Laparoscopic Appendectomy

Appendectomy represents a fundamental step in the training course of a surgeon in so much that for several decades it has been the first surgical operation assigned to a training surgeon. Yet, laparoscopic appendectomy has not spread with the same characteristics as the operation of cholecystectomy for which laparoscopy has rapidly become the gold standard. We can moreover note that nowadays, in spite of a certain initial distrust, the laparoscopic methodology is fully employed in the treatment of acute appendicitis, even though the use of such technique is controversial in cases of acute complicated appendicitis

Intermittent pneumatic compression in laparoscopic surgery for prevention of deep vein thrombosis and cellular damage from iatrogenic compartment syndrome

This study is aimed to evaluate the incidence of the postoperative deep vein thrombosis (DVT) and the cell damage from compartment iatrogenic syndrome, analyzing two groups of patients operated laparoscopically, one of which assisted with a Sequential Compression Device (SCD)

Choledochal cysts in pregnancy A case report and literature review

Aim is to demonstrate that surgery can be the best way to reduce the risk of malignancy in choledochal cysts (CC) and how hard can be the diagnosis and the treatment during pregnancy

L'apporto della chimica e della fisica allo studio della Zona Non Satura: limiti tecnici, scientifici e metodologici.

Tutti i fenomeni che hanno luogo nella Zona Non Satura sono connessi alle condizioni climatiche (precipitazioni, umidità, temperatura), all'attività vegetale e batterica, alle caratteristiche della matrice (porosità, conducibilità idraulica e composizione mineralogica). Uno studio idrogeologico e geochimico dettagliato è stato compiuto nei pressi del Centro ENEA-EUREX di Saluggia (Vercelli, Italia) al fine di descrivere le caratteristiche peculiari del sito. I risultati degli studi isotopici hanno permesso di stabilire che le perdite di acqua dal terreno avvengono per traspirazione, interessando tavolta anche la falda e che la ricarica non avviene per infiltrazione verticale

Predictive factors for incidental gallbladder cancer (IGBC) in patients undergoing cholecystectomy for presumed benign disease. A single-center experience

The incidence of incidental gallbladder cancer (IGBC) is estimated at 0.3-2.1%. The purpose of our study is to evaluate IGBC incidence in our department and to establish its predictive factors, considering patients' clinical characteristics and pre-operative ultrasound gallbladder features

Dietary Protein Supplementation Helps in Muscle Thickness Regain after Abdominal Wall Reconstruction for Incisional Hernia

A modern approach to incisional hernia is oriented toward midline restoration to re-establish abdominal wall physiology and to restore muscular strength. A high-protein diet has been demonstrated to improve muscle function and mass. The aim of this prospective study was to evaluate the effect of a high-protein diet on abdominal muscle remodeling in patients submitted to abdominal wall reconstruction (AWR). Forty-five patients submitted to elective AWR were prospectively divided into two groups depending on pre- and postoperative daily protein assumption: Group A patients were submitted to a standard 2300 kcal diet with 103 g of protein intake (males) and 1800 kcal diet with 80 g of protein intake (females) starting one month before surgery and lasting for three months postoperatively; Group B patients were submitted to the same dietary regimen plus 34 g of purified proteins daily. Patients underwent ultrasound scan preoperatively and three and six months after surgery, to evaluate the widest thickness of the rectus abdominis muscle on the transverse umbilical line. Three patients reporting hernia recurrence were excluded. No significant difference among the two groups in muscle thickness growth after surgery was observed at three months after surgery, even if a favorable trend in Group B was noted (10% vs 19%, P = not significant). At six months after surgery, Group B patients showed a significant difference in muscle thickening (13% vs 32%, P < 0.05 ). The study demonstrates a positive effect of a protein diet on the rectus abdominis muscle thickening after AWR. Further studies are needed

Dyslipidemia and cardiovascular prevention in the elderly: a balance between benefits and risks of statin treatment in a specific population

Introduction: Atherosclerotic Cardiovascular Diseases (CVD) are among the most relevant causes of morbidity and mortality worldwide, especially in aged people. Statins are one of the leading pharmacological interventions against atherosclerosis and are widely used to reduce the risk of occurring coronary artery diseases and related outcomes in both primary and secondary prevention. The management of chronic diseases is improved considerably over time, leading to an increase in life expectancy despite heavier comorbidity-related burdens in the elderly. Aims: The paper focused on the role of statins in the management of atherosclerosis and related burdens in elderly patients. Results: Statins are essential in reducing the risk of CVD in secondary and primary prevention, particularly in high-risk individuals. Guidelines encourage using specific algorithms with age-specific cut-offs to assess individual cardiovascular risk irrespective of baseline age, as the expansion of life expectancy produces favorable effects of statin treatment in those over 70. Discussion: Besides the estimation of baseline CV risk, a specific age-related assessment is also necessary before prescribing statin treatment in aged people focusing on frailty, potential pharmacological interactions due to polypharmacotherapy, cognitive impairment, and background chronic comorbidities, such as diabetes mellitus. Before starting statin therapy, an accurate choice of type and dose of statins is needed as potential adverse events are more prevalent with high-dose than low-to-moderate-dose regimens and with lipophile than hydrophile statins (e.g., potential implication on intra-cerebral cholesterol metabolism). Conclusion: Despite possible adverse events, elderly patients should receive statins, when appropriate, to avoid the first occurrence of recurrent cardiovascular events and related burdens

Dyslipidemia and Cardiovascular Prevention in the Elderly: A Balance between Benefits and Risks of Statin Treatment in a Specific Population

Introduction: Atherosclerotic Cardiovascular Diseases (CVD) are among the most relevant causes of morbidity and mortality worldwide, especially in aged people. Statins are one of the leading pharmacological interventions against atherosclerosis and are widely used to reduce the risk of occurring coronary artery diseases and related outcomes in both primary and secondary prevention. The management of chronic diseases is improved considerably over time, leading to an increase in life expectancy despite heavier comorbidity-related burdens in the elderly. Aims: The paper focused on the role of statins in the management of atherosclerosis and related burdens in elderly patients. Results: Statins are essential in reducing the risk of CVD in secondary and primary prevention, particularly in high-risk individuals. Guidelines encourage using specific algorithms with age-specific cutoffs to assess individual cardiovascular risk irrespective of baseline age, as the expansion of life expectancy produces favorable effects of statin treatment in those over 70. Discussion: Besides the estimation of baseline CV risk, a specific age-related assessment is also necessary before prescribing statin treatment in aged people focusing on frailty, potential pharmacological interactions due to polypharmacotherapy, cognitive impairment, and background chronic comorbidities, such as diabetes mellitus. Before starting statin therapy, an accurate choice of type and dose of statins is needed as potential adverse events are more prevalent with high-dose than low-to-moderatedose regimens and with lipophile than hydrophile statins (e.g., potential implication on intra-cerebral cholesterol metabolism). Conclusion: Despite possible adverse events, elderly patients should receive statins, when appropriate, to avoid the first occurrence of recurrent cardiovascular events and related burdens