0000000000458850
AUTHOR
M. C. Gioviale
A simple method to treat post-kydney transplantation lymphocele
OBJECTIVE: To describe our experience with ultrasonic-guided instillation of povidone-iodine to treat post-kidney transplantation lymphocele. Patients and methods. We studied the safety and efficacy of this procedure for treatment of lymphocele in 6 male kidney transplanted recipients in which we assisted a progressive increase of creatinine and urinary proteins levels and color-Doppler ultrasonography demonstrated an increase (25,4%) of index of resistence (IR) Using eco-colorDoppler, the related-graft lymphocele location and the distance to the anterior abdominal wall were determined; then, a radiopaque double-lumen catheter was used to instillate 5% povidone-iodine 10 ml. Results. Percut…
Obtaining mesenchymal stem cells from adipose tissue of murine origin: Experimental study
Stem cells have a key role in regenerative medicine and tissue engineering. Although not immortal, they are able to expand manyfold in culture retaining at the same time their growth and multilineage potential. They also show a migratory capacity when transplanted systemically in animal model with injuries. Thanks to their properties and their plasticity stem cells are of great importance since they can be used as a tool for repair damaged tissues and organs. Mesenchymal stem cells, in particular, have the ability to differentiate into lineages of mesodermal tissues, such as skeletal muscle, bone, tendons, cartilage, and fat under appropriate culturing conditions. Recent evidence suggest th…
The intestinal ecosystem and probiotics
The term "probiotic" comes from the greek "pro bios" and means "pro life": Nowadays, an increasing number of pharmaceutical preparations and functional foods are enriched with probiotics and for the patients it is increasingly important to receive information needed to know how to orient in the choice. The benefits from probiotics are many and include the modulation of the intestinal microflora (stimulation of beneficial bacteria and inhibition of pathogens), the support of bowel function and the stimulation of the immune system. This broad spectrum of beneficial effects to maintain efficient the intestinal ecosystem. Therefore, probiotics are an useful tool to prevent the formation of diso…
Towards an improvement of hospital services and streamlining of health care costs: The DRG analysis in Italy
The term Diagnosis-related Group (DRG) refers to a classification system used to assess hospital services with the aim of a better management of health care costs and improving performance. The DRG system focuses on the utilization of resources, and is not concerned with the specific type of care provided to the patient. This system highlights any diseconomies and eventual critical aspects of the hospital system. This article, starting from the history of heath care financing in Italy and pointing out the difficulty to define the "quality" of health care services, describes the variables used to evaluate correctly hospital performance based on the DRG system. These include Average Length of…
Enteral nutrition: Our experience with percutaneous endoscopic gastrostomy (PEG) and revision of literature
Enteral nutrition (EN), as parenteral nutrition (PN), can be used in cases of patients whose medical conditions prevent the intake of food by mouth; unlike PN, EN keeps the functionality of the digestive tract and it makes home management of patients easier. However, the experience and literature have documented a number of serious complications, fortunately rare, which depend on the methods used in EN realization. We report in this paper our experience in 44 cases of percutaneous endoscopic gastrostomy (PEG), concluding that it is a safe and complications-free procedure. We believe that a nutritional intervention is indicated when, improving nutritional status, patients can obtain a better…
Biocompatibility and biodegradability of electrospun phea-pla scaffolds: Our preliminary experience in a murine animal model
We obtained a nano-fibrillar scaffold starting from a polymeric solution which, through electrospinning, gave a biodegradable material with optimal mechanical features and the capacity to allow cell adhesion. In this paper we report the in-vivo application on a murine animal model of two electrospun biodegradable materials, specifically designed to create tubular structures. In one case PHEA-PLA was co-spun with silk fibroin (Fibro-PHEAPLA) by a parallel electrospinning process to obtain a scaffold with two different polymeric fibers. In the other case, PHEA-PLA was mixed with polycaprolactone (PCLPHEA-PLA) to obtain a hybrid fibers scaffold. The in-vitro assay showed fibroblast colonizatio…
Fentanyl and sufentanyl in fast track anaesthesia for major intra-abdominal surgery
Background and aim: Major intra-abdominal surgery is estimated to have high costs annually in Italy. In an attempt to decrease surgery costs and improve outcome for patients, fast-track programs have become popular. This is especially due both to the improvement of surgery and to the new anesthetic agents (regarding pharmacokinetic and pharmacodynamic) resulting in better care for patients. The aim of this study was to evaluate two different anesthetic protocols in patients undergoing scheduled anesthesia including the combination of two different opioids (fentanyl or sufentanil) with the same hypnotic and muscle relaxant. Material and Methods: 40 patients, with an American Society of Anest…
A case report of a difficult dissection of the iliac vessels conducted by means of the harmonic scalpel during a kidney transplantation
Background. The “difficult” preparation of iliac vessels in the kidney transplant recipient caused by a perivascular fibrosis with satellite lymphadenopathy is sometimes burdened by post-transplant complications (lymphocele, seroma and hematoma). Both iliac vascular adhesions and satellite lymphoadenopaty are often due to reiterate femoral cannulation aimed to hemodialysis. Patients and Methods: The case report concerns a 60 years old female uremic patient, on dialysis for about 4 years with perivascular fibrosis and pelvic lymphadenopathy caused by bilateral femoral artery catheterization. In the course of kidney transplant, preparation of the iliac vessels was performed by ultrasonic scal…
The management of postoperative pain after hemorrhoidectomy: Analysis of three methodics
Postoperative pain is one of the most common and disabling complications following hemorrhoidectomy. This study divided a total of 90 patients, undergone Milligan and Morgan hemorrhoidectomy, in three groups of 30 patient: Group A, undergone internal sphincterotomy after hemorrhoidectomy; Group B, treated with Diosmin 500 mg; Group C, treated with Paracetamol 1000 mg when required. The analysis of the median VAS score (Visual Analogic Scale) of postoperative pain, in every group pointed out a relationship between postoperative pain reduction and time at the three set checkpoints (1st, 3rd, 9th postoperative day) (R2= 0.9231 for Group A; R2= 0.9423 for group B; R2= 0.9423 for group C). Mean …