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Biomedical subjects

D Antonelli

Publications and source records attributed to D Antonelli.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Physiopathology of BPH obstruction].

The underlying BPH related mechanisms of outlet obstruction are outlined (modification of the shape of the bladder neck, failure of funnel formation, geometric variations of the urethra, alpha 1 adrenoceptors mediated sympathetic hyperactivity at the level of the lower genito-urinary tract). Bladder voiding dysfunction in response to prostate obstruction is also discussed and correlated to ultrastructural patterns and clinical symptoms. Finally, a pathogenetic mechanism for detrusor overactivity in obstructed bladder is suggested.

Humans↗
PubMed1995

[Alpha blockers, TUS-P and TUR-P in the treatment of benign prostatic hypertrophy. A comparison using multivariate statistical analysis].

To evaluate the effectiveness of Alpha-blockers, TUI-P and TUR-P in the treatment of obstruction due to BPH, 50 patients, never before treated, were considered. Fifteen were treated with alfuzosin chlorhydrate 7.5 mg/day for four months, 15 were submitted to TUI-P and 20 to TUR-P. In all patients linear purr was carried out before treatment and was repeated from 60 to 90 days after intervention in surgical patients and during the fourth month of treatment in patients treated with alfuzosin. The data obtained were analyzed with the T-test both for dependent and independent samples. The results show that Alpha-blocker contain an increase in maximal flow, without decreasing bladder voiding pressures. On the contrary TUI-P and TUR-P, besides the increase in maximal flow obtain a significant reduction of bladder pressures. The conclusions are the following: maximal flow alone is not a sufficient parameter to evaluate the work of the bladder, the entity of the obstruction and the effectiveness of the therapy. The treatment with Alpha-blockers is unable to reduce the obstruction due to BPH. TUI-P and TUR-P realize an effective deobstruction. Under the same deobstructing effect TUR-P assures a better voiding performance by obtaining higher flow values.

Adrenergic alpha-Antagonists↗
PubMed1995

Retroperitoneoscopy.

From October 1992 to June 1994, 12 nephrectomies (all for benign diseases), one nephropexy and 7 adrenalectomies (one pheochromocitoma, three adenomas, one cyst) were performed. In all the cases the retroperitoneal working space was created with direct CO2 insufflation (without balloon) with the patient in prone position. Four 10-12 mm ports were always inserted in the lumbar area. Eighteen procedures were successful (90%), 2 failed (one nephrectomy and one adrenalectomy) and underwent open surgery. Twelve procedures were carried out with the patients in prone position, six (one nephropexy and 5 nephrectomies) were performed with the patients in lateral de cubitus. The removal of organs was managed either through an enlarged port (phi 2 cm.) or by joining vertically the stabs of the two ports lateral to the sarcospinalis muscle. The average operative time was 4.10 hours) range 2.30-5.20). Both CO2 absorption and blood loss were negligible. No major complications were observed. Postoperative pain never required medications. All patients were able to stand on the 1st postoperative day. Mean postoperative hospitalisation was 4 days. Direct retroperitoneal approach provides optimal access for laparoscopic renal, proximal ureteral and adrenal surgery, avoiding extensive dissection and handling of intraperitoneal structures.

Absorption↗
PubMed1994

[Microalbuminuria and ischemic heart disease in noninsulin-dependent diabetes].

Prospective studies showed that hypersecretion of albumin in the urine of patients with type 2 diabetes mellitus is associated with high morbidity and mortality from cardiovascular disease and nephropathy. 65 type 2 diabetes from 6 family medicine practices were studied. Microalbuminuria was found in 37% and was significantly more common in men than in women (53% and 23%, respectively; p < 0.02). Uncontrolled blood glucose levels were also more common in men (p < 0.03). Using logistic regression with microalbuminuria as the dependent variable, a significant correlation was found with male gender, fasting blood glucose 155 mg/dl or more, and systolic blood pressure 159 mm Hg or higher. Among those with microalbuminuria, ischemic heart disease was significantly more common in those 65 years or older than in those younger (p = 0.02). This study strengthens the assumption that type 2 diabetics with microalbuminuria might be at greater risk for developing ischemic heart disease. Strict detection and control are recommended.

Adult↗
PubMed1993

Transiliac vein approach to a rate responsive permanent pacemaker implantation.

A 60-year-old patient was admitted for elective replacement of a depleted pulse generator. The pacemaker was implanted 5 years before because of sick sinus syndrome and it was connected to an epicardial lead due to total occlusion of the superior vena cava. The pacing threshold of the epicardial electrode was unacceptably high, so an endocardial lead was inserted through the iliac vein. The lead was connected to a VVIR pacemaker, which was located in the abdomen just lateral to the umbilicus. During a 1-year follow-up period, the patient felt well and pacemaker performance was satisfactory.

Cardiac Pacing, Artificial↗
PubMed1993

[Familial multiple bilateral carcinoma of the kidney: clinical strategy and surgical approach].

A case of familiar bilateral multicentric RCC in a young woman is an ideal model to evaluate preoperative and intraoperative diagnostic and surgical tools in order to achieve two distinct goals: the oncologic radicalness and the renal function preserved. Radical bilateral nephrectomy, the renal hypothermia by perfusion of both kidneys, the bench high resolution sonography of parenchyma, the choose of one kidney suitable for conservative surgery, the resection of suspect lesions with intraoperative pathology, the reconstructive bench surgery, the autotransplantation, are the steps accurately performed with particular concern to eradication of all the tumoral lesions present in the kidneys. The results confirm that renal function has been preserved with this method. Radicalness should be appointed by a longlasting follow up. However, as it is discussed, conservative surgery, when accurately performed can give results not different from radical demolitive surgery. In this paper tools to improve diagnostic and therapeutic methods are described in order to increase the diagnostic accuracy and the therapeutic efficacy. The possibility that this multiple RCC can be a part of the abnormalities occurring in the Von Hippel-Lindau syndrome does not change the surgical approach, being the RCC the worst prognostic factor of the syndrome.

Adult↗
PubMed1993

[Retroextraperitoneal laparoscopic nephrectomy].

The authors describe a new technique of laparoscopic nephrectomy; the retroextraperitoneal approach has been successfully performed in 4 patients with the following indications: 2 non functioning hydronephrotic kidneys, 2 atrophic chronic pyelonephritic kidneys. The patient was put in a proneoblique position after the retrograde placement of a ureteral catheter up to the renal pelvis, through which the contrast medium was injected. The Veress needle is inserted under fluoroscopic guidance into the perirenal fatty space which was insufflated with CO2. One 12 mm and three 10 mm Trocars were inserted into the cavity created by gas in the trapezoid area whose boundaries are: the 12th rib, the iliac crest, the posterior axillary line and the sacrospinalis muscle. The kidney was progressively dissected free with the traditional laparoscopic instruments (forceps and scissors). The artery has always been closed with clips. In two patients the vein has been stapled and cut with EndoGIA. After the section of the clipped ureter the kidney was removed en block by pulling it out through the 20 mm Kleiber Trocar in two cases and in the other two cases by extending to a length of 4 cm the port of one Trocar. The average total operating time was 4.35 hours and blood loss < 200 cc. The patients were all discharged on the fourth postoperative day. The advantages of the retroextraperitoneal approach with respect to open surgery are synthetically the following: a less traumatic and a more accurate dissection almost always bloodless; a shorter hospitalization period; an almost painless postoperative course.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Ligation of the internal spermatic vein through 2 laparoscopic ports].

Thirty-three two port laparoscopic internal spermatic vein ligations have been performed in 31 patients in our Department. The procedure carried out through two 10 mm ports in a mean time of 25 minutes decreases both the invasivity of intervention and the costs when reusable instruments are used. The technique is feasible with an operative laparoscope (working channel diameter 4 mm) through which a grasp can be maneuvered. The two port procedure is as safe as the three port procedures. Preliminary follow up indicated only one recurrence of varicocele (4%). Out of the 19 patients treated for male subfertility who have at least a 6 month follow up, eleven reported an improvement in seminal quality. All the patients but one were discharged on the first postoperative day. Laparoscopic internal spermatic vein ligation provides a real alternative to different surgical techniques decreasing postoperative pain and shortening period of convalescence with immediate return to full activity. The advantages of laparoscopic internal spermatic vein ligation are increased with the two port procedure.

Adolescent↗
PubMed1992

A Soviet nuclear pacemaker.

A Soviet nuclear pacemaker is described. It is a large VOO bipolar pacemaker, probably nonprogrammable. It has unique electrode connectors. No isotope leak or excessive radiation hazard was detected. Because we had no knowledge of its end-of-life markers and because of the impossibility of assuming long-term safety, the device was removed.

Aged↗
PubMed1992

[Medical treatment and impotence].

After having emphasized the importance of interdisciplinary diagnostic approach to the sexual impotence as a symptom and having made some comments about the erection's physiology, the Authors, according to their experience, take drugs into consideration for elective treatment of sexual intercourse.

Erectile Dysfunction↗
PubMed1992

[Current knowledge about metastatic neoplasms].

The best knowledge of the biological and genetic mechanism involved in the process of metastasizing must determine the attempt of elaborating new therapeutical modalities. The authors show the sequential events of the metastasizing process based on the most recent theories, underlining the way the organotropism of the neoplastic cells can be the explanation of the otherwise inexplicable metastases.

Animals↗
PubMed1992

[Clinical and prognostic significance of metastases].

The authors briefly illustrate some biological and epidemiologic characteristics of the malignant urologic tumors; then they describe the modalities of metastasizing underlining that this process is determined not only by hematic and lymphatic dissemination but also by sequential and complex events "metastatic fall", involving multiple guest-tumor intersections to the organotropism of the neoplastic cells and to their intrinsic aggressiveness and to the histological type of tumor. Afterwards the authors analytically analyze the most important malignant neoplasms of the urogenital apparatus either as clinical importance or as statistic incidence.

Adult↗
PubMed1990

Noonan's syndrome associated with hypoplastic left heart.

A case of a week old female baby, admitted because of apathy, hypothermia, dyspnea, jaundice and cyanosis is described. She had the characteristic phenotype of Turner's syndrome with normal karyotype. Signs of severe heart failure were present. Therapy with diuretics, digoxin, dopamine and mechanical ventilation were unsuccessful, and the patient died several hours after her admission. The anatomopathological examination revealed the presence of hypoplastic left heart syndrome with mitral atresia and aortic atresia, atrial septal defect, double outlet right ventricle, and a patent ductus arteriosus.

Abnormalities, Multiple↗
PubMed1990

[Polymorphous ventricular tachycardia in acute myocarditis ].

Myocarditis may present with a variety of electrocardiographic patterns. However, polymorphous ventricular tachycardia (PVT), potentially a highly malignant ventricular arrhythmia, has not been described in acute myocarditis. As far as we know, this is the first report of this arrhythmia in that condition. It is characterized by unusual resistance to both the common pharmacological and nonpharmacological approaches. This report of a 28-year-old woman demonstrates the role of PVT as a potential cause for sudden death among patients with subclinical myocarditis.

Acute Disease↗
PubMed1989

Intermittent superior caval venous syndrome due to permanent transvenous electrode.

A 75-year-old man began suffering from intermittent episodes of superior caval venous syndrome, seven years after implantation of an endocardial pacemaker via the right cephalic vein. The obstruction of the superior caval vein was confirmed by venography and computed tomography of the chest. Changes of the intrathoracic pressure were considered to be the mechanism responsible for the intermittence of the syndrome.

Aged↗