RESUMO
Fifty male children, aged between 3 and 10 years, were treated for a 12-day period with either trimethoprim (80-160 mg) plus sulphamethoxazole (400-800 mg) daily (co-trimoxazole) or 50-125 mg/day flurbiprofen rectally. The patients had been treated surgically for criptorchidism. Flurbiprofen showed good effectivity in controlling post-operative inflammation in urology. It is concluded that antimicrobial agents such as cotrimoxazole, because of their potential risks of damage at the cell's level, should be used only in presence of a bacterial infection.
Assuntos
Anti-Inflamatórios/uso terapêutico , Flurbiprofeno/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Propionatos/uso terapêutico , Sulfametoxazol/uso terapêutico , Trimetoprima/uso terapêutico , Criança , Pré-Escolar , Criptorquidismo/cirurgia , Combinação de Medicamentos/administração & dosagem , Combinação de Medicamentos/uso terapêutico , Edema/prevenção & controle , Flurbiprofeno/administração & dosagem , Humanos , Masculino , Distribuição Aleatória , Escroto , Sulfametoxazol/administração & dosagem , Supositórios , Equivalência Terapêutica , Trimetoprima/administração & dosagem , Combinação Trimetoprima e SulfametoxazolRESUMO
The Bladder T.C.C. represents about 70% of urological malignancies. Superficial T.C.C. is generally treated with T.U.R. followed by endocavitary chemoprophylaxis (Mitomycin, Antraciclines etc.). Invasive tumors are cured by radical cystectomy and reconstructive lower urinary tract. T1G3 bladder cancer (involvement but no invasion of muscle layers) is a "border line" lesion and is not uniformely treated (some Authors choose a "conservative approach with T.U.R. and chemoprophylaxis, some others prefer an "aggressive" treatment with radical cystectomy and urinary diversion. Authors present their experience in the treatment of T1G3 (19 patients in 4 years with one year minimum follow-up) with a "conservative" approach (bladder T.U.R.) but "aggressive" post-operative treatement (immunotherapy with B.C.G. vaccine) and endoscopic reevaluation after ten weeks from the first observation. Prognostic factors are examined (number and dimension of the tumors, concomitant mild or severe dysplasia, positive or not citology) in order to extrapolate patients that will be at risk for develop an aggressive disease.
Assuntos
Carcinoma de Células de Transição/terapia , Neoplasias da Bexiga Urinária/terapia , Antibióticos Antineoplásicos/uso terapêutico , Vacina BCG/uso terapêutico , Biópsia , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Terapia Combinada , Endoscopia , Epirubicina/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Prognóstico , Fatores de Tempo , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgiaRESUMO
The increasing interest and progress showed by the surgical treatment of the ureteropelvic junction obstruction, have evidenced some problems that have not completely solved. Problem in which there is division in opinion concerns the role of splinting with or without nephrostomy in pyeloplasty. A strong impulse for proximal urinary diversion after pyeloplasty derived from data provided by Caine and Hermann (1), who have demonstrated in cineradiographic studies that the normal ureteral peristalsis did not return for about 3 weeks after anastomosis. The authors, who use systematically urinary diversion in pyeloplasty, emphasize the usefulness of the Kidney Internal Stent Splint Set (K.I.S.S.S.). This device developed by Max Maizels, From Children's Memorial Hospital Chicago USA, is employed after pyeloplasty, when kidney drainage is mandatory for the success of the procedure. The set contains: sof-flex stent, 55 cm. long: closed segment 25 cm. long, with 12 cm. malleable tapered positioning stylet; "cut-out" segment 30 cm. long. Silicone retention disc with pull-tie; Luer-lock adapter; 10 Fr. polyvinylchloride connecting tube 30 cm long. Introduction with the malleable stylet is the same as a nephrostomy interoperatively placed. The closed portion of the stent is sutured with adsorbable suture to the renal capsule and is performed as a nephrostomy drainage catheter. The "cut-out" portion is advanced interoperatively into the ureter. The K.I.S.S.S. explains essentially a twofold function: first to defend the neo-anastomosis, secondly like a nephrostomy drainage.
Assuntos
Pelve Renal/cirurgia , Stents , Cateterismo Urinário/instrumentação , Derivação Urinária/instrumentação , Anastomose Cirúrgica , Pré-Escolar , Desenho de Equipamento , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The increasing of andrological valuation for erectile dysfunction (ED), happened in the last ten years, and induced chemical industries and sanitary system to supply correct answers from cultural, diagnostic and therapeutic views. All these events allowed the people to approach easily to uro-andrological valuations. This situation is perhaps a unique way to involve a great number of men in a wide uro-andrological screeening, that is useful, with a total patient and couple involvement, not only for a ED causes research, but also for incidental pathology screening (neoplastic or dismethabolic). Even if more expensive than a simplified diagnostic ED protocol (95% of the patients accept it, if there is a good counseling), this way of diagnostic valuation permit to hit the targets and to add permanently andrology to scientific specialty, as the science that studies the sexuality behaviour of the man and all its pathology.
Assuntos
Disfunção Erétil/diagnóstico , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
2 groups of enuretic children were respectively treated with anticholinergic drugs dicyclomine and oxybutynin chloride. The results of the trial clearly indicate oxybutynin as the most effective drug in the treatment of the disease.
Assuntos
Enurese/tratamento farmacológico , Ácidos Mandélicos/uso terapêutico , Parassimpatolíticos/uso terapêutico , Adolescente , Análise de Variância , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Diciclomina/uso terapêutico , Feminino , Humanos , MasculinoAssuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Hemangioma/diagnóstico , Hipertensão/etiologia , Neoplasias Renais/diagnóstico , Lipoma/diagnóstico , Feocromocitoma/diagnóstico , Neoplasias das Glândulas Suprarrenais/complicações , Diagnóstico Diferencial , Feminino , Hemangioma/complicações , Humanos , Neoplasias Renais/complicações , Lipoma/complicações , Pessoa de Meia-Idade , Feocromocitoma/complicaçõesAssuntos
Cardiopatias/complicações , Astenia Neurocirculatória/complicações , Transtornos Psicofisiológicos/etiologia , Síncope/etiologia , Adulto , Idoso , Feminino , Cardiopatias/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Personalidade , Testes Psicológicos , Síncope/psicologiaRESUMO
A case of renal oncocytoma angiographically diagnosed and successfully treated by in situ tumorectomy under local hypothermia is presented.
Assuntos
Adenoma/cirurgia , Neoplasias Renais/cirurgia , Adenoma/irrigação sanguínea , Humanos , Neoplasias Renais/irrigação sanguínea , Masculino , Radiografia , Artéria Renal/diagnóstico por imagem , Cálculos UreteraisRESUMO
A retrospective study of 88 cases of renal cell carcinoma is presented with emphasis on the follow-up and progestogens administration. Between the statistically homogeneous groups of patients treated with progesterone capronate and with other therapeutic regimens, no statistical difference in actuarial survival rate could be detected.
Assuntos
Adenocarcinoma/tratamento farmacológico , Neoplasias Renais/tratamento farmacológico , Progesterona/uso terapêutico , Adenocarcinoma/mortalidade , Adenocarcinoma/terapia , Feminino , Seguimentos , Humanos , Neoplasias Renais/mortalidade , Neoplasias Renais/terapia , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Ectopic corticoadrenal tissue is not a very uncommon finding during orchiopexy in children. The causes can be found in the period of organ development and gonadal migration (spermatic cord). From 1986 to 1990, we have performed 88 orchiopexy procedures in the Urology Service of "San Antonio Abad de Gallarate" Hospital. Only one case (1.13%) of juxta-funicular corticoadrenal ectopia has been observed. The aim of the present study is to determine the correct surgical approach to this incidental finding during surgery of the inguinal canal in pediatric patients.
Assuntos
Córtex Suprarrenal , Coristoma/cirurgia , Criptorquidismo/cirurgia , Neoplasias dos Genitais Masculinos/cirurgia , Cordão Espermático , Corticosteroides/metabolismo , Criança , Pré-Escolar , Coristoma/embriologia , Coristoma/epidemiologia , Coristoma/metabolismo , Coristoma/patologia , Criptorquidismo/complicações , Neoplasias dos Genitais Masculinos/embriologia , Neoplasias dos Genitais Masculinos/epidemiologia , Neoplasias dos Genitais Masculinos/metabolismo , Neoplasias dos Genitais Masculinos/patologia , Humanos , Incidência , Masculino , Síndromes Endócrinas Paraneoplásicas/prevenção & controleRESUMO
The authors describe their experience of 79 operations using the Chevron anterior transperitoneal approach in the treatment of 71 renal tumors and 8 cases of renal trauma. This approach respects the physiology of the respiratory system, has a low morbidity and mortality, in the post-operative period the need for anesthesia is moderate and hospitalization is shorter. The authors underscore the following advantages of the Chute-Baron-Olsson technique: it is easy to perform and can be easily extended, dehiscence and laparoceles are uncommon (only 2 of 79 patients). Furthermore, the Chevron partial or total approach in tumors and renal trauma permits exposure of an excellent inframesocolic and supramesocolic field and perfect control of the important elements of the renal vasculature.
Assuntos
Neoplasias Renais/cirurgia , Nefrectomia/métodos , Adulto , Feminino , Seguimentos , Humanos , Rim/lesões , Masculino , Pessoa de Meia-Idade , Nefrectomia/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologiaRESUMO
Benserazide, an inhibitor of dopa-decarboxylase, stimulates prolactin (Prl) release in normal women and in puerperae; nomifensine, a dopaminergic drug able to release dopamine and to inhibit its re-uptake at the post-synaptic level, inhibits Prl release in the same subjects. Similar modifications of Prl release are evident in selected cases of non-tumoral hyperprolactinaemia, while neither drug modifies Prl release in patients with a Prl-secreting pituitary adenoma, in patients with 'functional' hyperprolactinaemia and in patients with 'functional' hyperprolactinaemia and in patients with minor abnormalities of sellar tomography. Neither drug modified Prl release in patients with macro- or microadenomas; several patients in the remaining groups failed to respond to one or both tests, the concordance between the two tests averaging 75%. Patients responding to both tests, to one test or to neither test showed progressively higher basal Prl levels. Since benserazide and nomifensine can indicate the presence of a pituitary adenoma earlier than sellar tomography, our results indicate that patients with no Prl response to one or to both tests probably harbour a pituitary adenoma which cannot yet be revealed by sellar tomography.
Assuntos
Adenoma/metabolismo , Benserazida/farmacologia , Hidrazinas/farmacologia , Isoquinolinas/farmacologia , Nomifensina/farmacologia , Neoplasias Hipofisárias/metabolismo , Prolactina/metabolismo , Adenoma/diagnóstico , Feminino , Humanos , Neoplasias Hipofisárias/diagnóstico , Período Pós-Parto , Gravidez , Prolactina/sangueRESUMO
59 patients affected by amenorrhea or anovulation, 37 of whom also with galactorrhea, and with hyperprolactinemia of unknown origin (idiopathic hyperprolactinemia, 24 patients) or due to a pituitary microadenoma (tumoral hyperprolactinemia, 35 patients) were treated with metergoline (4-12 mg/day) or with bromocriptine (2.5 to 10 mg/day) for 90 days. The effectiveness of the two treatments was assessed on clinical grounds and by evaluating at monthly intervals serum progesterone levels, during the presumed luteal phase, and serum prolactin levels. The success rate with the two drugs was superimposable in terms of disappearance of galactorrhea and return of menses, normalization of prolactin levels and induction of ovulation. Also the number of pregnancies obtained (7 with metergoline, 9 with bromocriptine) was similar. With both drugs, the majority of patients responded to the treatment within the first month.
Assuntos
Adenoma/sangue , Bromocriptina/uso terapêutico , Ergolinas/uso terapêutico , Metergolina/uso terapêutico , Neoplasias Hipofisárias/sangue , Prolactina/sangue , Adenoma/tratamento farmacológico , Adulto , Amenorreia/tratamento farmacológico , Anovulação/tratamento farmacológico , Feminino , Galactorreia/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Neoplasias Hipofisárias/tratamento farmacológico , GravidezRESUMO
It is a widely diffused opinion that moving backwards in time the moment of the diagnosis of cancer of prostate, so that the tumor is detected earlier than normal, means that the treatment would be more effective than the one adopted in the usual times of diagnosis. For this reason the earlier diagnosis of prostate cancer has become more and more a compulsory target of the modern urologist, at a time of booming of the third age, of increased lifetime expectancy, of significant elevation of prostate cancer rate and of the persistent uncertainty of the efficacy of available treatments. Theoretically the mortality rate of prostate cancer can be reduced by the prevention programs and by the improvements of treatment methods, but the 'earlier' diagnosis is certainly an easier and less expensive strategy to achieve the same objective. The authors have evaluated the argyrophilic-nucleolar organizer region (Ag-NOR) proteins on 40 cases of adenocarcinoma of prostate collected through a multicentric program in France and in Italy. The Ag-NOR have been stained with silver technique set up by Ploton and Derenzini while the quantitative index has been evaluated by a semiautomatic system partially commercially available, partially modified by the authors. The conclusions: (a) the Ag-NOR index is a simple and reproducible method; (b) the Ag-NOR staging system corresponds to Gleason's grading; (c) the Ag-NOR elevation is a reliable marker of increased cell proliferation and is detectable much earlier than the morphologic changes of Gleason's classification.
Assuntos
Adenocarcinoma/patologia , Biomarcadores Tumorais/análise , Proteínas de Neoplasias/análise , Região Organizadora do Nucléolo/patologia , Neoplasias da Próstata/patologia , Adenocarcinoma/química , França , Humanos , Itália , Masculino , Região Organizadora do Nucléolo/química , Prognóstico , Neoplasias da Próstata/química , Estudos Retrospectivos , PrataRESUMO
The multiform biology of superficial bladder tumors, both morphologically and evolutively, and the lack of reliable predictors of progression have led the authors to study the Ag-NOR proteins as a new marker of these tumors. It is well known that particularly the low-grade superficial tumors frequently relapse on the same histologic and proliferative module. Their potential of progression is probably present at the time of the first manifestation of the disease or it can show itself along the relapsing evolution with classic modifications translating the cellular dedifferentiation. The NOR index, set up by the authors, has several advantages: firstly, it corresponds to a functional value of normal and neoplastic cells; secondly, it can be used also with paraffin blocks. Another advantage is the semiautomatic lecture, reproducible also in the urinary cytology, mainly of low-grade tumors, reducing the number of false-negatives. The conclusion of the study of 38 cases of superficial bladder cancer has induced the authors to believe that an increased NOR index is a reliable 'marker' of their progression. Therefore, the authors suggest the use of the NOR activity for the surveillance of the urothelial disease and for a more logical therapeutic strategy.