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M Costanzo

Publications and source records attributed to M Costanzo.

45 records · Page 3Linked to original sources
PubMedDate not supplied

Increased levels of NF-kappaB inhibitors (IkappaBalpha and IkappaBgamma) in the intestinal mucosa of Crohn's disease patients during infliximab treatment.

The treatment with infliximab is employed successfully in Crohn's disease (CD) but predictors of efficacy are lacking. Activation of the transcription factor NF-kB has been demonstrated in CD and its inhibition is one of the mechanisms by which anti-inflammatory agents exert their effects. We evaluated the production of TNFalpha by peripheral blood mononuclear cells (PBMC) and the levels of NF-kappaB family molecules in the intestinal mucosa during infliximab therapy in 12 patients. TNFalpha was assayed on supernatants of PBMC culture stimulated with PHA or LPS. Immunohistochemistry was also done on intestinal biopsies. In six patients, Western blot analysis of the NF-kappaB subunit Rel-A, and its inhibitors IkappaBalpha and IkappaBgamma was performed on intestinal biopsies and PBMC. The TNFalpha production by LPS stimulated PBMC showed mild changes, while it was increased by PHA-stimulated PBMC after treatment. The number of inflammatory cells in the intestinal mucosa was reduced (p<0.002) by the treatment. In five out of six cases we detected an increase of the IkappaBalpha and IkappaBgamma)inhibitor levels in intestinal biopsies after treatment. An increase of IkappaB inhibitors levels could be one of the mechanisms by which infliximab decreases NF-kappaB activity and exerts its anti-inflammatory effects.

Adult↗
PubMedDate not supplied

[Skin metastasis from renal carcinoma: epidemiologic and clinical features].

The Authors present an additional case of a 70-years old male patient with skin metastasis from renal cell carcinoma, 15 months after nephrectomy. The patient died ten months later for advanced neoplastic disease. Skin metastasis affect 3-6% of patients with renal cell carcinoma. The surgical treatment is mandatory for single nodule. Chemotherapy is often ineffectual. The prognosis is poor, with a 0-8% 5-years survival for patients with multiple nodules.

Aged↗
PubMedDate not supplied

[A questionable surgical problem: the right treatment of occult thyroid carcinoma].

INTRODUCTION: The authors review their experience about treatment of occult thyroid carcinoma. PATIENTS AND METHODS: 24 patients with papillary occult carcinoma of the thyroid were observed in the period 1999-2001. All carcinoma was 10 mm in diameter. In seventeen patients (71%) was performed a total thyroidectomy, while in seven (29%) a lobectomy; in four of seven patients treated with lobectomy was subsequently performed a total thyroidectomy. Total thyroidectomy wasn't performed in three female patients aged < 35 years, with a 5 mm diameter carcinoma. In two patients (8.3%) with nodal metastasis a lymph node excision was performed. All patients were alive and free of disease at last control. CONCLUSIONS: The incidental finding of occult thyroid carcinoma in a patient treated with a lobectomy does not entail a subsequent total thyroidectomy, because of this surgical procedure may be oncologically correct; therefore the authors believe that total thyroidectomy may be the treatment of choice of occult carcinoma, because it allows a correct oncological follow-up.

Adult↗
PubMedDate not supplied

[Surgery of thyroid pathologies in one-day surgery].

The surgery of the thyroid pathologies in Day and/or One-Day-Surgery requires a thorough choice former of the surgery of the patients and the availability of the team specialist that could guarantee an adequate nursing after surgery. The authors describe the advantages and the limits of the short confined to stay in hospital for the surgery of the thyroid pathologies. The selection criteria for patients undergoing thyroidectomy in One-Day-Surgery have been: euthyroid patients with benign pathologies concentrate only thyroid lobe and lack of associated pathologies as cardiopathy, broncopathy, nephropathy, hepatopaty, diabetes, etc. Were executed in general anaesthesia forty lobectomies for uninodular thyroid disease and three enucleoresections for a nodule of pyramidal lobe, and only two cases the histological definitive diagnosis of carcinoma has caused a second hospital stay. In all forty-three cases was used a drainage, removed after 24 hours.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

[Benign-thyroid nodule: what's therapy? Personal experience].

INTRODUCTION: Solitary thyroid nodule is an important pathology with an incidence of 2-5% in Italian population. The diagnosis was based on clinical exam, laboratory tests and ultrasonographic evaluation. MATERIALS AND METHODS: The study undertook has the purpose to assess the usefulness between lobe-isthmusectomy (with corresponding risk of possible relapse and complications for reintervention) and total thyroidectomy, (with corresponding post-surgical treatment complications), for benign thyroid disease with solitary nodule, on selected cases for disease and corresponding risk factors, in the retrospective clinical study, using laboratory tests and ultrasonographic evaluation. The study was conducted on 80 patients admitted from 1994 to 2000 with diagnosis of benign thyroid nodule and operated with lobeisthmusectomy. In seven patients the operation had to be converted in total thyroidectomy. RESULTS: Operative mortality was nil and long-term results at a mean follow-up of three years are encouraging. DISCUSSION: The main advantages of lobe-isthmusectomy for benign solitary thyroid nodule consist in less postoperative complications and less hospital stay. CONCLUSION: Therefore our experience has carried us to consider the lobectomy which treatment choice for all those benign thyroid diseases, with, solitary nodule.

Adult↗
PubMedDate not supplied

[Post-thyroidectomy hypocalcemia].

INTRODUCTION: The correlation between hypocalcemia and total thyroidectomy could be correlated to the influence practice from the TSH hormone on the thyroid C cells, in fact in conditions of hyperthyroidism the low values of the thyrotropin is correlated to a reduction of the plasmatic concentration of calcitonin and consequently of calcemia. of our study is verify the incidence of the hypocalcemia post-tyroidectomy and appraise the effectiveness of the pharmacological treatment with calcium salts and possibly D vitamin. MATERIALS AND METHODS: Of the 432 operated patients, 348 has stayed subjected to total thyroidectomy and 84 to loboistmusectomy. In none case subjected to emityroidectomy has been verified a hypocalcemia in the post-operative and in 67 cases in which we have administered pre-operative calcium salts orally, calcemia has sustained within acceptable values. RESULTS: Our experience only 1'11.2% of the patients subjected to total thyroidectomy they have presented a reduction of the calcemia to the of under of the 7.10 mg/dl and they have stayed subjected medical therapy with calcium salts in ev in the symptomatic forms, and to oral therapy in patients absent symptoms, while in two cases is not been practiced any therapy because the symptomatology has disappeared spontaneously DISCUSSION: Syndrome hypocalcemica has determined from the deficit-also transitory-parathyroid glands, from the action of the calcitonin (it favors the amassing of the calcium in to bon), and from a reduced bony reserve of calcium. In fact in those patients operated for a euthyroid goitre or for thyroid tumor the saving of the parathyroid glands avoids the outbreak of hypocalcemia (7, 8). Therefore the physio-pathological mechanism responsible of symptoms (excluded the medical causes: pharmacological treatments with steroid, oral conraceptives, diuretics, salts of lithium, oral antacid and diazepam) (9) also not being still of the all known, it would have his primum movens in the parathyroid glands ischemia. CONCLUSIONS: The precocious evaluation of the calcemia in the period post-operative is useful to discern the patients that will require of a pharmacological treatment of support, so that avoid of the serious and permanent damages to the varied organs.

Adolescent↗
PubMedDate not supplied

[Benign thyroid nodule: what is the treatment? Personal experience].

INTRODUCTION: Solitary thyroid nodule is an important pathology with an incidence of 2-5% in the Italian population. The diagnosis was based on clinical exam, laboratory tests and ultrasonographic evaluation. MATERIALS AND METHODS: The study undertook has the purpose to assess the usefulness between lobe-isthmusectomy (with corresponding risk of possible relapse and complications for reintervention) and total thyroidectomy (with corresponding post-surgical treatment complications), for benign thyroid disease with solitary nodule, on selected cases for disease and corresponding risk factors, in the retrospective clinical study, using laboratory tests and ultrasonographic evaluation. The study was conducted on 80 patients admitted from 1994 to 2000 with diagnosis of benign thyroid nodule and operated with lobe-isthmusectomy. In seven patients the operation had to be converted in total thyroidectomy. RESULTS: Operative mortality was nil and long-term results at a mean follow-up of three years are encouraging. DISCUSSION: The main advantages of lobe-isthmusectomy for benign solitary thyroid nodule consist in less postoperative complications and less hospital stay. CONCLUSIONS: Therefore our experience has carried us to consider the lobectomy which treatment of choice for all those benign thyroid diseases with solitary nodule.

Humans↗
PubMedDate not supplied

[The usefulness of thyroxine treatment after subtotal thyroidectomy for endemic goiter].

The aim of the present study was to assess the appropriateness and value of prophylactic thyroxine therapy in the treatment of postoperative complications (relapse, postoperative hypothyroidism) following subtotal thyroidectomy for endemic goiter. The study was carried out in a group of 139 patients undergoing subtotal thyroidectomy for endemic goiter between 1978 and 1987. Clinical follow-up included hematochemical and scintigraphic analyses. Patients were divided into two groups. The first group included 74 patients who received postoperative hormone replacement therapy. The second group of 65 patients did not receive any treatment. results show that hormone replacement therapy is unnecessary in most cases since the majority of patients require euthyroid values a few months after operation. Thyroxine therapy was indicated, however, in cases of clinically evident postoperative hypothyroidism which persisted during follow-up.

Adult↗