The value of segmental pressure measurement in the assessment of peripheral vascular disease.

In 60 patients with symptomatic peripheral vascular disease a study was performed to evaluate the reliability of segmental pressure measurement in detecting and localizing vascular lesions. Five groups of limbs with different pressure patterns were identified: normals, distals disease (diabetics), aorto-iliac disease, aorto-iliac and superficial femoral disease, superficial femoral and distal disease. The comparison with angiography showed the high efficacy of this method (when combined with Doppler study of the arteries) to localize and quantify the lesions. The combination with femoral intraarterial pressure measurement allows to predict exactly the segmental pressure after segmental vascular reconstructions. It is concluded that segmental pressure measurement (with the described technique) selects patients for angiography and surgery and can predict the outcome of vascular reconstruction.

Foam-sclerotherapy, surgery, sclerotherapy, and combined treatment for varicose veins: a 10-year, prospective, randomized, controlled, trial (VEDICO trial).

The study compared, by a prospective, randomized method, 6 treatment options: A: Sclerotherapy; B: High-dose sclerotherapy; C: Multiple ligations; D: Stab avulsion; E: Foam-sclerotherapy; F: Surgery (ligation) followed by sclerotherapy. Results were analyzed 10 years after inclusion and initial treatment. Endpoints of the study were variations in ambulatory venous pressure (AVP), refilling time (RT), presence of duplex-reflux, and number of recurrent or new incompetent venous sites. The number of patients, limbs, and treated venous segments were comparable in the 6 treatment groups, also comparable for age and sex distribution. The occurrence of new varicose veins at 5 years varied from 34% for group F (surgery + sclero) and ligation (C) to 44% for the foam + sclero group (E) and 48% for group A (dose 1 sclero). At 10 years the occurrence of new veins varied from 37% in F to 56% in A. At inclusion AVP was comparable in the different groups. At 10 years the decrease in AVP and the increase in RT (indicating decrease in reflux), was generally comparable in the different groups. Also at 10 years the number of new points of major incompetence was comparable in all treatment groups. These results indicate that, when correctly performed, all treatments may be similarly effective. "Standard," low-dose sclerotherapy appears to be less effective than high-dose sclero and foam-sclerotherapy which may obtain, in selected subjects, results comparable to surgery.

[Diagnosis of cerebrovascular diseases. International multicentric study]. / Diagnosi delle malattie cerebrovascolari. Studio policentrico internazionale.

A Polycentric International Study was performed to evaluate the diagnostic methods in patients with cerebrovascular diseases. New tools and new non-invasive methods were proposed by the 15 centers collaborating in this study. The difficulty of defining a standard method to investigate not invasively and invasively these patients still remains.

[Current diagnosis of venous diseases of the lower limbs]. / Diagnostica attuale della patologia venosa degli arti inferiori.

The haemodynamic of venous circulation of lower limbs seems to be not yet fully understood and different methods are available to study clinical patterns of venous insufficiency, deep venous incompetence or venous occlusion. Simple and common methods as venography, venous doppler and plethysmography are frequently used but other method as impedance plethysmography, ambulatory venous pressure, photoplethysmography, isotopes and thermography can be used for research or clinical investigation. The techniques and the indications of these tests are reviewed and critically analyzed to evaluate the best approach to the patients with venous pathology.

[Carcinoma with a branchial origin]. / Il carcinoma ad origine branchiale.

Carcinoma was observed in a patient with a branchial cyst of about 40 years' standing. The neoformation was removed, but the patient died as a result of cardiocirculatory complications a little more than a year later. Note is taken of the rarity of this form and the compliance of the reported case with the criteria laid down by Martin et al. in 1950.

[Neurinosarcoma of Vater's papilla. Apropos of a case]. / Il neurinosarcoma della papilla di Vater. A proposito di un caso.

Neurinosarcoma of Vater's ampulla is rarely observed. A case is presented in which the tumour did not occlude the ampulla and was thus detected intraoperatively. The head of the duodenum and the pancreas were ablated. Histological examination showed a fasciculated neoformation, in which the individual fasciculi ran parallel to or crossed each other. The nuclei displayed distinct atypical pictures. The little cytoplasm there was could only be clearly made out in areas involved in oedematous dissociation.

[Non-secreting malignant tumors of the adrenal cortex. Description of a case]. / I tumori maligni non secernenti del corticosurrene. Descrizione di un caso.

Non-secreting carcinoma of the suprarenal cortex is a rare from of neoplasia. A personal case, characterized by its large dimension (24 cm longitudinal diameter) is reported. Stress is laid on the need for early diagnosis although this is possible only in a limited number of patients owing to the disease's course. Only patients owing to the disease's course. Only early diagnosis, however, can enable the tumour to be removed before metastasis sets in. The malignity of these types is also pointed out, few patients surviving for longer than 5 years.