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Biomedical subjects

M Rossi

Publications and source records attributed to M Rossi.

At least 775 records · Page 43Linked to original sources
PubMedDate not supplied

[The carotid chemodectoma. Presentation of 4 clinical cases and review of the literature].

After a brief introduction about carotid body tumor's etiopathogenesis and clinical presentation, four clinical cases observed between January 1996 and December 1998 are described. Three of them have been classified as I and the last as III type according to Shamblin's classification. The diagnostic trial and surgical option needed by each patient are presented. The surgical treatment and the possibility of alternative or complementary techniques such as endovascular embolization and/or irradiation are discussed. The conclusion is drawn that surgical option for carotid body tumor is the best choice. Embolization, some hours before surgical treatment, can be a very useful procedure in order to reduce intraoperative risks and bleeding. Nevertheless surgery of carotid body tumor must be performed by surgical teams experienced in supra-aortic vessel treatment.

Adult↗
PubMedDate not supplied

[Clinical assessment of juvenile polyposis with particular reference to the risk of neoplastic malignancy. Analysis of 412 patients reported in the international literature].

The authors extensively review the international literature on juvenile polyposis, with particular reference to the risk of malignancy in the various forms of the disease (colorectal vs. generalized, familial vs. sporadic). Sixty-eight out of a total of 412 patients presented adenomatous changes in the polyps. In addition, 68 cancers were found. The rate of degeneration was analysed for all variants of juvenile polyposis, but no statistically significant differences were detected. The authors conclude that juvenile polyposis should be considered as being as challenging to the surgeon as familial polyposis syndromes and outline protocols for the screening, endoscopic and surgical treatment and follow-up of these patients.

Age Factors↗
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[Structure, function, and levels of neutrophil elastase after laparoscopic cholecystectomy].

Neutrophil elastase is a neutral proteinase present mainly in the azurophilic granules of segmented granulocytes, the main cells involved in the inflammatory response reaction. In our study we attempted to determine whether an enzyme such as neutrophil elastase produced by polymorpho-nuclear leukocytes could be an indicator capable of determining the degree of surgical trauma, comparing two surgical approaches, namely, laparoscopic cholecystectomy and open cholecystectomy. Plasma neutrophil elastase was determined photometrically, using an immune-activation immunoassay, in 66 patients (32 patients underwent open cholecystectomy and 34 laparoscopic cholecystectomy) 1 day before surgery and 1, 3, 6 and 12 days after surgery. We established a reference range for elastase by measuring the serum elastase concentration in 48 healthy control patients. A significant increase (p < 0.05) in plasma neutrophil elastase levels was observed on days 1, 3 and 6 after surgery in patients undergoing open cholecystectomy, whereas the levels of the enzyme were almost stable in patients undergoing laparoscopic cholecystectomy. We recorded two cases (6.2%) of respiratory tract infections in the "open" group. Neutrophil elastase is a good indicator for discriminating the severity of the surgical trauma, which is certainly more severe in laparotomy than in laparascopic cholecystectomy. Peripheral leukocyte function seems to be better preserved after laparoscopic surgery than after laparotomy.

Adult↗
PubMedDate not supplied

[Endoscopic diagnosis and treatment of juvenile solitary polyps, in the light of the unusual but proven neoplastic potential].

For many years a neoplastic potentiality of the juvenile polyps has been denied. The authors performed a critical review of the international literature about the neoplastic transformation of the juvenile polyps. Each examined case had to respect three conditions: 1) exhaustive hystological findings certifying a clear neoplastic degeneration of a juvenile polyp; 2) clear evidence of single juvenile polyposis (< 5), presence in the colon and rectum only and absence of familiarity; 3) reliable diagnostic practice (endoscopic and/or hystological evidence). During the review we collected 271 cases of juvenile polyposis observed in 12 countries, 97 of which (35.79%) showed neoplastic transformation, adenomatous type in 50 (18.45%) and carcinomatous type in 47 (17.34%), and 13 cases of neoplastic degeneration of single juvenile polyps. The review shows clearly and strongly that the risk of cancer in the juvenile polyposis can reach the risk of the adenomatous polyposis. The neoplastic degeneration exists in the single juvenile polyps even if in a lower degree.

Endoscopy, Gastrointestinal↗
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Acute biliary pancreatitis: staging and management.

BACKGROUND/AIMS: Acute biliary pancreatitis is a clinical entity with a high morbidity rate (15-50%) and mortality rate (20-35%). Early diagnosis has a primary importance for an appropriate treatment (75% of cases of idiopathic acute pancreatitis are of biliary origin). METHODOLOGY: Diagnosis of acute biliary pancreatitis in 78 patients was based on careful clinical and instrumental assessment: ultrasonography (76.9% of cases) and laboratory tests in 23.1% of cases. In our study we used the Ranson and APACHE II scores and 24 of the cases (30.7%) were classified as severe, while 54 (69.2%) were mild. All patients with severe acute biliary pancreatitis underwent emergency endoscopic retrograde cholangiopancreatography + endoscopic sphincterotomy (within 24-48 hours) followed by laparoscopic cholecystectomy (10 days). Patients with mild acute biliary pancreatitis underwent laparoscopic cholecystectomy associated with intraoperative cholangiography, within 10 days. RESULTS: In 19 patients with severe acute biliary pancreatitis operative endoscopy was curative. Subsequent laparoscopic cholecystectomy provoked subcutaneous emphysema only in one case but did not show any other serious morbidity. In the remaining 5 cases laparotomy was required because of necrosis, with a mortality rate of 60%. In all cases of mild acute biliary pancreatitis, laparoscopic cholecystectomy was successfully performed with a morbidity rate of 7.3%. Common bile duct stones were revealed with intraoperative cholangiography in 31.4% of the mild cases and in 75% of the severe cases. CONCLUSIONS: In conclusion acute biliary pancreatitis treatment is always surgical; in almost all severe cases it is performed with minimally invasive procedures (endoscopic retrograde cholangiopancreatography + endoscopic sphincterotomy with laparoscopic cholecystectomy < or = 10 days) if surgery is carried out within 24-48 hrs, as well in the mild cases (laparoscopic cholecystectomy + intraoperative cholangiography) when surgery is performed within 10 days.

Adolescent↗
PubMedDate not supplied

Skeletal muscle ultrastructural pathology in mice infected with Trypanosoma evansi.

An ultrastructural study of skeletal muscle alterations wascarried out in mice experimentally infected with Trypanosoma evansi. Manifested anomalies were found, in both muscle fibre and microvasculature. Muscle fibre changes included atrophy, autophagic vacuoles formation, mitochondrial degeneration, nuclei pyknosis and segmental necrosis. In another direction, the cytoplasm of capillary endothelial cells showed rough endoplasmic reticulum and mitochondrial swelling, as well as luminal infoldings; parasites were found in the endothelial cell cytoplasm. A mononuclear infiltrate, formed by macrophages and neutrophils, was also observed. This work shows that skeletal muscle is an important target tissue for Trypanosoma evansi.

Animals↗
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[Graves-Basedow disease associated with unusual variation of thyroid papillary carcinoma: a clinical case].

The authors describe a case of papillary carcinoma of the thyroid in a young patient with Graves-Basedow disease, diagnosed 10 years ago and now in long-term remission. Remission was achieved after many cycles of methimazole treatment for recurrent hyperthyroid disease. Clinical symptoms, characterized by pain and nodular swelling in the region of the left thyroid, did not improve after glucocorticoid treatment. Fine needle aspiration cytology disclosed papillary neoplasm of the left thyroid nodule: the decisive histological features, seen after total thyroidectomy, unexpectedly documented a diffuse sclerosing variety of papillary thyroid carcinoma. The patient underwent ablative radioiodine therapy with 131-I and is now in remission, confirmed by total body scintigraphy. The case merits attention because of: the uncommon association of Graves-Basedow disease and differentiated thyroid cancer; the type of tumor, i.e., a diffuse sclerosing variety of papillary thyroid carcinoma which is rarely found and is characterized by specific histological and clinical features.

Adult↗
PubMedDate not supplied

[Inflammatory markers after laparoscopy versus laparotomy cholecystectomy].

OBJECTIVE: The study is carried out to determine whether the level of IL-6 is altered and in what way after surgery as well as if such a change could be an indicator of increased morbidity after surgical treatment. MATERIALS OF THE STUDY: Chemiluminesence immunoeassay system was used in order to establish IL-6 level in blood samples of 71 patients that underwent abdominal surgery, 36 Laparoscopic Cholecystectomy (LC) and 35 Open Cholecystectomy (OC) at time 0 (before the operation), 1 h, 2 h, 3 h, 6 h, 24 h and 48 h after the operation. RESULTS: Plasma IL-6 levels are significantly increased after OC; we observed 3 cases of post-operative infections, in which IL-6 returned to normal levels 6 days after surgery. Analogous variation to the IL-6 levels was noted for the C-reactive protein levels. DISCUSSION: Laparoscopic cholecystectomy, a so called mini-invasive surgical procedure, is associated to a small increase of IL-6 serum levels and provides better post-operative conditions to the patients by reducing surgical stress and the infectious complications correlated to the surgical procedure. CONCLUSIONS: During OC there is a significant higher elevation of IL-6 serum levels than after laparoscopic cholecystectomy. Variation of C-reactive protein serum levels after surgery is analogous to variation of IL-6 levels.

Adult↗
PubMedDate not supplied

[Histochemical assessment of immunoreactivity of thyroid peroxidase and its correlation with biochemical activity].

BACKGROUND: Peroxidase content has been recently evaluated in normal thyroid and in different thyroid disorders by biochemical, histochemical, ultrastructural and immunocytochemical methods Nevertheless immunocytochemical detection of thyroid peroxidase in thyroid samples conventionally processed for histology hes never been done using a commercially available antibody, neither its correlation with the biochemical activity on adjacent samples. METHODS: In this study we have analyzed normal thyroid tissue (3 patients), follicular adenoma (2 patients) and multinodular goiter (2 patients) conventionally processed for histology and stiined by immunocytochemistry (Avidin Biotin System) using a polyclonal (rabbit) antibody for horseradish peroxidase (Serotec). Biochemical assay was performed on adjacent samples according to Hosoya method. RESULTS: Normal thyroid showed peroxidase immunoresectivity in the majority of follicular celis; neoplastic cells of adenomas were variably stained. Biochemical assay showed positive correlation with ICC ranging from 20.4 mg/mg/prot a in multinodular goiter to 42.12 in normal thyroid, up to 122 of follicular adenoma. CONCLUSIONS: Peroxidase content in the thyroid gland may be of clinical interest in several thyroid diseases, and in this study we have demonstrated that thyroid peroxidase can be detected by ICC in routinely processed thyroid samples using a commercially available antibody.

Humans↗
PubMedDate not supplied

In vitro effect of opioid agonist and antagonist on superoxide release by granulocytes.

The effect of the opioid agonist morphine and of the (-) and (+) stereoisomers of the antagonist naloxone were studied on the O2-generation from human granulocytes. Morphine or naloxone had no effect on basal or phorbol myristate acetate (PMA) stimulated O2-generation, while equimolar (-) naloxone and morphine concentrations (1 x 10-13 - 1 x 10-7 M) inhibited the stimulated O2-generation. The effect of (-) naloxone was stereospecific, suggesting the involvement of opioid receptors. The unmasking of non opioid effects of morphine could be responsible for the inhibition of O2-generation. It is suggested that the opioid control of oxidative metabolism in human granulocytes could involve multiple receptors mediating opposite effect.

Adult↗
PubMedDate not supplied

The safety and feasibility of laparoscopic cholecystectomy.

This study analyzes data from 100 consecutive patients with gallstone disease who underwent laparoscopic cholecystectomy (LC), a surgical technique rapidly emerging as the treatment of choice for this disease. LC has two major advantages: reduction of postoperative pain and a shortened hospital stay. LC was successfully completed in 88 patients, the main cause of conversion to open cholecystectomy being acute or chronic inflammation of the gallbladder. Analysis of risk factors showed that age, obesity, episodes of jaundice, pancreatitis, and acute or chronic cholecystitis are not absolute contraindications to LC. Mortality was absent and the intraoperative morbidity rate was 2%. No lesion of the main bile duct occurred. Seven minor post-operative complications that did not prolong hospital stay were also observed. These figures compare well with the mortality and morbidity of open cholecystectomy, and demonstrate that the significant benefits in terms of patient welfare and hospital costs of LC are not obtained at the expense of increased surgical risk.

Adult↗
PubMedDate not supplied

[Evaluation of the surgical risk in general surgery: usefulness of a predictive system based on statistical analysis].

1182 patients were prospectively studied in order to evaluate the surgical risk factors. Stepwise regression logistic procedure was employed for statistical analysis. Postoperative complications included death, cardiac, respiratory, hepatic and renal failure, wound infection and sepsis. Various preoperative conditions were associated with postoperative complications but some of them, as malnutrition or operations prolonged over two hours, occurred more frequently. Age did not appear as a major risk factor. The determination of surgical risk is a major problem in general surgical practice and many attempts have been realized in order to predict postoperative outcome. Clinical judgment is still nowadays fundamental but predictive scores based on statistical analysis have proved to be valid and useful tools. The authors underline the importance of surgical risk prediction in therapeutic programming, especially in the aged and in cancer patient. The surgical or non surgical option and the type of operation to be performed result from a careful evaluation of operative risk and expectancy and quality of life.

Adolescent↗
PubMedDate not supplied

[Penile injuries caused by masturbation with a vacuum cleaner. Description of a case and review of the literature].

The paper reports a case of penis injury which occurred while masturbating using a vacuum cleaner. This caused skin lesions and urethral lacerations which were successfully cured from both and esthetic and functional point of view. The Authors stress the extreme rarity of the case and comment on the pathological anatomy of lesions and surgical objectives on the basis of a review of the literature.

Adolescent↗
PubMedDate not supplied

Does rifaximin prevent complications of diverticular disease? A retrospective study.

While the treatment of complicated diverticular disease (DD) is standardized, the approach to the symptomatic DD and prevention of relapsing complicated DD is still debated. An open question is whether nonabsorbable antibiotics may reduce the incidence of major complications of DD. We wanted to retrospectively analyze the prevalence of this disease in a large population of patients undergoing colonoscopy in our center in the last 10 years. Patients with symptomatic or complicated DD were treated with rifaximin 1,200 mg/die for 10-12 days during the acute phase in addition to the appropriate systemic antibiotics, followed by a prophylactic regimen with 800 mg/die for 7 days every month. The patients were followed up to December 2003, and the incidence of new complications and the relapses of symptomatology were determined. A total of 11,344 patients were screened. Of them, 2,287 showed an anatomical diverticulosis, and 408 had a diagnosis of complicated DD. The results indicate that the prevalence of DD--either in the uncomplicated or complicated form--in our area (Abruzzo, Italy) is identical to that of European countries, whose diet is characterized by a low amount of fiber and a high content of calories and refined sugars. Along a period of 10 years, a relapsing symptomatology of DD was observed in 112 patients treated with rifaximin (4.89%), while new complications of the DD were observed in 27 patients (1.18%). The comparison of these data with those of larger published series suggests a possible role of rifaximin in the prevention of DD main complications.

Aged↗
PubMedDate not supplied

[Silicone occlusive sheeting vs silicone cushion for the treatment of hypertrophic and keloid scars. A prospective-randomized study].

BACKGROUND: Silicone gel and silicone occlusive sheeting are widely used at present for the treatment of hypertrophic and keloid scars. In recent studies the possibility was raised that static electricity generated by friction activated silicone sheeting could be the reason for this effect, and that it can, with time, cause involution of hypertrophic and keloid scars. Objective of this study was to test this hypothesis and to observe weather a continuous and also an increased negatively charged static electric field will shorten the treatment period. A silicone cushion was developed with the purpose of increasing a negative static-electric charge to accelerate the regression process. METHODS: From November 2001 to June 2002 we studied in a prospective randomized study, 72 patients with hypertrophic an keloid scars. The trial extended over a 8-month period. 37 patients underwent silicone occlusive sheeting, the remaining 35 patients underwent silicone cushion (Clinicel). RESULTS: Treatment with the silicone cushions yielded 74,2% cessation of itching and burning followed by pallor and flattening of the scar, some markedly so, over a few weeks to 5 months period. Additional 25,7% had their scars resolved in up to 8 months of treatment. Four patients (11,4%) who add recalcitrant scars with little response to the use of the silicone cushion were given intralesional corticosteroid injections, in addiction to the use of the cushion, resulting in a fairly rayed resolution of these scars over a period of 2 months. Treatment with the silicone occlusive sheeting yielded 52,3% itching and burning cessation followed by pallor and flattening of the scar, some markedly so, over a few weeks to 5 months period. Additional 22,1% had their scars resolved in up to 8 months of treatment. In conclusion by comparing the results of this trial using silicone cushions for the treatment of hypertrophic and keloid scars with those obtained using silicone gel or occlusive sheeting, a much faster response was demonstrated.

Cicatrix, Hypertrophic↗
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Factors influencing the presentation and outcome of tuberculous meningitis in childhood.

UNLABELLED: Tuberculosis (TB) is an important cause of morbidity and mortality worldwide. Here, we describe our experience of childhood tuberculous meningitis (TBM), focusing on factors influencing presentation and outcome. PATIENTS AND METHODS: Children aged 0-14 years, with diagnosis of TBM and 24 months of post-therapy follow-up, were evaluated in this retrospective study. RESULTS: Thirty-two patients with TBM were identified. Fever, nuchal rigidity and vomiting were the main presenting symptoms. Fourteen cases (44%) presented with cranial nerve palsy. Seventeen (53%) patients were in advanced stage of the disease on admission. Cerebrospinal fluid (CSF) examinations showed low glucose, high proteins and pleocytosis. A central nervous system device was placed in 4 cases (13%) because of worsening hydrocephalus. Four (13%) patients died, while 6 (19%) had sequelae. Faster normalization of CSF parameters was associated with better outcome. CONCLUSION: Early antimycobacterial therapy and close monitoring of TBM in childhood improve the outcome.

Adolescent↗
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[Evaluation of ambulatory medical care in Milan].

Ambulatory procedures are an essential component of health care both for their number and for their cost. We aim therefore to identify and to quantify the volume of ambulatory procedures performed in Milan during 2003. The data come from the Outpatient Care Information Report that collect much information by characteristics of patient, health care institution and procedure categories. The analyses in this report are based on absolute measures, utilization rates and concentration index. During the year 2003 nearly 20 millions of ambulatory procedures were performed in the public and private outpatient facilities of Milan for the resident population. The average annual rate was 15 procedures per person. Utilization varied according to patient age and sex, higher in women and in the elderly group, statistically significant variability is observed (p<0.001). Outpatient care accounts for high density supply (124 specialty points for 100,000 inhabitants). Utilization rate was not homogenous both for the medical specialties and for the geographical district distribution, all that, it seems depending on the activity concentration differences and complexity supply of services than on a different distribution of health needs. This analysis may be useful as methodological starting point for further investigating current outpatient care data and for identifying those sectors in need of corrective actions.

Adolescent↗