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Biomedical subjects

G Maggi

Publications and source records attributed to G Maggi.

At least 181 records · Page 10Linked to original sources

The value of selective mediastinoscopy in predicting resectability of patients with bronchogenic carcinoma.

From 1980 to 1990, 1505 patients underwent thoracotomy as definitive treatment for non small cell lung cancer. Computed tomography (CT) of the chest has been used routinely since 1984 for assessment of mediastinal lymph node involvement. A total of 235 cervical mediastinoscopies and 71 anterior parasternal mediastinotomies were performed on the same patient population as preoperative staging when CT scan demonstrated mediastinal lymph nodes larger than 1 cm. Radical resections showed a constant increase in number from 70.1% in the period 1980-84 to 82.7% in the period 1985-90. Exploratory thoracotomies and thoracotomies with residual tumor showed a parallel reduction: 14.5% in 1980-84 to 7.4% in 1985-90 for the former, 15.4% in 1980-84 to 9.8% in 1985-90 for the latter. The percentage of N2 disease to the total number of thoracotomies decreased from 23.6% in 1980-81 to 11.2% in 1989-90. We conclude that a selective use of cervical mediastinoscopy and anterior parasternal mediastinotomy, based upon the results of CT scan, may have contributed to reduce the number of exploratory thoracotomies and thoracotomies with residual tumor.

Carcinoma, Bronchogenic↗

Pure traumatic dislocation of the elbow.

A total of 89 patients with simple traumatic dislocation treated at the Rizzoli Orthopaedic Institute between 1975 and 1986 were reviewed. The authors considered trauma mechanism, treatment, and results. The evaluation showed that elbow dislocation without joint fracture has a favorable prognosis with return to complete functions. Frequently, para-articular calcifications do not negatively affect joint function. Immediate reduction and plaster immobilization for 2 to 3 weeks are required to obtain soft tissue repair, and in order to avoid functional restriction as a result of prolonged immobilization. After removal of plaster active mobilization is sufficient to obtain complete joint function.

Adolescent↗

Pleural abrasion in the treatment of recurrent or persistent spontaneous pneumothorax. Results of 94 consecutive cases.

In the ten-year period 1982 to 1991, 94 patients underwent pleural abrasion as definite treatment for spontaneous pneumothorax. Surgical indications included: 1) third recurrence of homolateral pneumothorax, 2) second recurrence of homolateral pneumothorax in the presence of alternating pneumothorax, and 3) persistent air leak with incomplete lung re-expansion in the presence of spontaneous pneumothorax treated with pleural drainage for more than 10 days. No deaths were observed in the present series. Post-operative complications were minimal and all reversible, including two cases of pleural effusion, one case of hemothorax, and one case of Horner's syndrome. Eighty cases were followed up from 7 to 91 months. No recurrences occurred during the follow-up period. Clinical, radiological and functional results appear satisfactory. Pleural abrasion seems to represent a valid surgical option in the treatment of recurrent or persistent spontaneous pneumothorax.

Adolescent↗

[Comparison of cytology and microhistology in ultrasonic_guided fine-needle biopsy of the prostate].

The authors performed US-guided biopsy on 30 consecutive patients with prostatic masses of an undefined nature. Two samples were taken from each patient, one using an aspirating needle and another using a cutting needle. The two techniques proved to be quite complementary, even in the light of subsequent diagnostic follow-ups. Moreover, the possibility of comparing the cytological findings with the pathologic ones, with a "double blind" technique, greatly increased bioptic reliability.

Biopsy, Needle↗

Tracheal stenosis. A study of 100 cases.

A series of 100 cases of tracheal stenoses, 66 non-neoplastic and 34 neoplastic, are reviewed; tracheal resection was performed in 28 inflammatory stenoses and in five tumours. A T-tube stent was used in 12 patients. Results were good in 81% of resections for non-neoplastic stenoses; two out of three resections for adenoid cystic carcinoma are alive after ten years and the third died after two years with metastases; two patients who received a tracheal resection for epidermoid carcinomas died after three and four years with metastases. Inflammatory tracheal stenoses treated using T-tube achieved good results only in one third of cases. Pre-operative preparation is the most important factor to obtain good results: end-to-end anastomosis requires a healthy mucosa without infection or ulcers.

Adolescent↗

Resection and radical lymphadenectomy for lung cancer: prognostic significance of lymphatic metastases.

From 1979 to 1987, 1103 thoracotomies were performed in patients with lung cancer: 824 (74.7%) radical resections, 141 (12.7%) palliative resections and 138 (12.5%) exploratory thoracotomies. Among the 965 patients who underwent resection, 539 patients were N0, 190 patients N1 and 236 patients N2. Among patients with N1 disease we observed more frequent hilar metastases in the more advanced tumors (p less than 0.05). In 84 out of the 232 N2 patients (36.2%; 13.4% of all patients) a skipping of all pulmonary sites was observed. The most commonly invaded mediastinal levels were the paratracheal nodes on the right and the aortic nodes on the left, followed by the subcarinal nodes. The greater the neoplastic involvement of pulmonary nodal sites, the higher the percentage of patients with N2 disease and the number of mediastinal levels with tumor cells (p less than 0.05). The 5-year survival rate is 60% for N0, 46% for N1 and 23% for N2 disease. There is no significant difference in survival between N2 and N1 + N2 patients. Metastatic involvement of both upper and lower mediastinal levels carries a poorer prognosis compared to involvement of one compartment only (p less than 0.02). Patients with findings of mediastinal metastatic involvement should be selected: studies on lymphatic metastases are useful to better establish surgical indications for N2 patients.

Humans↗

Microcirculation in the elderly.

Studies on microcirculation in the elderly include observations in the small vessels of the bulbar conjunctiva and of the nailbed with respect to a classification of the findings according to a number of semeiologic criteria (diameter and shape alterations, terminal capillary network, intravascular red cell aggregation). In vascular diseases of the elderly there are typical alterations of the capillaroscopic findings in the bulbar conjunctiva and in the nailbed, particularly in cases of arteriosclerosis, arterial hypertension, diabetic microangiopathy, heart failure, ischemic myocardiopathies. During the treatment with some vasoactive drugs (nicotinic acid and its derivatives, buflomedil, CPD-choline) there are marked modifications of the small conjunctival vessels, with evident dilatations, appearance of collaterals, increased homogeneity of the blood flow, better evidence of the capillary network and reduction of intravascular red cell aggregation.

Aged↗