Anterior tension-free and laparoscopic inguinal herniorrhaphies represent one of the most common surgical procedure. Postherniorrhaphy persistent pain due to injures of inguinal regional nerves is ...rare, difficult to cure, often disabling and involving malpractice litigation. In a prospective study, we evaluated the effectiveness of neurectomy of the iliohypogastric nerve in prevention of postoperative persistent pain after anterior tension free herniorrhaphy. Between 1992-1995, we performed 180 anterior herniorraphies in 151 male patients. Iliohypogastric nerve was removed in all the herniorrhaphies. Polypropylene plug and sutured mesh were employed. Postoperative pain and clinical relevance of hypo-anesthesia and paresthesia were assessed. No patient complained of postoperative persistent pain. Hypo-anesthesia, never considered incapacitating, was present in 1% of patients after 2 years. We consider neurectomy of the iliohypogastric nerve a potentially useful surgical step in preventing postoperative persistent pain after anterior tension-free herniorrhaphy.
In consideration of findings reported in the literature and of our study, we examined the correlation between antioxidants (beta-carotene, vitamin C, vitamin E) and colorectal carcinogenesis. ...Although diagnostic progress has been made in the last decades, no significant improvements in death rates have been achieved in the western world. Exogenous factors might be responsible for a complex alteration process of might be responsible for a complex alteration process of normal colonic mucosa into adenoma and carcinoma. Free radicals and reactive oxygen metabolites, due to increased production or to reduced inactivation, following a decrease in the antioxidant burden in the mucosa, might cause damage to DNA, thereby resulting in genetic alterations. This might represent the cause of the transformation process: normal mucosa --> adenoma --> carcinoma. In a prospective study, we observed a reduction of beta-carotene levels in normal colonic mucosa in patients with polyps and colorectal cancer. We also showed that beta-carotene supplementation raises levels of this micronutrient in the colonic mucosa of these patients. Findings from the literature and our trials show a significant decrease in the antioxidant capacity of colorectal mucosa in patients affected by colorectal cancer, although there is a significant interindividual variability. Such results suggest a possible chemopreventive role of antioxidant agents in colorectal cancer.
Bicarbonate-calcic water Ferrarelle has been administered both in the fasting state and during meals to patients suffering from gastro-esophageal reflux disease submitted to computerized pHmetry. ...Marked and lasting increase of esophageal and gastric pH was observed with significant differences from the effect of tap water. In addition, patients reported improvement of heart burn and acidity after the administration of the bicarbonate-calcic water. The alkalizing effect of the mineral water employed is therefore fully confirmed.
The authors report 47 cases of substernal goiters operated between 1971 and 1990. Forty-five patients had mediastinal-cervical-goiters (g.c.m.) and 2 had ectopic goiter (g.e.). Cervicotomy was ...performed in the 45 g.c.m., in 3 cases associated with sternal "split". The g.e. were treated with thoracotomy. Computed Tomography (TC) has been performed since 1984 in 26 patients; Magnetic Resonance (RM) since 1987 in 6 patients. The diagnostic accuracy for TC was 84.6% and 100% for MR on anatomical-topographic-definition, and 80.8% and 83.3% for presumptive diagnosis of nature, respectively. Considering the high diagnostic accuracy, the possibility to reconstruct the images in sagittal and coronal planes, the RM seems to be the elective diagnostic procedure for all substernal goiters.
