22 results on '"V Baraldini"'
Search Results
2. Laparoscopic Technique for Permanent Nonrefluxing Gastrostomy: Experimental Study in Pigs
- Author
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V. Baraldini, G.L. Monguzzi, R. Rossi, F. Addis, Luigi Pansini, E. Leva, G. Vanosi, Vincenzo Rossi, and Andrea Pansini
- Subjects
Mechanical ventilation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Stomach ,Gastrostomy ,Curvatures of the stomach ,Surgery ,medicine.anatomical_structure ,Orogastric tube ,Anesthesia ,Pediatrics, Perinatology and Child Health ,medicine ,Tube (fluid conveyance) ,Gastric antrum ,business ,Saline - Abstract
Purpose: This experimental study tested a modification of the Janeway technique for creation of permanent nonrefluxing gastrostomy performed laparoscopically in pigs. Materials and Methods: Six pigs (Large White-Landrace, mean weight 20 kg) were operated on under general anesthesia. The animals were kept under mechanical ventilation with oxygen and halothane by orotracheal intubation, and their vital functions were monitored continuously. A vascularized isoperistaltic tube was prepared with a flap from the gastric wall at the greater curvature, and a full-thickness tunnel was created on its extension toward the gastric antrum using automatic linear stapling devices (Endo-GIA and Endo-TA). The tunnel provides a unidirectional valvular mechanism at the proximal end of the gastric tube. Patency of the gastrostomy was proved by passing a Nelaton tube through it and draining the gastric contents. Continence was tested by filling the stomach with 5 L of saline through an orogastric tube while measuring intragas...
- Published
- 2001
3. Evidence-based operations in paediatric surgery
- Author
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V. Baraldini, Agostino Pierro, and Lewis Spitz
- Subjects
Pediatrics ,medicine.medical_specialty ,Evidence-Based Medicine ,Evidence-based practice ,Randomization ,Referral ,business.industry ,MEDLINE ,Retrospective cohort study ,General Medicine ,Evidence-based medicine ,Scientific evidence ,Surgical Procedures, Operative ,Pediatrics, Perinatology and Child Health ,Pediatric surgery ,medicine ,Humans ,Surgery ,Child ,business ,Randomized Controlled Trials as Topic ,Retrospective Studies - Abstract
It has been assumed that only 10% of medical interventions are supported by solid scientific evidence. The aim of this study was to determine the type of research evidence supporting operations in a tertiary referral paediatric surgical unit. All patients admitted over a 4-week period to two surgical firms were enrolled in the study. All major operations carried out on each patient since birth were evaluated. Patients for whom a diagnosis was not reached were excluded. A bibliographic database (MEDLINE) was used to search for the articles published between January 1986 and December 1995 on the analysed operations. The type of evidence supporting the operations was classified as follows: I=evidence from randomised controlled trials (RCTs); II=self-evident intervention (obvious effectiveness not requiring RCTs); III=evidence from prospective and/or comparative studies; IV=evidence from follow-up studies and/or retrospective case series; and V=intervention without substantial evidence for or against results of randomised trials. Seventy operations (32 individual types) were performed on 49 patients (1-5 operations/patient); 18 (26%) were supported by RCTs (type of evidence I). Two patients (3%) received a self-evident intervention (type II); 48 operations (68%) were based on non-randomised prospective or retrospective studies (type III=13%; type IV=55%). Two patients (3%) received an operation not supported by or against convincing scientific evidence (type V). A significant proportion of operations in paediatric surgery is supported by RCTs. However, the vast majority of these trials were conducted on adult patients. Sixty-eight per cent of the operations were based on prospective follow-up studies or retrospective case series, which may not represent solid scientific evidence. More RCTs are needed in paediatric surgery.
- Published
- 1998
4. IN VIVO EVALUATION OF TIMING, DEGREE, AND DISTRIBUTION OF BACTERIAL TRANSLOCATION FOLLOWING EXPERIMENTAL SMALL BOWEL TRANSPLANTATION
- Author
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Marco Braga, F. Mangili, Luca Gianotti, V Baraldini, Carlo Socci, Massimo Locatelli, C. Bergamo, P Magnani, V. Di Carlo, Gianotti, L, Bergamo, C, Braga, Marco, Socci, C, Baraldini, V, Magnani, P, Mangili, F, Locatelli, M, Dicarlo, V., Braga, M, and Di Carlo, V
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Time Factors ,Time Factor ,Isograft ,Escherichia coli Infection ,Chromosomal translocation ,Biology ,Gastroenterology ,Permeability ,Lactulose ,Postoperative Complications ,Indium Radioisotope ,In vivo ,Internal medicine ,Intestine, Small ,Escherichia coli ,Organometallic Compounds ,medicine ,Animals ,Mannitol ,Lung ,Escherichia coli Infections ,Organometallic Compound ,Transplantation ,Intestinal permeability ,Animal ,Graft Survival ,Indium Radioisotopes ,Oxyquinoline ,medicine.disease ,Small intestine ,Rats ,Transplantation, Isogeneic ,medicine.anatomical_structure ,Liver ,Rats, Inbred Lew ,Rat ,Postoperative Complication ,medicine.drug - Abstract
These studies were designed to evaluate the correlation between morphologic and functional changes after heterotopic auxiliary small bowel isograft with systemic venous drainage and two ostomies in 20 Lewis rats. Morphologic damage of the graft was scored by full-thickness biopsies before surgery and 1, 3, 5, and 7 days after transplant. Functional evaluation of the graft was done, at the same time points, by urinary excretion of lactulose and mannitol injected in the proximal ostomy. The intestinal permeability was also studied by injecting Escherichia coli labeled with indium-111 oxine in the proximal ostomy. Translocation of radiolabeled bacteria was quantitated in extraintestinal tissues by radionuclide counts and number of viable organisms and in vivo by scintigraphic imaging. One day after transplant, significant graft damage (score 17.2 +/- 4.2) was observed when compared with the pretransplant value (7.3 +/- 2.6). The degree of tissue injury was similar on days 3 (15.8 +/- 3.5) and 5 (16.1 +/- 3.9) after transplant and remained high on day 7 (11.8 +/- 2.8). The lactulose to mannitol ratio showed a significantly increased permeability on day 1 (17.5) versus pretransplant values (2.6), remained high on day 3 (8.6), and returned to normal values on day 5 (2.8). Translocation of bacteria to distant organs, as measured by both radionuclide counts and number of viable organisms, was strikingly enhanced on day 1 after transplantation, compared with control animals, but returned to the pretransplant value on day 3. A good qualitative and quantitative correlation was observed between radionuclide counts in the extraintestinal organs and in vivo images obtained by scintigraphic scanning. In conclusion, in this model, timing and degree of bacterial translocation do not seem to correlate well, with the exception of the acute post-transplantation phase, with morphologic and permeability changes of the graft. Evaluation of translocation by scintigraphic imaging appears a suitable approach to study in vivo the kinetics and distribution of this process.
- Published
- 1995
5. [Correction of venous hypertension in venous dysplasias]
- Author
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G, Vercellio, V, Baraldini, L, Cipolat, and M, Coletti
- Subjects
Adult ,Klippel-Trenaunay-Weber Syndrome ,Leg ,Adolescent ,Infant ,Blood Pressure ,Angiodysplasia ,Veins ,Arteriovenous Malformations ,Varicose Veins ,Venous Insufficiency ,Child, Preschool ,Practice Guidelines as Topic ,Sclerotherapy ,Humans ,Child ,Retrospective Studies - Published
- 2003
6. First steps of a new team in small bowel transplantation in rats
- Author
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C, Bergamo, V, Baraldini, L, Gianotti, C, Socci, M, Braga, and V, DiCarlo
- Subjects
Death ,Microsurgery ,Transplantation, Isogeneic ,Education, Continuing ,Transplantation, Heterotopic ,Rats, Inbred Lew ,Intestine, Small ,Animals ,Rats - Published
- 1994
7. Laparoscopic Technique for Permanent Nonrefluxing Gastrostomy: Experimental Study in Pigs.
- Author
-
G.L. Monguzzi, V. Baraldini, V. Rossi, E. Leva, A. Pansini, G. Vanosi, F. Addis, L. Pansini, and R. Rossi
- Abstract
Purpose: This experimental study tested a modification of the Janeway technique for creation of permanent nonrefluxing gastrostomy performed laparoscopically in pigs.Materials and Methods: Six pigs (Large White-Landrace, mean weight 20 kg) were operated on under general anesthesia. The animals were kept under mechanical ventilation with oxygen and halothane by orotracheal intubation, and their vital functions were monitored continuously. A vascularized isoperistaltic tube was prepared with a flap from the gastric wall at the greater curvature, and a full-thickness tunnel was created on its extension toward the gastric antrum using automatic linear stapling devices (Endo-GIA and Endo-TA). The tunnel provides a unidirectional valvular mechanism at the proximal end of the gastric tube. Patency of the gastrostomy was proved by passing a Nélaton tube through it and draining the gastric contents. Continence was tested by filling the stomach with 5 L of saline through an orogastric tube while measuring intragastric pressure up to values >40 cm H2O. All the animals were sacrificed at the end of the operation, the stomach was removed, and the gastrostomy was examined grossly.Results: All the operations were entirely performed laparoscopically with an average operative time of 45 minutes. All the gastrostomies were patent and continent. No major intraoperative complications occurred.Conclusion: This modification of the Janeway operation for permanent nonrefluxing gastrostomy is feasible with a laparoscopic technique. The gastrostomy is effective in providing continence, as demonstrated by the gastric filling test. [ABSTRACT FROM AUTHOR]
- Published
- 2001
- Full Text
- View/download PDF
8. Venous malformations in children: comparison between magnetic resonance imaging and histopathological findings.
- Author
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Tofanelli L, Napolitano M, Baraldini V, and Moneghini L
- Subjects
- Humans, Child, Male, Female, Child, Preschool, Infant, Adolescent, Retrospective Studies, Reproducibility of Results, Veins diagnostic imaging, Veins abnormalities, Veins pathology, Contrast Media, Sensitivity and Specificity, Observer Variation, Vascular Malformations diagnostic imaging, Magnetic Resonance Imaging methods
- Abstract
Background: Among low-flow vascular malformations, venous malformations are relatively frequent. The pathological patterns vary in severity and are generally characterized by dilated vessels and low-flow blood that over time can organize into phleboliths. Sometimes small capillary and/or lymphatic vessels may be associated, micro- and/or macro-shunts may form alone or in different combinations, and finally adipose tissue may be interposed between the malformed vessels. Magnetic resonance imaging (MRI) is a crucial examination for confirming venous malformations because it can accurately identify different features of the lesions., Objective: The aim of our study was to compare MRI and histopathological findings of venous malformations in children to assess the possibilities and limitations of MRI., Materials and Methods: In a retrospective study, two observers independently evaluated the contrast-enhanced MRI of 26 children with venous malformations. Several radiological parameters were considered and compared with histopathological findings. The agreement between the interobserver radiological evaluation and between histopathological and radiological diagnosis was verified using Cohen's kappa., Results: MRI interobserver agreement was excellent for micro-shunts and good for the remaining findings. The radiological-pathological agreement was perfect for the presence/absence of phleboliths and of macro-shunts and almost perfect for the presence of intralesional adipose tissue, lymphatic component, and micro-shunts., Conclusion: MRI in venous malformations can detect the presence of phleboliths, adipose tissue, and lymphatic components with excellent accuracy and good to excellent interobserver agreement. Furthermore, MR angiography can detect micro-shunts in simple and combined venous malformations with substantial agreement with histopathological findings., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2024
- Full Text
- View/download PDF
9. Giant congenital fibroblastic connective tissue nevus associated with vascular anomalies.
- Author
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Thanasi H, Fabiano A, Baraldini V, Cattaneo E, Spaccini L, Napolitano M, Collini P, and Moneghini L
- Subjects
- Humans, Vascular Malformations pathology, Male, Female, Infant, Newborn, Infant, Skin Neoplasms pathology, Nevus pathology
- Abstract
We described an unusual combination of fibroblastic connective nevus (FCTN) already present at birth with underlying vascular anomalies. Overall, the lesion appeared as a large purplish-brown mass in the groin region up to the third of the right thigh, with partial spontaneous regression during the first three months of life. The FCTN observed exhibited several unusual characteristics: it was congenital, large in size, and located in the lower limbs. Finally, it represented the first case described in which an FCTN arose in association with vascular anomalies., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
10. Guidelines for Vascular Anomalies by the Italian Society for the study of Vascular Anomalies (SISAV).
- Author
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Stillo F, Mattassi R, Diociaiuti A, Neri I, Baraldini V, Dalmonte P, Amato B, Ametrano O, Amico G, Bianchini G, Campisi C, Cattaneo E, Causin F, Cavalli R, Colletti G, Corbeddu M, Coppo P, DE Fiores A, DI Giuseppe P, El Hachem M, Esposito F, Fulcheri E, Gandolfo C, Grussu F, Guglielmo A, Leuzzi M, Manunza F, Moneghini L, Monzani N, Nicodemi E, Occella C, Orso M, Pagella F, Paolantonio G, Pasetti F, Rollo M, Ruggiero F, Santecchia L, Spaccini L, Taurino M, Vaghi M, Vercellio G, Zama M, Zocca A, Aguglia M, Castronovo EL, DE Lorenzi E, Fontana E, Gusson E, Lanza J, Lizzio R, Mancardi MM, and Rosina E
- Subjects
- Humans, Italy, Vascular Diseases, Vascular Malformations diagnosis, Vascular Malformations therapy
- Published
- 2022
- Full Text
- View/download PDF
11. Cerebellar dysplasia related to PIK3CA mutation: a three-case series.
- Author
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Di Stasi M, Izzo G, Cattaneo E, Baraldini V, Doneda C, Righini A, Graziani D, Toto V, and Parazzini C
- Subjects
- Female, Humans, Magnetic Resonance Imaging methods, Male, Phenotype, Class I Phosphatidylinositol 3-Kinases genetics, Megalencephaly genetics, Mutation genetics, Nervous System Malformations genetics
- Abstract
The term PROS (PIK3CA-Related Overgrowth Spectrum) indicates a wide spectrum of overgrowth disorders related to somatic mutations in PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) pathway. We present three cases with PIK3CA mutation and clinical characteristics encompassing MCAP (megalencephaly-capillary malformation) condition but lacking all criteria to a certain diagnosis, most of all showing prevalent and peculiar involvement of cerebellar structures at MRI (magnetic resonance imaging) mainly consisting in cortical rim thickening and abnormal orientation of folia axis. These cases expand the spectrum of intracranial MRI features in PIK3CA disorders.
- Published
- 2021
- Full Text
- View/download PDF
12. CD10 and CD34 as markers in vascular malformations with PIK3CA and TEK mutations.
- Author
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Moneghini L, Tosi D, Graziani D, Caretti A, Colletti G, Baraldini V, Cattaneo E, Spaccini L, Zocca A, and Bulfamante GP
- Subjects
- Adolescent, Adult, Biomarkers analysis, Child, Child, Preschool, DNA Mutational Analysis, Endothelial Cells pathology, Female, Genetic Predisposition to Disease, Humans, Immunohistochemistry, Infant, Male, Phenotype, Vascular Malformations pathology, Young Adult, Antigens, CD34 analysis, Class I Phosphatidylinositol 3-Kinases genetics, Endothelial Cells chemistry, Mutation, Neprilysin analysis, Receptor, TIE-2 genetics, Vascular Malformations genetics, Vascular Malformations metabolism
- Abstract
Aims: Vascular malformations (vMs) encompass a wide range of diseases often associated with somatic or, more rarely, germinal genetic mutations. A mutation in the PIK3Ca/mTOR pathway is more often involved in various vMs. CD10 and CD34 are cellular markers that may play a role in mesenchymal differentiation and proliferation. The aim of our study was to find a possible link between the immunohistochemical expression of CD10 and CD34 in vMs and their relationship with mutations in the PIK3CA/mTOR signaling pathway., Methods and Results: Our study on 58 samples of vMs showed that in endothelial cells, CD10 was significantly expressed in PIK3CA-mutated samples compared with samples without any mutation (p < 0.05), especially and even more consistently when compared with samples with mutation in other pathways (p < 0.0001). Conversely, in the same PIK3CA-mutated samples, CD34 expression in endothelial cells was significantly reduced compared with samples either without any mutation or mutations in other pathways (p < 0.05 and p < 0.0005). Compared with samples with mutations in other pathways, a significant overexpression of endothelial CD10 was also found in samples with TEK/TIE2 mutation, a gene linked to the PIK3CA/mTOR pathway (p < 0.01). However, CD34 expression was not altered. In samples with PIK3CA mutation, the CD10 expression was significantly increased in the stroma compared with samples with TEK/TIE2 gene or other gene mutations (p < 0.05)., Conclusion: Therefore, the CD10 and CD34 immunohistochemical profile could suggest/support the presence of mutations in the PIK3CA/mTOR pathway in samples of vMs., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
13. Head and neck vascular anomalies. A multidisciplinary approach and diagnostic criteria.
- Author
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Moneghini L, Sangiorgio V, Tosi D, Colletti G, Melchiorre F, Baraldini V, Graziani D, Alfano RM, Vercellio G, and Bulfamante G
- Subjects
- Hemangioma, Humans, Neck blood supply, Neck pathology, Vascular Malformations, Vascular Neoplasms
- Abstract
Vascular anomalies represent a heterogeneous group of pathologies of the circulatory system that can affect any type of hematic and /or lymphatic vessel of different diameter or anatomic site. The extreme variability of tissue types and districts involved by these lesions determines a wide heterogeneity of clinical manifestations, resulting in involvement of different medical expertise. In this context, a commonly agreed terminology is crucial for the appropriate evaluation and multidisciplinary management of patients. The ISSVA Classification that has its roots in the previous Classification of Mulliken and Glowacky distinguishes vascular anomalies in two main groups: vascular tumors and vascular malformations. In head and neck, where vascular anomalies are the most common benign lesions of infancy and childhood, correct diagnosis with the use of unequivocal terminology is more crucial for treatment considering the relevance of structures that can be involved. The aim of this work has been to clarify information and knowledges currently available in the field of vascular anomalies. Referring to ISSVA Classification, clinico- histopathological aspects of each entity have been elucidated., (© Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.)
- Published
- 2017
14. ISVI-IUA consensus document diagnostic guidelines of vascular anomalies: vascular malformations and hemangiomas.
- Author
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Lee BB, Antignani PL, Baraldini V, Baumgartner I, Berlien P, Blei F, Carrafiello GP, Grantzow R, Ianniello A, Laredo J, Loose D, Lopez Gutierrez JC, Markovic J, Mattassi R, Parsi K, Rabe E, Roztocil K, Shortell C, and Vaghi M
- Subjects
- Consensus, Diagnostic Imaging, Humans, International Cooperation, Societies, Medical, Hemangioma diagnosis, Vascular Malformations diagnosis
- Published
- 2015
15. Vascular Anomalies Guidelines by the Italian Society for the study of Vascular Anomalies (SISAV).
- Author
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Stillo F, Baraldini V, Dalmonte P, El Hachem M, Mattassi R, Vercellio G, Amato B, Bellini C, Bergui M, Bianchini G, Diociaiuti A, Campisi C, Gandolfo C, Gelmetti C, Moneghini L, Monti L, Magri C, Neri I, Paoloantonio G, Patrizi A, Rollo M, Santecchia L, Vaghi M, and Vercellino N
- Subjects
- Humans, Italy, Vascular Malformations epidemiology, Vascular Malformations etiology, Societies, Medical standards, Vascular Malformations classification, Vascular Malformations diagnosis, Vascular Malformations therapy
- Published
- 2015
16. Haemostatic squeezing and purse-string sutures: optimising surgical techniques for early excision of critical infantile haemangiomas.
- Author
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Baraldini V, Coletti M, Cigognetti F, and Vercellio G
- Subjects
- Blood Loss, Surgical prevention & control, Child, Preschool, Cicatrix prevention & control, Cohort Studies, Female, Follow-Up Studies, Hemangioma diagnosis, Humans, Infant, Male, Retrospective Studies, Risk Assessment, Severity of Illness Index, Skin Neoplasms diagnosis, Time Factors, Treatment Outcome, Wound Healing physiology, Hemangioma surgery, Hemostasis, Surgical methods, Skin Neoplasms surgery, Suture Techniques
- Abstract
Background/purpose: Surgical excision of critical infantile haemangiomas (HMs) is usually delayed until intralesional blood flow spontaneously decreases, but fibrofatty tissue and exuberant skin invariably remain even after total involution. The aim of this study was to describe 2 surgical techniques used for early excision in 50 selected cases of HM defined critical in site or size., Methods: Among a total of 952 patients affected by HM observed from 1999 to 2005, 50 children (5.2%) were submitted to early surgical removal of the tumour (age range, 6-24 months). In group 1, a technique of lenticular incision and linear closure was used in 34 patients using an original clamp for haemostasis during excision. In group 2, a modified round-block excision and purse-string closure technique was performed in 16 patients., Results: Only 2 patients required transfusion to replace intraoperative blood losses. Infection, delayed wound healing, and cheloids occurred in 3 patients in group 2. Satisfactory cosmetic results have been observed in most cases in both groups at a follow-up ranging from 6 months to 6 years., Conclusions: The range of indications for early surgical removal of critical HM might be enlarged to achieve earlier the better cosmetic results. A few surgical tricks can minimize intraoperative bleeding and optimise the surgical scar.
- Published
- 2007
- Full Text
- View/download PDF
17. Thoracic outlet syndrome in paediatrics: clinical presentation, surgical treatment, and outcome in a series of eight children.
- Author
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Vercellio G, Baraldini V, Gatti C, Coletti M, and Cipolat L
- Subjects
- Adolescent, Child, Decompression, Surgical methods, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Male, Phlebography methods, Ribs surgery, Subclavian Vein diagnostic imaging, Subclavian Vein pathology, Subclavian Vein surgery, Thoracic Outlet Syndrome complications, Thoracic Outlet Syndrome diagnostic imaging, Treatment Outcome, Venous Thrombosis diagnostic imaging, Venous Thrombosis etiology, Venous Thrombosis surgery, Thoracic Outlet Syndrome diagnosis, Thoracic Outlet Syndrome surgery
- Abstract
Background/purpose: This report reviews the clinical presentation, surgical treatment, and outcome of 8 children treated for the thoracic outlet syndrome (TOS) during the last 3 years., Methods: From 1998 through 2001 31 patients were admitted to our Vascular Surgery Unit with TOS. Eight of them (25.8%) were in the paediatric age group, 8 to 16 years (mean, 13 years). No sex prevalence was found. The presenting symptoms were neurologic in 2 patients (25%) and secondary to venous flow impairment in 6 (75%). At phlebography, venous thrombosis was seen in 2 cases, and functional intermittent obstruction was seen in 4. Seven patients underwent decompressive surgical partial resection of the first rib with transaxillary or supraclavicular access. One patient was treated conservatively., Results: There were no major postoperative complications. Mean hospital stay was 2.7 days. In no patient were there signs of recurrence after a mean follow-up of 18 months (range, 3 to 36 months)., Conclusions: In the authors' experience TOS in paediatric patients occurs with the same symptoms and thrombotic complications as in adults. The same surgical strategy adopted in adult patients is advisable for affected children., (Copyright 2003, Elsevier Science (USA). All rights reserved.)
- Published
- 2003
- Full Text
- View/download PDF
18. [Correction of venous hypertension in venous dysplasias].
- Author
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Vercellio G, Baraldini V, Cipolat L, and Coletti M
- Subjects
- Adolescent, Adult, Angiodysplasia physiopathology, Arteriovenous Malformations physiopathology, Blood Pressure, Child, Child, Preschool, Humans, Infant, Klippel-Trenaunay-Weber Syndrome physiopathology, Practice Guidelines as Topic, Retrospective Studies, Sclerotherapy, Varicose Veins surgery, Veins physiopathology, Venous Insufficiency physiopathology, Angiodysplasia surgery, Arteriovenous Malformations surgery, Klippel-Trenaunay-Weber Syndrome surgery, Leg blood supply, Venous Insufficiency surgery
- Published
- 2002
19. Early surgical management of Klippel-Trenaunay syndrome in childhood can prevent long-term haemodynamic effects of distal venous hypertension.
- Author
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Baraldini V, Coletti M, Cipolat L, Santuari D, and Vercellio G
- Subjects
- Adolescent, Age Factors, Arteriovenous Malformations surgery, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Laser Coagulation, Male, Postoperative Complications prevention & control, Sclerotherapy, Veins surgery, Venous Insufficiency surgery, Venous Insufficiency therapy, Klippel-Trenaunay-Weber Syndrome surgery, Veins abnormalities, Venous Insufficiency prevention & control, Venous Pressure physiology
- Abstract
Purpose: The aim of this study was to evaluate the authors' preliminary experience in early surgical treatment of distal venous hypertension (DVH) in children affected by Klippel-Trenaunay syndrome (KTS)., Methods: Clinical assessment, surgical management, and outcome of 29 children (18 girls, 11 boys) affected by KTS observed from October 1998 to October 2000 were reviewed retrospectively., Results: Patients ranged in age from 8 months to 17 years (median age at surgery, 10.3 years). The clinical findings are presented. Surgical treatments included stripping of persistent marginal vein (n = 16), multiple legation of bulky varicosities (n = 10), complementary sclerotherapy (n = 14) and laser photocoagulation (n = 13), and excision of associated lymphatic malformations (n = 5). No mortality or major postoperative morbidity occurred. Follow-up period ranged from 6 months to 2 years., Conclusion: These preliminary results suggest that early surgical management of DVH in KTS is safe and could be effective in preventing or minimising the long-term haemodynamic effects of DVH in absence of associated deep venous system anomalies.
- Published
- 2002
- Full Text
- View/download PDF
20. Evidence-based operations in paediatric surgery.
- Author
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Baraldini V, Spitz L, and Pierro A
- Subjects
- Child, Humans, Randomized Controlled Trials as Topic, Retrospective Studies, Surgical Procedures, Operative statistics & numerical data, Evidence-Based Medicine, Pediatrics standards, Surgical Procedures, Operative standards
- Abstract
It has been assumed that only 10% of medical interventions are supported by solid scientific evidence. The aim of this study was to determine the type of research evidence supporting operations in a tertiary referral paediatric surgical unit. All patients admitted over a 4-week period to two surgical firms were enrolled in the study. All major operations carried out on each patient since birth were evaluated. Patients for whom a diagnosis was not reached were excluded. A bibliographic database (MEDLINE) was used to search for the articles published between January 1986 and December 1995 on the analysed operations. The type of evidence supporting the operations was classified as follows: I=evidence from randomised controlled trials (RCTs); II=self-evident intervention (obvious effectiveness not requiring RCTs); III=evidence from prospective and/or comparative studies; IV=evidence from follow-up studies and/or retrospective case series; and V=intervention without substantial evidence for or against results of randomised trials. Seventy operations (32 individual types) were performed on 49 patients (1-5 operations/patient); 18 (26%) were supported by RCTs (type of evidence I). Two patients (3%) received a self-evident intervention (type II); 48 operations (68%) were based on non-randomised prospective or retrospective studies (type III=13%; type IV=55%). Two patients (3%) received an operation not supported by or against convincing scientific evidence (type V). A significant proportion of operations in paediatric surgery is supported by RCTs. However, the vast majority of these trials were conducted on adult patients. Sixty-eight per cent of the operations were based on prospective follow-up studies or retrospective case series, which may not represent solid scientific evidence. More RCTs are needed in paediatric surgery.
- Published
- 1998
- Full Text
- View/download PDF
21. In vivo evaluation of timing, degree, and distribution of bacterial translocation following experimental small bowel transplantation.
- Author
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Gianotti L, Bergamo C, Braga M, Socci C, Baraldini V, Magnani P, Mangili F, Locatelli M, and Di Carlo V
- Subjects
- Animals, Escherichia coli isolation & purification, Graft Survival, Indium Radioisotopes, Intestine, Small microbiology, Intestine, Small physiology, Lactulose metabolism, Liver microbiology, Lung microbiology, Male, Mannitol metabolism, Organometallic Compounds, Oxyquinoline analogs & derivatives, Permeability, Postoperative Complications microbiology, Rats, Rats, Inbred Lew, Time Factors, Transplantation, Isogeneic pathology, Escherichia coli physiology, Escherichia coli Infections physiopathology, Intestine, Small transplantation, Transplantation, Isogeneic physiology
- Abstract
These studies were designed to evaluate the correlation between morphologic and functional changes after heterotopic auxiliary small bowel isograft with systemic venous drainage and two ostomies in 20 Lewis rats. Morphologic damage of the graft was scored by full-thickness biopsies before surgery and 1, 3, 5, and 7 days after transplant. Functional evaluation of the graft was done, at the same time points, by urinary excretion of lactulose and mannitol injected in the proximal ostomy. The intestinal permeability was also studied by injecting Escherichia coli labeled with indium-111 oxine in the proximal ostomy. Translocation of radiolabeled bacteria was quantitated in extraintestinal tissues by radionuclide counts and number of viable organisms and in vivo by scintigraphic imaging. One day after transplant, significant graft damage (score 17.2 +/- 4.2) was observed when compared with the pretransplant value (7.3 +/- 2.6). The degree of tissue injury was similar on days 3 (15.8 +/- 3.5) and 5 (16.1 +/- 3.9) after transplant and remained high on day 7 (11.8 +/- 2.8). The lactulose to mannitol ratio showed a significantly increased permeability on day 1 (17.5) versus pretransplant values (2.6), remained high on day 3 (8.6), and returned to normal values on day 5 (2.8). Translocation of bacteria to distant organs, as measured by both radionuclide counts and number of viable organisms, was strikingly enhanced on day 1 after transplantation, compared with control animals, but returned to the pretransplant value on day 3. A good qualitative and quantitative correlation was observed between radionuclide counts in the extraintestinal organs and in vivo images obtained by scintigraphic scanning. In conclusion, in this model, timing and degree of bacterial translocation do not seem to correlate well, with the exception of the acute post-transplantation phase, with morphologic and permeability changes of the graft. Evaluation of translocation by scintigraphic imaging appears a suitable approach to study in vivo the kinetics and distribution of this process.
- Published
- 1995
22. First steps of a new team in small bowel transplantation in rats.
- Author
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Bergamo C, Baraldini V, Gianotti L, Socci C, Braga M, and DiCarlo V
- Subjects
- Animals, Death, Rats, Rats, Inbred Lew, Transplantation, Heterotopic, Transplantation, Isogeneic, Education, Continuing, Intestine, Small transplantation, Microsurgery methods
- Published
- 1994
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