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A rare case of acute compartment syndrome after saphenectomy

World Journal of Clinical Cases 2013年第2期1卷 84-86页

作者： Marco Milone Piero Venetucci Salvatore Iervolino caterina taffuri Giuseppe Salvatore Francesco Milone Department of Advanced Biomedical Science University "Federico Ⅱ" of Naples

Saphenectomy is one of the most validated criteria to treat varicose veins of the lower legs. Although many complications were well described, little is known about compartment syndrome due to muscle ischemia caused by constrictive bandages applied after stripping of varicose veins. We presented a case of successful conservative treatment of compartment syndrome after saphenectomy. Rehabilitation was found effective in improving fatigue, stiffness and tenderness showing the effectiveness of the combined conservative-rehabilitative treatment. However conservative treatment could not be considered the treatment of choice in daily practice. A severity score assessment of compartment syndrome should be useful to assess to which patients is allowed to not perform fasciotomy.

关键词： Compartment Saphenectomy Varicose veins Muscle ischemia Rehabilitation

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A vaginal drain of a pelvic abscess due to colonic diverticulitis

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世界临床病例杂志 2013年第2期1卷 82-83页

作者： Marco Milone Miguel Emilio Sosa Fernandez Piero Venetucci Paola Maietta Loredana Maria Sosa Fernandez caterina taffuri Francesco Milone Department of Advanced Biomedical Science University "Federico Ⅱ" of Naples

Although well recognized for tubo-ovarian abscesses, we report, in our best knowledge, the first case of a vaginal drain of a pelvic abscess due to colonic diverticulitis. A 78-year-old patient presented with abdominal and pelvic pain, fever(39.3 ℃) and an elevated white blood cell count(18500/mL). After abdominopelvic computed tomography the patient was presumed to have a pelvic abscess, which developed as a complication of the sigmoid diverticulitis. Due to the numerous intervening structures that create obstacles to safe percutaneous access, we planned a trans-vaginal drain. A rapid recovery was obtained within 2 d from the procedure and, at present, the follow-up was uneventful after 18 mo. We believe that transvaginal drain of pelvic abscess could be a useful alternative, when percutaneous approach is not feasible.

关键词： Vaginal Drain Diverticulitis Pelvic abscess Echography

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Bariatric surgery and diabetes remission: Sleeve gastrectomy or mini-gastric bypass?

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World Journal of Gastroenterology 2013年第39期19卷 6590-6597页

作者： Marco Milone Matteo Nicola Dario Di Minno Maddalena Leongito Paola Maietta Paolo Bianco caterina taffuri Dario Gaudioso Roberta Lupoli Silvia Savastano Francesco Milone Mario Musella Department of Advanced Biomedical Science University of Naples "Federico Ⅱ"80131 NaplesItaly

AIM:To investigate the weight loss and glycemic control status[blood glucose,hemoglobin A1c(HbA1c)and hypoglycaemic treatment].METHODS:The primary risk factor for type 2 diabetes is obesity,and 90%of all patients with type 2 diabetes are overweight or obese.Although a remarkable effect of bariatric surgery is the profound and durable resolution of type 2 diabetes clinical manifestations,little is known about the difference among various weight loss surgical procedures on diabetes remission.Data from patients referred during a 3-year period(from January2009 to December 2011)to the University of Naples"FedericoⅡ"diagnosed with obesity and diabetes were retrieved from a prospective database.The patients were split into two groups according to the surgical intervention performed[sleeve gastrectomy(SG)and mini-gastric bypass(MGB)].Weight loss and glycemic control status(blood glucose,HbA1c and hypoglycaemic treatment)were evaluated.RESULTS:A total of 53 subjects who underwent sleeve gastrectomy or mini-gastric bypass for obesity and diabetes were screened for the inclusion in this study.Of these,4 subjects were excluded because of surgical complications,7 subjects were omitted because young surgeons conducted the operations and 11 subjects were removed because of the lack of follow-up.Thirtyone obese patients were recruited for this study.A total of 15 subjects underwent SG(48.4%),and 16underwent MGB(51.6%).After adjusting for various clinical and demographic characteristics in a multivariate logistic regression analysis,high hemoglobin A1c was determined to be a negative predictor of diabetes remission at 12 mo(OR=0.366,95%CI:0.152-0.884).Using the same regression model,MGB showed a clear trend toward higher diabetes remission rates relative to SG(OR=3.780,95%CI:0.961-14.872).CONCLUSION:Although our results are encouraging regarding the effectiveness of mini-gastric bypass on diabetes remission,further studies are needed to provide definitive conclusions in selecting the ideal procedure for diabetes remission.

关键词： Bariatric surgery Sleeve Bypass Obesity and diabetes

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