0000000000464151
AUTHOR
A. I. Lo Monte
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…
Nutrition in inflammatory bowel disease patients
Inflammatory Bowel Diseases (IBD) is a chronic disorder characterized bya relapsing-remitting course, which alternates between active and quiescent states, ultimately impairing a patient's quality of life. The two main types of IBD are Crohn's disease (CD) and ulcerative colitis (UC). CD shows a transmural granulomatous inflammation that can involve any segment of the intestine affecting all layers of the intestinal wall while UC is limited to the mucosa and superficial sub-mucosa of the colon. In physiologial conditions the gut is costantly exposed to various antigens, commensal microflora and pathogens and the inflammatory response is finely balanced. Anyhow in some individuals with genet…
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…
Primary malignant fibrous histiocytoma of the mesocolon transversum.
Primary malignant fibrous histiocytoma (MFH) is a rare and biologically aggressive tumor. Differential diagnosis must include cystic neoplasms of the pancreas (mucinous and serous cystoadenoma or cystocarcinoma), cystic lymphangioma or mesothelioma and retroperitoneal haematoma. Making the right diagnosis preoperatively may be often difficult, but MFH may be suspected when a huge retroperitoneal mass is found at imaging in elderly patients. We report a case of a primary abdominal MFH originating from the mesocolon transversum.
One shoot seldinger central venous catheterization in dialyzed patients
Introduction: Central Venous Catheterization is necessary in uremic patient (before dialysis) and many other conditions. In this study we demonstrated the advantages of ultrasonography to perform the procedure. Materials and methods: 48 uremic patient were submitted to ultrasound-guided central venous catheterization. The procedure was performed following the Seldinger “one shot” technique. Results: The mean operative time was 4 minutes, with a high rate of success (100%) and a low percentage of complications (2%). Conclusion: The ultrasound-guided central venous catheterization is a safe procedure, rapid and easy to perform. The procedure has a low rate of failures and complications and a …
The influence of some dietary components on intestinal microbiota
The gut microbiota is the set of symbiotic microorganisms that resides in our intestine. The interaction between the gut microbiota and the mucosal immune system can be altered as a result of shifts in the composition or metabolic activity of the intestinal microflora. Recent studies establish that diet is one of the main involved factors in determining the microbial composition of the gut suggesting its role as external factor able to promote the onset of specific diseases by disrupting the immune homeostasis. Starting from the evidence that the 57% of the gut microbiota’s entire variation are due to dietary alterations this review aims at providing an overview of the positive impact of so…
Involvement of large rearrangements in MSH6 and PMS2 genes in southern Italian patients with lynch syndrome
Background and aim of the work: The Lynch Syndrome (LS) is associated with germline mutations in one of the MisMatch Repair (MMR) genes. Most of germline mutations are point variants, followed by large rearrangements that account to 15-55% of all pathogenic mutations. Many study reporting the frequency of large rearrangements in the MLH1 and MSH2 genes were performed, while, little is known about the contribution of large rearrangements in other MMR genes, as PMS2 and MSH6. Therefore, in this study we investigated the involvment of large rearrangements in MSH6 and PMS2 genes in a well-characterized series of 20 LS southern Italian patients. Methods: These large rearrangements are not usuall…
Intraoperative cholangiography during laparoscopic cholecystectomy: What role?
Aim: Laparoscopic cholecystectomy has increased the number of iatrogenic lesion of the biliary tree. In this study, we evaluate the role of intra-operative cholangiography in prevention of biliary tree iatrogenic lesions and early identification of choledocolithiasis, during laparoscopic cholecystectomy. Material of study: 169 patients who underwent laparoscopic cholecystectomy, were evaluated by means of intra-operative cholangiography. Patients were divided into two groups basing on the risk to develop biliary tree lithiasis. Discussion: Patients with a higher risk of postoperative complications effectively showed cholangiographic anomalies, including duct stones, dilations, anatomical va…
Nutrition, malnutrition and dietary interventions in inflammatory bowel disease
Inflammatory Bowel Disease (IBD), which includes both Crohn's disease (CD) and Ulcerative Colitis (UC), is a chronic idiopathic inflammatory disorder affecting the gastrointestinal tract. Diet, as a source of luminal antigens, is thought to be an important factor in the pathogenesis of IBD. often the nutritional status of patients is significantly compromised, particularly in CD. several factors, including drug-nutrient interactions, disease location, symptoms, and dietary restriction can lead to protein energy malnutrition and specific nutritional deficiencies. solid evidence regarding the accountability of certain dietary components in the etiology of IBD are lacking. With regard to malnu…
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…
Feeding the brain: the importance of nutrients for brain functions and health
‘We are what we eat’, said the philosopher Feuerbach. In fact, the quality of the food we eat affects our mind as well: the brain, which represents 2% of our body weight, consumes about 20% of the calories we eat each day. Follow a few rules could therefore help to feed properly our brain, so it works to the best of its ability. It is important to know properties of foods especially regarding their aminoacidic composition because aminoacids are components of neurotransmitters, molecules needed for brain transmission and function. It is also possible to choose specific food to prevent or support different diseases that affects nervous system.
Use of tailored intraperitoneal ePTFE dual mesh in permagna inguinal hernia
Here we report a case of a giant inguinoscrotal hernia in an elderly patients treated by means of an open positioning of intraperitoneal ePTFE dual mesh. In patients with giant inguinoscrotal hernia the forceful introduction of viscera in abdominal cavity and primary wall closure is burnened from respiratory complication, abdominal compartment syndrome, and defects in wound healing thus exposing the patients to further morbidity and mortality risk. The management of these patients is difficult because of the high occurrence of morbidity factors that affect the success on intervention independently of the technique of surgical repair. The tension- free technique we adopted consented us to ob…
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…
A SIMPLE TECHINIQUE TO IMPROVE RESIDUAL SKIN PLASTICITY FOR SCROTAL RECONSTRUCTION IN FOURNIER'S GANGRENE
A 50 years-old man developed 24 hours after hemorrhoidectomy a severe Fournier's gangrene of the scrotum necessitating surgical exeresis of more than 2/3 of scrotal skin followed by hyperbaric oxygen therapy. After the resolution of the septic phase, scrotum reconstruction was obtained by tissue expansion to avoid more invasive advanced reconstructive techniques. The procedure consisted of an enzymatic and mechanical debridement and progressive skin expansion by package of gauzes of increasing volume covered with a collagenasecloramphenicol ointment (Iruxol®- Smith and Nephew, Italy), then closing the wound edges by temporary stitches to put under tension the skin. The reestablishment of th…
Laparotomic vs laparoscopic ovariectomy: comparing the two methods. The ovariectomy in the bitch in laparoscopic era
BACKGROUND: The aim of the present work is to evaluate the effectiveness of the use of ultrasound scalpel during laparoscopic ovariectomy in the bitch. METHODS: Two groups of 10 subjects each, of different races and ages, were compared. In the first group, ovariectomy was performed laparoscopically, using harmonic scalpel to remove ovary. In the second group surgery was performed by means of classical laparotomy. RESULTS: Pre-operative time was similar in both groups. Total operative time, from incision to skin suture, showed significant difference between the two groups, being laparoscopy faster than laparotomy. Partial operative time for bilateral oophorectomy resulted lower using open te…
An unexpected surprise at the end of a "quiet" cholecystectomy. A case report and review of the literature
BACKGROUND: Anatomic unexpected variations in biliary tree may be discovered during laparoscopic cholecystectomy. CASE REPORT: A 57-year-old man was admitted for abdominal pain, vomiting and mild jaundice. Abdominal ultrasonography revealed a gallbladder containing multiple stones and biliary sludge. All pre-operative investigations showed no anatomical variations in extrahepatic biliary tree. During surgical intervention an accessory extrahepatic duct, connecting the IV segment of the liver to the fundus of gallbladder, was discovered. CONCLUSIONS: Pre-operative routine investigations for gall stones diseases may not reveal anatomic variations of biliary tree.
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 …