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Biomedical subjects

N R Netto

Publications and source records attributed to N R Netto.

At least 19 recordsLinked to original sources

Renal calculi in lower pole calices: what is the best method of treatment?

Percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy (ESWL*) can be used in the treatment of lower pole caliceal calculi. In a retrospective analysis these 2 therapies were compared for treatment of solitary lower pole caliceal calculi to evaluate morbidity. During a 2-year period 23 patients treated with percutaneous nephrolithotomy and 24 who underwent ESWL with the Siemens Lithostar were analyzed in regard to the success rate, effectiveness quotient, complication rate, length of hospitalization and disability period. Followup consisted of ultrasound and/or a plain film of the kidneys, ureters and bladder 1 day and 1 to 3 months postoperatively. A nephrotomogram was included in the ESWL group. Complete removal of all stone fragments was achieved in 93.6% of the patients treated percutaneously without retreatment. In the ESWL group the success rate was 79.2% with a 41.6% retreatment rate. On the other hand, the ESWL group had a shorter hospitalization and an earlier return to normal physical activities. Among the patients who underwent a percutaneous operation 13% had complications compared to 4.1% in the ESWL group. The recurrence rate was higher in the former group (13% within a median of 18 months, compared to 8.3% within a median of 11 months in the ESWL group). The mean stone diameter was 1.42 cm. in the percutaneous group and 1.22 cm. in the ESWL group. Stone composition was similar in both groups. Since ESWL is an effective noninvasive procedure without the need for routine anesthesia and hospitalization, and with prompt return of the patient to a normal life it must be considered the method of choice for lower caliceal stones less than 2 cm. in diameter. However, percutaneous nephrolithotomy will continue to have a primary role in the management of larger stones.

Adolescent

Vasography: experimental study.

Vasography may cause stricture of the vas deferens. The probable causes of this obstruction are traumatic lesion at the puncture site and the radiological contrast material used. Because of this problem we performed an experimental study using Wistar rats, which were divided into four groups: Group A - Control, Group B - injection of a saline solution, Group C - hypaque injection, Group D - hypaque plus saline solution. According to the results obtained it was concluded that the needle puncture is not responsible for stricture of the vas deferens. Hypaque is responsible for 5% of strictures and the use of a saline solution to wash the vas did not show any benefit.

Animals

Comparison between percutaneous nephrolithotomy and open stone procedures.

A total of 205 patients have undergone stone extraction surgery. Three groups were studied: in 70 patients the stones were removed by flank incision, in 20 patients by posterior incision and 80 patients were treated by percutaneous nephrolithotomy. Patients submitted to percutaneous nephrolithotomy had a shorter hospitalization, operative time and a significantly reduced period of recuperation, allowing earlier return to work and decreased disability. Narcotic drugs were demanded in a lower amount in the percutaneous nephrolithotomy group.

Adolescent

Concentrations of norfloxacin in prostatic tissues following oral administration in patients with benign prostatic hyperplasia.

For assessing plasma and tissue concentrations of norfloxacin after oral administration, twelve patients with benign prostatic hypertrophy (BPH) were given two doses of 400 mg norfloxacin approximately 12 hours apart prior to transurethral resection of the prostate (TURP). Prostatic tissue samples and blood samples were collected and assayed for norfloxacin content by HPLC. The mean peak norfloxacin concentration in plasma was 1.63 micrograms/ml (range 0.63 to 3.38 micrograms/ml). The mean peak concentration in prostatic tissue was 1.63 micrograms/g (range 0.75 to 3.30 micrograms/g). The plasma and prostatic tissue levels of norfloxacin exceeded the MIC's of most urinary tract pathogens. The data suggest that norfloxacin may be useful in the treatment of chronic bacterial prostatitis.

Administration, Oral

A comparative study of electrosurgical vs. cold urethrotomy in the treatment of urethral strictures.

Thirty-one patients with urethral stricture were subjected to internal urethrotomy under visual control. The patients were divided into two groups according to the surgical procedure: electrosurgical or cold resection. A modification of the Sachse knife was introduced in order to permit its use with the American Cystoscope Makers Inc. instruments. The success rate with cold resection was 81.81% and with the electrosurgical procedure 40%. Internal urethrotomy with cold resection is a simple and harmless operation, being a first choice in the treatment of urethral stricture.

Adolescent

Relation between the vaginal introital and perianal flora in recurrent cystitis in women.

15 patients with urinary infection were selected and analyzed in relation to infection in the vaginal and perianal areas. After treatment, 12 patients with urinary infection were cured, but bacterial organisms persisted in their vaginal and perianal areas. In spite of the persistence of the vaginal and perianal infection, those patients remained free of urinary infection. We can conclude that other factors, besides the persistency of bacterial organisms in the vaginal introitus and perianal regions, may be important in the development of ascending urinary infection.

Adolescent

Traumatic rupture of the corpora cavernosa.

Treatment of penile fracture, due to the low number of cases, still lacks adequate documentation. The authors present two cases of such pathology, which were treated conservatively, and presented penile deformities in the late follow up. Both conservative and surgical management are discussed; since surgery in these cases has low mortality and clinical treatment can be followed by various sequelae, the authors favour the former, stressing that it is mandatory in cases with urinary obstruction, progressive infiltration of cutaneous laceration.

Adult

Evaluation of the impairment of spermatogenesis in varicocele through semen analysis and testicular biopsy.

Twenty-four patients with varicocele and 26 normal men were analysed according to the seminal ejaculate and testicular biopsy. Patients were divided into two groups based on the criteria of sperm normality and abnormality, respectively. Hypospermatogenesis with both normal and abnormal seminal fluid occurred in the varicocele patients, but no statistical differences could be established when compared with each other. We concluded that testicular biopsy is not useful in the evaluation of patients with varicocele.

Adult

Varicocele: relation between anoxia and hypospermatogenesis.

Three groups of patients were analysed: varicocele patients with abnormal seminal fluid (17 cases), variococele and normal sperm (seven cases) and normal males (17 cases). Blood gas was secured in the internal spermatic vein, perpheric vein and femural artery, in an attempt to evaluate the possibility of altered gas content as a cause of spermatogenic depression. No statistical differences were found when we compared the three groups. We concluded that anoxia was not the cause of hypospermatogenesis in varicocele patients.

Adolescent

Congenital stricture of male urethra.

Seven cases of anterior urethral stricture were studied. The diagnosis was made by exclusion of the inflammatory and traumatic causes. In three cases the stricture was located in the bulbar and in four cases in the penile urethra. The results obtained were good, with a follow-up of 5 to 50 months. Considerations are made about embryogenic, diagnostic, clinical picture and treatment. The verification of extensive lesions of the urethra determined the use of more complex surgical techniques of Johansen's urethroplasty devised for the treatment of this kind of pathology.

Adolescent

Giant condyloma or Buschke-Loewenstein tumor.

The Buschke-Loewenstein tumor has a malignant clinical character but is histologically similar to the ordinary condyloma. The tumor grows deeply without invading the tissues, but compresses them and causes an intense inflammatory reaction. The diagnosis is clinical. Treatment with podophyllin and radiotherapy are not effective but bleomycin may be effective. Surgery is the accepted treatment and the extent of resection depends on the extent of the tumor.

Adult

Youssef's syndrome.

A case of menouria (Youssef's syndrome) following a vesicovaginal fistula repair is presented. The patient had typical clinical features of cyclic hematuria, absence of vaginal bleeding and complete urinary continence. Diagnosis was established by cystoscopy, cystography and hysterosalpingography which disclosed the communication between the bladder and the uterine cavity. Surgical treatment was hysterectomy with the closure of the bladder opening. The authors quote similar cases reported in the literature and attention is also called to the fact that the first case of menouria was reported in the literature by Machado in 1935.

Adult