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Biomedical subjects

M Conte

Publications and source records attributed to M Conte.

At least 19 recordsLinked to original sources
PubMed1995

Laparoscopic adrenalectomy.

Laparoscopic adrenalectomy has already been described by various authors. The present series consists of 25 consecutive, nonselected cases operated on in the Department of Surgery, University of Pisa. All operations were carried out using a minimal access technique, and there were no conversions to open surgery. The mean operative time was 109 min. The median postoperative stay was 3 days (range 2-5). There were no complications, and none of the patients required blood transfusion. This technique proved to be as safe as open surgery and caused less distress and allowed more rapid return to normal activity. Increased experience and the development of new laparoscopic equipment are expected to further reduce operative time.

Adrenal Gland Neoplasms↗
PubMed1995

Localized resectable neuroblastoma: results of the second study of the Italian Cooperative Group for Neuroblastoma.

PURPOSE: To optimize treatment for children with localized resectable neuroblastoma in 21 Italian institutions using a common protocol based on previous experience. PATIENTS AND METHODS: Between January 1985 and December 1992, 152 children aged 0 to 15 years with nondisseminated neuroblastoma were entered onto this study following complete resection of tumor without tumor rupture (TR) (stage 1), or resection with minimal tumor residue, and/or tumor infiltration of regional lymph nodes (LN+), and/or TR (stage 2). Of 144 assessable children, 69 were classified as having stage 1 disease and 75 as stage 2. Of stage 2 children, 49 had low-risk (LR) characteristics (age, 0 to 11 months or 1 to 15 years but negative lymph nodes and no TR). Stage 1 and stage 2 LR children did not receive adjuvant therapy. The remaining 26 stage 2 children had high-risk (HR) characteristics (age, 1 to 15 years with LN+ and/or TR) and received adjuvant chemotherapy for 6 months. RESULTS: Of 144 children, three died of therapy-related complications and 19 relapsed, of whom six died of disease. The estimated 5-year overall survival (OS) rate was 93% and the event-free survival (EFS) rate was 83%. Of 69 stage 1 children, one died postoperatively and five relapsed (one local and four disseminated, two of whom died), for 94% OS and 90% EFS rates. Of 49 stage 2 LR children, six relapsed (four local and two disseminated); relapses occurred in five of 20 infants with LN+, in one of four infants with TR, and in none of the remaining 25 children. One child died of disease and one of toxicity, for 96% OS and 85% EFS rates. Of 26 stage 2 HR children, eight relapsed (three of 20 with LN+, three of four with TR, and two of two with LN+ and TR), of whom three died of disease and one of toxicity, for 87% OS and 61% EFS rates. CONCLUSION: Our data confirm the overall good prognosis of children with localized resectable neuroblastoma. LN+ and TR predisposed to relapse at all ages, but infants tended to have a less aggressive course after relapse. Stage 1 and 2 LR children had 94% and 96% OS rates, respectively, which justifies a policy of no adjuvant chemotherapy. Eight of 26 children with stage 2 HR relapsed despite 6 months of chemotherapy; for these children, more intensive chemotherapy may be required.

Adolescent↗
PubMed1994

Comparison of putative virulence factors in Aeromonas hydrophila strains isolated from the marine environment and human diarrheal cases in southern Italy.

Aeromonas hydrophila strains isolated from the same geographical region (southern Italy) but from different sources (sea sediments and human diarrhea cases) were characterized for the production of potential virulence determinants, such as production of cytotoxins, cytotonic toxins, hemolysin, and dermonecrotic factors and their capacity to adhere to human intestinal 407 cells in vitro. The results showed that isolates from both the sources produced all or some of the virulence factors which may be involved in the pathogenesis of Aeromonas-associated infections. Our study indicates that further epidemiological studies are necessary to elucidate the public health significance of infections caused by Aeromonas spp.

Aeromonas hydrophila↗
PubMed1994

Preoperative ultrasound assessment of omental spread in ovarian cancer.

The accuracy of high-resolution ultrasound in the detection of macroscopic omental metastases was evaluated in 50 consecutive patients undergoing surgery for ovarian cancer. Ultrasound provided an overall diagnostic accuracy of 83.7%, with a sensitivity of 76.6% and a specificity of 100%. The sensitivity in the diagnosis of diffuse omental involvement was 93.3%. Moreover, the overall diagnostic accuracy, sensitivity and positive predictive value of the method increased as the study progressed. In the last 25 cases examined, in fact, these values were 94.7, 90, and 90%, respectively.

Adult↗
PubMed1993

[Ultrasonographic and urodynamic evaluation in stress incontinence].

Transvaginal sonography can show partial urinary penetration in the urethra in patients with no clinical incontinence. The Fluid Bridge Test-Pressure urodynamically demonstrates the same phenomenon. We compared these two technics in women with stress urinary incontinence (SUI). 49 patients underwent urodynamic testing and transvaginal sonography; 18 had SUI, 20 were asymptomatic postoperatively (Burch procedure) and 11 were normal controls. Urodynamics consisted of filling cystometry with saline (infusion speed: ml 70/min) using transurethral Foley catheter (n degree 14 Fr), and a profilometric-pressure Bard catheter (10 Fr); micturitional cystometry; uroflowmetry; clino- and orthostatic urethral pressure profile (UPP) (extraction speed: cm 0.5-1/sec; infusion speed: cm 1.2/min); sphincteric electromyography (EMG); FBT-P with the Bard catheter only. During extraction patients were requested to cough (stress condition). If the urethra is incompetent pressure is transmitted to the water column connected to the pressure transducer, and a "spike" is observed. A competent urethra shows little pressure variation. Ultrasound (US) equipment consisted in a General Electric (RT 3600) sonograph with an electronic transvaginal probe (7.5 MHz) inserted in a gel-lubricated condom. The probe was positioned in the vaginal vestibule in direct proximity to the urethra. Axial and coronal scannings were performed. Echo-imagings were submitted to "post-processing" on US recording equipment. Fluid penetration in the urethra was evident if iperchogenic "turbulence" was observed on playback of the dynamic sonogram on a videocassette recorder (VCR) connected to the sonograph. The SUI group shows leakage of water under stress without detrusorial activity and dynamic UPP with reduced transmission of abdominal pressure on the urethra.(ABSTRACT TRUNCATED AT 250 WORDS)

Electromyography↗
PubMed1992

[Screening of cancer of the breast].

Breast cancer is the commonest cancer in women. Screening for a severe and frequent disease with a long doubling time can be applied to breast cancer. Mammography is accepted by the population as a screening test, as it is simple, painless and safe. Many foreign studies combining either clinical examination and mammography or using mammography alone have confirmed the following elements: cancers are detected at an earlier stage than in the control population, screening of women under the age of 50 years does not provide convincing results, as a decreased mortality is only observed for women over the age of 50 years. Screening was introduced in France in 1989 by law and is now performed in 8 departments. The number of deaths prevented as a result of this action is estimated to be a minimum of 1,000 per year. Screening has positive effects on the quality of radiological equipment, improvement of preoperative detection techniques and on the accuracy of the pathology report. Inversely, its disadvantages include false-negative and false-positive results, leading to a certain number of negative operations. Screening will decrease the incidence of invasive cancers and mastectomies and the role of reconstructive surgery after mastectomy for breast cancer. However, the indications for plastic surgery in clinically detectable breast cancer will increase based on collaboration between breast cancer specialists and plastic surgeons.

Adult↗
PubMed1992

[Acute nonbacterial bronchopneumopathies in the 1st years of life. Diagnostic strategies and clinico-epidemiological peculiarities].

The authors summarise diagnostic strategies an clinical epidemiologic peculiarities of non-bacterial bronchopneumopathies in children. The role of classic viral agents (virus influenzal A-B, virus parainfluenza 2-3, RVS) is stressed without neglecting the role of other etiologic agents such as Chlamydia trachomatis, Mycoplasma pneumoniae and Pneumocystis carinii. The Authors point out the necessity of direct investigation (viral cultures, direct investigation in IF and ELISA, investigation with DNA probe use, etc.) and indirect serologic investigation to obtain the greatest possible accuracy an early diagnosis.

Acute Disease↗
PubMed1991

Neoadjuvant chemotherapy and radical surgery in locally advanced cervical cancer. Prognostic factors for response and survival.

Between January 1986 and September 1988, 75 patients with locally advanced cervical carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stages IB-III) received three courses of neoadjuvant chemotherapy (NAC), including cisplatin, bleomycin, and methotrexate (PBM). Fifteen percent of patients achieved a complete response (CR) and 68% a partial response (PR). Pretreatment characteristics were analyzed for response to NAC. Significantly lower response rates were found in patients with tumor size more than 5 cm in diameter and bilateral parametrial involvement to the pelvic side wall. None of the biological parameters studied was related to chemoresponsiveness. Patients achieving CR or PR had a significantly improved 3-year survival rate compared with those who did not respond. After NAC, radical surgery was possible in all responding patients. The median number of lymph nodes removed was 60. A lower than expected incidence of lymph node metastases was detected. None of the clinical and pathologic features considered was significantly correlated with the lymph node status. Twelve of the 62 operated patients had disease recurrence. Pathologic parametrial involvement and cervical infiltration equal to or deeper than 5 mm were found to be significant prognostic factors for recurrence. A 3-year, disease-free survival of 89%, 73%, and 43% for Stage IB-IIA, IIB, and III, respectively, was found. Among the operated patients these rates increased to 100%, 81%, and 66% for Stage IB-IIA, IIB, and III, respectively. A prospective randomized trial comparing NAC and surgery with radiotherapy alone is in progress.

Adenocarcinoma↗
PubMed1991

Ovarian fibrothecoma: sonographic and histologic findings.

The sonographic and histologic findings observed in 11 cases of ovarian fibrothecoma were compared, and an attempt was made to find a correlation between each histologic type of the tumor (pure thecoma, predominantly fibrous fibrothecoma, mixed fibrothecoma) and its sonographic appearance. The presence of a homogeneous echogenic pattern, with marked posterior acoustic shadowing, in the absence of any calcification, was highly suggestive of a predominantly fibrous ovarian fibrothecoma; the presence of a diffusely hypoechoic ovarian mass, with no posterior echo enhancement, was strikingly correlated with pure thecomas; mixed fibrothecomas were characterized by the presence of an echogenic pattern with no posterior acoustic shadowing. Sonographic findings, even though nonspecific, can provide the clinician with useful information which permits to detect these rare neoplasms preoperatively.

Adult↗
PubMed1990

Transvaginal ultrasound evaluation of myometrial invasion in endometrial carcinoma.

In 20 cases of histologically proved endometrial cancer the depth of myometrial invasion was ascertained by means of transvaginal ultrasound, using a high-frequency endocavitary probe. The sonographic findings were confirmed by histologic examination in 18 of the 20 patients evaluated (90.0%). Transvaginal ultrasound provides a fuller preoperative clinical picture and supplies additional diagnostic information which is invaluable in the choice of therapeutic approach.

Adult↗
PubMed1990

Ovarian carcinoma: an ultrasound study.

Between March 1986 and March 1989, 65 epithelial ovarian carcinomas were studied by means of real time high resolution ultrasound. The sonographic findings were correlated with FIGO stage, histotype and histological grade. The echostructure was compared with that of a group of 141 benign controls. Moreover, some sonographic patterns, significantly more frequent in the malignant tumors (ascites, irregular borders, peritoneal growths), were identified. The diagnosis of malignancy was as accurate as 90.0%, sensitivity and specificity were 84.7% and 92.3% respectively. Our results, coupled with the low costs involved and the non-invasiveness of the method, thus confirm that ultrasound can still be considered a primary technique in the preoperative assessment of ovarian masses.

Adenocarcinoma↗
PubMed1990

Pelvic lymphocele following radical para-aortic and pelvic lymphadenectomy for cervical carcinoma: incidence rate and percutaneous management.

Thirty-six women, treated with radical hysterectomy (Piver types III-IV) plus systematic para-aortic and pelvic lymphadenectomy for cervical carcinoma, underwent serial postoperative ultrasound examinations to determine the incidence of lymphocele and the therapeutic efficacy of percutaneous catheter drainage. Pelvic lymphoceles, ranging in volume from 46-300 mL, occurred in eight patients (22.2%) between the 12-24th postoperative day. Percutaneous catheter drainage, inserted under local anesthesia, was used for a mean time of 14.5 days (range 4-32), resulting in a mean daily drainage of 92.2 mL and a mean total volume of 1727.5 mL per patient. Catheter drainage allowed complete clinical and sonographic remission in all cases, and only one asymptomatic recurrence was observed at 3-month and 6-month follow-up. Ultrasound-guided percutaneous catheter drainage has proved to be a well-tolerated, safe, and effective technique in the management of lymphocele that obviates the need for more invasive surgical procedures.

Drainage↗
PubMed1989

[Monotherapy, empirical and targetted, with imipenem-cilastatin in sepsis of bacterial origin].

The authors describe an open study in 22 patients with febrile conditions of unknown origin who were treated with imipenem-cilastatin while waiting for routine laboratory and culture tests. These were done immediately at the patients' entry into hospital, after which imipenem-cilastatin treatment was started immediately, and was subsequently confirmed by the isolates and culture tests. The drug was found to be active and to eradicate the responsible organism in all cases. In addition, it was found to be easy to handle and not to give rise to side-effects or changes in laboratory tests.

Adolescent↗