapped around the autotransplanted trachea. In the other 3 pigs (group B), the omentum was not used. Eight of 9 group A pigs were killed, 1 or 2 months later, having had no signs of airway obstruction; the 9th pig was killed after 14 days because of airway obstruction. The 3 pigs in group B were killed after 11 to 13 days because of progressive respiratory obstruction. In the 8 asymptomatic pigs in group A, the omental flap was viable and tracheal growth was normal with no differences in diameter between normal and autotransplanted trachea. Histologically intact cartilage was lined with respiratory epithelium. In the one group A pig who was killed early, the omental flap was necrotic. In this pig and in the 3 group B animals, extensive tracheal necrosis and nonviable cartilage were observed. These findings indicate that in the pig, a 6-ring segment of trachea can be transplanted with vascularization provided by an omental flap.

Animals↗
PubMed1990

Neonatal malignant solid tumors.

We reviewed the 8 malignant solid tumors in children less than 1 month of age observed at the Pediatric Surgical Department of Padua University from 1968 to 1985. These were 6 neuroblastomas, 1 Wilms' tumor and 1 angiosarcoma; 5/8 are alive without evidence of disease with a median follow-up of 8 years. The importance of combined therapeutic approach and conservative surgery are stressed. The sensitiveness of infants to both chemotherapy and radiotherapy are considered. Surgery remains the treatment of choice when a radical resection is possible.

Combined Modality Therapy↗
PubMed1990

Airport malaria.

Explore the source record for details and available documents.

Aircraft↗
PubMed1988

[Health status of journalists and organization of work in a national daily newspaper].

A multidisciplinary investigation was performed on 173 reporters (53 men and 20 women) of a newspaper. The microclimate and illumination conditions of the main seat, in which the use of VDT was beginning, were satisfactory, although not all the instruments were correctly adjusted. A very low percentage of reporters working in the main center was suffering from arterial hypertension indicating the presence of the "healthy worker effect". The values of plasma cortisol and arterial blood pressure of 10 reporters of the main seat, except two cases, changed normally during the evening hours. It is to point out that among the reporters there was significant correlation between spondylosis and astigmatism. The psychological investigation evidenced that the reporters were aggressive, eager of success and with constant attention. The EMG biofeedback demonstrated in the reporters with a more prolonged period of employment nervous tension and difficulty in relaxing. Particularly, in the reporters of the main center, the Stait-Trait Anxiety Inventory was more altered than in those of the peripheral seats.

Adult↗
PubMedDate not supplied

[The flu syndrome: update and therapeutic and prophylactic approach].

Authors in the present work analyse the history of the flu from V century A.C. until our days. We can know the different flu epidemic the structure of the virus and to take note of the different preventing device; of these the core is the vaccine. Thanks the vaccine is possible to weaken the big epidemics. Authors attract the importance on the mass vaccine and conclude to mention the new antivirus drugs per os.

Antiviral Agents↗
PubMedDate not supplied

Initial experience with laparoscopic adrenal surgery in children: is endoscopic surgery recommended and safe for the treatment of adrenocortical neoplasms?

Through a review of 83 cases reported in literature, including our experience of two successful right laparoscopic adrenalectomies performed in a 3-year-old girl for androgen-secreting adenoma and in a 9-year-old male for pheochromocitoma, we have anaIyzed the indications, the techniques and the results of laparoscopic or retroperitoneoscopic adrenalectomy in children. Nineteen pheochromocytomas, 18 neuroblastomas, 15 adenomas, 12 ganglioneuromas, 9 hyperplasias, 2 carcinomas, 1 teratoma and 1 adrenogenital syndrome have been treated with excellent results (follow-up 1 month to 4 years) with no evidence of recurrence. The age range is from 1 month to 16 years with an equal female/male ratio. The tumor size range from 10 mm to 80 mm with approximately a mean of 40 mm. Sixty-three laparoscopies of which 54 lateral and 9 anterior have been performed versus 14 posterior retroperitoneoscopies. Regarding right adrenalectomy, 29 were laparoscopic and only 2 retroperitoneoscopic. With regards to left adrenalectomy, 23 were laparoscopic and 9 retroperitoneoscopic. Looking at bilateral lesions, these tumors were approached laparoscopically in 6 cases alternating both sides and 1 retroperitoneoscopically (this case was already operated on the other side). The operative time ranged from 25 minutes in newborn to 320 minutes in bilateral cases with an average of 120 minutes. Conversion rate is higher in retroperitoneoscopy (30%) (4 cases out of 13), than laparoscopy (6%) (4 cases out of 63). Specifically, for right retroperitoneoscopic adrenalectomy conversion rate was 100% (2 cases out 2), for left retroperitoneoscopic adrenalectomy 22.2% (2 cases out 9), for right laparoscopic adrenalectomy 6.8% (2 cases out of 29) and for left laparoscopic adrenalectomy 8.6% (2 cases out of 23). Only in 1 case were blood transfusions requested. Hospital stays ranged from 35 hours to 17 days with an average of 4 days. In conclusion the indications of endoscopic adrenalectomy in children are not different from those of traditional surgery and the well-known advantages of laparoscopic adrenal surgery should be applied to pediatric patients. It seems that there is no age and tumor size limits for a well-trained surgical team. Lateral transperitoneal approach is the most utilized with the child positioned in 90-degree flank decubitus. Laparoscopy is undoubtly preferred for right adrenalectomy (93% of cases), while for left adrenalectomy retroperitoneoscopy has been used in 39% of the cases. Considering the conversion rate and on the basis of our experience with adults, we recommend laparoscopic adrenalectomy for both right and left adrenal lesions, but we think that the pediatric surgeon should feel free to choose the approach in which he/she is more skilled. However, the best surgical result will be achieved if the pediatric and adult surgeon collaborate with their different experiences. Lastly, we suggest the use of new technological devices such as Ultracision Harmonic Scalpel which was a critical factor in our two successful right adrenalectomies.

Adrenal Cortex Neoplasms↗
PubMedDate not supplied

[Atypical jobs: current facts, health surveillance and monitoring].

Based on the analysis of data collected during scientific studies and on the knowledge gained from the investigations on flexible or new forms of jobs it can be observed that the increasing amount of industrial accidents reporting and the existence of bad frame of mind are to be charged to the lack of training, to the uncertainty related to these type of jobs, to the short duration of the employment timeframe, to the difficulty of being in line with the company security standards, to risky activities, to immigrants who hardly get socially integrated, to workers with a low level of education and to their limited work experience. Since lots of studies have demonstrated that workers are fully unsatisfied when they recognize the uncertainty of their job situation it is mandatory to intervene on the real implementation of training, health control, emergency management and monitoring, thus avoiding any kind of marginalization. Given the complexity of these new forms of jobs, it will be up to the supervising institutions to look for new and adequate models and tools to monitor and control all the different situations, always keeping in mind all the relevant rules and laws.

Employment↗
PubMedDate not supplied

[Long-term prognosis of patients with extrahepatic biliary atresia successfully treated with surgery. Our experience].

The long-term prognosis of extrahepatic biliary atresia after surgical restoration of bile flow is still controversial. An ongoing process of cirrhosis and the development of portal hypertension continue to create frequent and frustrating management problems. Clinical features, hepatic function, echotomography aspect, calcium-phosphorus metabolism and serum levels of 25-OH-D-3 were evaluated in 12 anicteric patients with extrahepatic biliary atresia successfully treated in a period from 1974 through 1987. Seven of these children had a total of 21 episodes of cholangitis. In five patients liver biopsy, obtained at the time of the external diversion closure, showed a biliary cirrhosis. Growth, development and hepatic function were normal in all children studied; one patient had esophageal varices. The serum levels of 25-OH-D3 in patients without oral supplementation of vitamin D are lower than normal. This deficit can be corrected by oral administration of vitamin D. Our study revealed that the children with successful portoenterostomy appeared to thrive normally and that they tolerated the relatively mild liver damage. We believe that Kasai operation should be done in all patients with extrahepatic biliary atresia and that the liver transplantation is to be reserved only in those with unsuccessful Kasai. In our experience external diversion was not useful to prevent cholangitis and moreover it complicates the hepatectomy in case of transplantation.

Biliary Atresia↗
PubMedDate not supplied

[Contribution of the Italian Society of Occupational Medicine and Industrial Health to the formulation of the EEC Directives].

There are some problems in medico-legal approach and law interpretation about AIDS. The European Community has developed a wide program for health protection at workplace, giving Directives containing interesting starting points for AIDS prevention. The author discusses the main rules to be applied in regulations and specific procedures, and stresses the contribution of the Italian Society of Occupational Medicine and Industrial Hygiene to the formulation of these Directives.

Acquired Immunodeficiency Syndrome↗