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Biomedical subjects

P Bobbio

Publications and source records attributed to P Bobbio.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Surgical treatment of pulmonary metastasis: diagnostic protocol and individualization of indication criteria].

Lung is the second most frequent site of cancer metastasis (29% of autopsies). At the present time, surgery is the only potentially curative treatment available to patients with no other secondary localizations. Solitary or multiple, unilateral or bilateral, and synchronous or metachronous appearing pulmonary shadows, in cancer patients, give rise to both diagnostic and therapeutic problems. Diagnostic methods are selected by sensibility and specificity. The most sensitive is the thoracic C.T. (sens. 94%; spec.: 76%) and the most specific is fine needle biopsy (sens.: 92%; spec.: 98%). These two tests alone provide diagnostic certainty in 97-100% of cases, including small (3-6 mm) subpleural and multiple lesions. Tomography, bronchoscopy or Ga-67 scanning are indicated only in selected cases. Selection of patients for surgical treatment is based on: 1) tumors almost exclusively producing pulmonary metastasis (soft tissue sarcomas, renal, head and neck cancers); 2) tumor-free time (1 year considered good long) 3) length of doubling time (+40 days). This selection criteria also applies to multiple and/or bilateral lesions. Surgical treatment consists of surgical excision with minimal parenchymal sacrifice. Long-term follow-up after metastasectomy, shows a considerable improvement in both the survival period and residual quality of life in comparison to patients not surgically treated, or treated by chemotherapy alone.

Humans↗
PubMed1983

[Cancer of the lung: software construction for data filing and processing].

Within the framework of "Neoplastic growth control", a N.R.C. Project developed in Italy on a national scale, the authors report their initial experience in the use of a microcomputer to file and process a number of data regarding all the patients with lung cancer treated by medical or surgical therapy since 1978. The hardware consists of a TRS 80 microcomputer with a RAM memory of 48 Kbyte, while the software is designed to file and process the data of about 2000 patients. Each patient is identified by 122 parameters. 80 cases have been stored up to now. Allowing a more efficient data analysis, this highly versatile programme will facilitate the management of the hospitalized patients and the backward and prospective evaluation of the different cases. In fact, the accurate and prompt availability of all the necessary information is a major step towards the selection of the best treatment for each patient.

Adult↗
PubMed1982

[Surgical indications in treatment of chronic bronchial suppurations].

The Authors report their experience (22 operations) concerning chronic bronchial suppurations of surgical interest. During the period considered (1964 - April 1982), among many pathological processes capable of conditioning a chronic bronchial suppuration, it has been observed a progressive decrease of "primitive" bronchiectasis and a percentage increase of "secondary" ones. Surgical treatment, unquestionably required in cases of cystic malformation or secondary obstruction, is now restricted to "primitive" cases with well-limited bronchiectasis or with complications (hemoptysis). Surgical therapy performed in these cases appears to grant good results both immediately (O% surgical mortality) and in the future.

Adolescent↗
PubMed1982

[Traumatic perforations of the esophagus].

The Authors describe 6 patients with esophageal jatrogenic of foreign body perforation treatment during the last 5 years. The early recognition and immediate direct suture of the lesion proved a simple and efficient treatment. At the contrary a delayed diagnosis represent the cause of morbidity and mortality (one case on the six described) being impossible a direct suture of the lesion as consequence of local and general infective complication leading to very long postoperative causes with possible iterative surgery. The use of T.P.N. and of antibiotic therapy gascromatografich testing guides for anaerobic infection provide today a much improved prognosis for these patients.

Adolescent↗
PubMed1982

[Prognostic findings in histopathology in bronchopulmonary carcinoma after surgery].

The prognostic value of hystological cell type, nuclear grading and mitotic index has been examined in 48 carcinomas of the lung after radical surgery. Three hystological cell types have been identified: squamous cell carcinoma (48%), large cell anaplastic carcinoma (33%) and adenocarcinoma (19%). The Nuclear Grade, ranging from 0 to 4, has been classified as low (N.G. less than 2) and high (N.G. greater than or equal to 2). The Mitotic Index (M.I.) has been considered as the mean of the number of the mitosis observed in 10 microscopic high power fields. (400 X). The 5 year survival rate is significantly higher in patients having large cell carcinoma or squamous cell carcinoma in relation to N.G. less than 2 and M.I. less than mean.

Adenocarcinoma↗
PubMed1982

[Local cellular immune response in bronchopulmonary carcinoma after surgery in relation to long-term prognosis].

The prognostic value of local stromal cell reaction has been examined in 48 carcinomas of the lung (23 squamous cell carcinomas, 16 large cell anaplastic carcinomas, 9 adenocarcinomas) after radical surgery. The intensity of the peri and intratumoral lymph cell (R.L.), plasma cell (P.R.) and macrophage (M.R.) reactions has been classified in low, moderate and high reactions. The 5 year survival rate is significantly higher in patients having large cell carcinoma and squamous cell carcinoma in relation to a high or moderate lymphocytic reaction. There is no correlation between the age of the patient and the stromal cell reaction.

Adenocarcinoma↗
PubMed1982

[Long-term results of lobectomy for bronchopulmonary carcinoma].

The Authors made a retrospective evaluation of the influence of stage, lymph-node involvement and hystological type on long term survival in 50 lung cancer patients who underwent "radical" lobectomy. The over all survival was 38%; as far as the oncotype was concerned large cell and epidermoidal carcinomas had the best survival rate. Stage and lymph node involvement turned, out to be the most important prognostical factors: only 8% of the N2 and 14% of the Stage III patients were alive after 5 years against 59% of the NO and 52% of the Stage I patients.

Adenocarcinoma↗
PubMed1979

[A middle esophageal ring].

The Authors, having observed a case of middle oesophageal web giving rise to severe dysphagia, discuss the aetiopathogenesis, the diagnosis and therapy of these rare oesophageal lesions. Because of its pathological feature, the reported case was succesfully treated by surgical resection of the ring, using a transthoracic approach.

Esophageal Stenosis↗
PubMed1979

[Plunging and intrathoracic goiters].

The authors report 21 cases of cervico-substernal and 9 cases of mediastino-cervical goiters. On the base of their experience they remark that the diagnosis of topographic mediastinal extent of goiter has never been a problem in the mean time that it remains difficult to recognize the possible tumoral nature of the lesion, also utilizing both thyroid angiography and superior caval phlebography. Removal of 27 of 30 goiters was effecuted by cervical approach alone. In two cases a thoraco-lateral approach was added to remove endothoracic neoplastic goiters and in the last case a partial sternotomy was necessary. The authors conclude that the occasional use of sternotomy is not the result of an aprioristic decision, but the consequence of a correct removal obtained through the cervicotomic approach, also for large mediastino-cervical goiters.

Adult↗
PubMed1978

[Traumatic chylothorax. A further indication for total parenteral nutrition].

Successful and rapid resolution of a serious cases of traumatic chylothorax by means of conservative management with TPN is reported. This method is clearly indicated as a mean of making up the calorie and amino acid need when litres of chyle are being lost every day. In addition, by resting the digestive tract it brings about a massive decrease in the production of lymph in the mesenteric district and thus leading to easier and earlier sufficiency of the collateral lymph drainage routes. The rapid decrease in quantity and the change over from chylous to serous chest drainage liquid after TPN are evidence of its soundness. An immediate lymphographic control revealed complete section of the duct. Two months later, collateral diaphragmatic and azygos circulation was observed. It is felt, therefore, that TPN extends the range of conservative management of posttraumatic and postoperative chylothorax.

Adult↗
PubMed1977

[Emergency colectomy in ulcerative colitis (author's transl)].

During the last 12 years 7 patients with ulcerative colitis were treated because of an acute complication consisting in 2 cases of colonic perforation, 3 cases of toxic megacolon (two of them perforated) and 2 cases of massive enterorragia. In all patients an emergency total colectomy was performed resulting a mortality of 3 cases, two of which had required the removal in a second time of the rectal stump. In 3 or 4 recovered patients we performed in a period of 7-15 months an ileo-proctostomy once confirmed the healing of the ulcerative lesions in the residual rectum. The problems concerning the indications and surgical procedures involved in such cases are discussed on the base of the personal experience, with particular consideration on advantages and limits of preserving a rectal stump. The authors agree on an eclectic behavior considering each case on the base of pathological findings, the age and the general and psychic conditions of the single patient.

Acute Disease↗