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Physiology-guided revascularization versus optimal medical therapy of nonculprit lesions in elderly patients with myocardial infarction: Rationale and design of the FIRE trial

Background: Myocardial infarction (MI) in elderly patients is associated with unfavorable prognosis, and it is becoming an increasingly prevalent condition. The prognosis of elderly patients is equally impaired in ST-segment elevation (STE) or non-STE (NSTE), and it is markedly worsened by the common presence of multivessel disease (MVD). Given the limited evidence available for elderly patients, it has not yet been established whether, as for younger patients, a complete revascularization strategy in MI patients with MVD should be advocated.

Average daily ischemic versus bleeding risk in patients with ACS undergoing PCI: Insights from the BleeMACS and RENAMI registries

Background: The risk of recurrent ischemia and bleeding after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) may vary during the first year of follow-up according to clinical presentation, and medical and interventional strategies. Methods: BleeMACS and RENAMI are 2 multicenter registries enrolling patients with ACS treated with PCI and clopidogrel, prasugrel, or ticagrelor. The average daily ischemic and bleeding risks (ADIR and ADBR) in the first year after PCI were the primary end points.

Anastomotic leakage in rectal surgery. Role of the ghost ileostomy

Background/Aim: A protective ileostomy performed during anterior resection in rectal surgery is considered a good practice to prevent anastomotic leakage. A derivative ostomy seems to be able to minimize the clinical consequences of an anastomotic leakage, but not to prevent it. The present study examined the role of the ghost ileostomy in anastomotic leakage following rectal surgery. Patients and Methods: This study included 82 patients that had undergone anterior rectal resection. A total of 32 patients underwent ghost ileostomy (GH) and 50 patients underwent ileostomy (IL).

Colovesical fistula complicating diverticular disease: Diagnosis and surgical management in elderly

Colovesical fistula (CVF) is pathological communication between the bladder and the large intestine, usually the sigmoid colon. CT is the preferred diagnostic imaging modality owing to its high sensitivity (over 90%). The surgical management of DD has evolved but still remains governed by clinical classification, namely, recurrent uncomplicated disease versus complicated disease In conclusion CT was the most sensitive and accurate exam to diagnose CVF in the cases. Then, we suggest CT as a first line investigation in all patients with suspected CVF

Nasal flap or cutaneous grafting in basal cell cancer of the nose. Comparison of two reconstructive possibilities

Basal cell cancer is a malignant tumor of the skin most common in Caucasians and more common in the areas of the head and neck. At the moment there are many suggested treatment methods, however the surgical approach remains the technique most often applied. It includes excision of the oncological safety margins and the subsequent reconstructive phase can utilize local flaps or cutaneous grafts.

Cholecystectomy for acute cholecystitis in octogenarians: impact of advanced age on post-operative outcome

BaCKgrOuND: The number of surgical operations in elderly patients is increasing due to the aging demographics of western populations. The aim of the present study was to investigate the peri-operative outcome of octogenarian patients undergoing cholecystectomy for acute cholecystitis.

Thyroid nodule recurrence following lobo-isthmectomy: incidence, patient’s characteristics, and risk factors

Purpose: This study was aimed at assessing the incidence and timing of thyroid nodules recurrence, defined as appearance of new benign or malignant nodules in contralateral lobe in patients with benign thyroid nodules or thyroid microcarcinoma treated with lobo-isthmectomy. Patient’s characteristics and risk factors associated with this phenomenon were also investigated. Methods: A retrospective study was performed by evaluating 413 patients undergoing lobo-isthmectomy with a minimum follow-up of 1 year.

The role of grade of injury in non-operative management of blunt hepatic and splenic trauma. Case series from a multicenter experience

This retrospective study shows the results of a 2 years application of a clinical pathway concerning the indications to NOM based on the patient's hemodynamic answer instead of on the injury grade of the lesions.We conducted a retrospective study applied on a patient's cohort, admitted in "Azienda Ospedaliero-Universitaria Ospedali Riuniti of Ancona" and in the Digestive and Emergency Surgery Department of the Santa Maria of Terni hospital between September 2015 and December 2017, all affected by blunt abdominal trauma, involving liver, spleen or both of them managed conservatively.

Use of negative pressure wound therapy systems after radical vulvectomy for advanced vulvar cancer

A retrospective cohort study was performed to evaluate the efficacy of negative pressure wound therapy in improving vulvectomy healing. Women who underwent radical vulvectomy with complete inguinofemoral lymphadenectomy for advanced vulvar cancer were divided into two groups according to immediate postoperative care: patients treated with negative pressure wound therapy using the device applied on the site of the wound (including vulva and inguinal region), and patients receiving conventional care. 18 patients were included in the study.

Stable or able? Effect of virtual reality stimulation on static balance of post-stroke patients and healthy subjects

Over the last decades, virtual reality (VR) emerged as a potential tool for developing new rehabilitation treatments in neurological patients. However, despite the increasing number of studies, a clear comprehension about the impact of immersive VR-treatment on balance and posture is still scarce. In the present study, we aimed to investigate the effects of VR cues on balance performances of subjects affected by stroke, age-matched healthy subjects, and young healthy subjects.

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