Two cases of monomicrobial intraabdominal abscesses due to KPC - 3 Klebsiella pneumoniaeST258 clone

Abstract Background Knowledge of the etiology of pyogenic liver and pancreatic abscesses is an important factor in determining the success of combined surgical and antibiotic treatment. Literature shows geographical variations in the prevalence and distribution of causative organisms, and the spread of Klebsiella pneumoniae carbapenemase-producing bacteria is an emerging cause of abdominal infections. Case presentation We herein describe two cases of intra-abdominal abscesses due to monomicrobial infection by Klebsiella pneumoniae Sequence Type 258 producing K. pneumoniae carbapenemase 3 (KPC-Kp). In case 1, a 50-year-old HIV-negative Italian woman with chronic pancreatitis showed infection…

Diagnostica e significato delle linfoadenopatie inguino-crurali

La termoablazione nel trattamento delle neoplasie epatiche primitive e secondarie

Radiofrequency thermoablation is a locoregional procedure based on the use of electromagnetic waves that induce movement and consequently the production of heat. This is the basis for the coagulative necrosis produced in the tissues. The method, experimented with and developed in the '90s, is today extensively used in the treatment of focal hepatic lesions, both primary and secondary. The factors that condition the procedure are related essentially to the characteristics of the tumours and to the possibility of obtaining a predictable area of necrosis that guarantees the radicality of the treatment. As regards primary neoplasms, it should be stressed that the treatment for hepatocellular ca…

Focal liver lesions: clinical usefulness of contrast-enhanced ultrasound in the selection of surgical patients

Purpose: to evaluate the role of contrast-enhanced ultrasound (CEUS) in the characterization of focal liver lesions (FLLs) for surgical patients selection. Materials and Methods: 135 consecutive patients (71 women, 64 men) with 165 FLLs (mean size: 3.1 cm) - 89 benign (10 simple cysts, 26 hemangiomas, 29 focal nodular hyperplasia (FNH), 2 hepatocellular adenomas, 11 focal fatty sparing, 3 focal fatty areas, 5 regenerative nodules, 2 hydatid cysts, 1 abscess) and 76 malignant - 47 metastases, 26 hepatocellular carcinomas and 3 peripheral cholangiocarcinomas - underwent CEUS after the administration of SonoVue®. Two readers reviewed in consensus baseline US and CEUS scans obtained 25-30 s (ar…

Seeding after radiofrequency thermal ablation of hepatocellular carcinoma in cirrhosis: a prospective study

L’uso del hrTSH nel follow up del microcarcinoma tiroideo in pazienti sottoposti a tiroidectomia totale

III-Po/35) The role of the left choleic artery in the rectum anterious resection with colo-anal anastomosis: technique and considerations of anastomosis oxigenation through nitric oxide valutation.

tiroide diagnostica per immagini e approccio clinico ragionato

Mortality in patients with hepatocellular carcinoma predicted by six scoring: none is the winner

IL FIBROADENOMA DELLA MAMMELLA: STUDIO SU 447 CASI

The authors examined a total of 519 nodules diagnosed preoperatively as mammary fibroadenomas between 1986 and 1991. 235 nodules were removed immediately after diagnosis, either because they had a diameter of over 3 cm or because they were present in women over 45 years old. The preoperative diagnosis was confirmed in 94.9% of cases and after histological examination the nodule was only found to be a carcinoma in one case (0,4%). Those cases not operated at the time of diagnosis were monitored for period of 2 years. At the end of this period 118 nodules had been removed due to a more or less rapid increase in volume. The histological examination of these nodules confirmed the initial diagno…

VALIDITA' DELL'ECOGRAFIA NELLA DIAGNOSTICA PREOPERATORIA DEI NODULI TIROIDEI MALIGNI

Validity of shape memory NiTi colon ring BioDynamix ColonRingTM (or NiTi CAR 27TM) to prevent anastomotic colorectal strictures. Preliminary results

PURPOSE: Anastomotic strictures occur in 3-30% of colorectal anastomosis and one of the main causes may be a reaction to the presence of the metal staples used for suturing. The aim of this study was to evaluate the efficacy of a compression anastomosis ring using the memory shaped device in initial, i.e. nickel-titanium alloy (NiTi) for the prevention of colorectal anastomotic strictures. PATIENTS AND METHODS: A compression anastomosis ring device (NiTi CAR 27) was used to perform compression anastomosis in 20 patients underwent left hemicolectomy and anterior resection of the rectum for carcinoma. An endoscopic check of the anastomosis was carried out at one month and at six months after …

La terapia adiuvante nelle pazienti affette da carcinoma mammario con linfonodi ascellari negativi. Attuale ruolo dei fattori prognostici nella condotta terapeutica.

L'impiego del Tissue-Link FB3.0 floating ball nelle resezioni epatiche

Le cancer du sein de la femme agée.

PERCUTANEOUS RADIOFREQUENCY THERMAL ABLATION 8 RFTA) OF SMALL HEPATOCELLUALR CARCINOMA: A PROSPECTIVE STUDY

PERCUTANEOUS RADIOFREQUENCY THERMAL ABLATION 8 RFTA) OF SMALL HEPATOCELLUALR CARCINOMA: A PROSPECTIVE STUDY Data: 2004 Dettaglio tipologia d'Ateneo: 3a - Articoli su riviste ISI (anche on line)

Percutaneous radiofrequency therma ablation of small hepatocellular carcinoma: a prospective study

Il trattamento delle lesioni epatiche primitive e secondarie con termoablazione mediante radiofrequenza

Levo folinic acid and 5-fluorouracil plus high dose epidoxorubicin as first line treatment for metastatic breast carcinoma

Twenty-two women affected by metastatic breast carcinoma have been treated with a combination of levo folinic acid 100 mg/m 2 plus 5-fluorouracil 450 mg/m 2 i.v. on day 1-2, and epidoxorubicin 75-90 mg/m 2 on day 2. This treatment cycle was repeated every 21-28 days. No patients had previously received chemotherapy for metastatic disease. Fourteen patients (64%) showed a major objective response with 3 complete (14%) and 11 partial responses (50%). Three patients showed a stabilization of disease and 5 (23%) progressed. All patients received ondansetron as antiemetic treatment which led to complete protection from vomiting in 68% of cases. Grade 1-2 diarrhea was recorded in 27% of the patie…

L'RFTA nel trattamento dell'epatocarcinoma su cirrosi

Variabili cliniche nella casistica del policlinico di Palermo nell’ambito del registro dei tumori della tiroide in Sicilia: Età, sesso, autoimmunità, tipo, dimensionilesionali e coinvolgimento delle stazioni linfonodali della tiroide

Bipolar electrothermic coagulation (ligasure bipolar vessel sealing system) in thyroid surgery

Subcutaneous recombinant human erythropoietin prevents chemotherapy-related anemia in patients with advanced cancer.

L'impiego dell'ecografia ascellare nel follow-up delle pazienti con linfonodi ascellari negativi sottoposte a biopsia del linfonodo sentinella per carcinoma della mammella.

Short term intensive preoperative chemotherapy with high doses of epirubicin plus G-CSF rescue for locally advanced Stage III breast carcinoma.

Fine-Needle Aspiration (FNAB) Molecular Analysis for the Diagnosis of Papillary Thyroid Carcinoma through BRAFv600E mutation and RET/PTC rearrangement

Objective: To evaluate BRAFV600E mutation on consecutive fine-needle aspiration biopsy (FNAB) specimens in order to assess FNAB’s usefulness in preoperative papillary thyroid carcinoma (PTC) diagnosis with the contemporaneous analysis of RET=PTC1 and RET=PTC3 rearrangements obtained from ex vivo thyroid nodules. Design: Thyroid FNABs from 156 subjects with nodules and 49 corresponding surgical samples were examined for the presence of BRAF mutation by real-time allele-specific polymerase chain reaction, confirmed with the use of a laser pressure catapulting system. Samples were also examined for RET=PTC rearrangements. The results were compared with the cytological diagnosis and histopathol…

L'impiego del Tachosil in chirurgia epatica

Il controllo delle perdite ematiche intra e post-operatorie caratterizza da sempre la chirurgia resettiva epatica. Nel corso degli ultimi anni notevoli progressi sono stati compiuti in tale ambito, grazie all'adozione di materiali e strumentari sempre più specifici ed efficaci che consento l'esecuzione di interventi resettivi con minime perdite ematiche ed una significativa riduzione dell'incidenza di complicanze emorragiche post-operatorie. Vengono presentati 2 casi di resezione epatica realizzata utilizzando un manipolo a radiofrequenza senza eseguire il clampaggio del peduncolo epatico e senza l'utilizzo di clips o legature per le piccole perdite dalla trancia di sezione. Un buon control…

Vinorelbine plus cisplatinum for the treatment of stage IIIB and IV non small cell lung carcinoma

Thirty consecutive patients with stage IIIB-IV non small cell lung cancer were treated with a combination of cisplatin 80 mg/m2 on day 1 plus vinorelbine 25-30 mg/m2 on days 1, 8. This cycle was repeated every 3 weeks. The overall response rate was 46%, with 1 patient showing a complete response and 13 patients (43%) a partial response with a mean duration of 8.4+ months. Six patients had a stabilization and 10 progressed. The main toxicities were represented by myelosuppression and nausea/vomiting. Grade 3 leukopenia was seen in 33% of cases, grade 2 thrombocytopenia in 12%, and phlebitis in the injection vein in 16%. Mild constipation was also recorded. The combination of cisplatin plus v…

Specific TP53 and/or Ki-ras mutations as independent predictors of clinical outcome in sporadic colorectal adenocarcinomas: results of a 5-year Gruppo Oncologico dell'Italia Meridionale (GOIM) prospective study

BACKGROUND: Although Ki-ras and TP53 mutations have probably been the genetic abnormalities most exhaustively implicated and studied in colorectal cancer (CRC) progression, their significance in terms of disease relapse and overall survival has not yet clearly been established. PATIENTS AND METHODS: A prospective study was carried out on paired tumor and normal colon tissue samples from a consecutive series of 160 previously-untreated patients, undergoing resective surgery for primary operable sporadic CRC. Mutations within the TP53 (exons 5-8) and Ki-ras (exon 2) genes were detected by PCR-SSCP analyses following sequencing. RESULTS: Mutation analyses of exons 5 to 8 of the TP53 gene showe…

L'impiego del linfonodo sentinella nel carcinoma del colon-retto. Considerazioni e proposta di tecnica

La via linfatica è una delle principali vie di diffusione metastatica di molte neoplasie. I linfonodi sono gli "snodi" di questo intricato sistema e in alcuni distretti assumono il ruolo di veri e propri check point, meglio ancora di "sentinella", in quanto il loro mancato coinvolgimento nella diffusione metastatica sembrerebbe poter escludere l'interessamento di quelli posti a monte. L'applicazione della tecnica di ricerca e identificazione del linfonodo sentinella, comunemente impiegata nei casi di melanoma e cancro della mammella, anche al carcinoma del colon-retto ha suscitato molto interesse ma, nonostante i molti studi compiuti al riguardo, non sono stati ancora ottenuti risultati tal…

Tumori della mammella.

FATTORI PROGNOSTICI DELLA RECIDIVA LOCALE DOPO CHIRURGIA CONSERVATIVA PER CARCINOMA DELLA MAMMELLA. NOSTRA ESPERIENZA

One of the most important problems linked to the conservative surgery of breast cancer consists of local recurrences (LR), even if it has now been proven that the appearance of LR has no influence on overal survival of the patients operated for breast cancer. We have considered 108 patients suffering from breast cancer and treated with quadrantectomy plus axillarydissection. In these patients were found 4 LR (3.7%), that in two cases appeared in the residual mammary gland and in other two cases were found on the skin scar. The mean time of occurrence of the LR was of 43 month (range 18-90 month). The authors have correlated the appearance of LR with some caracteristics of the tumor, as the …

Indication et limites du traitement par la L-Thyroxine dans la prophylaxie de la récidive après exérèse chirurgical pour pathologie thyroidienne bénigne a foncionnement normal.

Hashimoto Thyroiditis Coexistent with Papillary Thyroid Carcinoma

Several studies report a higher rate of papillary thyroid carcinomas (PTC) in patients with Hashimoto thyroiditis (HT), indicating a possible correlation between the two diseases. We studied a group of 89 subjects undergoing surgery for thyroid carcinomas compared with a control group of 89 subjects operated on for normofunctioning goiter, and a second group of 47 patients undergoing total thyroidectomy for HT. Association with HT was found in 19 of the 71 PTC subjects (26.7%) and in 8 goiter patients (8.9%), which was a significant difference ( P < 0.02). Thirteen of the HT patients, mostly with the nodular form, showed coexistent PTC (27.6%). HT and PTC coexisted in several morphologi…

Il trattamento dell'HCC mediante RFTA

The aetiological pattern of hepatocellular carcinoma ( HCC) in Italy is changing

The aetiological pattern of hepatocellular carcinoma ( HCC) in Italy is changing.

Tattica chirurgica nel trattamento delle neoplasie maligne della tiroide

Intraepidermal perianal Paget’s disease.

the Autthors report a case of localised perianal Paget's disease consisting of an eczematous lesion unresponsive to steroid anal treatment subsequently treated with local excision. the patient after 20 months is alive and presents no further signs of disease. The Authors therefore point out that in elderly patients with stage I perianal Paget's disease local wide excision is considered the best therapeutical choice.

La terapia adiuvante nel carcinoma del colon: un update della lettaratura