1,720,992 research outputs found
Caso clinico di una paziente operata di mastectomia con ricostruzione tramite TRAMF
No full textViene presentato il caso di una paziente sottoposta a mastectomia radicale sinistra per
carcinoma con successiva ricostruzione differita tramite lembo di retto dell’addome,
risultata in completa perdita del lembo a causa di estesa necrosi, la cui rimozione ha
reso necessaria la riparazione tramite lembo epigastrico. La paziente presentava
un’ampia regione cicatriziale retraente che coinvolgeva tutta la regione mammaria sinistra
e l’epigastrio omolaterale. Dopo numerosi tentativi per inserire e mantenere in sede
l’espansore, la paziente è stata inserita nel protocollo di lipofilling. Gli effettivi e talora
sorprendenti risultati da noi ottenuti clinicamente tramite la tecnica del lipofilling
nella quasi totalità delle pazienti, ci ha indotto a ritenere opportuna anche in questo
caso la valutazione dei miglioramenti strutturali dei tessuti trattati da un punto di vista
strumentale (ecotomografia
Nummular Headache and Its Surgical Treatment
No full textNummular headache (NH) is an uncommon primary headache characterized by pain limited to a precise small area of the scalp. There is no global consensus on its pathogenesis, but its extracranial origin is the most accepted theory. Moreover, peripheral mechanism is supported by the overlapping symptomatology of secondary forms of NH and is well described in the literature. However, a standard effective treatment is still lacking
Surgical Correction of Inverted Nipples
No full textNipple inversion is a common pathologic condition affecting 2%-10% of women. Congenital inversions are the most common forms, while acquired inversions are less frequent. This condition can induce psychological discomfort, functional problems that could prevent adequate breast feeding, and cosmetic dissatisfaction, and create local irritation and infection. The aim of this article was to provide a comprehensive review of the literature about surgical treatment of inverted nipple
An ethics for the living world: operation methods of Animal Ethics Committees in Italy
No full textINTRODUCTION AND OBJECTIVES. Coinciding with the recent implementation in Italy of the "Directive 2010/63/EU, regarding the protection of animals used for scientific purposes", the Authors would like to analyse the topic of the introduction of ethical committees for animal experimentation in Italy. This paper furthermore aims to underline some critical aspects concerning the actions taken by Italian institutions to comply with the provisions of EU. RESULTS AND DISCUSSION. The implementation of the recent Italian law (Decreto Legislativo n. 26 on 4 March 2014 Implementation of the Directive 2010/63/EU on the protection of animals used for scientific purposes) leans towards a restrictive interpretation of the European provisions about composition and responsibilities of "Ethical Committee for Animal Experimentation". In the composition of the bodies mentioned, we note a tendency to restrict the composition to few professional figures contemplated by Italian law, without guaranteeing the independence of each committee; also, an absence of hierarchical relationship between a research institution and his committee is apparent. Moreover, a critical aspect is the lack of decision-making powers of these new organisms in terms of ethical evaluation of protocols and research projects. CONCLUSIONS. What EU legislation imposes on the member states is to set up an animal-welfare body (art. 26). This represents a strong incentive for Italy to follow the steps of many other European Countries, where ad hoc ethical committees have been working for a long time. The proper functioning of these bodies may contribute to guarantee the safety and welfare of the animals inside the laboratories, and to balance the protection of animal life and the interests of research
Letter to the Editor: Response to Manzano Surroca et al. “Poland Sequence: Retrospective Analysis of 66 Cases.” Annals of Plastic Surgery, May 2019
No full textPhysicians' perception of the importance of ethical and deontological issues in a major Italian Province: pilot questionnaire and its validation
No full textBackground and aim: This study aims at validating a questionnaire on physicians' knowledge and perception of deontological and ethical rules that guide the medical profession, in a major Italian Province. Methods: We designed an on-line survey questionnaire. Participants (N=200) were asked to fill in information regarding their demographic features and knowledge of the deontological code. Results: Concerning the preliminary data, the median total score on knowledge of the deontological code was 0.50. A significant difference in the total score was observed among education groups. Specifically, the median total score among subjects with a specialist qualification was significantly lower than among those with only a medical degree. Conclusions: The tested instrument and methodology appear to be efficacious and reliable. Our preliminary data indicate that knowledge of the rules concerning medical deontology and the related principles of medical ethics seems to be very limited. Therefore, the authors plan to implement a second phase of the study, which will consist of the questionnaire' distribution to a broader and more representative sample
Skin Rejuvenation and Volume Enhancement with the Micro Superficial Enhanced Fluid Fat Injection (M-SEFFI) for Skin Aging of the Periocular and Perioral Regions
No full textBackground: Adipose-derived stromal and stem cells (ADSC) in autologous fat promises regenerative advantages, and injected into the dermal and subdermal layers, enhances rejuvenation and volume. However, extremely superficial fat injection with current techniques is limited. Objectives: Efficacy and viability evaluation of fat harvested with extremely small side port (0.3 mm) cannulae without further tissue manipulation for the correction of aging/thin skin in the periocular and perioral regions. Methods: Micro-superficial enhanced fluid fat injection (M-SEFFI) harvests adipose tissue with a multi-perforated cannula (0.3 mm), and autologous platelet rich plasma (PRP) is added. The tissue is injected into the dermal region of the periocular and perioral zones. Efficacy and viability were evaluated by histological and cell culture analysis. Clinical assessment included retrospective evaluation according to 1 = no effect, 2 = fair effect, 3 = good effect, 4 = excellent effect. Results: Between June 2014 and July 2015, 65 patients (7 men; mean age 49.7 years) were treated with M-SEFFI. No intraoperative complications or visible lumpiness were recorded. Analysis demonstrated mature, viable adipocytes with a strong stromal component. Following PRP addition, there was a greater proliferation noted in the M-SEFFI compared to the SEFFI (0.5 mm). Mean follow-up was 4.1 months. Clinical assessment by surgeons and patients at 1 month was 3.52 and 3.74, and 6 months 3.06 and 2.6 respectively. Conclusions: M-SEFFI is effective and viable for lump free skin rejuvenation and volume enhancement, through the extraction of smoother ADSC rich, autologous fat tissue that does not require further tissue manipulation, to correct skin aging
Clinical and Microbiological Characterization of Late Breast Implant Infections after Reconstructive Breast Cancer Surgery
No full textBackground: Implant infections represent a relevant problem after immediate breast cancer reconstruction. In addition to difficulties in distinguishing early infections from other post-surgical complications (such as hematoma, seroma, and liponecrosis) late breast implant infections still represent a grey area of our knowledge with regards to heir definition and management. To address this issue, we prospectively monitored breast cancer patients at their center. Methods: Between February 1, 2009, and May 31, 2013, we enrolled all patients undergoing breast implant reconstruction or expander-to-prosthesis substitution. Patients without at least 6mo of post-operative observation were excluded. We collected data from patient records including age, days from surgery (DFS), chemotherapy/radiotherapy, infecting microorganism, type of implant, antibiotic management and eventual implant removal. Sixty days from surgery were defined as the clinical threshold between early and late infection. Infections were further classified according to a graded scale into possible, probable and microbiologically proved. Results: Seventy-eight infections were recorded out of 766 surgical procedures (10.2%). Fifty-three (67%) cases occurred early ≤60 DFS, and 25 (33%) occurred late (i.e., beyond 60d). By defining infection types as possible, probable or proved, the majority of late infections were classified as proved (84%) compared with 56% of early infections (p=0.0014). Microbiological isolate distribution was similar in proved early infections compared with proved late infections. Among late infections, a delayed occurrence was observed after prosthesis placement compared with expander insertion. Late infections were fraught with lower treatment success rates (12% vs. 41%, p=0.009). Conclusion: Late infection represents a consistent proportion of infections after immediate breast implant reconstruction or prosthesis placement and bear lower chance of salvage after treatment. An increased attention is warranted to improve prevention and treatment strategies
Self-determination, healthcare treatment and minors in Italian clinical practice: ethical, psychological, juridical and medical-legal profiles
No full textThe social role of the minor, as indeed that of the physician, has changed markedly. This transformation has given rise to new patterns and responsibilities in the management of healthcare procedures that involve minors
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