Search PubMed⌕ Search

Biomedical subjects

M Villa

Publications and source records attributed to M Villa.

135 records · Page 8Linked to original sources
PubMedDate not supplied

Impalpable testis and laparoscopy: when the gonad is not visualized.

The diagnostic accuracy of laparoscopy for impalpable testis is well recognized. However, in some cases, laparoscopic findings may be misleading, and a viable gonad may be missed with significant medico-legal implications. From January 1993 to December 2000, 202 patients with 219 impalpable testes were evaluated. In 95 cases, the gonad was immediately visualized, and in 5, the presence of a testis was documented by inserting the scope into the processus vaginalis. In the 119 remaining cases, no gonad was seen while entering the abdomen with the laparoscope. All patients with documented vas and vessels exiting the inguinal ring were surgically explored. Ten testes were found, 8 ectopic, with significant changes in shape and position, and 2 were canalicular. In the absence of hormone stimulation, no testes were found while exploring patients with cord structures coursing a closed inguinal ring and with contralateral hypertrophy. In 1 patient with absent vas and vessels, the testis was found at the lower renal pole while removing a dysplastic kidney. Despite technical refinements and an increase in clinical practice, a small percentage of viable testes may be missed with laparoscopic findings consistent with absent/vanished inguinal testis. Therefore, inguinal exploration is mandatory in all these cases.

Child↗
PubMedDate not supplied

[Bone complications of renal transplantation. How to identify and prevent them].

Bone disease is a very frequent complication after renal transplantation (RTx). The main features of transplant bone disease include the osteopenic-osteoporotic syndrome, often complicated by fractures, avascular osteonecrosis of bones, bone pain syndrome and growth retardation in the children. The bone loss is greater during the first 12 months after RTx and can reach the osteoporotic range in above 40% of patients, with a fracture rate of 2-3% per year. The story of bone disease over the long pre-uremic and uremic period is one of the main causal factors. After RTx, glucocorticoid therapy seems to play the major causal role. Much more disputed is the role of the other immunosuppressive drugs, of persistent secondary hyperparathyroidism, and age. Hypophosphatemia and some genetic factors could also affect bone loss after RTx. Diabetic patients are particularly prone to develop bone disease after RTx. The main prophylactic interventions consist in the optimal control of hyperparathyroidism during the pre-transplant period, prescribing parathyroidectomy for autonomous hyperparathyroidism, not-responding to medical therapy. After RTx, both bisphosphonate and vitamin D metabolites, variably associated with calcium supplementation, have been demonstrated to have some beneficial effect on bone loss, at least in the first year after RTx. However, there are no data about the possible efficacy of these treatments on fracture rate.

Bone Diseases, Metabolic↗
PubMedDate not supplied

[Group dynamics].

Explore the source record for details and available documents.

Communication↗