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Long-term steroid treatment: a potential risk factor for uterine rupture during pregnancy? 长期类固醇治疗:妊娠期子宫破裂的潜在危险因素?
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
C Grigoriadis, A Tympa, V Delivoria, S Baka, K Theodoraki
{"title":"Long-term steroid treatment: a potential risk factor for uterine rupture during pregnancy?","authors":"C Grigoriadis,&nbsp;A Tympa,&nbsp;V Delivoria,&nbsp;S Baka,&nbsp;K Theodoraki","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>Uterine rupture during pregnancy is a rare but life threatening event in Obstetrics, with potentially catastrophic consequences for both the fetus and the mother. There are few published case reports that investigate the possible association between long-term steroid treatment and uterine rupture during the antenatal period.</p><p><strong>Case report: </strong>A 33-year-old G2P1 woman with obstetrical history of one previous transverse low-segment caesarean section presented at the 30th week of gestation with severe abdominal pain which started spontaneously one hour before. She had medical history of pemphigus under long-term treatment with prednisolone. Clinical examination showed acute abdomen while the fetus developed heart rate decelerations. Emergency caesarean section via Pfannenstiel incision under general anaesthesia was performed. Uterine rupture was recognised with localization not at the scar of the previous caesarean section but at the left posterolateral site of the uterine fundus. A healthy premature male infant with an excellent Apgar score and weight of 1510 gr. was delivered by a low-segment caesarean section. Surgical repair of the site of the rupture with isolated sutures followed. There was no need for hysterectomy as hemorrhage was controlled and hemodynamic stability of the woman was restored.</p><p><strong>Discussion: </strong>Uterine rupture should be included in the differential diagnosis by all obstetricians not only during labour but in acute abdominal pain during the antenatal period as well.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"112-114"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37014599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of a preventive bundle of measures for reducing surgical site infections in patients undergoing elective orthopedic procedures in a Hellenic Air Force Hospital. 在希腊空军医院进行选择性整形手术的病人中，预防措施束减少手术部位感染的有效性。
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
G Kritikou, K I Avgerinos, C Koutserimpas, F Sourri, D Hatzigeorgiou, C Kottaridi, I Bountouris
{"title":"Effectiveness of a preventive bundle of measures for reducing surgical site infections in patients undergoing elective orthopedic procedures in a Hellenic Air Force Hospital.","authors":"G Kritikou,&nbsp;K I Avgerinos,&nbsp;C Koutserimpas,&nbsp;F Sourri,&nbsp;D Hatzigeorgiou,&nbsp;C Kottaridi,&nbsp;I Bountouris","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Bundles of preventive measures may improve patient outcomes. The aim of this study is to investigate if a surgical site infections (SSIs) preventive bundle in orthopedic surgery patients can result in reduction of such infections, hospitalization length and cost.</p><p><strong>Methods: </strong>The present is a retrospective cohort study. A total of 1299 patients was admitted to hospital for an elective orthopedic procedure during 2012-2015. The patients were subjected to either an integrated three-stage SSIs preventive protocol or standard preventive measures. The two groups were compared for incidence of SSIs, median hospitalization length and median cost.</p><p><strong>Results: </strong>The incidence of SSIs was lower in the new-protocol group, when compared to the old protocol one (p=0.102). Median (md) hospitalization length was significantly lower in the new protocol group (md = 2) compared to \"old-protocol\" group (md= 5) [U = 280520, p<0.001]. Regarding arthroscopies, the median cost in the new protocol patients (md= 1500) was significantly lower compared to \"old-protocol\" patients (md= 1585) [(U= 112660), p < 0.001]. Knee arthroplasties' median costs did not differ (both mds= 4400, U = 2002, p > 0.05). For hip arthroplasties, the new protocol's patient median cost (md= 3000) was significantly lower than that of \"old-protocol\" (md = 4000) [U = 19680, p < 0.001].</p><p><strong>Conclusions: </strong>The use of a bundle of measures for the prevention of SSIs in a hospital's orthopedic operations proved effective, since it resulted in substantial decrease of SSIs, statistically significant decreased hospitalization length, as well as cost.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"120-126"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37014601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recurrent giant Brunner's gland adenoma. 复发性巨大布伦纳腺瘤。
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
J H Rodriguez-Quintero, O Santes, J Morales-Maza, U Clemente-Gutierrez, E Sanchez-Garcia Ramos, R Cortés-Gonzalez
{"title":"Recurrent giant Brunner's gland adenoma.","authors":"J H Rodriguez-Quintero,&nbsp;O Santes,&nbsp;J Morales-Maza,&nbsp;U Clemente-Gutierrez,&nbsp;E Sanchez-Garcia Ramos,&nbsp;R Cortés-Gonzalez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Benign duodenal tumours are extremely rare, with an incidence of 0.008% among general population; those originating from Brunner's Gland represent 11% of this neoplasms. Most cases remain asymptomatic and are often diagnosed during routine endoscopic procedures, however their clinical presentation may be variable making resection treatment of choice in order to prevent complications. Recurrence has not been reported previously on literature. 59-year-old male presented to the emergency department nine months following endoscopic resection of a 2x1.5cm Brunner's gland adenoma complaining of bloating, weight loss and gastro intestinal bleeding, diagnostic approach revealed a 10x4cm mass occupying the duodenum. Tumour size did not allow for endoscopic resection and surgical removal was performed with excellent outcome and no further recurrence at 30 months.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"127-131"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37014602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Benign multicystic mesothelioma: a case report of recurrent disease in a young adult with familiarity for renal cell carcinoma. 良性多囊间皮瘤:一例年轻成人肾细胞癌复发病例报告。
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
N Falco, F Colli, R Tutino, T Fontana, L Licari, G Rotolo, G Scerrino, G Salamone, G Gulotta
{"title":"Benign multicystic mesothelioma: a case report of recurrent disease in a young adult with familiarity for renal cell carcinoma.","authors":"N Falco,&nbsp;F Colli,&nbsp;R Tutino,&nbsp;T Fontana,&nbsp;L Licari,&nbsp;G Rotolo,&nbsp;G Scerrino,&nbsp;G Salamone,&nbsp;G Gulotta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Benign multi-cystic peritoneal mesothelioma (BMCM) is a very rare disease (about 150 cases observed). The aetiology is currently little-known, and the data collected, without having achieved conclusive re sults, identify two possible causes: neoplastic and reactive inflammatory. This case report refers to a recidivism of BCMC in a patient whose brother, few months before, underwent a left nephrectomy and right renal Radio Frequency Termo Ablation (RFTA) for bilateral papillary renal cell carcinoma. For the recurring trend, the onset in a male young patient without chronic inflammatory diseases evidence, the presence of a first degree relative with a rare carcinoma we supposed a neoplastic aetiology. The available literature suggests that both tumours (BCMC and renal cell carcinoma) are susceptible to oestrogens. This biomolecular mechanism could represent a valid antipathogenic hypothesis.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"145-148"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37280054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Choroidal metastasis from lung adenocarcinoma: a rare case report. 肺腺癌脉络膜转移一例。
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
C Porrello, R Gullo, C M Gagliardo, A Vaglica, M Palazzolo, F Giangregorio, D Iadicola, G Profita, F Lo Faso, G Tomasello, Fabrizio Carini, G Cocorullo
{"title":"Choroidal metastasis from lung adenocarcinoma: a rare case report.","authors":"C Porrello,&nbsp;R Gullo,&nbsp;C M Gagliardo,&nbsp;A Vaglica,&nbsp;M Palazzolo,&nbsp;F Giangregorio,&nbsp;D Iadicola,&nbsp;G Profita,&nbsp;F Lo Faso,&nbsp;G Tomasello,&nbsp;Fabrizio Carini,&nbsp;G Cocorullo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The choroid is the most common site for intraocular metastatic di sease. Orbital metastasis as metastatic site of lung adenocarcinoma is very rare and in literature a very exiguous number of cases is present. This is a case report of a woman with history of lung adenocarcinoma and, after surgery, detection of a choroidal mass described as lung metastasis, responding to Gefinitib therapy. However a biopsy was not performed. After two years there was a great dimension decrement of the lung metastasis but she is still suffering from recurrent pleural effusion, with pleural thickenings biopsied and diagnosed as recurrences of disease.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"137-140"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37280050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can initial inflammatory markers predict length of stay in uncomplicated diverticulitis? 初始炎症标志物能否预测无并发症憩室炎的住院时间?
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
S Parys, A Eranki, S Khamhing
{"title":"Can initial inflammatory markers predict length of stay in uncomplicated diverticulitis?","authors":"S Parys,&nbsp;A Eranki,&nbsp;S Khamhing","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the ability of White Cell Count (WCC), Neutrophil count & C-Reactive Protein (CRP) levels at admission to predict length of stay (LOS) in patients with uncomplicated diverticulitis.</p><p><strong>Method: </strong>This study was performed as a retrospective review of all patients admitted with CT proven uncomplicated diverticulitis over a one-year period. WCC, Neutrophils and CRP levels where recorded at admission. Uniform discharge criteria where used and length of stay measured. A correlation analysis was performed between the inflammatory markers and LOS.</p><p><strong>Results: </strong>A total of 84 admissions with uncomplicated diverticulitis was included in this study. Average LOS 3.06 (range 1-7 days). On Romaadmission average CRP was 55 (1-276), WCC 11.5 (4.5-35.6) and Neutrophils 8.37 (2.3-18.9). Peak inflammatory values were also measured with mean peak CRP 93.5 (3-325), WCC 11.6 (5.1-35.6) and neutrophils 8.47 (2.3-18.9). Inflammatory markers were correlated to LOS. Multivariate analysis and Fit Plots showed no correlation between any of the inflammatory markers and LOS. Using a modified Hinchey classification 8 patients were Hinchey 0, 60 Hinchey Ia and 16 Hinchey Ib. Hinchey classification was associated with longer LOS (Hinchey 0 mean LOS 2.63 days, Hinchey Ia 2.71 days, Hinchey Ib 4.4 days).</p><p><strong>Conclusion: </strong>There was a high degree of variation in the inflammatory markers at admission, as well as the peak level of these inflammatory markers during the patients stay. The extent to which these markers were raised did not correlate with the patients' length of stay. As such, the use of inflammatory markers has limited prognostic value in patients with uncomplicated diverticulitis.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"88-94"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37000905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Occasionally report of sacral chordoma; treatment and review of literature. 偶有骶脊索瘤的报道;文献的处理和回顾。
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
P Sallustio, M Minafra, R Laforgia, U Riccelli, P Lobascio, G Carbotta, G Balducci, N Palasciano
{"title":"Occasionally report of sacral chordoma; treatment and review of literature.","authors":"P Sallustio,&nbsp;M Minafra,&nbsp;R Laforgia,&nbsp;U Riccelli,&nbsp;P Lobascio,&nbsp;G Carbotta,&nbsp;G Balducci,&nbsp;N Palasciano","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Brain notochordal cell tumors (BTCN) are lesions arising from notochordal differentiation which affect the axial skeleton.</p><p><strong>Presentation of case: </strong>We report a case of a patient treated in our General Surgery Unit of the University Hospital of Bari, Italy, with occasional finding of sacral chordoma at the histological examination.</p><p><strong>Discussion: </strong>Because of their location, sacral chordomas can affect bowel and bladder with organ specific symptoms. Radiotherapy may be used as a palliative treatment or for recurrence in those patients who cannot be submitted to surgery.</p><p><strong>Conclusions: </strong>Due to the high local recurrence rate radiation therapy should be considered mandatory after any type of chordoma resection. Multidisciplinary management of the disease is mandatory and improve patient outcomes. Patients should have maximal tumor debulking with adjuvant radiotherapy when possible.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"132-136"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37014604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An enhanced outpatient modality for the treatment of hemorrhoidal disease: preliminary results. 加强门诊治疗痔疮疾病的方式:初步结果。
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
K Perivoliotis, M Spyridakis, E Zintzaras, E Arnaoutoglou, M G Pramateftakis, K Tepetes
{"title":"An enhanced outpatient modality for the treatment of hemorrhoidal disease: preliminary results.","authors":"K Perivoliotis,&nbsp;M Spyridakis,&nbsp;E Zintzaras,&nbsp;E Arnaoutoglou,&nbsp;M G Pramateftakis,&nbsp;K Tepetes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Surgical treatment of haemorrhoids is, primarily, performed on an outpatient basis, and as so, the reduction of the operative time and the hospitalization duration is necessary. In order to achieve these results, both the surgical procedure and the anaesthesia modality should be optimized. Therefore, in this randomized controlled trial, we proposed the hemorrhoidal arteries ligation under pudendal nerve block, as an enhanced outpatient modality, versus the standard of doppler guided hemorrhoidal arteries ligation under spinal anaesthesia. Preliminary results showed that the experimental group was characterized by a similar to the control arm, symptoms remission rate, a lower operation duration and an improved postoperative recovery.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"153-157"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37274508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Una vita a strati uniti. Il nutrimento e l'esercizio fisico per stare meglio oggi e domani]. 一种分层的生活。营养和运动使你今天和明天变得更好。
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
A Pulcini
{"title":"[Una vita a strati uniti. Il nutrimento e l'esercizio fisico per stare meglio oggi e domani].","authors":"A Pulcini","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"158"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37280055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is the social status a new prognostic factor in the Fournier's gangrene? 社会地位是富尼耶坏疽的一个新的预后因素吗?
IF 0.6
Giornale di Chirurgia Pub Date : 2019-03-01
B Capasso, M Pezzatini, M Cinquepalmi, M S Antonelli, G Caraceni, A Rampini, S Cardella, G Castagnola, S Maggi, A Brescia
{"title":"Is the social status a new prognostic factor in the Fournier's gangrene?","authors":"B Capasso,&nbsp;M Pezzatini,&nbsp;M Cinquepalmi,&nbsp;M S Antonelli,&nbsp;G Caraceni,&nbsp;A Rampini,&nbsp;S Cardella,&nbsp;G Castagnola,&nbsp;S Maggi,&nbsp;A Brescia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fournier's gangrene is a life-threatening acute necrotizing fasciitis of perianal, genitourinary and perineal areas. Local symptoms are scrotal swelling, erythema of scrotal skin and pain with generalized constitutional symptoms. The gangrene may extends to abdominal wall, intra-abdominal structures, and even in the retroperitoneal tissues. Urgent surgical debridement is crucial to warrant a good outcome since delayed intervention carries a poor prognosis. We report the case of a not diabetic patient with Fournier's disease presented with severe sepsis and successfully treated with urgent deep debridement and reconstructive surgery. We propose the social status of the patient as a prognostic factor with high impact for survival rate.</p>","PeriodicalId":46352,"journal":{"name":"Giornale di Chirurgia","volume":"40 2","pages":"141-144"},"PeriodicalIF":0.6,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37280052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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