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Sourcerecord Id Scopus 40682 Abstract Aim. Endovenous laser treatment (EVLT) appears to be an useful alternative to conventional surgery in treatment of advanced varicose veins, in ambulatory regimen too. Methods. Over a 1-year period, otherwise unselected consecutive series of 52 GSVs in 40 patients (36 females, 4 males; age 39 to 63 yrs.) with varicose veins due to GSV incompetence (up to 1,2 cm in diameter at the saphenofemoral junction) were included. After selective spinal anaesthesia, laser energy (diode laser 980 nm) was administered endovenously. A laser fiber (δ 600 μ; length 2 m) was inserted from malleolus to sapheno-femoral junction. Laser energy (12-15 J/sec. - 40-80 J/cm 2) was administered either continuously, during constant backpull of the laser fibre, or in a pulsed fashion (on time 1-2 sec.; off time 1 sec.; withdrawing the fibre 1 cm every 1 sec.). Results. Absence of flow on colour Doppler imaging was considered sign of successful occlusion of the GSV. Patients were evaluated clinically and with duplex US at 1 week, 1 month, six months, and 1 year. Successful occlusion of the GSV was noted in 44/52 GSVs (84,6%) after initial treatment. Twenty four of thirty limbs, followed for six months, remained closed (80,0%), and, among these, no recurrence was detected in limbs (20) followed-up at 1 year. Conclusion. Clinical efficacy of EVLT seems to be demonstrated by early, mid and long-term results, from many groups, comparable or superior to those reported for the other treatments of GSV reflux, including surgery.

Sourcerecord Id Scopus 21766

Sourcerecord Id Scopus 21766

Sourcerecord Id Scopus 25299 http://www.joplink.net/prev/200709/58.html Context More minimally invasive techniques are currently available for the surgical oncologist in the optimal staging of biliopancreatic cancer. Age is not a limitation for oncological surgery; tumor stage and co-morbidity define the surgical treatment. The increased age of population is accompanied by an increase of age-related diseases, such a cardiovascular disease, hypertension, arthritis and other malignancies. With the development of endoscopy, laparoscopy, ultrasonography and biopsy equipment, more minimally invasive techniques are currently available for the surgical oncologist to provide a better optimal diagnosis and staging strategy, followed by an appropriate surgical treatment of biliopancreatic cancer. Objective Improvement in the diagnostic and surgical care of elderly cancer patients will have a final impact on disease and overall survival rates of the different types of cancer treatment. Methods We retrospectively reviewed the records of patients between January 2001 and December 2006 who had either a mass in the biliopancreatic area classified as clinically resectable. Tumors were considered to be resectable when there was no evidence of distant extra pancreatic disease or involvement of lymphnodes outside the classics margins of resections. Occlusion or encasement of the superior mesenteric artery or vein, celiac artery or portal vein were used as a criteria for unresectability. Twenty-one patients over 65 and under 75 years (middle age 69) with primary biliopancreatic cancer were submitted to operations for potentially operative resection. In all cases staging laparoscopy was performed just prior to planned open exploration and resection. Results Fifteen patients underwent exploratory celiotomy for potential resection. Two of five patients (40%) with distal cholangiocarcinoma survived at 5 years. Six patients (28.6%) had unresectable disease identified at laparoscopy and were spared an unnecessary laparotomy. Conclusions Laparoscopy may have a role in the staging of patients with biliopancreatic malignancies. Staging laparoscopy should be performed to identify patients with metastasis in whom short term endoscopic palliation is satisfactory. Also in elderly pancreaticoduodenectomy for pancreatic and biliary has been associated with the falling post-operative morbidity and mortality rates and long term survival.

This study was conducted to obtain more detailed histopathological data on the application of EVLT in patients with an incompetent GSV. In ten surgical procedures, at the end of EVLT, a segment of terminal tract of the GSV (2-4 cm length) was collected in order to be microscopically analysed. Histopathological data were developed to clarify the injury of EVLT on the inner vessel wall, in order to improve clinical treatment efficacy and safety.

Sourcerecord Id Scopus 21893

Sourcerecord Id Scopus 2375 Endovenous laser treatment for great saphenous vein appears to be an useful alternative to conventional surgery in treatment of advanced varicose veins, in ambulatory regimen too. A recurring problem in laser applications is estimating the thermal response of target tissues to laser irradiation. This typically involves using an optical model to determine the distribution of absorbed laser energy and then using a thermal model to establish the temperature during and after laser irradiation. In the present work we have calculated the power irradiation of the walls of vessel, hypothesising a diameter of the vein cm 0.8-1.5, a length cm 70-90 and haematic flow equal zero. We used Lambert-Beer law, assuming a cylindrical symmetry in the incoming intensity irradiation (I-o), as in the case in the TEM00 mode. Omitting details we calculated a power irradiation, depending on the vein diameter, of 10-20 watt using diode laser 980 nm. This study offers high importance data in order to foresee the effective transfer of thermal damage to the vein wall through absorption of laser energy.http://apps.webofknowledge.com/full_record.do?product=UA&search_mode=GeneralSearch&qid=1&SID=Q1i@gpCm9b3mdEmO@n6&page=2&doc=14

8 citazioni su Scopus. 12 citazioni su GoogleScholar (4 citazioni ulteriori su riviste afro-asiatiche: patologia esotica) http://www.ncbi.nlm.nih.gov/pubmed/15305685 http://www.scopus.com/record/display.url?eid=2-s2.0-4844224277&origin=resultslist&sort=plf-f&src=s&sid=oNVoDQG_UHipYnJz9G131SP%3a420&sot=aut&sdt=a&sl=37&s=AU-ID%28%22Benassai%2c+Giacomo%22+6602920646%29&relpos=4&relpos=4&searchTerm=AU-ID(\"Benassai, Giacomo\" 6602920646) http://scholar.google.it/scholar?cites=10600420553796798074&as_sdt=2005&sciodt=0,5&hl=it Echinococcosis in humans is a zoonotic infection caused by larval stages of cestode species of the Echinococcus genus. In cystic echinococcosis (CE), caused by Echinococcus granulosus, the liver is the first and the more frequent involved organ, followed by the lung. Heart, spleen, kidney and brain are usually less involved. The finding of a cyst in course of echinococcosis is usually fortuitous, during ultrasound examination, X-ray or CT. The Authors report 4 cases of human CE admitted to the Department of Infectious Diseases University of Naples "Federico II". Each case is peculiar both for the organ involved by the cysts and for the symptomatolgy. The abdominal pain, in case 1 caused by gallstones, allowed, by the ultrasound examination, to find several hydatid cysts in the liver, never symptomatic until then. The woman, in case 2, was operated for cysts in the lung, without receiving pharmacological prophylaxis. The same occurred in case 4, in which the lack of prophylaxis caused very serious relapses. In case 3, the young woman underwent an ultrasound examination because of an abdominal pain. A unique large cyst extended only in the spleen. The specific serology for immunoglobulin anti-E. granulosus resulted positive 1:61 (n.v. < 50). The Albendazole therapy caused the disappareance of pain, quickly. Later, the patient was splenectomized. It's not clear why only the spleen was involved and why the anti-E. granulosus serum levels of were increased only a little. The man, in case 4, was admitted with chest pain and electrocardiographic findings of myocardial anterior ischemia. He underwent surgical treatment of three hepatic cysts by E. granulosus, during the previous year. Two-dimensional echocardiography, transesophageal echocardiography, and cardiac magnetic resonance revealed a round cystic mass, 6 x 6 mm, located in the middle interventricular septum. The cardiac isoenzymes were in the normal ranges, but the anti-E. granulosus immunoglobulins were positive 1:5120 (n.v. < 64). The patient was treated with Albendazole. This caused the almost simultaneous disappearance of the circular cystic and clinical and electrocardiographic findings of myocardial ischemia. A cardiac hydatid cyst is an uncommon lesion, occurring in about 0.4-2% of patients with echinococcosis. In conclusion, Cystic echinococcosis is a problem in Mediterranean regions because of the high population of stray dogs, favourable conditions created by man and, above all, the illegal slaughtering.

Background: Severe obesity is a risk factor for venous thromboembolism. The aim of the study is to establish the right dosology of parnaparin, a LMWH, which gives the highest prophylaxis efficacy compared with the lowest hemorrhagic risk and to confirm the LMWH efficacy. Methods: These preliminary data concern 10 patients with BMI >50 kg/m2. We made a clinical evaluation, researching thrombophilic markers, and an instrumental evaluation, with venous echocolordoppler and scintigram of lower limbs and of ilio-caval axis before surgery and after 7 days, and perfusional lung scintigram before surgery and after 9 days. We gave a parnaparin dose of 3,200 I.U. (0.3 ml) in the first day, a dose of 4,250 I.U. (0.4 ml) for 2 days, and a dose of 6,400 I.U. (0.6 ml) for the other two preoperative days and during hospitalization. Parnaparin was given at 8.00 a.m. every day, assaying the level of Xa and IIa factors in the blood, Xa/IIa ratio, in order to verify and to confirm the possibility of an equal efficacy with lower doses. After discharge, we used a dose of 6,400 I.U. (0.6 ml), prolonged for 30 days at home. Results: We found no hemorrhagic events. Only one patient, who interrupted the parnaparin treatment because of allergy at 5th day, had a pulmonary embolism on the 30th day. In the remaining 9 patients there were neither clinical nor instrumental thromboembolic events. Conclusions: According to these preliminary data, parnaparin proved to be a very safe and efficacious drug for thromboembolic venous prophylaxis in super-obese patients undergoing bariatric surgery.

Sourcerecord id Scopus: 23949

Sourcerecord Id Scopus 21766

Sourcerecord Id Scopus 21766

Sourcerecord Id Scopus 21766

Sourcerecord Id Scopus 21766

Sourcerecord Id Scopus 20482

Sourcerecord Id Scopus 20482