Biomedical subjects
Publications and source records attributed to M Ortolani.
Primary gastric lymphoma (P.G.L.), though rare, is nevertheless the most frequent non-epithelial neoplasm of the stomach. The Authors report their experience based on 18 cases of lymphoma observed from 1975 throughout 1989. Diagnostic and therapeutic problems related to the disease are stressed, uncertain in the results the former, still discussed the latter. The crucial role of surgery, either diagnostic or therapeutic, even in advanced stages, is underlined.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The Authors report the presence of two simultaneous neoplasms of the large bowel which are independent of each other from the histological point of view. The Authors point out the more interesting aspects of this particular neoplastic pathology, which creates different clinical syndromes; diagnosis and therapeutic possibilities were investigated. The frequency of these neoplasms is not exceptional, and, therefore, the possible existence even in subjects having a single tumor of the colon or rectum should not be neglected.
The Authors offer a critical review of their own five-year experience in the field of geriatric surgery, with special attention to actual results obtained. From these data they conclude that the progressive improvement of said results, such as it emerges from the documentation, owes partly to the surgeon's greater ability to cope with geriatric problems in his domain, and partly to increased awareness of the resources of geriatric surgery by the lay population.
The results are presented of experience in early surgical treatment of congenital dislocation of the hip, using the anteromedial approach described by Ludloff. Surgery was performed in 20 hips of 18 children, aged between 3 and 23 months, in whom conservative treatment had failed. Eleven cases were followed up for five to seven years after surgery. In 50% of the hips, additional surgery was required to correct deformities of the femoral neck or of the acetabulum. Early open reduction with the Ludloff procedure has many advantages over more traditional treatment.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In addition to the classical description of involvement of the cervical sympathetic in low root lesions (Claude Bernard-Horner syndrome), other sympathetic syndromes have been described accompanying the motor and sensory changes in obstetrical paralysis of the upper limb. Loss of sweat secretion can be deomonstrated by electrical skin resistance tests, and the authors describe their apparatus and method of investigating this in the newborn. Although sweat secretion is often scanty in the newborn, it can be enhanced with appropriate techniques, particularly in the areas richer in sweat glands. This method of investigating sympathetic nerve function has been used to clarify the location of the neurological damage and therefore it is of some value for the prognosis in obstetrical paralysis of the newborn.
Ortolani summarizes 40 years of experience with about 8,000 children with congenital hip dysplasia, treated from birth or at a very early age. All newborns should be screened and examined for congenital hip dysplasia and this exam should be repeated at one month and again in 3 months. The most reliable sign for the diagnosis of congenital hip dysplasia at birth is the "click" sign. The etiology of congenital hip dysplasia is in a localized fault in embryonic development. The treatment started just as early as the condition was suspected. Surgical treatment is recommended for all complete congenital hip dislocations not amenable to treatment by closed methods.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Recent publications stress the importance of exogenous or environmental factors in the aetiology and pathogenesis of dysplasia of the hip. For this reason ante- and post-natal postures were studied in detail especially intra-uterine malposition and the so-called "forced" or "adaptation decubitus" (Zwangshaltung, Schrägseite-Lage Syndrome, Congenital pelvic obliquity). Even with the data obtained from very early (neonatal) diagnosis no distinction can as yet be made between dysplasic alterations of the hip which are sometimes associated with the above-mentioned anomalies and true congenital dysplasia. Furthermore, intra-uterine malposition and consequent breech presentation would seem to be a result rather than the cause of congenital dysplasia which only rarely occurs without underlying primary hip-joint pathology.
Chronic allograft nephropathy (CAN) is an anatomical and clinical alteration, characterized by proteinuria, hypertension and a progressive decline in kidney function, which begins at variable times (months, years) and can lead to the loss of the transplanted organ. CAN pathogenesis, which remains to be fully clarified, involves both immunological (early acute rejection, hyperimmunization, HLA-mismatches between donor and recipient, suboptimal immunosuppression, etc) and non-immunological factors (ischemia/reperfusion injury, reduced nephron mass, age differences between donor and recipient, dialysis time, hypertension, dislipidemia, proteinuria, etc). The possible prevention strategies for CAN consist of procedures aimed at the reduction of some potential risk factors: optimization of the conditions for organ explantation, diminution of ischemia/reperfusion injury, aggressive pharmacological treatment of acute rejection episodes, routine utilization of anti-hypertensive and hypolipidemic agents, and appropriate and rational immunosuppressive regimen. Moreover, some categories of immunosuppressive drugs, such as calcineurin inhibitors, can have a nephrotoxic effect, often regardless of therapeutic dosage. The introduction in clinical practice of novel immunosuppressive drugs with no nephrotoxicity, like mycophenolate mofetil and rapamycin, makes therapeutical strategies able to reduce the incidence of CAN feasible.