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At least 541 records · Page 30Linked to original sources
PubMed1996

[Why are children hospitalized in Spain?].

OBJECTIVE: Hospital services represent a significant amount of the overall health care devoted to the pediatric population. This work describes regional differences in Spanish pediatric hospital admissions. PATIENTS AND METHODS: National, regional, age-specific and diagnostic-specific discharge rates were obtained from the 1987 Hospital Morbidity Survey. To assess regional variations, weighted coefficient of variations (WCV) were obtained. RESULTS: The overall national discharge rate was 60.45 discharges per 1000 children less than 15 years of age. The weighted coefficient of variation obtained for the sex and age adjusted discharge rates of the 10 more frequent diagnoses was highest for phimosis (56.13) and lowest for appendicitis (19.44). CONCLUSIONS: Differences in supply and professional practice style have been recognized as causes for the variations in hospital utilization. Hospitalization of patients represents costs and risks. They are justified when scientific evidence shows that their suggested benefits overcome their inconveniences. The existence of this difference leads to suspect that non-clinical factors could be decisive in medical decisions.

Adolescent↗
PubMedDate not supplied

[Induction anesthesia with fluothane and calipsol in children].

The study was carried out in a day-time hospital in 107 children aged 4 to 15 years operated on for inguinal and umbilical hernias, varicocele, cryptorchidism, hydrocele, and phimosis. Central hemodynamics and autonomic nervous system during induction narcosis with fluothane and calipsol were examined. The course of fluothane narcosis was more smooth than that of calipsol induction.

Adolescent↗
PubMed1996

Lidocaine-induced CNS toxicity--a case report.

Lidocaine is the first local anesthetic of the amide type to be introduced to clinical practice. It is a versatile drug and in anesthesia, is the most commonly used local anesthetic because of its aptness of potency, rapid onset, moderate duration of action and topical activity. It is relatively safe and useful in many other clinical settings. Unfortunately, systemic intoxication and psychotic reaction associated with its use often occur because of its popularity and wider safety margin, for which guide in use is often ignored and overdose becomes commonplace. Moreover, due to its universality in use seldom reports have recently dealt with lidocaine, particularly regarding its toxic reaction. Here, we present a case of lidocaine intoxication occurring during circumcision for a reviewal of the problem. A healthy young male, weighing 65 kg, underwent circumcision for phimosis under penile block with 2% lidocaine which totaled 600 mg. Twenty minutes after injection the patient developed headache, tinnitus, visual and auditory disturbances. Muscle twitching over the mouth angles, trismus and rigidity of extremities were also noted. Later in the course he became restless, agitative, hallucinative, talkative, and verbose with repetitious words. The whole course of the disorder lasted about 5 h. It was believed that lidocaine-induced CNS intoxication, manifested by psychotic reaction broke out. Treatment with thiopental was not very impressive. Also, we took this opportunity to discuss and review the toxic reaction associated with the use of lidocaine, its risk factors, mechanism, treatment and prevention. The complicated associations of lidocaine-induced CNS toxic reaction with central control of behavior and the neurotransmitter systems (adrenergic, dopaminergic and serotonin) were also touched.

Adult↗
PubMed1996

["Metastatic" Crohn's disease of the penis].

Inflammatory genital cutaneous involvement of Crohn's disease is a rare complication. In a 23 year old man, who had colonic Crohn's disease treated by colectomy 3 years earlier, a phimosis revealed a penile localisation of Crohn's disease. "Metastatic" locations of Crohn's disease are defined by granulomas sitting at a distance from the injured bowel. Their clinical manifestations are misleading and their course is independent of the digestive disease. In our patient, after failure of classical therapy, cyclosporin A permitted a slow regression.

Adult↗
PubMedDate not supplied

Crohn's disease of the prepuce in a 12-year-old boy: a case report and review of the literature.

We report a case of Crohn's disease with involvement of the foreskin in a 12-year-old boy. One year previously, on the basis of clinical features (diarrhea with blood, perianal fissures) and histologic examination, a diagnosis of Crohn's disease was made. Subsequently, he developed phimosis and balanitis and underwent circumcision. Sections submitted from the foreskin revealed noncaseating granulomatous inflammation consistent with Crohn's disease. Crohn's disease with involvement of the genitalia is unusual. Only 26 cases including our case have been reported in the scientific literature. We have analyzed these cases with emphasis on gender, age, clinical features, duration of Crohn's disease, and probable mode of spread to the genitalia. Careful examination of sections from genital lesions, including those submitted from the foreskin, is essential to detect small isolated granulomas that may then lead to the diagnosis of inflammatory bowel disease.

Child↗
PubMed1977

Ectopic ureters in a male cat.

A 16-week-old male cat with urinary incontinence was initially diagnosed as having a right ectopic ureter. Other abnormalities of the urinary system included phimosis, hydronephrosis, and localized right megaloureter. Surgical removal of the right kidney and right ureter was partially successful in stopping the urinary incontinence. Further radiographic studies and retrospective examination of initial radiographs revealed that the left ureter was also ectopic.

Animals↗
PubMed1997

Up-to-date management of carcinoma of the penis.

Squamous cell carcinoma is the most common tumour of the penis. It is a rare disease in Western countries, and it is often associated with phimosis, poor hygiene or human papilloma virus infection. It could be prevented or diagnosed early in most cases, but, due to cultural and educational reasons, it is often diagnosed late. Nodal metastases are relatively common, but distant dissemination is very rare. Radical surgery gives the best control of the primary tumour, but it is mutilating. Laser surgery for limited superficial lesions and sophisticated radiotherapy for relatively small infiltrating tumours have been successfully employed, alone or in combination with chemotherapy. The use of radical surgery can therefore be restricted to cases which are unsuitable for conservative treatment or to relapses. Survival mainly depends on nodal metastases, but management of regional lymph nodes is controversial. Radical inguinal or ileoinguinal lymphadenectomy can cure approximately 40-50% of patients with positive nodes, but nearly half of the patients with clinically enlarged nodes actually have no metastases. Invalidating oedema is a frequent complication of inguinal lymphadenectomy. The point is to restrict the operation to patients with positive nodes. Expectant policy can be dangerous because results of delayed lymphadenectomy are usually poor. Fine needle aspiration biopsy and imaging may be of help in diagnosing nodal metastases. Modified surgical procedures have been advocated in order to obtain a pathological staging of the inguinal nodes avoiding invalidating sequelae, but results are controversial. Depth of invasion, tumour grade and growth pattern are of help in identifying patients at a very high risk of harbouring nodal metastases. Squamous cell carcinoma of the penis is relatively responsive to chemotherapy. Limited experiences suggest that adjuvant chemotherapy can improve the long-term survival of patients with radically resected positive nodes, and primary chemotherapy can make resectable approximately 50% of cases with fixed inguinal metastases. However, chemotherapy alone is not curative for metastatic disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Squamous cell carcinoma of the penis in a circumcised man: a case for dermatology and urology, and review of the literature.

Squamous cell carcinoma of the penis is most frequent in uncircumcised men. Other contributing factors include human papillomavirus infection, phimosis, balanitis, and smoking. We present a patient, circumcised at birth, who showed penile squamous cell carcinoma in situ and was treated with carbon dioxide laser ablation. Squamous cell carcinoma rarely presents in patients circumcised as infants. Factors contributing to chronic inflammation may predispose to this disease. Carbon dioxide and neodymium:YAG lasers are two modalities that are successful in the treatment of in situ and probably early invasive penile carcinoma. Optimal treatment includes coordination with a urologist if urethral disease is present.

Aged↗
PubMed1997

[Day case surgery in Kuopio].

In day case surgery nursing the nurse must have multidisciplinary basic knowledge and skills and strong experience in nursing practice in order to be able to prepare a patient for an operation, to treat him during the operation and postoperatively and to give the patient guidance about care at home so that he understands it. A questionnaire which was completed by the patients in a day case surgery unit exposed that they were generally satisfied with their care. Some patients asked for more specific information about the physical activity they can have and what they may or may not do after the operation. Varicose veins patients asked for more guidance about bandaging, and phimosis patients wanted more information on how to take care of the wound during the healing process.

Ambulatory Surgical Procedures↗
PubMed1998

Squamous cell carcinoma of the penis

Squamous cell carcinoma is the most common tumour of the penis. It is a rare disease in Western countries, and occurs in patients after the sixth decade. The pattern of spread is loco-regional, and prognosis is poor when nodal metastases appear. The etiology of penis cancer is discussed, however human papillomavirus infection, tobacco, poor hygiene and phimosis are often associated with this disease. Radical surgery gives the best control of the primary tumour, but it is mutilating. Conservative therapies (laser, radiotherapy, and particularly brachytherapy.) are an attracting option. Regional lymph nodes management is extremely controversial. Lymph node metastases, invasion of corpus cavernosum, and poor differentiation are pejorative prognostic factors. More than half patients are responsive to modern polychemotherpy combinations. However responses are transient and chemotherapy alone is not curative for metastatic disease. Etiologic factors, clinical presentation, staging work-up requirements, prognostic factors and therapeutic modalities are detailed.

Journal Article↗
PubMed1998

[Clinical and epidemiological analysis of 1,451 pediatric surgery consultations in a third level hospital referred from the primary health care sector].

OBJECTIVE: The aim of this study was to determine the pediatric surgery demands in a third level hospital due to referrals from the primary health care sector in order to better plan the work and continuing education programs. PATIENTS AND METHODS: The total number of patients (1,451) consulting a service of pediatric surgery for the first time and referred from the primary care sector during a twelve month period were studied. RESULTS: A total number of 1,451 children, with a maximum age of 14 years consulted. The assistential pressure was 22.01 consultations/pediatrician/day in one year. Consultations by children older than 7 years of age comprised 31.42% of the total. As for the distribution of these consultations, 61.26% were with a previous appointment, 38.74% were remitted to the second level. The most frequent reasons for consultations were inguinal hernia and hydrocele (30.46% of the cases), followed by phimosis (28.8%), undescended testis (8.2%) and skin neoplasms (5.78%). CONCLUSIONS: The demands of pediatric surgery consultations referred from the primary health care sector is very important. It is necessary to adapt the continuing education programs so that pediatric residents and primary medicine physicians are more aware of the surgical pathologies that are most frequently found in primary care centers and to decrease the assistential pressure of the pediatric surgery consultations in the hospital.

Adolescent↗
PubMed1998

[Epidermoid carcinoma of the penis].

Squamous cell carcinoma is the most common tumour of the penis. It is a rare disease in Western countries, and occurs in patients after the sixth decade. The pattern of spread is loco-regional, and prognosis is poor when nodal metastases appear. The etiology of penis cancer is discussed, however human papillomavirus infection, tobacco, poor hygiene and phimosis are often associated with this disease. Radical surgery gives the best control of the primary tumour, but it is mutilating. Conservative therapies (laser, radiotherapy, and particularly brachytherapy...) are an attracting option. Regional lymph nodes management is extremely controversial. Lymph node metastases, invasion of corpus cavernosum, and poor differentiation are pejorative prognostic factors. More than half patients are responsive to modern polychemotherapy combinations. However responses are transient and chemotherapy alone is not curative for metastatic disease. Etiologic factors, clinical presentation, staging work-up requirements, prognostic factors and therapeutic modalities are detailed.

Carcinoma, Squamous Cell↗
PubMed1998

[Keratotic pseudoepitheliomatous and micaceous balanitis].

OBJECTIVE: To describe the clinical and histopathological manifestations of a case of pseudoepitheliomatous, keratotic and micaceous balanitis and review the literature on this rare condition. METHODS: A case of pseudoepitheliomatous, keratotic and micaceous balanitis in a 63-year-old man is presented. The lesion appeared a few months after undergoing circumcision due to phimosis and recurrent inflammatory balanitis. RESULTS: The lesion relapsed after topical treatment with 5-FU, cryotherapy and shaving-biopsy plus electrocoagulation. It was finally diagnosed as epidermoid carcinoma and surgically excised. CONCLUSIONS: The clinical and histopathological features, course and relationship between micaceous balanitis and carcinoma of the penis are reviewed.

Balanitis↗