Search PubMed⌕ Search

Biomedical subjects

D Sirinelli

Publications and source records attributed to D Sirinelli.

At least 37 records · Page 2Linked to original sources
PubMed1998

Iodixanol in paediatric excretory urography: efficiency and safety compared to iohexol.

BACKGROUND: Iodixanol (Visipaque, Nycomed Imaging AS, Oslo, Norway) is a new non-ionic and isotonic X-ray contrast medium. OBJECTIVE: To assess its safety and efficacy for paediatric excretory urography. MATERIALS AND METHODS: A three-centre trial in which 72 patients were randomised into three parallel groups: iodixanol 270 mgI/ml, iodixanol 320 mgI/ml and iohexol 300 mgI/ml (Omnipaque, Nycomed Imaging, Oslo, Norway). Doses ranging from 1 to 3 ml/kg never exceeded 50 ml. Pulse rate and blood pressure were recorded before, during, and after the examination. Adverse events, including injection associated discomfort, were recorded during and up to 24 h after the examination. The diagnostic quality of the urograms was assessed on a four-level scale. RESULTS: No serious adverse event occurred in any of the three groups. One patient who was given iodixanol 270 mgI/ml, three who received iodixanol 320 mgI/ml, and one who received iohexol 300 mgI/ml experienced transient adverse events. More than 80 % of the urograms in all three groups were rated "good" or "excellent". CONCLUSION: Iodixanol, either 270 mgI/ml or 320 mgI/ml, is well tolerated and efficacious for excretory urography in children.

Adolescent↗
PubMed1998

[Congenital stenosis of the piriform aperture: a cause of respiratory distress in newborn infants. Review of the literature, from 2 cases].

Congenital nasal pyriform aperture stenosis is a rare cause of neonatal airway obstruction. Computed tomography confirms the diagnosis and delineates the anomaly. This abnormality can be isolated or associated with abnormalities of the midface. The two options are surgical or medical treatment. The surgical treatment usually used is a surgical enlargement of the nasal pyriform aperture via a sublabial approach. We report 2 cases of congenital nasal stenosis treated successfully by an inter-maxillary disjunction followed by an expandable palatal plate. This simple and low morbidity technique allowed a durable transversal augmentation of the pyriform apertures.

Airway Obstruction↗
PubMed1998

[Comparison of three fat suppression sequences for the detection of vertebral detection. Turbo STIR, phase contrast gradient-echo, and MISTEC-Chopper after gadolinium injection].

OBJECTIVES: Assess three fat suppression sequences used to search for spinal metastases: TurboSTIR, phase contrast gradient-echo, and MISTEC-Chopper after gadolinium injection. MATERIAL AND METHODS: A prospective study was conducted in 10 patients with primary neoplasia. MIR sequences acquired (1 Tesla) were TurboSTIR, T1 spin-echo with and without gadolinium injection, phase contrast gradient-echo and M-Chop after gadolinium injection. Signal intensity in normal bone marrow, metastatic tissue, and subcutaneous fat as well as background noise was measured. Signal-to-noise (S/N) ratio was determined. Lesion borders, artefacts, and extent of detected lesions were determined quantitatively. Bone marrow signal intensity was also recorded. RESULTS: S/N ratio was best with gradient-echo which identified well the borders of lesions within the hemopoietic marrow. For lesions located in high-fat marrow (as in post-radiation marrow), the high intensity signal of the lesion confounded with the fat signal. TurboSTIR gave effective fat signal suppression and was particularly useful for yellow marrow, less so for red marrow. This technique confounded cell proliferation with perilesional edema (enlarging lesion extention). In one case, this sequence did not detect a small lesion visible with the two other sequences. This sequence was sensitive to artefacts (especially vascular artefacts) which can produce false nodular images. M-Chop gave good suppression of vertebral fat tissue (better for yellow marrow) but subjective detection of lesions was more difficult. CONCLUSION: The phase contrast gradient-echo sequence after gadlinium injection appeared to be the best sequence excepting cases of post-trauma (radiotherapy or chemotherapy) fat transformation of the marrow where the TurboSTIR sequence could be preferred.

Adipose Tissue↗
PubMed1998

[Videoscopic resection of a thrombosed aneurysm of a patent ductus arteriosus in a neonate].

Aneurysmal dilatation of a patent ductus arteriosus is a rare condition. One hundred and fifty three cases have been reported, of which 59 (39%) were operated, with an operative mortality of 16%. The authors report a case detected in a premature neonate on chest X-ray showing a mass in the mid-mediastinal region. Surgical resection was undertaken by video-thoracoscopy. Peroperative analysis of the resected specimen suggested a vascular structure and this was confirmed by histological study, which showed spontaneous aneurysm of a thrombosed patent ductus arteriosus or cystic residue of a patent ductus arteriousus. The authors underline the importance of peroperative puncture of structures of uncertain origin and the possibility of conversion of such a procedure to that of an extreme emergency.

Aneurysm↗
PubMed1997

[Hemangiomas and superficial vascular malformations of the head and neck. Classification, diagnosis, treatment].

Each kind of superficial vascular malformation (or "angioma") has been included in a widespread classification that has been elaborated by means of a multidisciplinary approach. At present, therapeutic management of these vascular malformations often needs one or several procedures of interventional radiology. The purpose of this paper in to illustrate embolization techniques in each indication and to describe advantages and drawbacks of these different techniques.

Diagnosis, Differential↗
PubMed1996

[Cutaneous immature hemangioma and hepatic angioma: there is no frequent association].

INTRODUCTION: The aim of this work was to determine the usefulness of systematic liver sonography in patients with immature cutaneous hemangiomas. PATIENTS AND METHODS: Children with immature cutaneous hemangiomas who met inclusion criteria underwent liver sonography. RESULTS: No case of hepatic angioma was observed. CONCLUSIONS: Liver sonography is not necessary as a routine test in children with several immature angiomas. This examination could be proposed in situations other than those evaluated in this work including miliary angiomas, unusual immature angiomas, hepatomegaly, unexplained heart failure.

Child, Preschool↗
PubMed1995

[Congenital adrenal hyperplasia and testicular hypertrophy].

BACKGROUND: Testicular tumors have been reported in boys and adolescents with congenital adrenal hyperplasia (CAH) inadequately controlled by hormonal therapy. CASE REPORTS: Two adolescents were treated for CAH due to 21-hydroxylase deficiency. They developed hyperplastic nodular testes at the age of 16 and 17 years, respectively. CAH in both was inadequately controlled as confirmed by hormonal studies. The tumors regressed after adequate steroid therapy in the first patient but persisted in the second patient despite normalization of 17-OH progesterone and plasma renin activity. CONCLUSION: Testicular ultrasonography should be systematic in all male patients with CAH since radiological findings are earlier than clinical manifestations. The ACTH-dependent tumors require intensification of hormonal therapy in order to obtain tumoral regression and to prevent infertility.

Adolescent↗
PubMed1992

[Septic erosion of the internal carotid artery and retrostylian phlegmon. Apropos of a case].

The vascular complications of peritonsillar phlegmons have become exceptional. On the basis of a recent case, the authors sum up the criteria of severity, including: white puncture sample, paralysis of the 9th, 10th, 11th, 12th cranial nerves and of the cervical sympathetic nerve. Computed tomography allows not only refining the topographic diagnosis, but even sometimes diagnosing a pseudoaneurysm before it is fissured. At this stage, intraoperative radiology may probably prevent the unavoidable secondary rupture. If it cannot be used, preventive ligation must be proposed. In the absence of cataclysmic hemorrhage, this easier procedure usually does not cause any irreversible neurological deficit. If performed in emergency, it may entail a major risk, not only a neurological risk, but a vital risk as well.

Carotid Artery Diseases↗
PubMed1991

[Reinhardt-Pfeiffer mesomelic dysplasia or dyschondrosteosis? Is the distinction well-founded? Apropos of a familial case with variable expression].

A familial observation of Reinhardt-Pfeiffer type mesomelic chondrodysplasia spanning three generations is reported. This case clearly shows that expression of the disease can vary widely within a given family. One member affected as a fetus had a severe form suggesting Langer mesomelic dwarfism syndrome, whereas his mother was free of clinical symptoms and his maternal aunt had a typical form of Reinhardt-Pfeiffer syndrome. Clinical manifestations in the other affected family members were perfectly consistent with dyschondrosteosis syndrome. The very broad spectrum of clinical patterns in this family suggests that there may be connections between the various types of mesomelic dysplasia. Establishing clear-cut distinctions between these entities, although useful in practice, may not accurately reflect molecular anomalies. Furthermore, the family member affected as a fetus also had Turner syndrome, which may have contributed to the severity of his condition. The possibility of identifying severe mesomelic dysplasias antenatally by ultrasonography should be pointed out.

Acrocephalosyndactylia↗
PubMed1989

Beckwith-wiedemann syndrome and neural crest tumors. A report of two cases.

We report 2 cases of thoracic neural crest tumors complicating the course in patients with Beckwith-Wiedemann syndrome (BWS). In the first patient, a thoracic neuroblastoma was fortuitously discovered at age 3 months on a chest film prior to a partial glossectomy. In the follow-up left nephroblastoma and a right kidney simple cyst appeared. In the second patient, a thoracic tumor which proved to be a mature ganglioneuroma was discovered at age 4 years on a follow up spinal radiograph. Although less frequent than nephroblastoma and/or adrenal tumors, the occurrence of thoracic neuroblastoma in BWS suggests that periodic chest radiograph and assays of HVA, VMA and Dopamine should be included in the follow-up protocol.

Beckwith-Wiedemann Syndrome↗
PubMed1989

[Calcification of the umbilical artery in small infants].

The practice of systematic X ray screening for congenital dislocation of the hip leads to the discovery of a somewhat rare anomaly: the calcification of the vestigial segment of the umbilical artery. The authors describe 6 cases of this peculiar condition of which the diagnosis is easy and does not necessitate any complementary investigation. This finding has no pathological significance; this condition must be considered as a normal variant.

Calcinosis↗
PubMed1988

[Infantile polycystic disease. Renal pseudotumoral growth in the postnatal period].

In the most common clinical expression of infantile polycystic disease, the kidneys are greatly enlarged in the neonatal period. When the child gets older the kidneys become smaller. In this case report, both kidneys kept growing after birth causing abdominal distention and respiratory distress. The differential diagnosis was a bilateral massive nephroblastomatosis, but the renal pathology showed characteristic features of infantile polycystic disease.

Genes, Recessive↗
PubMed1987

Urinoma and arterial hypertension complicating neonatal renal candidiasis.

During antibiotic treatment for E. coli urinary tract infection and meningitis, a male new born developed a Candida albicans urinary tract infection with a mycotic kidney abscess and pelvicalyceal fungus balls diagnosed by US investigations and confirmed by radiology. Three weeks later a perirenal urinoma with arterial hypertension developed. After surgical treatment of the urinoma the arterial pressure returned to normal.

Abscess↗
PubMed1987

[Polycystic renal dysplasia in children].

Ultrasonography has profoundly modified the diagnostic conditions of polycystic renal dysplasia in children. Non-palpable forms, which were previously most frequently missed, can now be detected during the antenatal period. In infants, ultrasonography generally provides a definite diagnosis, which can be confirmed by aspiration-opacification of the cysts. On the basis of a series of 40 cases and a review of the literature, the authors discuss the therapeutic implications of these new data. Surgery remains essential in cases of palpable polycystic renal dysplasia, especially when it is complicated. However, in the sub-clinical forms, as the risks of malignant degeneration and the incidence of post-operative complications are minimal in the one case and undefinable in the other, surgical excision is possible but not essential.

Child↗