RESUMEN
Human papillomavirus (HPV) is the agent of the most common sexually transmitted diseases causing a variety of clinical manifestations ranging from warts to cancer. Oncogenic HPV infection is the major cause of cervical cancer and less frequently of penile cancers. Its presence in semen is widely known, but the effects on fertility are still controversial. We developed a new approach to evaluate virus localisation in the different semen components. We analysed also the specific genotype localisation and viral DNA quantity by qPCR. Results show that HPV DNA can be identified in every fraction of semen: spermatozoa, somatic cells and seminal plasma. Different samples can contain the HPV DNA in different fractions and several HPV genotypes can be found in the same fraction. Additionally, different fractions may contain multiple HPV genotypes in different relative quantity. We analysed the wholeness of HPV DNA in sperm cells by qPCR. In one sample more than half of viral genomes were defective, suggesting a possible recombination event. The new method allows to easily distinguish different sperm infections and to observe the possible effects on semen. The data support the proposed role of HPV in decreased fertility and prompt new possible consequences of the infection in semen.
Asunto(s)
Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/epidemiología , Semen/virología , Adulto , ADN Viral/análisis , Genotipo , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Papillomaviridae/genética , Infecciones por Papillomavirus/virología , Prevalencia , Adulto JovenRESUMEN
In this study, for the first time, we demonstrated the presence of microRNAs and extracellular vesicles in human blastocoel fluid. The bioinformatic and comparative analyses identified the biological function of blastocoel fluid microRNAs and suggested a potential role inside the human blastocyst. We found 89 microRNAs, expressed at different levels, able to regulate critical signaling pathways controlling embryo development, such as pluripotency, cell reprogramming, epigenetic modifications, intercellular communication, cell adhesion and cell fate. Blastocoel fluid microRNAs reflect the miRNome of embryonic cells and their presence, associated with the discovery of extracellular vesicles, inside blastocoel fluid, strongly suggests their important role in mediating cell communication among blastocyst cells. Their characterization is important to better understand the earliest stages of embryogenesis and the complex circuits regulating pluripotency. Moreover, blastocoel fluid microRNA profiles could be influenced by blastocyst quality, therefore, microRNAs might be used to assess embryo potential in IVF cycles.
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Blastocisto/metabolismo , Líquidos Corporales/química , Vesículas Extracelulares/metabolismo , MicroARNs/análisis , Transcriptoma , Biología Computacional , Humanos , Anotación de Secuencia MolecularRESUMEN
BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) represents the most common chronic liver disease in industrialized countries. NAFLD has the potential to progress through the inflammatory phase of nonalcoholic steatohepatitis (NASH) to fibrosis, cirrhosis, and hepatocellular carcinoma. Identifying patients at risk for this transition is a relevant clinical challenge. The complexity of these phenotypes in vivo made necessary the development of in vitro models in order to dissect the molecular signalling affected in NAFLD and NASH, but also to identify potential circulating biomarkers. METHODS AND RESULTS: We profiled the expression of 754 cellular and medium-secreted human miRNAs in HepG2 cells after lipotoxic (Palmitate, model of NASH) or not-lipotoxic stimuli (Oleate-Palmitate, model of NAFLD). Results were validated through Single TaqMan assays. We performed computational analysis of miRNA targets and pathways. Oleate-palmitate treatment induced a variation of 2.8% and 10% of total miRNAs in cells and medium, respectively; palmitate treatment caused 10% and 19% intracellular and extracellular miRNA deregulation, respectively. We validated miR-126, miR-150, miR-223, miR-483-3p, miR-1226*, and miR-1290 deregulation. Through computational analysis, we observed that targets of both intracellular and extracellular DE miRNAs were involved in processes associated with the onset and progression of NAFLD and NASH, such as fatty acid metabolism, apoptosis and inflammation. CONCLUSIONS: These data would be useful to elucidate the role of miRNAs in the pathogenesis and progression of the NAFLD spectrum, but they also allow the identification of novel potential biomarkers for differential diagnosis to be tested in vivo.
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Hepatocitos/metabolismo , Hígado/metabolismo , MicroARNs/genética , Enfermedad del Hígado Graso no Alcohólico/genética , Antígenos CD36/genética , Antígenos CD36/metabolismo , Supervivencia Celular , Ceramidas/metabolismo , Coenzima A Ligasas/genética , Coenzima A Ligasas/metabolismo , Biología Computacional , Diglicéridos/metabolismo , Perfilación de la Expresión Génica/métodos , Regulación de la Expresión Génica , Redes Reguladoras de Genes , Marcadores Genéticos , Células Hep G2 , Hepatocitos/efectos de los fármacos , Hepatocitos/patología , Humanos , Proteínas Sustrato del Receptor de Insulina/genética , Proteínas Sustrato del Receptor de Insulina/metabolismo , Hígado/efectos de los fármacos , Hígado/patología , MicroARNs/metabolismo , Enfermedad del Hígado Graso no Alcohólico/inducido químicamente , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Enfermedad del Hígado Graso no Alcohólico/patología , Ácido Oléico/toxicidad , Análisis de Secuencia por Matrices de Oligonucleótidos , Ácido Palmítico/toxicidad , Fosforilación , Mapas de Interacción de Proteínas , Proteínas Proto-Oncogénicas c-akt/genética , Proteínas Proto-Oncogénicas c-akt/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transducción de Señal , Factores de TiempoRESUMEN
miRNA expression profile and predicted pathways involved in selected limb-girdle muscular dystrophy (LGMD)2A/2B patients were investigated. A total of 187 miRNAs were dysregulated in all patients, with six miRNAs showing opposite regulation in LGMD2A versus LGMD2B patients. Silico analysis evidence: (1) a cluster of the dysregulated miRNAs resulted primarily involved in inflammation and calcium metabolism, and (2) two genes predicted as controlled by calcium-assigned miRNAs (Vitamin D Receptor gene and Guanine Nucleotide Binding protein beta polypeptide 1gene) showed an evident upregulation in LGMD2B patients, in accordance with miRNA levels. Our data support alterations in calcium pathway status in LGMD 2A/B, suggesting myofibre calcium imbalance as a potential therapeutic target. Copyright © 2016 John Wiley & Sons, Ltd.
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Calcio/metabolismo , Perfilación de la Expresión Génica , MicroARNs/genética , Distrofia Muscular de Cinturas/genética , Receptores de Calcitriol/genética , Transducción de Señal/genética , Adolescente , Adulto , Niño , Preescolar , Femenino , Subunidades beta de la Proteína de Unión al GTP/genética , Subunidades beta de la Proteína de Unión al GTP/metabolismo , Regulación de la Expresión Génica , Humanos , Masculino , MicroARNs/metabolismo , Persona de Mediana Edad , Músculo Esquelético/metabolismo , Músculo Esquelético/patología , Receptores de Calcitriol/metabolismoRESUMEN
OBJECTIVE: We aimed to deepen the clinical utility of humiliation assessment in the study of depression. METHOD: We performed a correlational analysis of the relationship between humiliation, depression, resilience, and negative primary familial environment in 80 clinically depressed subjects (41 men and 39 women; mean age = 40.71, standard deviation SD = 9.94) and a strictly matched sample of 80 non-clinical subjects (41 men and 39 women; mean age = 40.64, SD = 10.24). We also implemented a hierarchical multiple regression analysis for each sample, to test the prediction of these variables on depression. RESULTS: Humiliation showed positive correlations with depressive factors, while negative correlations emerged with resilience in both samples. The hierarchical multiple regression analysis showed humiliation to be the most predictive factor of depression in the clinical sample only. CONCLUSION: This study improves the understanding of the relationship of humiliation and depression in both clinical and non-clinical populations.
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Depresión/psicología , Familia/psicología , Resiliencia Psicológica , Vergüenza , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
SCOPE: The aim of this study is to gain a clear understanding of the level of knowledge and training of staff members from psychiatric rehabilitation services in the Province of Taranto (Italy), where patients released from judicial psychiatric hospitals will be admitted. MATERIALS AND METHODS: A questionnaire taken from an earlier study on judicial psychiatric hospitals, conducted by The Ministry of Justice of the Department Penitentiary Administration - Superior Institute of Penitentiary Studies, was used in this study. Were contacted in advance of Directors 8 Community Rehabilitation and Psychiatric Care and Day Care Centres 7 present the province of Taranto, who has sought membership survey. RESULTS: Many requests for information and training regarding the problems and challenges related to the management of individuals who are mentally ill, perpetrators of crimes, and persons who are held in protective custody are made by those who work in these institutions. CONCLUSIONS: Hospital workers are highly apprehensive with regard to working with a patient population quite different from that which they are normally accustomed to. In order to confront these challenges, they, together with other colleagues from both the private and public services sector, have turned toward the concept of teamwork. One element of contradiction seems to be a low level of knowledge regarding what will be required of them when their work will be connected to the world of criminal justice in the future. The workers who were interviewed who have experience in working with patients from Judicial Psychiatric Hospitals seem to be up to the task of meeting the complex needs of the mentally ill and perpetrators of crimes within psychiatric rehabilitation facilities, as these patients must be kept under security.
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Actitud del Personal de Salud , Criminales/psicología , Hospitales Psiquiátricos , Trastornos Mentales/rehabilitación , Adulto , Femenino , Humanos , Italia , Proyectos Piloto , Encuestas y CuestionariosRESUMEN
INTRODUCTION: The aim of this survey was to evaluate the qualitative and quantitative relationship among women from Barletta--a national renowned wine center--and their alcohol consumption. METHODS: The AUDIT questionnaire was used to assess the prevalence of alcohol hazardous consumption among women. Questionnaires were submitted from March to November 2012. The sample was composed of 150 women older than 13 years of age, selected by stratified sampling based on age group. RESULTS: 107 women were enrolled with a total response rate of 71.3%. 62% of enrolled women consumes alcoholic beverages with a frequency that goes from 2-3 times a week to less than once a month, usually 1 or 2 alcoholic units. The binge-drinking was reported by 5% of women. Women who reported alcohol-related risk behaviors were less than 3%, they were single and between 18 and 60 years old and such behaviors occur less than once a month. The final score, calculated for all the women from their questionnaire answers, was not higher than 8, with an average score of 1.3 (SD = 1.5; range: 0 to 2.8). The comparison of the average scores of the three age groups showed a statistically significant difference (F = 5.8, p = 0.004). DISCUSSION: Data from literature showed a change in the habits of alcohol intake by the global, European and also Italian population. These changes also affect and involve female. Our study found a quite moderate alcohol consumption among women from Barletta, with only 1% who consumes 3 or more alcohol units and drink more than four times a week and 3% who had hazardous behavior related to their alcohol consumption. Statistical significance was found for the age and the lack of stable relationships. The analysis of characteristics of at risk women (old age and single-status) suggests that much attention should be paid to them and they should represent the main subject of future social interventions to prevent alcohol related problems in the city of Barletta.
Asunto(s)
Consumo Excesivo de Bebidas Alcohólicas/epidemiología , Adolescente , Adulto , Femenino , Humanos , Italia/epidemiología , Persona de Mediana Edad , Prevalencia , Asunción de Riesgos , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Cricopharyngeal foreign bodies (FBs) impaction in adults is a common clinical problem; without treatment, the sequelae may be lethal due to local and/or mediastinal infection. When direct laryngoscopy and flexible fiberoptic endoscopy are ineffective, rigid endoscopy is the method of choice requiring general anesthesia. The new video laryngoscopes represent a great advancement in the assessment of the laryngeal inlet. Aim of the study was to assess the feasibility of identifying and removing FBs impacted at crycofaringeal and upper oesophageal sphincter by the video laryngoscope. METHODS: In a period of 30 months, on an urgent basis, we systematically assessed by GlideScope® video laryngoscope all adult patients with a diagnosis of impacted crycofaringeal upper esophageal FB, after unsuccessful removal attempts in the otolaryngology or gastroenterology unit. RESULTS: Twenty-six consecutive patients were evaluated. In conscious sedation by video laryngoscope 17 FBs were identified and removed from the hypopharynx or upper esophageal sphincter. In 9 patients rigid endoscopy in general anesthesia and tracheal intubation was necessary to remove FBs impacted beyond the upper esophageal sphincter. CONCLUSION: In our experience video laryngoscope, because of the magnified vision, the better patient comfort and no requirement of general anesthesia, represents a great improvement in identifying and removing in conscious sedation even small and thin foreign bodies not recognized by radiological and otolaryngology examination and not readily detected by direct endoscopy.
Asunto(s)
Cuerpos Extraños/cirugía , Hipofaringe , Laringoscopios , Laringoscopía/métodos , Cirugía Asistida por Video , Adulto , Anciano , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Insulin-like growth factor 1 receptor (IGF1R) represents a novel molecular target in non-small-cell-lung cancer (NSCLC). IGF1R and epidermal growth factor receptor (EGFR) activation are essential to mediate tumor cell survival, proliferation, and invasion. This study investigates the prognostic role of IGF1R and EGFR in surgically resected NSCLC. MATERIALS AND METHODS: IGF1R and EGFR copy number gain (CNG) were tested by fluorescence in situ hybridization (FISH) and protein expression by immunohistochemistry (IHC) in 125 stage I-II-IIIA NSCLC patients. RESULTS: Fourty-six tumors (40.3%) were IGF1R FISH-positive (FISH+), and 76 (67.2%) were EGFR FISH+. Tumors with concomitant IGF1R/EGFR FISH+ were observed in 34 cases (30.1%). IGF1R and EGFR FISH+ were associated with SCC histology (p = 0.01 and p = 0.04, respectively). IGF1R and EGFR protein over-expression (IHC+) were detected in 45 (36.0%) and 69 (55.2%) cases, respectively. Tumors with concomitant IGF1R/EGFR IHC+ were detected in 31 (24.8%) patients. IGF1R/EGFR FISH+ and IGF1R/EGFR IHC+ were significantly associated (χ(2) = 4.02, p = 0.04). Patients with IGF1R/EGFR FISH+ and IGF1R/EGFR IHC+ were associated with shorter disease-free survival (DFS) (p = 0.05 and p = 0.05, respectively). Patients with concomitant IGF1R/EGFR FISH+/IHC+ had a worse DFS and overall survival (p = 0.005 and p = 0.01, respectively). The multivariate model confirmed that IGF1R/EGFR FISH+/IHC+ (hazard ratio (HR), 4.08; p = 0.01) and tumor stage (II-III vs I) (HR, 4.77; p = 0.003) were significantly associated with worse DFS. CONCLUSIONS: IGF1R/EGFR FISH+ correlates with IGF1R/EGFR IHC+. IGF1R/EGFR FISH+/IHC+ is an independent negative prognostic factor for DFS in early NSCLC. These features may have important implications for future anti-IGF1R therapeutic approaches.
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Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Receptores ErbB/biosíntesis , Receptores ErbB/genética , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/cirugía , Receptor IGF Tipo 1/biosíntesis , Receptor IGF Tipo 1/genética , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/patología , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Dosificación de Gen , Expresión Génica/fisiología , Humanos , Inmunohistoquímica , Hibridación in Situ , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Factores Sexuales , Fumar/efectos adversosRESUMEN
Mammary carcinoma arising in ectopic breast tissue is an uncommon occurrence. Most reported cases have involved ductal carcinoma, but other types, such as medullary, papillary, and lobular carcinomas, have been described. For pathologists, the diagnosis of mammary carcinoma arising in ectopic breast tissue can be difficult, especially in the axilla, where carcinoma of adnexal origin must be excluded. We describe a 51-year-old woman who developed invasive secretory ductal carcinoma in ectopic left axillary breast tissue and micrometastatic carcinoma in an ipsilateral axillary lymph node. The carcinoma arose in a left axillary mass that had been present for several years, from which she had secreted fluid during prior menstrual periods.
Asunto(s)
Axila , Neoplasias de la Mama/diagnóstico , Mama , Carcinoma Ductal de Mama/diagnóstico , Coristoma/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias de la Mama/terapia , Carcinoma Ductal de Mama/terapia , Quimioterapia Adyuvante , Coristoma/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Metástasis Linfática , Persona de Mediana Edad , Neoplasias Primarias Múltiples/terapia , Radioterapia Adyuvante , Resultado del TratamientoRESUMEN
The ultrasound scissors are recently emerging as an alternative surgical tool for dissection and haemostasis and have been extensively used in the field of minimally invasive surgery. We studied the utility and advantages of this instrument compared with electrocautery to perform axillary dissection. The operative and morbidity details of thirty-five breast cancer patients who underwent axillary dissection using the ultrasound scissors were compared with 35 matched controls operated with electrocautery by the same surgical team. There was no significant difference in the operating time between the ultrasound scissors and electrocautery group (36 and 30 mins, p>0.05). The blood loss (60 +/- 35 ml and 294 +/- 155 ml, p<0.001) and drainage volume (200 +/- 130 ml and 450 +/- 230 ml, p<0.001) were significantly lower in the ultrasound scissors group. There was a significant reduction of draining days in ultrasound scissors group (mean one and four days, respectively p<0.05). There was significant difference in the seroma rate between the two groups (10% and 30%, respectively). Axillary dissection using harmonic scalpel is feasible and the learning curve is short. Ultrasound scissor significantly reduces the blood loss and duration of drainage as compared to electrocautery.
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Neoplasias de la Mama/cirugía , Electrocoagulación , Escisión del Ganglio Linfático/instrumentación , Escisión del Ganglio Linfático/métodos , Terapia por Ultrasonido/instrumentación , Axila , Femenino , Humanos , Instrumentos QuirúrgicosRESUMEN
AIM: Iatrogenic damage to the recurrent laringeal nerve is the most feared complication in thyroid surgery and the main cause for vocal cord palsy. Prevention of such a lesion is based upon the thorough search for the nerve along its anatomic pathway. In the present study the Authors discuss an important anatomic variation: non-recurrent inferior laryngeal nerve, emphasizing the aspects of surgical anatomy, on the basis of their own experience in neck surgery. MATERIALS AND METHODS: The study takes into conideration 301 surgical interventions on the thyroid gland, in 268 women and 33 men; consisting in 256 total thyroidectomies and 45 loboisthmectomies, as follows: 186 for nodular goiter, 48 for follicular nodule, 34 for papillifer carcinoma, 33 for toxic goiter. The identification and exposure of inferior laryngeal nerve was performed according to the principles and technique by Lahey. RESULTS: The overall prevalence of non recurrent inferior laryngeal nerve was equal to 0.33% (1/301 operations). The anomaly is prevailing on the right side, being due by an anomalous reabsorption of the IV ventral arch. This is the cause of the formation of a subclavian artery that is responsible for dysphagia lusoria. CONCLUSIONS: The rationale for the preservation of recurrent nerve is its systematic identification and exposure along all its course from its laryngeal entry. Diagnosis of non recurrent inferior laryngeal nerve is exclusively intra-operative. The anomaly is clinically asymptomatic and its suspicion can be posed in case of vascular anomalies or dysphagia. In such a circumstance the golden diagnostic tool is the angio Tc-RMN, while both the EGDS and baritate esophagous can be of some diagnostic help.
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Nervio Laríngeo Recurrente/anomalías , Tiroidectomía , Femenino , Humanos , Complicaciones Intraoperatorias/prevención & control , Masculino , Traumatismos del Nervio Laríngeo RecurrenteRESUMEN
BACKGROUND: Medullary Thyroid Carcinoma (MTC) originates from the thyroid C cells and accounts for approximately 5-9% of all thyroid cancers. Aim of this study was to retrospectively evaluate the outcomes of 41 patients with MTC who underwent treatment at our institution. PATIENTS AND METHODS. We reviewed the records of 41 patients who underwent surgery between 1995 and 2004. The patients were divided into two groups: A) patients (n 30) without any previous surgery. B) patients (n 11) previously thyroidectomized and high calcitonin levels with or without radiological evidence of local regional or distant metastases. We performed total thyroidectomy with central compartment lymphadenectomy and ipsilateral modified radical neck dissection in group A patients. Group B patients underwent re-excision of the central neck compartment and bilateral modified radical neck dissection if it had not been previously performed. RESULTS: Most patients had major reduction in postoperative calcitonin levels. Compartmental dissection of the cervical node significantly improved the results of primary surgery and calcitonin returned to normal levels in approximately 60% of the patients in group A, but only the 30% of the patients in group B. CONCLUSIONS: The extent of the primary surgical resection and the evidence of local or distant metastases significantly influence the outcome of MTC patients. An extensive lymphadenectomy performed early in the treatment and re-operative cervical lymphadenectomy in patients with persistently high calcitonin levels after thyroidectomy significantly improved the outcome, although re-operation rarely results in normalized calcitonin levels and is associated with a higher incidence of complications.
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Carcinoma Medular/cirugía , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tiroidectomía/métodos , Resultado del Tratamiento , Adulto JovenRESUMEN
Molecular characterization of human female gametes should make it easier to understand the basis of certain infertility disorders. Biologically significant mRNAs have been analysed in single oocytes to search for molecular biomarkers of oocyte quality. Initial analysis was focused on mRNA for proteins involved in cell growth and cycle control, specifically those encoding members of the general transcription apparatus such as the subunits of the general transcription factor TFIID. This heteromultimeric protein, comprising about 15 subunits, is the most important general transcription factor of the second class. These proteins are essential for the initiation of transcription of protein-coding genes, so they must be present in mature oocytes for mRNA synthesis during the first phases of embryonic development. Semi-quantitative reverse transcriptionpolymerase chain reaction was used to identify different TFIID subunits in single oocytes and to search for differences in expression as compared with control tissues. The data show that the mRNAs for most TFIID subunits are indeed synthesized in oocytes, but their expression profiles differ markedly. TATAbox-binding protein associated factor 4B (TAF4B), TAF5 and TATAbox-binding protein-like 2 (TBPL2) are expressed at higher levels in oocytes than in control tissues. It is suggested that they could be used as biomarkers of oocyte quality.
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Biomarcadores/análisis , Oocitos/metabolismo , Factor de Transcripción TFIID/metabolismo , Secuencia de Bases , Femenino , Perfilación de la Expresión Génica , Humanos , Oocitos/citología , Subunidades de Proteína/metabolismo , ARN Mensajero/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Alineación de SecuenciaRESUMEN
AIM: Differentiated thyroid carcinomas (DTC) have a favourable outlook overall. Cornerstone of treatment is total thyroidectomy (TT), followed, if needed, by radiometabolic therapy. Such lesions however show a definite tendency to recur (about 35% of cases), generally in the first decade of follow-up: in 70% of patients such recurrence is local. Surgical resection is the only curative treatment option for local recurrence of well-differentiated thyroid cancer. Intraoperative ultrasonography (US) can be of significant help in facilitating localization and complete resection of lesions. The aim of the study was to review the authors' own experience with the use of such diagnostic method in the clinical setting of thyroid neoplasm recurrence. METHODS: Between January 2005 and March 2008 31 patients with DTC recurrences underwent intraoperative US exploration. Recurrences were easily identified and resected in all patients. Postoperative tireoglobuline (TG) was undetectable. RESULTS: In all 31 patients preoperative US confirmed the presence of the lesion. In 26 patients digital exploration of the surgical field did not yield a definitively positive finding, whereas in 5 the lesion was easily palpable. Intraoperative US revealed the presence of pathologic tissue in all cases, with examination time ranging from 4 to 14 minutes (median 8 minutes). In all cases surgical resection was complete, with pathologic confirmation of the sample, and no necessity to extend ablation. CONCLUSION: Intraoperative US can be of significant help in the identification of DTC recurrences, in particular when lesion dimensions are smaller than 10 mm in diameter and can facilitate a more radical excision of the tumor in a surgical field were anatomical landmarks can be altered by previous surgery and/or radiometabolic therapy.
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Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/cirugía , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/cirugía , Adulto , Femenino , Humanos , Masculino , UltrasonografíaRESUMEN
As the prevalence of breast cancer has increased over recent years many cases with unusual presentation are emerging. This review attempts to identify different types of primary malignancies that can affect the breast. A five years review was undertaken at the Breast Unit of Azienda Ospedaliera "Santa Maria", Terni (Italy). All cases of breast malignancy admitted to the Breast Unit between 2001 and 2005 were reviewed: 750 patients were diagnosed with malignant breast disease. Primary breast lymphoma (was found only in two cases accounting for an incidence of 0,26%. The pre-operative diagnosis was infiltrating carcinoma in both cases and the patients were treated with surgery and systemic chemotherapy; currently they are disease- free.
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Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/cirugía , Linfoma de Células B/tratamiento farmacológico , Linfoma de Células B/cirugía , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/diagnóstico , Quimioterapia Adyuvante , Femenino , Humanos , Linfoma de Células B/diagnóstico , Mastectomía/métodos , Persona de Mediana Edad , Estadificación de Neoplasias , Resultado del TratamientoRESUMEN
INTRODUCTION: We carried out a retrospective analysis of our experience in the management of Differentiated Thyroid Carcinoma (DTC), in order to better define prognostic factors (age, gender, histological type, stage) and outline a standard procedure, where it's possible, for surgical treatment. PATIENTS AND METHODS: Patient population consisted of 432 cases, operated from 1978 to 2003. We carried out 285 operations of total thyroidectomy of which 39 associated to some kind of lymphadenectomy, 66 totalization (21 pts had been operated in other institutes), 60 subtotal thyroidectomies and 21 lobo-isthmectomies. Survival and mortality curves for age, sex, histological type, grading and staging have been calculated. Kaplan-Meyer statistical elaboration for disease-free interval and Mann-Whitney test for the comparison of different clinical and pathological data have been employed. RESULTS: The statistical analysis puts in evidence that on 432 cases examined, with a follow-up from 1 to 25 ys (median = 6.33 ys) and with a drop-out of 60 cases (13.8 %), total mortality for cancer has been of 24 cases (6,4%), with a median interval free by disease of 4.2 ys (range 5 months to 25 ys), and a probability to stay free by disease at 12 and 24 months respectively of 95.1% and 91.6%. The median survival is resulted of 5.8 ys (range 1 to 25 ys) with a probability of survival at 24 and 48 months respectively of 97.5% and 94.3%. The multivariate analysis evidences the most important variables, i.e. age > 45 ys, tumor of intermediate malignancy, with size 1.5 cm, operative M+, significantly condition the prognosis, noticeably getting worse it, independently by the kind of carried out operation. CONCLUSION: Our present therapeutic choices are: 1. total thyroidectomy in the treatment of the apparently benign pathology when bilaterally with spread; the checking at the final histological exam of a cancer makes however think adequate the carried out operation; 2. lobo-isthmectomy in the treatment of unilateral benign pathology or with suspect FNAB for follicular neoplasm; the histological checking of a cancer makes think the operation adequate only in presence of favourable prognostic parameters, but in presence even of just one unfavourable variable, we consider necessary the totalization; 3. total thyroidectomy in presence of a certain or strongly suspected preoperative diagnosis of cancer.
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Carcinoma Papilar Folicular/cirugía , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Adulto , Carcinoma Papilar Folicular/patología , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Neoplasias de la Tiroides/patología , Resultado del TratamientoRESUMEN
Extrauterine or external endometriosis (e.e.) describes ectopic localization of functional endometrial tissue, a finding whose incidence is increasing due to the diffusion of laparoscopic procedures. The clinical presentation of such disease is often non-specific, even in those cases with a definite surgical indication, depending on the site and pathology of the lesions. Surgical planning is therefore difficult at times, specifically regarding the extent of resection in patients--as young women--willing to maintain fertility. The Authors report on 7 cases observed in their own experience (inguinal endometriosis--1 case, umbilical endometriosis--1 case, abdominal wall endometriosis--3 cases, intestinal endometriosis--1 case, diaphragmatic endometriosis associated with pneumothorax--1 case), representing the wide range of clinical settings related to e.e. Based on literature data, an analysis of clinical and diagnostic issues is carried out. Specifically, the problems related to extent of surgical resection in multifocal cases, possible malignant degeneration and localization on abdominal wall scars are discussed.
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Endometriosis/diagnóstico , Endometriosis/cirugía , Neoplasias de los Genitales Femeninos/diagnóstico , Neoplasias de los Genitales Femeninos/patología , Adulto , Femenino , HumanosRESUMEN
The present study reports the results of surgical treatment of 175 consecutive chronic pilonidalis sinus cases by excision alone, excision and primary closure, excision and Dufourmentel's flap technique. The analysis of hospital stay , average recovery time, patient compliance and percentages of failures and recurrences enables us to state that Dufourmentel's technique is the best choice, allowing fast recovery with minimal discomfort and lower rate of recurrence. Moreover the good compliance of the technique and the use of recently introduced more effective local anaesthetics have allowed us to plan the treatment in a day-surgery setting with good clinical results.