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11.
The Authors describe a case of primary rectal lymphoma. The primitive involvement of this area is infrequent. The Authors emphasize the difficulty of preoperative diagnosis. The therapeutic approach should allow for correct staging which is only obtained by means of diagnostic studies aimed at excluding multicentric localisation. Sensitivity to radiotherapy has led the Authors to propose it as primary treatment, at least in stage I; surgery must be considered elective in stage II or in cases of need. Chemotherapy is indicated alone or in association with radiotherapy or surgery. 相似文献
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G Marchesini G Forlani F Cerrelli R Manini S Natale L Baraldi G Ermini G Savorani D Zocchi N Melchionda 《Diabetic medicine》2004,21(4):383-387
AIMS: Different criteria have been proposed by the World Health Organization (WHO) and by the Third Report of the National Cholesterol Education Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATPIII) for the diagnosis of the metabolic syndrome. Its identification is of particular importance for coronary risk assessment. METHODS: The prevalence of the metabolic syndrome was determined according to the two different proposals in 1569 consecutive subjects with Type 2 diabetes. RESULTS: By the WHO proposal, 81% of cases (95% confidence interval, 79-83) were labelled as metabolic syndrome. Microalbuminuria had the highest specificity (99%) and visceral obesity the highest sensitivity (93%). Seventy-eight per cent of patients (95% CI, 76-80) fulfilled the ATPIII criteria for metabolic syndrome, low HDL-cholesterol having the highest specificity (95%), elevated blood pressure having the highest sensitivity. According to both proposals, 1113 patients were positive; 183 were concordantly negative, indicative of a fairly good agreement (k statistics, 0.464). Subjects only positive for the WHO proposal were more frequently males, had a lower BMI and a higher arterial pressure. Only subjects identified by the ATPIII proposal had a significantly higher prevalence of previously detected coronary heart disease. CONCLUSIONS: Minimum criteria for the metabolic syndrome are met in most patients with Type 2 diabetes. Correct identification of the syndrome is important for an integrated approach to reduce the high costs and the associated disabilities. The ATPIII proposal more clearly identifies the burden of coronary heart disease associated with the metabolic syndrome. 相似文献
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Massimo Bonacchi Edvin Prifti Massimo Maiani Gabriele Giunti Marzia Leacche 《European journal of cardio-thoracic surgery》2005,28(1):120-126
OBJECTIVE: The aim of this study was to evaluate the feasibility, safety and outcome of skeletonized bilateral internal mammary arteries (BIMA) in patients with unstable angina (UA) undergoing non-elective myocardial revascularization. METHODS: Between January 1997 and December 2003, 758 patients, mean age 62+/-12 years, underwent non-elective coronary artery bypass grafting (CABG) for unstable angina. Two hundred and five (27%) were operated emergently and 503 (73%) urgently. BIMA were employed in 320 (42%) patients (Group B) and isolated left IMA and/or saphenous vein grafts in the remaining 438 (58%) patients (Group M). RESULTS: In-hospital mortality (B = 5.9% and M = 5.3%), and perioperative myocardial infarction (B = 2.2%; M = 1.96%) were similar between the two groups (P = ns). Actuarial survival at 1, 3 and 7 years was 98.7, 97.5 and 96.2% in B and 99, 94.3 and 88.4% in M (P < 0.05 at 7 years follow-up). At 7 years follow-up, the event-free cardiac survival (92 vs. 87%, P = 0.021), angina-free survival (98.6 vs. 94%, P = 0.039), reoperation-free cardiac survival (98 vs. 95%, P = 0.04) and infarct-free cardiac survival (98.7 vs. 96%, P = 0.05) were better in Group B. Multivariate analysis identified age > 65 years (P = 0.02), LVEF < 35% (P = 0.01), > 1 ischemic irreversible area (P = 0.03) as independent predictors for late deaths, while the use of the LIMA (P=0.006) and both mammary arteries (P=0.001) decreased the risk of late deaths. CONCLUSIONS: The use of BIMA in non-elective CABG for UA is safe and effective. Mid-term outcome, however, are superior with improved freedom from cardiac death, from coronary reintervention and from myocardial infarction. 相似文献
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Rigatelli Gianluca; Cardaioli Paolo; Giordan Massimo; Roncon Loris 《European heart journal》2007,28(1):51
A 65-year-old hypertensive man with shortness of breath andatypical thoracic pain underwent coronary angiography for 相似文献
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Eugenio Neri Lucio Barabesi Dimitrios Buklas Luca A. Vricella Antonio Benvenuti Enrico Tucci Carlo Sassi Massimo Massetti 《European journal of cardio-thoracic surgery》2005,28(6):857-863
Objective: Increased dimension of the aortic root and proximal aorta is considered a significant risk factor for catastrophic events that involve the ascending aorta. The objective of this study was to determine the possible correlation between pre-dissection aortic diameter and the occurrence of Stanford type A aortic dissection. Methods: Samples of dissected ascending aortas were obtained from 220 patients at the time of their operation. Two groups were identified: patients with connective tissue disorders (Group 1, n = 94) and those without (Group 2, n = 126). Measurements of the true (intimal) lumen were conducted and extrapolated as reliable approximation of pre-dissection aortic diameter. The possible association of intimal diameter with anthropometric and demographic data was analyzed. Results: Median aortic diameter was, respectively, 41.8 and 41.3 mm for patients with and without connective tissue disorders (41.4 mm for the entire cohort). Data analysis indicated that 57% of patients had aortic diameter above 40 mm, while patients with frank aneurysm accounted only for 10%; this proportion was higher in Group 1 compared to Group 2 (17.2% vs 4.7%). Poor or no correlation was demonstrated between aortic size and any of the anthropometric or demographic variables essayed. Significant subgroup differences were found among patients with a history of cigarette smoking, hypertension, diabetes, chronic renal insufficiency, and bicuspid aortic valve. Conclusion: Although aortic diameter remains a strong indication for preventive surgery in patients with inherited connective tissue disorders, acute aortic dissection occurs rarely in the setting of true ascending aortic aneurysms, and despite normal or near-normal aortic size in more than one-third of subjects. Dissection superimposing on small aortic diameters can be regarded as an expression of substantial functional tissue susceptibility to aortic catastrophic events. 相似文献
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Pasquale Mastroroberto Massimo Chello Francesco Onorati Attilio Renzulli 《European journal of cardio-thoracic surgery》2005,27(3):531-2; author reply 532
20.
Massimo Bolognesi M.D. Claudio R. Nigg Ph.D. Massimo Massarini M.D. Sonia Lippke Ph.D. 《Annals of behavioral medicine》2006,31(2):179-185
Background: There is an alarming prevalence of obesity and sedentariness in Western countries. An ideal context for health promotion
and preventive medicine seems to be the setting of primary care provided by the general practitioner (GP).Purpose: Therefore, this study evaluated the impact of GPs’brief physical activity counseling for overweight and obese patients.Methods: Individuals recruited during routine physician visits were randomly split into an experimental (n = 48) group that received
the Patient-centered Assessment and Counseling for Exercise (PACE) protocol, and a usual-care control (n = 48) group. Body
mass index (BMI) and abdominal girth were assessed as objective biometrical parameters. Patients in the experimental group
self-reported their readiness for physical activity and self-efficacy.Results: The experimental group had significantly better BMI and abdominal girth compared with the control group after a 5- to 6-month
follow-up. Furthermore, the experimental group progressed in their stage of physical activity readiness and increased their
self-efficacy.Conclusions: The GPs’counseling for physical activity using the PACE protocol influenced mediators and biometrical outcomes in an Italian
primary care context.
An earlier version of this article was presented for the degree thesis in Community Psychology at the Bologna University.
The advisor was Professor Bruna Zani.
We thank the general practitioners who contributed to this project: Marcatelli M., Forgiarini A., Fabbri M., De Astis R.,
Aguzzoni F., Barbarossa L., Montalti M. (Azienda USL-Distretto di Cesena Italy), and we thank Silvano Zanuso (Technogym Research
Center-Gambettola Italy) for his helpful comments. 相似文献