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Biomedical subjects

M Monaco

Publications and source records attributed to M Monaco.

At least 91 records · Page 5Linked to original sources

[The surgical treatment of Zenker's diverticula by stapler diverticulectomy and myotomy under local anesthesia].

From 1990 to 1997, 12 patients with Zenker's diverticulum underwent TA 30-stapler diverticulectomy and cricopharyngeal myotomy. All patients were operated on under local anaesthesia. No death was observed. In two cases subcutaneous infection was drained with recovery. No post-operative fistulas were observed with radiologic control. At 6 months follow-up all patients were well. Advantages of both stapler diverticulectomy and local anesthesia are outlined.

Aged↗

[Thyroid surgery in assisted local anesthesia].

To evaluate the advantages of thyroidectomy under assisted local anesthesia, 35 cases operated on from January 1998 to February 1999 were reviewed. The patients were studied in ambulatory setting and adequately informed on the program of thyroid operation under local anesthesia. Multinodular goitre was present in all the cases. In 12 cases, it was intrathoracic. The morning of operation, all the patients underwent to pre-operative sedation and, in operative room, to local anesthesia with Mepivacaine 1% and adrenaline 1,200,000 U. The operations were performed with a mean of 30 cc of local anesthetic. During operation, in none case the conversion to general anesthesia was necessary. No mortality and morbility were registered. In the majority of cases, an analgesic was necessary meanly 4 hours after operation. The evening of operation in all the patient oral nutrition was restored. Twenty-nine patients were discharged from the hospital 48 hours after surgery. Eight days after operation, surgical recovery was evident in all the patients reviewed in the out patients setting. The advantages of thyroid surgery under assisted local anesthesia are outlined.

Adult↗

[Surgical treatment of arterial hypertension: experience and results].

Hypertension is a wide spread disease. In a small percentage of cases (nephrosclerosis, renovascular hypertension, endocrine hypertension) surgical treatment could be resolutive. The Authors describe their experience of the last five years about the subject, emphasize the technical detail taken and the results achieved; they outline the necessity to give the indications for surgery in wise manner considering clinical, laboratory and instrumental findings.

Humans↗

[Surgical indications in pulmonary tuberculosis].

Since the begin of the century, the surgery for treatment of pulmonary tuberculosis showed an important evolution. The procedure has proved to be useful in the 20% of patients. It appears that the percentage is drug-resistant or complicated. The authors describe their experience in the years from 1992 to 1997 and, in accordance with the literature in this field, outline the good prognosis to 5 years, with a percentage of 90-96% of non-infected patients. Very important is the time of surgical intervention, the compliance of the medical treatment in the previous 6 months, excepting in the emergency, and the perfect obliteration of pleural cavity to avoid next reinfection and the development of broncopleural fistulas.

Humans↗

[Azygos lobe and spontaneous pneumothorax].

The association azygos lobe-pneumothorax is a very rare event described in literature. The Authors report a case observed. The surgical procedure performed by traditional thoracotomy, was carried out with the section of the azygos and the resection of small blebs in pulmonary apex. Finally, emphasized possible different pathogenetic mechanisms.

Adult↗

[Pulmonary hernia].

Chest-wall hernia is a very unusual pathological event. The Authors report a singular diagnostic case of chest-wall hernia, miming rib tumor. Instrumental diagnostic tools and surgical treatment is reported. Finally patient's follow-up is discussed.

Hernia↗

[Intestinal angiodysplasia].

Intestinal angiodysplastic lesions represent one frequent source of gastro-enteric tract serious bleedings, endowed with present-day therapeutic implications. The Authors report a singular case of a bleeding of this kind. A selective arteriography analysis of the superior mesenteric artery immediately pointed out the necessity for a surgical intervention, which however has not proved being resolutive for recovery, because massive intestinal hemmorrhage recurrence occurred. The left gastric artery anomalous origin, being discovered in the first branch of the mesenteric artery, which was not recognized fully in advance, stressed, in fact, the need for a partial gastrectomy, firstly, and a full gastrectomy, subsequently. The post-surgery course got more serious for a small leak of the oesophageus-digiunal anastomosis and for a serious renal failure. NPT and haemodialysis helped to quickly solve those complications. Other hemorrhagic events have not occurred anymore, 5 years having passed since the surgical intervention.

Angiodysplasia↗

[Traumatic rupture of the esophagus caused by foreign body. Surgical treatment and results].

The aim of the study was the evaluation of emergency surgical treatment of traumatic oesophagus rupture due to the foreign body observed between 1990 and 1999. In three cases there was fortuite ingestion of foreign bodies (metallic money; alimentary particle; dentary prosthesis) and in one case it was a suicide attempt with ingestion of mascellary prosthesis. One case of death (25%) was observed, due to septic mediastinitis with pleuric compromision. The rarity of these lesions with high rate of mortality from septic mediastinitis and importance of early treatment are outlined.

Adult↗

[Role of thymectomy in the treatment of myasthenia gravis: considerations and personal cases].

The therapeutic impact of thymectomy on the clinical course of myasthenia gravis is still very controversial. In fact, while nowadays the surgical approach is widely adopted for thymomas, its role is still debatable in patients suffering from myasthenia gravis. The surgical approach of choice for total thymectomy is represented by median sternotomy. Other surgical methodologies include cervical access and partial sternotomy. All these approaches have shown excellent results in the exeresis of the thymus. More recently video-assisted thoracoscopic thymectomy has been proposed as a less invasive and similarly effective technique for the removal of this organ and the treatment of myasthenia gravis. Aim of the present study is to report Author's experience with thymectomy, emphasizing the data available in the international literature on the surgical mortality, complications and aesthetical results of the different surgical accesses.

Adult↗

[Surgical treatment of hydatid cysts].

Hydatidosis represents a form of helminthic zoonosis with a stronger medical, social and economic impact. It is endemic in some areas of the world including Mediterranean countries, and therefore Italy. The disease is often diagnosed in an advanced phase, due to the poor symptomatology in the early stages. The best treatment is surgery. Emergency surgery is similar to elective surgery, though in some cases is preferable only a drainage procedure until the stabilization of the genreal and local conditions of the patient allow a radical intervention. The Authors report on their five year experience of surgical treatment of compliated pulmonar hydatidosis pointing out that exeresis must be aimed at preserving pulmonar function as much as possible.

Adolescent↗

[Haemothorax and chylothorax: surgical approach].

Diseases causing blood accumulation in the pleural space (or haemothorax) are usually very demanding for diagnosis and require a multidisciplinar therapeutical approach in emergency. So, their treatment should always be immediate and should aim to restore the optimal patient's haemodynamic conditions and to find the site of bleeding. Chylothorax, a lymphatic effusion in the pleural space, is also a very important pathology, as it effects the nutritional and immunological state of the patient causing pleural involvement and respiratory insufficiency. Stabilisation of vital parameters with adequate systemic therapies (blood perfusions, fluids and pro-coagulation factors, TPN) preceeds surgery, which can be the placement of a thoracic drain or emergency thorascopy and/or thoracotomy. The Authors report the casistic of the latest three years for diagnosis and treatment of haemothorax and chylothorax stressing the advantages of a minimal invasive approach for evacuation and identification of the origin of bleeding and haemorrhage and/or lymphatic effusion control.

Adult↗

[Longitudinal study of a population exposed to risk of biomechanical overload of the upper limb].

One of the most important factors of the work-related musculoskeletal disorders of the upper extremities (WMSDs) is the biomechanical overload. The purpose of this study is to evaluate the possibility of the worker fitting to the job, to decrease the upper limb repetitive stress. In order to this aim, we have collected and compared, in different controls at the distance of two years, the clinical-anamnestic and instrumental data of a cohort of workers in a car industry.

Adult↗

[Antibiotic-resistance in Italy: activity of the first year of the surveillance project AR-ISS].

The antibiotic resistance surveillance project AR-ISS, started in 2001, is based on a network of 62 sentinel microbiological laboratories throughout the country. The laboratories collect and transmit data to the Istituto Superiore di Sanità on the antibiotic susceptibility of bloodstream isolates of 7 species: Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis/faecium, Klebsiella pneumoniae/oxytoca ed Escherichia coli. They also send selected bacterial strains for further characterization. Results of the first year of surveillance are presented and are compared with data from the previous study EARSS-Italia and from other European countries. Oxacillin resistance in S. aureus appears to be stable, however, it remains one of the highest in Europe (41,5%). No strain with intermediate susceptibility or resistance to vancomycin has been isolated. In S. pneumoniae, the level of penicillin resistance is moderate (10,8%), but macrolide resistance has increased greatly (37,6% versus 28,6% of the previous study), following a tendency common to several European countries. Unexpectedly, vancomycin resistance in E. faecium was found to be 18%, the highest in Europe. Presumptive ESBL production in Gram-negative organisms can be estimated at 20% in Klebsiella and 1% in E. coli. Ampicillin and ciprofloxacin resistance in E. coli (respectively 50% and 18%) are among the highest in Europe. In conclusion, the rate of antibiotic resistance in the species studied is worrisome and requires continuing monitoring. Although some activities of AR-ISS need improvements, the surveillance has the potentiality to produce relevant and representative data about antibiotic resistance in Italy that can be used for comparison at the European level.

Adolescent↗

[Indications, surgical strategies and evaluation of prognostic factors in the treatment of pulmonary metastases].

Pulmonary metastases resection is a method universally accepted in selected patients. Long-term survival reaches good levels after complete resection of lung metastases independently of primary tumour histology. The Authors emphasizes literature data; they report data of their experience no statistically significant but useful for valuation of results. They discuss of advantages vs disadvantages of the surgical procedures. In conclusion they believe metastasectomy is a safe treatment of pulmonary metastases.

Adolescent↗

[The evaluation of the presumed mutagenic activity of barium nitrate].

Barium nitrate, which is used in industry in the production of green signal lights, to remove gases from vacuum tubes, and in the production of barium oxide, was assayed to assess the possible mutagenic effects using both the Ames test (S. typhimurium TA 1535, TA 1537, TA 1538, TA 97a, TA 98, TA 100, TA 102c), with and without metabolic activation with the plate incorporation assay and pre-incubation assay methods, and using the mitotic crossing over test, the mitotic genic conversion test, and the retromutation test in Saccharomyces cerevisiae, D7 strain, with and without metabolic activation. In the experimental conditions of the study, at various gradually increasing concentrations, barium nitrate gave negative results.

Barium↗

[Mutagen activity of barium chloride in Salmonella typhimurium].

Barium chloride, which is an important industrial chemical used in pigments, lacquers, dyes, glass and pesticide production, leather tanning and cloth dying, was tested on Salmonella typhimurium (TA 1535, TA 1537, TA 1538, TA 97, TA 98, TA 100) with the reverse mutation test, with and without metabolic activation, to assess its possible genotoxic effects and any possible action with respect to standard mutagens (sodium azide, 9-aminoacridine, 2-nitrofluorene, mitomycine-C, 2 aminoacridine). Using the platelet incorporation technique, barium chloride at various progressive concentrations gave negative results under the experimental conditions of the study.

Barium↗