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Biomedical subjects

G Virgili

Publications and source records attributed to G Virgili.

At least 19 recordsLinked to original sources
PubMed1996

Endoscopic ballistic lithotripsy in the treatment of bladder calculi in patients with neurogenic voiding dysfunction.

Bladder stones represent a troublesome complication in patients suffering from neurogenic voiding dysfunction, in whom prompt and effective therapy is required. A variety of endoscopic lithotripsy methods are available; however, current devices can be tedious to use. We have treated 17 patients affected by bladder calculi and spinal cord injury or multiple sclerosis by means of the ballistic lithotripter EMS Swiss Lithoclast. The mean diameter of the stones was 2.7 cm. The mean operative time was 27 minutes. There were five intraoperative complications, including crises of autonomic dysreflexia (three patients) and light hematuria (two patients). There was no malfunction of the lithotripter and no long-term complications. All the patients were stone free at 6 months postoperatively. In conclusion, endoscopic lithotripsy with the ballistic lithotripter proved to be a very effective, rapid, and safe method for treating bladder calculi in patients with neurogenic bladders.

Adult↗
PubMed1996

Indocyanine green angiography in vitelliform macular lesions.

Many vitelliform macular diseases have been described through the years. Some arguments still exist about the appropriate terminology, the classification criteria and the etiopathogenesis. The alterations of the retinal pigment epithelium, the lipofuscin storage and the role of the choriocapillaris are being investigated. The aim of our study was to describe indocyanine angiographic features in Best's disease and pattern distrophies. Twenty-one eyes of 14 patients underwent indocyanine and fluorescein angiography. The indocyanine angiogram showed hypofluorescent and hyperfluorescent areas. The possible etiopathogenesis of the lesions includes a role of the retinal pigment epithelium.

Coloring Agents↗
PubMed1995

Continuous wave Nd:YAG laser photocoagulation in proliferative diabetic retinopathy.

AIMS: The therapeutic efficacy of the continuous wave (CW) Nd:YAG laser (working in the free running mode) was investigated in proliferative diabetic retinopathy (PDR) comparing it with a conventional laser source such as the krypton laser. METHODS: Twenty four eyes of 12 patients affected with bilateral PDR were included and divided in two groups. The right eyes were treated with a red krypton laser and the left eyes with a CW Nd:YAG laser. RESULTS: Three months after krypton photocoagulation 10 eyes showed a reduction or a complete regression of PDR and two eyes were unchanged. In the CW Nd:YAG laser group no eyes showed any regression of new vessels, in seven eyes the angiographic features were unchanged, and in five eyes they worsened. All the eyes of the second group underwent retreatment with the krypton laser after 3 or 6 months. After a mean follow up of 13 months all eyes in the krypton group showed a reduction or complete regression of PDR; in the retreated group 10 eyes improved and two were unchanged. CONCLUSIONS: The statistical analysis showed a highly significant difference (p = 0.001) between krypton and CW Nd:YAG laser which indicated the lack of efficacy of the latter in the treatment of PDR. In the krypton laser group no significant difference (p = 0.05) after the retreatment was found confirming the efficacy of this treatment.

Adult↗
PubMed1994

[Urethral diverticuli in patients with spinal cord injury: echographic study].

Urethral diverticula, a not infrequent complication in patients with spinal cord injuries, usually involve the bulbous urethra which is particularly exposed to the trauma of catheterism. Indeed, the frequent association of urethral trauma and infection is often the cause of diverticula in these patients. Diagnosis is made by ascending urethrogram, voiding cystourethrogram and urethroscopy. Eight patients between 20 and 45 years of age with spinal cord injuries who had used an indwelling catheter for periods ranging from 1 to 18 months and who presented urethral diverticula at conventional investigation, underwent transperineal and penile contact ultrasonography using 3.5 and 7.5 MhZ real-time scanners. Ultrasonography was performed during intraurethral injection of saline solution through a catheter positioned near the external urethral meatus. Before the scan all patients had undergone a neuro-urological physical examination, urine analysis and culture, renal and bladder ultrasonography, ascending urethrogram and voiding cystourethrogram, urethroscopy and urodynamic investigation. Ultrasonography identified all urethral diverticula, defined them morphologically, visualized the diverticula filling and emptying phases and evaluated urethral wall and periurethral tissue characteristics, without exposing patients to any dangerous gonadal irradiation. Ultrasonography cannot replace radiological investigation but is a valid alternative in cases of contrast medium allergy, when monitoring inoperable diverticula and in postoperative follow-ups.

Adult↗
PubMed1994

[Echography in prostatitis].

In many infertile patients abnormalities in sperm are due to prostatic inflammatory disease. In the male reproductive system temporary episodes of inflammation, caused by newly discovered micro-organisms such as Chlamydia Trachomatis and Ureaplasma Urealyticum, may occur frequently and cause sub-clinical inflammation. This rapidly became chronic and induce the development of anti-spermatozoon antibodies. This latent clinical pattern and lack of symptoms often means diagnosis is late and medical treatment inadequate. In recent years attention has been focused on transrectal ultrasonography as a possible gold standard for diagnosing prostatic inflammatory disease. Widespread use of technologically advanced instruments has significantly improved the quality and definition of prostatic images. This paper discusses the current role of transrectal ultrasonography in the diagnosis of prostatic inflammatory disease. Abnormalities in the ultrasound pattern, caused by infection, are analyzed in detail and discussed critically in order to assess their role as markers of prostatic inflammation.

Humans↗
PubMed1993

Intralesional alpha interferon therapy in papillary superficial transitional cell carcinoma of the bladder. A pilot study.

The tolerability, toxicity and therapeutic efficacy of recombinant interferon alpha-2a (rIFN alpha-2a), administered by intralesional injection, were evaluated in 15 patients with papillary superficial transitional cell carcinoma of the bladder, rIFN alpha-2a was delivered endoscopically in a single weekly dose of 3 x 10(6) IU for 4 weeks (total 12 x 10(6) IU). Transurethral resection of residual tumours was then performed. The response to treatment was assessed according to ultrasonographic, endoscopic and pathological findings. One patient achieved complete remission, 6 partial remission, 6 minor remission and 2 stabilisation of disease. All patients completed the course of treatment. A mild, transient, flu-like syndrome was documented after every injection. Immunological findings suggest that the antitumour effects of rIFN alpha 2a are not mediated through the immune system.

Aged↗
PubMed1993

[Cystic renal pathology].

Ultrasonography has a great interest in diagnosis of cystic kidney disorders for typical eco-pattern of this pathology. In this work we show the eco-pattern of the most common cystic kidney disorders. Particularly we examine simple cysts (typical, atypical, complicated), multicystic kidney dysplasia, autosomal recessive polycystic kidney disease (infantile) autosomal dominant polycystic kidney disease (adult age). The so-called neoplastic cysts (multiloculated cysts, multiloculated cysts nephroma, cystic nephroblastoma), medullar cysts (medullary sponge kidney, medullary cystic disease), parapyelic cysts, acquired cystic kidney disease in renal failure patients, parasitic cysts, epidermoid cysts. About this disorders we present the more typical and expressive ultrasonographic appearance and we define the role and the opportunity of diagnostic setting by echography, moreover ultrasonography allows us to make a differential diagnosis between cystic kidney disorders and other kidney disease.

Cysts↗
PubMed1993

[Echography during drug-induced erections in the study of penile plastic induration].

Clinical investigation is still fundamental in the diagnosis of La Peyronie's disease. In this study 36 patients underwent clinical investigation and ultrasound in basal conditions and during drug-induced erection, and the results were compared. In basal condition US does not provide much useful supplementary informations. During drug-induced erection US accurately visualizes plaque site and dimensions and anatomical abnormalities about corpora cavernosa, albuginea, septum and dorsal vessels.

Adult↗
PubMed1992

[Ultrasonography in the follow-up of patients after extracorporeal shockwave lithotripsy].

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized treatment of urinary stones, but created new clinical situations and problems in the interpretation of which x-rays and ultrasonography have proved invaluable. This paper defined the role of ultrasound in the follow-up of patients who had undergone ESWL and assessed its advantages and limitations in evaluating the efficacy of this form of therapy and in monitoring the elimination of stone fragments. The utility of ultrasound in the diagnosis and monitoring of the complications due to ESWL has been emphasized. Finally ultrasound is a valid tool when performing those echo-guided procedures which are essential for the treatment of obstructive complications secondary to ESWL.

Follow-Up Studies↗
PubMed1992

[Role of ultrasonography in the follow-up of surgically treated patients. Upper urinary tract. Complications after conservative surgery].

The Authors describe the purposes of ultrasonographic follow-up after both conservative surgery and endoscopic or endourological operations of the upper urinary tract. In these cases ultrasonography evaluates the results of normal surgery, the presence of early or late complications, and of iatrogenic lesions. The echo-patterns of deformations in the outline of the kidneys, of hematic, urinary or lymphatic collections (both retroperitoneal and intraperitoneal), of fistulas, of sclero-lipomatosis and of post-cicatrization hydronephrosis are described. The importance of evaluating the degree of obstruction by a dynamic ultrasonographic study with furosemide-test is emphasized. The ultrasonographic monitoring of urethral and pyelostomy setting of catheters is also described. The echo-patterns of retroperitoneal and intraperitoneal fluid collections and renal hematomas, in relation also the kind of fluid contained are widely discussed.

Endoscopy↗
PubMed1991

[Ultrasonically guided access to the kidney].

Ultrasonography is an ideal procedure to guide and control the diagnostic and therapeutical percutaneous renal puncture. Some procedures considered in pre-echographic period, long, complicated and not free from risks and complications, were transformed in routine manoeuvres by the advent of ultrasound. Nowadays, thanks to the ultrasound guide, is possible to perform a rapid, accurate, safe and without anesthesia puncture of the kidney and of the upper urinary tract. Several procedures contemplating the renal puncture, can be performed in out-patients.

Biopsy↗
PubMed1991

[Echography in andrological emergencies].

Ultrasonography is the first imaging method to undertake in all acute andrological disorders. It gives an accurate diagnostic picture in a high percentage of cases and is extremely useful for following patients during therapy and after surgery. The forms of acute andrological disorders, of both medical and surgical pertinence, that can be evaluated ultrasonographically include many prostate, seminal vesicle and external genital afflictions. Among the prostate and seminal vesicle disorders, of particular importance are acute prostate vesiculitis and prostatic abscess. Ultrasonography can be used to advantage in the latter as a guide to percutaneous transperineal drainage. The acute penis disorders that can be assessed by are essentially vascular affections (priapism and thrombosis of the corpus cavernosum). Ultrasonography, however, find its widest field of application in acute scrotum disorders. Ultrasonography is the most valid diagnostic aid for confirming clinical data in all forms of these disorders. It allow these that need medical treatment to be differentiated from those requiring surgery. Ultrasonography has good specificity in the differential diagnosis of spermatic cord and Morgagni's hydatid torsion, an acute scrotal affliction not uncommon in childhood, which is often self-limiting and, therefore, does not necessitate emergency surgery. Finally, ultrasonography is useful for distinguishing minor scrotal trauma which can be treated medically from major scrotal trauma which requires surgical intervention.

Acute Disease↗
PubMed1990

Diuretic ultrasound. A non-invasive technique for the assessment of upper tract obstruction.

A study was made of the diagnostic reliability of renal ultrasound with a diuretic in the evaluation of upper tract obstruction. The test comprised an initial renal ultrasound examination followed by the intravenous injection of 250 ml physiological saline with 40 mg frusemide; further ultrasound scans were carried out from 5 to 150 minutes later. A total of 67 patients was studied and the results were compared with those of diuretic intravenous urography, diuretic renography and, in some cases, the Whitaker test. Dynamic ultrasound with a diuretic showed a sensitivity of 94%, specificity of 94%, positive predictive value of 91% (obstructive), negative predictive value of 96% (non-obstruction) and a total diagnostic capacity of 94%.

Adolescent↗