[A fecal fistula in patient who underwent an abdomino-perineal resection with a continent magnetic prosthesis: observations on an obsolete technique].

The Authors consider a case of a patient who underwent an abdominal-perineal resection and presented a fecal fistula as a late complication of a magnetic prosthesis implant. After a revision of the literature, the Authors evaluate the reasons for abandoning this surgical technique of continence many years ago, underlying not only the complications observed during the experimentation but also the lack of those benefits for which this technique was proposed.

[A case of total spinal block during epidural anaesthesia].

Most cases of total spinal block have been reported in the literature. The displacement of the catheter and the consequent dural perforation are the causes in large percentage of the patients (75%). The Authors describe this case for the importance of the causes and outcome of the patient.

[Appendiceal lithiasis: case report and review of literature].

Appendiceal calculi are found in a limited percentage of patients. They are in association to an elevated prevalence of necrotic appendicitis and perforation of the appendix. The Authors report a case of acute appendicitis associated to appendiceal lithiasis with perforation of the organ.

[The thyroid nodule: cytomorphofunctional profile-therapeutic approach].

Analyzing a cohort of 16,400 thyroid nodules, sequentially examined since 1982, the value of preoperative echo-guided fine needle aspiration cytology (FNA) in discriminating benign lesion from malignant ones, has been assessed. Ultrasonography provides a useful support not only to guide the diagnostic FNA methodology, but also monitoring therapeutic procedure: evacuation of cyst, alcoholic sclerotization, laser therapy, effects of treatment on the size of the nodular structure. The correct interpretation of the imaging pictures should be rationally anchored to both clinical criteria and to circumstantial anamnestic analysis, as well as to physical examination, laboratory tests, instrumental systems, cytomorphological patterns, immunohistologic and biomolecular studies.

Rheological properties of protein-surfactant based gels.

Water-based protein-surfactant gels, formed by mixing bovine serum albumin (BSA) and sodium dodecyl sulfate in water, were investigated by rheological methods. The measurements were performed for many different protein-to-surfactant ratios as a function of the applied frequency, stress, or strain, as well as by changing the temperature, in the range between 15 and 65 degrees C. The rheological behavior of the gels as a function of applied frequency is interpreted in terms of the overlapping of at least two viscoelastic relaxation processes.

[Notes for a history of pediatrics].

The origins, major events and the Italian and foreign literature on the history of pediatrics are summarized. The origins of the word ''pediatrics'', the history of pediatric incunables and the first textbooks of pediatrics in Italian language are reviewed. Moreover, the foundation of the first pediatric hospital in Italy, the Italian history of academic schools in pediatrics, the first national congress and the formation of the national society of pediatrics are outlined.

[Anaesthesiologic problems about hyperthermic intraoperative intraperitoneal chemotherapy].

The literature considers hyperthermic intraoperative intraperitoneal chemotherapy a safe and effective procedure for peritoneal carcinomatosis, but a technical improvement is necessary. Regional chemotherapy anticipates the "downfall" of tumoral cells in the peritoneum. The Authors considered 5 patients--female, age 27-45 years, ASA 2--operated of peritonectomy in ovaric neoplasia with peritoneal metastasis.

[Pelvic abscesses. Treatment modalities and personal experience].

The pelvic abscesses as complication of surgical operations or various pathologies is a delicate clinical situation because of the possible and unexpected evolution into a settic shock with a high risk of death. The authors report their personal experience of 16 cases undergone surgical treatment. They underline the importance of an early diagnosis, of a control of the patient general conditions with a specific antibiotic therapy, of the possibility to treat this pathology in a percutaneous way with the help of radiologic techniques or eventually by surgery.

[Recent progress in the treatment of lower limb defects].

Technological and reconstructive surgical procedures improvments are limiting demolitive interventions on the lower limb for common pathologies and traumatology. From 1999 to 2002, 32 men and 14 women, from 18 to 54 years-old, were admitted at the Operative Unit of Plastic Surgery of ASL RMH. They were grouped according to cause and site of extremity defects and different surgical techniques.

[Day surgery in breast reconstructive surgery: our experience].

Breast cancer is the most common tumour in Italy in the female population, counting for about 40000 new cases every year. The psychological aspects of breast mutilation and the social and economic implications are receiving increasing attention. Despite of the diffusion of screening programs to detect pre-clinical breast cancers, 30% of patients still undergo radical interventions.

[Abdominal compartment syndrome: patophysiologic and clinic remarks].

The abdominal compartment syndrome is a high grade abdominal hypertension with clinical evidence of multiorgan failure (MOF). It is more and more frequently observed in intensive-care units as a complication in critical patients, but especially in traumatology and surgery. The incidence is highly variable according to the different trials but the severity of scores is the common factor.

Treatment of gunshot wounds to the colon: experience in a rural hospital during the civil war in Somalia.

Background: In the last few decades there has been a clear tendency in civilian practice towards primary repair of gunshot wounds to the colon, resulting in a substantial decrease in the number of colostomies performed for this type of injury.

Methods: The series described here comprises 24 patients with gunshot wounds to the colon treated at the hospital of Jowar in the Middle Shebelle region of Somalia between 1999 and 2001. All injuries were caused by war arms firing high-velocity projectiles.

About cardiovascular risk in non-cardiac surgery.

The perioperative management of patients at risk for cardiovascular diseases who undergo non-cardiac surgery has been subject of debate over the past few decades and is still of great interest. An adequate perioperative management may modify postoperative mortality and morbidity and may improve the long-term prognosis. The purpose of this review is to examine the present day knowledge regarding the preoperative evaluation and perioperative and postoperative management.

[Turnover of bone metabolism and prevalence of vertebral fractures in adrenal incidentalomas].

Aim of the study was to evaluate, in a homogeneous group of patients with adrenal incidentalomas (AI), calcium-phosphorus metabolism alterations, bone mineral density (BMD) and the prevalence of vertebral fractures. We selected 46 patients with adrenal incidentalomas (26M, 20F; age: M = 61 +/- 14, F = 65 +/- 10 years, BMI: M = 26.2 +/- 4 Kg/m2, F = 28.

Direct determination by capillary electrophoresis of cardiovascular drugs, previously included in liposomes.

The lipophilicity of some cardiovascular drugs was determined by capillary electrophoresis (CE). Mexiletine, amlodipine and indapamide, the drugs considered, were in contact with liposomial vescicles for 2, 4 or 6 h. After the contact time the drugs, penetrated into liposomial vesicles, were determined by CE using phosphate buffer (pH 6.

Micellar electrokinetic chromatography for determination of drug partition in phospholipids.

The lipophilicity of pipemidic, nalidixic and oxolinic acids was determined by forming phospholipidic micelles directly in an electrophoretic capillary. Phosphatidylcholine derivatives, namely L-alpha-dilauroyl phosphatidylcholine (DLPC) or L-alpha-dimiristoyl phosphatidylcholine (DMPC), were added in the run buffer (50 mM phosphate buffer at pH 7.4).

[Bioethics and adolescence. Reflections about corporeality, sexuality, health, education].

Bioethics plays an important role and has remarkable implications on all those who operate in the field of adolescentology at all levels. The forma mentis and the modus operandi that bioethics offers to each operator and educator will surely bring benefits towards the prevention of illness and the general well-being of adolescents, who will be tomorrow's adults. This paper, which analyses problems related to adolescence, such as corporeity, sexuality, health and education, underlines the need to consider them from a bioethical perspective.

[Primary adenocarcinoma of the ureter. Case report].

Primary ureteral adenocarcinoma is an infrequent histological type of urinary neoplasm. Many authors consider intestinal metaplasia the pivotal event of the pathogenetic process, whether it occurs on a pre-existing urothelial carcinoma or on a normal urothelium. Diagnosis is essentially based on case history and clinical findings (hematuria and pain) and on diagnostic imaging.

[Traumatic lesions of the diaphragm].

The Authors studied 30 cases of diaphragmatic traumatisms from 1972 to 2003 to stress the difficulty to achieve an early diagnosis and the need of their immediate treatment: 26 of these patients were male and 4 female (6.5:1); the pathogenesis was in 50% of cases an open trauma and in 50% a closed trauma. The mean age was 36.

[Colonic perforations after self-expandable metallic stenting: two case reports].

The use of self-expandable metallic stents in colorectal stenoses, both benign and malignant, is a recently born treatment, quickly widespread because of its simplicity and therapeutic efficacy. It is particulary useful, like emergency temporany treatment, in malignant colonic obstruction; in these cases the temporary endoprosthesis positioning allows the intestinal transit and to overcame the emergengy phase. After patient conditions improvement, he can be operated and the endoprosthesis removed within operating specimen.

[New devices for the invasive treatment of acute myocardial infarction].

Primary angioplasty has been demonstrated to be the best reperfusion therapy in patients with acute myocardial infarction. Anyway, its efficacy is reduced by the distal embolization, above all in the setting of acute myocardial infarction. In the last years, many devices have been designed in order to limit this complication which may lead to a poor prognosis.

[Emergency surgery for colorectal cancer: our experience].

Colorectal cancers have an extremely negative prognosis in the elderly, with a high percentage of clinical presentations requiring emergency surgery and high perioperative mortality rates. The clinical manifestations of this type of cancer set in a cutely in 20% of cases due to the sudden onset of one of the basic complications. The authors report on their experience with 79 patients undergoing emergency surgery for colorectal cancer.

Accounting for historical information in designing experiments: the Bayesian approach.

Two of the most important statistical problems in human and animal experimentation are the selection of an appropriate number of units to include in a given study and the allocation of these units to the various treatments. Properly addressing these issues allows the units to be used as efficiently as possible, which can contribute to addressing the overall issue of reducing the number of subjects in experimentation. To do so, reliable historical information is of particular importance.

Alterations of the sympathovagal balance evaluated by heart rate variability in a rare case of adult Still's disease.

We present a rare case of adult Still's disease with cardiac involvement (myocarditis and coronary arteritis). The autonomic nervous system function was evaluated by heart rate variability (HRV) analysis performed by 24-hour electrocardiographic recording during the acute phase of the disease and the remission (after 1 month and 1 year). The HRV parameters were studied in the time (standard deviation of all NN intervals-total power - SDNN, square root of the mean of the sum of the squares of the differences between adjacent NN - RMS-SD and HRV index) and frequency domains (low frequency, high frequency, and low frequency/high frequency).