Biomedical subjects

N Picardi

Publications and source records attributed to N Picardi.

153 records · Page 9Linked to original sources

PubMedDate not supplied

[The epidemiology of gallbladder cancer in Italy. ISTAT data 1970-1987].

The Italian surgeon needs to know the real situation about gallbladder carcinoma in Italy, his professional field of action: real incidence, sex and age characteristics and regional distribution with useful correlations to define the risk population. We can use nowadays the ISTAT data (since 1969 also in magnetic tape) about such neoplasia, based on death denunces. These differentiate gallbladder carcinoma from others hepatobiliary neoplasms and are referred to the whole national territory and allow and analyze for the various regions a period of 18 years (from 1970 to 1987). We have therefore the facility of a statistical index which give us the possibility to compare directly the specific mortality taxes between very different regions of residence from the point of view of population density, sex and age distribution on each year of the period considered. Also in Italy incidence of gallbladder carcinoma shows an absolute and relative increasing with age in both sexes, reaching the peak in the seventy's, with a M/F rate between 1/3 to 1/2, and with global incidence that is increasing in the last years. Risk factors could be in the age older than 50 years, in the females, in the long standing gallbladder lithiasis with wide cholesterinic stones on the basis of a chronic inflammation and consequent dysplasia, in the diet more far from the mediterranean's, and finally in papillomas and papillomatosis of gallbladder.

Adolescent↗

PubMedDate not supplied

[Acute non-calculous cholecystitis: rationale for absolute emergency cholecystectomy].

The authors report a case of biliary peritonitis in acute perforated alithiasic cholecystitis and they highlight the opportunity to consider the acute alithiasic cholecystitis as an absolute emergency, both for the pathogenetic prenits and the coon association with other pathologies that represent adjunctive risk factors.

Acute Disease↗

PubMedDate not supplied

[The distal pedicle fasciocutaneous flaps of the leg. Analysis of 21 cases of lower limb reconstruction].

The fascio-cutaneous flaps with distal pedicle, with the new discoveries on fascial and septal circulation of the lower limbs, are a valid reconstructing method for the loss of substance localized on the third inferior of the leg and in the heel's region. In 21 patients, 18 men and 3 women, fascio-cutaneous flaps were employed for the traumatic loss of substance, just in two cases consequentially to removal of maligns lesions, all of them were omolaterals except in three cases in which cross-leg were used. The results are satisfying if we remember that just in two cases we had partial necrosis and in other two cases we had to reinstate the flap which had survived just in his deep position. The advantages of using this technique are supported by his good results and simple execution, realising anyhow that complicated or contaminated trumas need more complex plastic reconstruction.

Adolescent↗

PubMedDate not supplied

[Injury of the popliteal artery & the popliteal branches: analysis of 31 consecutive cases].

In complex traumas of lower limbs it is fundamental the reducing of the time of ischemia to reduce the number of failures in repairing surgery and the percentage of the demolishing of necessity surgery. The experience of the authors is based on 31 complex traumas of lower limbs with distal vascular injuries to Hunter's canal, which were associated to bone, nervous and muscular lesions. In total we are treated 37 vascular injuries by interposition of venous autografts in 37 cases, lateral pacth in one case ant suture T-T in two cases. The protection of the reconstructed vases, in case of a concomitant loss of substance, was entrused to microvascular flaps for 7 times latissimus dorsi, iliac crest and fascio-cutaneous for 5 times posterior reversed with distal baset and for three times antero-lateral, which in three cases of them needed successively a dermoepidermic grafts. The bone injuries, which were treated by external fixation, intramedullary nailing, plate and screws, just in two cases became worse in pseudoarthroses and just in one in osteomyelitis. The reparation of nervous injuries had bad results just in two cases. The percentage of saving of the limb it was about 83.9%.

Female↗

PubMedDate not supplied

[Renal angiomyolipoma causing an acute abdomen].

Herewith referred a case of renal angiomyolipoma relieved on a patient of 62. The new involvement has been found following an evidence of a keen syntomathology related by a steep abdominal ache centred above all on the right hypocondrium followed by a general light ache. The ecography and the "TAC" on the bely have showed a new enlarged involvement, centred on the hypocondrium and on the right oval side of a diameter of nearly 35 cm, that moved anteriorly the right renal, with an involvement of a perirenal hematoma. The surgery has ended with a nephrectomy with the drop of the involvement on the renal tissue and the emorragical enlargement which has allowed a local nephrectomy and therefore to resume the organon as a new growth not dangerous. The histological diagnosis separated on the renal carcinoma han been possible with certainty only examining cruently the area after a tumorectomia, but the general clinical course and the evidence of the angioTAC had been realized towards the exact diagnosis.

Abdomen, Acute↗

PubMedDate not supplied

[Significance of antibiotic prophylaxis in infection prevention in biliary surgery. Personal experience].

Postoperative infections are one of the most frequent causes of morbidity in surgical patients. In biliary tract surgery the risk of septic complications is essentially increased by opening the bile ducts. Aim of this paper is to evaluate indications and effectiveness of short-term prophylaxis in preventing infective complications of biliary surgery. Authors report a personal six years review regarding 530 patients operated for biliary tract diseases. The patients were divided into two groups: the first one (n. 245) operated under short-term prophylaxis; the second one (n. 285) treated only postoperativelly with antibiotics. The results obtained show a significatively higher rate of infective complications in the second group of patients. There is a little difference between the groups in the case of elective cholecystectomy, whereas there is a great difference in case of non-elective surgery, bile ducts opening, external biliary drainages placement or sphincteropapillotomy. Authors furthermore emphasize how surgical results are conditioned by individual risk factors, especially obesity and diabetes.

Adult↗

PubMedDate not supplied

[Bilateral aneurysms of the popliteal artery].

INTRODUCTION: Popliteal artery aneurysms are the most common of peripheral arterial aneurysms. Popliteal aneurysms are bilateral in 42% of patients. Atherosclerosis and bacterial invasion of the arterial wall are the predominant etiologic factors of popliteal artery aneurysms. CLINICAL CASE: A male of 67 years old was referred to our institution for bilateral claudication and 150 m. free interval. The angiogram showed a partial occluded aneurysm of the right popliteal artery and a complete thrombosis of the left popliteal artery aneurysms. The left aneurysm was resected and a femoral popliteal by-pass was performed, using the inverted saphenous vein graft, associated with left lumbar sympathectomy. Six months later the contralateral aneurysm was excised and a Dacron femoro-popliteal by-pass graft was performed. Two years later Arteriographic and Doppler examination showed patent by-pass bilaterally. CONCLUSION: Popliteal artery aneurysms can be a threaten for the lower limbs, because of thromboembolic phenomena and occasional rupture. Surgery is the best treatment before the appearance of an acute complication and a by-pass with an autogenous vein graft or a Dacron graft are the most common surgical procedures performed. Thrombolytic therapy offers good results where an acute complication appears.

Aged↗

PubMedDate not supplied

[Deep parotidectomy with conservation of pre-neural tissue in the surgery for Warthin tumor].

The perfect acquaintance of the surgical anatomy of the parotid region associated to the rigid execution of the operative times by now standardized for the interventions on the parotid gland, they constitute a solid base of certainty on which found the own surgical choices. In some cases it's possible going away from the established rules to follow the impulses that the personal instinct suggests in the attempt of overcome unusual technical difficulty. The case in examination constitutes the tangible example to this enunciated, in which the technical difficulty of a neoplastic subneural bulk--the comfort on whose benignity arose from a preoperative FNAB (often but not always secure on the real histological nature)--that it could not be enucleated without dissect the trunk of the facial nerve, it imposed the adoption of technical extemporaneous solutions which, since dictate from the necessity of the moment, must not be recommended like rules to follow in all the situations, neither judged as rash surgical choices.

Female↗

PubMedDate not supplied

[Epidermoid carcinoma of the thyroid].

About thyroid neoplasms the epidermoidal carcinoma represents an ingrown minority (0.3-0.74%). Several etiopathological hypotheses are considered and this testifies the notable uncertainty that still winds the origin of the neoplasm. In the actual case, the more accredited hypothesis foresees the origin of the neoplasm from a histopathological of Hashimotos' tyhroiditis. The objectivity of the case in examination constitutes the clinical picture of reference of the malignant neoplasms of the thyroid: oligosintomatic low cervical mass of increased consistence, adherent to the imminent pianos strictly following laryngeal movements, dysfagia and dysfonia. Additionally they were present pulmonary and right cervical lymphonodal metastases. After an adjuvant treatment with Paraplatin and 5-FU, to some months from the intervention of total thyroidectomy, local relapse in form of a festered mass is highlighted in sovrajugular region with result in cutaneous-esophagustracheal fistula. The diagnosis of certainty of the neoplasm, despite the rarity, it doesn't constitute a problem, albeit the percents of survival, anyway substantially more favorable respect to anaplastic neoplasms, concerning to as numerical as chronological aspects, result to be hardly discouraging.

Aged↗