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Biomedical subjects

F Pagano

Publications and source records attributed to F Pagano.

At least 109 records · Page 6Linked to original sources
PubMed1988

Obstruction or no obstruction.

The authors review critically such parameters as symptomatology, post-micturition residual urine, bladder trabeculation and uroflowmetry that in the actual state of the art appear more accredited in the evaluation of lower urinary tract obstruction. All have some interpretative limits. However, uroflowmetry appears to be the most reliable and for this reason it is the first step in the study of suspected infravesical obstruction. It can discover equivocal situations in which pressure-flow studies only supply diagnostic help in order to avoid false diagnosis of infravesical obstruction and useless therapeutic approaches.

Diagnosis, Differential↗
PubMed1988

Skull fracture as a factor of increased risk in minor head injuries. Indication for a broader use of cerebral computed tomography scanning.

Two series of patients with a minor head injury (for a total of 182 cases), differing only in the presence and absence of a linear skull fracture, were admitted to a nonspecialized hospital and prospectively examined by computed tomography scanning. The presence of a fracture line proved to be significant, inasmuch as it was accompanied by approximately 38% of intracranial abnormalities versus 6% in the nonfracture cases. Early detection of any intracranial pathology that was still asymptomatic allowed prompt transfer of patients to the neurosurgical center, where operative treatment was carried out, when indicated, without mortality or morbidity. All operations (11 cases) were performed on patients with a fracture (105 cases) whereas none of the nonfracture patients (77 cases) required surgery. It is proposed that adult patients with minor head injuries with a skull fracture be submitted to computed tomography scanning in order that intracranial lesions may be detected, and treated, before the onset of clinical deterioration.

Adult↗
PubMed1988

Skull fracture as a risk factor of intracranial complications in minor head injuries: a prospective CT study in a series of 98 adult patients.

Ninety eight patients admitted to hospital after a minor head injury were studied by CT. Forty seven patients had a skull fracture and 51 did not. Significantly more intracranial lesions were found in those with a fracture (16) that those without (3) (p less than 0.01). Nine of the patients with a skull fracture and positive CT were transferred to a neurosurgical department, where six underwent operation. Operation was not required in patients without a skull fracture. Head injured patients with a skull fracture should undergo CT scanning to enable early detection of an intracranial haematoma.

Adolescent↗
PubMed1988

Therapeutical aspects of intrarenal artery aneurysms.

The relative infrequency of aneurysms of the branches of the renal artery produces some indecision as to the surgeon's therapeutical choice. The purpose of this study is to carefully examine the indications for surgical treatment and to select precise therapeutical criteria on the basis of 8 patients in whom aneurysms of the main renal artery or of its branches were diagnosed from 1978 to 1986. In 1 patient, the disease was bilateral with a ruptured main artery aneurysm. 5 aneurysms were treated surgically (the ruptured one by nephrectomy, 2 by ex situ revascularization and 2 by in situ revascularization). In the remaining cases, only periodical controls were performed. In 4 surgically treated patients, angiographic follow-up demonstrated a regular renal revascularization and in 1 patient a thrombosis on the site of the anastomosis. On the basis of personal experience, surgical treatment is required for aneurysms larger than 1.5 cm in size without or with partial calcification, aneurysms occurring in pregnant women or in patients likely to conceive in the future, expanding aneurysms, and renin-mediated hypertension. The introduction of microsurgical techniques and renal preservation makes it possible for the urologist to chose between various therapeutical means for the treatment of intrarenal aneurysms. Reconstruction of anatomical continuity of the arterial supply avoiding unnecessary operative demolishment is feasible.

Aneurysm↗
PubMed1988

Bilateral single ectopic ureter.

A case of successfully treated bilateral single ectopic ureter with a follow-up of 13 years is reported. The genesis of the incompetence of the vesical sphincter and its treatment are discussed.

Choristoma↗
PubMed1988

Prognostic factors in renal cell carcinoma.

In order to evaluate the prognostic factors of renal cell carcinoma (RCC), a retrospective study was carried out on 215 patients (150 men, 65 women) who had undergone surgical treatment from March 1979 to December 1986. The average age of the patients was 58 years (ranging from 15 to 85 years). The ratios of survival to tumor stage and grade, as well as to nodal and venous involvement, distant metastases at the time of diagnosis (as TNM classification) were evaluated by means of the actuarial method (life table). Corrected 5-year survival rates for stage T1-T4 were 100, 81, 68.9 and 0%, respectively. Grade 1 and grade 2 tumors had a 5-year survival rate of 66.5 and 52.8%, respectively; grade 3 had a 3-year survival rate of 46.5%. Nodal involvement at the time of diagnosis had a prediction value for the 3- and 5-year survival rate of 39.8 and 34.5%, respectively. Metastases at time of diagnosis had a 14.1% prediction value for a 3-year survival rate. Tumor extension to the vena cava (21 patients) affected survival in a significant way (55.8% at 3 years). A definite tendency towards lower stage and grade was observed in incidentally diagnosed RCC (11%). In conclusion, stage, grade, nodal and venous involvement as well as metastases at the time of diagnosis have a significant prognostic value in RCC. These data and the lack of early diagnostic methods for RCC suggest the routine use of renal ultrasonography in clinically asymptomatic patients during examination for suspected abdominal diseases and in high-risk patients (Von Hippel-Lindau disease smokers).

Actuarial Analysis↗
PubMed1988

Prognosis of bladder cancer. III. The value of radical cystectomy in the management of invasive bladder cancer.

From January 1979 to June 1982, 141 consecutive patients with bladder transitional cell carcinoma were treated with a single stage lymphadenectomy plus radical cystectomy. The survival rate observed in our patients, based on the TNM classification, was comparable with that reported for other groups employing contemporary surgery. Survivorship for patients with deep invasive tumors was also estimated by breaking down the pT3 stage, and patients with tumor confined to the bladder wall (pT3a) were separately evaluated from those with tumor extended outside (pT3b). The results obtained with this subdivision showed that pT3a patients have almost the same survival rate as pT2 patients. From these results it is concluded that radical cystectomy is a satisfactory curative treatment of bladder cancer confined to the bladder wall, whatever the extension of the muscular involvement. Such considerations suggest that, in order to achieve a more objective analysis of the results after radical cystectomy for invasive bladder cancer, a modification of clinical staging is necessary. Moreover, a simplification of the classification methods should provide a better identification of the elements required to assess the prognosis and to improve treatment planning.

Adult↗
PubMed1987

Urinary excretion of glycosaminoglycans in urological disease.

Altered urinary excretion of glycosaminoglycans (GAG) has been reported in patients with nephrolithiasis, with chronic glomerulonephritis, and incipient diabetic nephropathy, but evaluation of urinary GAG has not been reported in infections and proliferating diseases of the urinary tract. Urinary excretion of GAG was measured in 50 patients with idiopathic calcium nephrolithiasis (ICN) of whom 20 had associated urinary tract infection, in 20 subjects with recurrent infection of the urinary tract (UTI), and in 18 patients with bladder papillomatosis. Mean values were significantly lower in ICN, increased in papillomatosis, and in the normal range in UTI.

Diabetic Nephropathies↗
PubMed1987

[Epididymitis in adults. Retrospective study of 110 cases].

A review was conducted of 110 cases of epididymitis, most of these patients (71.9%), especially those under 50 years of age, having negative urine cultures: this appears to confirm the high frequency of Chlamydia T infection in the age group 20 to 50 years when sexual activity is at its maximum. Urinary output was normal in 60 of 79 patients and urography exploration provided normal results in 69 of the 110 patients (63%), particularly in those under 50. It is concluded, therefore, that urography is not necessary in patients under 50 but remains necessary in those in older age groups.

Acute Disease↗
PubMed1987

Prognosis of bladder cancer. I. Risk factors in superficial transitional cell carcinoma.

A retrospective study was carried out on 200 consecutive superficial transitional cell carcinomas of the bladder in order to identify which factors could influence the recurrence and/or progression of the tumor. Many parameters were considered, such as stage, grade, number, size, site, tumor-free interval and bladder mucosa mapping. A careful histological study of the initial tumor was employed and the tumors confined to the stromal core of the papillary tumor (T1a) were separated from those with invasion of the lamina propria of the bladder wall (T1b). The behavior of the T1b lesions observed in our study will be discussed in a forthcoming article. Recurrence occurred in 83% of our patients, and it was influenced by number and grade of the tumor and by the presence of dysplasia in normal-appearing mucosa. In 20% of our patients tumor progression occurred. Tumor progression was correlated with invasion of the lamina propria of the bladder wall, high-grade neoplasias, tumor-free interval, dysplasia or carcinoma in situ in normal-appearing mucosa. The results of our study suggest that, by these risk factors, a better prediction of the behavior of superficial transitional cell carcinoma and, as a consequence, more appropriate treatment can be provided.

Carcinoma, Transitional Cell↗
PubMed1987

Prognosis of bladder cancer. II. The fate of patients with T1b transitional cell bladder cancer.

We have reviewed the tumor progress in 46 patients who presented T1b lesions in a previous study on the prognosis of superficial bladder cancer. A group of 12 patients with single or very few localizations was treated by transurethral resection. Five patients progressed and were submitted to cystectomy. Two of these 5 patients died within 3 years of the surgical treatment. Twenty-seven patients with multiple lesions underwent cystectomy soon after the initial diagnosis. Nearly 30% experienced progression; 4 patients died within 4 years after cystectomy. A delayed cystectomy was performed in 7 patients with multifocal disease; in all but one the tumor progressed; 5 patients died between 7 and 28 months after the surgery.

Aged↗
PubMed1985

Sperm antibodies and infertility in patients with testicular cancer.

The level of antisperm antibodies using the enzyme-linked immunosorbent assay (ELISA) in the serum of 48 patients with testicular cancer before and after therapy is reviewed. This is not a linear study of each patient, but some conclusions can be drawn: In a high percentage of testicular cancer patients serum antisperm antibodies can be detected: 73.3 per cent before orchiectomy and 43.7 per cent overall. The percentage of patients with antibodies decreases with adequate therapy. In patients with advanced disease there is a higher percentage of positivity (50%) for serum antisperm antibodies than in patients with low-stage disease (30%). The higher percentage of antibodies-positive patients among those with infertility patterns could be an important argument that supports the hypothesis that autoimmune pathology can play a role in oligo/azoospermia in testicular cancer patients.

Adolescent↗
PubMed1985

Echography in vena cava invasion from renal tumors.

The last 4 cases of our case series of renal cell carcinoma (RCC) with caval or cavo-atrial invasion were studied by ultrasonography (US), computerized tomography (CT scan), arteriography (AG) and venocavography (VC) (inferior and/or superior). A comparison is made with these different methods, with particular emphasis on (US). The authors' conclusions are that ultrasound may replace anterograde inferior cavography in the evaluation of thrombotic extension and, in addition, it seems to be capable of eliminating the false-positives or -negatives of this method. AG and VC are no longer necessary to determine the cavo-atrial extension of a tumor thrombus from RCC when US and CT scan are available and are correctly integrated.

Aged↗
PubMed1985

Nonrefluxing colon conduits with a modified ureterocolonic anastomosis.

Urinary diversion by means of a colon conduit is particularly advantageous. In comparison with the ileal conduit an antireflux ureterocolonic anastomosis can be created, thus preventing renal damage in patients with a long life expectancy. Herein the authors present the results of 5 years experience with colon conduits and Pagano's ureterocolonic anastomosis.

Adolescent↗