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Biomedical subjects

C Campisi

Publications and source records attributed to C Campisi.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

[Advanced technology in emergency surgery: from microsurgery to robotics].

AIMS: State-of-the-Art on clinical applications of Advanced Technologies in Emergency Surgery. MATERIAL AND METHODS: Evaluation of present technological applications in Emergency Surgery, according also to author's personal experience and that of his School. RESULTS: Significant improvement of cost/benefits ratio at medium and long term and positive social implications. DISCUSSION: The rational application of Advanced Technologies in Emergency Surgery is expected in second level Italian DEA (e.g.: Department of Emergency and Trauma of the highest level), natural site of main Centers for Surgical Emergencies, according to National and International Literature analysis. CONCLUSIONS: The advantages of using the most advanced technologies in Emergency Surgery from the organizing point of view have positive implications on University School of Medicine ambit for educational programs and post-graduate schools.

Emergency Treatment↗
PubMedDate not supplied

[Post-mastectomy lymphedema: surgical therapy].

After some preliminary remarks concerning epidemiological data about post-mastectomy lymphedema, on the basis of specific etiologic and pathophysiologic aspects, authors report a modern clinical and instrumental staging of lymphedema and an accurate diagnostic protocol, which allows not only to study lymphedema at late stages, but also to individuate the disease at earliest stages. Protocols of medical, physical and rehabilitative treatment mostly used today are schematically described, and they include proper igienic measures for the prevention bacterial and micotic infections, manual lymph drainage, sequential compression therapy, exercises, thermotherapy, bandages and elastic garments. Authors underline above all the importance of Microsurgery in treating post-mastectomy lymphedema, by means of modern methods of lymphatic microsurgery, derivative or reconstructive (multiple lymphatic-venous anastomoses, lymphatic-venous-lymphatic plasty). The operation of multiple lymphatic-venous anastomoses represent the mostly used technique. The registry consists of 194 microsurgical operations, performed in patients treated and followed-up statistically in the last 15 years, with positive result in over 80% of cases.

Arm↗
PubMedDate not supplied

[Disability and lymphedema].

Axillary lymph-nodal dissection (ALD) for the surgical treatment of breast cancer plays an important role in consideration above all of the incidence of early and late complications (upper limb edema, pain at thoracic wall, impaired function of the limb), that sometimes can hide the real benefit for the patient. Arm lymphedema due to breast cancer treatment particularly represents a significantly disabling complication, from both physical and psychological points of view. It is useful, therefore, to inform patients about the necessity of a preventive treatment aimed at improving prognosis in relation to a possible future disability. Authors report some clinical experiences of work groups who studied psycho-physical damage due to lymphedema after breast cancer treatment. Finally, therapeutic and preventive procedures are pointed out with the aim of reducing the psycho-physical burden of disability correlated to lymphedema.

Arm↗
PubMedDate not supplied

[Lymphedema secondary to breast cancer treatment: possibility of diagnostic and therapeutic prevention].

We performed a prospective randomized study upon 50 patients who had undergone a breast cancer treatment, considering particularly the possibility of appearance of arm secondary lymphedema. The patients were divided in two groups of 25 patients each. In the 1st group, we performed only a clinical follow-up, whilst in the 2nd one, we used also lymphoscintigraphy. The aim of the study was to compare the incidence of arm secondary lymphedema in the two groups, and relate the data with those of the international literature, in order to identify diagnostic procedures indicative of the risk of development of lymphedema and find proper therapeutic preventive measures. It is certainty complex to foresee the appearance of arm lymphedema due to breast cancer treatment. No specific preventive therapeutic methods based upon particular diagnostic investigations were ever reported. Patients had undergone surgery and radiation for breast cancer in the period between April 1992 and June 1994, and controlled at over 5 years after operation. Upper limb lymphoscintigraphy was performed only in one of the two groups of 25 patients, before operation and, furthermore, after 1-3-6 months and 1-3 years from the treatment. Patients who presented lymphoscintigraphic alterations (dermal back flow, diffused or delayed transit of the tracer, etc.), before edema appeared clinically, underwent physical and rehabilitative therapy (bandages, manual lymphatic drainage, mechanical lymph drainage, elastic garments, etc.) and microsurgery (lymphatic-venous anastomoses at the arm), performed early (stages Ib and II) in patients not responsive to physical therapy. In the first group followed only clinically, secondary arm lymphedema occurred in 9 cases (36%), and appeared after a period variable from 1 week to 2 years (3-6 months averagely). In the second group, lymphoscintigraphy, performed preoperatively, permitted to find lymphatic impairment (absence of deltoid way, reduced axillary lymph nodal tracer uptake, delayed transit of the tracer) at the upper limb in 4 patients (15%). After breast cancer surgery, lymphoscintigraphy pointed out alterations of lymphatic circulation in 5 patients (20%) after 1 month, in other 6 cases (56%) at 6 months, other 5 (76%) after 1 year and 3 (88%) at 3 and 5 years. Physical preventive therapy performed in patients with positive lymphoscintigraphy, even before the clinical appearance of edema, allowed to find a clinically evident lymphedema only in 2 cases (8%). The last two patients underwent early (at stage Ib and II) microsurgical operation of lymphatic-venous anastomoses, with complete regression of edema and improved lymphatic drainage of the arm controlled by lymphoscintigraphy (appearance of preferential lymphatic pathways, absence of dermal back flow). Secondary arm lymphedema due to breast cancer treatment appears in 20-25% of cases till 35% when surgery is associated with radiotherapy. Lymphoscintigraphy allows to pointout alterations of lymphatic drainage before the clinical appearance of edema. Preventive physical and rehabilitative measures allows to reduce the clinical appearance of lymphedema significantly. Microsurgical operation performed precociously, at the early stages of the disease, permits to obtain the complete regression of the pathology thanks to the repair of preferential lymphatic pathways before of fibrosclerotic tissural alterations occur, which cause progressive worsening of clinical conditions, together with recurrent attacks of acute lymphangitis.

Adult↗
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[Diagnosis and therapy of severe acute colitis, still an open issue. Our experience].

From a review of a series of 12 cases of whom 52 operated and of the literature, the Authors discuss about aetiology, pathogenesis and diagnosis of severe colitis. Clinical and laboratory findings, CT and plain films of the abdomen and at last colonoscopy should be evaluated very carefully for certainty diagnosis of a severe acute colitis or toxic megacolon. They suggest a multidisciplinary approach as fundamental for medical management, for indications and correct timing of surgical procedures and to decrease postoperative morbility and mortality. Total colectomy with ileostomy is recommended in emergency surgical treatment of this colonic acute diseases, whereas for urgency operation, performed not later than 48-72 hour of adequate medical treatment, colectomy is suggested with ileorectal or ileoanal anastomosis and ileostomy.

Acute Disease↗
PubMedDate not supplied

[Possibility of using intracavitary perfusion hyperthermia in the treatment of gastric cancer: an study of its local and systemic effects].

The selective lethal effect of heat on neoplastic cells has been demonstrated by several experiments "in vitro" and "in vivo". In this paper the authors report their experience on endocavitary-hyperthermic perfusion of the stomach, performed with a hyperthermic-perfusion system invented and built by them. 12 rabbits were submitted to hyperthermic perfusion of the stomach at 42.5 C for a period of 50 minutes under general anesthesia. Three other rabbits were treated with normothermic perfusion for a further control. Rectal temperature was monitored during perfusion and gastric pH was evaluated after treatment by a gastrectomy. Neither death nor major complications were observed during and after treatment and physiologic functions were maintained. Animals were sacrificed at different times from the treatment and macroscopic and microscopic exams of the principal organs were performed. Edema of the gastric wall was present in rabbits killed after a short time from treatment, while it was absent in animals sacrificed after a longer time; in these animals normal aspect of gastric glands and no fibroblastic activity was evident. The authors consider the possibility of employing this treatment in curing advanced gastric cancer, eventually associated with hyperthermic perfusion of abdominal cavity.

Animals↗
PubMedDate not supplied

[Clinical-experimental models for the identification of immunologic parameters to be integrated in traditional staging systems of colorectal neoplasms].

The Authors evaluate new possible models for the staging of colorectal cancer based on clinico-morphological, histo-pathological and bio-immunological parameters. Particularly, they evaluate the possibility of studying host's immunological response against tumor spread by the examination of the "in situ" cellular responses. This study was performed by cytotoxic test and immunohistochemical evaluation of the lymphocytes. The latter seems to give better results compared to the first in the evaluation of the host's immunological response.

Colorectal Neoplasms↗
PubMedDate not supplied

[Interferons in the therapy of solid tumors].

Belonging to the vast family of cytokines, interferons (IFN) have recently been widely investigated concerning their possible clinical applications, both in virology and oncology. In this field results have been quite mixed but definitely encouraging. The best achievements have been obtained in hematology, and particularly in the treatment of hairy cell leukemia and chronic myelogenous leukemia, but new perspectives have also opened in the therapy of solid tumors, especially in the local treatment of superficial bladder cancer and ovarian cancer, AIDS-related Kaposi's sarcoma and malignant melanoma. IFN have in certain cases showed an efficacy comparable to that of classic treatments but with lower toxicity, and in some tumors they have even improved the results obtained so far, especially in combined therapy. We have here gathered the most recent results concerning the use of IFN in the therapy of solid tumors in order to highlight the new therapeutic opportunities available to clinical oncology.

Acquired Immunodeficiency Syndrome↗