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Biomedical subjects

S Martinoli

Publications and source records attributed to S Martinoli.

At least 19 recordsLinked to original sources
PubMed1992

[Gardner syndrome: possibility of early detection of carriers by examination of the ocular fundus?].

Through indirect ophthalmoscopic examination it was possible to analyse three families originated from the same Swiss alpine valley (Poschiavo) and carrying Gardner syndrome (SdG) to check if their members with SdG were presenting hypertrophic changes of the retinal epithelium which is supposed to be an early symptom of that syndrome. This lesion was found to be present only in two out of 11 patients (18%) with at least one symptom of SdG. Because of its lacking sensitivity, ophthalmoscopic examination is not able to substitute colonoscopy as a valid screening method to find out which members of a SdG-family are at risk to develop colonic poliposis and cancer.

Chromosome Aberrations↗
PubMed1992

[Open fractures. The problem of their classification and solution using the IMT-NV de l'AO (Osteosynthesis Study Group) system].

The IMT-NV system proposed by the AO-ASIF for classifying soft tissue injuries associated with long bone fractures allows to avoid the troubles of the historical discussion between two different opinions: which is the most important feature of an open fracture? The extent of the skin lesion or the deeper muscular and neurovascular damage? This classification as it is proposed in the new AO-manual will bring more precision and more possibilities in comparing different surgical approaches to this hard challenge called open fracture.

Fractures, Open↗
PubMed1992

[Final evaluation of the randomized multicenter study SAKK 40/81: adjuvant portal chemotherapy of curatively resected colorectal cancer].

Between 1981 and 1987, 533 patients from 9 institutions have been entered in a randomized trial to assess the value of adjuvant portal infusion (5-Fluorouracil, Mitomycin C) compared to radical surgery alone. Analysis of 469 evaluable patients at a median follow-up of 5.8 years revealed 110 recurrences in the control and 94 recurrences in the infusion group. Estimated 5-year disease-free survival was 52% and 61% respectively (hazard ratio 1:0.75; 95% confidence interval 0.57-0.99; p = 0.046). Overall survival was 59% in the control and 69 in the infusion group (p = 0.048). Adjuvant portal infusion did not influence the occurrence of liver metastases but reduced the overall recurrence rate.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Esophageal manometry prior to and following anti-reflux surgery].

We analysed the esophageal manometry of 36 patients before, and of 25 patients 1 to 14 years (5.8 years) after, fundoplication. The results were compared with the findings in 30 asymptomatic volunteers. Fundoplication raised the mean lower esophageal sphincter pressure from 6.2 mm Hg to 14.5 mm Hg, i.e. normal values (controls 20.2 mm Hg). The shortened lower esophageal sphincter length and its intraabdominal segment were overcorrected (increase from 3.2 to 5.2 cm [controls 4.1 cm] and 1.3 to 2.6 cm [controls 2.1 cm] respectively). The rate of non-specific motility disorders after fundoplication was reduced from 61% to 28% (controls 7%). A clear relationship between the success of fundoplication and either preoperative or postoperative manometric results could not be established.

Adult↗
PubMed1990

[Desmoid tumor and Gardner syndrome: a little known surgical dilemma. Presentation of 2 cases].

Two patients affected with Gardner's syndrome and desmoid tumour are presented: a 35-year-old man without polyposis coli who developed a clavicular posttraumatic desmoid tumour, and a 52-year-old woman with polyposis coli who died of an intra-abdominal desmoid tumour 3 years after prophylactic colectomy. A close follow-up of patients with Gardner's syndrome for early detection of desmoid tumours after surgery is recommended.

Abdominal Neoplasms↗
PubMed1990

[Hanggliding accidents: epidemiology and clinical aspects].

The authors reviewed their experience with hanggliding injuries, and additional cases in the literature. As most accidents are due to how people fly (inexperience), and where people fly, the authors conclude that an adequate training is mandatory.

Accidents, Aviation↗
PubMed1989

[Initial results of adjuvant portal liver infusion following radical surgery of colorectal cancer (Swiss Study Group for Epidemiologic and Clinical Cancer Research Study 40/81)].

Between July 1981 and June 1987, 533 patients from 7 participating institutions have been entered in a prospective randomized trial to assess the value of adjuvant portal infusion (5-Fluorouracil 500 mg/m2/d x 7 continuous infusion + Mitomycin-C 10 mg/m2 on day 1 as a bolus injection through portal venous catheter) compared to radical surgery alone. The portal venous catheter was placed through any side-branch of the mesenteric venous system during laparotomy for the primary tumour. Using the transabdominal route, there have been no catheter-related complications. Overall hospital mortality in the study was 1.75% and was not influenced by adjuvant treatment. Analysis of 469 eligible patients at a median follow-up of 48 months revealed 39.1% recurrencies in the control group and 31.8% in the infusion group (p = 0.09, logrank). Median survival of control patients is 72 months, of chemotherapy treated patients not yet reached. Significant survival advantages have been detected for those 195 (85%) patients who received full-dose adjuvant chemotherapy (67% versus 53% 5-year survival). Due to the low number of deaths in this trial, prolonged follow-up is needed for definitive survival conclusions.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Rupture of the anterior cruciate ligament at a peripheral hospital. Apropos of 70 cases].

Three years after surgery on average seventy patients with surgically "treated" or "repaired" lesions of the anterior cruciate ligament were evaluated. According to the operative technique, the patients were divided into 4 groups: Group I: suture of ligament only, Group II: Eriksson-Trillat plasty, Group III: McIntosh plasty, Group IV: Dacron plasty. The results were assessed according to the Marschall-score. Good results were obtained in the first group. The results with the fourth group were at the time of the examination "good" too, however, one third of them had to be reoperated in the following six months. For fresh ruptures of the ACL we advocate the primary suture of the ligament with, if necessary, an augmentation.

Adult↗
PubMed1989

[Traffic accident injuries in Tessin Canton in 1982 and 1985--epidemiology, surgery and socioeconomic aspects].

In the paper we present the result of an epidemiological study we conducted upon injuries due to road accidents in Canton Ticino. We reviewed 1471 injured patients during two periods: in 1982 we examined all patients evaluated in the Emergency Room and admitted - if required - in all the Canton Ticino Hospitals. In 1985 we reviewed only patients seen at Ospedale Civico Lugano and patients seen by the police department (SIR) because the lesions were life-threatening. 106 (8%) patients died, 206 (15%) were seriously injured (87 patients with chronic infirmity) and 1062 had slight injuries. The total lesions were 2900 and 839 surgical operations were necessary. These patients needed a 7804 days of hospitalization (677 days in the intensive care unit). Motorcycles represented 46.5% of the involved vehicles. The major risk groups by age are: 14-17 years old (motorcyclist), 18-29 years old (automobilists and motorcyclists), up to 13 and over 60 years of age (pedestrians). The percentage of the total road accidents which occur at the week-end is of 49.4%. At rush/hours (5.00 pm) the percentage of accident is 8.1% (115 accidents) and in the early morning hours the percentage is 5.5% (74 accidents). The annual hospitalization costs amounted to 3,200,000 sFr., whereas the real costs corresponding to production loss, social expenditures (25.737 were the days of disability) and in- and out patient care are as high as 100 million francs.

Accidents, Traffic↗
PubMed1989

[Blood transfusions and prognosis following curative resection of colorectal cancer: is there an association?].

More recently a number of retrospective analyses in rather ill defined patient populations demonstrated an association between perioperative blood transfusion and recurrence after curative resection of colorectal cancer. In the randomized trial (SAKK 40/81) (adjuvant cytotoxic intraportal infusion versus no further treatment) we evaluated the transfusion status in a well defined, prospectively documented and controlled patient population. Of 457 patients, 353 (77.2%) received either pre-, intra- or postoperatively blood transfusions. After a median follow-up of 4 years, the transfused patients developed significantly more recurrences (38.2%) than patients without blood transfusions (23.1%), the death-rate being 33.7% versus 23.0%, respectively. Patients without transfusion but treated with adjuvant intraportal chemotherapy are strikingly doing better (10.5% recurrences) than patients with perioperative blood transfusion not having an adjuvant treatment (44.5% recurrences).

Blood Transfusion↗
PubMed1989

[Traffic injuries in the Tessin Canton in 1982 and in 1985. Epidemiology, surgery and socioeconomic aspects].

In the paper we present the results of an epidemiological study we conducted upon injuries due to road accidents in Canton Ticino. We investigated into 1471 injured patients admitted to hospital during 1982 in Canton Ticino, all the in- and out-patients at the Ospedale Civico during 1985 and all the seriously injured patients in road accidents where the scientific police (SIR) were called in. 106 (8%) patients died, 206 (15%) were seriously injured (87 patients with chronic infirmity) and 1062 had slight injuries. The total lesions were 2900 and 839 surgical operations were necessary. These patients needed a total of 7804 days of hospitalization (677 days in the intensive care unit). Motorcycles represented 46.5 of the involved vehicles. The major risk groups by age are: 14-17-year-olds (motorcyclist), 18-29-year-olds (automobilists and motorcyclists), up to 13 and over 60 years of age (pedestrians). The percentage of the total road accidents which occur at the week-end is of 49.4%. At peak hours (17.00 p.m.) the percentage of accident is 8.1% (115 accidents) and in the small hours the percentage is of 5.5% (74 accidents). The annual hospitalization costs amounted to 3,200,000 SFr., whereas the real costs corresponding to production loss, social expenditures (25.737 were the days of disability) and in- and out-patient care are as high as 100 million francs.

Accidents, Traffic↗
PubMed1989

[The dynamized external fixator. Use and problems].

We report our experience with 11 patients treated with an external fixator that was dynamized at some stage of the treatment. In 7 patients bone union occurred without any other measures, 2 patients were protected in a cast after the external fixator removal, while 2 patients developed a non union that was plated and subsequently healed. According to these experiences, dynamization of an external fixator seems to be a reliable and elegant way to treat simple open shaft fractures, the method is however not advocated for more complex or comminuted fractures.

Adult↗
PubMed1987

[Can one use high thoracic epidural analgesia in postoperative intensive care of the myasthenia patient following trans-sternal thymectomy?].

Analgesia is an important problem in myasthenia gravis patients who have undergone transsternal thymectomy. Postoperative pain interferes with pulmonary function, which is already limited by the disease. The choice of medication is restricted because many analgesics are synergic to the myasthenia gravis syndrome and detrimental to the patient. Three patients with severe myasthenia gravis are presented who had undergone transsternal thymectomy with good postoperative results. They received high thoracal epidural anesthesia (C7-Th1/Th1-Th2/Th2-Th3) with a solution of bupivacaine and morphine (20 ml 0.25% bupivacaine with 10% morphine). The patients were extubated in the first 48 hours and monitoring of respiratory function (CV2, PO2, PCO2) showed satisfactory values. With this type of analgesia we obtained early mobilization and good patient cooperation. Although limited this favourable experience confirms that high thoracal epidural anesthesia is a sure technique which allows rapid weaning from the ventilator and maximum comfort for the patient. It avoids the use of other medication or analgesics which are contraindicated in these patients.

Adult↗