La pelviperitonectomia con chemioipertermia intraoperatoria nella malattia neoplastica avanzata del colon-retto

Background: Cytoreductive peritonectomy with hyperthermic intraoperative chemotherapy (HIPEC) is an established therapy for patients with gastrointestinal, gynaecological metastasised peritoneal carcinomatosis as well as primary peritoneal carcinomatous tumours. Surgical therapy of peritoneal surface malignancy from colorectal origin in combination with Hyperthermic Intraoperative Peritoneal Chemotherapy (HIPEC) has now become an established treatment approach in specialised centres. In this subset of patients hyperthermic intraperitoneal chemotherapy (HIPEC), after colo-rectal resection, may improve long-term survival. The available literature, in according with ours experience, suggests that, with appropriate patient selection, cytoreduction and HIPEC can be an effective therapy, particularly when all macroscopic tumor deposits are removed. Methods: Over the period from Genuary 2006 to April 2009, 5 patients affected by colorectal cancer underwent HIPEC in the surgical division “V. Bonomo” of Bari Hospital, after adequate criteria selection. Results: Median follow-up was 12 months. Complete clinical regression was achieved in all the 5 patients treated; 2 patiens are died for other causes, while the remaining 3 patients are alive, but 2 of these with abdominal recurrence. Conclusions: This procedure requires a high level of expertise. HIPEC with Bevacizumab and 5-FU, following cytoreductive surgery and Folfox 4 (systemic Chemotherapy), is now an entire part of treatment of peritoneal dissemination of colorectal malignancy, and it’s possible to hope prolonged survival, while the pathologic subtype remains the dominant factor in survival. Colorectal cancer, Metastases, Peritonectomy, HIPE

Prevalence and risk factors for urinary incontinence in Italy

Objectives: To analyze the frequency and risk factors for urinary incontinence (UI) in Italy. Methods: Eligible for this cross-sectional study were men aged greater than or equal to 50 years and women aged greater than or equal to 40, randomly identified among registered subjects of a network of general practitioners during the period March-October 1997. All subjects were invited by telephonic interview to determine the presence of UI, reported by the subjects as lass of urine in the last year. The subjects with UI were further questioned at home for evaluation of the type, degree and frequency of UI episodes. Results: Of the 5,488 subjects interviewed (2,767 women and 2,721 men), 92 (3%) men and 316 (11%)women reported at least one episode of UI during the year before the interview. The frequence of UI increased with age both in men and women, being 2 and 11% in men and women, respectively, aged 50-60 years and 7 and 16% in those aged greater than or equal to 70. Of the subjects with UI identified, 229 women and 64 men and a group of 289 subjects without UI were questionned at home using a detailed questionnaire. Six and 55% of men and women, respectively, reported stress incontinence, 20 and 12% urge incontinence and 20 and 24% mixed incontinence. The risk of UI increased with body mass index in women. A history of recurrent urinary infection was associated with UI in men and less markedly in women. No association emerged between education, smoking and alcohol or coffee consumption and risk of UI. Parity was directly associated with the risk of UI in women. Conclusions: The study offers a quantitative estimate of the prevalence of UI and its main risk factors in this Italian population