The role of intensive care unit diaries in the grieving process: A monocentric qualitative study.

Background: The growing importance of psychological recovery for patients and their families following intensive care unit (ICU) experiences in recent years cannot be overemphasized. The ICU diary is used to aid patients in reducing the prevalence of post-traumatic stress disorder, anxiety, and depression. The usefulness of maintaining a diary during the grieving process has not yet been thoroughly investigated.

Blunt hepatic and splenic trauma. A single Center experience using a multidisciplinary protocol.

Aim: The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C.

Results: Form 732 Trauma, 356(48.

Clinical strategies for the management of intestinal obstruction and pseudo-obstruction. A Delphi Consensus study of SICUT (Società Italiana di Chirurgia d'Urgenza e del Trauma).

Background: Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout.

Methods: The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds.

Outcomes in polytrauma: comparison between the results achieved in the Cesena Trauma Centre and in the Regional Registry of a (RRGT) of Emilia Romagna, Italy.

Aim: The aim of this retrospective study is to compare the outcomes achieved in the Trauma Centre of Cesena to those of the Regional Registry of Major Trauma (RRGT) of Emilia-Romagna, where a coordinated trauma care network has been implemented since 2001, based on the hub & spoke model.

Material Of Study: A group of 747 patients were compared to 3.803 cases of the RRGT.

COUP-TFII in pancreatic adenocarcinoma: clinical implication for patient survival and tumor progression.

Despite the accumulating knowledge of alterations in pancreatic cancer molecular pathways, no substantial improvements in the clinical prognosis have been made and this malignancy continues to be a leading cause of cancer death in the Western World. The orphan nuclear receptor COUP-TFII is a regulator of a wide range of biological processes and it may exert a pro-oncogenic role in cancer cells; interestingly, indirect evidences suggest that the receptor could be involved in pancreatic cancer. The aim of this study was to evaluate the expression of COUP-TFII in human pancreatic tumors and to unveil its role in the regulation of pancreatic tumor growth.

Development of a low cost laparostomy technique. Two years experience in the Trauma Center of Cesena, Italy.

Background: In the last few years laparostomy has become an even more useful option for the surgeon due to the development of the experience in the critical abdominal trauma and in the severe surgical urgencies as PANE and peritonitis with the introduction of Damage Control as surgical strategy to prevent the abdominal compartimental syndrom (ACS). After a laparostomy the surgeon needs to provide a delayed fascial closure to achieve the best outcome for the patient. The aim of this paper is to illustrate the experience and the results after the introduction of a modified laparostomy technique in our surgical activity.

Current trends in polytrauma management. Diagnostic and therapeutic algorithms operational in the Trauma Center of Cesena, Italy.

Introduction: The purpose of this paper is to present the most recent revision of diagnostic therapeutic protocols regarding polytrauma that are operational in the Trauma Center of Cesena, and to check what impact the progressive implementation and review of these algorithms has had on predefined indicators of results and utilization of diagnostic and therapeutic resources. Finally for the purpose of comparing the results obtained in a subgroup of patients treated in the Trauma Center of Cesena, with those obtained in a group homogeneous for ISS and year of hospitalization stored in the RRGT (Registro Regionale Grandi Traumi - Regional Major Trauma Registry).

Materials And Methods: Through a retrospective study we analyzed a population of 21,704 patients hospitalized for trauma in our Trauma Center from 2001 to November 2009, 40.

Thiazolidinediones inhibit hepatocarcinogenesis in hepatitis B virus-transgenic mice by peroxisome proliferator-activated receptor gamma-independent regulation of nucleophosmin.

Unlabelled: Antidiabetic thiazolidinediones (TZD) have in vitro antiproliferative effect in epithelial cancers, including hepatocellular carcinoma (HCC). The effective anticancer properties and the underlying molecular mechanisms of these drugs in vivo remain unclear. In addition, the primary biological target of TZD, the ligand-dependent transcription factor peroxisome proliferator-activated receptor gamma (PPARgamma), is up-regulated in HCC and seems to provide tumor-promoting responses.

The Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS) A retrospective review of 379 patients undergoing laparoscopic splenectomy.

In December 2000, the Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS) was formally launched under the auspices of the Italian Society for Endoscopic Surgery and New Technologies (SICE). The aim of this multicentre study was to analyse various aspects of the treatment that are still under discussion, such as the extension of the laparoscopic indications in cases of malignancy, independently of the associated splenomegaly, patient selection and operative techniques. A retrospective review of 379 patients undergoing laparoscopic splenectomy for haematological diseases from February 1, 1993, to September 15, 2005, was conducted.

[Hernia surgery with short hospitalization].

The hospital stay of 55 patients, 47 males and 8 females, admitted to hospital for surgical repair of inguinal (53 procedures) and crural (4 procedures) hernias was analyzed. The mean age was 60.7 years (range from 25 to 82 years), local anesthesia was the method of choice (55 procedures), it has suppressed post-anesthetic respiratory and urinary troubles.

[Iatrogenic lesions of cranial nerves during endarterectomy of the carotid artery].

Cranial nerve injuries may result from carotid endarterectomy. In a retrospective study of 222 surgical procedures, from July 1982 through June 1990 only three cranial nerve injuries were documented (1.35%).

Isolated true atherosclerotic aneurysms of the superficial femoral artery. Case report and literature review.

Isolated true atherosclerotic aneurysms of the superficial femoral artery are rare. We report an original case of superficial femoral artery aneurysm (SFAA) not associated with dilatation of the common femoral or popliteal artery. The review of the literature emphasizes the great latency of the disease and the high incidence of complication at presentation, as well as, echosonographic diagnostical advantages over angiography.

[Esophageal anastomosis using a stapler: new technical variants].

Stapling techniques are considered the safer alternative for esophageal anastomosis in the Authors experience. In order to further improve results they suggest stapled esophageal anastomoses should be constructed avoiding purse-string sutures and the use of purse-string devices or Satinsky forceps.

[Evaluation of prognostic parameters in colorectal carcinoma. I. Histopathological variability].

A careful histopathological analysis was performed on a series of 244 unselected surgically removed primary colonic and rectal cancers. Tumours were staged according to the TNM system. Tumour type (adenocarcinoma or mucinous carcinoma), grade of differentiation, character of invasive margin, degree of peritumoural lymphocytic infiltration, venous and neural invasion were found to be correlated with the clinico-pathological stage and in some ways interrelated.

Immunohistochemical assessment of growth fractions in colorectal adenocarcinomas with monoclonal antibody Ki-67. Relation to clinical and pathological variables.

Immunostaining with monoclonal antibody Ki-67 (MAb Ki-67) has been employed to determine the growth fractions in a series of 139 primary adenocarcinomas of the large bowel. A wide range (18.9-71.

[Mechanical staplers in colorectal surgery: cost-benefit ratio].

The cost/benefit ratio of stapled anastomoses in colorectal surgery has been retrospectively evaluated on the basis of a 8 year experience taking into account the overall costs in surgery as well as short term and long term benefits. With this aim, our experience was divided in two periods: 1st period: November 1970-January 1981: 598 hand sutures; 2nd period: February 1981-December 1988: 787 stapled sutures. Mechanical suturing was found to be superior based on the following: a) the average postoperative hospital stay decreased from 20.

[Technical considerations on 222 cases of esophageal anastomosis using a stapler].

The Authors report their experience with 222 esophagoenteric anastomoses, performed in 211 cases for malignant neoplasms (middle and lower third) of the esophagus or stomach. Particularly, they have performed 4 Sujura operations, 31 esophagogastric, 4 esophagocolic, 183 esophagojejunal anastomoses utilizing SPTU, ILS and EEA circular stapler. GIA was used in the preparation of the stomach before esophagogastroplasty.

[Reoperations in surgery of biliary lithiasis (author's transl)].

The Authors report on their cases of biliary surgery reoperation, necessary in 267 cases out of 3193 primary operations. After a short discussion of the aetiological, diagnostic and therapeutic problems of relapsing biliary pathology, they compare their results with those of the most important sets of cases reported in world literature.

[So-called cystic stump syndrome].

After outlining and discussing the etiology and pathophysiology of the postcholecystectomy syndrome, the authors describe their own series of 35 cases, therapeutic policies, and results obtained. In the discussion they suggest that the so-called cystic stump syndrome has probably been overplayed, since in the authors' own series of cases there was a high incidence of associated pathology.

[The role of supraduodenal choledocho-duodenostomy in non-neoplastic obstructive pathology of the principal bile duct].

The authors review the indications of their 146 cases of supraduodenal choledochoduodenostomy (SDC) from 1970 to 1977. The conditions for which the procedure was carried out were dilatation of the choledochus (100%), multiple calculosis (83%), and primitive or secondary stenosing odditis (17%). After a detailed discussion of these indications, the authors report their immediate and long-term results, which were good in 96% of the patients.