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Biomedical subjects

A Valente

Publications and source records attributed to A Valente.

89 records · Page 5Linked to original sources
PubMedDate not supplied

[Our experience with treatment of varicocele in a day-surgery protocol].

In the last few years the increasing interest for non-invasive operating techniques has allowed to reevaluate the sublinguinal varicocelectomy surgical technique for idiopathic varicocele surgical treatment. During the years 1998-2001, 29 patients have been operated on sub-inguinal varicocelectomy (14 patients were suffering from idiopathic varicocele of third grade, 11 of second grade, 3 of first grade, and 1 subclinical). Out of the 29 patients, only 10 were unable to procreate. All patients were operated under local anesthesia and discharged the same day (day-surgery). Owing to Authors' experience, the sublinguinal varicocelectomy by optical magnifying devices represents the "gold standard" in the idiopathic varicocele treatment because it allows to minimize relapsing rates, to limit post-operation complications, to improve the reproductive faculty of seminal fluid both qualitatively and quantitatively, to cut patient's operating costs significantly, to keep the operation time within acceptable limits, and to be easily learned and carried out.

Adult↗
PubMedDate not supplied

[Head trauma in a general surgery department: observations, diagnostic and therapeutic indications].

UNLABELLED: The authors reviewed the records of 927 patients admitted to Surgical Clinic University of L'Aquila from November 1986 to July 1990 with head trauma. The 5.6% (52 patients) had skull fractures. 23 (2.4%) patients sustained significant intracranial sequelae from their injuries, but only 4 (17.3%) of these also sustained fractures, 17 did not. Of the four fractures 1 were simple, 2 was depressed and 1 was basilar. The patients (17) without a skull fracture and positive CT were transferred to a neurosurgical department, where 12 underwent operation. The patients (4) with a skull fracture and positive CT and 2 patients with a depressed skull fracture and negative CT were transferred to a neurosurgical department where 5 (except 1 patient with simple fracture) underwent operation. The severity of coma was evaluated according to Glasgow Coma Scale (G.C.S.). The 2.4% of patients had the Glasgow Coma Scale = or less than 7. The CT or MNR are indicate in the presence of neurologic abnormalities. Overall mortality rate was about 0.53%. In the severe head trauma (G.C.S. = or less than 7) was of 17,3. IN CONCLUSION: the skull radiography is not indicated of routine and are performed for the evaluation of depressed fractures, of fracture of the cranial base and of cervical vertebrae: the MNR was found to be superior to CT and to be very effective in the detection of traumatic head lesions: the Glasgow Coma Scale is important for monitoring, stratification and prognostic evaluation of patients.

Adolescent↗
PubMedDate not supplied

[Non derivated surgery indications and limits in bile duct iatrogenic injuries treatment].

Recently the incidence of iatrogenic bile duct injuries has increased proportionally to development of the laparoscopic surgery. The objective of this study is to determine the possible application of non derivated surgical repairs in iatrogenic bile duct injuries treatment of the above procedures. These surgical approaches range from simply placing a surgical drainage to liver transplantation. With reference to Strasberg's classification non derivated treatments are listed, furthermore are discussed and analysed their indications and limits. Owing to their experience and specific literature, the authors came to the following conclusions: 1) These surgical options represent an ideal reconstruction technique because they restore bile ducts continuity without altering physiological mechanisms to which these anatomical structures are appointed. 2) The indications of applying these methods are rare and usually limited to those cases in which the lesion has been recognized during operation and in the immediate post operative period.

Anastomosis, Surgical↗
PubMedDate not supplied

Correlation between angiographic success and functional improvement assessed by exercise test following percutaneous transluminal coronary angioplasty.

Sixty-one consecutive patients with stable effort angina and single vessel disease underwent successful (reduction of coronary stenoses by greater than or equal to 20%) percutaneous transluminal coronary angioplasty (PTCA). Anatomical results were analysed on the basis of functional evaluation obtained by exercise test (ET) 1 week before (pre-PTCA) and within 1 month after (post-PTCA) PTCA. Total exercise duration and maximal double product significantly increased after PTCA (4.5 +/- 1 min vs 6.9 +/- 1.5 min, p less than 0.001 and 14.1 +/- 3.6 x 1000 mmHg x bpm vs 18 +/- 4.2 x 1000 mmHg x bpm, p less than 0.001). Pre-PTCA ET was positive in 43 patients (70%) and post-PTCA ET in 15 (24%). In patients with post-PTCA positive ET, mean stenosis diameter reduction was significantly lower than that obtained in patients with negative post-PTCA ET (29.6 +/- 8.9% vs 61.1 +/- 18.8%, p less than 0.001). In conclusion, PTCA improved exercise tolerance in the majority of patients with myocardial ischemia, however the definition of anatomical success used in this study appears to be poorly correlated with functional improvement as assessed by ET.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

[Brain mapping of middle latency auditory potentials in normal subjects].

The MLRs of 20 normal hearing adults were recorded by cerebral mapping. In regard to the Pa and Na waves, it is suggested that two different generation sites exist because of the different spatio-temporal distribution of the waves over the scalp. It is demonstrated that amplitudes measured by the "grand average" technique are constantly lower than those obtained with the manual determination, and they conclude that manual determination represents the most reliable method in order to calculate waves amplitude. Finally, it is suggested that, due to the different generation sites for Pa and Na waves and to the uneven distribution of the Na wave over the scalp, Pa amplitude should be measured from the baseline and not from the Na negative deflection. Moreover, in 14 cases, when one ear was stimulated the Pa wave obtained at most recording points was significantly larger than the one recorded contralaterally.

Acoustic Impedance Tests↗
PubMedDate not supplied

[Frequency of overjet, overbite and open bite in the deciduous dentition].

The authors studied the frequency of overjet, overbite and open bite in deciduous dentition in one hundred and twenty Brasilian white children, of both sexes, aged between 2 and 6 years old. The results showed that the deciduous dentition of that children was characterized for a moderate overjet and a light overbite and that overjet and open bite degree decrease with the increasing of the children's age.

Brazil↗
PubMedDate not supplied

[Facial prognathism and its relation to the cranial base in Brazilian children with Class I malocclusion].

The objective of this work was to study the degree of the facial prognathism, considering the relationships between the SNA and SNB angles with the saddle angle (NSAr and NSBa). The sample consisted of eighty cephalometric roentgenograms, taken in lateral norm, of Brazilian white children, forty boys and forty girls, with both dental and skeletal, class I malocclusions, with ages between 9 years and 2 months old and 13 years and 7 months old. Data were statistically analysed and the sample was divided in three groups considering the mean value and the standard deviation of the NSAr angle. Sixteen subjects (seven boys and nine girls, 20 percent of the sample) presented an NSAr angle that was smaller than 119.5 degrees (x - 1s); twenty subjects (forteen boys and six girls, 25 percent of the sample), showed an NSAr angle more than 127.5 degrees (x + 1s) and forty-four subjects (nineteen boys and twenty-five girls, 55 percent of the sample) had an NSAr angle value between 119.5 and 127.5 degrees (x +/- 1s). The results led to the following conclusions: 1. There is a negative correlation, statistically significant between the saddle angle (NSAr and NSBa) with the SNA angle in subjects with class I malocclusions. An NSAr or NSBa angle higher than the mean value plus one standard deviation, it is associated with of the maxilla retrognathism and contrariwise. 2. There is a negative correlation, statistically significant between the sadle angle (NSAr and NSBa) with the SNB angle in subjects with malocclusions. An NSAr or NSBa angle higher than the mean value plus one standard deviation, it is associated with the mandible retrognathism and contrariwise. 3. The normal values of the SNA and SNB angles for an individual and the degree of the facial prognathism should be determined individually, since that the values of these angles might be affected for cranial base morphology.

Adolescent↗
PubMedDate not supplied

[The role of blood transfusion on the postoperative morbidity of tumors of the colon and rectum].

UNLABELLED: Previous studies have demonstrated that perioperative blood transfusions in patients with colo-rectal cancer may be related to a poor p.o. prognosis. Blood transfusions have been reported to exert an immunosuppressive action thus representing a risk factor of p.o. septic complication. MATERIAL AND METHOD: 100 patients were investigated retrospectively (60 M. and 40 F., mean age 61.7 yrs, range 18-86). Location of the tumour was rectum in 49 cases, sigmoid in 33, descending colon in 9 and ascending colon in 9. Dukes' staging of the tumour was A in 16 cases, B in 34, C in 30, D in 20. 61% of the patients received blood transfusions, before the operation in 10, during the operation in 13, after the operation in 16. 22 patients received blood transfusions before, during and after the operation. P.o. septic complications were then correlated to number and timing of blood transfusions, sex and age of the patients, location of neoplasm, Dukes' staging, surgical technique, severe anemia and malnutrition. RESULTS: P.o. septic complications were observed in 25 patients, without significative correlation with patients sex and age, site and staging of the tumour, surgical technique, preoperative anemia and/or malnutrition. A statistically significative increase in the incidence of septic complications was observed only in transfused patients compared to non transfused (34% vs. 10.3% - X2 = 5.62, p less than 0.01). This was noted regardless the presence of advanced disease, location of the tumour, surgical technique employed. The increased incidence of septic p.o. complications was observed even comparing transfused to non-transfused grouped accordingly to the different factors considered in the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Colorectal Neoplasms↗
PubMedDate not supplied

[Is intraoperative cholangiography always indicated during videolaparoscopic cholecystectomy?].

Opinion is divided whether intra-operative cholangiography should be performed routinely or on a selective basis during laparoscopic cholecystectomy. The aims of the present study were to assess the safety, utility and indications of intraoperative cholangiography performed during laparoscopic cholecystectomy. 11 operative cholangiograms were attempted in 63 patients who underwent laparoscopic cholecystectomy (17.4%). Duration of post-operative hospitalization and interval to return to full activity were identical in the two groups. Cholangiography increased the duration of operation (mean 20.1 min: p < 0.01) and the total charges for the operation by almost L. 200,000. Cholangiograms were performed successfully in 100% of the patients and changed operative management in 2 patients. There was not false negative or positive study. No complications or deaths occurred that were due to cholangiography. In follow-up ranging from 1-9 months, there has been no clinical evidence of bile duct injury or retained common bile duct stones. The inescapable conclusion is that an absolute indication for performing cholangiography is unclear anatomy of biliary system. Whereas to document the presence of common bile duct stones, intra-operative cholangiography, neither routine nor selective, is needed. Patients who present with clinical or biochemical signs of choledocholithiasis, a history of cholangitis, acute biliary pancreatitis, or an abnormal CBD on sonogram should have preoperative ERCP and ES before contemplated laparoscopic cholecystectomy. Further advances and confidence with laparoscopic CBD exploration may further change the approach to these patients in the future. In this case selective intra-operative cholangiography is mandatory. However, additional prospective analysis of this patient subgroup is needed.

Adolescent↗
PubMedDate not supplied

[Relapse modalities in medulloblastoma].

We evaluated the modality of relapse and progression of medulloblastoma in 45 patients observed between 1981-1991. Children aged over 2 years were treated with surgery and postoperative radio-chemotherapy; among 12 children younger than 2 years, 8 were treated with surgery and chemotherapy and 4 with postoperative irradiation of remaining tumor. Cerebrospinal fluid shunting system was placed in 32 patients (71.1%). Patients were organized into three groups: group I (25 cases) = total tumor removal; group II (11 cases) = subtotal tumor removal; group III (9 cases) = partial tumor removal. 22 children died (48.8%: 10 of group I; 7 of group II; 5 of group III) at variable time interval from the operation during the following period. Among 23 alive patients, 3 are surviving with recurrence and progression of disease (all of group I), 20 are disease-free (44.4%: 12 of group I; 4 of group II; 4 of group III). Average postoperative follow-up period: 6 years for group I/II and 2 years for group III. Even if disease-free children are those treated by total-subtotal surgical removal (while local relapse occurs principally in patients treated by partial surgical resection: 44.4% of local relapse vs 12% of group I and 27% of group II), extensive surgery does not exclude possibility of metastatic localization in cerebrospinal axis, that occurs in 1/5-1/6 of all the patients without differences in each group. CSF shunting system did not cause extraneural metastases in our patients. We obtained long term survival rates or apparent recovery in almost 50% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Ménétrier's disease associated with a gastric ulcer: a clinical case report and review of the literature].

The authors report on a case of Ménétrier's disease, associated with antral gastric ulcer. The patient came at our observation after a severe high digestive bleeding. On the basis of the endoscopic diagnosis of gastric ulcer and because of the failure of medical treatment with continuous bleeding, the patient underwent subtotal gastrectomy. The histological examination of the specimen confirmed the benign nature of the gastric ulcer but revealed also the presence of Ménétrier's disease. After three years, an endoscopic control excluded the presence of the disease in the remaining stomach. The association between gastric ulcer and Ménétrier's disease is of difficult pathophysiological explanation in the literature. The presence of the ulcer, however, does not seem to influence the clinical evolution of the disease or the treatment, which, moreover, has not been codified as yet. In fact, cases of Ménétrier's disease are reported to have been cured with cortisol, anticholinergic, anti-H2 receptor and antifibrinolytic preparations or by surgery (subtotal gastrectomy, total gastrectomy). However, as in our patient, spontaneous remission of the disease with no treatment have been reported. The Ménétrier's disease, the treatment of which has yet to be codified, is still a difficult situation, in particular when associated to gastric ulcer.

Biopsy↗