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Biomedical subjects

A Lembo

Publications and source records attributed to A Lembo.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Conservative surgery of parenchymal renal carcinoma: urologic data from Lombardy].

We report the results of a questionnaire sent to various Urology departments in Lombardy about "Conservative Surgery in Renal Cell Carcinoma" which was the subject of discussion at the 50th meeting of the Lombardian Society of Urologist. 23 centres out of 34 i.e. 68% answered. 100% of the departments performed nephron sparing surgery, 91% in cases of imperative and elective indication and 9% only in imperative indication. 100% of the patients underwent preoperative staging with ultrasound and computer tomography. 48% treated in elective surgery only incidentally asintomatic discovered tumours, but 52% treated both incidentally and sintomatic ones. Elective surgery is suggested when the tumor has a diameter less than or up to 3 cm., from 3 to 5 cm., and more than 5 cm. in 48%, 48% and 4% of the urological departments respectively. 70% consider the importance of tumor location and do not perform partial nephrectomy when the tumor is intraparenchymal or in contact with the secretory tract. From a technical point of view 82% carried out partial nephrectomies while 18% carried out enucleation; 57% performed routinally frozen section on tumor bed and 61% do not performed lymphadenectomy. 83% believe in the multifocality problem. A macroscopic and microscopic haematuria does not condition the elective indication in 62% of the urology departments. The follow-up is carried out with ultrasonography alternated with CT in 78% of the departments and is continued for over 5 years in a likewise 52%. From 1990 to 1995, 3332 patients were surgically treated for renal cell carcinoma in 23 urology departments; 487 (14.6%) underwent nephron sparing surgery; 320 elective and 167 imperative indication. The local global relapse was 2.9% (14/487); 5.3% (9/167) in imperative group and 1.4% (5/320) in elective group. Conservative surgery in Lombardy will always try to have the golden standard treatment in the incidental, single renal cell carcinoma.

Carcinoma, Renal Cell↗
PubMed1996

[T1G3 transitional cell carcinoma of the bladder: our experience with 44 patients treated with intravesical BCG after TUR].

Forty-four patients affected by poorly differentiated (G3) superficial TCC invading lamina propria (stage T1) were treated with intravesical BCG. They underwent weekly instillations of 75 mg BCG for six week after trans-urethral resection (TUR) of bladder cancer. An additional induction course was given to patients who relapsed. A maintenance course with monthly instillations for twelve months followed in complete responder patients. After the first induction course, 34/44 patients (77.2%) showed complete response. In 10 patients a second induction course was necessary, with complete response in four. After one or two induction course, 38/44 patients (86.5%) showed complete response. The maintenance course was administered to 38 patients with 35/38 complete responses. After a median follow-up of 30 months, there were 29/44 (65.9%) disease free patients, 11/44 (25%) tumor recurrences and 4/44 (9%) tumor progressions. The drug has been well tolerated with few side effects. Our data suggest that intravescical BCG after TUR is effective in the treatment of high-risk superficial bladder cancer and we believe that it can be used a first approach in treating patients affected by T1G3 bladder cancer.

Administration, Intravesical↗
PubMed1996

[Precancerous lesions of the penis].

Premalignant penile lesions have been associated to squamous cancer, although the true incidence of progression of these entities to squamous cell carcinoma is unknown. These lesions may coexist with or may antecede the occurrence of carcinoma. For this reason close follow-up of the patient is necessary to detect early evidence of malignant degeneration.

Humans↗
PubMed1996

[Conventional surgical treatment of penile tumors].

The surgical treatment of primary lesion in Carcinoma of the penis is the total excision of the carcinoma with tumor free margins. Distal preputial carcinomas without deep infiltration are often treated by extensive circumcision. Partial or total amputation of the penis is required by the location and the extent of the tumor. The evaluation and the treatment of the lymph nodes in penile cancer are still unclear.

Humans↗
PubMed1996

Low dose Pasteur bacillus Calmette-Guerin regimen in stage T1, grade 3 bladder cancer therapy.

PURPOSE: We assessed the effectiveness of intravesical bacillus Calmette-Guerin (BCG) for high risk transitional cell carcinoma of the bladder. MATERIALS AND METHODS: A total of 51 patients with stage T1, grade 3 disease was treated with weekly instillations of 75 mg. Pasteur strain BCG for 6 weeks after transurethral resection for bladder cancer. An additional induction course was given to patients with relapse. Tumor-free patients followed a maintenance course with monthly instillations for 12 months. RESULTS: After the initial induction course 37 of 51 patients (72.5%) remained tumor-free. A second induction course was necessary in 13 patients. After 1 or 2 induction courses 44 of 51 patients (86.3%) were tumor-free. The maintenance course was administered to 44 patients, with 41 remaining tumor-free. After a median followup of 33 months (range 3 to 63) 28 patients (54.9%) were disease-free, 12 (23.5%) had recurrent tumors and 7 (13.7%) had progression. The risk of treatment failure was significantly greater for solid than papillary tumors (p = 0.0006), recurrent than primary tumors (p = 0.0052) and coexisting carcinoma in situ (p = 0.124) in multivariate analysis, and for early recurrence (p = 0.0001) in univariate analysis only. The drug was well tolerated with few side effects. CONCLUSIONS: Our data suggest that this low dose Pasteur BCG regimen is effective in the treatment of high risk superficial bladder cancer. Some tumor characteristics, such as solid appearance, coexisting carcinoma in situ, history of superficial transitional cell carcinoma and early relapse after the initial induction course, seem to be negative prognostic factors.

Adjuvants, Immunologic↗
PubMed1995

[Surgical treatment of benign prostatic hypertrophy: what and when TURP vs adenomectomy].

Surgical treatment is the gold standard for Benign Prostatic Hyperplasia (BPH) therapy. At the present diagnostic approach allows better patient selection and treatment assignment. In this work we have studied retrospectively the outcome of 120 BHP patients who underwent trans urethral resection (TURP) and of 145 BPH patients underwent "open" prostatectomy. In all the patients surgical time, prostate weight, indwelling catheter standing, rest in bed, early and late complications were evaluated. Irritative symptoms occurred after TURP in 10% of the cases. The two therapeutical options are not comparable for they technically different. The choice between the two depends on the accurate patient characterization and selection.

Bed Rest↗
PubMed1995

[Our current indications for radical prostatectomy].

Radical prostatectomy is the golden standard for localized prostate cancer. The identification of patients with intraprostatic disease who can be cured and will live long enough to benefit from a surgical therapy represents the primary goal of the authors. Target of this article is underlining the importance of an accurate preoperative staging through ultrasound-guided biopsy of seminal vesicles and periprostatic spaces. The positivity of the surgical margin after radical prostatectomy is also taken into account as it represents, according to the authors, an extremely important but often overlooked parameter.

Humans↗
PubMed1994

[Nerve-sparing retroperitoneal lymph node dissection in patients with non-seminomatous testicular tumors at clinical stage 1].

Retroperitoneal lymph node dissection (RPLND) for low stage testicular cancer involves a low rate of dry ejaculation. The nerve-sparing technique avoids the damage of sympathetic fibers. 7 cases of non seminomatous testicular cancer have been treated by the Author. Through midline incision and intestinal derotation the vascular plane and the sympathetic fiber are identified before starting lymph node dissection. All the patients report physiological ejaculation; the post-operative follow-up is still short but at the present all patients are tumor free. In low stage testicular cancer nerve-sparing lymphadenectomy preserve physiological ejaculation and reducing surgical morbidity as well.

Erectile Dysfunction↗
PubMed1993

[What not to do when confronted with a iatrogenic lesion of the ureter].

Starting from their experience, the Authors report about steps to avoid in case of ureteral injury. They make a distinction between emergencies and planned surgery. In particular they underline that it is always advisable to confine surgery to transcutaneous or surgical nephrostomy when the experience in reconstructive surgery of upper urinary tract is limited. The Authors further suggest strict follow-up so as to avoid loosing functioning renal units due to a silent progression of an ureteral lesion. Ureteral reconstruction is the golden standard of an ureteral lesion repair; long term stenting has to be limited to the cases where a definitive surgery is not possible either for general conditions or for primary malignant disease. The discussion is integrated with pictures of several cases.

Emergencies↗
PubMed1991

[Surgical treatment of diaphyseal fractures of the forearm during pre-adolescent age].

The results of treatment of 10 both-bone unstable diaphyseal fractures of the forearm in children by open-reduction and intramedullary fixation with Kirschner wiring of the radius are presented. All fractured healed in perfect alignment. No complications occurred. In a 3 year and 2 month follow-up all the patients had excellent results with full range of movement. The advantages of this method are: a) it is easy to carry out; b) it maintains anatomical reduction; c) a second operation to remove the internal fixation device is not required; d) fixation of the ulna is not necessary, because in all patients a realignment of the ulnar fragments occurred after radius reduction.

Bone Wires↗
PubMed1990

[The Freeman-Sheldon syndrome].

The authors report two cases of Freeman-Sheldon syndrome, characterised by recessive autosomic transmission, affecting a brother and a sister born of parents who were not blood relations. The syndrome, for which 50 cases are described in the literature, takes its name from the authors who were the first to describe it in 1938. The typical picture is based on congenital deformity involving the cranium, the face and the locomotor apparatus, with a particular aspect of the subject affected related to his or her expression, resembling that of someone whistling ("whistling face", Burian, 1963). In addition to the descriptive aspect of the syndrome and to the means of its transmission, the authors report orthopaedic aspects concerning the locomotor apparatus and problems related to the type of surgery performed.

Abnormalities, Multiple↗
PubMed1990

[Neoadjuvant chemotherapy of infiltrating carcinoma of the bladder: our experience].

From January 1987 until October 1989, 96 patients have been treated with radical cystectomy for locally advanced bladder cancer. Nineteen, out of 96 underwent chemotherapy (either M-VAC or M-VEC) before cystectomy. Five had T1G3 bladder tumor. After chemotherapy the results had been the following: 5 complete responses (CR) 26%, 7 partial responses (PR) (37%) and no changes in 7 patients (37%). During the first two courses of chemotherapy, 36 administrations out of 152 scheduled should have not been done because of drug toxicity. The seven patients who had no changes had a drug administration reduced of 41% with respect of a rate of reduction of 12% in the group of patients who had complete response. The urinary diversion after cystectomy were performed with a neobladder according to Reddy in 4 patients, with a colon conduit in 1 patient and with an ileal conduit in 12 patients. All the patients survived the surgery. We did not notice any difference in the follow up after surgery in those patients treated before cystectomy with chemotherapy with respect to the patients who underwent cystectomy without chemotherapy. Despite the fact that by now we can not state any conclusion about the efficacy of neoadiuvant chemotherapy, due both to the short follow up and to the small number of patients treated, we should however perform cystectomy in all the patients after chemotherapy because up to now we have no evidence that a conservative treatment of the bladder after chemotherapy could be safe.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Autosomal recessive form of whistling face syndrome in sibs.

Two sibs with the whistling face syndrome, born to unaffected parents, are presented. They had the full facial and limb manifestations typical of this disorder, for which there is evidence of autosomal dominant inheritance. The existence of an autosomal recessive form of this syndrome has been suspected previously on the basis of a limited number of observations. Our study substantiates genetic heterogeneity of this condition and suggests that the autosomal recessive form could be even less rare than is generally considered.

Abnormalities, Multiple↗
PubMed1987

[Epididymitis in adults. Retrospective study of 110 cases].

A review was conducted of 110 cases of epididymitis, most of these patients (71.9%), especially those under 50 years of age, having negative urine cultures: this appears to confirm the high frequency of Chlamydia T infection in the age group 20 to 50 years when sexual activity is at its maximum. Urinary output was normal in 60 of 79 patients and urography exploration provided normal results in 69 of the 110 patients (63%), particularly in those under 50. It is concluded, therefore, that urography is not necessary in patients under 50 but remains necessary in those in older age groups.

Acute Disease↗