Biomedical subjects

F Fusaro

Publications and source records attributed to F Fusaro.

4 recordsLinked to original sources

PubMed2002

Measures to prevent renal impairment after resection of retroperitoneal neuroblastoma.

Postoperative renal impairment has been reported after kidney-preserving resection of retroperitoneal neuroblastomas (NB). To avoid renal damage, intraoperative procedures include monitoring of central venous pressure (CVP) and diuresis, i.v. administration of electrolyte solutions, mannitol, and furosemide, and local application of lidocaine to the renal vessels. During the first 5 postoperative (p.o.) days, CVP, diuresis, body temperature (T), and lactate dehydrogenase (LDH) levels were monitored; color Doppler ultrasound (CDUS) was also performed on the 7th p.o. day. Simultaneous increases of T (>38.5 degrees ) and LDH (>1,500 IU/l) and/or reduction of urinary flow (< 1.5 ml/kg.h) were indicative of renal damage: in these cases dopamine was administered and CDUS performed. If renal blood flow was normal on CDUS, dopamine was administered for another 2 days; if a vascular thrombosis was detected, fibrinolytic agents (urokinase 4,000 IU/kg bolus and then 4,000 IU/kg.h for 24 h) were utilized. Between May 1997 and June 2000, 29 children (9 F, 20 M, aged) 6-72 months (median 39) affected by grade II inoperable, grade III, and grade IV NB underwent these preventive procedures at the time of surgical excision of the mass after chemotherapy 23 had an uneventful p.o. course. CDUS at 7 days was normal in 22; in 1 (polar resection at operation) it demonstrated a slight reduction of blood flow in the renal cortex. For all 23 patients, the CDUS at 3, 6, and 12 months was negative. Three patients showed a single altered parameter; the CDUS p.o. and during follow-up did not show any alteration. The other 3 patients had two or more altered parameters and were treated with dopamine: in 1 the initial CDUS was normal, but it later showed moderate hypotrophy; in 2 patients a vascular thrombosis was documented. Treatment with urokinase was successful in only 1 patient who had a normalized CDUS after 3 months. The 2nd child developed renal failure and needed hemodyalisis. In our experience, elevation of serum LDH and T and/or oliguria were good indicators of renal impairment. CDUS was also useful in detecting renal blood flow reduction and artery occlusion. These preliminary results show these intra- and postoperative measures to reliably avoid renal impairment in these children. Long-term follow-up could confirm the efficacy of these methods.

Adolescent↗

PubMed2001

Lung volume reduction surgery in lieu of pneumonectomy in an infant with severe unilateral pulmonary interstitial emphysema.

A male infant with a prenatal diagnosis (at 20 weeks' gestation) of cystic adenomatoid malformation was delivered after 38 weeks' gestation (birth weight, 3 kg) and admitted to the neonatal intensive care unit. During the first few days of life, he developed mild respiratory distress; a chest radiograph and computed tomography scan showed multiple cystic areas in the left lower lobe with hyperinflation and herniation of the upper lobe across the midline. At 3 weeks of age, a left lower lobectomy was performed for presumed cystic malformation. To our surprise the pathology reports revealed pulmonary interstitial emphysema. The postoperative chest radiograph was unchanged, and mechanical ventilation was necessary and required progressively increasing ventilatory settings to provide adequate support. High-frequency oscillatory ventilation and selective right bronchus intubation failed to improve lung function. After 3 weeks, a left thoracotomy was repeated and lung volume reduction was performed with removal of 50' of the peripheral hyperinflated parenchyma. Postoperative recovery was rapid; the child was weaned from the ventilator after 3 days and discharged after 3 weeks. Follow-up chest X-rays showed a normally expanded right lung with mediastinal structures back to midline and a small left lung. Favorable results persisted at 3 years of follow-up. This first and successful experience with lung volume reduction in a neonate suggests that infants who need removal of a large portion of lung parenchyma to achieve adequate ventilation and gas exchange, lung volume reduction surgery should be considered as an alternative to pneumonectomy.

Cystic Adenomatoid Malformation of Lung, Congenita↗

PubMed1998

[Steroid therapy of hemangioma in children].

Hemangiomata is the more frequent pediatric tumor, absent at birth and usually growing, sometimes very quickly, during the first week of life. It potentially represents a serious problem because of his unforeseeable evolution during the time: is it more useful to use a corticosteroid therapy or to wait for the involution of the tumor? Here we have the results of the treatment on 51 babies who presented with hemangiomas of various sites: 52.6% of the lesions were on the face and head, 13.4% on chest wall, 10% on upper limbs, 4% on abdominal wall, 10% on pelvis region and 10% multiple. Therapy was compression in 10% of patients, corticosteroid injection in 66%, oral administered corticosteroid in 12%, surgery post corticosteroid therapy in 11.5%, others in 2.5%. Best results were obtained on the lesion of the head and face (good in 96%), worst in those of the abdomen (any modification in 100%).

Adrenal Cortex Hormones↗

PubMed1997

[Phimosis: when does it require surgical intervention?].

One of the most recurrent questions in pediatric age is the phimosis; this is a frequently underestimated problem and its resolution often cause a lot of discomforts in babies and parents. In many countries it has been treated on the roots of ancient sanitary measures (circumcision) whereas in others it's routinely treated with painful and useless maneuvers; instead, until three years of age this don't represents a problem but the normal situation of the baby. Herein the authors report the results of topic corticosteroid treatment of fimosis in 83 patients aged 1-14 years, with good outcome in 86.7% of cases. Therapy and results are discussed.

Administration, Topical↗