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Biomedical subjects

L Bucci

Publications and source records attributed to L Bucci.

89 records · Page 5Linked to original sources
PubMedDate not supplied

Evaluation of DOWNSTAGING as leading concept in sphincter-saving surgery for rectal cancer after preoperative radio-chemotherapy (Preop RCT).

AIM: To evaluate the downstaging of rectal cancer after preop R +/- CT. METHODS: 392 patients (pts) with rectal cancer were observed. Only 172 pts (58%) with II and III stage cancer of middle and lower third were examined. Enrol-led pts were 168: 52 of them received preop R +/- CT (32 RT, 20 R + CT). Preop R +/- CT group included 14 middle third cancers (73%), 38 lower third (17%). In this group, tumor stage was as follows: 44 T3 stage tumors (86.4%), 8 (15.4%) T4. Mean age of this group was 57 years (range 42-67). Patients received 45 Gy for 5 weeks in 25 fractions and continuous administration of 5-FU (300-500 mg/m2/die). Surgery was performed 6 weeks +/- 7 days after the therapy. RESULTS: Downstaging, at least of 1 T-stage level, was detected in 45 patients (86%) (8 middle third; 32 lower third), in 5 (9.6%) (4 middle third, 1 lower third), tumor decreased to pT0N0, while in 7 (13.5%) (2 middle third, 5 lower third), there was no response. An Anterior Resection (AR) was performed in 40 patients (77%) [4 Downstaged to pT0N0 middle third cancers; 36 downstaged but with residual disease (8 middle third, 28 lower third)]; APR was performed in 12 (23%) (7 No responders patients, 1 Downstaged to pT0N0 lower third cancer, 4 downstaged but with residual disease of lower third). CONCLUSIONS: Preop R +/- CT is effective in obtaining a significative downstaging to allow sphincter saving surgery, without compromising oncological results.

Adult↗
PubMedDate not supplied

[Toxic megacolon: physiopathologic mechanism and surgical choices].

Toxic megacolon is the most dreadful complication arising in patients affected with inflammatory bowel diseases. Its incidence is rather rare, bur mortality rate is significantly high (about 40% of cases). Pathological modifications occurring in toxic megacolon deeply influence evolution and prognosis of this complication and, consequently, surgical choices. Starting from the pathophysiology of toxic megacolon, the Authors review their experience with acute colitis, emphasizing the need for a radical treatment, as only total colectomy can assure, versus Turnbull's operation or more decompression of the bowel. To save the colon means, in fact, to leave the source of sepsis "in situ". The authors experienced Turnbull's procedure only in one of the patients observed with "quoad vitam" poor results.

Colitis, Ulcerative↗
PubMedDate not supplied

[Aging and convulsions: possibility of primary epilepsy beginning in old age].

The authors have carried out a retrospective study of 63 patients with epileptic seizures occurring after 60 years of age. Possible aetiological factors, the semiology and frequency of seizures and existing correlations, including instrumental ones, have been studied. The necessity of methods capable of more detailed structural evaluations and functional measurements has emerged. These will reduce the incidence of those types of epilepsy which at present do not seem to result from lesions. The possibility of senile epilepsy due to changes typical of this period and occurring mainly in the 60 to 70 age group, seems, however, worthy of consideration.

Age Factors↗
PubMedDate not supplied

[A case of the Solomon syndrome].

The authors describe a trisintomatic case (with cutaneous, neurological and osseous alterations) of a syndrome of Solomon. The case appears peculiar for the tardy beginning of the manifestations.

Adult↗
PubMedDate not supplied

[Biohumoral variations during total parenteral nutrition with lipids. Effects on plasma lipoproteins in patients in cerebral coma in regression].

An assessment was made of the blood lipid pattern in a group of patients in critical situations subjected to T.P.N. with a mixed calorie intake (sugars, lipids, amino acids). It was found that the pronounced previous deficiency was corrected in a significantly shorter period, and that despite the large load on calories in the form of fats there were no changes worthy of note in the body fluids. Serial determination of lipoproteins before, during and after T.P.N. substantiated the clinical findings. Lab checks, within the limits set by intuitive variations, did not reveal alterations with a pathological meaning, for the very reason that they were not linked to organic enzyme and hormone deficiencies, but were positive changes attributable to the temporary exogenous input.

Coma↗
PubMedDate not supplied

[Metabolic imbalance during total parenteral nutrition. Experience in subjects with degenerative neurological diseases].

Various metabolic disturbances (hydroelectrolytic and basic acid imbalances, hypo- and hyper- glycaemia etc.) are among the possible complications of N.P.T. A comparative statistical study of similar patients undergoing N.P.T. and others not so treated demonstrates that far from stimulating metabolic disturbances, N.P.T. is able to reduce the incidence of such conditions.

Humans↗
PubMedDate not supplied

[Anorexia nervosa ].

The etiopathogenesis of the anorexia nervosa is still unknown although several hypotheses have been postulated. Recently it has been postulated that it may be due to biochemical derangement of the serotonin metabolism. Clinically the anorexia nervosa is characterized by an obsessive fear of gaining body weight and, therefore, by a phobic repulsion for the food. It differs, however from the phobic-obsessive psychoneurosis for the constant presence of the amenorrhea. The treatment requires psychopharmacology as well as psychotherapy.

Anorexia Nervosa↗
PubMedDate not supplied

[Chronic idiopathic intestinal pseudo-obstruction: a clinical case and review of the literature].

The authors report a case characterized by impairment of the intestinal function clinically mimicking a mechanical obstruction in the absence of any occluding lesion of the gut lumen. Different pathological conditions, different clinical syndromes, instrumental approach for the diagnosis as well as medical and surgical treatment of pseudo-obstruction are discussed. Surgery has not been proven to be effective in the clinical management of CIIP for the irreversibility of the myopathic or neuropathic lesions. The most frequent causes of death are unnecessary surgery, ab ingestis pneumonia, cardiac arrest and malnutrition.

Chronic Disease↗
PubMedDate not supplied

Massive lower gastrointestinal hemorrhage in patients with portal hypertensive enteropathy: a report of two cases.

Mucosal and vascular changes in the lower gastrointestinal tract occur commonly in patients with portal hypertension. Portal enteropathy, however, is usually asymptomatic, though occasionally clinically significant for chronic gastrointestinal bleeding. Massive hemorrhage has only rarely been described and its management is controversial. Even though more effective non-operative treatments are now available, an emergency porta-systemic shunt procedure remains an important option for selected patients. We report on two cases of massive lower gastrointestinal bleeding from portal hypertensive enteropathy secondary to post-viral cirrhosis.

Aged↗