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Bove A, Dei Rocini C, Di Renzo RM, Farrukh M, Palone G, Chiarini S, Staniscia T. Vitamin D Deficiency as a Predictive Factor of Transient Hypocalcemia after Total Thyroidectomy. Int J Endocrinol 2020; 2020:8875257. [PMID: 33101410 PMCID: PMC7569460 DOI: 10.1155/2020/8875257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/16/2020] [Accepted: 09/28/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Total thyroidectomy (TT) is recommended in the treatment of malignant and benignant thyroid diseases, and, to date, transient hypocalcemia is the most frequent complication after the procedure. We prospectively evaluated the role of vitamin D deficiency as a predictor of postoperative hypocalcemia. METHODS This is a prospective cohort study which was conducted between January 2016 and April 2019. A total of 177 consecutive patients (141 (79.7%) women and 36 (20.3%) men) who underwent TT were included in the current study. Hypocalcemia occurred when serum calcium levels were below 8.0 mg/dL or 1.10 mmol/L. Patients were divided into two groups (Group 1, normocalcemic; Group 2, hypocalcemic) and were assessed taking into consideration preoperative serum 25-hydroxy vitamin D (25-OHD) levels, preoperative serum calcium levels, thyroid hormone levels, sex, body mass index (BMI), and smoking habits. Vitamin D deficiency was defined as 25-OHD levels <25 ng/mL. RESULTS The incidence of postoperative asymptomatic and symptomatic hypocalcemia in the two groups was 19.8% and 15.8%, respectively. Preoperative 25-OHD level was significantly different between Group 1 and Group 2 (31.5 ± 15.0 ng/mL vs 18.7 ± 9.8 ng/mL,p=0.017). Logistic regression analysis revealed that preoperative vitamin D deficiency was a significant predictive factor of postoperative hypocalcemia (p=0.012), and, specifically, the risk of hypocalcemia increased 15-fold in patients with a preoperative vitamin D level <25 ng/mL (odds ratio [OR], 14.8). CONCLUSIONS Postoperative hypocalcemia is significantly associated with low preoperative levels of serum 25-OHD. Our studies demonstrate that vitamin D deficiency (<25 ng/mL) is an independent predictive factor of postoperative hypocalcemia.
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Affiliation(s)
- A. Bove
- Department of Medicine, Dentistry and Biotechnology, University “G. D'Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - C. Dei Rocini
- Department of Medicine, Dentistry and Biotechnology, University “G. D'Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - R. M. Di Renzo
- Department of Medicine, Dentistry and Biotechnology, University “G. D'Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - M. Farrukh
- Department of Medicine, Dentistry and Biotechnology, University “G. D'Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - G. Palone
- Department of Medicine, Dentistry and Biotechnology, University “G. D'Annunzio”, Via dei Vestini, 66100 Chieti, Italy
| | - S. Chiarini
- Department of Medicine and Ageing Sciences, University “G. D'Annunzio”, Chieti-Pescara, Italy
| | - T. Staniscia
- Department of Medicine and Ageing Sciences, University “G. D'Annunzio”, Chieti-Pescara, Italy
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D'Errico G, Rosa MA, Soluri A, Scafè R, Galli M, Chiarini S, Burgio N, Schiaratura A, Massa R, Scopinaro F. Radioguided Biopsy of Osteoid Osteoma: Usefulness of Imaging Probe. Tumori 2018; 88:S30-2. [PMID: 12365380 DOI: 10.1177/030089160208800333] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background When removal of osteoid osteoma is performed with open biopsy, the surgeon can be guided by radioactivity of 99mTc-MDP (methylene D- phosphonate) acquired by a probe. Material and methods We compared the performance of a commercially available ZnCdTe probe (Neoprobe 2000) and a one-square-inch-field-of-view imaging probe (IP) on two patients undergoing open biopsy for osteoid osteoma. Triphasic bone scintigraphy was performed before operation and Neoprobe as well as IP were used in the operating room by two nuclear physicians. When the surgeon asked for guidance, each nuclear physician had to indicate a precise direction. Results The surgeon asked for guidance once in the first operation, on a patient with osteoid osteoma of the femur, and four times in the second operation, for osteoid osteoma of the acetabulum. The indications provided by IP were correct 5/5 times, whereas the commercial probe was correct 3/5 times. Both devices were able to assess the surgical radicality. After biopsy, bone samples were divided into high-count and low-count samples. Pathological examination confirmed the presence of osteoid osteoma in high-count samples. Conclusions IP has already been used to guide biopsy, but only in breast disease. The present work confirms its good performance also in orthopedics as a portable mini gamma camera that can be used in the operating room.
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Affiliation(s)
- G D'Errico
- Catholic University Sacro Cuore, Rome, Italy
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3
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Scopinaro F, Pani R, Soluri A, Pellegrini R, Scafè R, De Vincentis G, Capoccetti F, David V, Chiarini S, Stella S. Detection of Sentinel Node in Breast Cancer: Pilot Study with the Imaging Probe. Tumori 2018; 86:329-31. [PMID: 11016719 DOI: 10.1177/030089160008600420] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The commonly used gamma probes are easy to use but also give rough information when employed in radioisotope-guided surgery. When images are required for exact localization, a gamma camera as well as a probe have to be used. Position-sensitive photomultipliers have contemporaneously allowed high-resolution scintigraphy and miniaturization of gamma cameras. We have assembled a miniature gamma camera with a 1-square-inch field of view and an intrinsic resolution of about 1 mm. When the minicamera is collimated with a large-holed, highly sensitive collimator, it acquires a spatial resolution of 3 mm. This prototype has been tested in the detection of difficult-to-image breast cancer sentinel nodes. Five nodes that had not been found with the usual technique of an Anger camera plus conventional probe were checked with the miniature camera that we named imaging probe: it actually is small enough to be used as a probe and large enough to give an image. One of the five nodes was found and imaged. It was small, disease-free, close to the tumor and probably hidden by the Compton halo around the peritumoral injection site. Our pilot study shows that the imaging probe, although still a prototype, has certain advantages over conventional methods when lymph node localization is required during surgery.
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Affiliation(s)
- F Scopinaro
- Dipartimento di Medicina Sperimentale e Patologia, Università La Sapienza, Roma, Italy
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Bove A, Di Renzo RM, Palone G, D'Addetta V, Caldararo F, Antonopulos C, Panaccio P, Chiarini S, Bongarzoni G. Which differences do elderly patients present in single-stage treatment for cholecysto-choledocholithiasis? Int J Surg 2014; 12 Suppl 2:S160-S163. [PMID: 25157986 DOI: 10.1016/j.ijsu.2014.08.358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/15/2014] [Indexed: 02/03/2023]
Abstract
Patients with symptomatic gallstones present common bile duct stones in approximately 10% of cases. It is possible to resolve both gallbladder and bile duct stones with a single procedure. The aim of this study is to determine the effectiveness of a single stage procedure for gallbladder and bile duct stones in the elderly patients and to expose the differences between the various techniques. From January 2008 to December 2013, we treated 1540 patients with gallbladder stones. In 152 cases, we also found bile duct stones. 150 of these were treated in a single stage procedure. We divided our patients into 2 groups: Group A was younger than 65 (104 patients); Group B was 65 or older (46 patients). We retrospectively compared sex, ASA score, conversion rate, success rate, post-operative complications, hospital stay, and treatment method. We had no intra-operative mortality. 1 patient in Group B, heart condition (ASA 4), died with multiple organ failure (MOF) 10 days after his operation. ASA score: 3.5 ± 0.5 in A vs 2 ± 0.9 in B (P 0.001), post-operative complications 6% in A vs 18.1% in B (P 0.0325) and hospital stay 4.1 ± 2.3 in A vs 9.5 ± 5.5 in B (P 0.0001) were significantly higher in Group B. No differences were found in term of success rate: 94% in A vs 90% in B (P 0.4944). The procedure used to obtain the clearance of the bile duct showed a different success rate across the two groups: for the patients under 65 years old, trans-cystic clearance (TC-CBDE) was successful in 90% of cases, and only 51% for those older than 65, where we had to recall 49% for laparo-endoscopic rendez-vous (RV-IOERC) (P 0.0014). In conclusion, single stage treatment is safe and effective also to elderly patients. The methods used in patients being younger than 65 years old is what appeared to be significantly different.
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Affiliation(s)
- A Bove
- Department of Experimental and Clinical Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
| | - R M Di Renzo
- Department of Experimental and Clinical Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
| | - G Palone
- Department of Experimental and Clinical Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
| | - V D'Addetta
- Department of Experimental and Clinical Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
| | - F Caldararo
- Department of Experimental and Clinical Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
| | - C Antonopulos
- Department of Experimental and Clinical Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
| | - P Panaccio
- Department of Experimental and Clinical Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
| | - S Chiarini
- Department of Medicine and Aging Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
| | - G Bongarzoni
- Department of Experimental and Clinical Sciences, University " G.D'Annunzio", Chieti-Pescara, Italy.
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Pizzi C, Santarella L, Costa MG, Manfrini O, Flacco ME, Capasso L, Chiarini S, Di Baldassarre A, Manzoli L. Pathophysiological mechanisms linking depression and atherosclerosis: an overview. J BIOL REG HOMEOS AG 2012; 26:775-782. [PMID: 23241128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
It is well recognized that depression is independently associated with cardiovascular events. However, uncertainties remain on the pathophysiological pathways underlying the association between depression and coronary heart disease. In addition to the traditional cardiovascular risk factors, autonomic nervous system (ANS), low grade of inflammation, platelet and hypothalamic-pituitary-adrenal axis function and genetic factors may adversely impact the endothelium of the arterial wall. We provide an overview of the pathophysiological mechanisms and indices which seem to have a role in promoting and accelerating atherosclerosis and its complications due to plaque rupture and thrombosis. Given that the relationship between depression and atherosclerosis cannot be fully explained by single mechanisms, which seem at least partially interrelated, the depression-related dysfunctions in the ANS and hypothalamic-pituitary-adrenal axis seem to play a major role, promoting chronic inflammation, endothelial dysfunction and platelet activation and aggregation, which in turn are key steps in the development of atherosclerosis and its complications.
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Pasta V, Chiarini S, Redler A, Monti M. Diagnostic and behavioural parameters differentiating proliferative muscolo-fascial low grade lesions. Case reports. G Chir 2010; 31:491-496. [PMID: 21232190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Pseudosarcomatous nodular fasciitis and desmoid tumors can be very similar at physical examination. Although their behaviours and cytologic aspects are very different, they both undergo the same surgical approach. Nevertheless, only desmoid tumors - because of their high rate of local recurrence - require a strict follow-up and further therapies when radicality of primary surgery could not be likely performed.
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Affiliation(s)
- V Pasta
- Sapienza Univesity, Rome, Italy
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Pasta V, Urciuoli P, Macrina N, Amabile MI, Chiarini S, Maturo A, Vergine M, Santucci E, Biffoni M, Scipioni P, Monti M. [Advantages and limits of tumescent anesthesia in outpatient surgery]. G Chir 2009; 30:112-116. [PMID: 19351463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The Authors report the results of the tumescent anesthesia in 187 patients submitted to various outpatient surgical procedures comparing with those in patients submitted to local anesthesia by direct infiltration.
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Affiliation(s)
- V Pasta
- "Sapienza" Università di Roma, Dipartimento di Scienze Chirurgiche, Italy
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8
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Pasta V, Martino G, Vergine M, Scipioni P, Amabile MI, Cardarelli A, Palmieri A, Santucci E, Chiarini S, Monti M. [Diagnostic and surgical problems of ectopic breast cancer]. G Chir 2009; 30:36-40. [PMID: 19272231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Cancer of supernumerary breast or ectopic breast tissue has haigher incidence than the cancer on ortotopic breast. This finding puts some problems about the diagnosis and therapy of ectopic breast cancer. The Authors describe their personal experience in three patients surgically treated and discuss about problems and solutions of this pathology.
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Affiliation(s)
- V Pasta
- Sapienza Università di Roma, I Facoltà di Medicina e Chirurgia, Dipartimento di Scienze Chirurgiche
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Stella S, Pasta V, Soluri A, Chiarini S. [Current role of surgery in the combined treatment of neoplastic diseases]. G Chir 2008; 29:5-7. [PMID: 18252142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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10
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Pasta V, Torcasio A, Tintisona O, Veneroso S, Sardella B, Vergine M, Amabile MI, D'Aulerio A, Chiarini S, Stella S, Monti M. [Pseudosarcomatous lesions: report of two cases]. G Chir 2006; 27:153-7. [PMID: 16768870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Of unknown etiology, mainly located on the upper limbs, the nodular fasciitis nowadays is considered as a reactive inflammatory lesion more than a neoplastic one. With very few symptoms, it can be diagnosed through histology and the extent of the excision is related to the report of the pathological examination.
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Affiliation(s)
- V Pasta
- Università degli Studi "La Sapienza" di Roma, Dipartimento Scienze Chirurgiche
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11
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Pasta V, Torcasio A, Vergine M, Veneroso S, Tintisona O, Amabile MI, Chiarini S, Monti M. [Breast lymphoma: diagnostic and surgical approach]. G Chir 2006; 27:161-4. [PMID: 16768872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
By clinical observation and surgical treatment of a patient with a primitive lymphoma of the breast, the authors describe the nosological approach, the correct diagnosis and the relative surgical treatment in that disease.
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Affiliation(s)
- V Pasta
- Università degli Studi "La Sapienza" di Roma
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Bove A, Corbellini L, Catania A, Chiarini S, Bongarzoni G, Stella S, De Antoni E, De Matteo G. Surgical controversies in the treatment of recurrent achalasia of the esophagus. Hepatogastroenterology 2001; 48:715-7. [PMID: 11462910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND/AIMS Surgery remains the first choice for achalasia of the esophagus with good results in 90% of cases. METHODOLOGY We studied the cause of failure for surgical treatment and the results of a second operation in 20 patients that were followed up for at least three years. RESULTS The results were good in 70% of the cases. CONCLUSIONS To improve this procedure, according to the authors, it is essential for a careful presurgery evaluation, an early reoperation in case of failure and a careful surgical technique in order to avoid periesophageal sclerosis.
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Affiliation(s)
- A Bove
- 3rd Department of General Surgery, University of Roma La Sapienza, Rome, Italy
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Abstract
In the microsurgical therapy of facial nerve palsy, the muscles most frequently utilized have been gracilis, latissimus dorsi, and pectoralis minor, this depending upon surgeons' personal experience. However, at the moment no satisfactory comparison studies are available; this work is a comparative study of the three most often used cadaver-derived muscles in surgical therapy of facial nerve palsy. The potential use of gracilis, latissimus dorsi, and pectoralis minor as free flaps has been assessed by analyzing their microsurgical, anatomical and functional parameters. Suitability has been evaluated by scoring each parameter from 0 to 3 (unsatisfactory, satisfactory, good, and excellent respectively). The results may provide the surgeon who undertakes this kind of technique with a useful data comparison.
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Affiliation(s)
- A Bove
- Department of General Surgery, University of Rome La Sapienza, Italy
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Bruzzese A, Chiarini S, Marchegiani C, Corbellini L, Stella S. [Endoscopic fragmentation of gastric phytobezoars as a valid alternative, in selected cases, to traditional surgery]. G Chir 1997; 18:485-7. [PMID: 9479949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Three cases of gastrointestinal bezoar are described. Two were submitted to conventional surgery and one to endoscopic fragmentation. The natural and postoperative pathophysiologic mechanisms responsible for the formation of bezoars were studied. The condition is generally asymptomatic, the clinical presentation being similar to that of gastritis and/or duodenitis. Endoscopy is the non-invasive technique of choice in the diagnosis of gastric bezoars. Treatment of these lesions in day-endoscopy consists in removal of the bezoar if less than 3 cm in diameter and fragmentation if larger in diameter followed by extraction of any fragments over 1 cm to prevent the risk of intestinal obstruction. Long term maintenance therapy with cisapride or metoclopramide is then immediately administered for preventive purposes, and it is also used in patients submitted to traditional gastric and/or duodenal surgery.
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Affiliation(s)
- A Bruzzese
- Cattedra di Patologia Chirurgica, Università degli Studi G. D'Annunzio, Chieti
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15
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Di Matteo G, Bove A, Chiarini S, Capuano LG, De Antoni E, Lanzi G, Lippolis G, Campana FP. Hepatic echinococcus disease: our experience over 22 years. Hepatogastroenterology 1996; 43:1562-5. [PMID: 8975966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND/AIMS It is important to single out the indications for surgery of hydatid disease of the liver at an early stage. For this, a fully comprehensive diagnostic work up of the patient is required. Surgery represents the most effective therapy and involves resection of the cysts and their outer capsule. This must be as complete as possible. MATERIAL AND METHODS Between 1970 and June 1992, 95 patients received this combined treatment for hydatid disease although only those presenting from 1985 were followed up. RESULTS No serious complications were noted apart from pyrexia due to secondary cholangitis or reactive pleuritis. This responded quickly to antibiotics and there was no mortality. No cases of relapse occurred although one case did show evidence of reappearance of the disease on serological testing alone, all other tests being negative. CONCLUSION The most effective treatment for echinococcus cystic disease of the liver is radical surgery. Results are best when surgery is combined with medical therapy of benzoimidazole drugs given pre- and post-operatively. From our experience, we are now confident that surgical treatment must always be preceded and then followed by treatment with benzoimidazole antihelminthics.
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Affiliation(s)
- G Di Matteo
- 3rd Department of General Surgery, University of Rome La Sapienza
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Stella S, Bruzzese A, Chiarini S. [Biological bases of the colorectal adenoma-carcinoma sequence]. G Chir 1996; 17:473-6. [PMID: 9044597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Bruzzese A, Chiarini S, Pasquino C, Favoriti M, Marchegiani C, Stella S. [Apudomas: nosographic and physiopathological aspects]. MINERVA CHIR 1996; 51:313-20. [PMID: 8783864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The authors intend to contribute to the knowledge of this complex and in part not fully defined subject of apudomas, in particular with regard to classification criteria and physiopathological aspects. After having examined the characteristics of these neoplasias (probably common embryonal origin, similar radioimmunological, immunohistochemical and ultrastructural characteristics, the capacity to convert amine precursors into amines), the authors focus on the most significant aspect of these carcinoids which, in the light of current knowledge, possess varying but undisputed degrees of biological aggressiveness. They also highlight the importance of the gastroenteric tract as an organ with an endocrine function and lastly affirm the value of the classification which, using the pancreas as the reference organ, distinguishes endocrine neoplasias in this tract into entopic and ectotopic examples.
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Affiliation(s)
- A Bruzzese
- Cattedra di Patologia Chirurgica, Universita degli Studi G. D'Annunzio, Chieti
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18
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Stella S, Chiarini S. [Radioimmunoguided surgery: its current status and outlook]. G Chir 1995; 16:337-40. [PMID: 8645536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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19
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Bruzzese A, Chiarini S, Pasquino C, Favoriti M, Stella S. [Phyllodes breast tumors: apropos 2 cases]. G Chir 1995; 16:366-8. [PMID: 8645542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The observation of two cases of phyllode tumors of the breast, one benign and the other malignant, brought the Authors to focus the fundamental aspects of these neoplasias. The histologic coexistence of both epithelial and connectival components, a relative unpredictable clinical evolution, the high frequency of recurrences, the stromal hyperproduction and modifications as expression of malignancy, and the need for large excisions are the fundamental characteristics of these tumors, which are considered transitional forms between benignity and malignancy.
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Affiliation(s)
- A Bruzzese
- Cattedra di Patologia Chirurgica, Università degli Studi G. D'Annunzio, Chieti
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20
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Bruzzese A, Chiarini S, Pasquino C, Stella S. [Indications and surgical treatment of Crohn disease]. MINERVA CHIR 1995; 50:59-63. [PMID: 7617261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
On the basis of their experience (a series of 21 surgical approaches), the authors subdivide the indications for surgical treatment into absolutes and relatives. They recommend to operate also for relative indications in order to improve the patient's way of life, avoiding the establishment of extensive adhesions, under-nourishment and invalid subocclusive symptomatology. As the surgical treatment is not curative and is burdened from repeated operations, the authors suggest using a conservative surgery. They confirm the uninfluence, to prevent fistula and/or local recurrence, to carry out an anastomosis on healthy or slightly macroscopic disease tissues.
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Affiliation(s)
- A Bruzzese
- Cattedra di Chirurgia Generale, Università degli Studi, G. D'Annunizio, Chieti
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21
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Filippini A, Zuccarini F, Trulli R, Aceto L, Visini R, Chiarini S, Santucci E, Gaspari AL, De Pascale A, Genovesi N. [Hepatic resection for hepatocellular carcinoma. The nonsurgical treatment of a late complication]. G Chir 1991; 12:375-8. [PMID: 1661123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- A Filippini
- Semeiotica Chirurgica, Università degli Studi di Chieti
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22
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Chiarini S, Bove A, Filippini A, Lania M, Mongardini M, Ipri D, Sica G, Zakaria M, Gaspari AL. [Free microvascularized flaps in head and neck lesions: the technics of microsurgical reconstruction]. G Chir 1991; 12:54-5. [PMID: 1867977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors report their experience of microsurgical reconstructive techniques using musculo-cutaneous free flaps after radical operations for head and neck neoplasms.
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Affiliation(s)
- S Chiarini
- Semeiotica Chirurgica, Università degli Studi G. D'Annunzio, Chieti
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Chiarini S, Filippini A, Lania M, Mongardini M, Irpi D, Zakaria M, Sica G, Gaspari AL. [Indications for a reconstructive technique using micro-revascularized free flaps in traumatic and neoplastic lesions: our clinical experience]. G Chir 1990; 11:647-9. [PMID: 2091727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- S Chiarini
- Semeiotica Chirurgica, Università degli Studi G. D'Annunzio, Chieti
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24
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Chiarini S, Filippini A, Lania M, Mongardini M, Sica G, Zakaria M, Gaspari AL. [A case of carcinoma of the cervical esophagus treated with interposition of an intestinal loop revascularized using a microsurgical technique]. G Chir 1990; 11:631-2. [PMID: 2091723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Authors present a case of hypopharyngeal tumor in which digestive continuity was assured by a jejunal autotransplant. Tumoral exeresis and jejunal preparation were carried out at the same time by two surgical teams. The use of microsurgical techniques assures the revascularization of the neck transplant by implementing the superior thyroid artery and the internal jugular vein. Digestive anastomoses complete the operation.
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Affiliation(s)
- S Chiarini
- Semeiotica Chirurgica, Università degli Studi G. D'Annunzio, Chieti
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25
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Filippini A, Zuccarini F, Trulli R, Aceto L, Santucci E, Chiarini S, Rapani C, Gaspari AL. [Role of microsurgery in chronic distal obstructive arteriopathies]. G Chir 1990; 11:625-7. [PMID: 2091721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Authors analyze the role of microsurgery in the treatment of chronic obstructive arteriopathies. In accordance with their results, they stress the usefulness of the microtechniques in the rescue of ischaemic limbs due to distal occlusion, and how these procedures are less dangerous than amputation, even though results are not long lasting.
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Affiliation(s)
- A Filippini
- Istituto di Semeiotica Chirurgica, Università degli Studi G. D'Annunzio, Chieti
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26
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Mongardini M, Benedetti F, Chiarini S, Palazzini G. [Venous replacement surgery: history, update and perspectives]. G Chir 1990; 11:371-81. [PMID: 2147562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The impulse given to vascular surgery by new technologies has facilitated the use of the bypass technique in a number of arterial pathologies with better and better results over time. At the moment, however, we haven't a "sure prosthesis" in venous surgery. Our intention has been to examine the most significant developments, studying all the available material dating from the beginnings of the art up to the present. After a careful examination of the venous pathophysiology as well as the most valid surgical approaches, we tried to evaluate on laboratory animals the results of experimental graft replacement of the inferior vena cava. In this study we analysed prostheses in PTFE, biological prostheses, spiral composite vein grafts, arterial autologous grafts. For the experimental study we used 55 rabbits (New Zealand and Fiandra). Results have been rather successful with respect to biological prostheses (62.5% patency) and PTFE (66.6%). As for spiral composite vein graft prosthesis patency over time was very low (16.6%); this was affected by the different venous graft (heterologous graft) and caval wall thicknesses. Arterial autologous graft was carried out only once because rabbit experimented on did not stand up to surgical stress.
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Affiliation(s)
- M Mongardini
- Ill Clinica Chirurgica Generale e Térapia Chirurgica, Università degli Studi La Sapienza, Roma
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27
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Chiarini S, Bove A, Horvath F, Marchese V, Mongardini M, Ortensi A. [Experimental microsurgery: the main technical bases for research]. G Chir 1990; 11:197-205. [PMID: 2223508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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28
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Cancrini A, Mongardini M, Bellotti C, Boemi L, Benedetti F, Tarroni D, Chiarini S. [Mesorectal resection in oncologic surgery]. G Chir 1989; 10:51-4. [PMID: 2518531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A surgical technique to "en bloc" resect the mesorectum while performing an anterior resection is here described. The procedure aims at preserving those nerves whose injury is responsible for a series of neurological sequalae, which affect the patient's quality of life. Fifteen dissections were carried out in order to demonstrate the possibility to perform an accurate mesorectal lymphadenectomy while preserving, in most cases, the nervi erigentes and, in some cases, the hypogastric plexus.
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Cancrini A, Mongardini M, Benedetti F, Bellotti C, Boemi L, Chiarini S, Tarroni D, Greco L. [Vascular substitution in oncologic surgery]. G Chir 1988; 9:912-5. [PMID: 3152907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Renauld A, Pinto JE, Sverdlik RC, Chiarini S, Foglia VG. [Studies of the rat of disappearance of exogenous insulin from the blood in the dog. I. Effect of cortisol]. Acta Diabetol Lat 1971; 8:419-27. [PMID: 5116952 DOI: 10.1007/bf01550879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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