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Biomedical subjects

N Picardi

Publications and source records attributed to N Picardi.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

[Diagnostic and oncologic updating on gallbladder papilloma. Personal experience and review of the literature].

After a correct definition of the pathologic meaning of "papilloma of gallbladder" and the considerations about the main epidemiologic, pathogenetic and diagnostic guidelines, the authors discuss the meaning of the apparent higher frequency of this pathology in the biliary tract than in the gallbladder localization. This condition probably derives from the precocious appearance of pain or jaundice during choledocal pathology respects to the asymptomatic gallbladder localization. Moreover, using morphological indicators of intracholecistic ultrasonography, the gallbladder's polypoid lesions are divided in group s and for each of the m are indicate d most/actual curative criteria. Currently tendency is to check periodically gallbladder polypoid lesions, and to recure to surgery when the lesion result large more than 1 cm, single, associated with stones, when the patient is older than 50 years and when there is a clear clinical symptomatology. Finally, the authors discuss the malignance evolution of these lesions attaching importance as prognostic role to the study of the K-ras and p-53 proto-oncogenes, because they consider the carcinogenesis like a "multi-step" evolution.

Adult↗
PubMedDate not supplied

[Adrenal incidentaloma: a dopamine-secreting pheochromocytoma with an atypical clinical picture. A case report and review of the literature].

INTRODUCTION: The increasing and consolidated uses of US and CT scan in the diagnosis of abdominal diseases has improved the detection of adrenal asymptomatic masses. Current literature points out that these nodules are identified by 1:100 abdominal CT every year. On the other hand, about 50% of the adrenal tumors are discovered by autopsy. The diagnostic difficulties may be due both to clinical silence and to atypical clinical expressions of the neoplasm--as in the case report--where a pheochromocytoma shows non-specific abdominal symptoms rather than the typical signs of catecholamine overproduction. CASE REPORT: Author,s report a suprarenal right pheochromocytoma, secreting dopamine prevalently. The tumor showed abdominal symptoms without history of hypertensive paroxysms, or better still in normotension regimen. DISCUSSION AND CONCLUSIONS: According to current literature, abdominal symptoms occur in about 7% of all suprarenal pheochromocytomas. Most of these tumors prevalently secrete dopamine, that seems to make the prognosis worse. US, CT scan and CT-guided fine needle biopsy weren't able to characterize the real nature of the adrenal incidentaloma. On the contrary, the hormonal screening--by monitoring the urinary VMA and fractioned catecholamines through 24 hours--was decisive for the diagnosis of pheochromocytoma. The adrenal incidentalomas diagnostic significance is tied to the concept that adrenalectomy can change their prognosis, especially in case of pheochromocytoma, where a recovery rate about 90% can be achieved. Authors agree that adrenalectomy my must be performed in all case of "functioning" adrenal tumors and "nonfunctioning" ones with > 6 cm size. Of last years the laparoscopic approach has extended the adrenalectomy's indications to mass with size ranging between 3 and 6 cm., while lesions < 3 cm. size require only a follow up by means of imaging techniques and hormonal monitoring.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Perspectives of scientific publications of surgery in Italy. Perspectives on the article of M. Rubino and Al. "Types of surgical articles. Comparative analysis of three Italian and three foreign journals".

The globalization of the information and the wide use of the English language in the scientific world impose a not avoidable comparison to the scientific Italian journals, but with value indicators that if accepted without criticism could humble the undeniable internal values. In fact such comparison is based certainly on the quality of the contents, but it has already as background parameter the language of publication if the aim is that of an adequate diffusion. The questions that rise from the analysis of the problem are essentially two: if there is still room nowadays for surgical scientific publications in Italian language and if it is correct to accept in a closed box the indicator of international comparison conditioned by the English language, with the consequence that the definite value judgement is entrusted to external opinions. Certainly the Italian journals of surgery must aim both to quality and to their diffusion for reaffirm and validate their cultural rights. The quality depends on the authors and on the surgical environment in which they operate, beyond the engagement of the scientific direction of the journal; the diffusion on the correct employment of the English language, at last of the abstracts, and on the general editorial strategy pointing to encourage and promote the widest coverage of critique. It remains but to bravely loose the knot represented from the proposal of a uncritical acceptance of the indicator of the IMPACT FACTOR with the consequent absolute judge of quality, that fatally depends from an egemonic Anglo-Saxon filter, not exempt from an unavoidable lobbystic imprint.

England↗
PubMedDate not supplied

[Guideline concepts of the present-day surgery in breast cancer].

The more important trends of nowadays surgery for breast cancer are those of an advanced rationalization of combined strategies in a multidisciplinary view. Moreover it takes advantages from the availability of an extremely modern diagnostic instrumentation used in search of a truly early diagnosis, based on scheduled screening and surveillance criteria both for general population and particularly for that at risk. In this way it is easier and possible to adopt less radical and more conservative surgical techniques, whose effectiveness is well demonstrated in association with adjuvant treatment thanks to the convergence of multiple competences. The better results of the last years are certainly related to the collaboration of surgeons with oncologists, thanks to the ever more effectiveness of adjuvant chemo- and radiotherapy, that make more acceptable the attitude for the reconstructive and the conservative surgery whenever possible. This interpretation of the actual positive results of breast cancer surgery point the way to follow, and are the basis for hoping further improvement in the treatment of this disease, ever more efficacious whilst that diagnosis precocious be more and more.

Adult↗