Guidelines for venous thromboembolism and clinical practice in Italy : a nationwide survey

INTRODUCTION: Venous thromboembolism (VTE) is a major health problem that has fostered the definition of specific guidelines by Scientific Societies. The type of procedure as well as trauma are crucial for VTE in surgical patients (General Surgery, Gynaecology and Orthopaedics). MATHERIALS AND METHODS: The project stemmed from a National grant from the Italian Ministry of research. A data-survey framework was prepared and made available as a form to be filled and was sent to 714 centres to investigate the application of the guidelines for VTE across the national territory. RESULTS: A number of 146 centres replied (20,4% of total): 48 Departments of General Surgery, 46 Departments of Ginaecology, 52 Departments of Orthopaedics. About 70% of the Centres had appropriate information about surgery as a risk factor for VTE. The answers have demonstrated an adequate knowledge of the instrumental and laboratory diagnostic pathways, useful to confirm diagnostic suspect of TE (80%). The data concerning diagnostic data waiting and morbidity/mortality have been further analyzed. Data waiting have been compared with morbidity and mortality rates related to DVT-PE that showed an increase of mortality connected to the diagnostic data timing of supply with an exponential trend linked to the data acquisition delay. CONCLUSIONS: Risk stratification and adequate application of prophylaxis and treatment devices represent a real possibility to control morbidity and mortality for VTE. Moreover diagnostic data waiting conditions adequate prophylaxis. In Italy, only the 40% of the centres is able to supply diagnostic data within 12 hours. KEY WORDS: Deep Vein Thrombosis, Pulmonary Embolism, Venous Thromboembolism, Guideline

[Perioperative changes in the plasma levels of fibrinogen and D-dimer during laparoscopic cholecystectomy: the preliminary results of a prospective randomized clinical study]

Considering that laparoscopic procedure is associated with increased resistance to lower-limb venous return and subsequent stasis, with possible implications in terms of thromboembolic complications, the aim of our study was to investigate prospectively the coagulative-fibrinolytic profile, in laparoscopic and open cholecystectomy, in patients randomly alloted to receive or not preoperative heparin

[Splenic pseudoaneurysms following acute pancreatitis]

Splenic artery pseudoaneurysms are the most common of visceral artery pseudoaneurysms. Splenic pseudoaneurysms appear to have developed as a consequence of inflammatory processes adjacent to the splenic artery, particularly acute pancreatitis and chronic pancreatitis with associated pseudocysts. They are often asymptomatic and picked up on abdominal examination for ultrasound or CT scanning for other conditions. Complications include rupture with retroperitoneal hemorrhage or intraperitoneal hemorrhage. Two cases of splenic pseudoaneurysms, following acute pancreatitis, are reported between the years 1987 and 1996

[Effect of octreotide on the hepatic metastasis of human colorectal cancer: an experimental model in athymic mice]

The aim of this randomized study was to determine the effects of octreotide therapy on the growth and development of experimental liver metastases from a human colonic cancer cell line (HT 29) in nude mice model. No important and significant difference could be found between mice, lungs and liver weights of both groups as well as lung metastatization; indeed, significant was the difference between groups concerning liver, metastases (the majority of them were in treated group): in spite of the small number of data collected, which does not allow to draw any conclusion on the efficacy of this drug on liver metastases, we believe that octreotide therapy does not affect dramatically the growth and development of liver metastases from a human colon cancer