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Biomedical subjects

P Mendes da Costa

Publications and source records attributed to P Mendes da Costa.

At least 19 recordsLinked to original sources
PubMed2003

Localized renal cell carcinoma of an unusually large size: case report.

Renal cell carcinoma has a variable clinical course. Size is a prognostic factor correlated with venous invasion, lymph node or distant metastases. These are more often encountered when the size exceeds 10 cm. For 20 years, incidental renal tumours have represented the majority of diagnosed cases, as a result of more common use of imaging techniques. We report a case of renal cell carcinoma of an unusually large size, without metastatic or locally advanced disease. Histology revealed a pT2 clear cell renal cell carcinoma of 31 x 31 x 10 cm, which was totally resected. It is the first case reported of localized conventional renal cell carcinoma reaching such a size.

Aged↗
PubMed2003

Surgical management of recurrent colon haemorrhage of unknown origin.

Although both endoscopy and angiography have profoundly changed the management of lower GI bleeding, the choice, timing and sequence of these procedures as well as the indications for surgery remain a matter of debate. In cases of massive bleeding, early angiography should be performed as the first choice examination. When this fails, exploratory laparotomy, including peroperative colonoscopy after colonic wash-out, should not be discarded as a diagnostic possibility. If no source of bleeding is identified notwithstanding colonoscopic evaluation in excellent conditions, and it can be assumed that the bleeding has ceased, a conservative attitude may reasonably be advocated.

Angiodysplasia↗
PubMed2002

[Large intraperitoneal leiomyosarcoma. Report of a case and review of the literature].

The leiomyosarcoma are rare tumors, accounting for only 0.1% to 3% of all gastrointestinal malignancies. 150 new cases are diagnosed annually in the United States. The spectacular character of leiomyosarcoma consists in its measurements, its size reaching 35 x 25 x 17 cm, its weight 5.5 kg, and in the asymptomatic character of the tumor. The final diagnosis, although suspect with preoperative diagnostic procedure, is obtained after histologic examination. Complete surgical excision is the best treatment, the role of radiation therapy and chemotherapy are not yet established.

Adult↗
PubMed1999

Surgery in Belgium.

To fully understand the present state of surgery in Belgium, it is necessary to know the structure of the Belgian State, the type of education, the statutory health insurance system, and the professional bodies representing surgeons. One of the most important problems is the excessive number of physicians, which recently led to the establishment of limits on the number of candidates receiving medical certification. Surgical training modalities are described and the results of a retrospective study concerning the quality of training are detailed. The continuing medical education and peer-review system (accreditation) is presented.

Accreditation↗
PubMed1997

[Conservative surgical treatment of a spontaneous splenic rupture during infectious mononucleosis. Report of a case and review of the [Conservative surgical treatment of a spontaneous splenic rupture during infectious mononucleosis. Case report and literature review].

A spontaneous splenic rupture occurred in a 31 year old patient suffering from infectious mononucleosis. An echography and an abdominal CT Scan revealed a rupture of the inferior pole of the spleen with a hemoperitoneum. A conservative surgical treatment was performed. Postoperative course was uneventful. This case-report draws the attention to the possibility of a conservative surgical treatment of a splenic rupture in the course of infectious mononucleosis. This attitude avoids the complications of splenectomy.

Adult↗
PubMed1996

[Biliary ileus].

A case of gallstone ileus in an elderly woman is described and attention is drawn to the insidious clinical presentation and the significance of the often subtle radiological signs. The data from the literature specifies these aspects and allows a more complete review of this relatively rare pathology in order to remind its importance in differential diagnosis to emergency clinicians and radiologists.

Biliary Fistula↗
PubMed1992

Amikacin once daily plus metronidazole versus amikacin twice daily plus metronidazole in colorectal surgery.

Amikacin administered once a day plus metronidazole is compared with amikacin given twice a day plus metronidazole in colorectal surgery (prophylactic or therapeutic antibiotic treatment). A total of 325 patients were studied in this randomized multicenter trial. The results of this trial suggest that a single daily dose of amikacin is equally as effective in combating infectious postoperative complications as twice a day administration. The side effects were similar, with the exception of renal effects, which were somewhat more pronounced in once a day amikacin administration. Nevertheless, all the renal function alterations were transient and we observed no definitive renal insufficiency.

Adult↗
PubMed1983

[Surgery of acute cholecystitis in patients 80 years of age or older].

In 17 Belgian surgical centers, 324 operations have been performed for acute cholecystitis in patients 80 years of age or older. In this group of patients: 1. The incidence of acute cholecystitis is hardly higher in women than in men. 2. The patients were operated within 24 hours of admission in 38% of cases. The main bile duct was surgically explored in 1/3 of patients. Cholecystostomy or simple drainage were used in 1/10 of cases only. 3. Operative mortality was 19%. It was higher for patients operated as emergencies than for delayed operations and higher also when the cholecystectomy was associated with an exploration of the bile duct. The ideal treatment for such patients should thus be a cholecystectomy with an endoscopic sphincterotomy.

Acute Disease↗
PubMed1983

[Surgery in the octogenarian (introduction). Results of a national survey].

Presentation of the results of a national, multicentric and retrospective study regarding the surgery of the octogenarian. The series counts 7,407 patients accepted for surgery, and which can be divided into 4,581 women (61.8%) and 2,826 men (38.2%) of an average age of 84.4 years old (extremities 80-101 years old). The global mortality of this population of elderly (whether operated on or not) amounts to 16.7%. The postoperative mortality of the 4,177 operated patients is 18.2% with different rates according to the surgical disciplines: 34.7% for surgery of the colon, 23.2% for bone surgery, 22.4% for vascular surgery, 15.3% for biliary surgery, 8.7% for urologic surgery and 5.6% for cardiac surgery.

Age Factors↗
PubMed1983

[Implantation of a cardiac pacemaker in the octogenarian].

Thirteen centres, specialized in pacemakers and studying the implantation, brought together their material. Consequently, 785 patients living with a pacemaker (PM) were grouped. The average age at the time of the first implantation is 83,5 years old. The mortality of 7.5% as well as the morbidity of 16% lie very low. Nevertheless, their causes are discussed and compared to those resulting from other types of surgical pathologies on the octogenarian. It seems that the implantation of a PM, even on a person of 80 or older, is an efficient therapeutic gesture, benign and capable of normalizing the chances and quality of life on a long term basis.

Aged↗