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1.
Biomed Res Int ; 2018: 6486407, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29693012

RESUMO

OBJECTIVE: Cesarean scar pregnancy (CSP) is a rare condition that occurs when the pregnancy implants in a cesarean scar. An early diagnosis and a proper management are fundamental to prevent maternal complications. We review and discuss the different treatment employed in our unit to reduce morbidity, preserve fertility, and predict possible complications. METHODS: The reported treatment has been expectant management, operative hysteroscopy approach, and intramuscular injection of 50 mg methotrexate (MTX), followed by cervical dilation and manual vacuum aspiration (D&S) with a Karman cannula under ultrasound guidance, uterine artery embolization (UAE), and manual vacuum aspiration under ultrasound guidance and uterine artery embolization before surgical laparotomic resection. RESULTS: Complications were more frequent in women with a history of three or more cesarean section deliveries and with a myometrial thickness thinner than 2 mm. MTX and D&S treatment appear to be most effective and safe at the early age of pregnancy, while UAE and D&S are related to the highest risk of complication in any age of pregnancy. CONCLUSION: An appropriate preoperative diagnostic evaluation, the identification of cases at higher risk, and those eligible for a conservative treatment are fundamental to reduce complications.


Assuntos
Cesárea/efeitos adversos , Gravidez Ectópica/tratamento farmacológico , Gravidez Ectópica/etiologia , Feminino , Humanos , Metotrexato/uso terapêutico , Gravidez , Estudos Retrospectivos
2.
Gynecol Oncol ; 134(3): 556-60, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24967744

RESUMO

OBJECTIVES: Lymphoceles are among the most common post-operative complications of pelvic lymphadenectomy, with a reported incidence of 1% to 29% in gynecology oncology. Several studies evaluated the effectiveness of biological glues on reducing lymphoceles, but no data on gynecological patients are available. We evaluated the effectiveness of cyanoacrylic glues (n-butyl cyanoacrylate) (Glubran 2 - GEM s.r.l., Italy) in preventing lymphocele on 30 patients who underwent pelvic lymphadenectomy for endometrial or cervical cancer. METHODS: Single-blind prospective randomized study. Patients were divided into 2 groups: pelvic lymphadenectomy plus n-butyl cyanoacrylate (treatment group: 44 patients) and pelvic lymphadenectomy without n-butyl cyanoacrylate (control group: 44 patients). Primary endpoint was incidence of pelvic lymphocele in the two groups 30 days after surgery, and evaluated with pelvic ultrasound and RMI examination. Secondary endpoints evaluated drainage volume of lymphorrhea 36, 48, 72 and 96 h after surgery. RESULTS: 15% in the treatment group and 36.6% in the control group had lymphocele 1month after the procedure (p<0.03; RR 0.4 [95% CI 0.152-0.999]). Concerning the secondary outcome in group A the amount of lymphorrhea presented a constant significant decrease during evaluation; on the contrary, in group B, after an initial decrease at 48 h, the amount of lymphorrhea remained unchanged; at all considered times the amount of lymphorrhea resulted significantly greater in controls. CONCLUSION: Intraoperative application of n-butyl cyanoacrylate seems to reduce lymph production after pelvic lymphadenectomy, providing a useful additional treatment option for reducing drainage volume and preventing lymphocele development after pelvic lymphadenectomy.


Assuntos
Adesivos , Excisão de Linfonodo/efeitos adversos , Linfocele/prevenção & controle , Neoplasias Uterinas/cirurgia , Cianoacrilatos , Feminino , Humanos , Incidência , Linfocele/epidemiologia , Pessoa de Meia-Idade , Pelve , Estudos Prospectivos , Método Simples-Cego
3.
G Chir ; 34(3): 82-5, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23578412

RESUMO

Extra Ovarian Primary Peritoneal Carcinoma (EOPPC) is a rare type of adenocarcinoma of the pelvic and abdominal peritoneum. The objective examination and the histological aspect of the neoplasia virtually overlaps with that of ovarian carcinoma. The reported case is that of a 72 year-old patient who had undergone a total hysterectomy with bilateral annessiectomy surgery 20 years earlier subsequently to a diagnosis for uterine leiomyomatosis. The patient came to our attention presenting recurring abdominal pain, constipation, weight loss, severe asthenia and fever. Her blood test results showed hypochromic microcytic anemia and a remarkable increase CA125 marker levels. Instrumental diagnostics with Ultrasound (US) and CT scans indicated the presence of a single peritoneal mass (10-12 cm diameter) close to the great epiploon. The patient was operated through a midline abdominal incision and the mass was removed with the great omentum. No primary tumor was found anywhere else in the abdomen and in the pelvis. The operation lasted approximately 50 minutes. The post-operative course was normal and the patient was discharged four days later. The histological exam of the neoplasia, supported by immunohistochemical analysis, showed a significant positivity for CA 125, vimentin and cytocheratin, presence of psammoma bodies, and cytoarchitectural pattern resembling that of a serous ovarian carcinoma even in absence of primitiveness, leading to a final diagnosis of EOPPC. The patient later underwent six cycles of chemotherapy with paclitaxel (135 mg/m²/24 hr) in association with cisplatin (75mg/m²). At the fourth year follow-up no sign of relapse was observed.


Assuntos
Carcinoma/diagnóstico , Histerectomia , Ovariectomia , Neoplasias Peritoneais/diagnóstico , Idoso , Feminino , Humanos
4.
Gynecol Oncol ; 124(3): 444-51, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22119994

RESUMO

GOALS: To evaluate differences and changes in quality of life (QoL), lifestyle behavior and employment experience of young in comparison to midlife adults in response to early stage gynecologic cancer diagnoses. METHODS: 263 patients, divided into two age groups (Group A: ≤ 45 and Group B: >45 years), were interviewed on their QoL, lifestyle behavior (dietary habits, tobacco and alcohol use, physical activity) and employment experience (employment status and working time) at diagnosis and within 4 years from the treatment. The QoL was evaluated by European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) and its specific modules for each cancer type (in particular endometrium, cervix, ovarian and breast). RESULTS: Global health status was significantly different between the two groups. In the younger age group a more relevant cancer interference on family life and social activities and a greater impact on perception of health status have been observed. Young women were more affected by fatigue, constipation, gastrointestinal symptoms, lymphedema, poor body image and impaired sexuality. Cancer diagnosis had a major negative impact on employment of younger patients. Conversely, younger patients had overall better health behavior. They reported a higher daily intake of fruits and vegetables, along with lower alcohol consumption, furthermore they were a little more physically active than midlife adults. CONCLUSIONS: To enhance quality of life and to promote healthy lifestyle behavior of female cancer patients, particularly in younger age, it is essential to assure multidisciplinary approaches with specific medical intervention and psychosocial supports. Indeed, midlife adults seem to have a more rapid adaptive tendency to return towards levels of well-being, following cancer diagnosis and treatment, than younger patients.


Assuntos
Emprego , Neoplasias dos Genitais Femininos/psicologia , Comportamentos Relacionados com a Saúde , Estilo de Vida , Sobreviventes/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
5.
Eur J Gynaecol Oncol ; 32(3): 350-2, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21797134

RESUMO

BACKGROUND: Primary endometrial squamous cell carcinoma (PSECC) is a rare neoplasm. Squamous epithelium derived from endometrioid cancer or from cervical squamous cell carcinoma. The prevalence is about 0.1%. The genesis, histogenesis and biological behavior are unknown. CASE PRESENTATION: A 48-year old woman in postmenopause, referring pelvic pain and vaginal bleeding. Transvaginal ultrasound showed a bulky uterus with the endometrium containing an hyperecogenic area. Endometrial biopsy found an epidermoid carcinoma. MRI showed a 4 x 2 x 1.2 cm mass occupying the uterine cavity. The patient underwent radical treatment. Pathological examination showed features of PSECC. The mutation of p53 tumor suppressor protein was disclosed in 15% of neoplastic cells. PCR revealed the absence of HPV DNA. CONCLUSIONS: The findings of our case move us to underline that the pathogenesis of this tumor is still unclear. Moreover, preoperative diagnosis and staging of PESCC is extremely difficult. Most patients do not show characteristic symptoms and predisposing factors, making it almost impossible to diagnose the precise localization of tumor origin.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias do Endométrio/patologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/cirurgia , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Resultado do Tratamento , Proteína Supressora de Tumor p53/genética
7.
Minim Invasive Neurosurg ; 49(6): 347-52, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17323261

RESUMO

OBJECTIVE: The aim of this study is to report on the role of neuroendoscopy during the management of hydrocephalus that led to the diagnosis of intracranial tumoral dissemination and the subsequent finding of a spinal cord glioma. METHODS AND RESULTS: We present two children each with an intramedullary astrocytoma that presented initially with hydrocephalus without spinal cord symptoms. In both cases leptomeningeal gliomatous dissemination was asserted during routine endoscopy for the management of hydrocephalus. The diagnosis of a cervical and a lower thoracic intramedullary tumor was made soon after on magnetic resonance imaging. CONCLUSIONS: Spinal cord MRI with contrast should be considered initially in selected cases of hydrocephalus without evident diagnosis. The intraoperative diagnosis of gliomatous dissemination and secondary hydrocephalus due to unrecognized spinal cord gliomas was possible, in our experience, with the routine use of the neuroendoscope.


Assuntos
Astrocitoma/cirurgia , Endoscopia , Neoplasias da Medula Espinal/cirurgia , Astrocitoma/diagnóstico , Astrocitoma/patologia , Pré-Escolar , Craniotomia , Humanos , Hidrocefalia/diagnóstico , Hidrocefalia/patologia , Hidrocefalia/cirurgia , Lactente , Imagem Cinética por Ressonância Magnética , Masculino , Meninges/patologia , Invasividade Neoplásica/patologia , Ponte/patologia , Medula Espinal/patologia , Medula Espinal/cirurgia , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/patologia , Terceiro Ventrículo/patologia , Tomografia Computadorizada por Raios X , Derivação Ventriculoperitoneal , Ventriculostomia
8.
Surg Endosc ; 17(12): 1914-8, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14574547

RESUMO

BACKGROUND: Although the feasibility of minor laparoscopic liver resections (LLR) has been demonstrated, data comparing the open vs the laparoscopic approach to liver resection are lacking. METHODS: We compared 30 LLR with 30 open liver resections (OLR) in a pair-matched analysis. The indications for resection were malignant disease in 47% of the LLR and 83% of the OLR. The average size of the lesions was 42 mm for LLR and 41 mm for OLR. Five wedge resections, 12 segmentectomies, and 13 bisegmentectomies were performed in each group. RESULTS: The conversion rate for LLR was nil. The mean operative time was 148 min for LLR and 142 min for OLR. Mean blood loss was minimal in the LLR group (320 vs 479 ml; p < 0.05). Postoperative complications occurred in 6.6% of the patients in each group; there were no deaths. The mean postoperative hospital stay was shorter for LLR patients (6.4 vs 8.7 days; p < 0.05). In tumors, the resection margin was <1 cm in 43% of the LLR patients and 40% of the OLR patients ( p = NS). CONCLUSIONS: Minor LLR of the anterior segments has the same rates of mortality and morbidity as OLR. However, the laparoscopic approach reduces blood loss and postoperative hospital stay.


Assuntos
Hepatectomia/métodos , Laparoscopia/métodos , Adulto , Idoso , Perda Sanguínea Cirúrgica , Carcinoma Hepatocelular/cirurgia , Colecistectomia Laparoscópica , Colectomia , Estudos de Viabilidade , Feminino , Hemangioma/cirurgia , Hepatectomia/estatística & dados numéricos , Herniorrafia , Humanos , Laparoscopia/estatística & dados numéricos , Tempo de Internação , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos
10.
Pediatr Pathol Mol Med ; 20(3): 203-7, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11486351

RESUMO

Multiple intestinal atresia is a rare disorder with vascular or hereditary etiology. So far, the occurrence of this malformation along with omphalocele has not been reported. We describe a boy born from a nonconsanguineous gypsy couple with intrauterine growth retardation, omphalocele, and multiple intestinal atresia from the pylorus to the rectum. The microscopic examination of the intestine shows multiple small lumina with a sieve-like appearance. This is characteristic of the hereditary atresias and suggests development of a defect in (re)canalization during embryogenesis. The association with omphalocele indicates a common developmental defect may be present.


Assuntos
Hérnia Umbilical , Atresia Intestinal , Humanos , Recém-Nascido , Masculino
11.
Acta Paediatr ; 89(11): 1312-5, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11106041

RESUMO

AIM: To assess the incidence of cagA (cytotoxin-associated protein) and to evaluate its correlation with endoscopic-histologic findings and with eradication rate in a series of children affected by Helicobacter pylori (H. pylori) gastritis. METHODS: Fifty consecutive H. pylori gastritis children (27M; median age 10 y and 11 mo) were tested for IgG cagA protein (Western Blot technique). Pretreatment H. pylori infection was assessed on the grounds of endoscopic antral biopsy specimens by means of rapid urease test and histologic examination (Giemsa staining). All the children were treated with omeprazole (1 mg/kg/d), clarithromycin (15 mg/kg/d) and amoxycillin (50 mg/kg/d) for 2 wk. According to universally accepted clinical practice, outcome of treatment was assessed by 13C urea breath test at least 6 wk after the end of therapy. RESULTS: Thirty-five children (70%) were seropositive to cagA+ protein (median age 11 y and 1 mo). Endoscopic findings of cagA+ patients were similar to those of cagA- patients. In cagA seropositive patients the severity of histologic gastritis was higher (p < 0.05) and the granulocytic infiltration more marked (p < 0.01) than in seronegative ones. In cagA+ children, H. pylori eradication rate was significantly lower (p < 0.02). CONCLUSIONS: cagA testing may be of useful clinical interest because its positivity can imply a more severe gastritis and a lower susceptibility to eradication treatment.


Assuntos
Proteínas de Bactérias/genética , Gastrite/etiologia , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/genética , Adolescente , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Antiulcerosos/administração & dosagem , Anticorpos Antibacterianos/análise , Proteínas de Bactérias/sangue , Criança , Pré-Escolar , Claritromicina/administração & dosagem , Interpretação Estatística de Dados , Quimioterapia Combinada , Dispepsia/etiologia , Feminino , Gastrite/diagnóstico , Infecções por Helicobacter/sangue , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/imunologia , Humanos , Técnicas Imunoenzimáticas , Imunoglobulina G/análise , Masculino , Omeprazol/administração & dosagem , Penicilinas/administração & dosagem
12.
Ultrastruct Pathol ; 23(5): 319-23, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10582269

RESUMO

Mucin accumulation in ependymomas is thought to be limited to the myxopapillary variant and represents an important diagnostic feature. Similarly, signet-ring cells in ependymomas have been shown by electron microscopy to represent microrosette instead of mucin secretion. This study describes an infratentorial ependymoma largely composed of mucinous areas and signet-ring cells. The ependymal nature of mucin-secreting cells was confirmed by ultrastructural analysis. This case widens the variable spectrum of ependymal morphology. The value of electron microscopy in differentiating central nervous system neoplasms showing mucous secretion is stressed.


Assuntos
Ependimoma/patologia , Neoplasias Infratentoriais/patologia , Mucinas/metabolismo , Biomarcadores Tumorais/análise , Pré-Escolar , Epêndima/ultraestrutura , Ependimoma/metabolismo , Ependimoma/cirurgia , Feminino , Humanos , Técnicas Imunoenzimáticas , Neoplasias Infratentoriais/metabolismo , Neoplasias Infratentoriais/cirurgia , Imageamento por Ressonância Magnética , Mucinas/ultraestrutura , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vacúolos/ultraestrutura
13.
Urology ; 53(5): 904-7, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10223481

RESUMO

OBJECTIVES: This study sought to show the effectiveness and safety of three repeated alcohol injections for the treatment of simple large renal cysts. METHODS: From September 1991 to December 1997 we treated 72 renal cysts. The cyst was drained with an 8F mono J stent. Ninety-five percent sterile ethanol was injected into the cyst and left in place for 20 minutes. Two repeat alcohol injections were performed every 24 hours. After the third alcohol injection, the catheter was removed. To avoid pain in the last 39 patients, 20 mL of 2% lidocaine hydrochloride was injected into the cyst for 15 minutes before the alcohol injections. RESULTS: The follow-up period ranged from 8 to 83 months (mean 48). One patient underwent surgical intervention because of considerable bleeding in the cystic cavity that occurred after percutaneous drainage. In 1 patient in whom the cystic cavity communicated with the urinary tract, no alcohol injections were performed. After the repeated alcohol injections, the cystic cavity completely disappeared in 68 of the 70 treated cysts at first ultrasound examination. This result, observed at the first ultrasound control observation, remained unchanged during follow-up. CONCLUSIONS: In our experience, percutaneous drainage with three repeated alcohol injections offers a high rate of success without the cost and morbidity associated with other procedures, such as operation or laparoscopy.


Assuntos
Drenagem/métodos , Etanol/administração & dosagem , Doenças Renais Císticas/terapia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade
14.
J Ultrasound Med ; 18(3): 237-41, 1999 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10082359

RESUMO

The current investigation aimed to check the effectiveness of transvaginal ultrasonography in the diagnosis of organic urethral diseases, comparing its results with those of conventional examinations (physical examination, voiding cystourethrography, pelvic ultrasonography, cystourethroscopy). Transvaginal ultrasonography was performed in 560 female patients with recurrent cystitis, dysuria, or palpable masses and diagnosed the following urethral diseases: 25 diverticula, seven stenoses, three carcinomas, two leiomyomas of periurethral tissue, and one incomplete duplex urethra. In our study transvaginal ultrasonography proved to be the most reliable diagnostic tool among imaging methods used.


Assuntos
Endossonografia , Doenças Uretrais/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Recidiva , Reprodutibilidade dos Testes , Estudos Retrospectivos , Vagina/diagnóstico por imagem
15.
Urol Res ; 25(6): 391-4, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9443647

RESUMO

The aim of the study was to evaluate the applicability to urine samples of the Amplified Mycobacterium tuberculosis Direct Detection Test (AMTD), which is currently used to identify this organism in respiratory specimens within a few hours. The study was performed on 95 patients, comprising 35 subjects with a high index of suspicion for active tuberculosis of the urinary tract and 60 subjects with evidence of non-mycobacterial disease. One urine specimen from each subject was examined by microscopy, culture and AMTD. AMTD was positive in 38 specimens and negative in 57. Assuming culture as the reference standard, the sensitivity, specificity, positive predictive value and negative predictive value of AMTD were 100%, 91.93%, 86.84% and 100%, respectively. Reassessing the discrepancies between AMTD and culture by review of patients' charts, the sensitivity, specificity, positive predictive value and negative predictive value of AMTD were 100%, 93.44%, 89.47% and 100%. The results of the study as well as the characteristics of AMTD encourage its use for the rapid recognition of urinary tract tuberculosis, although its findings should be interpreted cautiously when the clinical picture is not consistent with an active tuberculosis.


Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Urogenital/urina , Adulto , Idoso , Idoso de 80 Anos ou mais , Amplificação de Genes , Genes Bacterianos , Humanos , Pessoa de Meia-Idade , Mycobacterium tuberculosis/genética , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Tuberculose Urogenital/diagnóstico , Tuberculose Urogenital/microbiologia
16.
Arch Ital Urol Androl ; 68(5 Suppl): 151-3, 1996 Dec.
Artigo em Italiano | MEDLINE | ID: mdl-9162349

RESUMO

The Authors describe their experience about the use of vaginal ultrasound in the diagnosis of some organic disease of the female urethra. The ultrasonography was performed with the 5 Mhz endocavitary probe and patients in lithotomy position and filled bladder. With this method has been possible value the urethral and peri-urethral echostructure and urethral calibre during micturition. the Authors visualized 20 urethral diverticula, 6 stenosis, 2 carcinomas and 1 leiomyoma. They show the great reliability of this investigation and argue that it may be present as a first instrumental approach in the clinical suspicion of an organic pathology of the female urethra.


Assuntos
Doenças Uretrais/diagnóstico por imagem , Feminino , Humanos , Radiografia , Ultrassonografia , Vagina
17.
Arch Ital Urol Androl ; 68(5 Suppl): 163-5, 1996 Dec.
Artigo em Italiano | MEDLINE | ID: mdl-9162352

RESUMO

Hypermobility of the bladder neck in response to increased intraabdominal pressure is one cause of stress urinary incontinence in women. Vaginal ultrasound (u.s.) is reliable and minimally invasive method for demonstrating bladder neck hypermobility. The Authors studied 50 women with S.U.I. and 40 with no history of S.U.I. measuring the distance from the bladder neck to the midline of the symphysis pubis (P.V.) and the angle between the BP line and the midline of the symphysis pubis (A.I.U.). The continent women were characterized by a median A.I.U. of 70 degrees and mean B.P. of 25.6 mm, at rest, a median A.I.U. of 80 degrees and a mean B.P. of 20 mm. at stress. The incontinent women were characterized by a median A.I.U. of 80 degrees and mean P.V. of 22.5 mm. at rest, and a median A.I.U. of 95 degrees and mean P.V. of 10 mm. at stress. There is a significant difference between the two groups. The Authors recommend the vaginal u.s. as reliable, practical, economical and patient accepted method to study the bladder neck mobility.


Assuntos
Incontinência Urinária por Estresse/diagnóstico por imagem , Feminino , Humanos , Ultrassonografia , Uretra/diagnóstico por imagem , Incontinência Urinária por Estresse/fisiopatologia , Urodinâmica
18.
Arch Ital Urol Androl ; 68(5 Suppl): 197-9, 1996 Dec.
Artigo em Italiano | MEDLINE | ID: mdl-9162361

RESUMO

The Authors report their results on the treatment of simple voluminous renal cyst with percutaneous drainage and three times repeated sclerosis with pure alcohol every 24 hours. After a mean follow-up of 28 months They report a 96% of success with only two recurrences. Since the fair results and low invasiveness of the method, the Authors propose the repeated alcoholization in the treatment of simple voluminous renal cysts.


Assuntos
Drenagem , Etanol/uso terapêutico , Doenças Renais Císticas/terapia , Soluções Esclerosantes/uso terapêutico , Escleroterapia , Terapia Combinada , Drenagem/métodos , Seguimentos , Humanos , Doenças Renais Císticas/diagnóstico por imagem , Doenças Renais Císticas/cirurgia , Recidiva , Soluções Esclerosantes/administração & dosagem , Ultrassonografia
19.
Arch Ital Urol Androl ; 68(5 Suppl): 211-4, 1996 Dec.
Artigo em Italiano | MEDLINE | ID: mdl-9162364

RESUMO

In this study the Authors examine the utility of the ultrasonographic investigation in the preoperative evaluation of 22 patients submitted to nephrectomy for tubercular lesions, comparing the informations obtained from this procedure with the histologic report. The renal ultrasonography execute with a Toshiba 3.5 Mhz probe, has been utilized to value morphology, volume, parenchymal echostructure and hydronephrosis. According to the Author's series, the ultrasonography has shown a 100% sensitivity permitting to well value the presence of parenchymal lesions and hydronephrosis. As regards the tubercular renal injuries the ultrasonography is non-specific because it does not allow to have pathognomonic images. The results obtained from the U.S. are overlapping to the Results Related from the literature for abdominal CT. The Authors argue that U.S., rapid and economical investigation is an efficient complement to the urography for an exhaustive preoperative evaluation of patients suffering from renal Tuberculosis.


Assuntos
Tuberculose Renal/diagnóstico por imagem , Humanos , Hidronefrose/etiologia , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X , Tuberculoma/diagnóstico por imagem , Tuberculose Renal/complicações , Ultrassonografia
20.
Minerva Pediatr ; 46(12): 569-74, 1994 Dec.
Artigo em Italiano | MEDLINE | ID: mdl-7731420

RESUMO

Hydrogen concentration in expired breath depends on the fraction of ingested carbohydrates unabsorbed by the small intestinal mucosa which reach the large intestine and are fermented by the colonic flora. The aim of this study is to assess whether in coeliac children breath hydrogen excretion reflects the histological changes in the jejunal mucosa. Hydrogen breath test was performed on 40 children (15 males 25 females) divided into three groups. Group I (controls): 9 children with symptoms suggestive of coeliac disease who, after the appropriate workup, were found to suffer from other gastrointestinal disorders and had abnormal jejunal mucosa. Group II: 14 children who had been diagnosed as coeliacs according to the ESPGAN criteria, were kept on a gluten free diet for a minimum of 6 months and had a normal jejunal mucosa. Group III: 17 coeliac children who ate small quantities of gluten or were on a normal diet. At histology, 10 of them showed a total and 7 a partial atrophy of the jejunal mucosa. Breath hydrogen levels were measured both at baseline and after ingestion of a 2% sorbitol solution in water, at 30 minute intervals for four hours. The peak hydrogen level and the total surface area under the hydrogen excretion curve were also assessed. Coeliac children on a gluten containing diet excrete significantly more H2 than controls or coeliacs on a gluten free diet. Patients with more severe histological lesions had higher peak H2 levels and greater total excretion areas. In coeliac children, sorbitol breath H2 test represents a simple noninvasive technique to detect impaired jejunal function and it should have an important role as a screening test and in assessing dietary compliance.


Assuntos
Testes Respiratórios/métodos , Doença Celíaca/diagnóstico , Hidrogênio/análise , Mucosa Intestinal/patologia , Jejuno/patologia , Adolescente , Doença Celíaca/metabolismo , Doença Celíaca/patologia , Criança , Pré-Escolar , Carboidratos da Dieta/metabolismo , Feminino , Glutens/metabolismo , Humanos , Mucosa Intestinal/metabolismo , Jejuno/metabolismo , Masculino
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