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61.
Pérez-Vicente F Arroyo A Serrano P Candela F Sánchez A Calpena R 《International journal of colorectal disease》2006,21(1):38-43
Background and aims Despite the excellent results published on circular stapled mucosectomy (CSM), there is still some concern about the application of PPH-33 in the advanced haemorrhoidal disease, where a major prolapse may lead to insufficient resection and ensuing early recurrence. This study is aimed at comparing the outcomes after single purse-string CSM versus double purse-string CSM.Patients and methods A prospective randomised clinical trial of single versus double purse-string CSM for grade III–IV symptomatic haemorrhoids was used. One hundred consecutive patients were randomised to single (group 1, N=50) versus double purse-string CSM (group 2, N=50).Results The mean age was 50.7 years, with a predominance of males (63 vs. 37). Haemorrhoids were classified as grade III in 59% and grade IV in 41% of the patients. Mean follow-up was 26 months. Demographic and clinical features showed no differences between the two groups. The size of the resected doughnut was greater in group 2 (4.95 vs. 3.55 cm; p<0.05), as was the distance of the suture from the dentate line (3.56 vs. 3.16 cm; p<0.05). Early postoperative pain was significantly less in group 2 (linear analogue scale from 0 to 10), 2.08 vs. 3.56 (p<0.001). Postoperative haemorrhage was absent or minimal in 79% of patients. Three patients from group 1 reported persistent pain that was resolved within the first few postoperative months. There were two recurrences in group 1.Conclusion Double purse-string CSM resects a greater doughnut, increases the distance of the staple suture from the dentate line and reduces early postoperative pain in comparison to single purse-string CSM. Larger series are necessary to assert whether recurrence is lower. 相似文献
62.
Massimo Offidani Laura Corvatta Claudia Polloni Maria-Novella Piersantelli Silvia Gentili Piero Galieni Giuseppe Visani Francesco Alesiani Massimo Catarini Marino Brunori Arduino Samori Maurizio Burattini Riccardo Centurioni Mario Ferranti Luciano Giuliodori Marco Candela Anna Mele Monica Marconi Pietro Leoni 《British journal of haematology》2009,144(5):653-659
Maintenance therapy was explored in multiple myeloma (MM) patients after conventional thalidomide, dexamethasone and pegylated liposomal doxorubicin (ThaDD). Patients with newly or relapsed MM obtaining at least minor response after 6 ThaDD courses, were randomised to receive α-interferon (IFN) 3 MU 3 times a week or thalidomide 100 mg daily until relapse. Both groups also received pulsed dexamethasone 20 mg 4 d a month. Fifty-one patients were randomized in the IFN-dexamethasone (ID) arm and 52 in the thalidomide-dexamethasone (TD) arm. The characteristics of two groups were similar. A significantly better 2-years progression-free survival (PFS; 63% vs. 32%; P = 0·024) and overall survival (84% vs. 68%; P = 0·030) was observed in the thalidomide arm. In high-risk patients and in those achieving less than very good partial response after induction, TD fared better in term of PFS. Main side effects were peripheral neuropathy and constipation in TD group, fatigue, anorexia and haematological toxicity in ID arm. There was a 21% probability of discontinuation at 3 years in the thalidomide arm and 44% in the IFN arm ( P = 0·014). Low-dose thalidomide plus pulsed low-dose dexamethasone after conventional thalidomide combination-based therapy was also feasible in the long term, enabling significantly better residual disease control if compared with a standard maintenance therapy. 相似文献
63.
Purpose There is no optimum surgical method of repair for high extrasphincteric fistula-in-ano. We describe a relatively simple procedure
for surgery of extrasphincteric fistula, which entirely preserves the anal sphincter, does not interfere with anal function,
and does not preclude the possibility of further surgery, if necessary.
Methods Five patients have been treated for high extrasphincteric fistula with a stapled endorectal flap by using a circular hemorrhoidal
stapler gun. The procedure involved two 180° pursestrings placed above the dentate line and 3 cm apart, proximal and distal
to the internal opening. On firing, the result was the excision of a 180° rectal flap, containing the internal ostium, and
including rectal mucosa and submucosa.
Results No perioperative complications were encountered. There was some temporary difficulty in controlling flatus and/or defecatory
urgency in two patients, which spontaneously reversed with no treatment within the first two postoperative months. The mean
Cleveland Clinic Score of Incontinence did not vary significantly after surgery. Overall anal manometry did not register any
significant differences between preoperative and postoperative values. With up to 26 months of follow-up, none of the fistulas
recurred.
Conclusions These preliminary promising results suggest that the stapled endorectal flap could have a role in the management of high extrasphincteric
fistula-in-ano.
An erratum to this article is available at . 相似文献
64.
65.
Pamela Minicozzi Francesca Bella Angela Toss Adriano Giacomin Mario Fusco Maurizio Zarcone Rosario Tumino Fabio Falcini Rosaria Cesaraccio Giuseppa Candela Francesco La Rosa Massimo Federico Milena Sant 《Journal of cancer research and clinical oncology》2013,139(9):1569-1577
Purpose
No population-based study has investigated breast cancer (BC) subtypes defined by including Ki67. The aim of this study was to evaluate the relative proportions of immunohistochemical subtypes and differences in relative and disease-free survival between subtypes, in relation to patient and other cancer characteristics in Italian BC patient.Methods
Information on estrogen, progesterone, human epidermal growth factor (HER2), Ki67, and relapses was obtained for 3,381 cases, sampled randomly and anonymously from cases diagnosed in 2003–2005 in nine Italian cancer registries. Relative excess risks (RERs) of death and risks of relapse 5 years after diagnosis were estimated.Results
Luminal A cancers were 42 % of the total, luminal B 27 %, luminal-HER2 14 %, triple-negative 11 %, and HER2-enriched 7 %. For non-metastatic (3,302) cases, 4 and 7 % developed locoregional and distant metastases, respectively. RERs of death and risks of relapse were significantly greater for all cancer subtypes than luminal A, particularly for triple-negative and HER2-enriched cancers, which were more frequent in women <40 years.Conclusions
Our population-based findings confirm that subtype is an independent prognostic factor for BC. Triple-negative and HER2-enriched subtypes would benefit from the development and wide application, respectively, of targeted treatments, which would also improve survival for younger patients. 相似文献66.
67.
J M García Páez A Carrera San Martín J V García Sestafe E Jorge I Millán I Candela 《Biomaterials》1990,11(3):186-190
Assessment of relaxation (loss of load within a given time) without apparent deformation is a necessary step before durability assay of biomaterials. From results obtained using calf pericardium, the following conclusions were drawn: (a) there is no limit to relaxation for this biomaterials; (b) the lesser the load applied, the greater the relaxation; and (c) the relaxation curve follows the logarithmic function y = K1 - K2 - Int. These findings demonstrate the poor behaviour of the biomaterial at supposedly low loads and suggest that rupture-point load is not a reliable reference to determine the safety coefficient of calf pericardium used in cardiac bioprostheses. 相似文献
68.
Recommendations for the use of sensor‐augmented pumps with predictive low‐glucose suspend features in children: The importance of education 下载免费PDF全文
Andrea E Scaramuzza Claudia Arnaldi Valentino Cherubini Elvira Piccinno Ivana Rabbone Sonia Toni Stefano Tumini Gilberto Candela Paola Cipriano Lucia Ferrito Lorenzo Lenzi Davide Tinti Ohad Cohen Fortunato Lombardo 《Pediatric diabetes》2017,18(8):883-889
Abstract: Sensor‐augmented pumps, which consist of a pump and a continuous glucose monitoring system, offer considerable therapeutic opportunities, despite requiring close attention in the early phase of their use. The aim of this paper is to provide recommendations on the use of a predictive low glucose management (PLGM) system (Minimed 640G?, Medtronic, Northridge, CA, USA) in adolescents with type 1 diabetes either at the start of therapy or during follow‐up. Sound clinical recommendations on PLGM are of increasing importance since several recent papers have reported significant clinical improvements in patients with PLGM, especially in adults. These recommendations are based on the experience of a group of pediatric endocrinologists who collaborated to closely and intensively study the on‐boarding of adolescent patients with type 1 diabetes on automated systems to gain first‐hand experience and peer‐to‐peer insights in a unique free‐living environment. The suggestions provided here are indicative, so can be adapted to the individual realities and experiences of different diabetes centers. However, we believe that close adherence to the proposed scheme is likely to increase the chances of improving the clinical and metabolic outcomes of patients treated with this therapy. 相似文献
69.
Quiroga Martínez J Gualis Cardona J Gregorio Crespo B Cabanyes Candela S Cilleruelo Ramos A Duque Medina JL 《Archivos de bronconeumología》2008,44(2):113-115
Acute poststernotomy mediastinitis is a serious complication of cardiac surgery and is associated with high mortality. Conservative treatment with local debridement, irrigating-suction systems, and specific antibiotic therapy is sometimes inadequate. Omentoplasty is occasionally used for reconstruction and the treatment of various chest diseases. This useful procedure is most often indicated for suppurative processes and radionecrosis, to complement myoplasty, or to cover a chest wall prosthesis. When used to treat poststernotomy mediastinitis secondary to cardiac surgery, omentoplasty improves control of infection and prognosis. We describe 2 cases of poststernotomy mediastinitis secondary to cardiac revascularization surgery in which omentoplasty was an effective treatment. Excellent control of infection was achieved. 相似文献
70.
Chinchilloidea are a clade of caviomorph rodents that includes seven living species, the Dinomyidae Dinomys branickii, the Chinchillidae Lagostomus maximus, two species of Chinchilla and three species of Lagidium. In addition, two extinct families are traditionally considered chinchilloids – Neoepiblemidae and Cephalomyidae. The phylogeny of the Chinchilloidea has so far not been well established and is based on partial analyses. Studying the anatomy and ontogeny of extinct and extant taxa, we propose homologies for the upper molars of Chinchilloidea for which these homologies have not been previously proposed: that is the Chinchillidae Prolagostomus, Lagostomus, Lagidium and Chinchilla, and the Neoepiblemidae Neoepiblema and Phoberomys. We identify patterns of occlusal simplification within Chinchilloidea and evaluate its importance in an evolutionary context. A phylogenetic analysis recovered Dinomyidae, Chinchillidae and Neoepiblemidae as clades. ‘Cephalomyidae’ have not been not recovered as a monophyletic group and ‘cephalomyids’ are closely related to Neoepiblemidae. Branisamys is not included within the Dinomyidae and appears to be a basal chinchilloid. 相似文献