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Introduction: Ultrasound (US)-guided fine needle aspiration (FNA) of percutaneous, transparietal endothoracic lesions, is a useful method in the diagnostic process for anatomopathological characterization. This sampling is a minimally invasive procedure, with a low complication rate and can be performed under loco-regional anesthesia Material and methods: We retrospectively studied (2009 to 2019) the utility of US guided transthoracic FNA in the diagnosis of suspected endothoracic lesions on 54 patients (34 men and 20 women), aged between 44 and 79 years, with pleural, pulmonary or mediastinal neoplasm viewable with an US examination. Results: The definitive diagnosis of malignant or benign neoplastic disease was obtained by the pathological examination of the material obtained through the US-guided FNA or by other procedures performed subsequently: biopsies/surgery and clinical information, associated with clinical follow-up. The accuracy of the US guided FNA was 94.4% (51/54) with a sensitivity of 93.8% (93.8) and specificity of 100% (5/5); multiple FNA were performed in 24% of cases (13/54). Conclusions: US-guided FNA is a procedure that can be performed in one day surgery and allows a significant reduction in healthcare costs and has a particularly high diagnostic accuracy with good patient compliance.

Introduction: Malignant pleural effusion (PE) is a rather frequent complication of several intrathoracic and extrathoracic tumors and has an incidence of about 660 patients per million inhabitants per year. Materials and methods: We retrospectively studied (2000 to 2018) the utility of US guided percutaneous puncture (PP) of PE, in the diagnosis/therapy of 121 patients (67 women and 54 men) with PE and suspected malignant neoplasm, mean age 52 years (39-78 years), Results: The diagnostic accuracy of the US guided PP fluid examination, (diagnoses of malignant PE), was 91.7% (111/121), with sensitivity of 89.5% (86/96) and specificity of 100%. (25/25). 10 patients did not have confirmation of malignant PE with US guided PP; the malignancy diagnosis was obtained by biopsy with other surgical procedure. Conclusions: The use of chest US has allowed us to reduce procedure time, hospital stay, with a significant reduction in healthcare costs, and to obtain a particularly high diagnostic accuracy with good patient compliance. We did not observe major complications during US guided PP; minor complications were found in 16.9% (14 cases) with the presence of mild chest pain.

Port-a-cath catheterization is often required for those patients who need long-term therapies (malnutrition, neoplasm, renal failure, other severe diseases). The use of ports for a wide range of indications is not exempt from complications. Ultrasound-guided central venous catheterization (CVC) is a safe and fast technique for the introduction of the catheter inside a central vein. This retrospective study reports our experience with US-guided CVC in patient eligible for port-a-cath implantation.From January 2007 to March 2017, 108 CVC (out of 770 procedures), were positioned using an ultrasound guide, with the new "one-shoot technique" (group 1) and the classic Seldinger technique (group 2).One-shoot techniques showed a reduced operative time, in comparison to Seldinger technique, with a negligible minor complication rate. No major complication were evidenced.CVC is a safe procedure, although not free from complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts and complications; it is helpful in patients with vascular anatomical variations, with no visualized or palpable landmarks or for patients with coagulation disorders.

Obiettivi. Con questa revisione della letteratura ci proponiamo di valutare quali sono i fattori che possono essere valutati nei pazienti da sottoporre a tiroidectomia ai fini di una migliore gestione preoperatoria e post-operatoria dell’ipoparatiroidismo transitorio e definitivo. Discussione. L’ipoparatiroidismo transitorio è una complicanza potenzialmente grave che include una vasta gamma di segni e sintomi che permane solo per poche settimane dopo l’intervento chirurgico. L’ipoparatiroidismo definitivo si verifica quando è necessario un trattamento medico per un periodo maggiore di 12 mesi. I fattori di rischio che ne possono influenzare l’insorgenza in seguito ad interventi di tiroidectomia sono molteplici: biochimici preoperatori e post opera- tori, il sesso femminile, la malattia di Graves e le malattie neoplastiche della tiroide, l’abilità del chirurgo e la tecnica chirurgica utilizzata. Il trattamento medico prevede la somministrazione di calcio, vitamina D e talvolta magnesio. Conclusioni: Anche se i fattori biologici e biochimici legati al paziente ricoprono una certa importanza nella correlazione con l’ipoparatiroidismo, riteniamo che i fattori causali più importanti sono da correlare alle variabili intraoperatorie come l’esperienza del chirurgo e la tecnica utilizzata che deve mirare alla visualizzazione e al rispetto in situ delle paratiroidi. Aims. This review evaluates those main risk factors that can affect patients undergoing thyroidectomy, to reach a better pre- and post-operative management of transient and permanent hypoparathyroidism. Discussion. The transient hypoparathyroidism is a potentially severe complication of thyroidectomy, including a wide range of signs and symptoms that persists for a few weeks. The definitive hypoparathyroidism occurs when a medical treatment is necessary over 12 months. Risk factors that may influence the onset of this condition after thyroidectomy include: pre- and post-operative biochemical factors, such as serum calcium levels, vitamin D blood concentrations and intact PTH. Other involved factors could be summarized as follow: female sex, Graves' or thyroid neoplastic diseases, surgeon's dexterity and surgical technique. The medical treatment includes the administration of calcium, vitamin D and magnesium sometimes. Conclusions. Although biological and biochemical factors could be related to iatrogenic hypoparathyroidism, the surgeon's experience and the used surgical technique still maintain a crucial role in the aetiology of this important complication.

This review evaluates those main risk factors that can affect patients undergoing thyroidectomy, to reach a better pre- and post-operative management of transient and permanent hypoparathyroidism.The transient hypoparathyroidism is a potentially severe complication of thyroidectomy, including a wide range of signs and symptoms that persists for a few weeks. The definitive hypoparathyroidism occurs when a medical treatment is necessary over 12 months. Risk factors that may influence the onset of this condition after thyroidectomy include: pre- and post-operative biochemical factors, such as serum calcium levels, vitamin D blood concentrations and intact PTH. Other involved factors could be summarized as follow: female sex, Graves' or thyroid neoplastic diseases, surgeon's dexterity and surgical technique. The medical treatment includes the administration of calcium, vitamin D and magnesium sometimes.Although biological and biochemical factors could be related to iatrogenic hypoparathyroidism, the surgeon's experience and the used surgical technique still maintain a crucial role in the aetiology of this important complication.

A 50 years-old man developed 24 hours after hemorrhoidectomy a severe Fournier's gangrene of the scrotum necessitating surgical exeresis of more than 2/3 of scrotal skin followed by hyperbaric oxygen therapy. After the resolution of the septic phase, scrotum reconstruction was obtained by tissue expansion to avoid more invasive advanced reconstructive techniques. The procedure consisted of an enzymatic and mechanical debridement and progressive skin expansion by package of gauzes of increasing volume covered with a collagenasecloramphenicol ointment (Iruxol®- Smith and Nephew, Italy), then closing the wound edges by temporary stitches to put under tension the skin. The reestablishment of the natural elasticity of the scrotal skin was obtained in ten days and at the final closure of the wound edges an acceptable optimal aesthetic result was achieved.

The aim of this study was to evaluate the effectiveness of the laparoscopic cholecystectomy performed in two uremic patients with gallstones. From January to July 2004, 15 patients with gallstones underwent to laparoscopic cholecystectomy (LC). Two patients had chronic renal failure on haemodyalisis: a symptomatic fourty-two old woman, which had primitive hyperparathyroidism and primitive hyperaldosteronism, and asymptomatic transplant candidate fifty-five old man. No minor and major complications occurred and both patients were discharged 4 days after LC. Even in uremic patients the L.C. must be the gold standard for the treatment of gallstones both symptomatic and asymptomatic.

BACKGROUND AND OBJECTIVES: Performing a central venous catheterization (CVC) on older patients for long-term central intravenous therapy could be a very important procedure. It could be associated with a high incidence of related complications, especially on over 65-year-old, high risk, selected patients. METHODS: The authors analyzed the results of 72 central venous CVC of internal jugular vein performed on over 65-year-old patients with ultrasound (US) guide from January 1998 to April 2003. RESULTS: The average performing time was 4 min, with 98.7% of success, 0% of major complications, and 4.1% of minor complications (one mild vagal hypotension and two catheter dislocation). CONCLUSIONS: The US guided technique is a safer procedure especially in older patients; it affords an easier and more rapid cannulation of a central vein, drastically reducing major and minor complications.

The authors analized the result of 175 central venous ca he- terization CVC. of internal jugular vein performed with the ultrasound guide (US) from January 1998 to October 2002. The average performing time was 45 minutes. 98.2% of success and 4% of complications (one pagal hypotension, one artery puncture, four catheter dislocation, one haeiuatoinai). The US guide CVC is a safe procedure with short performing time, low rate of failures and complications and high rate of success: it is helpful in all patients with vascular anatomical variations, with not visualized or Land marks and with coagulation disorders.

Puntura percutanea eco-guidata e puntura TC-guidata di neoformazioni endotoraciche Data: 2004 Dettaglio tipologia d'Ateneo: 3a - Articoli su riviste ISI (anche on line)

PURPOSE: To compare the effectiveness, safety and time needed to perform central venous catheterization (CVC) in the presence or absence of an ultrasound (US) guide. METHODS: Between January 1999 and February 2002 we performed CVCs in 196 patients: 105 patients received US guided CVC (group I) and 91 patients had CVC without US guide (group II). RESULTS: The average time to perform CVC was shorter with US guide (4 vs 7 min). The utilization of the US guide was also associated with improved success (98.09% vs 91.2%, p

After oral administration of [3H]cabergoline to man at a single nominal dose of 0.6 mg/subject radioactivity is mainly eliminated by the faecal route (72% of the dose after 10 days). Urine contains 18% of the dose after the same period. The unchanged drug and metabolites present in urine were identified by comparison with reference compounds and quantified by radio-TLC analysis. Cabergoline is extensively metabolized. Unchanged drug in 0-24 h urine represents less than 14% of urinary radioactivity, reaching 20% in 0-96 h urine. The acid derivative FCE 21589 is the main metabolite, amounting to 38% and 30% of the urinary radioactivity in 0-24 h and 0-96 h urine, respectively. The amide derivative FCE 21590 appears to be present in only a small amount, accounting for no more than 4% of the urinary radioactivity in the urine of the first 24 hours after administration and increasing to about 8% in the 0-96 h urine.