Il Giornale di chirurgia
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Il Giornale di chirurgia · Jan 2007
[Surgical treatment of painful amputation neuromas with hyaluronic acid gel. Preliminary study of six patients].
Amputation neuroma is the consequence of a traumatic event that interrupt the anatomic structure of a nerve. After the lesion, the nerve begin an plerosis attempt. This condition determines hyposensitivity on its innervation area and a painful syndrome. ⋯ This operation reduces or eliminates axonal nerve's flux. The hyaluronic acid (Hyaloglide 0.8-1 ml) use is based on the necessity of proximal stump preservation from mechanical and thermic stimuli that are responsible of typical neuroma's symptoms. In this study we used hyaluronic acid on six painful amputation neuroma patterns on sensitive nerves of upper and lower extremities.
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Il Giornale di chirurgia · Oct 2006
Case ReportsPost-traumatic pseudoaneurysm of internal mammary artery: a case report.
Pseudoaneurysm of the internal mammary artery can be a rare complication of surgery, particularly post-sternotomy, or determined by a direct trauma, usually a stab wound. This report presents a pseudoaneurysm by a stab, diagnosed by chest computed tomography scan performed for hemothorax recurrence. The patient underwent left thoracotomy in third intercostal space; mammary vessels were identified above and below the pseudoaneurysm sac and tied. The postoperative course was uneventful.
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Il Giornale di chirurgia · Aug 2006
[Post-operative analgesia in thoracic surgery: physiopathological features, therapeutic framework and methodologies].
Pain after surgery is a major handicap for patients as it bounds and decreases ability for spontaneous movement, cough and deep breathing, aiding the onset of complications and invalidating the recovery capabilities of operated patients. In thoracic surgery, the need to compile and employ guidelines for post-surgical pain management has become a pressing requirement in recent years. Currently available protocols include several options of treatment that are frequently a subject in the most recent scientific papers and play a key role, as they constitute the framework upon which building with changes and fixes that take account of incidental circumstances, in relation to both patients and surgery, again for both the organizational and structural features of the surgical environment. Purpose of this job is a thorough analysis of post-operating analgesic treatments for thoracic surgery, introducing the most effective ones currently available as for channels and procedures of administration, as well as possible side effects or complications.
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Il Giornale di chirurgia · Jan 2006
Case ReportsTumor-induced hypophosphatemic osteomalacia associated with tertiary hyperparathyroidism: a case report.
Tumor-induced hypophosphatemic osteomalacia is a syndrome characterized by urinary phosphate wasting related to the presence of a slowly-growing tumor of mesenchymal origin. The characteristic laboratory findings are normal serum calcium, marked hypophosphatemia, increased serum alkaline phosphatase, markedly reduced renal tubular reabsorption of phosphorus and inappropriately low levels of 1,25-dihydroxyvitamin D [1,25-(OH)2D]. ⋯ Tumour-induced osteomalacia is a very rare syndrome associated in 5% of cases with tertiary hyperparathyroidism due to long-term therapy with phosphorus and vitamin D. The initial diagnosis of primary hyperparathyroidism, confirmed by the parathyroid MIBI-scintigraphy, would lead us to an inappropriate surgical treatment. Therefore we want to stress the importance of In111-octreotide scintigraphy in detecting tumours, rich in somatostatin receptors, in presence of an hypophosphatemic syndrome.
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The Authors conducted a study on 780 patients who underwent surgery. Fourteen patients developed operative table-induced pressure ulcers of different gravity. ⋯ Therefore, special attention should be paid to preoperative, intraoperative and postoperative prevention. The knowledge of the pathology, specialized personnel and the use of appropriate facilities can reduce the risks of complication that are important sanitary and economic issue.