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Biomedical subjects

F Losinno

Publications and source records attributed to F Losinno.

29 records · Page 2Linked to original sources

[Percutaneous nephropyelolithotomy].

The fact that one can perform a wide passage through the kidney percutaneously with the subsequent introduction of a 26 F nephroscope has radically changed the technique used to remove kidney stones. They may either be extracted directly with forceps or following ultrasonic lithotripsy. The authors report their experience of 39 cases, in 32 of which the method was successful, 3 complications have been reported. The advantages of this method, both for the patient and for the community, are discussed in comparison to the surgical pielolithotomy. The problems concerning the dose absorbed by the operator are also examined.

Adult↗

Renal scintigraphy versus renal vein renin activity for identifying and treating renovascular hypertension.

This paper compares renal scintigraphy (RS) with renal vein renin activity (RVRA), intravenous pyelography (IVP), and peripheral plasma renin activity (pPRA) in a population of hypertensive subjects with suspect renovascular hypertension (RVH), of whom 30 underwent surgery, in order to evaluate (a) screening ability of RS for RVH, and (b) surgical prognosis of RS for RVH. RS agreed with arteriographic findings of arterial stenosis in 91% of patients and proved more sensitive as a screening test than IVP and pPRA. The false-negative rate of RS was 9% and the false-positive rate was 10%. In the patients who underwent surgery RS was positive in 89% and RVRA in 85% of those who benefited from surgery. In this series false-negatives for RS occurred only in the presence of extensive collateral circulation, where RVRA also gave the same result. In patients who had been operated on, the sensitivity and specificity of RS, compared to RVRA, were very high. Our work supports the view that RS is a good screening test in RVH; moreover, it seems to be as accurate as RVRA as a surgical prognostic method for curable RVH.

Adolescent↗

Evaluation by captopril renal scintigraphy and echo-Doppler flowmetry of hypertensive patients at high risk for renal artery stenosis.

Sixty-three hypertensive patients with probability of obstructive renal artery disease underwent both Captopril renal scintigraphy (CRS) and echo-Doppler flowmetry (EDF) before undergoing renal angiography. Angiography revealed renal artery stenosis (RAS) in 42 patients (unilaterally in 26 and bilaterally in 16). The sensitivity and specificity in the identification of RAS > or = 50% were 90% and 94%, respectively for Captopril renography, and 85% and 78% for echo-Doppler flowmetry. Captopril renography correctly identified stenoses greater than 50%, which is usually held to be the limit of hemodynamic significance. While the Doppler examination was more sensitive than Captopril renography (sensitivity 79% versus 64%) in the detection of all degrees of RAS, less information on the functional significance of RAS was provided. Both CRS and EDF could be usefully employed to assess kidney perfusion, but their appropriate clinical use must take into account inherent differences between the two techniques.

Adolescent↗

[Refractory hypertention in a female patient with renal failure].

We report one sixty-seven years-old female who presented with hypertension refractory to antihypertensive drugs. She had an elevated BP for approximately 15 years. In the last 8-10 months her hypertension had become difficult to control. Her BP ranged between 180/100 mmHg and 220/1220 mmHg on atenolol 100 mg once daily, methyldopa 500 mg three times daily, furosemide 25 mg twice daily, doxazosine 4 mg twice daily. When she was referred to our unit serum creatinine was 2.3 mg/dL and she had a mild proteinuria (70 mg/dL) without microematuria. Ultrasonography showed a left kidney size in the low-normal range (LD 11 cm) and a small right kidney (LD 9 cm). Renal angiography showed a severe, ostial stenosis of the left renal artery and a total thrombosis of the right renal artery with a blood supply to the right kidney provided by collateral channels. An ACE-I was added to the therapy but a sharp increase in serum creatinina (up to 6.4 mg/dL) prompted us to withdraw the drug. She underwent a renal angioplasty on the left side and a Palmaz stent was placed. The control angiography showed a good anatomical result. Three months after the manoeuvre the patient was again referred to our unit with headache, nausea vomiting and hyper-tension refractory to amlodipine 10 mg/day, doxazosine 4 mg twice a a day, atenolol 50 mg/day, furosemide 50 mg/day. A doppler ultrasonography and a magnetic resonance angiogram showed no restenosis on the treated artery. An ACE-I was again administered and BP on this drug was 145/90 mmHg after one month and 130/85 after three months. Headache, nausea and vomiting disappeared. Serum creatinina kept unchanged (2.2 mg/dL). Comment. In this case the benefit of angioplasty on blood pressure control was indirect. Apparently the manoeuvre showed no effect on blood pressure, but the angioplasty allowed us to use of an ACE-Inhibitor, without any negative effect on renal function, and thus to adequately control blood pressure.

Aged↗

[Syringocele or cystic diagnosis of Cowper's gland ducts].

Cystic dilatation of bulbo-urethral gland ducts (Cowper's syringocele) is an uncommon abnormality, frequently asymptomatic, showing various radiographic patterns. The lesion is more commonly seen in children, but it may be found in adults too, and may cause dysuria, pollakiuria, stranguria and posturinary dribbling. Fourteen patients with syringocele were observed: 6 of them were asymptomatic, while in 8 the most common symptoms were posturinary dribbling and stranguria. X-ray examination showed 7 cases of perforated syringocele, 4 cases of ruptured syringocele, 2 cases of simple syringocele and 1 case of imperforate syringocele. Various theories are reported to explain how the lesion forms and the differences are analyzed which characterize different kinds of urethral lesions.

Adolescent↗