[Cholecystectomy with laparoscopy and laparotomy. Analysis of the complications]

Laparoscopic cholecystectomy (LC) has been adopted by many as the treatment of choice for uncomplicated biliary lithiasis; since an increasing number of surgeons use LC even in complicated cases, we examined our series in order to see if this is the correct procedure. We report on the results of our first 252 LC and compare them with our latest 66 open cholecystectomies, in order to evaluate number and importance of postoperative complications. Besides we compare complications in patients below and over 60 years of age to verify if age bears any significance. We found no difference in frequency of complications among patients younger or older than 60; highly significant is, on the contrary, the difference in complications between the two procedures, the incidence being much lower in the laparoscopic one. We state that LC is a safe and effective procedure and suggest it as the method of choice for the treatment of any symptomatic gallbladder stone disease.

[Schistosomiasis: possible cause of ectopic pregnancy. Four clinical cases]

The Authors describe 4 cases of ectopic pregnancy associated with foci of schistosomiasis and point out the relevance of mass screening on urine, stool and vaginal secretions in those areas where schistosomiasis is endemic and frequent the involvement of female genital tract. Utilization of laparoscopy in all cases where as adnexal mass and/or a history of unexplained infertility is found is finally advocated.

Clinical outcome of fetal uropathy. II. Sensitivity of echography for prenatal detection of obstructive pathology

Among 8,579 neonates born between February 1, 1981 and March 31, 1987, and cleared by prenatal sonography for significant urinary tract abnormality 158 subsequently were hospitalized because of signs or symptoms of urinary tract disease, predominantly urinary tract infection. Evaluation of these 158 patients revealed 24 with vesicoureteral reflux, 7 with duplicated systems (2 of which showed reflux), 1 with the syndrome of Fraley, 1 with pyelectasis and 5 with mild hydronephrosis (3 secondary to reflux and 2 with diethylenetriaminepentaacetic acid renal scans considered to be nonobstructed). There was no incidence of significant obstructive uropathy that had been missed by the previous prenatal sonography and that surfaced subsequently to cause morbidity in this series. The principal disorder of the urinary tract that may fail prenatal investigation is vesicoureteral reflux.

Clinical outcome of fetal uropathy. I. Predictive value of prenatal echography positive for obstructive uropathy

Clinical followup was performed in 73 neonates with a prenatal echographic suspicion of uropathy. Of 42 patients with a prenatal suspicion of unilateral hydronephrosis only 15 had pathological obstruction and 2 had multicystic dysplastic kidneys. Among 10 infants with a prenatal suspicion of bilateral hydronephrosis only 1 had true bilateral obstruction and 2 had unilateral obstruction. In 2 patients hydroureteronephrosis seen on prenatal echography was due to massive bilateral vesicoureteral reflux. In this group there was also a multicystic dysplastic kidney and 1 patient with bilateral cystic dysplasia. There was a prenatal suspicion of cystic disease in 8 infants. Postnatally, diagnosis was multicystic dysplastic kidney in 2 patients and a simple renal cyst in 4. The remaining 2 neonates had obstructive uropathy. Finally, of 13 neonates with a prenatal suspicion of anatomical-echo-structural abnormalities a definitive abnormality could be established in only 8. The predictive value of prenatal echography positive for obstructive uropathy was 34.6%.

Persistence of poliovirus-neutralizing antibodies 2-16 years after immunization with live attenuated vaccine. A seroepidemiologic survey in the mainland of Venice

A seroepidemiological survey was conducted on subjects who had received a full vaccination course with live attenuated poliovirus 2-16 years before. For strains 1 and 2 prevalence of seropositives and median values dropped gradually during the first 10 years; strain 3 showed a much earlier decline. Environmental displacement of wild poliovirus by the attenuated, less immunogenic strain might eventually induce a 'gap', should complacency hamper needed vaccination efforts.

[Availability, consumption of alcoholic beverages and alcohol-related mortality in Italy]

On the basis of the W.H.O. guide lines the relevant parameters for the study of alcoholism in Italy have been identified. The production and utilization of alcoholic substances is very high, then appears to have reached a plateau about ten years ago. Likewise, consumption has not increased since a few years. Hospital admissions for symptoms related to alcoholism are no more available after the closure of all mental hospitals in 1978. Alcohol-related deaths seem to be stable, as well as cause specific death rates for cirrhosis .

[Improvement in the efficiency of an ambulatory service case load by applying a computerized method (patient flow analysis)]

The authors describe the application of a technique called Patient Flow Analysis aimed at the improvement of Clinic Personnel efficiency and reduction of patient waiting time. Results were satisfactory and encourage further experiences.

Evaluation of a structured alcohol education course in a secondary school system in north Italy

The authors describe the results of an alcohol education course given to 2166 high school students in the area of Padua, Italy. An evaluation was performed, utilizing a before and after technique: it was shown that baseline knowledge of relevant information on alcohology was similar among younger and older teenagers; also, baseline information and course gain varied according to question content.

Defining legitimate births in Fulton County, Georgia, 1977

In 1977, the parents of 1,043 births recorded for 15 to 19 year old women in Fulton County, Georgia, were classified as married. However, only 36 per cent of these births could be linked with marriage certificates. An analysis of the unlinked birth certificates showed that the overwhelming majority of teenage parents did not appear to be legally married. The absence of a specific statement regarding marital status on birth certificates results in inaccuracies in the reporting of births according to marital status of parents.

[Pathology of alcoholism. Experiences and treatment possibilities]

In the present study, the state of art of alcohol-related pathology is described, and the most credited etiological theories reviewed. An effort has been made to apply theory to the daily practice of the health practitioner and the social worker, who operate in the field. Particular emphasis has been given to the experience in the County of Dolo, Italy, where alcohol-related problems have been successfully dealt with by the Alcoholism Unit of the local General Hospital.