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In this report the authors outline the main historical aspects of haemorrhoids after a thorough review of the literature. The first texts concerning haemorrhoids are the ancient Egyptian papyruses. The twenty centuries of the history of haemorrhoids are marked by multiple pathogenetic theories, and of these the vascular and the sliding of the anal mucosa are still valid. From an analysis of the historical texts and the most recent publications, we deduce that the principles of therapy are substantially unchanged since the days of Hippocrates. In conclusion, we can say that, as in ancient times, the therapy of haemorrhoids is based on three fundamental approaches: surgical treatment, ambulatorial non-surgical treatment and medical treatment.

The sentinel node is the first lymph node reached by metastasising cells from a primary tumour. Numerous studies have confirmed and demonstrated the reliability of the sentinel node biopsy hypothesis, on account of the high identification rate and overall accuracy of dye-guided and radio-guided procedures. It is remarkable that the concept of lymphatic mapping was not introduced until the end of the twentieth century. The development of the dynamic technique of intraoperative lymphatic mapping in the 1990s resulted in general acceptance of the sentinel node theory. The current literature suggests that sentinel node biopsy may eventually replace axillary dissection as the nodal staging procedure of choice in early breast cancer. This report describes the history and validation of the sentinel node biopsy technique, with particular reference to breast cancer.

Since it was introduced in the 1990s, axillary sentinel lymph-node biopsy has been rapidly and widely adopted to avoid complete axillary dissection (though this is still the standard procedure). The aims of the study were two-fold: (i) to determine the value of different techniques of sentinel lymph-node identification and (ii) to verify the predictive value of such procedures through histological examination of the sentinel lymph node and axillary dissection in the same patients. Both sentinel lymph-node biopsy and axillary dissection were performed in 230 patients with T1 and T2 (< 3 cm) carcinoma of the breast. Preoperative lymphoscintigraphy was able to identify the sentinel lymph node in 97.4% of cases, but, with an intraoperative hand-held probe, it was possible to find the sentinel lymph node in 98.2% of cases (226/230 patients). The sentinel lymph node was metastatic in 49.1% of cases (111/226 patients) and negative in 50.9% (115/226). The incidence of false-negative cases was 2.6% (2/115 patients). The predictive value of the sentinel lymph node was 98.7%. Finally, lymph-mode mapping is possible is a very high percentage of patients and therefore it is always advisable to use all three methods of identification together. The diagnostic reliability of sentinel lymph-node status is equally high. At present there no studies are available with a long-term follow-up to confirm these findings, and therefore axillary dissection is still the standard surgical treatment for breast cancer.

24-hour oesophageal pH monitoring with a dual pH probe is considered to be the most sensitive test for diagnosing GORD-related otolaryngological manifestations. In this study we evaluate an initial diagnostic approach with digital videofluorography associated to the water siphon test and primary "ex juvantibus" therapy with proton pump inhibitors for patients with supra-oesophageal symptoms of GORD. The results of Nissen fundoplication surgical treatment are also assessed in some of these patients. Two hundred and thirty patients with suspected GORD-related supra-oesophageal symptoms were referred for videofluorography and the water siphon test. When hiatal hernia and/or reflux were found, patients were referred for medical therapy with proton pump inhibitors. Five patients, who had had a good or excellent response to the medical therapy, but had a recurrence underwent laparoscopic Nissen fundoplication and videofluorography 6 months after surgery. Within 6 months, more than 80% of patients had an excellent or good response to medical therapy. In patients undergoing laparoscopic Nissen fundoplication, hoarseness and chronic cough disappeared within 3 months and videofluorography showed good morphofunctional results of the surgery. In patients with GORD-related supra-oesophageal manifestations, videofluorography plus the water siphon test is useful initial investigation, and laparoscopic Nissen fundoplication can be a valid alternative therapeutic option.