[Intestinal intussusception: easy diagnosis in the 21st Century? Outcome of five years experiences]. / Invaginazione intestinale: una diagnosi facile nel 21 degrees secolo? Outcome degli ultimi 5 anni.

UNLABELLED: Intussusception is an entity well codify in pediatric surgery, with guidelines well defined since years in terms of imaging and procedures. MATERIAL: From January '99 to Dec. '03, 25 children were admitted to the Department of Pediatric Surgery of the Children's Hospital of Milan. All the aspects related to the pathology have been evaluated in the study. RESULTS: 25 patients have been studied. 23/25 presented severe pain, 19/25 normal bowel movements in the last 3 hours and in 9/25 a mass were detected at clinical examination.19/25 were submitted to laparotomy after failure of reduction through barium enema, and in 17/19 a manual reduction were performed. Only 2 patients required a bowel resection with primary anastomosis. The analysis of the delay of diagnosis, the delta-T between beginning of the symptoms and first medical evaluation was of 16,23 h. (3-72), and the delta-T between the first evaluation and diagnosis was 18,7 h. The interval between diagnosis and surgery was of 4,3. CONCLUSION: Authors believe that intussusception still represent a challenge for medical and surgical emergency team, supported by the data in literature. Imaging procedures must not be constricted in case of minimal suspicions of intestinal intussusception.

Hyperthermia at 434 MHz in the treatment of overuse sport tendinopathies: a randomised controlled clinical trial.

The objective of this randomized study was to compare a thermotherapy system, hyperthermia at 434 MHz and conventional ultrasound in the treatment of overuse sports tendinopathies. The study group consisted of 44 athletes, 33 males and 11 females (age 26 +/- 4.56 years) affected by tendinopathies at lower extremities (patellar or achilles tendons). After elucidation of the kind of trial, 22 patients were randomly assigned to hyperthermia and 22 to ultrasound. The patients received after a pain measurement and ultrasound scanning 12 treatments, 3 times a week for 4 weeks. The same standardized examination was done at the end of treatment and 1 month after the end of treatment. The assessor physician was unaware of the treatment allocation. The patients were asked to rate the ultimate outcome on the base of pain resolution and return to sports activity. Both groups had a significant decrease of symptoms (P<0.001). Hyperthermia, however, demonstrated better effects on the reduction of VAS score and on the subjective overall satisfaction (77 %) of excellent and good results in comparison to the 33 % of ultrasound. In patients with chronic overuse tendinopathies hyperthermia at 434 MHz showed encouraging results, with short-term clinical improvement, safety and no side effects.

A controlled study on the effects of hyperthermia at 434 MHz and conventional ultrasound upon muscle injuries in sport.

BACKGROUND: Hyperthermia equipment using a 434 MHz applicator with water bolus elevate to therapeutic temperatures (from 41 to 45 degrees C) delineated volumes of tissue target, down to a depth of 3 to 5 cm. The aim of our study was to evaluate the efficacy of hyperthermia in the treatment of muscle injuries, in comparison with a conventional modality like ultrasound. METHODS: A prospective randomised controlled design was used. Forty patients, 29 males and 11 females, with mean age of 26.2+/-3 ranging between 18 and 35 years affected by acute muscular injuries of different sites and severity participated this study. Twenty-one patients received hyperthermia (group A) and the remaining 19 (group B) ultrasound. Both groups received nine applications, three times per week with a duration of 30' for the group (A), and 15' for the group (B). All the patients underwent a clinical examination including a pain measurement and a ultrasound scanning before, at the end and after one month follow-up. An additional ultrasonography was made after the fourth session to compare the effect of each treatment on the initial course of haematoma resolution. RESULTS: Both groups had a significant decrease of the pain (p< 0.001). The hyperthermia group showed a significantly higher effect on VAS score and on haematoma resolution after two weeks of treatment. CONCLUSIONS: Even with a limited number of cases our results show that the hyperthermia is a highly innovative, safe and reliable modality for the treatment of acute sport muscle injuries.