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Biomedical subjects

E Ricci

Publications and source records attributed to E Ricci.

214 records · Page 12Linked to original sources
PubMedDate not supplied

Thyroid surgery in patients aged over 80 years.

In the past 5 years (1987-1991), we admitted for thyroid surgery 12 patients older than 80 years. Indications for surgery were represented by goiter causing tracheal compression and severe dyspnoea in 6 cases, and by preoperative cytological report of malignancy in the other 6 cases. The dyspnoea represented an absolute surgical indication. All patients but one were treated by cervicotomy; in one case we performed a median sternotomy. Frozen section was performed in all patients with cytological report of malignancy. Histology detected 3 differentiated cancers, 2 anaplastic cancers, and one follicular adenoma. The patients with benign disease were treated by 4 subtotal thyroidectomies and 3 total lobectomies. Three out of 5 affected by malignant lesions were submitted to a total thyroidectomy (differentiated carcinomas) and 2 to palliative thyroidectomy (anaplastic carcinoma). In this series there were neither intraoperative mortality nor major surgical complications. All the patients with dyspnoea were cured by surgery. All the patients affected by differentiated cancer were alive and well 8, 13 and 18 months after surgery. The mean survival of patients with anaplastic cancer was 12 months.

Adenoma↗
PubMedDate not supplied

Small bowel angiodysplasia: usefulness of peroperative enteroscopy.

In this report the Authors present the case of an old patient treated for chronic recurrent bleeding from small bowel angiodysplasia. The diagnosis was missed by the conventional methods: angiography and scintiscan with marked erythrocytes. Diagnosis was instead possible by using intraoperative enteroscopy. The Authors stress the usefulness of this technique that permits the exploration of the mucosal by trans-illumination to discover bleeding and vascular anomalies of the bowel.

Angiodysplasia↗
PubMedDate not supplied

[Hemidiaphragmatic reconstruction: the evaluation of 3 clinical cases].

The Authors after a review of the embriology, physiology and pathophysiology of diaphragm, report three cases of congenital or acquired diaphragmatical hernias. They discuss advantages and disadvantages of different surgical techniques on the basis of their technical experience as well as results obtained.

Aged↗
PubMedDate not supplied

Routine coronary angioplasty with autoperfusion balloon catheter: Can prolonged inflations reduce myocardial ischemia and preserve myocardial function?

Percutaneous transluminal coronary angioplasty (PTCA) is an established technique in the management of patients with angina pectoris or acute myocardial infarction. One of the major problems related to PTCA is myocardial ischemia following balloon catheter occlusion of the coronary artery. A new device utilized in an attempt to counteract myocardial ischemia is the perfusion balloon catheter which allows passive transmission of pulsatile blood flow to the distal myocardial bed. Our purpose was to compare immediate results following traditional PTCA and autoperfusion balloon PTCA in two groups randomly assigned to receive one of the two treatments (total patients n. = 158). The results show that coronary angioplasty was successfully performed in 98.87% of patients treated with autoperfusion PTCA and in 97.10% of those treated with conventional PTCA. In the autoperfusion PTCA group we observed a lower incidence (statistically significant) of ST elevation and of minor complications. We conclude that autoperfusion balloon catheter angioplasty may be recommended for its immediate success rate with good patient tolerance and lower incidence of in-hospital complications.

Adult↗
PubMedDate not supplied

[Postoperative organotherapy for multinodular goiter].

Post-operative therapy with L-Tiroxine can have a suppressive or substitutional aim. After a total thyroidectomy the patients need a substitutional therapy, while after subtotal thyroidectomy the aim of the therapy is to suppress the TSH secretion. In the second case we want either to avoid the recurrence, either to give the hormones that residual gland cannot produce. The drug of choice is L-Tiroxine for both suppressive o substitutional therapy: There is a difference in dosage, that must be greater in first case. While there are some doubts in the literature on the success of the suppressive therapy, we believe that there is enough evidence of his utility.

Goiter, Nodular↗
PubMedDate not supplied

[An update on parathyroid surgery].

The operative management of patients with hyperparathyroidism is controversial. High rates of persistent hypercalcemia and postoperative hypoparathyroidism are seen in multiple hyperplasia and bilateral neck exploration. Patients undergoing unilateral neck exploration with removal of a single parathyroid adenoma have a rapid clearance of PTH which declines within hours after surgery. There is a sensitive immunometric assay (IRMA) for the intact molecule which demonstrates a decline in 15 minutes during surgery. Intraoperative measurement of PTH may be complementary to surgical skill and histopathologic information and may modulate extension of neck exploration.

Adenoma↗
PubMedDate not supplied

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS).

We report the clinical, pathological, and genetic findings of a case of MELAS syndrome. This was a man who died for metabolic failure at the age of 27 years. His familiar history was positive for hypoacusia and stroke. He was of short stature and presented mild mental retardation. Since the age of 21 he suffered from recurrent brain-ischemic lesions mainly in the occipital lobes, documented by repeated CT scans. The laboratory data and muscle biopsy disclosed lactic acidosis with ragged red fibres. Neurophysiological data and peripheral nerve biopsy showed an axonal neuropathy. A point mutation in the tRNALeu(UUR) gene of mitochondrial DNA was detected in 5 post-mortem tissues and in muscle biopsy. No defects of mitochondrial respiratory chain were detected. The histological and ultrastructural studies of the brain showed multiple and heterogeneous ischemic lesions with no obvious alterations of cerebral blood vessels. These lesions do not correspond to the vascular territories of main cerebral arteries. Our observations support the hypothesis that local metabolic alterations would play a crucial role in the pathogenesis of cerebral ischemic lesions in MELAS. The correlation between genetic, biochemical, and pathological data are discussed.

Adult↗
PubMedDate not supplied

[Surgery of hyperthyroidism. Personal experience].

The Authors report their experience in the management of surgical hyperthyroidism, evaluating the different clinical pictures and the possibility of non surgical treatment. Advantages and disadvantages of both hemithyroidectomy and total thyroidectomy, are also described. The Authors conclude affirming their preference for techniques such as total hemithyroidectomy or thyroidectomy in some types of hyperthyroidism.

Adult↗
PubMedDate not supplied

[Venous ulcers of the lower limbs in the aged. Indications for bandages].

BACKGROUND: There are many causes of ulcer of the lower limb. In the elderly, venous ulcers and arteriosclerosis often coexist; for this reason pressure bandages might be contraindicated for the risk of precipitating a potentially critical arterial flow. In this work, the conditions which allow a safely treatment with pressure bandage in the elderly are evaluated. MATERIAL AND METHOD: Eleven self-sufficient elderly, with venous ulcerations to one leg only, and ankle pressure/omeral pressure between 0.92 and 0.86 were treated with elastic bandaging of the leg. RESULTS: All patients completed the treatment, with healing of the ulcer obtained in 3-8 months time. So far none of them relapsed. CONCLUSIONS: In the elderly, in selected cases, when Pc/Po > 0.86, pressure bandages can be safely applied to heal the ulcer, without running the risk of endangering arterial circulation.

Age Factors↗