Biomedical subjects

E Bettelli

Publications and source records attributed to E Bettelli.

10 recordsLinked to original sources

PubMed2003

[Rectal cancer in women].

A retrospective chart review was performed utilizing the First Department of Surgery of the University of Rome "La Sapienza" Medical School database. Ninety-two women who underwent abdominal surgery between 1980 and 1993 for rectal cancer were identified. Data collected included demographics, history, intraoperative findings and complications, cancer histology and stage and follow up. Special attention was focused on intraoperative incidental gynecological findings and follow up. Twenty-two patients being previously submitted to hysterectomy and three with oral intake of hormones were dismitted from the study. Of the remaining 67 patients gynecological procedure was associated to rectal surgery because of a previously undiagnosed gynecological condition. No prophylactic oophorectomies were performed. At follow up 7 patients experienced further surgery for gynecologic disease. The necessity to offer these patients the benefit of a preoperative informed decision about adjunctive gynecologic surgery and indications for bilateral oophorectomy is discussed.

Adult↗

PubMed2002

[Pancreatic anastomotic fistula after pancreaticoduodenectomy: incidence, significance and treatment].

The Authors reviewed the complications, and outcomes in a consecutives series of 97 patients undergoing pancreaticoduodenectomy. The clinical leak rate in this series was 21.8%. There was a difference in the pancreatic leak rate in those patients who underwent pancreatic ductal closure or end to end pancreaticojejunal invagination compared with end to side pancreaticojejunal anastomosis. The postoperative complication rate was 41.8% and the most common complications were pancreatic fistula. 9 deaths occurred in hospital or within 30 days from operation. Univariate and multivariate analysis revealed that operative technique, the pathological status of the pancreatic remnant, and mayor complications were the significant risk factors for the development of pancreatic anastomotic leak. In the 2000s pancreatic leak remains a potentially lethal problem. After pancreaticoduodenectomy, pancreatic remnant management by end to side pancreaticojejunostomy appeared safe in low-risk patients. Morbidity was greatest after pancreatic duct closure without anastomosis.

Aged↗

PubMed2001

Impact of axillary level I and II lymphnode dissection on the therapy of stage I and II breast cancer.

BACKGROUND: Routine performance of axillary node dissection (AND) in the treatment of stage I and II breast cancer has become controversial because of pretended morbidity of this procedure and progressing consent for sentinel lymphadenectomy. METHODS: Ninety-four consecutive patients who underwent AND for clinical stage I and II breast cancer were evaluated for a range of 48.3 months after surgery for movement and sensory alterations and arm swelling. Arm circumference was measured in all patients at the same four sites on both the operated and non operated sides preoperatively and in the immediate and late postoperative course. Capacity for movement was assessed pre- and postoperatively as active ranging at the shoulder joint. Postoperative numbness and paresthesias were assessed by standard questions. RESULTS: No patient had axillary recurrence. None of the detected differences between the preoperative and postoperative arm circumferences reached statistical significance. No persistent motion limitation was observed. Pain, numbness, paresthesia were detected in almost all patients in the immediate postoperative period but resolved spontaneously in all cases within 6 months. The obese body habit was detected on multivariate analysis as the only significant predictor of edema. CONCLUSIONS: No significant morbidity and no axillary recurrence were observed in current experience to follow AND. These findings suggest that axillary level I and II dissection remains an effective and safe tool for diagnostic, as well therapeutic, purposes in the treatment of stage I and II breast cancer. Further studies are necessary before it can safely be reported that axillary node dissection is an optional part of the treatment of stage I and II breast cancer.

Adult↗

PubMed2000

Role of astrocytes in antigen presentation and naive T-cell activation.

Astrocytes may have a role in antigen presentation in inflammatory diseases of the central nervous system (CNS) such as MS and EAE. In this study, we have assessed whether purified astrocyte cultures could stimulate naive CD4(+) or CD8(+) T-cells from TCR transgenic mice. As previously described, astrocytes sustained antigen-specific CD4(+) T-cell proliferation only in the presence of IFN-gamma, which promotes expression of both MHC class II and B7 molecules on astrocytes. In addition, we show that astrocytes also have the capacity to present antigens to naive CD8(+) T-cell and promote their proliferation. In one system, this CD8(+) T-cell proliferation was dependent on IFN-gamma-induced upregulation of B7 molecules on astrocytes. However, in a second TCR transgenic system, astrocytes could induce naive CD8(+) T-cell proliferation even in the absence of IFN-gamma. The possible implications of these findings for the pathophysiology of CNS inflammatory diseases are discussed.

Animals↗

PubMed2000

The role of cytokines in experimental autoimmune encephalomyelitis.

Experimental autoimmune encephalomyelitis (EAE) is an animal model of the demyelinating disease multiple sclerosis. In EAE cytokines play a critical role in defining the Th1 or Th2 nature of the autoantigen directed immune response, and in propagating and regulating inflammation within the central nervous system. In this review we summarize some of the recent developments in the field of cytokine research that relate to this model of human disease, focusing principally on disease induced with the autoantigens myelin proteolipid protein and myelin oligodendrocyte protein.

Cytokines↗

PubMed1998

IL-10 is critical in the regulation of autoimmune encephalomyelitis as demonstrated by studies of IL-10- and IL-4-deficient and transgenic mice.

Experimental autoimmune encephalomyelitis (EAE) and other organ-specific autoimmune diseases are induced by autoantigen-specific Th1 cells. In contrast, transfer of autoantigen-reactive Th2 cells that produce IL-4 and IL-10 can prevent and/or reverse EAE. The relative roles of these two Th2 cytokines in the regulation of EAE has not been evaluated. Utilizing IL-4 and IL-10 knockout mice deficient for these cytokines and IL-10 and IL-4 transgenic mice overexpressing these cytokines, we demonstrate that IL-10-deficient mice (IL-10(-/-)) are more susceptible and develop a more severe EAE when compared with IL-4-deficient mice (IL-4(-/-)) or wild-type mice. T cells from IL-10(-/-) mice exhibit a stronger Ag-specific proliferation, produce more proinflammatory cytokines (IFN-gamma and TNF-alpha) when stimulated with an encephalitogenic peptide, and induce very severe EAE upon transfer into wild-type mice. In contrast, while IL-4 transgenic mice develop similar disease compared with their nontransgenic littermates, mice transgenic for IL-10 are completely resistant to the development of EAE. Taken together, our data suggest that IL-10 plays a more critical role in the regulation of EAE by regulating autopathogenic Th1 responses.

Adoptive Transfer↗

PubMedDate not supplied

[Ambulatory closed surgery for the treatment of pilonidal sinus].

Pilonidal disease (PD) is a common chronic disorder of the sacrococcygeal region afflecting young people. Despite several methods for treating PD have been described, the management remains controversial. Recent reports have advocated different surgical approaches such as open or closed technique, but recurrence plagues all forms of therapy. We conducted this case review to evaluate the validity of an outpatient closed technique in the treatment of chronic pilonidal disease. Between January 1997 and July 1999, 65 consecutive patients with quiescent chronic PD were electively treated by surgical excision of the cyst and primary closure. There were 47 men (72%) and 18 women (28%) in this study. Patients ranged in age from 14 to 47 years, the average age being 21 years. The median healing time was 8 days and the median time to return to full work was 20 days (range 10-25). Infection and recurrence rates were 1.5% and 4.6% respectively. There was no correlation among recurrence rate, postoperative infection, or prior surgery. Cyst excision and primary closure is a safe, low cost operation with a very high long-term success rate and a negligible rate of complications. It can successfully be performed under local anaesthesia in an outpatient facility.

Adolescent↗

PubMedDate not supplied

[Use of ileostomy and colostomy as temporal derivation in colorectal surgery].

A retrospective study on 41 patients with primary stoma creation after low anterior resection of the rectum was made. Among the 41 patients 24 had a loop colostomy (Group A) and 17 had a loop ileostomy (Group B). The two groups were well matched for each of the data analysed and there was no significant difference in the rate of complications related to stomas creation and closure. In this study the Authors suggest that loop ileostomy is the best procedure to electively defunctionate colorectal anastomoses.

Adenocarcinoma↗

PubMedDate not supplied

[Carcinoma of the male breast. Prognostic factors and outcome of surgical treatment].

A retrospective study was made on 18 male patients with breast carcinoma treated at the Department of Surgery "Pietro Valdoni" of the University "La Sapienza" of Rome, Medical School. Demographics, pathology, stages, and treatment were determined from clinical reports. All patients but one underwent modified radical mastectomy. The length of follow up averaged 57.5 months. Five years actuarial survival rate was 62%. In the current study the Authors suggest that the clinical, prognostic and treatment features of breast carcinoma in men are similar to those reported in literature for post-menopausal women.

Aged↗

PubMedDate not supplied

[Cecal volvulus].

A retrospective study on 18 patients with cecal volvulus surgically treated was made. Demographics and clinical data, as well as treatment were determined from clinical reports. The operative procedures employed were cecostomy (56%), cecopexy (22%) and right colectomy (22%). The length of follow up averaged 63 months and there was one recurrence. The Authors suggest that cecostomy should be employed in patients with viable bowel, and resection should be limited to cases with gangrene.

Cecal Diseases↗